How to care during the acute phase of cerebral infarction?

During the acute phase of cerebral infarction, patients are advised to rest in bed with their heads flat, receive oxygen in a timely manner, and prevent respiratory and urinary tract infections. At the same time, they should also pay attention to the correct use of some anticoagulant and blood-activating and blood-stasis-removing drugs.

1. General treatment should be resting in bed with the head flat, and oxygen should be given if necessary. Blood pressure is generally not lowered unless it is extremely high. Turn over frequently, pay attention to the patency of the airway, prevent respiratory and urinary tract infections, and prevent bedsores.

2. Low molecular weight dextran: 500 ml intravenous drip daily for two weeks.

3. Vasodilators: intermittent inhalation of mixed gas (6-7% carbon dioxide, 50-95% oxygen), 250 ml of 5% sodium bicarbonate intravenously, 1-2 times a day, 100 mg of papaverine added to 250 ml of glucose solution slowly intravenously, once a day for two weeks. Vasodilators are only used in the first 1-2 days or 3 weeks after the onset of the disease, otherwise cerebral steal syndrome may occur, which will aggravate hypoxic damage to brain tissue.

4. Anticoagulant treatment: 12500 units of heparin are added to 1000 ml of 5% glucose, normal saline or 10% glucose solution and slowly dripped intravenously (at a rate of 20 drops per minute for 24-48 hours. In addition to heparin, hirudin can also be used for anticoagulation, which mainly blocks the effect of thrombin on fibrinogen and hinders blood coagulation. 20 mg of hirudin can prevent 400 g of blood from coagulating, and has a good effect on improving the thick, sticky and coagulated state of patients with ischemic cerebrovascular disease due to abnormal blood rheology. Oral anticoagulants can be taken at the same time on the first day, such as 300 mg of new biscoumarol, 100-200 mg of biscoumarol, and 4-8 mg of new anticoagulant).

5. The prevention and treatment of long-acting Chinese patent medicines with dual effects of promoting blood circulation and removing blood stasis, aromatic invigorating the mind, lowering lipids and anticoagulation can effectively improve physical symptoms and prevent recurrence and progression.

6. Surgical treatment of carotid artery obstruction can be performed by thrombectomy. For patients with transient ischemic attack and intracranial arterial system obstruction, anastomosis of the superficial temporal artery and the middle cerebral artery can be performed on the affected side.