The cause of vasculitis is still unknown. Statistics show that the incidence of vasculitis in cold areas is higher than that in warm areas, and the incidence of smokers is higher than that of non-smokers. Therefore, most scholars believe that the onset of vasculitis is related to long-term smoking and catching cold. Others believe that it is related to immune genetic factors.
This disease mostly occurs in young people aged 20-40, and the ratio of male to female is 29∶ 1. It mainly involves several groups of arteries in front of the tibia, behind the tibia and the dorsum of the calf. In severe cases, it can involve the femoral artery and even all the blood vessels in the limbs. Thrombosis, lumen occlusion and insufficient blood supply can cause thrombophlebitis, arteritis, intermittent claudication, tissue malnutrition and even necrosis, which seriously harms health.
The diagnosis of thromboangiitis obliterans is based on the following points:
(1) onset in young men;
(2) Intermittent claudication of one or both lower limbs;
(3) The pulse of dorsum pedis or posterior tibial artery is weakened or disappeared;
(4) Patients with superficial wandering thrombophlebitis without hypertension, hyperlipidemia, diabetes and arteriosclerosis;
(5) Limb posture test: the patient lies on his back, and his lower limbs are raised by 45 degrees. After 3 minutes, the skin color changes of his feet are observed. The skin of affected limbs and feet, especially toes, is pale or sallow, and the tenderness of fingers is more obvious, accompanied by numbness and pain. Ask the patient to sit up, let the lower limbs droop naturally, and the skin color will slowly recover or turn blue-purple.
Chinese medicine believes that vasculitis is caused by
Vasculitis, called thromboangiitis obliterans, is a serious disease caused by vascular inflammation caused by thromboembolism of small and medium arteries in lower limbs.
The cause of vasculitis is still unknown. Statistics show that the incidence of vasculitis in cold areas is higher than that in warm areas, and the incidence of smokers is higher than that of non-smokers. Therefore, most scholars believe that the onset of vasculitis is related to long-term smoking and catching cold. Others believe that it is related to immune genetic factors.
This disease mostly occurs in young people aged 20-40, and the ratio of male to female is? 29∶ 1? . It mainly involves several groups of arteries in front of the tibia, behind the tibia and the dorsum of the calf. In severe cases, it can involve the femoral artery and even all the blood vessels in the limbs. Thrombosis, lumen occlusion and insufficient blood supply can cause thrombophlebitis, arteritis, intermittent claudication, tissue malnutrition and even necrosis, which seriously harms health.
The diagnosis of thromboangiitis obliterans is based on the following points:
(1) onset in young men;
(2) Intermittent claudication of one or both lower limbs;
(3) The pulse of dorsum pedis or posterior tibial artery is weakened or disappeared;
(4) Patients with superficial wandering thrombophlebitis without hypertension, hyperlipidemia, diabetes and arteriosclerosis;
(5) Limb posture test: the patient lies on his back, and his lower limbs are raised by 45 degrees. After 3 minutes, the skin color changes of his feet are observed. The skin of affected limbs and feet, especially toes, is pale or sallow, and the tenderness of fingers is more obvious, accompanied by numbness and pain. Ask the patient to sit up, let the lower limbs droop naturally, and the skin color will slowly recover or turn blue-purple.
Chinese medicine classifies vasculitis as gangrene. As early as Huangdi Neijing, there were records about this disease. Ma Peizhi's Surgical Medical Record says: "The ancient book says that Stan is warm and the ointment is too thick, but ... it will lead to gangrene ... the feet are swollen and hot, the toes are still cold, the flesh and blood are dead, the joints are cracked for a long time, the sewage seeps out, and the tendons are broken and the meat is broken." ..... Look at its endowment strength, it should be caused by accumulated heat, mainly nourishing yin and clearing fire. "
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Like vasculitis
CCTV International Channel (8 September 2005 15:05)
Chief physician Wu Danming, director of vascular surgery in Liaoning Provincial People's Hospital, is good at treating peripheral vascular obstructive diseases by combining intravascular interventional therapy with surgery. He has completed more than 2,000 angiography cases, published 35 papers and participated in 5 monographs. (Left)
Yi Wei, deputy chief physician of vascular surgery in Liaoning Provincial People's Hospital, is good at surgical operation and interventional treatment of peripheral vascular diseases, and has deep attainments in noninvasive and minimally invasive examination of vascular diseases. He has published more than ten papers and participated in two monographs. (right)
Q: What is vasculitis?
A: Vasculitis is actually an inflammatory manifestation of the vascular wall itself, which has nothing to do with bacterial infection. The blood vessel wall is divided into three layers. Combined with a picture, the left side is a normal blood vessel, which is divided into inner layer, middle layer and outer layer. The inner layer is smooth and the blood flows smoothly. The middle layer is the muscle layer, which keeps the elasticity of blood vessels, and the outer layer is a very smooth structure separated from other tissues. Let's look at the picture on the right. The vascular wall is involved in the lesion from the inside out. Inflammatory changes in the inner layer lead to stenosis of the vascular lumen, so blood supply cannot be supplied. The serious change caused by the middle layer is that the muscles are relatively stiff and have poor elasticity. Once the outer layer breaks through, some tissues around blood vessels, nerves, adventitia and muscles also participate in inflammatory changes, resulting in a series of symptoms.
Q: What kind of people are particularly susceptible to this vasculitis?
A: The high-risk group of vasculitis.
1, smokers (especially young men)
2. Nervous people
3. Unbalanced nutrition
4. Residents in cold and humid areas
5. Family genetic factors
Q: What are the clinical manifestations of vasculitis?
A: Early symptoms:
1, numbness, coldness and pain
2, easy to fatigue, leg acid.
3. The pulse is weakened and gradually disappears.
Mid-term symptoms:
1, leg pain during exercise.
2, muscle twitching, especially at night.
3. Intermittent claudication
Late symptoms:
1, persistent severe pain
2, the skin is dark red and dark brown, and ulcers appear.
3. The feet and toes turn black and necrotic.
Q: What does intermittent claudication mean?
A: This is a medical term. Our usual understanding is the symptoms after exercise. There is nothing to show during the break. In addition to limping, patients also have a very obvious feeling that their feet are very, very cold. Even in very warm weather, he wears thick socks and sleeps with a thick quilt. He felt like putting his feet in the freezer, so the patient was very scared.
Q: What are the treatments for vasculitis?
Answer: 1, vascular bypass surgery, which we understand as vascular bypass surgery. In fact, it means the same thing as heart bypass, except that this lesion appears in the limbs, and mainly in the lower limbs. For example, this damage is limited to a few centimeters or more. We can give up this road and open a new one. There are two possibilities. One is that it needs a lot of engineering to repair it, so it is better to have another one. Another possibility is that it can't be repaired at all, so let's have another artificial blood vessel. Ensure the nutrition of blood supply below the knee joint.
2. Drug nuclear physical therapy. Drug therapy mainly refers to the inhibition of vasculitis in the chest or the further deterioration of the disease by drugs.
3. Interventional therapy. Interventional therapy is equivalent to intravascular surgery, and the effect of surgery can be achieved without surgery. Interventional technology, the most representative of which is intravascular ultrasound ablation technology, recanalizes blocked blood vessels by ultrasound with one wavelength.
Q: How do patients choose which method to apply?
A: The use of treatment methods is based on the specific situation of patients, involving many factors, and there are strict definitions in medicine. We can simply understand that, for example, blood vessels are tunnels. Due to various reasons, such as earthquake or soil erosion, it involves collapse or has collapsed. Then check it quickly and see what the tunnel is like. If it collapses completely, there is no way to do another one, which is what we call bypass surgery. If the stone partially falls or cracks, then we should clean the tunnel first, just like if there is only a little water dripping in the tunnel, use a little cement locally and plant some trees on the mountain to keep soil erosion. This is medication. According to the specific situation of patients, it is used clinically in medicine. According to the degree of stenosis, the length of the lesion, and the state of the patient's whole body, many patients use interventional therapy more, because interventional therapy has little influence on patients, and the repeatability of interventional therapy is very strong, which patients can tolerate. Intervention, surgery, medication, we can't definitely separate them, we can complement each other.
Q: Why does advanced vasculitis hurt so much?
A: There are two mechanisms. One is that there is no nutrition in the area. Without nutrition, muscles will be necrotic, and necrosis will naturally hurt. The other is complete paralysis of blood vessels. For example, there is something wrong with the adventitia. There are many nerves attached to the adventitia of blood vessels, which send signals to the brain about vascular diseases, such as health, pain, necrosis and some special nerve conduction in muscles. Vasculitis corrodes these nerves, so his sensitivity is different at this time. For example, if we adults touch a cup of hot water, it may be a little hot, but for children.
Q: What is the examination content of vasculitis reexamination?
Answer: 1, skin color, temperature
2. Measurement of ankle arterial pressure
3. Color Doppler ultrasound
4、CT、MRI
5. Arterial radiography
Q: After vasculitis is cured, how to prevent recurrence?
Answer: 1. Quit smoking and limit alcohol.
2. The limbs are full of warmth
3. Prevention of trauma
4. Good living habits
5, adhere to drug treatment