Post-thrombophlebitis tus kab mob yog tus cwj pwm los ntawm kev nyuaj siab nyob rau hauv cov ntshav venous los ntawm qis extremities, uas tshwm sim tom qab sib sib zog nqus vein thrombosis. Clinically, tus kab mob no tuaj yeem tshwm sim nws tus kheej tsuas yog ob peb xyoos tom qab mob thrombosis. Nyob rau tib lub sijhawm, cov neeg mob muaj kev hnov mob hauv qhov cuam tshuam ntawm ceg ceg, mob thaum tsaus ntuj, o thiab annular pigmentation tsim, tau txais fibrous ntom dhau sijhawm.
Cov lus xaus rau kev kuaj mob ntawm "tus kab mob tom qab thrombophlebitis" (ICD code 10 I87.0) yog ua raws cov txiaj ntsig ntawm kev kuaj ultrasound ntawm cov leeg ntawm cov leeg thiab cov ntaub ntawv anamnestic. Kev nce circulatory decompensation yog ib qho qhia rau kev kho mob ntawm cov kab mob no.
Kev tshwm sim
Thaum lub sij hawm sib sib zog nqus vein thrombosis, ib daim ntawv thrombus nyob rau hauv lub lumen ntawm lub nkoj. Tom qab cov txheej txheem mob tshwm sim, thromboticMasses undergo ib nrab lysis thiab pib hloov los ntawm cov ntaub so ntswg. Yog hais tias lysis predominates nyob rau hauv cov ntaub ntawv no, recanalization tshwm sim, nyob rau hauv uas cov hlab ntsha lumen rov qab. Thaum thrombi hloov los ntawm cov ntaub so ntswg sib txuas, occlusion tsim (ua tiav kaw ntawm lub nkoj lumen).
Kev kho dua tshiab ntawm vascular lumen feem ntau yog nrog kev puas tsuaj ntawm cov qauv valve hauv thaj tsam ntawm thrombus localization. Yog li ntawd, tsis hais txog qhov tseem ceeb ntawm qee cov txheej txheem, qhov tshwm sim ntawm phlebothrombosis feem ntau yog cov ntshav tsis txaus nyob rau hauv cov leeg sib sib zog nqus.
Kev nce siab hauv cov hlab ntsha no ua rau muaj kev nthuav dav (ectasia) thiab tsis ua haujlwm ntawm cov hlab ntsha perforating. Ntshav los ntawm cov hlab ntsha sib sib zog nqus pib tawm mus rau hauv lub lumen ntawm cov hlab ntsha sab nraud. Cov hlab ntsha subcutaneous pib nthuav dav thiab tseem ua tsis tiav. Tom qab ntawd, tag nrho cov hlab ntsha ntawm cov hlab ntsha ntawm sab qis yog koom nrog cov txheej txheem pathological.
Qhov teeb meem tom ntej uas tsis tuaj yeem ntawm tus mob no yog microcirculatory ntshawv siab. Kev noj zaub mov tsis zoo ntawm daim tawv nqaij ua rau pom cov kab mob trophic. Kev txav ntawm cov ntshav los ntawm cov hlab ntsha feem ntau yog muab los ntawm cov leeg nqaij. Vim yog ischemia, cov leeg nqaij contractility maj mam tsis muaj zog, uas ua rau cov tsos mob tshwm sim ntawm venous insufficiency.
Kev faib tawm
Hauv cov tshuaj, muaj ob txoj hauv kev rau cov kab mob xws li kab mob tom qab thrombophlebitis(edematous-varicose thiab edematous daim ntawv), nrog rau peb theem ntawm kev loj hlob:
- Kev mob o, mob ceg hnyav.
- Persistent edema nrog rau cov kab mob trophic (kev cuam tshuam ntawm daim tawv nqaij pigmentation, lipodermatosclerosis, eczema).
Symptomatics
Cov tsos mob thawj zaug ntawm tus kab mob tom qab tus kab mob thrombophlebitis feem ntau tshwm sim ob peb lub hlis lossis xyoo tom qab kev loj hlob ntawm mob thrombosis. Thaum pib ntawm tus kab mob no, cov neeg yws yws ntawm qhov mob, ib qho kev xav ntawm tag nrho cov ceg, hnyav thaum taug kev lossis sawv. Pw tsaug zog, tom qab muab tus ntiv tes tso rau hauv txoj hauj lwm siab, cov tsos mob yuav txo qis. Cov tsos mob ntawm tus kab mob ntawm cov kab mob tom qab thrombophlebitis yog qhov mob mob ntawm cov leeg nqaij ntawm cov leeg mob, uas tshwm sim thaum hmo ntuj.
Varicose hloov
Cov kev tshawb fawb niaj hnub hauv thaj chaw kho mob phlebology tau pom tias kwv yees li 25% ntawm cov neeg mob no pathology yog nrog los ntawm varicose hloov nyob rau hauv cov phab ntsa ntawm cov leeg ntawm sab ceg. Edema ntawm qhov sib txawv yog pom nyob rau hauv yuav luag txhua tus neeg mob. Ob peb lub hlis tom qab qhov pib ntawm edema, indurating mob nyob rau hauv cov ntaub so ntswg mos tshwm. Hauv cov ntaub so ntswg subcutaneous thiab daim tawv nqaij, cov txheej txheem ntawm kev tsim cov ntaub so ntswg pib. Cov ntaub mos mos tau txais qhov ntom ntom, daim tawv nqaij pib ua rau cov ntaub so ntswg subcutaneous, thiab nws txoj kev txav mus los tau ploj mus.
Annular pigmentation
SpecificCov tsos mob ntawm xws li mob xws li kab mob tom qab thrombophlebitis yog lub nplhaib-pigmentation. Cov kev hloov zoo sib xws pib saum cov pob taws thiab maj mam npog qhov qis ntawm sab ceg. Nyob rau hauv lub neej yav tom ntej, dermatitis, quaj los yog qhuav eczema tej zaum yuav tshwm sim nyob rau hauv cov cheeb tsam no, thiab nyob rau hauv lub lig lub sij hawm ntawm tus kab mob, lub sij hawm ntev uas tsis yog-kho trophic ulcers yog tsim.
Post-thrombophlebitis kab mob ntawm qis qis hauv cov neeg mob sib txawv tuaj yeem ua mus rau ntau txoj hauv kev. Hauv qee cov neeg mob, cov txheej txheem pathological rau lub sij hawm ntev manifests nws tus kheej tsis tshua muaj zog los yog nrog cov tsos mob me me, nyob rau hauv tas li ntawd nws nce mus sai heev thiab tuaj yeem ua rau kev loj hlob ntawm trophic mob thiab kev tsis taus mus tas li.
ntsuas ntsuas
Yog tias xav tias muaj kab mob ntawm cov kab mob tom qab thrombophlebitis, tus kws kho mob yuav tsum paub seb tus neeg mob puas muaj kab mob xws li thrombophlebitis. Qee cov neeg mob uas muaj tus kab mob no tsis tig mus rau phlebologists nyob rau lub sijhawm, yog li ntawd, thaum qhia meej txog anamnesis, nws yog ib qho tsim nyog yuav tsum tau ua tib zoo saib xyuas lub sijhawm ntev ntawm o ntawm txhais ceg thiab kev zoo siab nrog nws.
Txhawm rau kom paub meej qhov kev kuaj mob, qee qhov kev ntsuas ntsuas tau ua tiav, piv txwv li, ultrasound ntawm cov hlab ntsha ntawm sab qis. Txhawm rau txiav txim siab cov duab, thaj chaw ntawm qhov txhab thiab qib ntawm hemodynamic cuam tshuam yog siv:
- radionucleoid phlebography ntawm extremities;
- rheovasography;
- ultrasound angioscanning.
Kev kho mob
Thaum hloov kholub sij hawm (thawj 12 lub hlis tom qab thrombophlebitis), cov neeg mob tau sau tseg kev kho mob. Qhov taw qhia tseem ceeb rau kev cuam tshuam kev phais yog suav tias yog kev ua kom ntxov ntxov ntawm kev ncig ntawm qhov teeb meem ntawm ceg ceg ntawm qhov kev loj hlob.
Tom qab kawg ntawm lub sijhawm hloov kho, cov kev kho mob feem ntau yog nyob ntawm theem thiab daim ntawv ntawm cov kab mob xws li kab mob post-thrombophlebitis. Nyob rau theem ntawm kev them nyiaj thiab subcompensation ntawm circulatory disorders, kev siv tas li ntawm compression elastic txhais tau tias (cov ris tsho hauv qab, cov hnab looj tes), nrog rau cov kev ntsuas ntawm lub cev, tau pom zoo. Txawm tias tsis muaj cov tsos mob ntawm cov kab mob hauv lub cev, cov neeg mob uas muaj tus kab mob tom qab thrombophlebitis yog contraindicated hauv kev ua haujlwm hnyav, ua haujlwm hauv qhov txias, hauv khw kub, nrog rau kev ua haujlwm nrog kev nyob ntev ntawm lawv txhais taw.
Yog tias muaj cov tsos mob ntawm cov hlab ntshav decompensation, tus neeg mob tau muab tshuaj los ntawm qeb ntawm cov tshuaj tiv thaiv kab mob (pentoxifylline, dipyridamole, acetylsalicylic acid), fibrinolytics, tshuaj uas txo qhov mob ntawm phab ntsa venous (hydroxyethyl rutoside, horse chestnut extract., tribenoside, troxerutin). Nyob rau hauv lub xub ntiag ntawm trophic mob, multivitamin, pyridoxine, desensitizing tshuaj yog qhia. Nrog rau kev kuaj mob ntawm "tus kab mob tom qab thrombophlebitis", cov lus pom zoo yuav tsum ua raws li nruj me ntsis.
kho mob phais
Kev phais ua tsis tautshem tawm tag nrho cov pathology. Kev ua haujlwm tsuas yog pab kom ncua qhov tshwm sim ntawm cov kab mob pathological hauv lub venous system. Hauv qhov no, kev kho mob phais tsuas yog ua tiav thaum tsis muaj txiaj ntsig zoo los ntawm kev kho kom zoo.
Yam kev cuam tshuam kev phais
Hom kev phais hauv qab no rau kev kuaj mob tom qab thrombophlebitis (ICD 10 I87.0) yuav tsum raug sau tseg:
- Kho cov haujlwm (miniphlebectomy thiab phlebectomy), dhau los ntawm cov leeg saphenous cuam tshuam los ntawm varicose leeg raug tshem tawm, thiab cov leeg sib txuas lus kuj tau ligated.
- Kev phais kho dua tshiab (plasty thiab resection ntawm cov leeg, hu ua bypass grafting).
Txog hnub no, tsis muaj cov txheej txheem kho mob, suav nrog kev kho mob phais, tuaj yeem tiv thaiv kev loj hlob ntawm tus kab mob tom qab thrombophlebitis hauv nws cov chav kawm tsis zoo. Kwv yees li ntawm 10 xyoo tom qab kuaj pom, 38% ntawm cov neeg mob ua tsis taus.
Yuav siv tshuaj dab tsi los kho?
Postthrombophlebitis kab mob yog cov txheej txheem pathological uas yuav tsum tau siv tas li ntawm ntau yam tshuaj uas tuaj yeem ua rau qeeb ntawm tus kab mob thiab txo qis kev siv zog thiab mob hnyav. Cov neeg mob yog cov tshuaj uas tiv thaiv thiab kho cov phab ntsa vascular, normalize microcirculationntshav thiab rheological tsis. Cov tshuaj tau noj nyob rau hauv ob lub hlis kev kawm, nrog kev cuam tshuam. Cov kab mob tom qab thrombophlebitis ntawm qis extremities yog qhov tsis kaj siab heev.
Kev kho mob kuj muaj nyob rau hauv qhov tseeb tias tus neeg mob tau txais cov tshuaj antioxidants, tshuaj tiv thaiv kab mob thiab tshuaj tiv thaiv kab mob. Yog tias muaj kab mob trophic tshwm sim, cov tshuaj tua kab mob tau muab tshuaj. Reparants thiab phlebotonics ntxiv rau cov tshuaj no. Nyob rau hauv tas li ntawd mus rau lub systemic tshuaj, nws yog tsim nyog los siv tshuaj pleev, gels, cream uas muaj antithrombotic thiab anti-inflammatory zog. Ntawm cov tshuaj kws kho mob tshaj plaws yog:
- tshuaj pleev heparin;
- "Troxevasin";
- "Flebodia";
- Detralex.
Zoo nyob ntawm theem ntawm kev kho, theem ntawm tus kab mob thiab teeb meem, radon da dej, electrophoresis, magnetotherapy, darsonvalization, ozone da dej thiab lwm yam txheej txheem yuav raug sau tseg.
