Mob peripheral leeg - txhais ceg

Mob peripheral artery (PAD) yog cov mob ntawm cov hlab ntsha uas xa rau txhais ceg thiab txhais taw. Nws tshwm sim vim txoj kev nqaim ntawm cov hlab ntsha hauv ob txhais ceg. Qhov no ua rau cov ntshav ntws tsawg, uas tuaj yeem ua rau mob rau lwm lub zog thiab lwm cov ntaub so ntswg.

PAD tshwm sim los ntawm atherosclerosis. Qhov teeb meem no tshwm sim thaum cov khoom siv roj (quav hniav) ua rau cov phab ntsa ntawm koj cov hlab ntsha thiab ua rau lawv nqaim dua. Cov phab ntsa ntawm cov hlab ntsha kuj tseem ua stiffer thiab tsis tuaj yeem nthuav (nthuav tawm) kom tso ntshav ntshav ntau dua thaum xav tau.

Raws li qhov tshwm sim, cov leeg ntawm koj ob txhais ceg tsis tuaj yeem muaj ntshav txaus thiab oxygen thaum lawv ua haujlwm hnyav (xws li thaum tawm dag zog lossis taug kev). Yog tias PAD yuav mob heev, yuav tsis muaj ntshav thiab oxygen txaus, txawm tias cov leeg yuav so.

PAD yog ib qho kev ntshawv siab ntau. Nws feem ntau cuam tshuam rau cov txiv neej hnub nyoog tshaj 50 xyoos, tab sis cov poj niam tuaj yeem mob nws tib yam nkaus. Cov tib neeg muaj kev pheej hmoo siab dua yog tias lawv muaj keeb kwm:

• Cov roj (cholesterol) tsis zoo
• Mob ntshav qab zib
• Kab mob hauv lub plawv (mob hlab ntshav hlab plawv)
• Ntshav siab (tawg)
• Kab mob rau lub raum uas muaj mob hemodialysis
• Haus Yeeb
• Mob stroke (kab mob cerebrovascular)

Cov tsos mob tseem ceeb ntawm PAD yog qhov mob, ua tiav, nkees, kub nyhiab, lossis tsis xis nyob rau cov leeg ntawm koj txhais taw, plab hlaub lossis ncej puab. Cov tsos mob no feem ntau tshwm sim thaum taug kev lossis qoj ib ce, thiab ploj mus tom qab ob peb feeb so.

• Thaum xub thawj, cov tsos mob no tuaj yeem tshwm sim thaum koj taug kev nce toj, mus nrawm dua, lossis taug kev ntev mus.
• Maj mam, cov tsos mob tshwm sim sai dua thiab nrog kev tawm dag zog tsawg.
• Koj ob txhais ceg lossis txhais taw yuav xis nyob thaum koj so. Ob txhais ceg kuj yuav txias rau qhov kov, thiab daim tawv nqaij yuav ua ntsej muag daj.

Thaum PAD yuav mob hnyav, koj yuav muaj:

• Cuam meem txom
• Mob thiab ntswj thaum hmo ntuj
• Mob los yog nruj rau hauv taw lossis taw, uas yuav ua tau mob hnyav heev txawm tias qhov hnyav ntawm cov khaub ncaws lossis cov ntaub pua chaw pw yog qhov mob
• Qhov mob mob heev dua thaum koj tsa koj ob txhais ceg, thiab txhim kho thaum koj dai koj ob txhais ceg hla lub txaj
• Daim tawv nqaij uas zoo li tsaus thiab xiav
• Cov mob uas tsis zoo

Thaum lub sijhawm kuaj mob, tus kws kho mob yuav nrhiav pom:

• Lub suab nrov thaum lub stethoscope muab tso rau ntawm txoj leeg ntshav (txoj hlab ntshav tawm)
• Kev ua kom ntshav siab nyob rau hauv cov ceg
• Lub cev tsis muaj zog lossis tsis tshua pom nyob hauv cov ceg

Thaum PAD loj dua, kev tshawb pom yuav suav nrog:

• Plab plab hlaub uas tuaj me (ua zes los sis atrophy)
• Cov plaub hau poob thoob ob txhais ceg, ko taw, thiab ntiv taw
• Kev hnov ​​mob, tsis los ntshav tawm ntawm txhais taw lossis ntiv taw (feem ntau yog xim dub) uas maj mam kho zoo
• Kev daj ntseg ntawm daim tawv nqaij lossis xim xiav hauv qab ntiv taw lossis ko taw (cyanosis)
• Ci, tawv
• Tuab toenails

Kev kuaj ntshav tuaj yeem pom cov roj ntsha siab lossis ntshav qab zib.

Kev ntsuam xyuas rau PAD suav nrog:

• Angiography ntawm ceg
• Ntshav ntsuas ntsuas hauv caj npab thiab txhais ceg piv rau qhov sib piv (pob luj taws / tes taw ntshav, lossis ABI)
• Doppler ultrasound tub ntxhais kawm ntawm qhov muaj txiaj ntsig
• Magnetic resonance angiography lossis CT angiography

Tej yam uas koj tuaj yeem ua tau los tswj PAD suav nrog:

• Tawm kev qoj ib ce nrog so kom txaus. Taug kev lossis ua lwm yam haujlwm mus txog ntawm qhov mob thiab hloov nws nrog lub sijhawm so. Sij hawm dhau mus, koj cov kev ncig tuaj yeem hloov kho zoo li qhov tshiab, cov hlab ntsha me. Nco ntsoov nrog tus kws khomob tham uantej pib qoj ib ce.
• Txiav kev haus luam yeeb. Kev haus luam yeeb ua rau cov hlab ntsha me, ua rau cov ntshav muaj peev xwm ua cov pa oxygen, thiab nce qhov kev pheej hmoo ntawm kev tawm tsam (thrombi thiab emboli).
• Saib xyuas koj txhais taw, tshwj xeeb yog tias koj tseem muaj ntshav qab zib. Rau khau kom haum. Ua tib zoo saib rau txhua qhov kev txiav, khawb, lossis raug mob, thiab pom koj tus kws kho mob tam sim ntawd. Cov nqaij mos ua kom zoo sai thiab muaj feem kis tau zoo thaum muaj kev ncig qis.
• Nco ntsoov tias koj cov ntshav siab yog tswj tau zoo.
• Yog tias koj rog dhau lawm, txo koj qhov hnyav.
• Yog tias koj cov roj (cholesterol) siab, noj cov rog thiab cov zaub mov muaj roj tsawg.
• Saib xyuas koj cov ntshav qab zib kom qis yog tias koj muaj ntshav qab zib, thiab tswj nws.

Cov tshuaj kho mob tej zaum yuav xav tau los tswj kev puas tsuaj, suav nrog:

• Cov tshuaj aspirin lossis cov tshuaj hu ua Clopidogrel (Plavix), uas ua kom koj cov ntshav tawm hauv cov ntshav khov. TSIS TXHOB noj cov tshuaj no yam tsis tau xub tham nrog koj tus kws kho mob.
• Cilostazol, ib cov tshuaj uas ua haujlwm los nthuav (nthuav dav) cov leeg ntshav los yog cov hlab ntsha rau cov plaub hau-rau-hnyav uas tsis yog tus xaiv rau kev phais mob.
• Cov tshuaj los pab txo qis koj cov roj (cholesterol).
• Kev kho mob siab.

Yog tias koj noj tshuaj rau ntshav siab lossis ntshav qab zib, noj nws raws li koj tus kws kho mob tau hais tseg.

Kev phais mob yuav raug ua yog tias qhov mob hnyav thiab cuam tshuam rau koj lub peev xwm los ua haujlwm lossis ua cov haujlwm tseem ceeb, koj muaj kev mob ntawm so, lossis koj muaj mob los yog mob ntawm koj txhais taw uas tsis zoo. Cov kev xaiv yog:

• Tus txheej txheem qhib cov pob txha nqaim lossis thaiv cov hlab ntsha uas muab ntshav rau koj ob txhais ceg
• Kev phais tawm kom rov qab muab cov ntshav ib ncig ntawm cov hlab ntshav uas thaiv ntawd

Qee cov neeg nrog PAD yuav raug tshem tawm povtseg (txiav tawm).

Feem ntau ntawm PAD ntawm ob txhais ceg tuaj yeem tswj tau yam tsis muaj kev phais mob. Txawm hais tias kev phais muab cov tsos mob zoo los ntawm kev mob hnyav, cov mob angioplasty thiab stenting cov txheej txheem raug siv nyob rau hauv qhov chaw phais ntau thiab ntau zaus.

Teeb meem yuav suav nrog:

• Cov ntshav txhaws lossis ntshav khov uas thaiv cov hlab ntsha me
• Kab mob rau cov hlab ntshav
• Cuam meem txom
• Qhib qhov ncauj tawm (mob txhab rau sab ceg qis)
• Cov nqaij mos ua kom tuag (mob tuag tes tuag taw)
• Cuam tshuam los ntawm txhais ceg lossis ko taw yuav tsum tau txiav tu ncua

Hu rau koj tus kws khomob yog koj muaj:

• Ceg ceg lossis txhais taw uas txias mus rau qhov kov, daj ntseg, xiav, lossis loog
• Mob hauv siab lossis ua pa luv nrog mob ceg
• Mob ceg uas tsis ploj mus, txawm tias thaum koj tsis taug kev los sis txav mus (hu ua mob so)
• Cov ceg uas liab liab, kub, lossis o tuaj
• Cov qhov ncauj tshiab / mob txhab
• Cov tsos mob ntawm kev kis mob (ua npaws, liab, mob ib ce)
• Cov tsos mob ntawm tus mob arteriosclerosis ntawm qhov tshaj

Tsis muaj kev tshuaj ntsuam xyuas raug pom zoo kom paub tseeb PAD hauv cov neeg mob yam tsis muaj tsos mob.

Qee qhov kev pheej hmoo rau tus kab mob hlab ntsha uas koj tuaj yeem hloov yog:

• Tsis haus luam yeeb. Yog koj haus luam yeeb, tsum.
• Kev tswj koj cov roj (cholesterol) los ntawm kev noj haus, qoj ib ce, thiab tshuaj noj.
• Tswj kev ntshav siab los ntawm kev noj haus, kev tawm dag zog, thiab tshuaj, yog tias xav tau.
• Tswj ntshav qab zib los ntawm kev noj haus, qoj ib ce, thiab tshuaj, yog tias xav tau.
• Tawm dag zog tsawg kawg 30 feeb nyob rau ib hnub.
• Ua kom lub cev noj qab nyob zoo los ntawm kev noj zaub mov zoo, noj tsawg dua, thiab koom nrog pab kom yuag, yog tias koj xav kom poob phaus.
• Kawm kev noj qab haus huv txoj hauv kev los tiv thaiv kev ntxhov siab los ntawm cov chav kawm tshwj xeeb los yog cov phiaj xwm, lossis tej yam xws li kev xav los yog yoga.
• Txwv txiav koj haus cawv ntau npaum li cas haus 1 haus ib hnub rau cov poj niam thiab 2 ib hnub rau txiv neej.

Peripheral vascular kab mob; PVD; PAD; Arteriosclerosis obliterans; Kev txhaws ntawm cov ceg txhaws; Claudication; Sib quas zug claudication; Vaso-occlusive tus kab mob ntawm ob txhais ceg; Arterial tsis txaus ntseeg ntawm txhais ceg; Rov mob caj dab thiab mob plab ntswj; Plab plab mob nrog kev tawm dag zog

• Angioplasty thiab stent muab tso rau - cov hlab ntsha peripheral - tawm
• Antiplatelet tshuaj - P2Y12 inhibitors
• Cov roj khov thiab txoj kev ua neej
• Kev noj haus cov rog piav qhia
• Cov lus qhia zaub mov nrawm
• Kev txiav tes taw - kev tawm mus
• Yuav nyeem daim ntawv zaub mov li cas
• Txiav ceg txiav - tawm paug
• Ceg ceg lossis txhais taw txiav - kev hloov pauv
• Mediterranean noj
• Peripheral artery bypass - txhais ceg - paug

• Atherosclerosis ntawm qhov xaus
• Arterial bypass ceg - series

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Ridker PM, Libby P, Buring JE. Cov cim phom sij thiab tiv thaiv kev tiv thaiv kab mob plawv thawj zaug. Hauv: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Plawv Lub Plawv: Phau Ntawv Qhia Txog Cov Tshuaj Mob plawvCov. 11th ed. Philadelphia, PA: Elsevier; 2019: chap 45.

Simons JP, Robinson WP, Schanzer A. Txo cov leeg ntshav ntau dua: kev tswj hwm kev kho mob thiab kev txiav txim siab. Hauv: Siavy AN, Perler BA, eds. Rutherford's Kev Kho Mob Ntshav Qab Zib thiab Kev Kho Mob EndovascularCov. 9le ed. Philadelphia, PA: Elsevier; 2019: chap 105.

Asmeskas Cov Kev Pabcuam Tiv Thaiv Cov Haujlwm, Curry SJ, Krist AH, Owens DK, li al. Kev soj ntsuam seb puas pom kab mob ntshav hlab hlwb thiab kab mob plawv nrog rau qhov ntsuas ntawm pob taws-tes taw-hauv qab no: Asmeskas Kev Pab Tiv Thaiv Cov Lus Taw Qhia Cov Lus Taw Qhia. JAMACov. 2018; 320 (2): 177-183. PMID: 29998344 pubmed.ncbi.nlm.nih.gov/29998344/.

CJ Dawb. Atherosclerotic peripheral arterial kab mob. Hauv: Goldman L, Schafer AI, eds. Goldman-Cecil TshuajCov. 26th ed. Philadelphia, PA: Elsevier; 2020: chap 71.