Vascular disease
Introduction
Introduction to vascular disease Vascular disease, also known as peripheral vascular disease, is clinically referred to as vascular disease other than cardiovascular and cerebrovascular diseases, including diseases of the three systems of arteries, veins and lymph. Common vascular diseases include phlebitis, vasculitis, varicose veins, lower extremity arteriosclerosis obliterans, and Raynaud's syndrome. According to the World Health Organization, peripheral vascular disease is a highly harmful and highly irritating species. If it is not cured for a long time, the condition will progress progressively, and severe cases will lead to amputation and disability, and even life-threatening. basic knowledge Proportion of disease: according to different vascular diseases, the proportion of illness is different Susceptible people: no specific population Mode of infection: non-infectious Complications: venous thrombosis, lower extremity venous thrombosis, pulmonary embolism
Cause
Cause of vascular disease
1, congenital reasons: the patient's valve may be born with some minor problems, coupled with acquired stress, it will form varicose veins.
2, drug stimulation: intravenous input strong irritant, high concentration of drugs or long-term use, damage to venous endothelial cells, superficial varices, blood stasis.
3, other adverse stimulating factors: obesity, smoking, trauma caused by venous endothelial injury, bacterial infections. After venous intimal injury, a thrombus is formed, which quickly leads to inflammation of the entire superficial vein wall, even involving the surrounding tissue of the vein, and there is exudate, localized pain, swelling and tenderness of the cord-like hard or beaded induration The systemic response is not obvious.
Prevention
Vascular disease prevention
1, first of all to prevent cold and warm, especially the limbs.
2, diet, living, there must be regular. Eat less or not sticky foods, such as glutinous rice noodles, rice cakes, sesame sugar and the like.
3, should quit smoking and alcohol, to avoid mood fluctuations, to prevent overwork and strenuous exercise.
4, the daily diet should be light, eat more fresh vegetables, fruits and other foods rich in vitamins.
5, should participate in appropriate fitness exercises. It is especially important to find the initial symptoms in time to go to the hospital for examination, and actively treat, to achieve early detection and early treatment.
Complication
Vascular disease complications Complications, venous thrombosis, lower extremity venous thrombosis, pulmonary embolism
1. Edema: The symptoms of edema are not obvious, and it is aggravated at night and has a feeling of pain.
2, skin pigmentation: long-term venous hypertension leads to increased capillary permeability in the calf, rupture of red blood cells after exudation, deposition of erythropoietin under the skin, making the skin black, from point to sheet.
3, bleeding: varicose veins patients with very fragile skin, it is prone to rupture of varicose veins and cause massive bleeding.
4, ulcers: the most common consequence of varicose veins is the varicose veins caused by skin nutrition changes leading to ulcers, such ulcers can be long-lasting, local malodorous pus, will have a serious impact on daily life.
5, venous thrombosis: some patients can form a thrombus in the superficial vein of varicose veins, manifested as local redness and swelling, hard block formation, pain affects walking. If left untreated, the thrombus may spread to the deep veins up or through the traffic vein, causing deep vein thrombosis, and the risk of life-threatening pulmonary embolism.
Symptom
Symptoms of vascular disease Common symptoms Limb pain The anterior medial side of the leg appears to be abnormal skin part of the skin... Muscle atrophy Skin tenderness Limb ulcer Skin necrosis Skin wet cold thigh Capillaries obvious
Phlebitis: (full name thrombophlebitis) refers to acute aseptic inflammation of venous blood vessels. According to different lesions, phlebitis can be divided into superficial phlebitis and deep phlebitis. A small number of patients may have fever, increased total white blood cells, etc., patients often complain of pain and swelling. Causes of venous thrombosis are many, such as trauma, surgery, pregnancy, childbirth, heart disease, malignant tumors, oral contraceptives and long-term standing, squatting, sedentary, long-term, etc., more common is the disease caused by surgery .
Varicose veins: If simple superficial varicose veins of the lower extremities, the general clinical symptoms are mild, the progress is slow, and more often manifest as simple varicose veins. In a few cases, there may be thrombophlebitis, venous ulcers, etc.; if deep venous valve insufficiency, Even if the deep venous return is blocked, the condition is relatively heavy, the calf is heavy when standing, easy to fatigue, even swelling and bursting pain of the lower limbs, and later skin nutrient changes, desquamation, atrophy, hyperpigmentation, eczema The formation of ulcers.
Vasculitis: thromboangiitis obliterans. Thromboangiitis obliterans is a rare segmental inflammatory disease of chronic recurrent small arteries and veins, which is more common in lower limbs. It is characterized by ischemia, pain, intermittent claudication, weakened or disappeared pulsation of the dorsal artery, and superficial superficial phlebitis. In severe cases, there are ulcers and necrosis of the extremities.
Lower extremity arteriosclerosis obliterans: generally seen in middle-aged and elderly people, early no obvious symptoms, or only mild discomfort, such as chills, cold and so on. After that, intermittent claudication symptoms gradually appear, which are characteristic symptoms of lower extremity arteriosclerosis obliterans. After walking for a certain distance, the affected limbs are fatigued and sore, and they are forced to rest for a period of time; after the rest, the symptoms can be completely relieved, and the symptoms reappear after walking again. The distance of each walk and the time of rest are generally fixed; in addition, the pain There is a correlation between the site and the location of the vascular lesion. When the lesion develops further, there is a resting pain, that is, there is pain in the extremity when the patient rests, and it is easy to occur when lying down and resting at night. The extremities can have ulcers and gangrene, which are mostly caused by mild limb injuries.
Reynolds Syndrome: A group of syndromes in which the paroxysmal fingers (toes) are pale, purple, and then flushed due to cold or emotional agitation. No special cause is called idiopathic Raynaud's syndrome; secondary to other diseases, it is called secondary Raynaud's syndrome.
Examine
Vascular disease examination
1. Determination of venous pressure: the venous pressure of the affected limb is elevated, suggesting that there is obstruction of the proximal cardiac vein at the lateral pressure;
2, ultrasound: two-dimensional ultrasound imaging can be directly improved to see the conclusion of thrombosis in the large vein, with Doppler to measure the experience of intravenous blood flow velocity, and observe whether the normal leadership reaction of breathing and compression action exists, such inspection is near The diagnostic rate of deep venous thrombosis in the next month can reach 95%; the sensitivity to the diagnosis of distal patients is only 50%-70%, but the specificity can reach 95%;
3, radionuclide health check: 125I fibrinogen scan is used for the diagnosis of children with this disease, contrary to ultrasound examination, the detection rate of deep vein thrombosis in the gastrocnemius can be as high as 90%, and the proximal end The diagnosis of deep vein thrombosis has been poorly specific. The main disadvantage of this test is that it takes 48-72 hours to inject the radionuclide to show the effect.
4. Impedance plethysmography (IPG) and venous flowmetry (PRG): the former uses skin electrodes, the latter uses a pneumatic cuff to measure changes in venous volume under physiological changes, with venous obstruction, with breathing and cuff The amplitude of the volume wave caused by deflation and deflation is small. The positive rate of the diagnosis of the formation of the proximal deep vein snow mountain can reach 90%, and the sensitivity to the diagnosis of the distal is significantly reduced.
5, deep venography
The contrast agent is injected from the superficial vein of the foot, and the cuff is used at the proximal end. It is easy to start the contrast agent directly into the deep venous system. If there is a venous filling defect, the diagnosis and positioning diagnosis can be made. The diagnosis of superficial venous thrombosis is easier, and the signs of local discharge symptoms are more obvious.
Diagnosis
Diagnosis of vascular disease
According to the medical history, local manifestations, obvious morphological features, relevant hematological positive indicators and accurate imaging results, which vascular disease belongs to can be diagnosed. Pay attention to distinguishing each other according to the characteristics of the disease.
