Hauv cov txheej txheem kev noj qab haus huv niaj hnub no, txhua yam kab mob tau muab faib ua pawg raws li cov tsos mob, qhov hnyav ntawm chav kawm thiab lwm yam cim. Pathology ntawm qis extremities tsis muaj kev zam. Hauv peb tsab xov xwm, peb yuav xav txog qhov kev faib tawm ntawm cov kab mob venous muaj nyob.
Vim li cas thiaj nkag siab qhov kev kuaj mob?
Ntau tus tib neeg pom nws nkag siab tsis tau vim li cas thiaj qhia kev faib tawm? Saib ntawm lawv cov ntaub ntawv kho mob, cov neeg mob pom cov lej ruaj khov nyob ntawd. Txawm hais tias nws yog ua ntej, dub thiab dawb, cov kws kho mob tau sau tag nrho cov ntsiab lus tseem ceeb thiab nrog kev kuaj mob ntawm lawv cov neeg mob, uas tuaj yeem nyeem tau yooj yim txhua lub sijhawm. Yog li, vim li cas kev kho mob niaj hnub tau qhia cov ntawv sau rau ntau yam kab mob?
- Cov npe nkag ntawm cov kab mob tsuas yog nyeem tau los ntawm tus kws tshaj lij xwb, uas tseem ceeb heev rau kev khaws cov ntaub ntawv tsis pub lwm tus paub.
- Nrog rau qhov kev tshwm sim ntawm lub computer technology, feem ntau ntawm cov ntaub ntawv rau kev yooj yim ntawm lawv systematization, thiab nyob rau hauv tas li ntawd, kev soj ntsuam tau nkag mus rau hauv cov kev pab cuam nyob rau hauv daim ntawv ntawm alphanumeric codes.
- InternationalKev sib koom ua ke, nrog rau cov qauv kev cai ntawm kab mob, ua rau nws muaj peev xwm txiav txim siab qhov kev kuaj mob, txawm tias nws tau tsim nyob rau lwm lub tebchaws.
Kev faib cov kab mob tuaj yeem yog thoob ntiaj teb lossis tau txais kev pom zoo hauv kev saib xyuas kev noj qab haus huv ntawm ib lub tebchaws.
Siv daim ntawv kho mob ICD-10
Cov ntaub ntawv tseem ceeb siv los ntawm cov kws kho mob thoob ntiaj teb yog lub npe hu ua ICD-10, uas yog qhov hloov kho tshiab thiab hloov kho tshiab ntawm cov txheej txheem kev faib tawm rau ntau yam kab mob. Tus lej "10" qhia tias Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb tau hloov kho thiab kho dua tshiab kaum zaug lawm.
Raws li cov ntaub ntawv no, cov kab mob ntawm cov hlab ntsha tau suav nrog hauv chav kawm cuaj hauv qab lub npe: "Pathologies ntawm cov hlab ntsha." Cov npe no muaj cov npe dav tshaj plaws ntawm kev kuaj mob nrog thiab tsis muaj ntau yam teeb meem uas tuaj yeem kuaj tau thaum varicose leeg tshwm. Piv txwv li, cov kab mob varicose ntawm qis qis tuaj yeem pom nyob rau hauv tus lej 183:
- Code 183.9 hais txog varicose leeg uas daws tsis muaj teeb meem hauv daim ntawv ntawm trophic ulcers lossis o.
- Code 183.1 qhia txog varicose pathology ntawm ob txhais ceg nrog kev txhim kho ntawm cov txheej txheem inflammatory.
- Designation 183.2 qhia tias muaj kab mob varicose nrog rau qhov pom ntawm necrotic trophic ulcers thiab cov txheej txheem inflammatory.
- Code 183.0 qhia txog kab mob varicose, uas yog nrog los ntawm trophic ulcers.
YogKev kuaj mob raws li ICD-10 kev faib tawm zoo heev pab txhawb kev txiav txim siab ntawm cov ntaub ntawv qhia meej txog tus kab mob ntawm cov leeg ntawm sab qis. Raws li ib feem ntawm qhov no, cov teeb meem loj dua tau muab zais hauv qab lwm cov lej:
- Kev faib cov lej 180.0 qhia txog cov teeb meem hauv daim ntawv ntawm phlebitis, thiab, ntxiv rau, thrombophlebitis, uas tau nyob hauv qee thaj chaw.
- Code 181 qhia txog kev txhim kho ntawm embolism thiab thrombosis ntawm cov hlab ntsha hauv tus neeg mob.
- 184.0 qhia tias muaj ntau hom hemorrhoids nrog cov teeb meem cuam tshuam thiab thrombosis.
- Code 186.2 txhais tau hais tias varicose leeg ntawm lub plab me me thiab perineum.
YThrombophlebitis
Yuav ua li cas yog kab mob ntawm cov leeg ntawm ob txhais ceg? Ib qho tseem ceeb ntawm cov teeb meem varicose yog sawv cev los ntawm txhua yam ntawm cov hlab ntsha sib sib zog nqus, tshwj xeeb tshaj yog thrombophlebitis. Cov theem no yog nrog, raws li txoj cai, los ntawm inflammatory txheej txheem nyob rau hauv lub venous phab ntsa, raws li ib tug tshwm sim ntawm cov blockages yog tsim nyob rau hauv lub lumen ntawm cov hlab ntsha. Tau kawg, qhov no ua rau cov ntshav ntws zoo heev. Hauv qhov no, thrombophlebitis yog ib yam mob uas ua rau ua rau cov ntshav txhaws, uas tuaj yeem ua rau cov hlab ntsha tseem ceeb.
txhawm rau kuaj mob thrombophlebitis, siv lub cipher, uas ua rau nws muaj peev xwm ua kom paub meej cov nuances ntawm cov txheej txheem tsis tu ncua, piv txwv li, thaj chaw hauv cheeb tsam, muaj qhov flotation thiab qhov hnyav ntawm qhov ntws. Yog li, kev faib tawm ntawm thrombophlebitis yog ua raws li cov hauv qab no:
- Hom txheej txheem pathological, piv txwv li: mob (txog ib hlis), daim ntawv subacute(txog peb lub hlis), mob ntev. Tus kab mob thrombophlebitis ntev tau kuaj pom tom qab peb lub hlis txij li qhov pib ntawm thawj cov tsos mob ntawm tus kab mob venous.
- hom keeb kwm ntawm cov txheej txheem pathological, piv txwv li, varicose leeg pib tawm tsam keeb kwm ntawm cov teeb meem cuam tshuam nrog cev xeeb tub, yug menyuam, hormonal tsis ua haujlwm, kev ua xua lossis kis kab mob.
- Kev txheeb xyuas tus kab mob venous ntev - txheej txheem uas ntes cov leeg sab nraud lossis tob ntawm ob txhais ceg thiab lub plab.
- Qhov dej ntws. Raws li cov txheej txheem no, cov txheej txheem ntawm tus kab mob tej zaum yuav tsis-purulent los yog purulent.
Tag nrho cov npe kev faib tawm yog suav nrog hauv daim ntawv ICD-10 nyob rau hauv cov lej lej los ntawm 100 txog 199. Cov txiaj ntsig no suav nrog hauv qeb raws li lub npe dav dav "Pathologies ntawm cov hlab ntshav". Raws li cov tsiaj ntawv thiab lej encryption, lwm yam kev faib tawm ntawm cov kab mob tau raug tsim nyob rau hauv kev kho mob.
Kev faib tawm los ntawm cov ntawv
Ntxiv rau qhov kev faib tawm thoob ntiaj teb, kuj tseem muaj cov tshwj xeeb uas tau tsim thiab siv los ntawm cov kws kho mob los ntawm ntau lub teb chaws. Piv txwv li, nyob rau hauv Russia, nws tus kheej clarifying kev faib ntawm cov hlab ntsha kab mob tau tsim ncaj qha raws li lawv daim ntawv. Txoj kev no suav nrog ob peb theem hauv qab no hauv kev txhim kho pathologies cuam tshuam nrog cov leeg:
- Tsim cov segmental varicose leeg yam tsis muaj reflux.
- Kev txhim kho segmental varicose vascular kab mob nrog pathological tawm ntawm cov kua dej, uas tshwm sim nyob rau saum npoo, thiab, ntxiv rau, kev sib txuas luscov leeg.
- Cov tsos mob ntawm tus kab mob varicose uas muaj cov kab mob pathological tawm ntawm cov kua dej uas tshwm sim los ntawm cov leeg sib sib zog nqus.
Qhov kev faib tawm ua rau nws muaj peev xwm ua kom pom tseeb tias qhov pathology txhim kho li cas, ntxiv rau, tus yam ntxwv yog muab cov kab mob ntawm cov leeg ntawm sab qis thiab cov hlab ntsha, nrog rau cov kab mob pathological ntawm cov ntshav khiav.
Degrees of venous insufficiency
Raws li tib qhov kev faib tawm, muaj plaub theem hauv qab no ntawm kev mob venous insufficiency:
- Zero degree qhia tias tsis muaj cov venous insufficiency.
- Qib thib ob qhia tias muaj qhov hnyav ntawm ob txhais ceg, uas hloov mus ua o.
- Qhov thib peb ntawm cov kab mob ntawm cov hlab ntsha ntawm cov leeg qis qhia tau tias tsis tu ncua thiab tsis tu ncua edema, sclerosis ntawm phab ntsa vascular, thiab ntxiv rau, hyperpigmentation ntawm daim tawv nqaij thiab dermatitis.
- Qib plaub qhia txog qhov pom ntawm cov ntaub so ntswg hloov pauv thiab rwj.
Nws yog ib txwm ua kom ntxiv qee yam teeb meem thaum kho rau kev kuaj mob. Piv txwv li, muaj teeb meem nyob rau hauv daim ntawv ntawm ntau yam los ntshav los ntawm cov hlab ntsha, cov tsos ntawm cov ntshav txhaws, o ntawm lymph nodes, kab mob, necrosis, trophic hloov nyob rau hauv cov ntaub so ntswg, eczema, thiab thiaj li nyob.
Kev faib raws li Savelyev
Txaus siab rau qhov kev thov niaj hnub no ntawm cov kws kho mob hauv tsev yog Saveliev kev faib tawm, uas qhia txog qib ntshav txaus cuam tshuam hauv cov ceg:
- Theem ntawm kev them nyiaj, uas yog tus cwj pwm los ntawm qhov yuav luag tsis tiav ntawm cov tsos mob ntawm tus kab mob, tshwj tsis yog qhov tsis xis nyob hauv thaj tsam ntawm cov hlab ntsha puas tsuaj.
- Theem ntawm subcompensation, uas yog lub sijhawm uas cov tsos mob ntawm tus kab mob hnyav zuj zus, pom kev pom lawv tus kheej nyob rau hauv daim ntawv ntawm reticular qauv, thiab symptomatically nyob rau hauv daim ntawv ntawm edema nrog rau tingling, khaus, hnyav, cramps. thiab lwm yam tshwm sim ntawm varicose pathology ntawm extremities. Nyob rau tib lub sijhawm, stagnation nyob rau hauv cov ntaub so ntswg yog hnyav heev, thiab cov ntshav ib txwm muaj kev cuam tshuam.
- theem ntawm decompensation yog cim los ntawm qhov tshwm sim ntawm kev ua txhaum loj ntawm cov ntshav ntws, uas yog nrog los ntawm hyperpigmentation thiab o ntawm cov ntaub so ntswg uas nyob ib sab. Cov tsos mob ntawm lub sijhawm no tuaj yeem ua rau hnyav zuj zus thiab ua rau mob tsis tu ncua. Cov tsos mob ntawm cov nqaij mos necrotic thiab trophic ulcers tsis suav nrog.
Anatomical localization
Nws muaj kev faib tawm raws li qhov chaw anatomical ntawm cov leeg leeg leeg, uas yog qhov tseem ceeb heev hauv kev kuaj xyuas kom raug:
- txheej txheem varicose leeg ntawm cov hlab ntsha loj saphenous.
- Cov txheej txheem ntawm varicose leeg ntawm cov leeg saphenous me me.
- Cov txheej txheem ntawm varicose leeg ntawm cov hlab ntsha loj thiab me saphenous.
- Cov txheej txheem ntawm varicose leeg ntawm cov leeg sab nraud.
CEAP classes
Muaj kev faib thoob ntiaj teb ntawm cov kab mob hauv cov hlab ntsha, uas yog raws li cov tsos mob thiab cov tsos mob ntawm pathology. Nws hu ua CEAR, qhov twg:
- "C" sawv raudaim duab kho mob ntawm tus kab mob.
- "E" qhia txog etiology ntawm tus kab mob.
- "A" nqa cov ntaub ntawv hais txog lub cev ntawm lub cev ntawm txoj haujlwm ntawm cov leeg leeg.
- "P" qhia txog cov txheej txheem ntawm kev loj hlob ntawm varicose leeg.
Cov kws kho mob feem ntau siv ntu "C", uas, dhau los, muab faib ua qib ntawm xoom mus rau rau. Yog li, txhua theem ntawm daim duab kho mob ntawm ceg leeg leeg muaj nws cov chav kawm:
- Zero chav kawm yog cov ntaub ntawv hais txog qhov tsis muaj qhov pom tseeb ntawm varicose leeg ntawm cov extremities. Tab sis tib lub sijhawm, cov neeg mob tuaj yeem yws txog qhov hnyav thiab qaug zog ntawm ob txhais ceg.
- thawj chav kawm txhais tau hais tias koj tuaj yeem pom cov tsos ntawm tus qauv reticular (asterisks, meshes). Tib lub sijhawm, cov neeg mob raug mob los ntawm kev mob hmo ntuj.
- chav kawm thib ob qhia qhov pom ntawm qhov pom tseeb ntawm cov leeg thiab cov hlab ntsha, uas tuaj yeem ua kom pom tseeb ntawm qhov muag.
- Cov chav kawm thib peb qhia tias cov neeg mob raug kev txom nyem los ntawm o ntawm ceg ceg, pastosity ntawm cov ntaub so ntswg thiab lwm yam tsos mob ntawm varicose veins uas tsis ploj tom qab so.
- chav kawm plaub qhia tau hais tias cov leeg varicose thiab leeg leeg, nrog rau cov tawv nqaij tawv thiab o ntawm daim tawv nqaij uas nyob ib sab.
- Qib tsib yog cim los ntawm qhov tshwm sim ntawm qhov txhab mob, thiab ntxiv rau, cov tsos mob ntawm thrombophlebitis thiab necrotic hloov pauv.
- Qib thib rau yog nrog los ntawm kev tsim cov tshuaj tsis zoo. Tsis tas li ntawd, cov neeg mob tej zaum yuav muaj cov kab mob sib sib zog nqus trophic.
NyobKev faib tawm ntawm ntu "E" thiab "A" tuaj yeem tsim kev kuaj mob tiv thaiv keeb kwm yav dhau los ntawm kev puas tsuaj rau cov hlab ntsha sib sib zog nqus thiab sab nraud, nrog rau kom paub meej cov etiology ntawm tus kab mob. Tshooj "P", nyob rau hauv lem, ua kom nws muaj peev xwm qhia tau meej muaj ntau yam refluxes nyob rau hauv cov cheeb tsam cuam tshuam ntawm lub venous txaj.
Disability Scale
Raws li ib feem ntawm kev kuaj mob ntawm varicose leeg, nws yog ib qho tseem ceeb uas yuav tsum tau coj mus rau hauv tus account tus naj npawb ntawm cov kab mob hloov pauv, qhov loj me thiab lub sijhawm thaum muaj kab mob. Lub xub ntiag ntawm relapses thiab lawv tag nrho cov naj npawb kuj raug coj mus rau hauv tus account. Ntawm lwm yam, cov ntaub ntawv hais txog kev muaj peev xwm ua haujlwm ntawm cov neeg mob uas muaj kab mob varicose leeg yuav tsum tau qhia meej, uas yog ua los ntawm kev txo qis kev ua haujlwm:
- "Zero" qhia txog qhov tsis zoo ntawm cov kab mob ntawm cov leeg ntawm cov leeg, uas tsis tas yuav muaj kev txwv ntawm kev ua haujlwm.
- "Ib" qhia cov tsos mob ntawm tus kab mob uas tsis tas yuav muaj kev tsis taus.
- "Deuce" qhia txog qhov muaj cov tsos mob ntawm tus kab mob, uas tsis pub tus neeg mob ua haujlwm ntau tshaj yim teev, thaum kho kho yog qhov yuav tsum tau ua.
- "Peb" qhia tias muaj kev tsis taus tiav.
Yog li, ua tsaug rau qhov kev faib tawm, nws muaj peev xwm hais qhia lub xeev ntawm tus kabmob ntawm qee lub sijhawm, tshwj xeeb tshaj yog thaum nws loj hlob lossis, ntawm qhov tsis sib xws, tsis tshwm sim nws tus kheej hauv txhua txoj kev. Cov txheej txheem kev faib tawm uas twb muaj lawm ua rau nws muaj peev xwm tsim tau ntau qhov kev kuaj mob ntawm tus neeg mob tshwj xeeb, qhia txog qhov muaj ntau yam teeb meem, thiab lwm yam.
Cov txheej txheem CEAP nthuav tawm qhia cov kab mob hauv cov hlab ntsha hauv cov lus nthuav dav txaus, tab sis txawv ntawm ntau cov ntsiab lus sib txawv, uas, dhau los, tau cuam tshuam hauv qhov kawg cipher. Yog li, txhua qhov kev faib tawm ntawm cov teeb meem nrog cov leeg yog, ua ntej ntawm tag nrho cov, cov npe ntawm cov kab mob cuam tshuam, uas ua rau nws ua tau kom raug tsis yog tsuas yog txiav txim siab xwb, tab sis ua kev kuaj mob.
Kev kho cov kab mob leeg
Kev kho rau cov kab mob no txawv, nyob ntawm qib kev loj hlob.
Sclerotherapy yog siv los tshem tawm cov pob me me lossis txuas ntxiv.
Raws li kev kho mob ib txwm muaj, cov neeg mob tau pom zoo cov hnab looj tshwj xeeb uas muaj qhov elasticity siab, nrog rau kev tawm dag zog tshwj xeeb nrog ob txhais ceg tsa siab. Nws yuav siv tau rau cov leeg varicose nrog rau cov kab mob kab mob ntev.
Kev phais yog qhia yog tias tsis muaj txiaj ntsig zoo los ntawm txoj kev dhau los, ntau yam teeb meem tshwm sim thaum lub sijhawm muaj tus kabmob (qhov txhab lossis los ntshav hnyav).
Tshuaj kho mob kuj yuav xav tau, tshwj xeeb tshaj yog tias nws yog hom kab mob siab heev lossis kev txhim kho ntawm cov teeb meem.
Txhawm rau txo qhov txaus ntshai, koj yuav tsum mob siab rau lub sijhawm rau koj ob txhais taw thiab kev noj qab haus huv. Koj yuav tsum ua kom sov koj ob txhais ceg tsis tu ncua, ua dej cawv compresses, siv tshuaj ntsuab decoctions, thiab ua ib qho tshwj xeeb ntawm kev tawm dag zog lub cev.
