Leg diseases and treatment

First, thank you for your trust. I will try my best to answer these questions. (1) The first is leg thrombosis, also called "venous thrombosis of lower limbs". Venous thrombosis of lower limbs refers to venous thrombosis of lower limbs, and there is no age or gender difference. Thrombosis mainly occurs in veins of limbs, especially deep veins of lower limbs, and the treatment effect is often poor, often leaving deep vein obstruction or venous valve insufficiency of lower limbs. Occasionally, pulmonary embolism may occur due to thrombus shedding. The three major factors of venous thrombosis are venous blood flow stagnation, venous wall injury and hypercoagulability. But in the above three factors, any single factor is often not enough to cause disease, and it must be a combination of many factors, especially the slow blood flow and hypercoagulability, which may lead to thrombosis. (2) Explain the pathological changes of pathological venous thrombosis in detail according to your requirements. Thrombosis is mainly caused by hypercoagulability and slow blood flow. Thrombosis is usually only slightly attached to the tube wall, which is easy to fall off and easily cause pulmonary embolism. After the inflammatory reaction is stimulated, the adhesion between thrombus and blood vessel wall can also be closer. According to the composition of thrombus, there are three types of venous thrombosis: ① Red thrombus is the most common and its composition is relatively uniform. Platelets and leukocytes are dispersed in colloidal blocks of red blood cells and cellulose; ② White thrombus is basically composed of cellulose, white blood cells and layered platelets, with only a few red blood cells; ③ Mixed thrombus consists of white thrombus in the head, flaky red thrombus and white thrombus in the body, and red thrombus or flaky thrombus in the tail. The degree of venous reflux disorder caused by venous thrombosis depends on the size and location of the involved blood vessels, as well as the scope and nature of thrombosis. Occlusion of the distal venous pressure increases, capillary congestion, endothelial cell hypoxia, capillary permeability increases, resulting in distal limb swelling. The increase of deep venous pressure and venous reflux disorder make the communicating branch vein expand and open, blocking the distal blood flow from entering the superficial vein through the communicating branch, and the superficial vein expands. Thrombosis can spread to the vicinity of the heart along the direction of venous blood flow, and leg thrombosis can continue to extend to the inferior vena cava or even the opposite side. When the thrombus completely blocks the vein trunk, it can also extend retrograde to the distal end. Thrombosis can fall off, pass through the right heart with blood flow, and embolize in the pulmonary artery, leading to pulmonary embolism. On the other hand, the thrombus can be organized, recanalized and re-intimated, and the venous lumen can be restored to a certain extent. Because the lumen is affected by the contraction of fibrous tissue, the valve itself is destroyed, which may lead to venous valve insufficiency. (3) Clinical manifestations of deep venous thrombosis of lower limbs Deep venous thrombosis of lower limbs can occur anywhere. There are two common types in clinic: calf muscular venous plexus thrombosis and iliofemoral venous thrombosis. The former is located at the end, called peripheral type; The latter is located in the center and is called the central type. Whether peripheral or central, it can spread anterograde or expand retrograde, involving the whole limb, which is called mixed type, which is the most common in clinic. Leg muscular venous plexus thrombosis (peripheral type) is the most common site of postoperative deep venous thrombosis. Because of the small range of lesions, mild inflammatory reaction and inconspicuous clinical symptoms, it is easy to be ignored. I usually feel pain or swelling in my calf, tenderness in my gastrocnemius and slight swelling in my ankle. If the foot is bent back sharply when the knee joint is extended, the gastrocnemius and soleus muscles will be lengthened, which can stimulate the inflammatory pain caused by thrombosis and produce gastrocnemius pain, which is called homans's sign positive. Because it does not affect the blood return, the superficial venous pressure generally does not increase. If the thrombus continues to spread proximally, its clinical manifestations will become more and more obvious, such as leg swelling, superficial vein dilatation and tenderness along popliteal vein's fossa. Thrombosis of iliofemoral vein (central type) is more common on the left side, which may be related to the compression of the left common iliac vein by the right common iliac artery across the left common iliac vein. Sudden onset; Local pain and tenderness; The swelling of the affected limb below inguinal ligament is obvious; Superficial vein dilatation, especially in groin and lower abdominal wall; In the third area of the thigh, you can feel the cord-like substance filled with thrombus in the femoral vein; Accompanied by fever, but generally does not exceed 38.5℃. Anterograde dilation can invade the inferior vena cava. If the thrombus falls off, it may cause pulmonary embolism, cough, chest pain, dyspnea, cyanosis, shock and even sudden death. Whether it is the retrograde spread of iliofemoral venous thrombosis or the anterograde expansion of calf muscular venous thrombosis, as long as the whole deep venous system of lower limbs is involved, it is called mixed type. Clinical manifestation is a combination of two manifestations. However, the latter is occult, with mild initial symptoms until it involves iliofemoral vein and presents arc-shaped manifestations. Whenever the onset is sudden, regardless of the retrograde expansion of iliofemoral vein thrombosis or the anterograde spread of leg venous plexus thrombosis, as long as the thrombus grows, the whole venous system of the affected limb is almost completely blocked, and at the same time, the artery is violently convulsed, which is called femoral contusion. The pain is severe, the whole limb is obviously swollen, the skin is tense, shiny and purple, some can blister, the skin temperature is obviously reduced, and the pulse of the dorsal foot and posterior tibial artery disappears. The systemic reaction is obvious, the body temperature often reaches above 39℃, and shock and venous gangrene of limbs may occur. △ In addition, people, with the growth of age, diseases will find you one after another. In fact, I have been thinking about a problem since I read your account. I don't know what's wrong with your girlfriend's mother's physical condition, because she is dirty, injured and completely damaged, so the description is very general as far as your problem is concerned. I hope you don't mind my being blunt. If you want to get better completely, it is the best choice to make your body work normally, otherwise, even if you cure this, it will take a long time, somewhere else. . . My personal space also has health consultation topics. If there is not enough space here, you can leave a message on the space, and I am willing to answer in detail. All right, cut the crap and continue to answer questions. Second, the explanation of leg thrombosis and edema. It can also be seen from here that because I don't know the physical condition of my girlfriend and mother, the explanation will be very lengthy, so this is the only way to be detailed. The causes of edema are very complicated, lurking in the brain, muscles, bones, lymph, skin and other parts. Edema will make metabolism worse, and the skin is prone to wrinkles, spots and relaxation; It also produces cellulite and fat. Because of gravity, the lower body is particularly prone to gain weight. Moreover, edema makes people prone to fatigue and mental illness. In the long run, it will cause autonomic nerve disorder, and even sympathetic and parasympathetic nerves will not work normally and fall into a state of depression. The following are the common causes of "leg edema" in outpatient department: 1) Heart failure and leg phlebitis are the two main causes of chronic (long-term) leg swelling. According to clinical practice, phlebitis can only cause one leg swelling, while congestive heart failure can cause both legs swelling; Phlebitis can cause pain, but swelling caused by heart failure will not. All kinds of diseases that cause leg swelling have different pathogenesis and characteristics. 2) Diseases such as heart disease, hypertension, virus infection or heart valve disease make the heart muscle weak. At this time, the heart can't send blood to the lungs smoothly, and the blood begins to flow back into the veins, and then it will flow into the organ below the heart-the liver, which makes the liver congested and swollen. If the situation does not improve, blood will even flow back to the veins of the legs, resulting in swelling of the legs. 3) People with severe kidney disease will be swollen all over, and no one will be spared from his legs, face and fingers. The reason why the whole body is swollen is that protein loses too much urine. 4) Severe liver disease in the later stage will lead to leg swelling due to two mechanisms. One is that liver cells can't produce enough protein because of damage, and the result is just like the loss of protein caused by kidney disease; In order to balance the protein content in blood vessels and surrounding tissues, the liquid in blood will flow into the tissues, causing the tissues to swell. The other is that the liver has scar, which makes the blood flowing from the leg to the heart unable to pass through the liver, resulting in the phenomenon of blood backflow. In addition, swollen glands or tumors in abdominal cavity may also compress veins, thus causing leg swelling. 5) Hunger Due to the lack of protein in the diet, the liquid in the blood oozes from the blood vessels and enters the tissues of the body, thus causing abdominal swelling and leg phenomenon. When the abdomen is swollen, the abdominal cavity contains such liquid, which is the same as when the kidney and liver are sick. 6) Severe hypothyroidism can also cause edema all over the body, including the legs. The causes of this symptom are the same as those of kidney and liver diseases mentioned above, all of which are to balance the content of protein in blood vessels and tissues, so that the fluid can flow out of blood vessels and enter tissues, causing swelling. 7) leg swelling caused by drugs: testosterone (the most commonly used drug for treating impotence); Long-term use of steroids (for arthritis, asthma, cancer, etc. ); Estrogen; Oral contraceptives; Some antidepressants (phenylenediamine sulfate); Keywords antihypertensive drugs, methyldopa; And a newly invented calcium ion blocker for treating cardiovascular diseases. 8) The pericardium is infected by viruses or other diseases, or becomes thick and hard after heart surgery, just like putting a suit of armor on the heart, which will hinder the normal contraction and relaxation of the myocardium. As a result, blood can't flow back to the right ventricle, and it flows back to the veins, causing swelling of the neck veins and abdomen, and finally swelling of the legs. 9) If the face and legs swell at the same time, it may be due to: thyroid insufficiency, general malaise caused by some allergic reactions, pericardial lesions and heart pressure, trichinosis caused by eating meat infected with Trichinella spiralis but not cooked, or kidney disease. 10) If the swollen leg has brown pigmentation, especially when the pigmentation is around the ankle, this swelling is usually caused by a long-term disease caused by chronic varicose veins. Due to space reasons, the subsequent detailed explanation will be reflected in the following detailed rules. Forgive yourself.