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本文就脑血管损害中的脑出血和脑梗塞急性期的治疗加以叙述,并谈谈有关急性期治疗上的某些争议问题。脑血管损害发病时的处理脑血管损害急性期治疗的根本原则是;第一,确保呼吸循环机能,减轻脑水肿,去除颅内高压,纠正脑循环代谢障碍;第二,预防和治疗合并症,维持良好的全身状态。1.确保气道通畅这是最重要的,必须迅速进行。如果持续低氧血症,可使脑组织损害加重而促进脑水肿。高度意识障碍时引起舌根下沉、误咽的危险性很大。如这些引起气道闭塞,可导致低氧血症。为了确保气道通畅,可使头部后屈伸展,将下颚推向前上方,使之开口(三通道动作)。高度意识障碍无咽反射时,插入气管导管。有唾液和痰潴留时,用内拉通氏导管等吸引。因呕吐而误咽的危险性大时,取麻痹侧肢体向上的侧卧位或半腹卧位。在确保气道通畅的情况下用氧罩或鼻导管等,吸氧2～3L。
This article describes the treatment of cerebral hemorrhage and acute cerebral infarction in cerebrovascular injury and discusses some of the controversial issues in the treatment of acute phase. The treatment of cerebrovascular damage The basic principles of the treatment of acute cerebrovascular injury are: first, to ensure respiratory function, reduce cerebral edema, removal of intracranial hypertension, cerebral metabolic disorders to correct; second, prevention and treatment of complications, Maintain a good general condition. 1. Make sure the airway is clear. This is the most important and must be done quickly. If sustained hypoxemia, brain tissue damage can be increased to promote cerebral edema. Caused by a high degree of disturbance of tongue base subsidence, the risk of swallowing a lot. If these cause airway occlusion, can lead to hypoxemia. In order to ensure airway patency, head extension can be extended, pushing the jaw above the front, make it open (three-channel action). Highly conscious disorder without gag reflex, insert the endotracheal tube. With saliva and sputum retention, the use of internal lead and other catheters attract. Vomiting and vomiting due to the risk of large, take the side of the paralysis side of the lateral position or half abdominal position. In the case of ensuring airway patency with oxygen mask or nasal catheter, oxygen 2 ~ 3L.