Autumn and winter alternating weather becomingcooler pay more attention to their lower extremity vascular gradually into the early autumn, especially old people will think of leg, toe cold in the situation more and more obvious, in addition to its own The new supersedes the old. slowly, but also can not be ignored one of the vascular factors. If the hair is cool, toe aches. Need to be vigilant of lower extremity arterial occlusive disease, need assessment, diagnosis and treatment of further. Clinical features: primary, primary early no obvious symptoms, or only slight discomfort, such as chills, cold; II, gradually increase can occur after walking distance after lower limb fatigue, soreness, forced to rest after a period of discomfort can be completely alleviated, and the recurrence of symptoms time walk, this is the typical symptoms of intermittent claudication; further development of stage III, lesions showed lower extremity pain that patients at rest, rest at night is more obvious, this is the rest pain and night pain; IV, such as uncontrolled progress eventually limbs ulcers, gangrene. Inspection methods: such as the above symptoms and discomfort, the need for the following checks: 1. vascular ultrasound is a noninvasive and effective method can give a preliminary diagnosis for screening methods. 2. ankle brachial index (ABI): you can determine the initial conditions of lower limb ischemia. The ABI value is less than 0.9 which is of diagnostic significance, the lower the value that more severe ischemia. 3.CT angiography: this method can quickly and accurately determine the location and severity of vascular lesions, follow-up treatment can provide accurate reference value. Treatment: the treatment 1. basic diseases: lower extremity arterial occlusive disease is a systemic arteriosclerosis in the lower limb local performance, therefore, need to look at the overall and treatment, such as: strict control of blood pressure, blood glucose, smoking cessation, protection of lower extremity toe skin, avoid hot water feet to prevent skin damage, scald etc.. At the same time, also need drug treatment at the same time, antiplatelet drugs (aspirin and clopidogrel) and microcirculation drugs; 2. surgery: traditional surgery and minimally invasive treatment are effective methods. Suggestion: if you have hypertension, diabetes, hyperlipidemia, smoking and other basic diseases and bad habits, you need to pay attention, usually need to strictly control the basic diseases, absolute quit. If the hair is cool, with lower limb pain, ulceration of skin for healing, you need timely to conduct a detailed examination of vascular surgery specialist. Correspondent: Zhang Yingying Liu Yongchang

秋冬交替天气渐凉 多关注自己的下肢血管   渐入初深秋,特别是老年人会自感小腿、足趾发凉的情况愈加明显,除了自身新陈代谢缓慢外,血管病变也是不容忽视的因素之一。   如果出现足趾发凉、疼痛等情况,需要警惕下肢动脉硬化闭塞症的发生,就需要进一步的评估、诊断及治疗。   临床特征:   Ⅰ期、初发早期可无明显症状,或仅有轻微不适,如畏寒、发凉等;   Ⅱ期、逐渐加重后可出现行走一段距离后下肢的疲劳、酸痛感,需被迫休息一段时间后不适感可完全缓解,再次行走后症状复现,此为典型的症状,即间歇性跛行;   Ⅲ期、病变进一步发展,表现为患者休息时即出现下肢的疼痛,夜间休息时更加明显,此为静息痛、夜间痛;   Ⅳ期、如病情未控制继续进展,最终肢体可出现溃疡、坏疽。   检查方法:   如出现上述的症状及不适,需行以下检查:   1.血管彩超是无创有效的方法可给予初步的诊断,为常用的筛查手段。   2. 踝肱指数(ABI):可以初步判断下肢缺血情况。ABI值小于0.9即有诊断意义,数值越低提示缺血愈加严重。   3.CT血管造影:此方法能准确、快速判断血管病变部位及严重程度,对后续的治疗能提供准确的参考价值。   治疗:   1.基础疾病的治疗:下肢动脉硬化闭塞症是一全身动脉硬化在下肢的局部表现,因此,必需要整体看待和治疗,如:严格的控制血压、血糖、戒烟等,保护下肢足趾皮肤,避免热水烫脚等以防皮肤破损、烫伤等。同时,药物治疗也需要同时进行,抗血小板药(阿司匹林、氯吡格雷)、改善微循环药物等;   2.手术:传统外科手术、介入微创治疗都是可行有效方法。   建议:   如您有高血压、糖尿病、高血脂、吸烟等基础疾病及不良嗜好,就需要注意了,平时就需要绝对戒烟、严格控制基础疾病。如伴有下肢的发凉、疼痛,破溃皮肤长久不愈合,就需要及时到血管外科专科进行详细的检查。   通讯员:张颖颖 刘永昌相关的主题文章:

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