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Peripheral Vascular Diseases,周围血管疾病 山东中西医结合大学 普外科,Thromboangitis Obliterans(Buergers Disease),ETIOLOGY External-cigarette smoking,frigid irritation,injury,infection,sexual hormone, etc Internal-hereditary susceptibility ,autoimmune disease,high coagulation status of blood,etc,PATHOLOGY (1)invading middle and small arteries and veins,common on lower limb (2)artery-sclerosis,stricture,occlusion(segmental distribution) (3)perivascular inflammationinfiltration of inflammatory cells,proliferation,fibrosis,etc (4)changes of veins-inflammation,thrombosis,fibrosis,etc,CLINICAL PRESENTATION mainly including(1)tiredness,intermittent claudication;(2)pain,numbness,silent(rest)pain;(3)migratory supperficial thrombo- phlebitis;(4)decrease or loss of arterial pulse; (5)ischemic arterial ulcer, dry & wet gangrene.,Three stages are divided according to the extent of arterial ischemia &disease status (natural history): 1st stage: Local Ischemiafunctional spasm & stricture of artery. 2nd stage: Nutritional Dysfunctionsevere stricture &occlusion of artery. 3rd stage : Necrosis & Gangrenecomplete occlusion of artery.,DIAGNOSIS history + symptoms & signs + special exam: Buergers test Doppler ultrasound Angiography (DSA) MRA,DIFFERENTIAL DIAGNOSIS atherosclerosis obliteration (ASO,动脉硬化闭塞症) acute arterial embolism(急性动脉栓塞) multiple arteritis(多发性大动脉炎) diabetic foot(糖尿病足,糖尿病性坏疽) Raynauds syndrome(雷诺综合征),TREATMENT Nonsurgical therapy cessation of cigarette smoking functional exercises vasodilators & analgetics anticoagulants high-pressure oxygen therapy Chinese medicine,Surgical therapy lumbar sympathectomy PTA (percutaneous transluminal angioplasty) arterial bypass procedures arteiovenostomy amputation,Venous Diseases of Lower Extremity,INTRODUCTION General division: reflux, occlusive Classification Diagnosis,Simple Varices of Lower Extremity great saphenous varices 1.ETIOLOGY congenital venous abnormality high venous pressure,2.PATHOLOGY venous valve atrophy or loss reflux of venous blood and sludging of blood skin pigemntation , anoxemia of local tissue dermatitis, erosion , ulcer, etc 3.PRESENTATION mainly manifestationsuperficial venous twists and turns, segmental dilitation. dermatitis, erosion, ulcer,4.DIAGNOSIS clinical presentations + adjuvant exam. Trendelenburgs test Perthes test Pratts test Angiography (venous) Differential Diagnosis,TREATMENT Nonsurgical therapy avoid standing for a long time wear elastic stockings sclerosing therapy drugs Surgical therapy ligating & stripping the great or/and lesser saphenous vein & its branches,Primary Incompetence of Deep Venous Valve of Lower Limbs,DEFINITION CLINICAL PRESENTATION similar to simple venous varices of lower extremity, but the symptoms are more severe DIAGNOSIS doppler ultrasonogrphy photoelectric plethysmography venous angiography (antegrade &re

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