What is the manifestation of the ischemic phase of Buerger s disease

The symptoms of the ischemic phase of thromboangiitis obliterans include various abnormal sensations such as pallor, coldness, pain, numbness and other parts of the toes, a decrease in temperature when touched, and a weakening or disappearance of the pulse of the arteries in the feet such as the dorsalis pedis artery or the posterior tibial artery. Patients may also have manifestations of nutritional deficiencies, such as thinning or abnormal thickening of nails, roughening, chronic ulceration of the extremities in severe cases and long-term non-union, and local necrosis and blackening in more severe cases. If necrosis, blackening and chronic ulcers do not heal for a long time, slow infection, inflammation and pus exudation, local ulceration and redness, swelling and pain at the edges will occur, which are typical symptoms of the ischemic phase of thromboangiitis obliterans.

The disease is more common in young adults and is more common in the lower limbs. The affected limb presents temporary or persistent pallor, cyanosis, burning and tingling pain, the skin color of the affected limb becomes red when it hangs, it becomes white when lifted, followed by numbness of the toes, pain in the calf muscles, irritation when walking, and disappearance at rest; Superficial phlebitis and edema often occur in the lower legs. On examination, dorsalis pedis pulse is diminished or absent.

As the disease progresses, intermittent claudication and Raynaud's phenomenon may occur, pain worsens at night, and pain in the toes is severe, cyanosis, and then ulceration or gangrene at the end of the toes and blackening, which gradually spreads to the proximal end.

Vasculitis is more common in young and middle-aged men, and accumulates more limbs, which is an arterial disease whose cause is not clear, resulting in small and medium-sized arteriolatic lesions until the narrowing or even occlusion of blood vessels 5261. Vasculitis is generally thought to be related to sex hormones, cold, dampness, smoking, autoimmunity, and other factors. In the early stage of vasculitis, the patient's symptoms include limb numbness, soreness, sensitivity to cold, intermittent claudication, the symptoms at this stage are easy to be confused with the lumbar intervertebral disc pressing close to the sciatic nerve, and in severe 4102, intermittent claudication can occur, the pain is aggravated, and the dorsalis pedis artery and posterior tibial artery disappear, if it is not appropriate at this time, it is very easy to ulcerate, and the wound is not easy to heal after ulceration.1653 Together, causing limb necrosis, then there will be a risk of amputation.

Buerger's disease is a rare chronic segmental inflammatory disease of arterioles and veins, and is more common in the lower limbs. Presents with ischemia, pain, intermittent claudication, decreased or absent dorsalis pedis pulse, migratory superficial phlebitis, and in severe cases, acral ulceration and necrosis.

The ischemic phase of thromboangiitis obliterans is characterized by intermittent claudication.

Quit smoking, because smoking can change the viscosity of the blood, and the blood becomes viscous and easy to stagnate.

Answer]: B Clinical manifestations and stages of thromboangiitis obliterans. Stage 1 (ischemic phase):

Numbness, coldness, mild intermittent claudication, and recurrent superficial phlebitis migrans may occur. On examination, the skin temperature of the affected limb is slightly low, the color is pale, and the pulse of the dorsum of the foot or posterior tibial artery is weakened. The functional (spasticity) of this shed period is greater than the organic factor.

Stage 2 (Nutritional Disorder): Symptoms worsen, intermittent claudication becomes apparent, pain becomes persistent resting pain, and it is severe at night. On examination, the skin temperature of the affected limb is markedly reduced, the color is pale, or purple spots and flushing appear, the calf muscles are atrophied, and the dorsum of the foot or posterior tibial artery pulse is absent.

Stage 3 (necrotic stage): The symptoms continue to worsen, the toes of the affected limb are blackened, gangrene, ulcers form, and the pain is severe and persistent. It is clear that the artery is completely occluded at this stage, and the collateral circulation does not guarantee the survival of the toes.

a.Rest the pain of jujube meditation.

b.Intermittent claudication.

c.Decreased dorsalis pedis artery pulsation.

d.The affected limb is numb and cold.

e.The ulcer of the toe is closed.

Correct answer to the rock crack case: a

Guan Chun stared at the care of the ischemic phase of thromboangiitis obliterans, and the mistake was that it was next to () aDefinitely quit smoking.

b.Give low molecular weight dextran.

c.Cut the tubular dilator with blood.

d.Analgesics are needed to relieve pain.

e.Be mentally prepared.

Correct answer: d

Source Book Answer]: c

Buerger's disease is an inflammatory, phased, and periodic chronic disease involving blood vessels. Arterial occlusion can cause ischemic soreness in the affected limb due to involvement of small and medium-sized blood vessels in the lower extremities, with intermittent clefted jujube claudication, which is the main symptom in the early stages.

a.Pain at rest.

b.Intermittent onset of sudden onset of pain.

c.Intermittent pain with activity.

d.Increased sensitivity to cold.

e.Local** color variation.

Correct answer: d