Obliterating endarteritis ntawm qis extremities yog ib yam kab mob txaus ntshai heev, tsis quav ntsej cov tsos mob uas tuaj yeem ua rau txiav txiav. Hmoov tsis zoo, nyob rau hauv thawj theem, thaum kev kho mob zoo tshaj plaws, pathology xyaum tsis tshwm sim nws tus kheej, uas ua rau nws nyuaj rau kev kuaj mob. Endarteritis yog yooj yim tsis meej pem nrog rau lwm yam kab mob, xws li ib tug teeb meem tshwm sim ntau zaus nyob rau hauv cov txiv neej (nws muaj peev xwm txawm yuav hais tau tseeb hais tias feem ntau cov poj niam muaj zog raug kev txom nyem los ntawm obliterating endarteritis).
Kev piav qhia tus kab mob
Obliterating endarteritis ntawm cov extremities yog ib tug kab mob inflammatory ntawm cov hlab ntsha uas yog ib tug mob ntev. Raws li qhov tshwm sim ntawm cov txheej txheem pathological, cov txheej txheem ntawm cov ntshav tau cuam tshuam, uas nws thiaj li ua kom tiav cov hlab ntsha lumen thiab tsim cov gangrene. Raws li txoj cai, qhov mob yog nyob rau hauv cov hlab ntsha ntawm ob txhais ceg thiab ko taw.
Raws li tus kab mob no zuj zus, oxygen tsawg nkag mus rau ob txhais ceg, uas ua rau muaj kev puas tsuaj rau cov ntaub so ntswg, cuam tshuam kev ua haujlwm ntawm lub cev thiab lawv cov necrosis. Feem ntau cov txiv neej raug kev txom nyem los ntawm no pathology. Qhov piv ntawm cov txiv neej cov neeg mob rau cov poj niam uas muaj tib yam kev kuaj mob yog 99: 1. Obliterating endarteritis ntawm qis extremities yog ib qho ntawm feem ntau ua rau txiav txiav ceg nyob rau hauv kuj noj qab nyob zoo, hluas thiab muaj peev xwm-bodied txiv neej.
Qee zaum, tus kab mob no yuam kev tsis meej pem nrog atherosclerosis obliterans. Cov tsos mob ntawm obliterating endarteritis thiab atherosclerosis zoo sib xws, tab sis cov kab mob muaj ntau yam sib txawv ntawm qhov tshwm sim. Yog li, endarteritis feem ntau cuam tshuam rau ib pawg neeg ntawm cov hluas (txij li nees nkaum mus rau plaub caug xyoo), nyob rau hauv cov hlab ntsha ntawm ob txhais ceg thiab ko taw. Obliterating atherosclerosis yog qhov tshwm sim ntawm cov kab mob atherosclerosis, nws tau txiav txim siab hauv cov neeg laus, cuam tshuam rau cov hlab ntsha loj thiab nthuav dav.
Tus kab mob ze tshaj plaws rau obliterating endarteritis ntawm extremities yog thromboangiitis, los yog Buerger's kab mob. Qhov no pathology cuam tshuam rau cov txiv neej ntawm nruab nrab hnub nyoog qeb. Cov neeg mob feem ntau kuaj pom tus kab mob no yog cov neeg haus luam yeeb hnyav. Cov kab mob uas tau teev tseg saum toj no tsuas yog kho tau zoo nyob rau theem pib. Hauv cov theem tom qab, tsuas yog kev txiav caj dab tuaj yeem pab tau.
Caus of endarteritis
Daim ntawv teev npeCov zej zog kho mob tseem tsis tau tsim cov laj thawj lossis muaj feem cuam tshuam rau obliterating endarteritis. Nws tsis tuaj yeem tshawb pom qhov tseeb tias qhov tshwm sim ntawm tus kab mob tshwm sim hauv ib tus neeg twg. Nws paub tias lub cev tsuas yog pib tsim cov tshuaj uas ua rau cov phab ntsa ntawm nws cov hlab ntsha puas. Tom qab ntawd, cov txheej txheem inflammatory tshwm sim hauv lawv. Tom qab ntawd, cov ntaub ntawv sib txuas ntawm cov chaw cuam tshuam, nqaim qhov khoob. Cov laj thawj ntawm kev tsim cov tshuaj tiv thaiv zoo li no tseem tsis tau nkag siab tag nrho.
Tsuas muaj kev xav txog qhov ua rau obliterating endarteritis ntawm extremities. Nws feem ntau lees paub tias pathology tshwm sim vim muaj ntau yam kab mob uas tsis kho, tawm tsam keeb kwm ntawm atherosclerosis ntawm ob txhais ceg, ntau hom ntshav txhaws, lossis raws li qhov tshwm sim ntawm kev tsis haum rau nicotine hauv cov neeg haus luam yeeb hnyav. Nws paub tias cov neeg haus luam yeeb feem ntau raug rau mob endarteritis.
Pathology tuaj yeem tsim tawm tsam keeb kwm yav dhau los ntawm lub sijhawm ntev lossis luv luv, tab sis muaj kev ntxhov siab heev, nrog rau qhov tsis zoo ntawm ob txhais ceg. Cov pab pawg muaj kev pheej hmoo suav nrog cov uas tau txais frostbite ntawm lawv ko taw. Tsis tas li ntawd, raws li twb tau hais lawm, cov txiv neej yog nquag mus obliterating endarteritis. Kev kis kab mob ntev, kev raug mob rau cov ceg, kev ua haujlwm tsis zoo ntawm cov qog adrenal thiab cov kab mob hauv nruab nrog cev, thiab kev txo qis ntawm cov lymphocytes hauv cov ntshav ua rau lub sijhawm ntev ntawm cov hlab ntsha (uas yog ib qho kev pheej hmoo).
Pathogenesis ntawm tus kab mob
Thaum ntxov tshaj plaws ntawm kev loj hlob ntawm tus kab mob, tsuas yog vascular spasms xwb. Qhov no yog nrog los ntawm ib tug thickening ntawm lub internaldaim nyias nyias ntawm cov phab ntsa vascular, kev hloov pauv pathological. Tom qab ntawd, cov teeb meem trophic tshwm sim, cov txheej txheem degenerative uas ua rau kom nqaim lossis ua tiav qhov txhaws ntawm lumen ntawm cov hlab ntsha. Qhov ntev ntawm thaj chaw pathological tuaj yeem yog los ntawm ob mus rau nees nkaum centimeters.
Lub network uas tsim nyob ib puag ncig thaj chaw puas tsuaj no tsis tas muab cov ntaub so ntswg ua haujlwm raws sijhawm. Tom qab ntawd, circulatory tsis ua haujlwm tshwm sim. Ib tug neeg raug kev txom nyem los ntawm obliterating endarteritis, nyob rau theem no ntawm txoj kev loj hlob ntawm tus kab mob, pib pom limp, mob hnyav tshwm sim. Yog tias ua ntej lawv tau pom tsuas yog nrog kev thauj khoom ntau dhau, tam sim no lawv tuaj yeem tshwm sim thaum taug kev (khiav, qoj ib ce), thiab so. Tawm tsam keeb kwm ntawm tus kab mob hauv qab, neuritis (ischemic) tsim.
Nyob rau hauv cov ntaub ntawv ntawm obliterating endarteritis, kws kho mob txawv plaub theem. Thaum xub thawj, dystrophic hloov nyob rau hauv lub paj hlwb xaus pib tsim. Tsis muaj cov tsos mob tshwm sim, yog li nws tseem tsis tuaj yeem pib kho mob ntawm obliterating endarteritis ntawm qis extremities nyob rau theem no. Txhua yam kab mob uas tuaj yeem ua rau tib neeg xav txog kev loj hlob ntawm tus kab mob yog them los ntawm cov ntshav ncig.
Nyob rau theem thib ob, vasospasm nrog rau qhov tsis muaj ntshav txaus thiab tsis muaj peev xwm rov ua kom rov qab los ntawm kev siv nyiaj hauv lub cev. Cov theem ntawm tus kab mob no yog yus muaj los ntawm xws li kev kho mob tshwm sim raws li txias taw yuav luag ntawmtxhua qhov kub thiab txias, qaug zog, mob ib ntus thiab lameness tshwm sim.
theem thib peb yog tus cwj pwm los ntawm kev cuam tshuam trophic hauv cov txheej ntawm phab ntsa vascular. Lub pulsation nyob rau hauv cov hlab ntsha yog tsis muaj zog. Mob tam sim no tshwm sim nyob rau hauv ib qho chaw ntsiag to. Qhov thib plaub theem yog tag nrho thrombosis ntawm cov hlab ntsha. Cov theem no yog irreversible, tus neeg mob tsim cov ntaub so ntswg necrosis thiab gangrene ntawm limb. Tsis muaj tshuaj los yog lwm yam kev kho mob uas tsis yog-radical yuav tso tseg cov pathology. Tsuas yog kev txiav caj dab yuav pab tau rau theem plaub.
Kev faib kab mob
Hauv kev txiav txim siab ntau, cov tsos mob ntawm obliterating endarteritis ntawm qis extremities txawv me ntsis nyob ntawm seb hom kab mob, tab sis qhov no cuam tshuam rau qhov mob hnyav. Nrog rau daim ntawv txwv, tsuas yog cov hlab ntsha ntawm cov leeg sab nraud raug cuam tshuam, tus kab mob no maj mam zuj zus, uas ua rau nws muaj peev xwm ua tau raws li kev ntsuas tsim nyog hauv lub sijhawm. Generalized endarteritis cuam tshuam tsis tsuas cov hlab ntsha, tab sis kuj cov ceg ntawm lub aorta, cerebral thiab coronary arteries.
Raws li qhov mob hnyav npaum li cas, muaj plaub theem ntawm limb ischemia thaum obliterating endarteritis. Thaum xub thawj, qhov yooj yim tshaj plaws, tus neeg mob xav tias tsis xis nyob thaum taug kev deb ntawm ib mais lossis ntau dua. Ntawm tus neeg mob thib ob tuaj yeem taug kev ntau dua 200 m (theem II A) lossis tsawg dua (theem II B) ua ntej pib mob. Nyob rau hauv lub thib peb degree, ua ntej qhov pib ntawm qhov mob, nws muaj peev xwm mus taug kev ib tug deb ntawm txog 25 m. Nws kuj yog tus yam ntxwv ntawm qhov mob thaum so. Qhov thib plaub theem yog tus cwj pwm los ntawm kev tsim ntawm necrotic tsis xws luag thiab tsis xis nyob tas li, uas nce nrog cov load ntawm ob txhais ceg. Cov duab ntawm obliterating endarteritis nyob rau theem siab yog shocking.
Symptoms of endarteritis
Cia peb mus rau cov tsos mob thiab kev kho mob ntawm obliterating endarteritis ntawm qis extremities. Thaum xub thawj, tus neeg mob pib hnov mob me ntsis nrog kev tawm dag zog ntau dhau, qaug zog tshwm sim, mob plab hauv plab thiab ko taw, thiab cov ntiv taw ua loog. Ntau tus neeg tau txias taw. Qee zaum, nyob rau theem no, cov ntshav txhaws pib tsim nyob rau hauv cov hlab ntsha ntawm sab qis. Nyob rau hauv lub neej yav tom ntej, tag nrho cov tsos mob saum toj no hnyav, mob tshwm sim thaum taug kev, qee zaum lameness tuaj yeem pom. Tus neeg mob twb yuam kom so so thaum taug kev.
Feem ntau, qhov mob yog tsom rau thaj tsam ntawm cov ntiv tes, ob txhais taw, hauv cov leeg ntawm sab ceg. Cov tawv nqaij tuaj yeem qhuav heev, tev tawm, tau txais cov xim xiav. Toenails pib loj hlob qeeb, deform, tawg thiab exfoliate. Tej zaum yuav muaj plaub hau poob ntawm ob txhais ceg. Lub pulsation ntawm cov hlab ntsha yog xav tias tsis muaj zog. Tom qab ntawd qhov mob pib mob heev thaum hmo ntuj, cov leeg nqaij atrophy, daim tawv nqaij o, trophic ulcers tuaj yeem tsim ntawm ko taw thiab ntiv tes. Cov ntshav ntws hauv cov hlab ntsha ntawm ko taw tsis tau txiav txim siab ntxiv lawm.
Thaum kawg ntawm txoj kev loj hlob ntawm tus kab mob, gangrene ntawm qis extremities raug kuaj. Qhov pib ntawm pathology yog txuam nrog kev cuam tshuam tsis zoo ntawm lwm yam (piv txwv li, tshwm sim los ntawm kev txiav los yogqhov txhab, ua txhaum ntawm kev ncaj ncees ntawm daim tawv nqaij) ntawm cov kab mob uas twb muaj lawm. Gangrene feem ntau cuam tshuam rau cov ntiv tes thiab ko taw, qee zaum kis mus rau ob txhais ceg. Toxemia, uas loj hlob sai nrog gangrene, yuav tsum tau txiav tawm ntawm ceg ceg.
Kev kuaj kab mob
Kev kuaj mob ntawm obliterating endarteritis muaj ntau txoj hauv kev. Tus kws kho mob yuav sau ib qho anamnesis, ua ib qho kev ntsuam xyuas los txheeb xyuas cov ntshav tsis txaus rau cov ceg. Thermography, angiography, rheovasography, ultrasound, oscillography thiab cov txheej txheem zoo sib xws pab tsim kev kuaj mob. Txhawm rau txhawm rau vascular spasms, parrentral blockade yog ua.
Kev kho mob endarteritis
Nyob rau theem pib, kev kho mob ntawm obliterating endarteritis ntawm extremities yog ua tau nrog tshuaj. Kev kho mob, raws li txoj cai, lub hom phiaj txhawm rau tshem tawm cov txheej txheem inflammatory, txo qis ntawm cov phab ntsa vascular, txhim kho cov ntshav ncig thiab tiv thaiv thrombosis. Antispasmodics (nicotinic acid los yog Drotaverine), tshuaj tua kab mob thiab tshuaj tiv thaiv kab mob, corticosteroids, vitamin complexes (vitamin E, C, B yog tshwj xeeb tshaj yog pab tau), anticoagulants yog siv raws li ib feem ntawm cov chav kawm. Intra-arterial txhaj ntawm alprostadil tau qhia.
Kev kho mob zoo thiab balneological, physiotherapy, oxygenation. Hydrosulfide, coniferous, radon da dej, ko taw da dej, electrophoresis, ozocerite daim ntaub ntawv tuaj yeem nqa tawm ntawm kev kho mob spa. Ib qho yuav tsum tau ua ua ntej rau kev kho kom zoo yog tus neeg mob tsis kam haus luam yeeb tag.nyob rau hauv txhua daim ntawv.
Kev phais rau obliterating endarteritis yog qhia rau mob hnyav, mob hnyav uas tshwm sim thaum so. Kev cuam tshuam tuaj yeem ua rau palliative, uas yog, txhim kho txoj haujlwm ntawm cov hlab ntsha, lossis rov tsim kho. Nyob rau hauv tas li ntawd, cov kws kho mob rov qab impaired ntshav ncig. Cov haujlwm zoo li no yuav cuam tshuam txog kev hloov ntshav, tab sis tsis tshua ua. Qhov taw qhia rau kev txiav tawm yog kev loj hlob gangrene. Yog hais tias tus necrosis muaj ib txoj kab meej ntawm demarcation, necrectomy los yog amputation ntawm ib feem me me ntawm lub limb yuav raug txwv.
kev kho neeg zoo
Txhawb kev kho mob ntawm obliterating endarteritis yog ua tau nrog kev pab ntawm lwm yam tshuaj. Cov kev kho neeg zoo tiag tiag yuav tsuas yog nyob rau hauv thawj theem ntawm kev loj hlob ntawm tus kab mob, thiab txawm tias tom qab ntawd lawv yuav tsum tau siv tshwj xeeb hauv kev ua ke nrog cov tshuaj "tswj hwm" uas tau sau los ntawm tus kws kho mob. Kev kho mob ntawm obliterating endarteritis nyob rau hauv tsev yog nqa tawm nrog decoctions ntawm cov tshuaj ntsuab tshuaj uas muaj cleansing zog, tiv thaiv o, restore phab ntsa ntawm cov hlab ntsha, ntxiv dag zog rau lawv.
Nws tuaj yeem pab tau, piv txwv li, ib phau ntawm St. John's wort, chamomile, yarrow, pob kws stigmas thiab birch buds. Cov tshuaj qhuav qhuav (lawv tuaj yeem yuav ntawm txhua lub tsev muag tshuaj) yuav tsum tau noj hauv qhov sib npaug. Koj yuav xav tau ib lub khob iav nrog lub hau kaw ntom ntom. Ib tablespoon ntawm sau yuav tsum tau nchuav nrog 0.5 liv ntawm boiled dej xwb. Qhov sib tov yog infused rau 30 feeb. Zib ntab tuaj yeem ntxiv rau cov tshuaj ntsuab no. Haus cov dej txias yuav tsum yog thaum sawv ntxov thiab yav tsaus ntuj, 30 feeb ua ntej noj mov. Cov txiaj ntsig zoo tshaj plaws tuaj yeem ua tiav yog tias koj haus cov decoction hauv cov chav kawm: noj cov tshuaj rau ib hlis, so rau lub hlis tom ntej.
Txhawm rau npaj lwm cov tshuaj kho, koj yuav xav tau horsetail (40 grams), hawthorn (100 grams) thiab roob roob (60 grams). Ib nrab ib tablespoon ntawm xws li qhuav sib tov yuav tsum tau nchuav nrog ib khob dej (boiling). Cov tshuaj pej xeem yuav infused rau ib nrab ib teev. Tom qab nws koj yuav tsum tau haus ib chav kawm ntawm ib lub hlis. Haus ib tablespoon 30 feeb ua ntej noj mov, peb zaug hauv ib hnub.
Dill noob, Japanese sophora, mistletoe dawb, helichrysum yog qhov zoo rau kev ntxuav cov hlab ntsha. Nws raug nquahu kom ntxuav cov hlab ntsha rau 3-5 hnub ua ke kom haus cov tshuaj yej muaj zog nrog mis nyuj txhua ob peb teev. Tsis tu ncua qos yaj ywm broth thiab citrus sib tov yuav pab tau. Cov tom kawg yog npaj los ntawm lemons thiab txiv kab ntxwv. Citruses (ib zaug ib zaug) yuav tsum tau crushed nyob rau hauv ib tug blender, ntxiv ib teaspoon ntawm zib mu mus rau puree, sib tov, hloov mus rau ib lub khob hub. Cov tshuaj no (peb teaspoons) yuav tsum tau noj ib hnub ib zaug ua ntej noj mov.
Kev siv xiav iodine zoo heev. Ib tug teaspoon ntawm starch yuav tsum tau diluted nyob rau hauv 50 ml ntawm dej, ntxiv ib teaspoon suab thaj, ib tug pinch ntawm citric acid mus rau qhov sib tov. Ntxiv 150 ml ntawm boiling dej (li peb lub hlis twg ntawm ib khob). Thaum cov tshuaj pej xeem tshuaj tau txias, koj yuav tsum tau ntxiv ib teaspoon ntawm iodine (5%) nyob rau ntawd. Haus ib tablespoon ib hnub ib zaug. Iodine tshem tawm cov cholesterol los ntawm cov ntshav, ntxuav cov hlab ntsha,ntxiv dag zog rau lub plawv cov leeg thiab ntxiv dag zog rau lub cev tiv thaiv kab mob. Xws li ib tug muaj pes tsawg leeg yuav tsum tau siv nrog ceev faj, raws li nws yuav ua rau muaj kev tsis haum tshuaj. Yog qhov no tshwm sim ces koj yuav tsum tso tseg txoj kev kho pej xeem no.
Tus kws kho mob kwv yees
Qhov xwm txheej rau kev txhim kho ntawm obliterating endarteritis nyob rau hauv txhua rooj plaub yog nyob ntawm kev tshem tawm cov kev cuam tshuam tsis zoo ntawm provoking yam, txo qis ntawm kev raug mob thiab ntau yam kev raug mob ntawm cov leeg qis, kev tsis tu ncua ntawm kev kho tshuaj thiab kev soj ntsuam los ntawm tus kws phais mob vascular.. Nyob rau hauv cov xwm txheej zoo, nws muaj peev xwm tswj tau qhov kev zam txim rau lub sijhawm ntev thiab zam kom tsis txhob kis tus kabmob. Txwv tsis pub, kev txiav caj dab caj dab yog kev zam.
tiv thaiv kab mob
Txhawm rau tiv thaiv kev loj hlob ntawm tus kab mob lossis txo tus nqi ntawm nws kis, koj yuav tsum ua raws li ob peb txoj cai. Nco ntsoov categorically tsis txhob haus luam yeeb, nws yog ntshaw kom tsis txhob haus cawv. Tsis txhob tso cai hypothermia lossis frostbite ntawm ob txhais ceg, tsis txhob nyob hauv chav txias ntev.
Cov zaub mov qab ntsev, ntsim thiab rog dhau yuav tsum tsis suav nrog kev noj haus. Feem ntau, nws yog qhov zoo dua los ua raws li cov cai ntawm kev noj qab haus huv ntawm kev noj qab haus huv - qhov no yuav pab txo qis kev pheej hmoo ntawm ntau yam kab mob. Tsis tas li ntawd, kev ua kis las muaj txiaj ntsig zoo, tab sis nws yog ib qho tsim nyog los tiv thaiv ob txhais ceg ntawm bruises thiab lwm yam kev raug mob. Hais txog kev ua si lub cev, qhov tseem ceeb tshaj plaws yog khiav, ua luam dej thiab caij tsheb kauj vab. Tseeb tiagtaug kev ntev tau pom zoo.
Koj yuav tsum tau xyuam xim rau kev xaiv khau. Ko taw yuav tsum tsis txhob khov, hws, raug nyem. Daim tawv nqaij yuav tsum ua pa. Yog tias ua tau, koj yuav tsum xaiv cov khau zoo ua los ntawm cov khoom siv ntuj tsim, xis nyob. Nws yog ib qho tsim nyog yuav tsum muaj tsawg kawg yog ob nkawm khau ntawm ib qho kev hloov pauv kom tsis txhob hnav cov khau ntub thiab qhuav tsis nyob rau hauv nruab nrab cua sov radiators, tab sis nyob rau hauv ib tug natural txoj kev.
Txhua hnub koj yuav tsum ntxuav koj txhais taw nrog dej sov thiab xab npum. Nyob rau tib lub sijhawm, nws raug nquahu kom siv cov tshuaj pleev ib ce nourishing ko taw. Nws yog qhov zoo los thov nws ua ntej mus pw, thiab muab cov thom khwm sov rau saum.
Txhua yam kev ua haujlwm saum toj no yuav pab ua kom qeeb qeeb ntawm tus kabmob, yog tias nws twb tshwm sim lawm. Tsis tas li ntawd, ib zaug kuaj pom, kev kho mob tsim nyog yuav tsum pib tam sim.
