How to treat cerebral thrombosis caused by hemodialysis

The management of blood clots in hemodialysis depends on the location of the thrombosis, as follows:

1. If the thrombus occurs at the catheter site, it can be a thrombus in the catheter or a thrombus around the catheter, which will cause the blood flow velocity during hemodialysis to not meet the requirements of blood purification. If it is an intracatheter thrombosis, urokinase can be injected into the catheter for thrombolysis**, and if the effect is not good, the catheter can be replaced;

2. If it is a thrombus at the arteriovenous fistula, it usually occurs in patients with stenosis in the arteriovenous fistula, that is, patients with slower local blood flow, and local thrombosis is prone to occur. Other factors, such as prolonged compression after dialysis, or excessive and rapid dehydration during dialysis, resulting in hypotension, or the patient being a hypercoagulable patient, accelerate the risk of local thrombosis. If there is a thrombus in the arteriovenous fistula, it must be treated as soon as possible, and urokinase should be injected locally for drug thrombolysis, and at the same time, a more experienced vascular access doctor will give manual massage.

If it is effective, it can recanalize the blood vessels; If this is ineffective, surgical intervention should be carried out in a timely manner, including thrombectomy, transballoon dilation of thromboctomy, and further opening of the blood vessels. Since thrombosis at the arteriovenous fistula occurs in patients with stenosis in the arteriovenous fistula, even if the purpose of vascular recanalization is achieved through drug thrombolysis or manual massage, it is necessary to intervene in the stenosis through active surgery** to change the stenosis situation, otherwise it is easy to reappear thrombosis at the arteriovenous fistula.

Some patients with cerebral thrombosis have hypertension, the amount of salt should be small, and a low-salt diet should be adopted, with 3 grams of salt per day, and salt can be added after cooking and mixed well.

If salt is added to the cooking, the cooked dish will still be bland and difficult to eat. To increase your appetite, you can add some vinegar, tomato paste, and tahini when stir-frying. Vinegar can be flavored, but also to accelerate the dissolution of fat, promote digestion and absorption, sesame paste has a high calcium content, regular consumption can supplement calcium, calcium ions can increase the compactness of the vascular endothelium, to prevent cerebral hemorrhage has certain benefits.

Patients with cerebral thrombosis should drink water frequently: especially in the early morning and evening, drinking water in the early morning can dilute the gastrointestinal tract, and after the water enters the bloodstream, it is excreted in the form of sweat and urine with activity. The biggest benefit of drinking water before sleep is that it can thin the blood and prevent thromboembolism.

To increase dietary fiber and vitamin C in foods, including whole grains, vegetables and fruits. Some foods such as onions, garlic, shiitake mushrooms, fungus, kelp, hawthorn, seaweed, weak tea, konjac and other foods have lipid-lowering effects.

Quit smoking and drinking. Do not smoke, drink less, combine work and rest, live a regular life, avoid sleeping after meals, and control weight.

1.Drugs**.

Principles of Acute Phase Medications**.

1) Ultra-early**: First, to raise the public's awareness of the emergency and first aid of stroke, and to understand the importance and necessity of ultra-early**. Seek medical attention immediately after the onset of the disease, if there are no contraindications, strive to dissolve thrombolysis within a time window of 3 to 6 hours**, reduce cerebral metabolism, control cerebral edema and protect brain cells, and save the ischemic penumbra;

2) individualization** according to the patient's age, ischemic stroke type, degree of illness and underlying diseases, etc.**;

3) Prevention and treatment of complications such as infection, cerebral heart syndrome, hypothalamic injury, post-stroke anxiety or depression, syndrome of abnormal antidiuretic hormone secretion and multi-organ failure;

4) Holistic approach to support symptomatic and early support; Timely preventive interventions for stroke risk factors such as hypertension, diabetes, and heart disease have been taken to reduce the rate of ** and reduce the rate of disability.

2.Surgery**.

Craniotomy and decompression can be performed for patients with severe cerebral edema mass effect and signs of cerebral herniation in supratentorial large-area cerebral infarction; In patients whose condition worsens due to cerebellar infarction due to compression of the brainstem, life can be saved by aspiration of infarcted cerebellar tissue and decompression of the posterior fossa.

3.****。

It should be carried out early, and short-term and long-term plans should be formulated in accordance with the principle of individualization, and the method should be selected in stages and according to local conditions. Targeted physical fitness and skill training is provided to patients to reduce the disability rate, improve the recovery of neurological function, improve the quality of life, and reintegrate into society.

Let's make the situation clear first, hemodialysis requires heparinization, which generally leads to cerebral hemorrhage, not cerebral thrombosis, and uremia patients have a tendency to bleed, and there is a problem with conventional **, that is, dehydration and intracranial pressure lowering drugs should be used with caution.

Buerger's disease is a rare chronic segmental inflammatory disease of arterioles and veins, and is more common in the lower limbs. Presents with ischemia, pain, intermittent claudication, decreased or absent dorsalis pedis pulse, migratory superficial phlebitis, and in severe cases, acral ulceration and necrosis.

Thrombolysis recanalization can be performed as soon as possible when thrombolysis targets are met.

The manifestations of arteriosclerosis are mainly determined by vascular lesions and the degree of ischemia of the affected organs, and most patients with early arteriosclerosis have almost no clinical symptoms. For patients with arteriosclerosis in the middle stage, most patients have more or less clinical symptoms such as palpitations, chest pain, chest tightness, headache, dizziness, cold numbness in the limbs, soreness and laziness in the limbs, claudication, decreased vision, memory loss, insomnia and dreams.