Nyob rau hauv ib tug neeg uas tau haus luam yeeb tau ntau xyoo, dhau sij hawm, nyob rau hauv lub zog ntawm nicotine, cov hlab ntsha nqaim, yog li cov ntshav ntws maj mam mus rau hauv qis extremities. Tsis tas li ntawd, cov tshuaj no ua rau erythrocytes los ua ke, uas ua rau pom cov ntshav txhaws hauv cov hlab ntsha uas thaiv cov ntshav ntws, cov hlwb tsis tau txais cov khoom noj kom zoo thiab tuag. Nyob rau tib lub sijhawm, tag nrho cov khoom nruab nrog cev pib tuag, cov ntaub ntawv gangrene, yog li cov kab mob no tau txiav. Xws li cov kab mob hauv cov tshuaj feem ntau hu ua obliterating endarteritis, thiab nyob rau hauv cov neeg nws yog hu ua "smoker's ob txhais ceg" los yog "tobacco gangrene". Yog li, vim muaj kev mob siab rau kev haus luam yeeb, ib tug neeg ua tsis taus.
Kev piav qhia
Enarteritis yog suav tias yog ib qho kab mob inflammatory uas cuam tshuam rau cov hlab ntsha thiab ua rau cov hlab ntsha tsis zoo, thiabyav tom ntej - mus kaw lub lumen thiab gangrene ntawm qis extremities. Yog li, ob txhais ceg ntawm tus neeg haus luam yeeb tsis tau txais cov pa oxygen los ntawm cov ntshav, cov ntaub so ntswg maj mam cuam tshuam, qhov no ua rau necrosis ntawm ib feem ntawm lub cev. Feem ntau, cov txiv neej hnub nyoog nruab nrab uas haus luam yeeb tas li raug tus kab mob no.
Yog vim li cas
Tam sim no, cov laj thawj tseeb uas ua rau muaj tus kab mob no tsis paub meej. Nws feem ntau lees paub tias tus kab mob ntawm tus neeg haus luam yeeb, uas ob txhais ceg feem ntau cuam tshuam, tshwm sim los ntawm kev tsim cov tshuaj tiv thaiv hauv lub cev, uas muaj kev cuam tshuam rau cov phab ntsa ntawm cov hlab ntsha. Nyob rau tib lub sijhawm, lawv pib ua rau mob, cov ntaub so ntswg tshwm, uas ua rau lub qhov khoob hauv cov hlab ntsha. Vim li cas cov tshuaj tiv thaiv no tsim tawm hauv lub cev, cov kws kho mob tsis tuaj yeem muab cov lus teb meej. Raws li lwm txoj kev xav, tus kab mob tuaj yeem tshwm sim nrog kev ua xua rau nicotine, atherosclerosis, kab mob thiab ntshav txhaws. Nws tsuas yog paub tseeb tias, ua ntej ntawm tag nrho cov, cov neeg haus luam yeeb raug tus kab mob no.
Symptoms
Obliterating endarteritis, lossis "smoker's ob txhais ceg", cov tsos mob yog raws li nram no:
- Hnyav hauv qis qis thaum taug kev, lawv nkees sai.
- Xav txias hauv nqua, o thiab loog.
- Pleness ntawm daim tawv nqaij, deformation ntawm cov rau tes.
- Tsim cov kab mob, necrosis thiab gangrene.
- No mem tes hauv ceg.
- Qhov tshwm sim ntawm convulsions thaum txav thiab so.
- Nruam claudication, uas yog cov tsos mob tseem ceeb ntawm tus kab mob hauv qablub npe "smoker's ob txhais ceg", daim duab uas txuas nrog.
theem kab mob
Obliterating endarteritis tsim maj mam thiab cyclically. Nws yog ib txwm ua kom paub qhov txawv cov theem hauv qab no ntawm kev txhim kho tus kab mob:
- theem pib yog qhov ua rau me ntsis nqaim ntawm lumen ntawm cov hlab ntsha, cov ntshav ncig tsis cuam tshuam. Cov tsos mob ntawm tus kab mob tsis tshwm sim, yog li nws nyuaj heev rau kev kuaj mob nyob rau theem no.
- Theem ischemic yog tshwm sim los ntawm kev ua tsis zoo ntawm cov ntshav ncig, sib cuam tshuam claudication tsim, tus neeg haus luam yeeb ob txhais ceg tau nkees sai thiab yuav luag txhua zaus txias. Kev kuaj mob nyob rau theem no ua rau nws kho tau tus kab mob.
- theem trophic yog tus cwj pwm los ntawm kev ua txhaum ntawm cov pa oxygen thiab cov as-ham rau cov ntaub so ntswg. Cov plaub hau ntog tawm ntawm sab qis, rau tes yog deformed, daim tawv nqaij tig xiav, mem tes tsis hnov. Cov theem no yog ib qho qhia txog tus kab mob uas tau pib lawm.
- Lub rwj-necrotic theem yog tus cwj pwm los ntawm qhov tshwm sim ntawm convulsions, tsis muaj mem tes hauv ob txhais ceg, mob tas li, tsis muaj peev xwm txav tau, cov leeg nqaij atrophy, ntau qhov txhab thiab cov nqaij mos necrosis. Nyob rau theem no, tus kab mob "tus neeg haus luam yeeb ko taw" yog qhov nyuaj los kho, vim nws yuav luag tsis tuaj yeem nres cov txheej txheem kev puas tsuaj.
- Gangrene tshwm sim thaum necrosis thiab rwj tsis kho. Nws yog qhuav thiab ntub. Hauv thawj kis, ob txhais taw thiab ntiv tes tig dub thiab tuag. Hauv qhov thib ob, tus neeg haus luam yeeb ob txhais ceg (daim duab thiab cov lus piav qhia ntawm tus kab mob tsis zoo siab heev) pib o, tso cov co toxins uas lom tag nrho lub cev.kab mob. Txhawm rau tiv thaiv cov ntshav lom thiab kev tuag ntawm tib neeg, cov ceg ceg raug txiav.
Diagnosis
Kev kuaj mob yog ua tau zoo tshaj plaws nyob rau theem pib ntawm tus kab mob. Qhov no yuav tsum tau ua tam sim ntawd, txij li txoj hmoo ntxiv ntawm ib tus neeg nyob ntawm kev kho raws sijhawm. Txhawm rau kuaj xyuas zaum kawg, nws yuav tsum tau ua cov kev tshawb fawb no:
- Kev kuaj kab mob fungal, kis kab mob thiab kis kab mob.
- Ultrasound yog ua los ntsuas qhov mob ntawm cov nqaij mos.
- Rheovasography yog xav tau los ntsuas qhov ceev ntawm cov ntshav txav.
- Thermography, uas txiav txim siab qhov muaj qhov txawv txav hauv cov ntaub so ntswg ntawm qis qis.
- Capillaroscopy, uas tshuaj xyuas cov kab mob ntawm cov hlab ntsha, cov ntshav microcirculation hauv cov ceg.
- Angiography yog ua los ntsuas lub xeev ntawm cov hlab ntsha, cov ntshav ntws, qhov loj ntawm cov txheej txheem inflammatory.
Differential Diagnosis
Kev kuaj mob zoo li no yuav tsum tsis suav nrog cov kab mob uas muaj cov tsos mob zoo sib xws, xws li atherosclerosis. Ob leeg ntawm cov kab mob no yuav luag zoo ib yam, tab sis atherosclerosis muaj nyob rau hauv cov neeg uas muaj hnub nyoog tshaj tsib caug xyoo, nws tsim symmetrically thiab cuam tshuam rau cov hlab ntsha loj, tsis zoo li endarteritis.
Kev kho mob
Kev kho tus neeg haus luam yeeb ko taw yuav tsum tau kho tam sim. Tab sis nws yog tsis yooj yim sua kom kho tau qhov no pathology kiag li, koj tsuas tuaj yeem qeeb nws txoj kev loj hlob. Ua ntej tshaj plaws, tus neeg mob yuav tsum tso tseg kev haus luam yeeb thiab cawv, kom raugnoj thiab txav ntau. Tus kws kho mob sau tshuaj, kho lub cev rau cov neeg mob, lwm txoj kev kho mob kuj siv tau. Nyob rau theem tom ntej ntawm tus kab mob, kev phais yog tsim nyog. Anti-spasmodic thiab antihistamines, cov vitamins, tshuaj uas ua rau cov ntshav nyias, cov tshuaj tiv thaiv coagulants tau muab los ntawm cov tshuaj. Baromassage, thermal txheej txheem, electrophoresis, magnetotherapy yog sau.
Yog li, tus kab mob "tus neeg haus luam yeeb ko taw" kev kho mob cuam tshuam nrog kev nyuaj, yog tias txhua yam no tsis ua haujlwm, lawv mus rau kev phais. Qhov no yog ua los ntawm shunting los yog tshem tawm cov hlab ntsha thiab hloov nws nrog ib tug prosthesis. Qee zaum, lub thrombus raug tshem tawm uas thaiv cov lumen ntawm cov hlab ntsha. Hauv qhov mob hnyav tshaj plaws, kev txiav cov ceg yog ua. Qhov no yog siv thaum muaj kev hem thawj rau tus neeg mob lub neej. Obliterating endarteritis yog ib qho mob hnyav heev, yog li kev noj tshuaj rau tus kheej yog contraindicated ntawm no. Tag nrho txoj kev ntsuas yuav tsum tau ua raws li kev saib xyuas nruj ntawm tus kws kho mob. Kev kho mob yuav tsum tau ua yam tsis poob, txwv tsis pub muaj kev hem thawj rau tus neeg mob lub neej.
"Smoker's feet": kev kho mob pej xeem tshuaj
Txoj kev kho neeg pej xeem tsuas yog siv rau thawj theem ntawm kev txhim kho tus kab mob ua ke nrog tshuaj thiab kho lub cev. Rau qhov no, tshuaj ntsuab npaj tau siv, uas ntxiv dag zog thiab kho cov phab ntsa ntawm cov hlab ntsha, ntxuav lawv thiab txo qhov mob. Chamomile paj, yarrow, pob kws stigmas, birch buds thiab St. John's wort yog zoo haum rau lub hom phiaj no. Cov notag nrho cov tshuaj yog noj nyob rau hauv sib npaug zos proportions, muab tso rau hauv ib lub thawv thiab ncuav nrog boiling dej (ib nrab ib liter), teem cia rau ib teev. Lub tincture yog noj ib nrab ib teev ua ntej noj mov, ob zaug ib hnub twg. Nws pab ntxuav cov hlab ntsha, ua kom lawv lub suab nrov. Siv cov tshuaj hauv cov chav kawm nrog so ntawm ib hlis. Kev xaiv txiv hmab txiv ntoo pab ntau heev. Ua li no, coj ib tug txiv kab ntxwv thiab ib tug txiv qaub txhua, grind lawv nrog ib tug blender, ntxiv ib diav ntawm zib mu thiab sib tov. Qhov sib tov yog noj hauv peb tablespoons ua ntej noj mov. Khaws cov tshuaj pej xeem hauv qhov txias.
Kev Tiv Thaiv
Yuav kom tus kab mob tsis tsim, nws yog ib qho tsim nyog yuav tsum tsis txhob haus luam yeeb thawj zaug. Nws kuj tseem pom zoo kom ua kom koj txhais taw sov, tiv thaiv lawv los ntawm hypothermia, saib xyuas koj cov khoom noj los ntawm kev tshem cov ntsev, rog thiab ntsim ntawm cov zaub mov. Nws yog ib qho tsim nyog los saib xyuas koj qhov hnyav, raws li phaus ntxiv tso rau ntawm koj ob txhais ceg. Txhawm rau ua qhov no, koj tuaj yeem koom nrog kev ua si lub cev, kev ua si (khiav, ua luam dej), taug kev ntev ntawm ko taw. Taw yuav tsum tau tiv thaiv los ntawm kev puas tsuaj thiab raug mob, khau yuav tsum tsis txhob ua rau tsis xis nyob. Nws kuj tseem ceeb heev uas yuav tsum ua raws li cov cai ntawm kev nyiam huv, saib xyuas koj ob txhais taw txhua hnub, thiab saib xyuas cov qib roj cholesterol hauv cov ntshav. Tag nrho cov kev tiv thaiv no yuav pab txo qis kev pheej hmoo ntawm kev txhim kho pathology. Rau cov neeg uas twb tau kuaj pom tus kab mob no lawm, cov lus qhia saum toj no yuav pab tswj kev noj qab haus huv rau lub sijhawm ntev.
Huab cua
Qhov kev cia siab ntawm tus kab mob nyob ntawm seb yuav ua li castus neeg mob yuav ceev faj, txij li kev kho mob raws sij hawm ua rau nws muaj peev xwm tshem tau tus kab mob kom tiav. Cov teeb meem ib txwm xaus nrog kev txiav tawm ntawm ib lossis ob txhais ceg, ua raws li kev siv prostheses. Yog tias thaj chaw necrotic, cov pob dub tau pom ntawm cov ceg, ces nws tsis tuaj yeem tiv thaiv cov txheej txheem kab mob. Yog li ntawd, nws raug nquahu kom tsis txhob pib tus kab mob, tab sis yuav tsum kho nws kom raws sijhawm kom khaws koj txoj kev noj qab haus huv thiab lub neej. Thaum ib tug neeg pom tias muaj pathology nyob rau lub sijhawm, qhov kev cia siab yuav zoo, txij li thaum ntxov ntawm endarteritis lawv ua yam tsis muaj kev phais.
Yog li, obliterating endarteritis yog ib qho mob hnyav uas ua rau muaj kev hem thawj rau lub neej thiab kev noj qab haus huv ntawm tus neeg mob. Txij li qhov tseem ceeb ntawm nws txoj kev loj hlob yog kev haus luam yeeb, nws yog ib qho tsim nyog yuav tsum tso tseg tus cwj pwm no. Cov pa luam yeeb muaj ntau tshaj li plaub txhiab yam khoom uas muaj kev puas tsuaj rau cov hlwb uas nyob rau ntawm phab ntsa ntawm cov hlab ntsha, yog li ntawd, cov xwm txheej tau tsim rau kev txhim kho ntawm cov kab mob no, uas yog nrov npe hu ua "smoker's ob txhais ceg". Piv txwv li, carbon monoxide txhawb kev tsim cov carboxyhemoglobin hauv cov ntshav, uas cuam tshuam hemoglobin, vim tias cov ntaub so ntswg tsis tau txais oxygen txaus thiab tuag. Nicotine tuaj yeem ua kom cov viscosity ntawm cov ntshav, tsim cov ntshav txhaws hauv cov hlab ntsha. Tag nrho cov no ua rau muaj kev swb ntawm cov qis qis nrog ib qho mob uas tsis tuaj yeem kho tau tom qab theem.
