第五十章周围血管与淋巴管疾病.doc

第五十章 周围血管和淋巴管疾病 Try to depict the diagnostic basis of simple superficial varicose veins of lower limbs. Patients present with superficial varicose veins along the course of greater saphenous vein and / or lesser saphenous vein and their tributaries, and complain of heaviness, fatigue of involved lower extremities should be considered of superficial varicose veins. Physical examinations revealed superficial varicose veins along the course of greater saphenous vein and / or lesser saphenous vein and their tributaries, some patients have skin alterations such as pigmentation over varicose veins in calf, especially at gaiter area. For severe ones, even have mild edema around ankle and ulcer above medial malleolus level. Perthes test and Trendelenburg test might be help to identify the patency of blood reflux in deep vein and valvular function in perforator, respectively. Duplex ultrasound, venography will help confirm the diagnosis, and differentiate from deep venous thrombosis and primary deep venous insufficiency. For moment, venography is the 揼olden standard?for the diagnosis of simple superficial varicose veins. 2. Try to depict the etiology of deep venous thrombosis (DVT) in lower limbs. The etiology of deep venous thrombosis (DVT) includes venous stasis, venous injury and hypercoagulation. Any reasons which can caused abovementioned states will result in DVT. Long-time bedding, peripheral venous ectasia caused by epidural anesthesia or general anesthesia, thus result in venous stasis. Left iliac vein compressed by both crossed right common iliac artery and the third lumbar vertebra in about 2/3 population, it抯 the most often location where thrombosis will occur. Intravenous infusion of stimulus or hyperosmotic solution, venous injury caused by fracture, local contusion will result in venous thrombosis. Major operations are most frequent causes for hypercoagulation. Burn injury or severe dehydration will pachyhemia, thus result in hypercoagulation. Factors prod