Zhejiang Online - Health Network, September 17 (Zhejiang Online Correspondent Jiang Ming) In June this year, the medical journal "The Lancet" published an article pointing out that among the top ten causes of death in China in recent years, the top three are: stroke , ischemic heart disease, lung cancer. Stroke has become the disease with the highest fatality rate in my country. According to the "China Stroke Prevention and Treatment Report 2018", one person in my country has a stroke every 12 seconds, and one person dies from this disease every 21 seconds. Moreover, about 75% of post-stroke patients have varying degrees of disability, of which 40% are severely disabled!
Stroke has the characteristics of high morbidity, mortality, disability, recurrence and complications, which not only brings great misfortune to the patient himself, but also to the entire family.
Recently, 79-year-old Teacher Yang suffered a stroke in the middle of the night and was sent to the Second Hospital of Zhejiang University of Traditional Chinese Medicine for emergency treatment. Wang Cheng, the neurosurgeon in charge of the operation, said that this aunt was "lucky". Clinically, her vertebrobasilar artery embolism (a type of stroke) has a mortality rate of more than 85%, because it involves the brainstem and cerebellum. Most patients who "survive" have severe functional impairment. And she went from the expectation of "death or disability" to being able to speak and raise her hands three hours after the operation, and now she can eat and walk on her own. This is a very gratifying result for the doctor.
Dr. Wang Cheng said that Teacher Yang’s treatment experience can be said to be a typical case. From the onset of illness, sending to the hospital, communication, and rescue, many correct practices are worth recommending to the public.
She woke up early in the morning and urinated at night, only to faint in the toilet.
Her family immediately called 120.
Three hours after the operation, Teacher Yang raised his hands. Raising her hands this time had a different meaning for her, ranging from heartache to sudden dizziness and confusion, to being able to communicate and move normally. This series of changes made Teacher Yang a little excited: "In the neurosurgery intensive care unit, there was a patient in the same situation as me who didn't wake up for two months. Not only was my life saved, but I also had no problem moving my hands and feet. Doctor He said that I recovered quickly and could be discharged from the hospital. "
"I felt uncomfortable with my heart that week, and sometimes my heart beat very fast." Teacher Yang said that the morning before the onset of the disease, I still felt a little pain in the back of my head. "I have had high blood pressure for 20 years. I thought it was because my blood pressure had gone up, but I took a measurement that morning and found it was not high."
html At around 4 a.m. on August 30, Teacher Yang got up to go to the toilet. Suddenly he felt like the world was spinning and he struggled to cry. : "Old man, old man..." Teacher Yang's wife heard the call and got up, and found that her wife had collapsed in the toilet. He hurriedly dialed his son's phone number. "Don't be anxious, don't be anxious! You call 120 first and send mom to the hospital immediately. We'll meet directly at the hospital." The son on the other end of the phone warned his father. Soon, Teacher Yang was sent to the emergency room of the Second Hospital of Zhejiang University of Traditional Chinese Medicine. After a series of examinations, he was diagnosed with acute cerebral infarction.For patients with cerebral infarction, time is the big brain. From the heartache and dizziness before the onset of , to confusion and irritability in the emergency room, and unable to move his left hand and foot, Teacher Yang's condition is getting worse and worse.
When asking about the medical history, Teacher Yang’s son said: In addition to suffering from high blood pressure, diabetes, , and atrial fibrillation, , which attacks intermittently, Mr. Yang’s son had used aspirin before. Two or three years ago, I felt sick to my stomach after taking the medicine. I also read articles about not taking aspirin regularly, so I stopped taking the medicine.
Soon, the results of the emergency cerebral vascular magnetic resonance examination came out. Teacher Yang’s cerebral infarction was caused by basilar artery occlusion, and his condition was extremely critical.
At the same time, the first aid procedure of the hospital stroke center was started immediately. First aid, examination, joint consultation, anesthesia, surgery and other rescue links are "green lighted all the way". At around five o'clock in the morning, all the medical and nursing staff for the interventional surgery were in place, and a "time-competing brain" operation began.
"Doctor, do whatever you want to do, I believe in you!" The pre-operative conversation received strong support from Teacher Yang's son. In the cath lab, the stroke team worked together to perform intracranial artery interventional thrombectomy.Doctors Wang Cheng and Zhang Guojun inserted the thrombectomy device into the cerebral artery, which acted like a "straw" to suck the thrombus in the blood vessel like jelly and remove it. Half an hour after the operation, the anesthesia gradually wore off, and Teacher Yang regained consciousness. He could accurately reply to the doctor's questions, and he could also make fists with his hands to respond.
"I am grateful to the hospital from the bottom of my heart. My mother's surgery was timely and successful. Now she can eat and walk on her own, and she doesn't look like she had suffered a stroke." Teacher Yang's son specially sent a banner to express the gratitude of his family. "I still remember Dr. Wang Cheng's words very well. At the door of the operating room, I asked him anxiously where to pay. He told me, 'No hurry, no rush, save people first!', he gave me this simple sentence. It was quite touching. I would also like to thank several doctors and nurses who came from home early in the morning on the day of the operation. It was really not easy! "
These three points are very important in stroke rescue.
Think about it carefully, has anyone around you suffered from a stroke? Or they may be bedridden, or half paralyzed, or their conversational memory is not as good as before...
Dr. Wang Cheng said that a stroke occurs when blood vessels in the brain rupture or become blocked. If left unchecked for too long, brain cells will die quickly, resulting in severe disability or death. Therefore, rescuing patients with acute cerebral infarction must be "race against time". The earlier the treatment is given, the fewer sequelae will be and the better the effect will be.
Taking Teacher Yang’s case as an example, there are three main points that were done well, which are also the key points in stroke rescue: sending the patient to the hospital as soon as possible, making a decisive decision by the family, and handling it accurately with specialists.
As soon as the incident happened, the first reaction of many people was often: Are you tired? Take a rest first! When they realize something is wrong, the family panics again and waits for the person who made the decision to make a decision. Often, the best time for treatment is missed due to this waiting. During Mr. Yang's illness, his calls for help and the decisive actions of his wife and son are worthy of praise. Second, a successful treatment is inseparable from the support and trust of both doctors and patients. At this time, the family members are hesitant, the doctors are anxious, and the patients are suffering. Third, the stroke center responds quickly and has good coordination among multiple departments. This is the advantage of the stroke center: the multi-scientific team has professional technical guarantees, the "green light" throughout the process makes the access smoother, and the medical staff will rush to the patient's side as quickly as possible no matter day or night, shortening the treatment time. to the minimum.
To prevent and treat blood clots, can aspirin still be used?
Why did Teacher Yang suffer a sudden stroke? Experts from the Neurosurgery Department and the Cardiology Department of the Second Hospital of Zhejiang University of Traditional Chinese Medicine jointly analyzed the medical history and believed that Ms. Yang’s stroke was probably caused by atrial fibrillation that formed a thrombus and caused detachment. This was closely related to her neglect of anticoagulation treatment. Now, Teacher Yang has been transferred to the cardiology department to continue treatment.
Mr. Yang’s medical doctor and deputy chief physician Dou Liping, deputy director of the Department of Cardiology, said: Mr. Yang’s medication was stopped correctly, but his approach was wrong!
Teacher Yang has strong indications for anticoagulant therapy, but aspirin is not recommended for anticoagulant treatment of atrial fibrillation. After controlling blood pressure, you can choose warfarin or new anticoagulants, and check your coagulation function regularly. At the same time, hypertension should be actively treated to minimize the risk of further strokes.
To prevent blood clots, can aspirin still be used? Director Dou pointed out that clinically, the efficacy of aspirin in preventing myocardial infarction and cerebral infarction is certain, but the specific medication plan should be formulated by a specialist. "Why do you think she did it wrong? Stopping medication without authorization is a taboo in clinical practice and is extremely dangerous."
Teacher Yang, like many elderly patients, has many basic diseases, such as hypertension, coronary heart disease, atrial fibrillation, Diabetes and hyperlipidemia are all causes of stroke. Failure to pay attention to the control of these basic diseases will increase the risk of stroke.
How to prevent and treat stroke for the elderly who suffer from multiple diseases at the same time? Director Dou said that risk factors must first be changed, such as smoking, unhealthy diet, obesity, lack of exercise, excessive drinking, etc. Second, patients must follow the doctor’s instructions. Long-term drug treatment of hypertension, atrial fibrillation, and diabetes should be adhered to. You must not stop taking medicine without authorization. Teacher Yang is a typical case.Third, for patients who have already suffered a stroke, rehabilitation care should be strengthened to prevent the condition from getting worse.
Director Dou Liping also mentioned that for healthy people in their forties and fifties, whether they can take aspirin to prevent blood clots, she believes that cardiovascular disease risk assessment needs to be carried out, including the patient's age, gender, whether they smoke, and body mass index. , blood pressure, blood sugar, blood lipids, etc., only high-risk groups are recommended to use it in small doses, and the general population does not need it.
(Source: Zhejiang Online)
