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*Only for medical professionals to read for reference.
October 29, 2021 is the 16th World Stroke Day.
The medical community will join hands with the "Huashan Hospital Neurology Department" to show you these things~ Stroke is stronger than the "China Stroke Report" released in 2020 "It shows that the prevalence of stroke in China is 1114.
8/100,000, the annual incidence rate is 246.
8/100,000, the mortality rate is 149.
49/100,000, and the average age of stroke patients is 66.
4 years
.
On a global scale, China has become the country with the highest lifetime risk of stroke and the heaviest disease burden
.
2019 Shanghai Cardiovascular and Cerebrovascular Acute Event Monitoring Report: The incidence rate of stroke in the registered population was 578.
84/100,000 (increased by 2.
12% from 2018), of which the incidence of cerebral infarction (non-lacunal) was 296.
95/100,000, transient brain The incidence of ischemic attack was 67.
97/100,000, and the incidence of cerebral parenchymal hemorrhage was 42.
40/100,000
.
Acute ischemic stroke, also called cerebral infarction, the key to treatment is to start reperfusion therapy as soon as possible to save the ischemic penumbra
.
At present, intravenous thrombolysis in the acute phase and endovascular treatment for anterior circulation large vessel occlusive ischemic stroke are effective treatments widely recommended by international guidelines
.
The results of the National Stroke Registration Study in China suggest that the actual proportion of patients with acute cerebral infarction who meet the indications for intravenous thrombolytic therapy is only 18.
3%, which has increased in recent years, but it is still not satisfactory
.
Shanghai has always been at the forefront of the country.
In 2019, the proportion of intravenous thrombolysis in patients with acute cerebral infarction within 4.
5 hours of onset in Shanghai has reached 36%
.
But compared with developed countries, the ratio is still low
.
Therefore, the prevention of stroke is very critical, and a series of preventive measures are needed to reduce the burden of disease
.
A healthy life>
.
To put it simply: Keep your mouth shut and move your legs away
.
The so-called "Mediterranean" diet is to eat more vegetables, fruits, grains, supplement fish, eggs, milk and other high-quality protein, and eat less red meat such as beef and mutton
.
Appropriate physical exercise is recommended to exercise 3-5 times a week within the scope of ability, each exercise time is about 40 minutes, it is appropriate to sweat slightly
.
Reduce body fat, especially visceral fat, and maintain good health through diet control and exercise
.
According to the recommendations of the "Guidelines for Citizen Weight Management Health and Health" of the China Health Management Association, the body mass index, namely weight (Kg)/height (m)2, should be maintained between 18.
5-24
.
It is clear that smoking increases the risk of stroke
.
Smokers should quit smoking; non-smokers should also avoid passive smoking
.
Secondly, actively control the risk factors of stroke
.
The main risk factors for stroke include atrial fibrillation, hypertension, diabetes, and hyperlipidemia
.
Atrial fibrillation is the most important risk factor for cardiogenic stroke
.
Middle-aged and elderly people should have regular physical examinations to find atrial fibrillation early
.
Patients who are diagnosed with atrial fibrillation are recommended to see a cardiologist or neurologist to agree on a treatment plan to prevent stroke
.
Hypertension, hyperglycemia, and hyperlipidemia, commonly known as the "three highs", are the main causes of atherosclerosis of the heart and brain vessels
.
According to the recommendations of the "Chinese Guidelines for Primary Prevention of Cerebrovascular Diseases 2019", patients with early or mild hypertension should first be treated with life>
.
Ordinary hypertensive patients should lower their blood pressure to <140/90mmHg; hypertensive patients with diabetes or proteinuria nephropathy should be further reduced to 130/80mmHg
.
Diabetes patients should first improve their life>
.
It is recommended that the blood sugar control of general diabetic patients should pay attention to glycosylated hemoglobin (HbA1c), and the target value of HbA1c is <7.
0%
.
Men over the age of 40 and postmenopausal women should undergo blood lipid examinations every year.
Patients with elevated blood lipids should first control their diet, recommend statins as the first choice as appropriate, and reduce low-density lipoprotein (LDL-C) levels as a prevention and control heart.
The primary intervention target for cerebrovascular events
.
Secondary Stroke Prevention For patients who have already had a stroke, how to avoid a second stroke? The above-mentioned healthy life>
.
The use of antithrombotic drugs is the top priority for preventing recurrence in patients with ischemic stroke (cerebral infarction) and transient ischemic attack (TIA)
.
For patients with non-cardiac stroke such as large atherosclerosis and small vessel disease, antiplatelet therapy can significantly reduce the risk of recurrence of serious cardiovascular events in patients
.
Antiplatelet therapy is recommended for all patients without absolute contraindications
.
Antiplatelet drugs include aspirin, clopidogrel, cilostazol, ticagrelor, etc.
.
For patients with cardioembolism caused by non-valvular atrial fibrillation, anticoagulant therapy is recommended, including warfarin, rivaroxaban, dabigatran, and idoxaban
.
The use of antithrombotic drugs may increase the risk of bleeding, so it is recommended that patients use it under the guidance of a neurologist
.
Post-stroke related issues Management of stroke has a high disability rate.
How to reduce the disability rate after stroke and return to life better? Rehabilitation treatment after stroke is indispensable
.
Modern rehabilitation theory and practice have proved that effective rehabilitation training can reduce the functional disability of stroke patients, improve patient satisfaction, accelerate the rehabilitation process of stroke, reduce potential nursing costs, and reduce the burden on families
.
After stroke patients are stable, they should undergo rehabilitation as soon as possible.
In a standardized rehabilitation center, fully consider the patient's physical strength, endurance, and cardiorespiratory conditions, and choose a gradual approach to carry out individualized treatment
.
About one-third of stroke patients will experience post-stroke cognitive dysfunction (PSCI).
PSCI will cause a significant increase in the pressure of care, a significant decline in the patient's quality of life, ability of daily living, and mental health, and a significant increase in the burden of family and social diseases
.
According to the “Experts Consensus on the Management of Cognitive Impairment after Stroke 2021”, it is recommended to conduct early cognitive screening of patients during hospitalization after an acute stroke event, and conduct neuropsychological evaluation and follow-up every 3 months thereafter; multi-dimensionality if necessary A full set of cognitive function assessments to clarify the occurrence and evolution of PSCI
.
For patients with PSCI, the application of drugs to improve the cognitive function and ability of daily living of the patients, and cognitive training intervention
.
In summary, stroke is preventable and curable! Once a stroke occurs, receiving intravenous thrombolysis or intravascular intervention and other vascular recanalization treatments within a time window can significantly improve the prognosis
.
Therefore, "be alert to stroke symptoms, identify and treat as soon as possible", "struggle for'B' every second, and treat the brain
.
"
Expert Profile Professor Dong Qiang Director, Chief Physician, and Doctoral Supervisor, Department of Neurology, Huashan Hospital Affiliated to Fudan University, Deputy Director, National Center for Neurological Diseases (Huashan), Director, Shanghai Neurology Medical Quality Control Center Director, Shanghai Neurological Disease Clinical Medical Center, Shanghai Director of the Shanghai Stroke Prevention and Treatment Service System Expert Committee Deputy Director, Shanghai Stroke Prevention and Treatment Center Deputy Director, Chinese Medical Association Neurology Branch Deputy Chairman (8th), Chinese Stroke Society Vice President, Shanghai Medical Association Neurology Specialist Branch No.
The current chairman of the tenth committee, the chairman of the Neurologist Branch of the Shanghai Medical Doctor Association, the executive vice chairman of the Shanghai Stroke Association
October 29, 2021 is the 16th World Stroke Day.
The medical community will join hands with the "Huashan Hospital Neurology Department" to show you these things~ Stroke is stronger than the "China Stroke Report" released in 2020 "It shows that the prevalence of stroke in China is 1114.
8/100,000, the annual incidence rate is 246.
8/100,000, the mortality rate is 149.
49/100,000, and the average age of stroke patients is 66.
4 years
.
On a global scale, China has become the country with the highest lifetime risk of stroke and the heaviest disease burden
.
2019 Shanghai Cardiovascular and Cerebrovascular Acute Event Monitoring Report: The incidence rate of stroke in the registered population was 578.
84/100,000 (increased by 2.
12% from 2018), of which the incidence of cerebral infarction (non-lacunal) was 296.
95/100,000, transient brain The incidence of ischemic attack was 67.
97/100,000, and the incidence of cerebral parenchymal hemorrhage was 42.
40/100,000
.
Acute ischemic stroke, also called cerebral infarction, the key to treatment is to start reperfusion therapy as soon as possible to save the ischemic penumbra
.
At present, intravenous thrombolysis in the acute phase and endovascular treatment for anterior circulation large vessel occlusive ischemic stroke are effective treatments widely recommended by international guidelines
.
The results of the National Stroke Registration Study in China suggest that the actual proportion of patients with acute cerebral infarction who meet the indications for intravenous thrombolytic therapy is only 18.
3%, which has increased in recent years, but it is still not satisfactory
.
Shanghai has always been at the forefront of the country.
In 2019, the proportion of intravenous thrombolysis in patients with acute cerebral infarction within 4.
5 hours of onset in Shanghai has reached 36%
.
But compared with developed countries, the ratio is still low
.
Therefore, the prevention of stroke is very critical, and a series of preventive measures are needed to reduce the burden of disease
.
A healthy life>
.
To put it simply: Keep your mouth shut and move your legs away
.
The so-called "Mediterranean" diet is to eat more vegetables, fruits, grains, supplement fish, eggs, milk and other high-quality protein, and eat less red meat such as beef and mutton
.
Appropriate physical exercise is recommended to exercise 3-5 times a week within the scope of ability, each exercise time is about 40 minutes, it is appropriate to sweat slightly
.
Reduce body fat, especially visceral fat, and maintain good health through diet control and exercise
.
According to the recommendations of the "Guidelines for Citizen Weight Management Health and Health" of the China Health Management Association, the body mass index, namely weight (Kg)/height (m)2, should be maintained between 18.
5-24
.
It is clear that smoking increases the risk of stroke
.
Smokers should quit smoking; non-smokers should also avoid passive smoking
.
Secondly, actively control the risk factors of stroke
.
The main risk factors for stroke include atrial fibrillation, hypertension, diabetes, and hyperlipidemia
.
Atrial fibrillation is the most important risk factor for cardiogenic stroke
.
Middle-aged and elderly people should have regular physical examinations to find atrial fibrillation early
.
Patients who are diagnosed with atrial fibrillation are recommended to see a cardiologist or neurologist to agree on a treatment plan to prevent stroke
.
Hypertension, hyperglycemia, and hyperlipidemia, commonly known as the "three highs", are the main causes of atherosclerosis of the heart and brain vessels
.
According to the recommendations of the "Chinese Guidelines for Primary Prevention of Cerebrovascular Diseases 2019", patients with early or mild hypertension should first be treated with life>
.
Ordinary hypertensive patients should lower their blood pressure to <140/90mmHg; hypertensive patients with diabetes or proteinuria nephropathy should be further reduced to 130/80mmHg
.
Diabetes patients should first improve their life>
.
It is recommended that the blood sugar control of general diabetic patients should pay attention to glycosylated hemoglobin (HbA1c), and the target value of HbA1c is <7.
0%
.
Men over the age of 40 and postmenopausal women should undergo blood lipid examinations every year.
Patients with elevated blood lipids should first control their diet, recommend statins as the first choice as appropriate, and reduce low-density lipoprotein (LDL-C) levels as a prevention and control heart.
The primary intervention target for cerebrovascular events
.
Secondary Stroke Prevention For patients who have already had a stroke, how to avoid a second stroke? The above-mentioned healthy life>
.
The use of antithrombotic drugs is the top priority for preventing recurrence in patients with ischemic stroke (cerebral infarction) and transient ischemic attack (TIA)
.
For patients with non-cardiac stroke such as large atherosclerosis and small vessel disease, antiplatelet therapy can significantly reduce the risk of recurrence of serious cardiovascular events in patients
.
Antiplatelet therapy is recommended for all patients without absolute contraindications
.
Antiplatelet drugs include aspirin, clopidogrel, cilostazol, ticagrelor, etc.
.
For patients with cardioembolism caused by non-valvular atrial fibrillation, anticoagulant therapy is recommended, including warfarin, rivaroxaban, dabigatran, and idoxaban
.
The use of antithrombotic drugs may increase the risk of bleeding, so it is recommended that patients use it under the guidance of a neurologist
.
Post-stroke related issues Management of stroke has a high disability rate.
How to reduce the disability rate after stroke and return to life better? Rehabilitation treatment after stroke is indispensable
.
Modern rehabilitation theory and practice have proved that effective rehabilitation training can reduce the functional disability of stroke patients, improve patient satisfaction, accelerate the rehabilitation process of stroke, reduce potential nursing costs, and reduce the burden on families
.
After stroke patients are stable, they should undergo rehabilitation as soon as possible.
In a standardized rehabilitation center, fully consider the patient's physical strength, endurance, and cardiorespiratory conditions, and choose a gradual approach to carry out individualized treatment
.
About one-third of stroke patients will experience post-stroke cognitive dysfunction (PSCI).
PSCI will cause a significant increase in the pressure of care, a significant decline in the patient's quality of life, ability of daily living, and mental health, and a significant increase in the burden of family and social diseases
.
According to the “Experts Consensus on the Management of Cognitive Impairment after Stroke 2021”, it is recommended to conduct early cognitive screening of patients during hospitalization after an acute stroke event, and conduct neuropsychological evaluation and follow-up every 3 months thereafter; multi-dimensionality if necessary A full set of cognitive function assessments to clarify the occurrence and evolution of PSCI
.
For patients with PSCI, the application of drugs to improve the cognitive function and ability of daily living of the patients, and cognitive training intervention
.
In summary, stroke is preventable and curable! Once a stroke occurs, receiving intravenous thrombolysis or intravascular intervention and other vascular recanalization treatments within a time window can significantly improve the prognosis
.
Therefore, "be alert to stroke symptoms, identify and treat as soon as possible", "struggle for'B' every second, and treat the brain
.
"
Expert Profile Professor Dong Qiang Director, Chief Physician, and Doctoral Supervisor, Department of Neurology, Huashan Hospital Affiliated to Fudan University, Deputy Director, National Center for Neurological Diseases (Huashan), Director, Shanghai Neurology Medical Quality Control Center Director, Shanghai Neurological Disease Clinical Medical Center, Shanghai Director of the Shanghai Stroke Prevention and Treatment Service System Expert Committee Deputy Director, Shanghai Stroke Prevention and Treatment Center Deputy Director, Chinese Medical Association Neurology Branch Deputy Chairman (8th), Chinese Stroke Society Vice President, Shanghai Medical Association Neurology Specialist Branch No.
The current chairman of the tenth committee, the chairman of the Neurologist Branch of the Shanghai Medical Doctor Association, the executive vice chairman of the Shanghai Stroke Association
