中風搶救爭分奪秒Stroke race against time to save

中風搶救爭分奪秒 急救中風病人分秒必爭，送醫時間越快，醫生進行治療的選項越多。 一旦中風來襲，就意味著展開與時間的競賽；從跡象與症狀的出現，到醫護人員的急救措施，可以說是分秒必爭，每一個環節都影響病人的存活率，以及身體機能受損的程度。 人體腦部的組成非常精緻而脆弱，需要血液不斷的滋養，而中風襲擊之下，血液供應中斷，腦部組織開始壞死，生命時鐘也就在死亡之路運轉。在醫院急診室有一些急救程序，希望能抑制腦部組織的進一步惡化。但在病人被送入急診室之前，時間最為關鍵，病人接受適當救護的時間越晚，腦部組織受損越嚴重。 中風通常是有兩種不同的發病方式。第一類稱為缺血性中風，是由於流向腦部組織的血流遭受中斷，使腦部缺血而產生急性發作，通常是因動脈硬化而引起腦血栓和腦栓塞。最典型的阻塞部位是頸動脈血管，但身體其他部位形成的血栓，也可能隨著血液流動，最後阻塞在較窄的腦血管中而引發中風。據估計，80%美國人的中風屬於這個類型。 另外一個類型是出血性中風，是腦部和周圍組織發生溢血的情形，通常是由於動脈瘤導致血管壁破裂，或者由於高血壓使腦部微細血管破裂而溢血。 10月份馬友醫院（Mayo Clinic）保健通訊說，當醫生對中風病人進行急救時，首先必須診斷中風類型，然後才能採取適當的治療。在診斷時，醫生在病人頭部進行電腦斷層掃描(CT scan），迅速分辨是缺血性中風，還是出血性中風。除了CT掃描之外，急救的檢驗可能還有心電圖測驗，以確定病人是否同時有心臟病發作或心房纖維顫動的情形。驗血、胸部X光檢驗、以及頸動脈超聲檢查(carotid ultrasonography)都可能採用，作為診斷的依據。 馬友醫院保健通訊說，無論是什麼原因引發中風，迅速送往醫院可以增加生存機會，以及減少生理功能永久失常的程度。拿缺血性中風來說，送醫時間越快，醫生清理血栓的治療選項越多。在這些選項中，最常用的是在靜脈中注射血栓溶解劑。這種藥物隨著血液在周身的循環系統中流動，最後會觸及血管中引發中風的血栓，而予以溶解，恢復腦部的血液供應。但是，這種靜脈注射必須在中風症狀一出現後的3個小時內施行，一過了這個時限，出血的風險就會大大提高，弊多於利。 最近研發出來的一些醫療程序，已經可以使靜脈血栓溶解劑注射時限延長，其中一個方法是，使用X光影像，在血管中把一個細小的導管引到血栓所在處，然後在導管中注射血栓溶解劑。在某些情形下，這項技術可以把施用時限延長到中風症狀出現後的6小時。 另外一個在靜脈中進行的療法是，把一條尖端帶有鑽頭的導管探向血栓形成處，然後把鑽頭鑽進血栓，予以拔除。這項技術可以與注射血栓溶解劑同時進行，對某些病人可以延長注射時限到症狀出現後8小時。 在溢血性中風的情況中，急救治療大多在加護病房中進行。加護病房中的各種設備可以提供最大程度的治療和照顧，包括控制頭痛、血壓和體溫，防止腦部腫脹和其他併發症。在有些情形下，可能要施行神經外科手術，取出血栓，或者封住流血的動脈瘤。 2008-10-19 Stroke race against time to save First-aid stroke patients against the clock, the faster the time taken to hospital, doctors treated more options. Once the stroke struck, it means and time to start the race; from the signs and symptoms appear, to the medical staff first-aid measures can be said to be against the clock, every affected patient survival, as well as the extent of damage to bodily functions . The composition of the human brain is very delicate and fragile and needs constant nourishment of blood, and the attack of stroke, blood supply, necrosis of the brain began life in the death clock is running. In the hospital emergency room, some first-aid procedures, hoping to curb further deterioration of the brain's organization. However, the patient was admitted to the emergency room before the most critical time, patients receive proper care of the later time, the more severe brain tissue damage. There are usually two types of stroke incidence in different ways. The first category is called ischemic stroke, is due to flow to the brain from the Organization of the interruption of blood flow, brain ischemia resulting from acute, usually as a result of atherosclerosis caused by cerebral thrombosis and cerebral embolism. The most typical site is blocked carotid arteries, but other parts of the body of the formation of thrombus, with the blood flow may also be the last block in narrow blood vessels in the brain and cause a stroke. It is estimated that 80 percent of Americans belong to this type of stroke. Another type is a hemorrhagic stroke, brain and surrounding tissue occurred in the case Yixue, usually due to aneurysm rupture led to the blood vessel wall, or high blood pressure due to the brain so that the tiny blood vessels rupture and Yixue. Oct. Ma Hospital (Mayo Clinic) Health Communications, said that when doctors first aid stroke patients, the diagnosis must first type of stroke before they are able to take appropriate treatment. At the time of diagnosis, the doctor for the patient in the head CT scan (CT scan), is quick to distinguish ischemic stroke, or bleeding stroke. In addition to the CT scan, the first test there may be electrocardiogram test to determine whether a patient has a heart attack or atrial fibrillation. A blood test, chest X-ray examinations, as well as carotid artery ultrasound (carotid ultrasonography) can be used as the basis for the diagnosis. Ma said that the hospital health care communications, no matter what the reason is the cause of stroke, the hospital can quickly increase the chances of survival and to reduce the physiological functions of permanent disorders. Take ischemic stroke, the faster the time taken to hospital, doctor's treatment of thrombosis clean up more options. Of these options, the most commonly used in the intravenous injection of thrombolytic agents. With the drug in the blood flow in the circulatory system of the whole body, the final touch of vascular thrombosis in stroke lead, and be dissolved, to restore the brain's blood supply. However, this must be intravenous stroke symptoms appeared after 3 hours in the implementation, over the time limit, the risk of bleeding will be greatly enhanced, more harm than good. Recently developed a number of medical procedures, it should be able to make intravenous injection of thrombolytic agents to extend the time limit, one of the ways is to use X-ray images of blood vessels in a small catheter into the host thrombosis, and then injection catheter in thrombolytic Agent. In some cases, the technology can be applied to extend the working hours of stroke onset of symptoms after 6 hours. In another vein therapy is carried out, with a bit of a cutting-edge detection to the catheter thrombosis, and then bit into thrombosis, to be uprooted. The technology can be injected with thrombolytic agents at the same time, some patients may be extended injection time is 8 hours after the onset of symptoms. Yixue in stroke cases, most of the first-aid treatment in the intensive care unit carried out. Intensive care unit in a variety of equipment can provide the greatest degree of care and treatment, including headache control, blood pressure and body temperature to prevent brain swelling and other complications. In some cases, may have to implement nerve surgery, out thrombosis, or blood sealed the aneurysm. 2008-10-19 View more information, see the World Journal reported that e-ePaper

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