Ib qhov txhab ntawm txhais ceg uas tsis kho? Nws tuaj yeem yog qhov txhab varicose, hauv lwm lo lus, varicose rwj. Nws tshwm sim nyob rau theem kawg ntawm evolution ntawm mob venous insufficiency theem nrab mus rau varicose leeg los yog mus rau sequelae ntawm phlebitis. Txawm hais tias nws tsis mob heev, nws yuav tsum muaj kev kho mob hauv zos uas tsim nyog, nrog rau kev tswj hwm tus kab mob venous hauv nqe lus nug kom tsis txhob rov tshwm sim.

Lus txhais

Varicose veins, txwv tsis pub hu ua varicose ulcers lossis venous ulcers, yog ib qho teeb meem ntawm varicose leeg lossis phlebitis uas feem ntau tshwm sim tom qab lub sijhawm ntev ntawm kev loj hlob.

Nws tshwm sim raws li qhov txhab ntawm txhais ceg - classical hauv pob taws - nrog kev poob ntawm cov khoom siv tawv nqaij, lub sijhawm kho ntawm ntau dua ib hlis. Tso tseg tsis kho, nws tuaj yeem dhau los ua tus kab mob superinfected thiab txuas ntxiv mus rau lub hlis lossis ntau xyoo.

Lub venous rwj yog txawv los ntawm cov hlab ntsha ulcer, uas tshwm sim los ntawm cov kab mob hlab ntsha ntawm cov ceg qis, feem ntau txuas rau atherosclerosis lossis ntshav qab zib.

Ua rau

Lub qhov txhab varicose tshwm sim nyob rau hauv lub sij hawm lig ntawm evolution ntawm mob venous insufficiency. Cov leeg sab nraud lossis cov hlab ntsha sib sib zog nqus tsis muab qhov tseeb venous rov qab mus rau lub plawv thiab cov ntshav yuav stagnate.

• Nyob rau hauv cov neeg uas muaj varicose leeg, muaj ib tug poob ntawm elasticity ntawm cov hlab ntsha raws li ib tug tsis ua hauj lwm ntawm li qub equipping phab ntsa ntawm cov hlab ntsha, uas nws lub luag hauj lwm yog los tiv thaiv reflux.
• Venous insufficiency kuj tuaj yeem yog vim qhov tshwm sim ntawm phlebitis (venous thrombosis). Hauv qhov no, stagnation ntawm cov ntshav thiab nce ntshav siab nws thiaj li ua rau kev puas tsuaj rau cov li qub.
• Tsis tshua muaj, kab mob hauv lub cev, thawj qhov sib sib zog nqus valve tsis txaus, yog lub luag haujlwm rau venous insufficiency.
• Ib qho tsis txaus ntawm cov leeg nqaij calf kuj pom tau ntau zaus.

Nyob rau hauv txhua rooj plaub, stasis (ntshav stagnation) ua rau kub siab nyob rau hauv ob txhais ceg thiab pob taws, nrog rau cov kua dej inflammatory. Cov ntaub so ntswg kev txom nyem yog txuas nrog lub xub ntiag ntawm co toxins thiab tsis muaj as-ham thiab oxygen mov. Nws ua rau lawv puas tsuaj (necrosis).

diagnostic

Kev soj ntsuam kuaj mob ua los ntawm tus kws kho mob phlebologist ua rau nws muaj peev xwm ua kom kuaj tau thiab ntsuas qhov mob hnyav. Kev ntsuas thiab cov duab ntawm lub qhov txhab tuaj yeem nqa tau.

Kev paub txog tus neeg mob keeb kwm (phlebitis, hnub nyoog ntawm varicose leeg, thiab lwm yam) yog qhov tseem ceeb. 

Tus kws kho mob tseem nrhiav kom ntseeg tau tias kev puas tsuaj ntawm cov hlab ntsha tsis cuam tshuam nrog lub hauv paus chiv keeb. Nws yuav muaj peev xwm saib xyuas cov tsos mob uas cuam tshuam (tshwj xeeb yog mob thiab ntuav claudication), kom hnov ​​​​txog cov hlab ntsha thiab ntsuas qhov siab ntawm lub pob taws.

Venous echo-doppler 

Qhov kev ntsuas ntsuas no yog siv los ntsuas cov ntshav ntws thiab ntsuas nws qhov nrawm. Nws yog siv los txheeb xyuas lub hauv paus chiv keeb ntawm varicose rwj. 

Cov kev ntsuam xyuas ntxiv

Ntau yam kev ntsuam xyuas ua rau nws ua tau kom kho qhov kev kuaj mob:

• kuaj ntshav,
• kuaj kab mob,
• biopsies…

Cov neeg txhawj xeeb

Qhov zaus ntawm venous ulcer nce nrog lub hnub nyoog. Hauv qee qhov kev tshawb fawb, kab mob ntawm ceg (txuas ntxiv 9 zaug ntawm 10 rau venous puas), cuam tshuam txog li 1% ntawm cov pej xeem, 3% ntawm tshaj 65s thiab 5% ntawm tshaj 80s.

Muaj tseeb poj niam predominance ntawm tus kab mob.

Risk yam tseem ceeb

Cov no yog cov venous insufficiency:

• caj ces,
• Hauv cov poj niam, cov xwm txheej hormonal,
• ntev sawv ntsug,
• lub cev tsis ua haujlwm,
• rog dhau,
• haus luam yeeb,
• rov raug cua sov (da dej kub heev, cua sov hauv qab, thiab lwm yam) ...

Mob venous insufficiency yog tshwm sim los ntawm ntau yam tsos mob: hnyav ceg, edema, muaj kab laug sab leeg (me me purplish venules nyob rau saum npoo) los yog varicose leeg, cramps, thiab lwm yam.

Kev hloov ntawm daim tawv nqaij feem ntau ua ntej qhov tsim ntawm qhov txhab varicose:

• ocher dermatitis (o ntawm daim tawv nqaij),
• ib tug dawb atrophy,
• hypodermatitis (mob ntawm qhov sib sib zog nqus dermis),
• varicose eczema (liab khaus khaus thaj ua rau thaj).

Evolution ntawm qhov txhab

Lub qhov txhab varicose zaum hauv qab lub hauv caug, feem ntau ntawm pob taws, hauv thaj tsam ntawm malleolus. Nws tuaj yeem tshwm sim los ntawm kev khaus khaus lossis kev poob siab me.

Cov tawv nqaij tawg thiab tsim ib lub qhov tsua nrog cov npoo tsis sib xws thiab xim liab, qee zaum zoo nkauj heev.

Cov tsos mob ntawm qhov txhab txawv nyob ntawm theem ntawm kev loj hlob:

• Cov ntaub so ntswg necrosis yog thawj zaug qhia los ntawm cov xim dub.
• Nyob rau hauv lub fibrous theem, lub qhov txhab yuav npog nrog ib tug yellowish txheej thiab oozes nquag. Qhov kev pheej hmoo ntawm kev kis kab mob siab heev. Cov qhov txhab purulent muaj cov tsos mob ntsuab.
• Txoj kev kho mob yog qhov nyuaj. Nws thawj zaug tshwm sim nyob rau hauv fleshy buds, ua ntej lub epidermis los npog lub qhov txhab.

Nws yuav tsum tau muab sau tseg hais tias ib tug arterial rwj zaum ntau zaus nyob rau hauv ko taw, nyob rau hauv cov cheeb tsam ntawm kev sib txhuam.

mob

Varicose txhab feem ntau tsis mob heev. Qhov mob tseem ceeb qhia tau tias muaj cov kab mob hauv cov hlab ntsha lossis cov kab mob superinfection.

Kev saib xyuas hauv zos

Ua los ntawm tus kws saib xyuas neeg mob, kev saib xyuas hauv zos yuav tsum tau hloov mus rau theem ntawm evolution ntawm rwj. Kev kho mob yuav tsum tau saib xyuas tsis tu ncua (ntau zaus hauv ib lub lis piam) nyob rau lub sijhawm ntev.

Lub qhov txhab yog thawj zaug ua tib zoo ntxuav, ua tib zoo ntxuav nrog xab npum thiab dej los yog siv tshuaj betadine-hom tshuaj thaum lub qhov txhab kis kab mob. Yog tias tsim nyog, tus kws saib xyuas neeg mob ua cov khib nyiab, uas yog hais txog kev ntxuav kom tob nrog kev tshem tawm cov khib nyiab fibrinous.

Kev saib xyuas yog ua tiav los ntawm kev so ntawm kev hnav khaub ncaws tsim nyog, piv txwv li:

• fatty hnav khaub ncaws yog tias qhov txhab qhuav,
• absorbent hnav khaub ncaws (hydrocellular, alginates) thaum exudation,
• hemostatic hnav khaub ncaws (alginates) thaum cov ntshav khiav,
• nyiaj hnav khaub ncaws nyob rau hauv cov ntaub ntawv ntawm superinfection.

Kev hnav khaub ncaws zib ntab tau raug sim hauv kev kho mob venous ulcers, tab sis tsis pom zoo.

Compression (venous tuav)

Kev kho mob ntawm qhov ua rau ntawm qhov txhab varicose yog qhov tsim nyog. Elastic compression yog siv los txo qis hauv zos edema thiab txhim kho venous rov qab. Tus kws kho mob hloov nws cov tshuaj raws li theem ntawm kev kho mob ntawm qhov txhab, qhov muaj lossis tsis muaj edema thiab tus neeg mob lub siab ntev.

Cov cuab yeej sib txawv muaj nyob, uas yuav tsum tau hnav 24 teev hauv ib hnub, lossis txij hnub sawv mus txog hnub poob:

• Multilayer bandages (ntau qhov superimposed bands) feem ntau yog qhov tsim nyog tshaj plaws thaum pib kho,
• yooj yim elastic bands los yog elastic compression stockings yog feem ntau muab raws li ib tug thib ob kauj ruam.

Kev kho mob ntawm varicose leeg

Feem ntau tsim nyog los tiv thaiv rov tshwm sim, kev kho mob ntawm varicose leeg koom nrog, tshwj xeeb, sclerotherapy thiab phais venous.

Kev hloov pauv

Daim tawv nqaij grafts nyob rau hauv pastilles los yog mesh yog ua tau thaum muaj varicose rwj tiv thaiv cov pa kev kho mob rau ntau tshaj 6 lub hlis.

Ntiaj teb txhawb

Tus kws kho mob xyuas kom meej tias cov tshuaj tiv thaiv kab mob tetanus yog nyob rau hnub. Kev tswj hwm kuj tuaj yeem suav nrog kev ntsuas kev noj qab haus huv-kev noj qab haus huv (tshuaj tiv thaiv kev rog lossis tiv thaiv kev noj zaub mov tsis zoo), kev kho mob, kev tso dej lymphatic ua los ntawm tus kws kho mob lub cev, thiab lwm yam.

Kev tiv thaiv ntawm qhov txhab varicose yog ua raws tib lub hauv paus ntsiab lus ntawm venous insufficiency.

Cov kev cai ntawm kev nyiam huv ntawm lub neej ua lub luag haujlwm tseem ceeb. Kev ua lub cev ua rau cov ntshav ncig thiab tiv thaiv qhov tsos ntawm varicose leeg. Peb pom zoo kom koj taug kev tsawg kawg 30 feeb hauv ib hnub, tsawg kawg peb zaug hauv ib lub lis piam. Tshwj xeeb tshaj yog, txhua yam kev ua kis las uas ua haujlwm ntawm cov nyuj (cycling, seev cev, thiab lwm yam) txhim kho venous rov qab.

Lwm yam kev ntsuas (pw nrog tsa taw, tsis txhob da dej kub dhau, sauna, cua sov hauv qab, raug lub hnub ntev lossis txawm tias hnav khaub ncaws nruj uas cuam tshuam cov ntshav ncig, thiab lwm yam) yog qhov tsim nyog tshwj xeeb rau cov neeg uas twb tsis zoo lawm. Kuj ceev faj rau kev mus los hauv huab cua!

Peb tseem yuav khaws peb lub peev xwm los ntawm kev ua kom lub cev hnyav, noj zaub mov kom zoo thiab tsis txhob haus luam yeeb.