Obliterating endarteritis
Contents:
Description:
The obliterating endarteritis is the disease affecting vessels of preferential lower extremities, leading to the progressing blood circulation disturbance, which is coming to an end quite often with gangrene. The disease it affects more men of middle and young age.
Symptoms of the Obliterating endarteritis:
The main specific symptom allowing to suspect and reveal an obliterating endarteritis is the alternating lameness: the severe pain in gastrocnemius muscles forcing the patient to shorten a stride and to stop through certain intervals of a way. After small rest pain disappears and the patient moves further.
Emergence of this symptom is connected with insufficient intake of oxygen and nutrients to muscles of legs, owing to defeat of vessels.
Allocate 5 phases of a disease which are consistently replacing one another:
1. The patient is capable to pass 1 and more than a km before emergence of an onychalgia;
2. Pain arises at the movement on distance about 200 m;
3. Pain arises when walking on distance of 25 m, pains at rest develop.
4. Along with pain ulcer and necrotic changes on extremity integuments appear.
5. Gangrene.
In addition to the alternating lameness patients complain of weight in legs, bystry fatigue, feeling of crawling of goosebumps, perspiration. Externally the disease is shown by pallor and a cold snap of an affected area of an extremity, at the initial stages, and emergence of not healing trophic ulcers in the started cases. It is weakened or at all the pulsation on the main arteries of the lower extremity vanishes.
The disease sometimes progresses slowly, aggravations are replaced by remissions that the long time allows the patient not to see a doctor. But quite often the disease promptly develops, quickly leading to irreversible changes in vessels and tissues of an extremity. Therefore, at the first signs of disturbance of blood circulation in legs it is necessary to ask for medical care immediately.
Reasons of the Obliterating endarteritis:
The etiology of an obliterating endarteritis is up to the end not found out, but factors which influence promotes development of a disease are defined.
1. Smoking
2. Frequent long overcooling of legs
3. Psychological tension, stresses.
4. Chronic poisoning with some poisons
5. Alcohol abuse
6. Abundance of greasy food in a diet
The resistant spasm of arteries and capillaries of the lower extremities is the cornerstone of a disease. Against the background of a spasm development of the inflammatory process in a wall of an artery causing narrowing of a gleam of a vessel up to its full obstruction (occlusion) begins. In development of an inflammation the large role is played by autoimmune processes: in blood of patients antibodies to cells of own vascular wall appear.
Treatment of the Obliterating endarteritis:
At early stages of a disease treatment preferential conservative. Reception of medicines, physiotherapeutic procedures are intended to remove a spasm of a vascular wall, to prevent a thrombogenesis in a vessel gleam, to improve microcirculation. Several groups of drugs are applied to this purpose:
1. Spasmolysants
2. Antiagreganta
3. Vitamins (In, E, C, PP)
4. Antihistaminic drugs
From physiotherapeutic procedures the good therapeutic effect at early stages is rendered by diadynamic currents, a diathermy, a barotherapy. At late detection of a disease, and also at inefficiency of drug treatment resort to surgery.
If the small site of an artery is struck (to 15 cm), then it is deleted. If pathological process affected the site more than 15 cm, then resort to shunting or prosthetics of an artery. The most frequent operation at an obliterating endarteritis is aortobedrenny shunting: from a belly part of an aorta to a femoral artery bypassing an affected area the artificial vessel is sewed.
Operation of a sympathectomy gives good effect: the crossing of sympathetic nervous trunks leading to stopping of a vascular spasm. At a gangrenosis resort to amputation of the struck segment or all extremity.
