Vasculitis is a more stubborn vascular disease, for many years has been considered incurable, and eventually have to be amputated, due to bilateral lesions, many patients even double lower limb high amputation, seriously affecting the quality of life. With the development of science and technology, the rapid improvement of minimally invasive technology in recent years, so that the original was considered a “no-go” vasculitis calf lesions, can also be well treated. Therefore, as long as early standardized treatment, proper care, normal life can be completely achieved.
What is called vasculitis
The full name of vasculitis is “thrombo-occlusive vasculitis”, is a metabolic inflammatory disease that occurs in the blood vessels, not related to bacterial infection, mainly invading small and medium-sized arteries, mostly in the lower limbs, the invaded arteries are segmental stenosis, occlusion, the formation of thrombotic blockage, causing impaired blood circulation in the limbs, local tissue hypoxia, loss of nutrition, the occurrence of ulceration, gangrene. Ulceration and gangrene occur. People at high risk of developing vasculitis are smokers (especially young men), nervous people, people with nutritional imbalance, people living in cold and wet areas, and family genetic factors. The majority of cases occur in men between the ages of 20 and 40, and are rare in women.
What are the manifestations of vasculitis?
The early symptoms are usually just a lack of energy in the lower extremities, walking soreness, or cold extremities, fear of cold, further development will appear characteristic pain, medically called “intermittent claudication”, manifested as walking for a period of calf muscles or the soles of the feet appear soreness, swelling, weakness, or varying degrees of pain, can be relieved by a short rest, and then walk the same distance again will appear the same pain. The pain can be relieved after a short rest, and then the same pain will appear again after walking the same distance. Further development of the pain will appear at night, the pain is light during the day, aggravated at night, the pain is severe and unbearable, patients often sit with their knees, pounding their chests and feet, pain is unbearable. Patients often sit on their knees until dawn and suffer for a minute until dawn, and may suffer from emotional disturbance, dizziness and back pain. If not properly treated, it will enter the necrotic phase, with ulcers and necrosis of the extremities, the extremities become black, like dry branches, some fall off on their own, and after falling off, the ulcers are often left behind and do not heal for a long time. In Chinese medicine, this feature is called “gangrene” and is often accompanied by fever, dry mouth, loss of appetite, insomnia, constipation, and yellow urine.
Treatment of vasculitis
The main focus is on improving and enhancing blood circulation in the limbs, relieving and alleviating pain, and saving the limbs.
1.Conservative treatment
(1) General treatment: In addition to the prohibition of smoking, you should also prevent cold, moisture and trauma, and not overheat, so as not to increase the amount of tissue hypoxia.
(2) Drug treatment a, Chinese herbal medicine b, vasodilators c, antibiotics and sedatives d
(3) Other: reduce blood viscosity, anti-platelet aggregation and other drugs, hyperbaric oxygen therapy, etc.
2.Surgical treatment
For vascular obstruction, there are mainly endoluminal angioplasty and arterial bypass surgery. Arterial bypass grafting is to build a “vascular bridge” through self or artificial blood vessels to cross the obstructed section of blood vessels so that the proximal blood flows through the “bridge” to the distal ischemic section to restore the blood supply to the ischemic tissue of the distal limb. Endoluminal angioplasty is a surgical procedure that does not require an incision. It is performed by inserting a balloon catheter through the eye of a needle to dilate the narrowed or blocked blood vessel, remodeling the intima, increasing the blood flow and improving the distal blood supply. In particular, the small and long balloon technique carried out by Renji Hospital in recent years has enabled good recanalization of narrowed vessels in the lower legs, which were originally thought to be off-limits, greatly saving the diseased limbs of patients with vasculitis. This method has the advantages of minimally invasive, no incision (if there is a “cut”, it is the eye of a needle), little trauma, quick recovery, no pain, low cost, etc. Therefore, it is especially suitable for elderly and frail patients.
Prevention of vasculitis
1, quit smoking and limit alcohol smoking is an important factor in vasculitis. Nicotine in tobacco is a vasoconstrictive substance smoking can make the skin vasoconstriction, slow blood flow finger or toe skin temperature significantly reduced. Therefore, the prevention of thrombo-occlusive vasculitis must first actively quit smoking. As the saying goes: to smoke do not feet, to feet do not smoke. Absolute cessation of smoking is an important measure to curb the change of the disease.
2, limb warmth, especially in winter and spring should avoid cold, humidity, as little as possible in the outdoor stay and work for a long time. Wash your hands and feet with hot water every day to promote local blood circulation. Dry and rub with petroleum jelly, glycerin, etc. It is forbidden to wash feet with cold or excessively hot water. Overheating, will also promote the progress of the lesion.
3, prevention of trauma should usually wear loose cloth shoes, proper ventilation, so that the feet in a warm and dry environment; trimming finger (toe) nail, pay special attention to not cut too deep. Prevent minor trauma from causing serious consequences, with gangrene or ulcers should go to the hospital as soon as possible, do not self-medication, trimming to cause greater consequences; even the usually disregarded mycotic infections, such as tinea pedis, can also pose a threat to the affected limb, so avoid foot collisions, pressure injuries, once the trauma or foot mycotic infections should be treated promptly.
4, good habits low salt and low fat diet, you can drink more water, usually eat more black fungus. Adhere to sports exercise is also very important.
5, adhere to drug therapy to reduce blood viscosity blood flow is slow, blood viscosity increases, can cause thrombosis, so that the original narrowed arteries are completely blocked. And can take small doses of aspirin under the guidance of a doctor. Control hypertension and blood sugar.
6, strengthen exercise functional exercise can not only prevent muscle atrophy, but also make the blood flow of the limb increase, prompting the opening of vascular side branches, the amount of activity should be appropriate. Because the affected limb itself is in a state of ischemia, excessive activity is bound to aggravate the symptoms. Method: The affected limb should be raised and lowered, such as Buerger exercise, which means that the patient should lie down, raise the affected limb more than 45 degrees, then lower it at the bedside for 2-3 minutes, then place it in the horizontal position for 2 minutes, and rotate the foot and extend and flex it for 20 minutes repeatedly, several times a day. Or simply walking, walking speed and distance, all in order not to produce limb pain.