Treatment

更新于 2026年10月31日 版权声明
4.Treatment

(1)Admit to HDU:A recent stroke patient within 48 hours should be monitored in HDU for 72 hours!

(2)Tolerate BP up to 220/120 mm Hg for the acute phase.

(3)If systolic pressure>220 mm Hg,the blood pressure should be decrease slowly.e.g.by hydralazine 5mg until lowered by 10%~15%.

(4)Fasting and water-deprivation until swallowing evaluation was finished.

(5)Oxygenation:Maintain O2 saturation>92%.

(6)IV fluids:correction dehydration.

(7)Anticonvulsants if needed,e.g diazepam 10mg

(8)Treat fever aggressively,T>38℃with ice pack and antipyretics

(9)Hyperglycemic control(<180 mg/d L=10 mmol/L,avoid hypoglycemia)

(10)Physiotherapy to start immediately,instruct guardians

(11)Prevent and treat any complications:Aspiration pneumonia,pulmonary embolism,Pressure sores,spasticity,depression seizures,dementia.

①Primary Prevention of stroke(ischaemic and haemorrhagic):

Reduction of high blood pressure,stopping smoking,weight reduction.

Cholesterol reduction,Control the blood sugar.(https://www.daowen.com)

Prevent and treat infections(e.g.HIV,Syphilis,TB).

②Secondary prevention ischaemic stroke or TIA:

Antiplatelet agents,e.g.aspirin 75~150 mg qd(for ischaemic).

Anticoagulation with warfarin 5~7.5 mg/d,overlap 3 days with heparin or LMW heparin if atrial fibrillation occur.

Abbreviations

SBE:亚急性心内膜炎

VDRL:梅毒血清检测

HZ(hydralazine):肼苯哒嗪

ADMIT:承认

HDU:高依赖病房

TIA:短暂性脑缺血发作

LMWH(low molecular weight heparin):低分子肝素

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