回應文章 - 有關中風管理
1. Never delay expert medical care by WM Chan
Pl see the following comments from a consultant
in Accident & Emergency care. My advice is that, with
the excellent ambulance service and good network of public
hospitals in HK, never delay expert medical care. Always call
the ambulance when in doubt, and that includes minor strokes
or what we call TIA(transient ischaemic attacks : any inability
of movement of limb, even if transient, should be regarded
as possible sign or prodromal of stroke)
WM
Thank you.
I have seen this message before. I believe it comes from someone
who have great faith in traditional Chinese medicine but lacking
the knowlegde of pathophysiology of cerebrovascular accident,
There are several obvious mistakes in this 'theory'
1. The 'theory assumed that all stroke are due to haemorrhage,
but in fact , 85% of stroke are ischemic stroke, only 15%
are haemorrhagic stroke.
2. In Ischaemic stroke, it is established that quick access
to CT brain to exclude haemorrhage so that thrombolytic therapy
can be given within 3 hours can minimze the degree of brain
damage, and improve survival and preserve neurological function,
thus even if the 'theroy' was correct for haemorrhagic stroke,
the delay in sending the patients to hospital will cause further
harm to at least 85% of stroke patients.
3. It has never been established that passive movement of
a person will cause increase in blood pressure, furthermore,
our brain has the amazing auto-regulation which will maintain
a steady pressure inside the brain even during our vigarous
physical exercise state. It is highly imaginative to think
that passsive movement of transporting the patient by ambulance
will overwhelm such auto-regulation.
4. Inflicting pain by puncturing the finger tips will definately
casue more adrenalin secretion then moving the patient, and
the adrenalin so secreted will more likely cause incrtease
BP and bleeding than moving the patient. The rate of bleeding
depends on BP which of course also depends on blood volume.
The effect of releasing blood (cause decrease in blood volume)
through finger tip will be extremely insignificant.
5. The so call successful experience deserve no discussion
at all because many stroke aptient will have spontaneous partial
or full recovery by themselves, we call it minor stroke.
回應文章 - 有關中風管理
2. Consult private expert doctors instead by
MY Lau
Dear All,
This is my advice on stroke management:
Consult private expert doctors instead of going to public
hospitals--in order not to delay medical care. My mother was
rushed to a public hospital after she suffered from stroke,
and was given a scan only on the following day after she was
transferred to another hospital--a delay of one and a half
day.
She suffered 4 years in bed after that--later I learn from
some friends with similar experience to learn that it is not
advisable to consult public hospitals. Delay often cause the
patient great suffering, suffering which could be cured IF
THEY ARE GIVEN PROPER CARE IN TIME.
I hope I am not offending public hospital workers, this is
my horrible and sad experience and my mother's case is in
no way an exception.
Regards,
Mun Yee
中風急病治療重要是盡快醫
剛外遊回來。如何應付中風,那位急症科醫生已詳細指出原文的謬誤,毋須贅言。中風急病治療重要是盡快醫及找專科(腦神經內科)。預防則更為重要,可惜很多人都不重視自己的日常照料。至於私家或公立則無一定,公立服務的確差參差不齊。但今年起多家公立都應設立了加快中風診斷服務。
黃震遐
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