Ileofemoralny Thrombosis: izimbangela, izimpawu, ukwelashwa

Yikuphi isifo zingavezelwa uhlelo emithambo yegazi yomuntu? Kungani kwenzeka nenkinga enjalo, futhi ke ziphathwe kanjani? Le mibuzo kanye neminye sizobe uphendule esihlokweni samanje.

Uhlolojikelele

Ileofemoralny thrombosis - thrombosis is ukushaya femoral ngokujulile kanye emithanjeni iliac. Lesi sifo abiwa elinye ifomu, njengoba ebonakala ngu ukugeleza kwetfulwe esindayo futhi babe sengozini enkulu yokufa ezinzima embolism yamaphaphu ngaye.

Izici lesi sifo

thrombosis Ileofemoralny ingaqala hhayi kuphela abadala kodwa futhi izingane. Kulokhu, lesi sifo sisihle, futhi ukwelashwa kuphumelela ngempela. 'Phakathi kwabantwana bakwa kakhulu ukuthuthukisa embolism yamaphaphu noma retrombosis kuphawulwe.

Njengoba for iziguli omdala, esenzela zona, lesi sifo ihambisana yezinkinga kuhle ezinzima. Ngakho-ke kubalulekile ukuba kungaziwa ukuthi kwakuyisifo sini ngesikhathi.

Izimpawu main

Thrombosis ithuthukiswe ngemithambo femoral noma iliac, ephelezelwa izimpawu ezifana:

• amachashazi brown usayizi encane, izipikha ngezinyawo zawo futhi musa zinyamalale lapho sicindezelwe;
• umkhuhlane;
• ukuvuvukala ezinzima ukuthi singenzeka kuwo womabili emikhawulweni aphansi noma omunye wabo;
• purple-abomvu noma bluish ibala;
• kancane kancane wandisa ubuhlungu umlenze noma imilenze yomibili kanti imbilapho (ngezinye izikhathi).

Izimpawu thrombosis oyingozi. esigabeni

Acute thrombosis ileofemoralny has izigaba eziningana ukuthuthukiswa. Kuye izimpawu zabo zingase zibe izici zabo. Ake sixoxe ngazo ngokuningiliziwe:

• Isigaba prodromal. Ngalesi nesigaba lesi sifo isiguli yobuhlungu kwasendaweni ahlukahlukene. Bangakwazi esiyitholayo esifundeni lumbosacral, esiswini ephansi, kanye ukunqotshwa nasemilenzeni aphansi. Ezidabukile ubuhlungu syndrome ne has imvelo buthuntu. Futhi, isiguli enomkhuhlane.
• Isinyathelo izimpawu zokwelashwa libizwa. It libhekene uziqu-zintathu zakudala nokubonakaliswa. Ngamanye amazwi, isiguli ukuvuvukala ezinzima, izinguquko umbala wesikhumba, futhi ubuhlungu. Phela, lo yokugcina esiyitholayo ithole, imbilapho ithangazi anteromedial. Ubunjalo ubuhlungu bukhulu kanye ehlasela umzimba. Njengoba for ukuvuvukala, it ithumba lonke lelo zwe, elisukela imbilapho ezinyaweni. Ngezinye izikhathi, amanani azo ayanda is baphawula phezu maximus gluteus futhi kuhlanganiswe umuzwa ukugcwala futhi umuzwa wobukhulu ezingalweni nasemilenzeni aphansi.

Njengoba ijwabu edematous bakucindezele elinamandla imithambo yegazi, ukugeleza kwegazi ukuphazamiseka kwenzeka, spasm nasemilenzeni ukuthuthukisa ischemia acute, obonakaliswe ubuhlungu obuhlabayo, ukungabi luvelo pulsations ekhipha igazi enhliziyweni.

Njengoba kushiwo ngenhla, omunye izimpawu zesifo okukhulunywa ushintsho umbala kwesikhumba. Kungenzeka umbala okhanyayo noma cyanotic. Umbala White kwenzeka ngenxa imithambo spasm ezihlobene. isimo esinjalo kuhambisana sebuhlungwini obunzima. Umbala umbala oluhlaza okwesibhakabhaka noma cyanotic siyenzeka esimweni lapho iliac noma Umthambo femoral akuyona ekufezeni imisebenzi yayo ngqo, okusho outflow legazi kubo cishe eziphukile ngokuphelele. Kuyinto uphawu kubaluleke kakhulu ukuthi isiguli kungabonwa hip iphethini liphinyiselwe emithanjeni ongama.

Ngo ileofemoralny jikelele thrombosis libhekene isimo eyanelisayo jikelele isiguli. Nokho, kungase kakhulu ziwohloka ukuthuthukiswa lokugula oyingozi. Lokhu kubonisa ekuqaleni isimo esibucayi.

izimbangela

Uhlelo emithambo yegazi yomuntu kungenzeka ibe ngaphansi kwegunya izinguquko ezihlukahlukene. Ngokuvamile, iziguli deep vein thrombosis. Lesi sifo kwenzeka ngenxa yokukhula kancane ukugeleza kwegazi futhi ekunqandeni yayo neziyaluyalu, kanye umonakalo odongeni emithambo yegazi.

Ukuthuthukiswa ileofemoralnogo thrombosis kungavuka khona isici, futhi uma kukhona eziningana. Ochwepheshe basikisela amaphuzu alandelayo sokuqala anomthelela ukuvela kwalesi sifo:

• ukulimala siqu;
• isikhathi eside embhedeni ukuphumula;
• DIC;
• ukutheleleka nge imvelaphi webhaktheriya;
• isikhathi kwangemva kokubeletha;
• yokwamukela nokukhandela imbeleko;
• ukhulelwe;
• okubulalayo nokuhlala ingozi mass okhalo;
• useshonile we iliac nokuvaleka kwemithambo femoral futhi aorta besisu;
• simila popliteal;
• cystic retroperitoneal;
• umonakalo iatrogenic ukuze ngemithambo ejulile.

Yezimbangela ezivame kakhulu

Ngokuvamile ileofemoralny thrombosis wemikhawulo aphansi, libhekene yokujama tsi igazi kule mithambo, eba phakathi nenkathi yokukhulelwa. Futhi, lesi sifo kungavuka ngenxa immobilization isikhathi eside esingamahlalakhona of valve emithambo yegazi.

Esinye isici esibalulekile ekuthuthukiseni lesi sifo okukhulunywa kuyinto zokugula wegazi coagulation, kuhlanganise azalwa naso noma bathenga isimo thrombophilic.

ukuhlola

sitholakale kanjani thrombosis wemikhawulo aphansi? Izimpawu zesifo kuvetwa bha. Kodwa ngaphezu luhlolo lwangaphandle esiguli, odokotela bavame asebenzise ezinye izindlela zokuxilonga, okuyinto ethulwa ngesimo:

• ukuskena nge fibrinogen;
• ukuskena Duplex;
• venography radionuclide, okuyinto eyenziwa uma kwenzeka ukuthi isiguli singayivumeli izinto radiopaque;
• wehla noma sinyuka venography radiopaque.

ukwelashwa

thrombosis Ileofemoralny kufanele baphathwe kahle ngendlela efanayo nezinye izinhlobo thrombosis. Ezimweni eziningi, ukwelapha lesi sifo wenziwa endaweni esibhedlela. Kusekelwe ukuphuza imishanguzo ezilandelayo:

• ejenti eqeda ukuvuvukala;
• ejenti antiplatelet;
• anticoagulants.

Uma iliac noma femoral Umthambo emangazwe hhayi kakhulu, futhi lesi sifo kusaqalwa yentuthuko, ngoba izindlela zayo ukwelashwa ingase isetshenziselwe lula nokuqedwa thrombus.

Uma kukhona usongo thromboembolism, lwalumumethe zokuvimbela yayo. Le nqubo ibizwa eyenziwa besebenzisa Ligation ka vein femoral, vena cava isihlungi ukufakwa noma plication phansi kunabaphostoli vena cava.

Uma isiguli ine acute thrombosis ileofemoralny ke ukwenza izinto zokuthutha layo esibhedlela. Kulokhu, isiguli kufanele babe sesimweni yizikhukhula. Ngaphambi test, wabelwe embhedeni ukuphumula, bese benza ultrasound futhi venography.

Uma kwenzeka ukuthi izimo luhlolo yesiguli bengekho, ngaphansi kokuqondisa ochwepheshe ke ezinqunyiwe anticoagulants, okuyinto okufanele zithathwe izinsuku eziyishumi.

Ngokusho imibiko wezazi, acute thrombosis emithambo yegazi kufanele aphathwe ngokucophelela, usebenzisa amaqembu amathathu izidakamizwa:

• thrombolytics noma fibrinolytics;
• anticoagulants;
• ejenti Antiplatelet.

Kufanele kuqashelwe ukuthi imishanguzo anticoagulant kusekelwe ukusetshenziswa izindlela ezilandelayo:

• ongaphakeme yamangqamuzana isisindo heparin ;
• heparins unfractionated;
• fondaparinux pentasaccharide.

With ukuthuthukiswa thrombolysis edinga ukusetshenziswa streptokinase noma urokinase, is kakhulu anda ngokwempilo yangenyama nesineke ngenxa ukwanda ukopha. Ngakho-ke, le ndlela isetshenziswa kuphela ezimweni ezimbi kakhulu, isibonelo, uma thrombosis okwandile athuthukiswe futhi muva nje, okungukuthi, hhayi ngaphezulu kweviki eledlule.

ukwelashwa Thrombolytic ngoba thrombosis ileofemoralnogo zinhlobo Kwenziwa emva kwalokho, njengoba azosethwa isihlungi cava. Lokhu kungenxa yokuthi leli ukwelashwa kusiza ukuhambisa igazi ihlule ku Umthambo yamaphaphu, okungaholela ukuthuthukiswa izenzakalo thromboembolic.

kokungenela kuhlinzwa

Lapho ileofemoralnom thrombosis option kungenzeka bokuhlinzwa. It is olwenziwa yokuhlola izimpawu ezisemqoka, kuye ngokuthi ingozi yokuba embolism yamaphaphu.

Kufanele kuqashelwe ukuthi le operation ngokuvamile eyenziwa uma kukhona usongo esibhibhayo pooling eyeqile Lokusakaza inqubo sokugembula e bakhiphe elezinga eliphansi vena cava.

Ungase futhi susa kwakheka iliac kwesokunxele vein thrombus retrograde. Le nqubo Kwenziwa ngokusebenzisa imbobo flebotomicheskoe, okwenza e vein femoral. Kufanele kuqashelwe ukuthi inketho okunjalo akwenzeki ngaso sonke isikhathi, njengoba iliac kwesokudla Vienna ungaba ingcindezi enkulu.

Ngokusho ochwepheshe, ukuhlinzwa ukuze ususe ihlule legazi noma kunjalo ayikwazi kwenziwe ukuvuvukala okwenzeka vein, futhi khona ngodonga intravascular.

yezinkinga

Lo mcimbi ukwehluleka kudokotela, kanye nokwelashwa okungalungile ileofemoralnogo thrombosis nesineke angagcina inkinga ngempela ngokuba yingozi kwezinkolelo-embolism yamaphaphu. Ngakho-ke kubaluleke kakhulu ukuba baqonde ukuthi lapho ebona noma iyiphi uphawu, kanye ngiboshelwa ukusolwa ngokushushumbisa thrombosis, kufanele ngokushesha ubuze udokotela abanolwazi.

ekuvimbeleni izifo

Ukuze ugweme yemiphumela yokugula ezilinganisweni umbuzo zokuvimbela kufanele agcine ngaphansi, okuyinto okuhloswe ngayo ukwenza ngcono isimo jikelele isiguli nezitsha bakhe ngokukhethekile.

Libuye isihluthulelo impilo ende futhi enhle kuyinto umsebenzi ngokulinganisela nokudla ngendlela efanele.

Ukuze ugweme ngokuphelele ukuthuthukiswa thrombosis, isiguli kufanele ngokucophelela ziqashwe indlela yabo yokuphila. Kuyadingeka ukuqeda yonke imikhuba emibi futhi njalo ngilugcinile udokotela.

Endabeni le emithambo yegazi uhlelo isifo sekuqalile ukuthuthukisa, kumele uthobele yonke izinyathelo ukuthi kuvinjelwe yezinkinga kungenzeka. Kulesi sigaba sokukhula ihlanganisa nokuqedwa ephelele zonke izici eziyingozi, ngokulinganisela imodi umsebenzi, futhi anticoagulant kahle akhethiwe kanye therapy antiplatelet.

Ngokusho kochwepheshe, thrombosis ifomu ileofemoralnoy - lena ngempela isifo esiyingozi kakhulu uyakwazi ukubangela umonakalo ebalulekile impilo yabantu. Nokho, kufanele kuphawulwe ukuthi lesi sifo esilaphekayo, kuhlanganise uma wethulwa isikhathi. Into esemqoka - ungalilahli ithemba futhi ungayeki, bese ulandela yonke izincomo udokotela abanolwazi.