Leg vein thrombosis

Leg vein thrombosis - yakadzika vein thrombosis

Zviri mukati

Leg vein thrombosis imamiriro ekuti ropa rakagwamba (thrombus) rinoumba mutsinga yakadzika mugumbo. Izvi zvinogona kudzora kuyerera kweropa uye kukonzera kuzvimba, kurwadziwa, kutsvuka, uye kudziya mugumbo rakabatwa. Leg vein thrombosis inogonawo kutungamirira kumatambudziko akakomba akadai se pulmonary embolism kana chikamu che thrombus chikabva chaenda kumapapu. Pulmonary embolism chirwere chinowanzouraya. Thrombophlebitis inofanira kusiyaniswa kubva pakadzika mutsinga thrombosis. Nekudaro, iwe haufanirwe kuita mutsauko uyu iwe pachako, asi kuti taura nana mazvikokota ane ruzivo mukuvhiya kwevascular uye phlebology uye iongororwe nekiriniki, neultrasound uye kuburikidza neakakosha murabhoritari bvunzo. Thrombophlebitis kazhinji haina ngozi kupfuura leg vein thrombosis, asi muzviitiko zvisingawanzoitiki zvinogona kukonzera kudzika kwetsinga kana pulmonary embolism.

Zviratidzo zvekudzika mutsinga thrombosis

Zviratidzo zveyakadzika vein thrombosis zvinogona kusiyana zvichienderana nenzvimbo uye chiyero chevhavha, asi zvimwe zviratidzo zvinozivikanwa zvinosanganisira:

Kuzvimba kwegumbo rakabatwa, kazhinji kune rumwe rutivi
Kurwadza kwegumbo, kazhinji mumhuru kana mutsoka
Kutsvuka, kudziya, kana kushanduka kweganda pamusoro pegwara
Kunzwa tension kana matinji mugumbo

Zviratidzo izvi hazviitike nguva dzose kana kuti zvinyoro. Dzimwe nguva avo vanobatwa vanongoona thrombosis kana ichitungamira kune complication senge pulmonary embolism. A pulmonary embolism injodzi inotyisidzira hupenyu inokonzerwa nekukasira Atemkushungurudzika, kurwadziwa muchipfuva, kukosora kana kukosora ropa. Kana uine chimwe kana zvimwe zvezviratidzo izvi, unofanira kunyatsoona chiremba kuti aone chikonzero uye wotanga kurapwa kwakakodzera.

Kurapa kwegumbo thrombosis

Deep vein thrombosis inogona kurapwa nemishonga, compression stockings, kana, muzviitiko zvisingawanzo, kuvhiyiwa. Kurapa kune chinangwa chekudzivirira kuti clot isakura kana kubvisa uye kuderedza njodzi yekukuvara kunotevera. Kurapa kunogona kuitwa kuchipatara kana kuti murwere, zvichienderana nekuti murwere anoda kuongororwa zvakadii. Kurapa kazhinji kunosanganisira matanho anotevera:

Mishonga inoderedza ropa (anticoagulants), iyo inodzivirira kuumbwa kwekuwedzera kweropa uye kukurudzira kuparara kweiyo thrombus iripo. Mishonga iyi inogona kupihwa semapiritsi kana majekiseni. Kurapa kwezvinodhaka kunogona kunyungudutsa chikamu kana zvachose kuputika. Kukura kweiyo thrombosis, kureba kwetsinga yakakanganisika uye kushanda kweiyo anticoagulant therapy inosarudza kuti tsinga dzakavharwa ne thrombosis dzichavhurwazve nekurapa kwezvinodhaka.
Kumanikidza masokisi kana mabhandeji anoshandisa kupfakanyika zvinyoro pagumbo uye kunatsiridza kuyerera kweropa. Idzi dzinofanira kupfekwa kwemwedzi inoverengeka.
Itai maekisesaizi panzvimbo yekuzorora pamubhedha: Munguva yakapfuura, murwere wese ane thrombosis aifanira kurara pamubhedha kuti adzivise njodzi yepulmonary embolism. Nheyo dzemazuva ano dzakasiyana uye maekisesaizi anowanzo bvumidzwa pasi peropa rinoshanda rakaonda uye compression therapy kusimudzira kuyerera kweropa uye kuderedza kuzvimba. Nekudaro, izvi zvinofanirwa kuitwa chete pasi pekutungamirwa nachiremba uye neanoshanda anticoagulation - kuonda kweropa - uye kurapwa kwekumanikidza.
Painkiller chete munguva pfupi kana kurwadziwa kwakanyanya
Kupindira kwekuvhiya kwe thrombosis zvinongodiwa muzviitiko zvisingawanzoitiki kana mishonga isingashande kana isingabvumirwi. Iyo thrombus inogona kubviswa nemuchina (thrombectomy) kana mudziyo unogona kushandiswa kudzivirira kuti isasvike pamapapu (vena cava sefa). Ndiani anofanira kuvhiyiwa anosarudzwa zvichienderana nachiremba, kiriniki uye zvavanosarudza. Kana iyo thrombosis ichionekwa mudhipatimendi remishonga yemukati kana mune yekunze venous maitiro, maitiro ekuchengetedza anowanzo kurongerwa. Kana zvinodiwa zvehunyanzvi uye zvevashandi zvevenous thrombectomy zvakasangana, ipapo chiratidzo chekuvhiya kubviswa kwethrombosis chinogona kuitwa, nekudaro kudzivirira kusakwana kwehupenyu hwese. Kurapa kwekuvhiya kunoenderanawo nekuda kwemurwere: kushingaira kwaakaita, makore mangani, kana akaziviswa nezvenjodzi dzepulmonary embolism nekuvhiyiwa kana kuti pasina. Naizvozvo, kurapwa kweiyo yakanyanya thrombosis inogara iri sarudzo yakabatana pakati pevascular surgeon uye murwere.

Nguva yekurapa kune yakadzika vein thrombosis

Nguva yekurapa kwegumbo vein thrombosis inobva pane zvakasiyana-siyana, zvakadai senzvimbo, chiyero uye chinokonzera thrombosis uye, pamusoro pezvose, pamhando yekurapa yakasarudzwa. Kurapa kwegumbo vein thrombosis kunogona kuitwa kune murwere wekunze kana kuti inpatient, zvichienderana nekuti murwere anoda kuongororwa zvakadii. Nguva yekurapa inosiyana zvichienderana nenyaya yega, asi paavhareji unogona kutarisira nguva dzinotevera:

Mushonga wekuderedza ropa unofanira kutorwa kweinenge mwedzi mitatu kusvika mitanhatu.
Iyo compression stockings kana mabhandeji anofanirwa kupfekwa kweinenge mwedzi mitanhatu.
Kufamba kwegumbo kunofanira kutanga nokukurumidza sezvinobvira uye kuenderera mberi nguva dzose
Nzira dzekuvhiya dzinogara kweawa imwe kusvika maviri uye dzinowanzoda kugara muchipatara kwenguva pfupi kwezuva rimwe kusvika maviri

Zvikonzero uye njodzi dze thrombosis

Izvo zvinokonzeresa kudzika kwevein thrombosis zvinhu zvakati wandei zvinowedzera mukana wekuti kugwamba kweropa kuumbike mutsinga yakadzika yegumbo uye kuvharidzira kubuda kweropa. Risk factors zvinosanganisira:

Kukuvadza kumadziro emudziyo: Izvi zvinogona kukonzerwa nekukuvara, kuzvimba, kutapukirwa kana mamota anotsamwisa kana kushandura madziro emukati metsinga.
Kuderera kwekuyerera kweropa: Izvi zvinogona kuitika nekuda kwekushayikwa kwekurovedza muviri, kugara kana kurara pasi kwenguva yakareba, varicose veins kana moyo kusakundikana, izvo zvinononoka kana kutadzisa kudzoka kweropa kumwoyo.
Kuwedzera kwekuita kweropa kuvhara: Izvi zvinogona kukonzerwa nemajini, mahomoni, mishonga, kenza kana zvimwe zvirwere zvinokanganisa kuenzana pakati pekuvhara zvinhu uye anticoagulants muropa.

Zvimwe zvengozi ndezvenguva pfupi, zvakadai sekuvhiyiwa, pamuviri kana rwendo rurefu. Zvimwe zvinokonzera njodzi ndezvekusingaperi, zvakadai sekukwegura, kufutisa kana kusvuta. Izvo zvinokonzera njodzi zvinogonawo kusimbisa mumwe nemumwe uye kuwedzera njodzi yethrombosis.

Kuongororwa kwegumbo revha thrombosis

Kuti uongorore deep vein thrombosis - phlebothrombosis - kune nzira dzakasiyana-siyana dzinogona kushandiswa zvichienderana nekufungira uye kuwanikwa. Zvinonyanya kukosha ndezvi:

ari Nhoroondo uye kuongororwa kwekliniki, die “Blickdiagnose” – das heißt der Eindruck des Erfahrenen über den betroffenen Patienten, wobei der Arzt nach möglichen Risikofaktoren, Symptomen und Befunden fragt und das betroffene Bein untersucht. Dabei kann er auf typische Zeichen wie Schwellung, Rötung, Schmerz oder Überwärmung achten. Allerdings sind diese Zeichen nicht immer vorhanden oder eindeutig.
ari Duplex sonography, iyo inonzi ultrasound scan inoratidza zvose maumbirwo uye kushanda kwetsinga. Chiremba anogona kuona kana tsinga yakavharwa neropa kana kuti kwete. Iyi nzira inokurumidza, iri nyore uye isina njodzi uye inoonekwa senzira yesarudzo yekuongorora yakadzika mutsinga phlebothrombosis.
Der D-dimer bvunzo, inova yekuongorora ropa inoona kuparara kwezvinhu zvekuvhara ropa muropa. Kuwedzera kukosha kunogona kuratidza thrombosis, asi inogonawo kuva nezvimwe zvikonzero. Kukosha kwakajairika kazhinji hakusanganisi thrombosis. Muedzo uyu unowanzo shandiswa pamwe chete neduplex sonography.
ari Phlebography, inova bvunzo yeX-ray umo chinosiyanisa chinopinzwa mutsinga kuti chionekwe. Chiremba anogona kuona kana tsinga yacho iri patent kana yakatetepa. Iyi nzira inoonekwa seyakarurama kwazvo, asi zvakare invasive uye yakabatana nemhedzisiro. Saka inongoshandiswa kashoma kana dzimwe nzira dzisina kukwana kana kuti dzisipo.

Kuti uongorore thrombosis, kune dzakasiyana-siyana genetic test inogona kuongorora ropa clotting factor. Zvinonyanya kukosha ndezvi:

ari Factor V Leiden mutation, iyo inozivikanwawo seAPC kuramba, inotemerwa neAPC genotyping. Ihosha yenhaka inokanganisa kugwamba kweropa. Izvi zvinoreva kuti avo vanobatwa vane njodzi huru yekuwana ropa clot (thrombosis). Chirwere chinowanzokonzerwa nekuchinja kwemajini muropa rekuvhara chinhu V (verenga: shanu). Iko kushanduka kunoreva kuti chinhu V hachichakwanisa kutsemurwa zvakanaka neprotein C (APC), iyo inotungamirira kukuwedzera kwekuda kuvhara. Iko kuchinja kunogona kuonekwa ne genetic test.
ari Prothrombin kuchinja G20210A, chinova chirwere chekuzvarwa nacho chinokanganisawo kugwamba kweropa. Izvi zvinoreva kuti avo vanobatwa vane njodzi huru yekukudziridza zvese zviri zviviri venous uye arterial thrombosis. Chirwere chacho chinokonzerwa nekuchinja kwemajini munharaunda yekutonga yeprothrombin gene, iyo inotungamirira kuwedzera kwekutaura kwejeni uye nokudaro kuunganidza prothrombin mu plasma. Iko kuchinja kunogona kuonekwa ne genetic test.
ari Kuchinja kweMTHFR, inova chirwere chekugara nhaka chinokanganisa enzyme methylenetetrahydrofolate reductase (MTHFR). Iyo enzyme inoita basa rakakosha muhomocysteine metabolism. Homocysteine chigadzirwa chekuparara kwemethionine metabolism, iyo pamazinga akakwirira inogona kutungamirira kukuvadzwa kumadziro emidziyo uye kushandiswa kweplatelet. Iko kuchinja kunogona kuonekwa ne genetic test.

Aya ma genetic test akakodzera kuongororwa kwethrombosis nekuti anogona kuona njodzi yega yega yethrombosis. Zvisinei, havasi ivo voga vanosarudza, asi vanofanira kugara vachifunga pamwe chete nezvimwe zvinhu zvakadai senhoroondo yechirwere, zviratidzo uye mararamiro erabhoritari. Mukuwedzera, vanogona kungoratidza genetic predisposition, asi haigoni kufanotaura kana uye rini thrombosis ichaitika. Saka zvakakosha kutora mamwe matanho ekudzivirira kuderedza dambudziko re thrombosis, ona pamusoro apa.

Pamusoro peiyo genetic test yatatotaura kwauri, kune mamwe ma laboratory bvunzo anogona kuwedzera njodzi yethrombosis. Izvi zvinosanganisira ¹ ²:

ari kuwedzera kwehuwandu hwefibrinogen, chinhu chakakosha chekuvhara chinogonesa kuumbwa kweshinda dzefibrin. Fibrinogen inogona kuwedzerwa nekuda kwekuzvimba, hutachiona, kusvuta kana kushushikana uye zvinotungamira kune yakawedzera tsika yekugwamba.
ari kuwedzera kwehuwandu hwechinhu VIII, chimwe chinhu chinovhara chinokurudzira kushandiswa kwechinhu X uye nokudaro kuumbwa kwethrombin. Factor VIII inogona kuwedzerwa nekuda kwekuzvitakura, kutora mahormone, kenza kana zvimwe zvirwere uye inogona kuwedzera njodzi yethrombosis.
Kushaikwa kweprotein C (Maumbirwo eFibrin akanganiswa)
Kushaikwa kweprotein S (Maumbirwo eFibrin akanganiswa)
Factor VIII kuwedzera mu antihemophilic globulin A - inosimudzira fibrin kuumbwa uye nokudaro thrombosis.
von Willebrand-Jürgens chinhu (vWF; coagulation factor VIII-yakabatana antigen kana von Willebrand factor antigen, vWF: Ag)
platelet count
ari kuwedzera kwehuwandu hwe lipoprotein (a), mafuta eropa ane maitiro akafanana neplasminogen. Plasminogen ienzyme inobatsira kunyungudutsa magwamba eropa. Lipoprotein (a) inogona kuvharidzira kusunga uye kushandiswa kweplasminogen kune fibrin uye nokudaro kukurudzira kuvhara.
ari kuwedzera kwehuwandu hwehomocysteine, amino acid inogadzirwa apo metabolism ye folic acid uye vhitamini B12 inovhiringidzika. Homocysteine inogona kukuvadza madziro emidziyo uye kuwedzera platelet activation, ichiwedzera njodzi ye arterial uye venous thrombosis.
ari kuwedzera kuwanda kweantiphospholipid antibodies, boka re autoantibodies rakanangana ne phospholipids. Phospholipids zvikamu zvemasero membranes uye anoita basa mukugwamba kweropa. Antiphospholipid antibodies inogona kukanganisa kushanda kwephospholipids uye kutungamirira kune kuwedzera kwekuda kuvhara. Izvi zvinonzi antiphospholipid syndrome.
Lupus anticoagulant

Iyi miedzo ye laboratory inogona kuratidza njodzi ye thrombosis, asi haigone kuzvisarudzira wega. Dzinofanirwa kugara dzichitariswa pamwe chete nezvimwe zvinhu zvakaita senhoroondo, zviratidzo uye zvidzidzo zvekufungidzira. Mukuwedzera, vanogona kungoratidza mamiriro echinguva, asi havagoni kufanotaura kana uye rini thrombosis ichaitika. Saka zvakakosha kutorawo mamwe matanho ekudzivirira kuderedza njodzi yethrombosis.

Leg vein thrombosis