What are the guidelines for the treatment of cerebral hemorrhage?

Cerebral hemorrhage is a relatively serious disease with high mortality and disability rates. Therefore, when a patient becomes ill, emergency treatment should be given in a timely manner. After emergency treatment, the patient should rest in bed in a timely manner. During the treatment process, the patient should maintain unobstructed breathing, pay attention to the patient's electrolyte balance, supplement nutrition in a timely manner, and take medication in a timely manner, etc.

What are the conventional treatment options for cerebral hemorrhage?

1. When treating cerebral hemorrhage, the patient generally needs to rest in bed for 2 to 4 weeks and the rest environment should be kept absolutely quiet. Family members should pay attention to avoid emotional excitement and high blood pressure in patients with cerebral hemorrhage. Always closely observe the vital signs of patients with cerebral hemorrhage, such as body temperature, pulse, respiration and blood pressure, and pay attention to changes in the patient's pupils and consciousness.

2. When treating cerebral hemorrhage, it is necessary to pay attention to keeping the patient's airway open and clearing respiratory secretions or inhalations in a timely manner. When necessary, tracheal intubation or endotracheal intubation should be performed promptly. Patients with cerebral hemorrhage who have impaired consciousness and gastrointestinal bleeding should fast for 24 to 48 hours and empty their stomach contents when necessary.

3. When treating cerebral hemorrhage, patients should pay attention to water, electrolyte balance and nutrition. The daily fluid intake of patients with cerebral hemorrhage can be calculated based on urine volume + 500ml. If there is high fever, sweating, or vomiting, maintain the central venous pressure at 5-12mmHg or the pulmonary wedge pressure at 10-14mmHg. Pay attention to prevent water and electrolyte disorders to avoid aggravating cerebral edema. Patients with cerebral hemorrhage should supplement sodium, potassium, sugar and calories every day.

4. When treating cerebral hemorrhage, it is necessary to adjust the patient's blood sugar in time. High or low blood sugar should be corrected in time. It is best to maintain the blood sugar level between 6 and 9 mmol/L.

5. For patients with cerebral hemorrhage who have obvious headaches and excessive irritability, sedatives and analgesics may be given as appropriate; those with constipation may choose laxatives.

6. Reduce intracranial pressure. Brain edema after cerebral hemorrhage reaches its peak in about 48 hours, lasts for 3 to 5 days, and then gradually subsides, and may last for 2 to 3 weeks or longer. Cerebral edema can increase intracranial pressure and cause brain herniation, which is the main factor affecting the mortality and functional recovery of cerebral hemorrhage. Actively controlling cerebral edema and reducing intracranial pressure are important parts of the acute treatment of cerebral hemorrhage.

Treatment of cerebral hemorrhage.

1. Drug treatment of cerebral hemorrhage

After a cerebral hemorrhage, the brain tissue around the hematoma is ischemic and hypoxic, and the nerve cells in the lesion are in a state of calcium overload. The use of calcium channel antagonists can alleviate the overload state, prevent cell death, improve cerebral microcirculation, and increase cerebral blood supply. Commonly used drugs include nimodipine (Nidal), 20-40 mg, 3 times/day; or nimodipine (Nimotop), 30 mg, 3 times/day; cinnarizine (Ceramide), 25 mg, 3 times/day. Use with caution in patients with hypotension, significant cerebral edema, or increased intracranial pressure.

2. Surgery for Cerebral Hemorrhage

Commonly used methods for hematoma removal surgery include neuroendoscopic treatment technology; minimally invasive surgery for hypertensive cerebral hemorrhage; craniotomy with bone flap or bone window to remove hematoma; CT-guided stereotactic aspiration treatment; ventricular drainage and hematoma dissolution.

3. General treatment of cerebral hemorrhage

Comatose patients with cerebral hemorrhage should have their head positioned on the side rather than in a supine position to prevent the tongue from falling back and blocking the airway. Turn over and pat the back in time to facilitate coughing up of sputum. At the same time, suction the sputum frequently or inhale it through nebulization to facilitate the humidification of the sputum. When there are signs of respiratory obstruction, tracheotomy should be performed in time to avoid hypoxia and aggravation of cerebral edema.