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中風
• 組員 :
• 吳柏徵
• 林柏孝
• 胡曜倉
• 蔡克沂
簡介 :
中風( stroke 、 cerebrovascular accident (CVA) )是指由於
腦部供血受阻而迅速發展成的腦功能損失,又稱腦卒中。分兩種
類型:一種是由血栓或栓塞所造成的缺血(缺乏血液供應),稱
缺血性腦卒中,一種
是由出血所造成的,稱出血性腦卒中。
中風屬於急症,可能造成永久性神經損害,如果不及時診斷和治
療可能會造成併發症或死亡。全世界疾病致死病歷中,中風是第
2 大死因,並具有發病到致死間距極短的特點。
中風的危險因素包括高齡,高血壓,有中風病史或
短暫性腦缺血發作( TIA ),糖尿病,膽固醇過高,抽煙,
心室顫動。高血壓是中風最重要的危險因素。
分類 :
• 中風可分為兩大類:缺血性和出血性。缺
血是由於血液供應中斷,而腦出血是由於
腦血管破裂或不正常的血管結構。 80% 的
中風是由於腦缺血;其餘的是由於出血。
• 圖表
缺血性中風 :
• 缺血性中風是由於腦部供血不足,導致腦
組織功能障礙及壞死。有四個原因可導致
缺血性中風:血栓(腦部形成阻塞血塊)
,栓塞(栓塞從其他地方形成,見下),
系統性供血不足(一般性系統性供血不足
,如休克)和靜脈血栓。未知原因的中風
稱為來源不明。
出血性中風 :
• 顱內出血是顱骨內任何地方的的血液積累。通常將顱內出
血分為內出血(腦內出血)和外出血(頭骨內,大腦外)。
內出血是由於顱內腦實質性出血或腦室內 出血。外出血又
分為硬膜外血腫(硬腦膜和顱骨間出血),硬膜下血腫和
蛛網膜下腔出血(蛛網膜和軟脊膜之間)。大部分的出血
性中風都有其特殊的癥狀(如頭 痛,前頭部外傷)。
• 腦出血( ICH )是出血直接進入腦組織,形成一個逐漸擴
大的血腫。 ICH 常發生在小動脈,常見病因是高血壓,外
傷,出血疾病,澱粉樣血管病,非法使 用毒品(如安非他
明或古柯鹼)和血管畸形。血腫不斷擴大直到周圍組織限
制它的擴大,或出血進入腦室系統,腦脊液,或軟腦膜而
解壓。三分之一的顱內出血發生 於大腦的右心室。腦出血
30 天之後死亡率是 44% ,高於缺血性中風,甚至高於非
常致命的蛛網膜下腔出血。
癥狀和體癥 :
• 中風通常發展迅速(數秒到數分鐘),但亦可以
是進程緩慢的一種症狀。部份病人在中風初期會
有輕微症狀,如:記憶減退、感受能力(聽覺、
視覺等)衰退,神智 不清,行為異常 ; 若未能盡
快得到適當治療,可引發嚴重後果,對病人造成
不可逆轉的傷害。中風癥狀和受損部位有關,因
此癥狀呈多樣性。缺血性中風,通常隻影 響受阻
動脈附近的腦組織。出血性中風影響局部腦組織
,但由於出血及顱內壓增高,往往也影響整個大
腦。綜合病史,神經學檢查,以及發病危險因素
,醫生可以在 確切原因尚未知曉之前快速診斷中
風的解剖學性質(即哪一部分的腦受影響)
預防 :
• 鑒於中風的嚴重性,預防是一個重要的公
共健康問題。中風每年需要治療的次數計
算,次級預防比初級預防有效的多。最近
的指南詳細列出了中風初級預防的證據。
因為中風可能表明潛在的動脈粥樣硬化,
確定病人其他心血管疾病如冠心病的風險
很重要。反過來說,阿司匹林可以防止心
肌梗死病人的第一次中風。
治療 :
• 中風的早期識別非常重要。只有詳細的身
體檢查及醫學影像學資料才能確診是否中
風,類型和程度;因此即使是一般的中風
徵兆,也應該到醫院求診。
• 研究顯示,在中風專科醫院治療的病人,
患者復甦的幾率比較高。
健教   中風

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健教 中風