Ileofemoralny Thrombosis: zimayambitsa, zizindikiro, chithandizo

Amene matenda poyera kuti dongosolo venous wa munthu? Chifukwa vuto zikachitika, nanga ankachitira? Awa ndi mafunso ena ife adzayankha m'nkhani pano.

mwachidule

Ileofemoralny thrombosis - thrombosis ndi pomenya femoral kwambiri ndi mitsempha iliac. matenda allocated mu mawonekedwe osiyana, monga yodziwika ndi otaya mwachilungamo lolemera ndi chiopsezo cha aakulu m'mapapo mwanga embolism iye.

Features matendawa

thrombosis Ileofemoralny angathe osati akulu komanso ana. Pankhaniyi, matenda bwino, ndipo mankhwala ndi bwino zedi. Pakati pa ana ambiri kukhala embolism m'mapapo mwanga kapena retrombosis taonera.

Monga odwala wamkulu, kwa iwo, matenda umabweretsanso mavuto wokongola kwambiri. Choncho opani mu nthawi.

Zizindikiro zazikulu

Thrombosis anayamba mu mitsempha femoral kapena iliac, limodzi ndi zizindikiro monga:

• madontho bulauni kukula laling'ono, okamba pa mapazi awo ndi chiyani kutha pamene mbamuikha;
• malungo;
• kutupa moti angayambe pa m'makona onse m'munsi kapena pa m'modzi wa iwo;
• wofiirira-ofiira kapena bluish khungu;
• pang'onopang'ono kwambiri ululu mwendo kapena miyendo komanso groin (nthawi zina).

Zizindikiro za thrombosis pachimake. siteji

Pachimake thrombosis ileofemoralny ali magawo angapo a chitukuko. Malinga matenda awo akhale ndi makhalidwe awo. Tiyeni tione iwo mwatsatanetsatane:

• Mbali prodromal. Pa nthawi imeneyi matendawa wodwalayo ululu wa kutanthauzira zosiyanasiyana. Iwo akhoza kufika m'dera lumbosacral, pamimba m'munsi, komanso kugonjetsedwa kwa miyendo m'munsi. Kupweteka ululu syndrome ndipo ali chikhalidwe wosasamala. Komanso, wodwalayo watentha thupi.
• Khwelero kutchulidwa zizindikiro matenda. Iwo amakhala ndi wa ku tingachipeze powerenga za kuonekera. M'mawu ena, wodwalayo kutupa kwambiri, kusintha mu khungu, ndipo ululu. Zodabwitsa ndizakuti, yotsirizira ndi adazindikira ng'ombe, groin ndi anteromedial ntchafu. Chikhalidwe cha ululu ali kwambiri ndipo akakufunsani. Koma kutupa, izo likuthandiza dera lonse ndi chochokera groin kumapazi. Nthawi zina kutupa zimawonedwa pa gluteus Maximus ndipo pamodzi ndi lingaliro la chidzalo ndi kumverera kwa kulemera mu miyendo m'munsi.

Popeza minofu edematous khama kuthamanga kwambiri ziwiya magazi, magazi chisokonezo zikachitika, kuphipha ndi miyendo kukhala pachimake ischemia, m'kukoma kupweteka kwambiri, kupanda tilinazo ndi pulsations wolumikizira.

Monga tanena chimodzi mwa zizindikiro za matenda funso ndi kusintha mtundu wa khungu. Iwo akhoza kukhala wotumbululuka kapena cyanotic mtundu. White mitundu kumachitika chifukwa kuphipha zokhudzana mitsempha. okhumudwa limodzi ndi ululu. Mtundu buluu kapena cyanotic mtundu zimawonedwa mu nkhani imene iliac kapena mtsempha wamagazi femoral si kukwaniritsa ntchito zake mwachindunji, mwachitsanzo outflow wa magazi pa iwo pafupifupi mwathunthu wosweka. Nkofunika chizindikiro ndi kuti wodwalayo Tingaone pa ntchafu kutchulidwa chitsanzo cha mitsempha subcutaneous.

Mu ileofemoralny ambiri thrombosis yodziwika zogwira mtima chikhalidwe ambiri wodwala. Komabe, mwina kwambiri iwonongeke mu chitukuko cha matenda pachimake. Izi zikusonyeza chiyambi cha vuto lalikulu.

zimayambitsa

Dongosolo venous munthu zikhoza kukhala zinthu zosiyanasiyana zimasintha. Nthawi zambiri, odwala ndi thrombosis kwambiri m'mitsempha. matenda Izi zimachitika chifukwa amachepetsa magazi ndi matenda ake clotting, komanso kuwonongeka kwa mpanda venous.

Development ileofemoralnogo thrombosis angayambe pamaso pa mfundo imodzi, ndipo ngati pali zingapo. Akatswiri amati mfundo yoyambira zimene zimachititsa zikamera wa matenda:

• kuvulala munthu;
• yaitali bedi mpumulo;
• DIC;
• matenda ndi chiyambi bakiteriya;
• nthawi postpartum;
• phwando kulera;
• mimba;
• zilonda ndi mtima wabwino m'chiuno misa;
• aneurysm wa iliac ndi mitsempha femoral ndi msempha m'mimba;
• popliteal chotupa;
• retroperitoneal fibrosis;
• kuwonongeka iatrogenic kwa mitsempha kwambiri.

Zimakonda

Nthawi zambiri ileofemoralny thrombosis wa malekezero a m'munsi, yodziwika ndi stagnation magazi mu mitsempha, akufotokozera pa mimba. Komanso, matenda angayambe chifukwa immobilization yaitali ndi insufficiency kuli nthambi venous.

Chinthu china chofunika mu chitukuko cha matenda funso ndi kudwala kwa coagulation magazi, kuphatikizapo kobadwa nako kapena kugula boma thrombophilic.

diagnostics

Kodi matenda thrombosis wa malekezero a m'munsi? Zizindikiro za matenda anafotokoza bwino ndithu. Koma kuwonjezera Kupenda kunja wodwala, madokotala nthawi zambiri kugwiritsa ntchito njira zina matenda amene anapereka mu mawonekedwe a:

• chindodo ndi fibrinogen;
• duplex chindodo;
• radionuclide venography, yomwe ikuchitika kukachitika kuti wodwalayo wosalolera wa zinthu radiopaque;
• kutsika kapena kukwera venography radiopaque.

chithandizo

thrombosis Ileofemoralny apatsidwe thandizo chimodzimodzi monga momwe zina thrombosis. Nthawi zambiri, chithandizo cha matenda ikuchitika mu chilengedwe kuchipatala. Bukuli lili ndi kutenga mankhwala zotsatirazi:

• odana ndi yotupa wothandizila;
• antiplatelet wothandizila;
• anticoagulants.

Ngati iliac kapena femoral mtsempha wamagazi anadabwa zambiri, ndipo matenda ali mu magawo oyambirira a chitukuko, chifukwa njira zake mankhwala akhoza kugwiritsidwa ntchito kuti lithandizire yanyumba thrombus.

Ngati pali kuopseza thromboembolism, mwambo kupewa ake. Ndondomeko anachita ntchito ligation ya m'mitsempha femoral, vena cava fyuluta unsembe kapena plication otsika vena cava.

Ngati wodwalayo ndi pachimake thrombosis ileofemoralny ndiye kuchita mayendedwe ake kuchipatala. Pankhaniyi, wodwala ayenera kukhala mu malo mosabvuta. Pamaso mayeso, iye anatumizidwa ku bedi zina, kuchita ultrasound ndi venography.

Mu chochitika kuti zinthu kufufuza wodwala ali kwina, kuyang'aniridwa ndi akatswiri izo Kwalamulidwa anticoagulants, amene ayenera kumwedwa kwa masiku khumi.

Malinga ndi malipoti a akatswiri thrombosis pachimake venous apatsidwe thandizo comprehensively, m'magulu atatu mankhwala:

• thrombolytics kapena fibrinolytics;
• anticoagulants;
• Antiplatelet wothandizira.

Tikumbukenso kuti mankhwala anticoagulant zachokera ntchito njira zotsatirazi:

• heparin otsika maselo kulemera ;
• unfractionated heparins;
• pentasaccharide fondaparinux.

Ndi chitukuko cha thrombolysis chimene chimafuna ntchito streptokinase kapena urokinase, ali kwambiri kuchuluka imfa mtima chifukwa ndi kuwonjezeka mu magazi. Choncho, njira imeneyi ntchito pokha pokha kwambiri, mwachitsanzo, ngati thrombosis ambiri anayamba posachedwapa, ie, osapitirira sabata zapitazo.

Thrombolytic mankhwala thrombosis ileofemoralnogo mitundu ikuchitika pambuyo Komanso, kudzakhala cava fyuluta. Ichi ndi chifukwa chakuti mankhwala zimenezi zimathandiza kusuntha magazi aumirira mu mtsempha wamagazi m'mapapo mwanga, tingayambe chitukuko cha zochitika thromboembolic.

alowererepo opaleshoni

Pamene ileofemoralnom thrombosis zotheka njira ya opaleshoni. Iwo wochititsidwa ndi zizindikiro yofunika, malingana ndi chiopsezo kukhala embolism m'mapapo mwanga.

Iwo ayenera kukumbukira kuti ntchito za nkhaniyo ikuchitika pamene pali kuwopsyeza kwa chilonda venous ndi kafalitsidwe wa ndondomeko pathological mu otsika vena cava.

Mukhozanso kuchotsa anapanga lamanzere iliac mtsempha thrombus retrograde. Ndondomeko ikuchitika mwa dzenje flebotomicheskoe, zomwe zimachititsa mu mtsempha femoral. Tikumbukenso kuti mwina zimenezi sizingatheke, kuyambira iliac bwino Vienna angakhale ndi kuthamanga kwambiri.

Malinga ndi akatswiri, opareshoni kuchotsa magazi aumirira Mulimonsemo sangathe ikuchitika pa adhesions zikuchitika mu mtsempha, ndi pamaso pa partitions intravascular.

zosokonezeka

Mwambo kulephera kwa dokotala, komanso mankhwala cholakwika ileofemoralnogo thrombosis wodwala angathe vuto loopsa ndithu embolism m'mapapo mwanga. Choncho ndikofunika kumvetsetsa kuti pamene kuona chizindikiro chilichonse, komanso kukayikitsa thrombosis, muyenera yomweyo kufunsa dokotala wodziwa.

kupewa matenda

Pofuna kupewa zotsatira za matenda mu miyeso funso njira chofunika kuti akhale pansi, amene umalimbana kuwongolera mkhalidwe wonse wa wodwalayo ndi ziwiya zake makamaka.

Ndi chinsinsi yaitali ndi moyo ndi zinthu zolimbitsa komanso kudya chakudya chabwino.

Kupewa kwathunthu chitukuko cha thrombosis, wodwala ayenera kuyang'aniridwa kwa moyo wawo. M'pofunika kuthetsa makhalidwe onse oipa ndipo nthawi anati dokotala.

Pankhani ya matenda venous dongosolo wayamba kale kukhala, muyenera kutsatira zinthu zonse zimene zodzitetezera kuti Cholinga chake popewa mavuto zotheka. Mu ndondomeko iyi ikukhudza kuwonongedwa kwathunthu kwa zinthu zonse chiopsezo, zolimbitsa ntchito mode, ndi molondola anasankha anticoagulant ndi mankhwala antiplatelet.

Akatswiri amanena thrombosis mawonekedwe ileofemoralnoy - ichi ndithu matenda amene amatha kuwononga kwambiri kuti thanzi la munthu. Komabe, tisaiwale kuti matenda ndi n'ngochiritsika, kuphatikizapo pamene unayambitsidwa mu nthawi. Chinthu chachikulu - musataye mtima ndipo musasiye ndi kutsatira malangizo onse a dotolo odziwa.