What is the best treatment for cerebral hemorrhage?

In case of cerebral hemorrhage, it is important to take the patient to the doctor in time to avoid life-threatening conditions. Current treatments include dehydration to reduce intracranial pressure, control of high blood pressure, and daily lifestyle adjustments. These patients need to rest and, if necessary, oxygen.

1. General treatment

It is recommended to receive treatment nearby and avoid moving as much as possible; keep quiet, rest in bed, and reduce visits; keep the airway open, clear respiratory secretions in time, and use oxygen when necessary; if there is high fever, active cooling treatment should be given; strengthen nursing care and maintain the functional position of limbs; those with impaired consciousness or gastrointestinal bleeding should fast for 24 to 48 hours, and then place a nasogastric tube for feeding as appropriate to ensure nutrition and maintain water and electrolyte balance.

2 Dehydration reduces intracranial pressure

Control of cerebral edema: Cerebral edema reaches its peak at about 48 hours after hemorrhage and gradually subsides after 3 to 5 days. During this period, intracranial pressure may increase or brain herniation may form, so it should be actively controlled and treated. Commonly used: ① Mannitol: 20% mannitol 125-250ml, intravenous drip, once every 6-8 hours, course of treatment 7-10 days. Patients with coronary heart disease, myocardial infarction, heart failure and renal insufficiency should use it with caution; ② Diuretics: Furosemide is more commonly used, and is often used in combination with mannitol to enhance the dehydration effect, 40 mg each time, 2 to 4 times a day, intravenous injection; ③ Glycerol: It should be used in the improvement period of mild symptoms or severe conditions, 10% compound glycerol solution 500 ml, once a day, intravenous drip, 3 to 6 hours to complete. Hemolysis is likely to occur when the dosage is too large or the infusion is too fast; ④ 20% human serum albumin 50-100ml, once a day, intravenous drip, is more suitable for patients with hypoproteinemia. ⑤ Dexamethasone: It usually takes 12 to 36 hours after administration to show its anti-cerebral edema effect, but it is prone to infection, induce upper gastrointestinal stress ulcers, and affect the control of blood pressure and blood sugar, so routine use is not recommended.

3. Control high blood pressure

Increased blood pressure after cerebral hemorrhage is necessary to maintain effective cerebral perfusion pressure. When intracranial pressure decreases, blood pressure will also decrease. Therefore, antihypertensive drugs are usually not needed, especially strong antihypertensive drugs such as injection of reserpine. If systolic blood pressure

23.9～30.6kpa (180～230mmHg) or diastolic blood pressure 14.0～18.6kpa (105～140mmHg), oral antihypertensive drugs are recommended; systolic blood pressure is less than 23.9kpa

Or diastolic blood pressure at 14.0kpa

The patient can be observed without taking antihypertensive drugs. If blood pressure continues to rise after the acute phase, systemic antihypertensive treatment should be given. A sudden drop in blood pressure during the acute phase indicates that the condition is critical, and blood pressure-opening treatments such as dopamine and metaraminol should be given promptly.