Mr. Li, 59 years old, has been suffering from hypertension for a long time and has no history of other major diseases. In daily life, I don't pay attention to controlling my diet, I often eat pickles for breakfast, I usually put a lot of salt in cooking, I often eat cured meat, I don't take antihypertensive drugs regularly, I am usually busy with work, and I can't check or measure my blood pressure regularly.
Some time ago, Mr. Li was admitted to the hospital due to sudden severe headache and syncope, and when he was admitted to the hospital, he was confused, his speech was slurred, his right limb was weak, his expression showed a painful expression, his body temperature, pulse and breathing were normal, and he was initially suspected of cerebral hemorrhage, and relevant examinations were urgently carried out.
We performed a CT examination of the patient's head, and found that a cloudy opacity with a diameter of about 3 cm was seen in the right cerebral hemisphere, accompanied by edema and indentation of the surrounding brain parenchyma, and the CT value was highCombined with the clinical manifestations and CT imaging characteristics of the patient, the diagnosis was right cerebral hemisphere cerebral hemorrhage. Routine blood tests showed a mildly elevated white blood cell count and elevated C-reactive protein levels, suggesting some inflammation, and coagulation and liver and kidney function tests also showed some degree of abnormality.
The patient was immediately taken to the neurosurgery emergency department for a cranial CT scan, and after confirming the intracerebral hemorrhage, he was immediately transferred to the neurosurgery wardCranial pressure monitoring was performed to determine the intracranial pressure so that the next step could be carried out**, and the monitoring showed intracranial pressure50kpa, which requires timely blood pressure lowering**, we use intravenous infusion of mannitol to reduce intracranial pressure, because of long-term hypertension, this sudden intracerebral hemorrhage is closely related to hypertension
The first priority is to control and lower the patient's blood pressure to reduce the risk of continued bleeding, and to give antihypertensive drugs to reduce the patient's hypertensive state to keep the patient's cerebral blood vessels stable.
After intracerebral hemorrhage is confirmed, patients are given coagulation and antifibrinolysis** promptly to control the extent of intracerebral hemorrhage and to prevent further expansion of hemorrhage as much as possible. After intracerebral hemorrhage, hematoma and inflammation in the bleeding area may cause increased intracranial pressure, which in turn affects blood perfusion and metabolism in brain tissueTherefore, patients are monitored for cranial pressure and, if necessary, reduced by using analgesic sedatives or drainage decompression.
In the process of **, the patient is confused and weak, and comprehensive nutritional support and nursing work are required, the patient's condition changes are closely observed, and nursing measures are adjusted in time to prevent the occurrence of pressure ulcers and other complications.
Through rescue and symptomatic treatment, Mr. Li's condition is stable, and we have formulated a prognosis for him**, which requires timely physical and ** training to help patients recover limb function and reduce the risk of long-term stroke sequelae, and at the same time provide psychological care to patients to help them face the disease positively and rebuild confidence.
Through the case of Mr. Li, we learned about the dangers of hypertension, once the acute complication of hypertension occurs, it is likely to cause harm to our lives, so hypertensive patients should not only control blood pressure in time, but also prevent the occurrence of hypertension complications, especially cerebral hemorrhage.
High blood pressure is a potential health risk factor that can lead to a range of serious complications, including heart disease, stroke, brain hemorrhage, and more。Intracerebral hemorrhage is a bleeding event that occurs in brain tissue, and one of the main causes of this is high blood pressure. The process of intracerebral hemorrhage due to hypertension is complex and involves a variety of physiological and pathological mechanisms.
High blood pressure may lead to hardening of the arteries and the formation of aneurysmsHigh blood pressure can cause persistent damage to the lining of the arteries, leading to hardening of the arteries, which in turn increases the risk of aneurysm formation. Arteriosclerosis is damage to the endothelial cells of the arteries and inflammation of the cells, resulting in thickening of the lining of the arteries, loss of elasticity and narrowing of the lumen of the blood vessels.
An aneurysm is a bulge in which a part of the artery wall protrudes to form a blood vessel wall, and these bulges are usually fragile and prone to rupture. This condition will make the artery wall become fragile, the ability to withstand the impact of the blood is reduced, and when the pressure inside the blood vessel is too high, the blood flow needs more impact force, and the fragile blood vessel wall cannot withstand the huge impact force, which may lead to the rupture of the blood vessel, which in turn causes cerebral hemorrhage.
Intracerebral hemorrhage is caused by damage to brain tissue. Long-term hypertension damages the small blood vessels of the brain, and the rupture of small blood vessels is one of the main causes of cerebral hemorrhage. In the case of high blood pressure, the pressure on the inner wall of the artery increases, making the wall of the blood vessel fragile and prone to rupture, leading to microinfarction of brain tissue, which may also lead to the occurrence of cerebral hemorrhage. High blood pressure can also lead to rupture of intracranial aneurysms
Intracranial aneurysm refers to the abnormal expansion of blood vessels in the brain, making the blood vessel walls very fragile and prone to rupture, and when high blood pressure causes small blood vessels in brain tissue to rupture, it can also lead to intracranial aneurysm rupture, causing cerebral hemorrhage.
In addition, high blood pressure can also lead to an imbalance in the balance of blood vessels. Under normal circumstances, the balance between the inside and outside of the blood vessels needs to be maintained. High blood pressure causes an increase in pressure within blood vessels, while the elasticity of the blood vessel walls decreases, and the balance between the inside and outside of blood vessels is disrupted.
When the balance between the inside and outside of the blood vessel is disrupted, the pressure inside the blood vessel may cause the blood vessel to rupture, which eventually leads to the occurrence of cerebral hemorrhage, and high blood pressure will cause the heart to increase the burden and increase the blood output of the heart, which will lead to an increase in blood flow; When blood flows faster, the pressure on the walls of blood vessels also increases, which can lead to the rupture of blood vessels.
In addition to this, hypertension can also cause intracerebral hemorrhage due to cerebral ischemia-reperfusion injury. High blood pressure causes blood vessels in the brain to dilate in response to a state of high pressure within the blood vessels, which can lead to cerebral ischemia-reperfusion injury.
Cerebral ischemia-reperfusion injury refers to when brain tissue is ischemic due to insufficient blood**, and then the blood ** is restored, the resupplied blood causes cell damage and triggers an inflammatory response.
Cerebral ischemia-reperfusion injury may lead to the rupture of blood vessels in brain tissue, resulting in intracerebral hemorrhage, which may occur separately or interact, and together lead to the occurrence of intracerebral hemorrhage.
Diet is one of the important factors that affect blood pressure, and controlling diet is very important to prevent hypertension and its complications. In the diet of people with high blood pressure, it is necessary to avoid or touch less food, even if you are craving.
The first is high-salt foods
A high-salt diet is a major cause of high blood pressure. Too much sodium will lead to water retention in the body, increase the amount of fluid in the blood vessels, lead to an increase in blood pressure, cause long-term damage to the blood vessels in the brain, and over time it is easy to lead to brittleness of blood vessels, and it is easy to cause cerebral hemorrhage in the impact of high blood flow, so we should eat less of this kind of food, this kind of food will also affect kidney function and further increase blood pressureTherefore, patients should avoid excessive consumption of sodium-rich foods such as pickles, pickled products, and canned foods.
At the same time, it is necessary to pay attention to adding less salt to the table, try to choose low-salt or salt-free condiments when eating food, eat more fresh fruits and vegetables, and exercise in moderation, which can help control blood pressure and improve cardiovascular health.
The second is high-sugar foods
People with high blood pressure need to reduce their consumption of foods high in sugar. Too much sugar can lead to problems such as obesity, insulin resistance, and heart disease, all of which can increase the risk of developing high blood pressure. Therefore, people with high blood pressure need to avoid high-sugar foods such as candy, chocolate, desserts, sugary drinks, etc。At the same time, it is necessary to control the intake of starchy foods such as rice, noodles, bread, etc., because these foods are converted into sugar very quickly. Choose carbohydrate foods with a low GI index, cereals and multigrains are more suitable for people with high blood pressure.
The third is high-fat foods
This type of food increases the risk of fat accumulation, and the fat in the blood also increases, which is not conducive to blood flow, increases the pressure of blood flow, and increases the risk of heart loadIt will not only cause an increase in blood lipids, but also lead to the production of lipid plaques, which is not conducive to blood flow, resulting in a decrease in blood flow velocity and an increase in blood pressure.
At the same time, for the consumption of meat, you can choose lean meat or fish, limit the intake of red meat and processed meat products, and moderate amounts of saturated fat and trans fat are also important for patients with high blood pressure.
In terms of diet, it is also necessary to pay attention to the reasonable combination of dietary structure. Foods rich in high-quality protein, fiber, and vitamins, such as vegetables, fruits, whole grains, nuts, and legumes, should be eaten, which can help alleviate high blood pressure and reduce the risk of cardiovascular diseaseIt is also important to consume low-fat dairy products in moderation, such as low-fat milk and natural yogurt.
In addition, limiting alcohol consumption and quitting smoking are also important dietary principles for people with high blood pressure. Controlling your diet, exercising moderately, and living a good lifestyle are all keys to preventing high blood pressure and reducing the risk of complications. High blood pressure can not only cause a complication of cerebral hemorrhage, but also affect the occurrence of other complications, which are also life-threatening, and we should be aware of it and prevent it.
1) Myocardial infarction:
High blood pressure increases the workload of the heart, leading to insufficient blood supply to the heart muscle, which can lead to myocardial infarction. When blood pressure is too high, the heart needs more oxygen and nutrients to meet its needs for normal function
Due to arteriosclerosis and narrowing of blood vessels, blood is restricted**, leading to myocardial ischemia. If myocardial ischemia lasts for a long time, it can lead to myocardial infarction, which is the death of part of the heart muscle.
2) Cerebral infarction:
High blood pressure increases the pressure on the blood vessels in the brain, making them more likely to rupture or form blood clots. When blood pressure is too high, the elasticity of the blood vessel walls is compromised, and rupture and bleeding are prone to occur.
At the same time, high blood pressure can also cause damage to the lining of blood vessels, forming blood clots, blocking cerebral blood vessels, and leading to cerebral infarction. Cerebral infarction refers to the interruption of blood in a certain part of the brain, resulting in ischemia and necrosis of that part of the brain tissue.
3) Aortic dissection:
High blood pressure increases the pressure in the aorta, causing damage to the wall of the aorta, which in turn leads to aortic dissection. Aortic dissection is a hematoma that forms between the inner and outer layers of the aorta, allowing blood to flow through the dissection and further peel away the aortic wall. In this condition, the normal blood flow to the aorta is obstructed, which can lead to a rupture of the aorta in severe cases, which can be life-threatening.
4) Kidney failure:
High blood pressure can cause damage to the kidneys, leading to a gradual decline in kidney function and eventually kidney failure. High blood pressure causes arteriolar spasm and increased glomerular filtration pressure, resulting in increased glomerular filtration rate and damage to the glomerular filtration membrane.
Long-term high blood pressure can also lead to arteriole sclerosis and glomerulosclerosis, further impairing kidney function. When kidney function is severely impaired, waste products and toxins in the body cannot be excreted normally, leading to the occurrence of uremia.
Hypertension is a chronic disease, but if left uncontrolled, it can lead to a range of acute complications. In addition to intracerebral hemorrhage, hypertension can lead to acute complications such as myocardial infarction, cerebral infarction, aortic dissection, and kidney failure. Therefore, it is very important for patients with hypertension to control their blood pressure in a timely manner, have regular check-ups and ** to reduce the risk of complications.
Repeatedly remind high blood pressure not to want cerebral hemorrhage, high salt food, high sugar food and high fat food these three foods to touch less, no matter how hungry you have to endure, the above-mentioned Mr. Li long-term eating of high salt food, resulting in poor blood pressure control, cerebral hemorrhage This is an acute complication, which shows that blood pressure control is very important to us, we must pay attention to the acute onset of hypertension, and take preventive measures in time to prevent these complications from threatening our life and health.
Literature Reference:1.Liu Guocheng, Yu Xiaolong, Wang Zhijun. Pathophysiological mechanisms of hypertensive intracerebral hemorrhage and **[J].China Medical Guide, 2018, 20(12): 123-126
2.Chen Lanzhong, Xiong Tingguang. ** and clinical features of hypertensive intracerebral hemorrhage[J].Current Medicine, 2015, 21(24): 173-174