facial puffiness
Introduction
Introduction When the body increases too much water and does not discharge, it is edema. At the same time as weight gain, there will be eyelid swelling, ankle or calf edema. Most of the edema is caused by kidney or heart disease. However, sometimes ascites from liver disease, malnutrition caused by insufficient protein, or hormonal abnormalities of menopausal disorders can cause edema. If the edema starts from the face and then expands to the whole body, there is a high possibility of suffering from kidney disease, but it may also be acute nephritis or kidney disease.
Cause
Cause
There are kidney glomerulonephritis caused by immune injury and pyelonephritis related to bacterial infection. In addition, patients with diabetes, hypertension, and systemic lupus erythematosus often have kidney disease, which causes facial edema. Heart diseases such as heart Decay, liver diseases, endocrine diseases, gynecological endocrine metabolism, etc. can also cause facial edema.
Examine
an examination
Related inspection
Electrocardiogram, liver function test, urine routine blood glucose
The current situation is that it is necessary to actively judge according to the original disease, so that the inspection will be targeted.
For example, the heart needs to check the electrocardiogram, myocardial enzymes, heart color ultrasound and so on.
The kidney needs to check urine routine, B-ultrasound, and renal function.
The liver needs to check the liver function, liver and gallbladder B ultrasound.
For endocrine diseases, you need to check fasting blood sugar, thyroid hormone, rheumatoid factor and so on.
Diagnosis
Differential diagnosis
Common symptoms of kidney disease are edema, high blood pressure, low or no urine, polyuria, frequent urination, hematuria, increased foam in the urine, back pain and other systemic symptoms.
(1) Edema: often occurs in the eyelids, athlete's foot and back buttocks. In severe cases, it may be accompanied by pleural effusion, ascites and perineum (scrotum, labia) edema. If the skin is damaged, the edema fluid can overflow. The position of the edema can move with the change of body position. For example, the soft tissue around the eyelid is most obvious when lying down, and the depression can be found in the medial malleolus after standing or sedentary. Edema is accompanied by oliguria and weight gain. Severe patients with systemic edema can be as high as 20-30L, so to identify edema, it is advisable to get up every day after emptying, urinating, fasting to measure weight, observe daily changes.
(2) Hypertension: Kidney patients should pay attention to check blood pressure when they seek medical treatment. If blood pressure rises, it is often aggravated by the condition. On the other hand, patients with hypertension should also pay attention to check urine routine, observe the relationship between blood pressure changes and urine protein increase and decrease, so that doctors can identify hypertension caused by kidney disease or kidney damage caused by high blood pressure.
(3) oliguria or no urine: adult 24-hour urine volume less than 400ml (or less than 15-20m1 per hour) called oliguria, less than lOOml called anuria. At this time, the kidneys have been unable to excrete the body's metabolic wastes and toxins from the urine, unable to regulate the stability and balance of water, electrolytes and the internal environment, and should be urgently consulted by a doctor.
(4) polyuria and nocturia: more than 2,500 ml of urine per day and night is called polyuria. If there is no drinking water, no diuretic drugs, no diabetes, no kidney system other factors such as diabetes insipidus, polyuria is a manifestation of tubular insufficiency. Normal people have a certain amount of urine during the day and night. The amount of urine in the day should be more than that in the night. The ratio is 2 to 3:1, and the nocturia should not exceed 750 ml. If nocturia increases, the ratio of day to night urine volume changes, which is also a manifestation of renal tubular dysfunction. If the examination reveals a decrease in urine specific gravity and urine permeation concentration, Chinese medicine believes that the occurrence of this phenomenon is caused by weak kidney, subordinates, and no power.
(5) urinary frequency: frequent urination refers to the number of urination, but the amount of urine is very small each time, urgency refers to unable to hold urine; dysuria refers to urinary tract and abdominal pain when urinating, more common in cystitis.
(6) Hematuria: It is caused by blood glomeruli, renal tubules or roads mixed with urine. If the amount of bleeding is large, no auxiliary tools are needed, and the naked eye can detect the gross hematuria; the amount of bleeding is small, the naked eye can not be seen, and the sediment smear is taken after centrifugation and sedimentation, and the microscopic hematuria can be found by microscopic observation. It is generally believed that gross hematuria is more common in urological diseases such as stones and tumors, and microscopic hematuria is mostly caused by glomerular diseases.
(7) Increased foam in the urine: it is a manifestation of a large amount of protein in the urine. At this time, urine routine and 24-hour urine protein quantitative examination should be performed.
(8) low back pain: paroxysmal severe low back pain, even along the lateral abdomen to the inner side of the perineal thigh, or with vomiting, known as "renal colic", more common in renal pelvis or ureteral stones, at this time to observe the presence or absence of hematuria. In pyelonephritis, low back pain is often accompanied by fever. The kidney area (the back of the ribs on the back side of the back, that is, the back waist) has sputum pain. Urine tests can detect leukocytosis, and urine culture has bacterial growth. Most of the glomerular diseases are only discomfort in the waist, dull pain, or only the backache.
(9) Others: If there is mental wilting, loss of appetite, soft limbs, pale complexion, anemia, etc., the possibility of chronic renal failure should be considered. It is advisable to do blood and urine tests in time. It begins to swell from the face and then expands to the whole body.
