From Dr Yu-Min Lin, Geriatrician, CMDHB
這篇文章內容是由 Stroke Foundation NZ 網站 翻譯轉載。
防止中風 Preventing Stroke
甚麼是中風？ What is a stroke?
A stroke is a brain attack–a sudden interruption of blood flow to parts of your brain causing damage to brain cells. There are two main types of stroke, ischaemic and haemorrhagic.
1. 缺血性中風 （ISCHAEMIC STROKE）
Ischaemic strokes are caused by narrowing or clogging of arteries leading to the brain, or by a blood clot or piece of debris breaking away from a blood vessel and causing a blockage in one of the brain arteries. Ischaemic stroke is the most common type of stroke.
2. 出血性中風 （HAEMORRHAGIC STROKE）
A haemorrhagic stroke is caused by an artery in the brain bursting and bleeding. Blood is forced into brain tissue, damaging cells so that area of the brain can’t function. This can happen because the person was born with a faulty artery, or because disease has caused the artery walls to become thin and brittle.
中風的後果 THE EFFECTS OF STROKE
Different types of strokes can cause similar damage.
- ‧ 意識喪失
- ‧ 偏癱
- ‧ 語言不利、理解遲鈍
- ‧ 吞咽和進食困難
- ‧ 大小便失禁
- ‧ 感知功能喪失或出現障礙
- ‧ 一側失明
- ‧ 喪失記憶
- ‧ 喪失控制情緒的能力，出現情緒變化無常、沮喪、疲憊、情緒低落等現象
These effects may occur depending on which area of the brain has been damaged:
- • Loss of consciousness
- • Paralysis or weakness, involving face, arm, or leg on one side.
- • Difficulty talking and understanding
- • Difficulty with swallowing or feeding
- • Incontinence, loss of bladder and bowel control
- • Loss or impairment of sensation
- • Partial loss of vision to one side
- • Loss of memory
- • Loss of emotional control, mood changes, depression, fatigue, frustration.
導致中風的因素 Stroke risk factors
Usually strokes happen because of a combination of factors, such as certain medical conditions (ie high blood pressure), inherited characteristics or unhealthy lifestyle (eg smoking or poor diet). Sudden shocks or an argument almost never cause strokes.
SIMPLE STEPS TO REDUCING THE RISK OF STROKE
1. 量血壓 （Check your blood pressure）
High blood pressure is one of the greatest risk factors for stroke. The chance of having a stroke is up to seven times higher for people with high blood pressure than for those with normal or low blood pressure. Failure to detect and control high blood pressure is the number one cause of avoidable strokes.
High blood pressure rarely gives any warning signs so have your blood pressure checked regularly – twice a year is a good rule of thumb, especially for those over about 45 years of age. If you have high blood pressure, it is important that you take the advice and treatment suggested by your doctor.
Your doctor will recommend changes to your lifestyle such as losing weight, changing unhealthy eating habits, exercising more or stopping smoking. These measures are essential if you are going to stay as well as possible.
In many cases your doctor will also prescribe medication to control your blood pressure. Never give up taking your tablets without talking to your doctor first. If you stop taking them your risk of stroke will rise.
2. 戒煙 (Stop smoking)
或致電“戒煙熱線電話＂0800 778 778。
Smoking quadruples the risk of stroke. If you stop smoking today your risk of having a stroke will begin to drop. Many people find it difficult to stop smoking but there are a lot of things that can help you. Talk to your GP for advice and support or call the Smoking Quit Line on 0800 778 778.
3. 鍛煉 (Exercise)
Physically inactive people have more risk of stroke than people who keep active. As little as 30 minutes of moderate exercise a day can increase your fitness and reduce your risk of stroke. Any physical activity is good as long as it is enough to make you slightly warm and a little out of breath. Try taking the stairs instead of the lift, gardening, walking to the dairy to get the paper.
4. 飲酒限量 (Limit the amount of alcohol you drink)
Drinking lots of alcohol at once can raise your blood pressure. This increases the risk of a blood vessel bursting and bleeding into the brain. Regular heavy drinking also increases your risk of stroke.
5. 注意飲食，控制體重 (Eat a healthy diet & control your weight)
Cutting down on the amount of fat and salt in your diet should lower your blood pressure and your cholesterol level. Too much fat in your diet can also cause atherosclerosis (narrowing of the arteries) or clots which can cause strokes.
Try to eat a balanced diet with lots of fresh fruit and vegetables, grains and a moderate amount of lean meat or low fat protein each day.
Being overweight strains the entire circulatory system and predisposes you to higher cholesterol levels, high blood pressure and diabetes, all of which increase your risk of stroke.
6. 降低血液中的膽固醇 (Lower your serum cholesterol)
Cholesterol is essential to the body’s cells. Normally your body produces all the cholesterol you need. Foods high in cholesterol and saturated fats can accelerate atherosclerosis. Your doctor can arrange a blood test to check your cholesterol levels. Your doctor will recommend the best way to reduce your cholesterol levels.
7. 檢查是否有心房纖維性顫動 (Find out if you have atrial fibrillation)
心房纖維性顫動(簡稱房顫)是心臟高頻率､無規律跳動的一種。房顫症患者發生中風的危險性較大。如果你知道或懷疑自己患有房顫，應立即求醫。醫生會幫你決定如何最好地控制病情。Atrial fibrillation is a type of rapid irregular heartbeat. People with this condition have a greater risk of stroke. If you know or suspect you may have atrial fibrillation it is important you see your doctor, who will help you decide the best way to manage this problem.
其他危險因素 Other Risk Factors﹕
8. 服用避孕藥 (Taking the contraceptive pill)
口服避孕藥可能增加中風的可能性。避孕藥會使血液變稠並較容易形成血栓，患高血壓的機會因此增加。高血壓患者和吸煙者如果服用避孕藥，發生中風的危險性就更大。請向醫生諮詢有關事宜，這非常重要。Taking oral contraceptives can increase your risk of stroke. The Pill makes the blood stickier and more susceptible to forming clots and increases the chance of high blood pressure. If you have high blood pressure or smoke and take the Pill your risk increases. It is important to discuss these things with your doctor who will be able to advise you on the risks and benefits.
小中風 (又叫短暫性缺血發作，簡稱TIA’S) MINI STROKES
部分中風發生得非常突然，但也會有預兆，其中最常見的預兆即是小中風或TIA’S。短暫性缺血發作 (TIA’S) 的症狀與中風很相似，只是前者持續不到24小時。(症狀如果持續 24 小時以上，則叫中風。)
Some strokes are very sudden but there can be warning signs. Usually the warning is in the form of a mini stroke or Transient Ischaemic Attack (TIA). Transient Ischaemic Attack symptoms are very similar to those of a stroke but last for less than 24 hours (symptoms lasting longer than 24 hours are called a stroke).
- ‧ 臉部或肢體 (特別是一側肢體) 麻木､震顫或癱瘓
- ‧ 突發性一支眼睛或雙眼視力模糊
- ‧ 突發性語言不利或理解遲鈍
- ‧ 突發性頭暈､失去平衡､動作不利
- ‧ 突發性劇烈頭痛，通常在頭部一側或向下靠近頸部位置
- ‧ 短暫昏厥
- ‧ 短暫糊塗
Anyone with these symptoms should see a doctor immediately. Common symptoms include:
- • Numbness, tingling, paralysis of face, arm or leg especially on one side of the body
- • Sudden blurred or limited vision in one or both eyes
- • Sudden difficulty speaking or understanding what others are saying
- • Sudden dizziness, loss of balance, difficulty with movements
- • Sudden intense headache, often on one side or down the neck
- • Brief spell of fainting
- • A brief episode of confusion
Risk factors multiply:
If you have two or more risk factors for stroke then your risk of stroke multiplies.
吸煙 + 高血壓 = 發生中風的危險性比常人高 18 倍以上
• Smoking + high blood pressure = risk of at least 18 times higher than normal
吸煙 + 高血壓 + 另一項中風因素 = 發生中風的危險性大大增加
• Smoking + high blood pressure + one other factor will increase the risk significantly more
• If you have four or more risk factors you are sitting on a bomb!
Getting rid of even one risk factor will significantly reduce your chance of having a stroke over the next few years.