Lo lus "thrombophlebitis ntawm cov hlab ntsha sab nraud" yog hais txog cov kab mob pathological uas cov txheej txheem inflammatory tshwm sim hauv cov phab ntsa ntawm cov hlab ntsha. Nyob rau tib lub sijhawm, cov ntshav txhaws tau tsim uas txhaws cov lumen ntawm cov leeg. Tus kab mob no tuaj yeem ua rau muaj kev ywj pheej hauv qhov xwm txheej lossis yog ib qho kev tshwm sim hauv lub cev ntawm lwm tus kab mob. Yog tias thawj cov tsos mob tshwm sim tshwm sim, nws yuav tsum tau hu rau phlebologist kom sai li sai tau. Tus kws kho mob tshwj xeeb yuav tshaj tawm kev xa mus rau kev kuaj mob nyuaj thiab, raws li cov txiaj ntsig tau txais, yuav teeb tsa kev kho mob rau thrombophlebitis ntawm cov leeg sab nraud. Nws tuaj yeem suav nrog ob qho tib si kev saib xyuas thiab kev ua haujlwm.
Pathogenesis
Thrombophlebitis ntawm ob leeg tob thiab cov leeg sab nraud yog ib txwm ua rau kev ua haujlwm tsis zoo ntawm ntau lub tshuab. Hauv lwm lo lus, tus kab mob yog multifactorial.
Feem ntau yog lub hauv pausyog qhov tshwm sim ib txhij ntawm cov teeb meem hauv kev ua haujlwm ntawm cov hlab plawv, lymphatic thiab circulatory systems. Yog tias koj tsis quav ntsej cov cim ceeb toom, qhov kev ua ntawm cov xwm txheej no yuav ua rau thrombophlebitis.
Txoj kev txhim kho ntawm tus kab mob yog ua raws li kev mob ntawm phab ntsa vascular nrog rau kev tsim cov ntshav txhaws. Feem ntau, cov txheej txheem pathological yog microbial nyob rau hauv qhov xwm txheej. Tab sis qee zaum nws tshwm sim tias tiv thaiv keeb kwm yav dhau los ntawm thrombophlebitis ntawm cov leeg sab nraud, cov kab mob sib kis tau txuas nrog. Nyob rau hauv cov ntaub ntawv no, nws yog kev cai hais tias tus txheej txheem yog purulent.
Muaj ob txoj hauv kev rau kev txhim kho tus kabmob:
- Nyob zoo tam sim no. Thrombogenesis nres, o tshwm sim. Tom qab ntawd, lub patency ntawm cov hlab ntsha sib thooj yog rov qab los. Qhov no tuaj yeem tshwm sim ntawm nws tus kheej lossis tom qab kho. Txawm li cas los xij, nws tsis tuaj yeem hais txog qhov ploj ntawm tus kab mob hauv qhov no, vim tias kev puas tsuaj rau lub valvular apparatus yog ib txwm pom, thiab tom qab ntawd qhov no ua rau cov duab kho mob ntawm cov hlab ntsha tsis txaus.
- Cov txheej txheem inflammatory tau nce mus ntxiv. Hauv qhov no, ib qho kawg ntawm cov hlab ntsha yog txuas rau ntawm phab ntsa venous, thiab lwm qhov yog nyob ncaj qha rau hauv lub lumen ntawm lub nkoj. Nyob rau hauv cov ntaub ntawv no, nws yog kev cai hais tias lub thrombus muaj ib tug unstable xeev. Nws txoj kev loj hlob nyob rau hauv qhov teeb meem no yog qhia upwards. Nws yog ib qho tsim nyog sau cia tias txawm tias nyob rau hauv lub zog tsis muaj zog, cov hlab ntsha tuaj yeem tawm. Qhov no cuam tshuam nrog qhov tshwm sim ntawm thromboembolism - kab mob uas feem ntau ua rau tuag.
Tsis taukom tso cai rau kev loj hlob ntawm cov teeb meem txaus ntshai, nws yog ib qho tsim nyog hu rau tus kws kho mob phlebologist thaum thawj cov cim ceeb toom tshwm sim.
Etiology
Raws li tau hais los saum no, cov hlab ntsha ntawm cov hlab ntsha sab nraud yog ib hom kab mob ntau yam. Nws txhim kho nrog kev sib xyaw ua ke ntawm cov xwm txheej tsis zoo hauv qab no:
- Kev raug mob rau lub nkoj phab ntsa. Cov veins superficial yog ua rau ntau hom kev puas tsuaj. Txawm tias me me raug mob tuaj yeem ua rau thrombophlebitis. Feem ntau, kev txiav, bruises thiab ua tsis raug kev kho mob manipulations ua raws li provoking yam.
- Kev txo qis ntawm cov ntshav ncig. Feem ntau, tus mob no yog tshwm sim los ntawm lub sij hawm immobilization ntawm ib tug neeg. Piv txwv li, nws muaj mob hnyav, thiab nws yuav tsum ua tib zoo saib xyuas kev pw tsaug zog. Lub plawv tsis ua hauj lwm kuj feem ntau ua rau txo cov ntshav khiav.
- Hloov pauv hauv cov muaj pes tsawg leeg thiab cov khoom ntawm cov kua dej sib txuas. Qhov no feem ntau tshwm sim nrog ntshav qab zib. Tsis tas li ntawd, cov ntshav thickens thaum lub cev qhuav dej, xws li thaum ntuav lossis raws plab.
Tsis tas li, cov kab mob hauv qab no tuaj yeem dhau los ua qhov ua rau thrombophlebitis ntawm cov leeg sab nraud:
- kev raug mob loj.
- Kev phais yav dhau los.
- Pathologies ntawm kis etiology.
- Nyob rau hauv lub cev rhiab heev rau allergens.
- Malignant neoplasms.
- Hormonal imbalance.
- Ntauslub cev nyhav.
- Kev ua txhaum ntawm cov txheej txheem ntawm kev ua haujlwm kho mob.
Tsis tas li ntawd, cov tsos mob ntawm thrombophlebitis ntawm cov hlab ntsha sab nraud feem ntau tshwm sim hauv cov poj niam thaum cev xeeb tub thiab tom qab rho menyuam.
kab mob daim ntawv
Nyob ntawm cov xwm txheej etiological, tus kab mob tuaj yeem ua tau txawv:
- Kev kis mob. Nyob rau hauv cov ntaub ntawv no, thrombophlebitis tej zaum yuav txuam nrog purulent o los yog ib tug teeb meem ntawm kis pathologies. Tus kab mob kuj tuaj yeem tshwm sim tom qab yug menyuam lossis phais.
- Tsis muaj kab mob. Nyob rau hauv cov ntaub ntawv no, lub pathology yuav ua tau tom qab mob los yog migratory. Feem ntau, thrombophlebitis yog ib qho teeb meem ntawm cov kab mob ntawm cov hlab plawv lossis varicose leeg.
Cov kws kho mob hais tias yam tsis muaj kev kho mob, txhua hom thrombophlebitis tuaj yeem ua rau lub paj hlwb, lymphatic system thiab cov kab mob somatic koom nrog cov txheej txheem inflammatory. Ntxiv mus, muaj kev pheej hmoo ntawm tus kab mob septic.
daim duab kho mob
Cov tsos mob ntawm tus kab mob thiab lawv qhov hnyav ncaj qha nyob ntawm hom kab mob thiab nws qhov hnyav.
Trombophlebitis ntawm cov leeg sab nrauv tuaj yeem yog:
- Ntxhais. Cov theem no txhim kho li 2-3 hnub. Cov veins superficial nrog thrombophlebitis o nyob rau hauv cheeb tsam ntawm localization ntawm cov ntshav txhaws. Cov xwm txheej ntawm tus neeg mob hnyav zuj zus tuaj. Mob thrombophlebitis ntawm cov leeg sab nrauv yog nrog los ntawm qhov kub thiab txias.lub cev.
- Ntawm. Cov tsos mob tsis zoo li hais tau nyob rau hauv cov ntaub ntawv ntawm mob thrombophlebitis ntawm cov leeg sab nraud ntawm sab qis. Cov txheej txheem inflammatory tshwm sim sluggishly, thiab, raws li txoj cai, nws yog ib qho teeb meem ntawm varicose leeg. Yog tias koj nias koj tus ntiv tes rau ntawm qhov chaw uas cov ntshav txhaws nyob, nws yuav loj tuaj. Mob rhiab heev yog pronounced. Tsis tas li ntawd, lub caj pas yog o.
- Purulent. Nws tshwm sim yog tias muaj kev mob siab rau ntawm daim tawv nqaij. Cov txheej txheem pathological yog nrog los ntawm cov tsos mob ntawm intoxication, tshwj xeeb tshaj yog lub cev kub.
- Tsis muaj kuab paug. Lub provoking yam nyob rau hauv cov ntaub ntawv no yog ua txhaum ntawm lub zog ntawm cov ntshav khiav. Raws li txoj cai, tus mob no yog qhov tshwm sim ntawm thickening ntawm cov kua txuas cov ntaub so ntswg. Kev noj qab nyob zoo ntawm ib tug neeg yog qhov txaus siab, tab sis cov kab txaij liab yog pom ntawm daim tawv nqaij, thaum kov, qhov mob tshwm sim tshwm sim. Non-purulent thrombophlebitis daws ntawm nws tus kheej los yog ua ntev.
Nws yog ib qho tseem ceeb kom paub tus kab mob nyob rau lub sijhawm. Ua li no, koj yuav tsum to taub zoo npaum li cas thrombophlebitis txawv ntawm varicose leeg.
thawj cov tsos mob yog ib txwm mob ntawm tus ncej puab lossis sab ceg. Thrombophlebitis ntawm cov hlab ntsha sab nraud kuj nrog o thiab liab. Ntxiv mus, ib tug neeg muaj hnab hauv qab nws ob lub qhov muag. Cov hlab ntsha swells zoo heev, txhua qhov kev sim kov cov tawv nqaij saum toj no ua rau mob hnyav. Lub sijhawm ntawd, lub cev kub nce mus txog 39 degrees thiab siab dua.
Varicose veins tsis mob ntawm palpation, tab sis ntawm daim tawv nqaijntawm lawv tsis muaj reddenings. Kuj tsis muaj qhov nce hauv lub cev kub. Yog koj tsa koj ob txhais ceg, qhov nro yuav sai sai.
Txawm hais tias qhov mob hnyav ntawm cov tsos mob ntawm thrombophlebitis ntawm cov hlab ntsha ntawm cov leeg sab nraud, nws tsis tuaj yeem ncua kev kho tus kab mob. Nws yog ib qho tseem ceeb kom nco ntsoov tias tsis quav ntsej cov cim ceeb toom tuaj yeem ua rau tuag taus.
Diagnosis
Kev kuaj kab mob tsis yooj yim. Tus kws kho mob phlebologist tuaj yeem ua qhov kev kuaj mob twb nyob rau theem ntawm kev kuaj lub cev thiab sau cov ntaub ntawv anamnesis.
Yuav kom paub meej tias nws, xim duplex ultrasound raug tshuaj. Thaum lub sijhawm kawm, tus kws kho mob tau txais lub sijhawm los nrhiav qhov tseeb qhov chaw ntawm lub thrombus, nrog rau kev soj ntsuam qhov tshwm sim ntawm nws qhov kev tshem tawm.
Ntxiv mus, tus kws kho mob phlebologist yuav sau ntawv:
- Rheovasography. Nrog rau txoj kev no, koj tuaj yeem ua tib zoo kawm cov txheej txheem ntawm cov ntshav ncig.
- CT, MRI.
- Venography. Qhov no yog ib txoj kev kuaj X-ray uas suav nrog kev qhia txog tus neeg sawv cev sib txawv rau hauv tus neeg mob lub cev.
Raws li cov txiaj ntsig ntawm kev tshuaj ntsuam xyuas, tus kws kho mob tau kos cov kev kho mob zoo tshaj plaws rau thrombophlebitis ntawm cov leeg sab nraud.
kev kho mob zoo
Yog tias lub nkoj muaj mob hauv qab ceg, tsis tas yuav mus pw hauv tsev kho mob. Txawm li cas los xij, nyob rau hauv lub xub ntiag ntawm ascending thrombophlebitis ntawm cov hlab ntsha superficial, thaum cov hlab ntsha tuaj yeem nyob hauv thaj tsam ncej puab, kev kho mob yog nqa tawm hauv tsev kho mob.
Lub hom phiaj ntawm kev kho mobTxheej xwm:
- Tiv thaiv kev hloov pauv ntawm cov txheej txheem inflammatory mus rau cov leeg sib sib zog nqus.
- Tiv thaiv kev txhim kho ntawm txhua yam teeb meem.
- Txhim kho cov txheej txheem inflammatory.
- Tiv thaiv cov ntshav txhaws.
Yog tias muaj qhov tsis txaus ntseeg ntawm kev txhim kho ntawm embolism, tus neeg mob raug muab tso rau hauv txaj. Tsis ua li ntawd yuav ua rau tus neeg mob ua rau lawv lub neej. Nyob rau hauv txhua rooj plaub, kev siv lub cev yuav tsum raug txo kom tsawg.
Cov kev kho mob classic rau thrombophlebitis yog raws li hauv qab no:
- Elastic bandaging lossis hnav compression stockings. Kev xaiv yog ua los ntawm tus kws kho mob raws li keeb kwm thiab kev kuaj mob.
- Kev tswj hwm cov tshuaj tiv thaiv kab mob hauv cov hlab ntsha hauv thawj 7 hnub. Cov tshuaj no ua rau cov kua dej sib txuas ua ke, uas, dhau los, tiv thaiv thrombosis. Feem ntau cov tshuaj yog Enoxaparin. Tom qab 7 hnub, kev hloov mus rau qhov ncauj tshuaj tiv thaiv kab mob (Aspirin cardio) tau ua tiav.
- Txais phlebotics. Tsim los nres cov txheej txheem inflammatory. Raws li txoj cai, cov kws kho mob sau tshuaj Troxerutin. Txhawm rau tshem tawm qhov mob, NSAIDs kuj tau sau tseg (piv txwv li, Ibuprofen, Diclofenac).
- Tshuaj pleev ib ce ntawm cov khoom lag luam heparin. Cov tshuaj pleev rau thrombophlebitis ntawm cov leeg sab nrauv pab tshem tawm qhov mob thiab lwm yam tsis xis nyob. Feem ntau, cov kws kho mob muab tshuaj Heparin.
- Siv nyiaj uas pab tshem tawm qhov o. Piv txwv li: Wobenzym.
- Tshuaj pleev ib ce ntawm cov khoom siv propolis. Tawm tsam qhov backdrop ntawm lawvsiv tshem tawm qhov mob thiab tua cov kab mob.
Ntxiv mus, tus kws kho mob yuav sau ib chav kho mob ntawm lub cev. Qhov zoo tshaj plaws yog cov hauv qab no: UV, electrophoresis, infrared radiation, magnetotherapy, laser therapy thiab barotherapy.
kev kho mob phais
Yog txoj kev saib xyuas tsis tau zoo, tus kws kho mob tau xaj kev phais.
Tam sim no, cov hauv qab no tau siv hauv kev xyaum:
- Bandaging ntawm cov hlab ntsha cuam tshuam. Lub hom phiaj ntawm kev ua haujlwm yog txwv tsis pub cov txheej txheem ntawm cov ntshav tawm mus rau hauv cov hlab ntsha sab nraud ntawm qhov tob tob. Kev cuam tshuam yog ua raws li kev tshuaj loog hauv zos.
- Venectomy. Thaum lub sijhawm ua haujlwm, tus kws phais ua rau ntau qhov kev phais hauv daim tawv nqaij. Los ntawm cov qhov tsim, tus kws kho mob tshem tawm cov hlab ntsha uas hloov pauv nrog kev pab ntawm hooks.
- Excision of thrombosed nodes.
Tom qab ua haujlwm, nws yog ib qho tsim nyog yuav tsum txo qis kev siv lub cev ib ntus kom tsawg. Tsis tas li ntawd, nws raug nquahu kom ua raws li kev noj haus uas feem ntau noj cov zaub mov uas muaj fiber ntau. Tsis tas li ntawd, cov zaub mov yuav tsum muaj xws li: Ginger paus, hawthorn txiv hmab txiv ntoo, qej, valerian paus, capsicum.
Yog tias koj ua raws li txhua tus kws kho mob cov lus pom zoo, koj tuaj yeem suav tau tias qhov kev rov zoo tag nrho yuav tuaj hauv 2-3 lub lis piam.
Huab cua
Qhov tshwm sim ntawm tus kab mob ncaj qha nyob ntawm lub sijhawm khokws kho mob. Yog tias koj teem sijhawm nrog tus kws kho mob phlebologist tam sim ntawd tom qab qhov pib tshwm sim thawj zaug, koj tuaj yeem zam tau ntau yam teeb meem loj.
Kev tsis quav ntsej txog cov tsos mob ua rau muaj qhov tshwm sim hauv qab no:
- Abscess.
- eczema.
- Phlegmon ntawm qis extremities.
- Lymphadenitis.
- Gangrene.
- Sepsis.
- YDeep vein thrombosis.
- Emboli.
Nco ntsoov tias muaj ntau yam teeb meem no ua rau muaj kev phom sij tsis yog rau kev noj qab haus huv xwb, tab sis kuj rau lub neej.
Kev Tiv Thaiv
Txhawm rau tiv thaiv kev txhim kho ntawm thrombophlebitis ntawm cov hlab ntsha sab nraud, cov cai hauv qab no yuav tsum tau ua raws:
- Yog tias koj cov dej num niaj hnub koom nrog zaum hauv ib txoj haujlwm ntev, koj yuav tsum tau so ib ntus thiab sov so.
- tsa ceg qis thaum twg ua tau.
- taug kev ntev txhua hnub.
- Yog rog rog, kho cov zaub mov kom txo lub cev hnyav.
- Ua ib ce sawv ntxov txhua hnub.
- Kua huv.
Ntxiv rau, yog tias muaj cov tsos mob ntawm varicose leeg, koj yuav tsum tau hu rau phlebologist. Kev kho mob raws sij hawm ntawm tus kab mob yuav zam kev txhim kho thrombophlebitis.
In xaus
Pathology yog multifactorial. Cov chav kawm ntawm thrombophlebitis yog tus cwj pwm los ntawm kev tshwm sim ib txhij ntawm cov txheej txheem inflammatory hauv phab ntsa venous thiab tsim cov ntshav txhaws. Thaum cov tsos mob ntxhov siab tshwm sim,koj tuaj yeem tiv tauj tus kws kho mob kom sai li sai tau. Tus kws kho mob yuav xa daim ntawv xa mus rau kev kuaj xyuas, raws li cov txiaj ntsig ntawm nws yuav kos cov kev kho mob zoo.
