Dialogue with domestic and foreign experts: Three points should be kept in mind when quickly recognizing stroke

"After publishing an article on the rapid identification of stroke in the "Lancet" sub-Journal, governments at all levels, academics and experts from all walks of life, as well as fellow scholars, and ordinary people, are actively promoting it all over the country.

In an interview with The Paper (www.

Stroke, commonly known as "stroke", is an acute cerebrovascular disease with the characteristics of high morbidity, high disability, high mortality, high recurrence rate and high economic burden.

The "Three-Step Recognition Method for Stroke 120" proposed by Zhao Jing and others in 2016 was even adapted into a brainwashing divine song that day.

On October 29, 2016, on World Stroke Day, the top international academic journal "The Lancet Neurology" published an online publication of Zhao Jing and Dr.

The so-called "stroke 120 three-step identification method" is to use the medical emergency telephone number 1-2-0, which is well-known to the people across the country, as a quick identification tool that can facilitate the memory of stroke, and convert these 3 numbers into 3 methods for identifying stroke , Where "1" means "1 look at an asymmetrical face", "2" means "2 check whether the arm has unilateral weakness", and "0" means "listen", that is, "(zero) whether the speech is clear" .

It is worth noting that it is not enough to recognize a stroke quickly.

Germany's stroke rehabilitation model is recognized as the world's best.

The biggest "misunderstanding" of stroke is not knowing

Most people's cognition of stroke only occurs when their own strokes or family members have strokes.

In Zhao Jing's view, the public still needs more popular science in quickly identifying strokes.

"In the past few years, we feel that the greatest achievement we have achieved is the training of grassroots doctors.

Zhao Jing hopes, “If the concept of stroke 120 can be spread like everyone catches fire and hit 119, the final disability rate of stroke across China will drop significantly.

Of course, from the current point of view, we seem to be at a loss for strokes other than first aid after a stroke.

He repeatedly emphasized that “a stroke is preventable, and once a stroke occurs, it can also be prevented again.

Under the prevention-oriented disease management initiative, primary prevention is considered to be the fundamental measure to reduce the incidence of stroke, and it is also one of the best ways to reduce the disease burden of stroke patients.

Zhao Jing suggested, “Prevention of stroke requires the development of healthy living habits.

Schulebo emphasizes preventable from the aspect of "eating".
He mentioned that after patients learn about stroke, the next step is to teach them how to do it.
"First of all, patients need to have a good understanding of how they treat their bodies daily.
The most important part of this is to start with eating.
In Germany, everyone will put about 50% of their energy on preventing the recurrence of a second cerebral infarction.
.
"

He also suggested to the Chinese public, “We must let families, not only women, but also more men, understand how to cook properly, improve nutrition in all aspects, and advocate comparison of intake in all aspects.
healthy diet habit.
"

Schulerbo said that stroke is "a complete destruction" of human beings.
This destruction is not only manifested in the body, but many patients also have speech, cognition, emotion or consciousness problems.

Recovery is not only within 6 months

In addition to prevention and first aid, rehabilitation is also generally under-recognized.

Zhao Jing described it in this way, that the patients and their families “did not know” about the rehabilitation.
"He doesn't know the difference between rehabilitation and exercise at home, so we often persuade patients to do rehabilitation.
He said that I go home to recover by myself.
He thinks that I go home and take a walk, and practicing fitness equipment in the community is called rehabilitation.
, These are totally different things.
"

Zhao Jing emphasized that the first point is that the public currently has insufficient awareness of rehabilitation, and the second point is that the sooner you enter the rehabilitation, the better.
"Why can't our rehabilitation be carried out in the early stage? Because even neurologists don't know the importance of rehabilitation.
This is actually very important, so while popularizing with ordinary people, we must first popularize neurologists.
" Zhao Jing Mentioned the severity of the rehabilitation of stroke patients.

He has always emphasized that as long as the vital signs are stable during admission, early rehabilitation must be carried out.
Zhao Jing told The Paper News reporter, “Everyone understands that rehabilitation is high-intensity training.
In fact, every time period has different forms and contents of rehabilitation.
Therefore, the rehabilitation doctors will formulate different stages of rehabilitation programs.
We suggest Intervene early when the condition is stable, because the longer the injury, the more sequelae will be left.
There is no doubt.

However, in the reality that the popularization of stroke first aid still needs to be further strengthened, "the road to recovery and popularization is very long.
"

Schulerbo also talked to The Paper about the importance of early intervention in rehabilitation.
"On the one hand, it is to control the blood pressure, heartbeat, and various vital signs of patients, and on the other hand, it is to help patients do some rehabilitation that suits them at all stages.
treatment.
"

"In the Department of Rehabilitation Medicine of Shanghai International Medical Center supported by JiDa Rehabilitation, 76% of patients start rehabilitation within 6 months after the onset of stroke.
The sooner the stroke is recovered, the better.
For example, we have a patient who cannot be independent after a stroke.
Walking, unable to move his upper limbs, unable to take care of himself, and impaired cognition.
However, he started standardized and targeted intensive rehabilitation training as soon as he was treated in the acute phase.
After 1 month, he basically realized eating, transfer, and treatment A short-distance walk accompanied by a teacher.
With the recovery of physical strength and self-confidence, the language function is gradually restored.
" Shu Lebo introduced.

It is worth noting that Schulebo also does not advocate overemphasizing the 6-month recovery "golden period".
"When we talk about the use of opportunities, we often mention a golden period.
This golden period generally refers to within 6 months after a stroke, but there are actually some misunderstandings.
" This is the reason for the misunderstanding, he When it comes to insurance payment abroad, “there is a time limit for insurance payment.
Only during the 6 months they can get a more appropriate insurance payment, so they emphasize the recovery within 6 months after stroke.
"

But in fact, “we can see that after 6 to 12 months or 12 months after stroke, there will be a recovery rate of nearly 30% and 20%.
Therefore, the German side will determine that as long as there are patients with functional improvements, Rehabilitation must be done.
"

Taking the language learning of infants and young children as an example, he mentioned, “It usually takes one or two years.
In fact, the language rehabilitation of patients after stroke is the same.
This is a very long-term process.
Of course, the sooner you are sure The more you can see the effect.
"

For stroke patients, “rehabilitation is like a marathon runner, requiring a long process.
” Schulerbo emphasized that rehabilitation must run through the entire process of disease treatment and recovery, from early treatment in the ward at the acute stage to the rehabilitation center.
Treatment, and continues to continue treatment at home.

He also reminded, stroke rehabilitation is a multi-dimensional dynamic system of treatment, in addition to the refinement of the individual rehabilitation program, even taking into account the physical and psychological needs of humane care.