腦梗塞病人的護(hù)理課件整理

腦梗塞病人的護(hù)理朱瑞Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL教學(xué)內(nèi)容概念分類腦血栓形成腦栓塞Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL概念腦梗塞(cerebralinfarctionCI系各種原因?qū)е履X動(dòng)脈血流中斷,局部腦組織發(fā)生缺血缺氧性壞死或腦軟化而岀現(xiàn)相應(yīng)神經(jīng)功能缺損。Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、概念●腦血栓形成(cerebralthrombosis)即動(dòng)脈血栓性腦梗死。是在腦動(dòng)脈粥樣硬化等動(dòng)脈壁病變的基礎(chǔ)上形成血栓,造成該動(dòng)脈供血區(qū)血流中斷,局部組織發(fā)生缺血、缺氧壞死而出現(xiàn)相應(yīng)的神經(jīng)癥狀和體征。Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病因與發(fā)病機(jī)制●病因腦動(dòng)脈粥樣硬化(伴高血壓最常見);腦動(dòng)脈炎;先天性腦動(dòng)脈狹窄;血液粘稠度增加。誘因所有導(dǎo)致血流緩慢、血壓降低的因素。Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL病因與發(fā)病機(jī)制發(fā)病機(jī)制粥樣斑塊脫落→管壁潰瘍→pt粘附→血栓個(gè)促進(jìn)管腔狹窄+血壓下降、血流緩慢、脫水Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、病理與病理生理●病理分期(梗死后)血栓超早期(1-6h)缺血部分急性期(6-24h)壞死期(24-48h)軟化期(3d-3W)恢復(fù)期(3-4W后)Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL、病理與病理生理病理生理缺血半影區(qū)(半暗帶:IP)梗死灶中心壞死區(qū)周圍可恢復(fù)的部分血流灌注區(qū)。治療時(shí)間窗卒中發(fā)生后最有效的治療時(shí)間(6h之內(nèi))。Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL四、臨床表現(xiàn)●臨床類型完全型卒中(completestroke)進(jìn)展型卒中(progressivestroke)緩慢進(jìn)展型卒中;大塊梗死型卒中(大面積梗死);Evaluadononly.chAsposeslidesforNET4odientPEvaluationonly.CreatedwithAsposeSlidesforNET4.0dientProfilo71Copyright2019-2019AsposePtyL四、臨床表現(xiàn)特別提示因梗死部位不同表現(xiàn)亦異最常見表現(xiàn)為失語、偏癱、偏身感覺障礙Evaluadononly.chAsposeslidesforNET4odie