The autumn wind is dazzling, the weather turns cold, some middle -aged and elderly friends obviously feel the cold feet, "calf belly" is sour, and even some people have pain in the back legs.EssenceIn this case, many people think it is the problem of old cold legs or lumbar spine.
In fact, if you often "go away" like this, it is likely that there is a problem with the lower limb arteries.This gait has a medical term called "intermittent lame", which is the main clinical manifestation of lower limb arteriosclerosis occlusion.When the weather turns cool, we must be more alert to this disease.
This disease is easier to find the elderly
The blood vessels in the human body are like a pipe, and the nutrients needed to transport life activities to all parts of our body.Like the water pipe in the house, it will produce scale and rust after a long period of use, and the blood vessels will "rust" with age.
Due to some chronic diseases and unhealthy lifestyle, lipids in the blood will accumulate in the blood vessel wall to produce aired pulse hardened plaques.As the plaque increases, the vascular lumen gradually narrows or even occlude, and the blood flow flowing to the lower limbs will decrease, and the symptoms of the lower limb ischemia will occur."Stop stop" is the symptoms of post -motion muscle ischemia caused by lower limb arteries and occlusion.
Poor arteriosclerosis occlusion is a common disease in vascular surgery, and its incidence increases with age.According to foreign literature reports, the incidence of people under the age of 70 is 3%-10%, and the incidence of people over the age of 70 is 15%-20%.It is estimated that there are 20 million arteriosclerosis occlusion in my country, and the patient groups have increased year by year with the aging population.
The four major factors are blood vessels blocked the culprit
So why does the lower limb arteriosclerosis occlusion?The occurrence of arteriosclerosis and occlusion in the lower limbs has a lot to do with lifestyle, such as smoking, not healthy diet structure, too much intake of salt, etc.These unhealthy lifestyles can cause diabetes, hypertension, and hyperlipidemia.And smoking, diabetes, hypertension and hyperlipidemia are the four culprits that cause lower limb arteries.There is clear evidence that smoking can cause lower limb disease.Nicotine and other substances in tobacco can cause damage to vascular endothelials and accelerate the occurrence and development of atherosclerosis. Therefore, smoking abstinence is absolute for patients with lower limb arteriosclerosis occlusion.At the same time, diabetes also increases the occurrence of lower limb arteriosclerosis.The incidence of arteriosclerosis occlusion in the lower limb arteriosclerotic occlusion in the people with diabetes is 3-5 times that of normal people, and the symptoms and prognosis of patients with diabetes are much worse than others.
In addition, long -term hypertension will cause endothelial damage, and lipids in the blood will accumulate in the damaged vascular part. Therefore, patients with arteriosclerosis and occlusion of the lower limbs need to control blood pressure and oral lipid -lowering drugs to slow the progress of plaques.
These inspections dismantle the illusion of "old cold legs"
In the early stages of the disease, the lower limb arteriosclerosis can be manifested as cold and numbness of the legs and feet. Sometimes, the leg muscle spasm may occur after exercise, that is, "cramps".These symptoms lack specificity. Many people mistakenly believe that they are old -cold legs or lumbar spine problems, which delay the condition.Here, I would like to remind my middle -aged and elderly friends who have the above symptoms should go to the hospital’s vascular surgery for related examinations to determine whether treatment is required.
With the progress of the condition, intermittent clamor will occur on the basis of cold and numbness, which is the first stop and stop we mentioned. If you have not been able to see it in time, the distance of the clamor will gradually shorten.From the beginning to be able to walk hundreds of meters, gradually decreased to 200 meters or even tens of meters.
If the condition continues to deteriorate, there will be "static pain".At this time, even when you do n’t exercise, you will have pain in your legs or feet, especially when you fall asleep at night, which will be more serious, making people sleep and food unhappy.
So, how can I judge whether I have the arteriosclerotic occlusion in the lower limbs?Due to the lack of specific symptoms in the early days, we must go to hospitals with vascular surgery for treatment for relevant professional examinations.For example, the measurement of limb arterial blood pressure, lower limb arterial ultrasound examination, CTA, magnetic resonance, etc. These tests can help determine whether there is a stenosis in the vascular, and arterial angiography may be performed if necessary.
Not only the legs and feet are cold and even amputation
Due to insufficient understanding of the disease, some patients think they are "old cold legs", just wear more or paste plaster, bubble feet.However, it can be seen from the development process of arteriosclerosis and occlusion disease in lower limbs that if it is not treated in time, the consequences may be very serious.Once "static dysfunction" occurs, active treatment must be actively treated, otherwise the disease will enter the stage of chronic limb threat ischemia.At this stage, even if the feet are broken a little, it is very difficult to heal, and the lower limbs gradually appear necrotic or even the amputation, which will endanger life.
A study shows that among all patients with arteriosclerosis occlusion in all lower limbs, the 5-year mortality rate is about 10-15%, and when the disease progresses to the stage of chronic threatening limb ischemia, its mortality rate is as high as 70%within 5 years.And 2/3 of patients with chronic limb threatening ischemia performed amputation within 5 years after diagnosis.
Therefore, it is very important to seek medical management early medical treatment to delay the progress of the disease.
In addition, lower limb arteriosclerosis occlusion is often a local manifestation of systemic vascular disease. Patients with lower limb arterial diseases often combine cardiovascular and cerebrovascular diseases.This means that once patients have the problem of myocardial infarction or cerebral infarction, they must also pay attention to whether the lower limb arteries are narrow and occluded, so as not to delay the treatment and cause serious consequences such as amputation.
Different diseases are different
The treatment of lower limb arteriosclerosis and occlusion includes general conventional treatment, drug treatment, intravusal intervention therapy, and surgical therapy. Specialists in vascular surgery will choose different treatment methods based on the patient’s disease.
Generally treatment is also the intervention of lifestyle, the most important of which is to quit smoking.Quit smoking can significantly delay the continued increase of the condition; secondly, a reasonable and healthy diet, eat more low -salt and low sugar, high cellulose, and plant foods containing unsaturated fatty acids, such as beans, fruits, vegetables, etcPersist in walking every day to increase the formation of the side branch cycle to improve ischemia.
Drug treatment In addition to controlling basic diseases, taking hypoglycemic drugs, antihypertensive drugs, and blood lipid drugs on time to control blood glucose, blood pressure, and blood lipids. For patients with severe lame symptoms, vascular surgeons will also open some expandable arteries to patients.Drugs, anti -platelet drugs, anticoagulant drugs, etc. If necessary, some painkillers will be prescribed.
The main role of these drugs is to control the continued development of the disease, improve the limb ischemia, relieve pain, and promote ulcer healing.Most patients’ condition can be effectively controlled through general treatment and drug treatment. Only a part of patients with severe illness, such as severe lameness affecting the quality of life, "static dysfunction", and even patients with limb ulcers.Essence
In -cavity treatment is also called intervention surgery. It refers to choosing the blood vessels that have no lesions on the surface of the human body.Some special guides and catheters.Under the surveillance of X -ray, it reaches the blood vessels, and the narrow or occlusion blood vessels are opened through the dilatation of the balloon, and then the stent or other follow -up treatment is selected according to the situation.
Surgical treatment mainly refers to bypass transplantation, which is commonly known as bridge surgery.Whether it is intervention or surgery, it is not once and for all. After surgery, it needs to be reviewed regularly, and insist on controlling basic diseases on time.
Text/Qu Chengjia Zhang Yunxin Liu Jianlong (Beijing Jishui Tan Hospital)