Oxygen therapy for cerebrovascular system diseases
- Categories:Oxygen Knowledge
- Time of issue:2021-05-19 13:20
Oxygen therapy for cerebrovascular system diseases
The brain is inside the skull and consists of the cerebrum, diencephalon, brain stem and cerebellum. The brain is spherical, and the surface of the cerebral hemisphere is called the cerebral cortex. The brain is composed of countless nerve cells and brain cells, and brain cells are very sensitive to hypoxia. In cerebral atherosclerosis, the blood flow of vegetative cells in small arteries is reduced, and the function of brain cells is also reduced. When cerebral thrombosis occurs in cerebral arteries; cerebral embolism, cerebral aneurysm rupture or hemorrhage or tumor compression, brain cells can undergo degeneration and necrosis.
Cerebrovascular disease refers to the blood supply disorder of the brain tissue caused by the disease of the blood vessel itself or the disorder of the blood circulation of the whole body.
Cerebrovascular disease is one of the common clinical diseases. According to relevant statistics, the incidence rate is 150-200 people per 100,000 people. The death rate of cerebrovascular diseases reached 101.31 to 117 52 people per 100,000, accounting for 15 to 20% of the total deaths from various diseases. The incidence of cerebrovascular diseases is closely related to age. The older the age, the higher the incidence. Modern medicine lists cerebrovascular diseases, malignant tumors, and cardiovascular diseases as the top three diseases with the highest mortality in humans today.
The average weight of the brain is 1500 grams, which is 2 to 3% of the body weight, but its oxygen consumption accounts for 20% of the total body oxygen intake. The metabolism of the brain requires 72 liters of oxygen and 150 grams of glucose every 24 hours. Each time the heart contracts 70 ml of blood, of which 10 to 15 ml is supplied to the brain. Moreover, the energy reserve and anaerobic metabolism capacity of brain tissue is extremely small, generally only a very small amount (about 2 grams) of glucose and glycogen are stored, and energy metabolism is almost entirely dependent on the continuous transport of glucose and oxygen by the bloodstream. Under normal body temperature, if hypoxia, the physiological function of the brain can only be maintained for 4-6 minutes, the midbrain can be maintained for 5-10 minutes, the cerebellum can be maintained for 10-15 minutes, and the medulla oblongata can be maintained for 20-30 minutes. In other words, if the human body is hypoxic, the brain tissue, especially the cortex of the brain, will be the first to bear the brunt. When the supply of glucose and oxygen is reduced to a critical level, the function of brain cells can only be maintained for a few minutes. Therefore, when a patient suffers from cerebrovascular disease, it will affect the respiratory center and cause hypoxia. Hypoxia can increase the permeability of local brain capillaries, congestion and edema of the brain tissue, and brain edema, which in turn makes the hypoxia phenomenon more serious. Severe cerebral hypoxia, the astrocytes around the capillaries quickly swell, compressing the capillaries, making the lumen narrow or even deformed, and the capillary endothelial cells also swell, forming rash-like protrusions of varying sizes. Narrow or block the lumen, block blood flow, cause ischemia or blood stasis, and aggravate cerebral hypoxia and edema.
Cerebrovascular disease is a frequently-occurring disease in the elderly, and the condition is more critical. In the event of a sudden attack, if there is no immediate oxygen replenishment measures, even if rescued, more than 1/3 will be left with permanent disability, and some may relapse again. Therefore, oxygen health care and emergency oxygen delivery are very important for the prevention and treatment of cerebrovascular diseases.
Common diseases of the cerebrovascular system include cerebral ischemia, cerebral thrombosis and cerebral embolism, and cerebral vertigo. In addition, many neurological diseases do not directly cause hypoxia in the brain, but the final result is hypoxia in brain tissue, such as spinal cord injury, cranial nerve and peripheral neuropathy (such as trigeminal neuralgia, facial nerve palsy, polyneuritis, gravis Asthenia) and so on.
All the nutrients needed by the human brain are transported by blood. If the brain is ischemia, it will cause a series of brain diseases. The longer the brain ischemia, the less glucose and oxygen can meet the needs of brain cells. As a result, brain cells will be irreversibly damaged, and even become unconscious vegetatives that can only maintain physiological metabolism. Therefore, cerebral ischemia should be actively prevented.
Transient ischemic attack is also called transient insufficiency of blood supply to the brain. It usually occurs when the body is weak or when the spirit is suddenly nervous or excited. The pathogenesis is mainly cerebral vasospasm or microembolism, which significantly reduces cerebral blood flow and makes cerebral blood supply insufficient. This type of cerebral blood supply is insufficient and the condition is very urgent, but the duration of symptoms is short, usually only a few minutes, and the longest is not more than 24 hours. The symptoms can alleviate spontaneously without leaving any sequelae, but they can recur. Such patients often have symptoms such as dizziness, nausea, vomiting, transient half-body numbness, transient hemiplegia and transient disturbance of consciousness.
The principle of treatment for transient cerebral hypoxia is to dilate blood vessels so that the blood can flow smoothly through the brain. It can be used for intravenous pulse therapy, oral administration of PSS, brain benefit disorder, sibelin and so on. Because transient ischemia is a transient insufficiency of blood supply to the brain, resulting in transient hypoxia in the brain tissue, people who are able to inhale oxygen should supplement with oxygen. Generally, the oxygen flow rate is 2 liters/min. When the symptoms are completely relieved, stop breathing. Oxygen, this can increase the blood oxygen concentration in the blood, and at the same time the physically dissolved oxygen in the blood also increases, so that the symptoms of hypoxia in the brain tissue can be corrected. At the same time, the increase in blood oxygen concentration can reduce blood viscosity and resolve microthrombosis. From the day after the onset of illness, oxygen inhalation 1 to 2 times a day, 1 to 2 times each time, for 2 to 3 weeks, can play a role in preventing recurrence.
Acute cerebral hypoxia is mostly caused by cerebral blood supply disorders. At the initial attack, the patient exhibits hyperactivity, euphoria, decreased judgment, and fine motor disorders. As hypoxia worsens or the time is prolonged, the brain changes from excitement to inhibition, and the patient is slow to respond, apathetic, lethargic, loss of consciousness and even convulsions. Oxygen therapy should be given to such patients immediately. The purpose is to increase the partial pressure of blood oxygen to improve the hypoxic state of the patient's body. If the patient has clinical symptoms such as coma, hemiplegia, mistakes, etc., doctors will adopt different treatment methods according to the nature of the patient's brain lesions to prevent serious damage to the brain tissue. The hyperbaric oxygen chambers in modern hospitals are designed to increase blood oxygen tension, increase blood oxygen diffusion and the oxygen content of brain tissue, so as to improve symptoms such as cerebral ischemia and hypoxia, and to restore consciousness and limb function as soon as possible.
Cerebral infarction is caused by avascular necrosis or softening of brain tissue due to blockage of blood vessels. Cerebral infarction is a common disease, which includes cerebral thrombosis and cerebral embolism. In atherosclerosis, due to the rough surface of the atherosclerotic plaque, it is very easy to cause blood to coagulate on the plaque. The clot can cause vascular occlusion at the lesion, especially when the blood flow is slow (such as sleep, bed rest). This situation. This is what people often call cerebral thrombosis, also called cerebral thrombosis. Cerebral embolism means that the pillars in other parts of the body fall off, travel to the brain with the blood, and block the blood vessels in a certain part of the brain, causing cerebral tissue ischemia, hypoxia, and brain tissue necrosis.
Whether it is cerebral thrombosis or cerebral embolism, the symptoms are dizziness, weakness, numbness, language barriers, mistakes and even hemiplegia. Cerebral thrombosis usually occurs during sleep. Often the patient is in good health before going to bed, and there is no discomfort until he wakes up in the morning and suddenly finds that one limb is weak. The situation of patients with cerebral embolism is different, and the above symptoms are often found suddenly during activities.
In the hospital, the treatment of patients with cerebral thrombosis and cerebral embolism is basically the same. The principle of drug administration is to actively dilate blood vessels. Commonly used drugs such as Maitong, Limozine, Venoruton, Niacin, Naoyizine, Antithrombotic Pills, PSS, etc. are taken orally. At the same time, patients are also treated with thrombolytic therapy, such as streptokinase and agkistrodon antithrombotic enzyme, which are commonly used drugs to dissolve thrombus. At the same time, it is necessary to supplement vitamins BI, B6, and various amino acids.
Since cerebral infarction is the ischemia and hypoxia of the brain tissue in the infarcted area, oxygen therapy is an active and effective symptomatic therapy in order to minimize the damage to the brain tissue. When the blood oxygen concentration increases, the blood viscosity decreases, thereby reducing brain tissue damage. For patients with acute cerebral infarction, the nasal tube is generally used to inhale pure oxygen with a flow rate of 4 liters/min. If possible, hyperbaric oxygen therapy The effect is better. During the recovery period, the patient can receive oxygen therapy at home for 1 to 2 hours each time for two weeks of continuous treatment, which can achieve better results. If the patient can inhale a small amount of fresh oxygen every day during the recovery period, it can effectively prevent the recurrence of cerebral infarction.
Vertigo refers to a person's illusion about the relationship between oneself and the space position, the appearance of paroxysmal rotation of oneself and surrounding scenery, often accompanied by symptoms such as nausea, vomiting, sweating, or blood pressure drop, and even transient disturbance of consciousness. The cause of vertigo is mostly caused by diseases of the inner ear and cranial nerves. The vertigo that requires oxygen therapy is mainly Meniere's disease.
Meniere's disease is caused by ischemia and hypoxia in the inner ear, most of which are sudden onset, which occurs once every few months and years, and lasts for several minutes to several days. It can be induced by fatigue and emotional excitement. At the time of the onset, the patient felt his vision rotates, unstable standing, nausea and vomiting, profuse sweating, tinnitus, pale complexion, afraid to open his eyes or move his head, and hearing loss after the attack.
Patients should stay in bed during an attack to prevent falls due to lack of physical strength, and generally take atropine, sedatives and neurotrophic drugs. Patients with oxygen inhalation conditions should inhale oxygen as soon as possible, because increasing the partial pressure of blood oxygen and blood oxygen content can help alleviate the hypoxic state of the inner ear and gradually relieve the symptoms. Oxygen can be inhaled at home once a day with a flow rate of 1 to 2 liters/min.
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