Raynaud's disease-What is Raynaud's disease?
Raynaud's disease is a vascular functional disease, the most typical symptoms of the hands feet cold or emotional pale - cyanosis - the onset of the process of flushing and warmth after gradually returning to normal. Incidence of mostly women. The early stages, hands symptoms of long duration involving the feet of the symptoms. Symptoms women generally want to check the immune system, Raynaud's phenomenon due to the initial performance of immune system disorders, immune system diseases, including lupus, vasculitis or rheumatic vasculitis. The case of pure Raynaud's phenomenon or Raynaud's syndrome, treatment and prognosis are better, such as not to delay treatment can return to normal. Such as delays in treatment, the final outcome with thromboangiitis obliterans three similar (toe) side of the ulcer, necrosis. The disease is mostly blood stasis, yin yang.
Raynaud's disease - Disease OverviewRaynaud's disease - arterial change Raynaud's disease is a vascular functional disease, Raynaud's disease early pathological changes, Raynaud's disease, but in late were seen in histological changes.A. Refers to the toe artery changes: Raynaud's disease generally does not appear to refer to the toe arterial wall pathological changes, Raynaud's disease, but late due to nutritional disorders can refers to toe arterial intimal hyperplasia, fracture of the elastic membrane and muscular thickening. the terminal branches of the vessel lumen narrowing. Thrombosis with occlusive vascular disease, not easy to distinguish.
Two. Microcirculation of Raynaud's disease change, there are two aspects: ① subcutaneous capillaries pathological changes, depending on the severity. Raynaud's disease early and mid-term general change is not obvious, the vast majority of severe cases see telangiectasia, a ring, filamentous or irregular flexion. Blood flow is slow and sluggish. Some cases of Raynaud's disease visible blood cell extravasation and thrombosis. With crusty change, the capillary number can also be reduced. The ② telangiectasia sign. Such a change hands and forearms of Raynaud's disease patients seen in a long time and face, much like the spider-like hemangiomas, but no center of a small artery. Telangiectasia under the microscope, including the expansion of the venous plexus in the nipple lumen, the blood flow through slowly.
3. Skin and subcutaneous tissue disorders: Raynaud's disease long-term recurrent, so that the peripheral hypoxia refers to toe the formation of superficial ulcers, a warm climate to restore the formation of stem necrosis in Raynaud's disease progression, severe cases, up to the periosteum . Refers to the extremely slow toenail growth, thickening, uneven, late to see the peripheral skin, or even hand-foot skin smooth, meager and atrophy of the subcutaneous tissue hardening and the formation of the contraction of scar as scleroderma.
4. Bone: severe cases of Raynaud's disease can produce refers to toe decalcification, osteoporosis.
5 Nerve tissue: Raynaud's disease is generally sympathetic ganglia no histological changes, but severe cases had paravertebral ganglion cells of the nutrient vessels of the narrow channel, and a secondary connective tissue edema, infiltration of lymphocytes and ganglion cell degeneration and other changes. Another report of spinal cord lateral horn sympathetic cell changes.
Raynaud's disease - the cause of diseaseThe cause of Raynaud's disease Raynaud's disease so far is not clear, but cold, injury, and drug stimulation is caused by local vascular spasm, lack of vasodilation abnormal or peptides are also important factors vasomotor nerve center of the medulla oblongata is the skin. muscle vasoconstriction tension of the primary regulating center, certain areas of the hypothalamus and cerebral cortex is also an important regulatory part of these areas, damage to, can also lead to the occurrence of this disease. Due to peripheral vascular innervation characteristics, namely sympathetic vasoconstrictor nerve fibers, but in certain areas for the vasodilatory nerve fibers, while the hands and feet but only vasoconstrictor nerve fibers, so the vasospasm disease is common in the limbs involvement.
Raynaud's disease in addition to the above, it was considered that the central nervous system dysfunction, sympathetic hyperfunction can lead to the disease. Addition, Raynaud's disease, genetic, immune dysfunction, and congenital acral artery defects can lead to Raynaud's disease.Raynaud's disease pathogenesis, the two doctrines. First, cold stimuli can lead to a single finger of Raynaud's phenomenon attacks, and asked the local defects so that the view of increased vascular cold sensitivity. Second, sympathetic nerve activity partial Kang, cause blood vessels to increase in the contraction effect of the normal stimulus.
Raynaud's disease the main cause of spasm of the small arteries of the extremities, the reason may be related to the following factors:① central nervous system dysfunction, sympathetic hyperfunction lead to Raynaud's disease;② blood circulation of epinephrine and norepinephrine content increased the lead to Raynaud's disease;③ The condition often aggravated at the menstrual period, pregnancy reduced, and it was felt that the cause of Raynaud's disease and endocrine;④ limb small arteries defect, a normal physiological phenomenon demonstrated overreaction lead to Raynaud's disease;⑤ was also suggested that initially the extremities of small arteries to cold overreaction, followed by arterial intimal hyperplasia, poor blood flow due to the long-term vascular spasm, when there are extremities small artery flow reduced physiological factors can act on lesions artery caused by the onset of Raynaud's disease;⑥ patients often have a family history, suggesting that may lead to Raynaud's disease and genetic;Lead to Raynaud's disease the ⑦ immune and connective tissue diseases such as scleroderma, systemic lupus erythematosus, nodular polyarteritis, dermatomyositis, rheumatoid arthritis, polymyositis, mixed connective tissue disease, B hepatitis antigen-induced vasculitis, drug-induced vasculitis and Sjagren syndrome complicated by Raynaud's disease;⑧ recently, referring to the destruction of platelets accelerate the release of serotonin or thromboxane A2 and other factors cause vasoconstriction lead to Raynaud's disease;⑨ obstructive arterial disease, such as arteriosclerosis obliterans, thromboembolic vasculitis and other causes of Raynaud's disease;⑩ physical factors such as vibration damage, direct arterial injury, frostbite, etc.; a certain drug-induced Raynaud's disease, such as ergot, lead, thallium, arsenic poisoning, polyvinyl chloride, beta-blockers, the cells poisons, contraceptives, etc.; b affect the mechanism of neurovascular factors, such as cervical rib, anterior scalene muscle syndrome, carpal tunnel syndrome, thoracic outlet syndrome, improper use of crutches oppression axillary Ministry of tumor compression of the brachial plexus and subclavian vessels cervical inflammation, or rupture of the nucleus pulposus, peripheral neuritis, syringomyelia, or tabes lead to Raynaud's disease; c blood agglutinin increased cryoglobulinemia, polycythemia vera, paroxysmal hemoglobinuria, etc. lead to Raynaud's disease; d variant angina patients, 26% had migraine, 24% have Raynaud's syndrome, suggesting that there is a regional arterial spasm systemic defects in patients with Raynaud's disease. e reported Raynaud's disease and idiopathic pulmonary arterial hypertension, may reflect the abnormal increase of peripheral vascular tone secondary to cardiac output was severely reduced.
Raynaud's disease - Clinical manifestationsRaynaud's disease - clinical manifestations in patients with Raynaud's disease is often due to exposure to cold or a finger after exposure to low temperature attack, also due to the emotional, mental stress induced. Raynaud's disease in patients with seizures characterized by (toe), skin color suddenly turned white, then into purple and then convert to flushing, intermittent attacks. Raynaud's disease more common with your fingers while toe rare.
Raynaud's disease attacks childhood, often refers to the ring fingertips, with the lesions progress gradually extended to the entire finger or palm, but the thumb is less disease, accompanied by local cold, numbness, tingling, and soreness or other abnormalities feeling. Systemic and local temperature decreased, but the radial artery or dorsalis pedis artery pulse normal.
Raynaud's disease onset, the attack time for more than a few minutes to half an hour or so relieve itself. When the skin into flushing, often accompanied by burning and tingling, and then converted to normal color. Raynaud's disease in the attack, local heating, rub the affected limb, waving limbs, can attack aborted. The progress of the disease symptoms get worse, frequent seizures, each attack a sustainable one hour or more, sometimes the need to hand, foot and immersed in warm water to suspend the attack.
The main clinical manifestations when the cold stimulus or mental stress, the finger skin typical of Raynaud's phenomenon, pale - cyanosis - flushing - normal intermittent skin color changes. Finger showing a pale and cyanotic fingers at the end may be associated with numbness, tingling, cold and insensitive. To take precautionary measures. The skin color of the hand into a wave of red, often rise in skin temperature, then you can have a mild burning pain. Then the skin color is normal, the symptoms disappear. Significant seasonal incidence of early, that is the cold season episodes of frequent and arterial spasm duration is longer, and reduce the number of attacks in the warm season, arterial spasm of short duration, or rarely attack. Serious illness is more sensitive to cold, so in the winter can not be in the outdoor activities and work.
Raynaud's phenomenon, although the characteristics of the disease clinical manifestations. However, many patients lack the typical skin color changed regularly, mostly in advanced cases. According to 1966 statistics of 45 cases, such as Heng Chuan, accounted for 65% of a typical skin color change, there are two skin color accounted for 22%, and a skin color (pale or cyanotic) changes accounted for 13%. Hines reported 100 cases, showing the three skin color changes, only 22%, showing pale accounted for 41% only.
Therefore, in the diagnosis of the disease should not be solely on the basis of typical Raynaud's phenomenon. Apart from some people, the majority of the patient's condition have varying degrees of progressive finger blood circulation obvious obstacle to the critical temperature, finger blood vessel contraction, increased from the normal 17-18 ° C to 25-26 ° C (Heng Chuan, in 1978). Therefore, the temperature slightly to cause arterial spasm. Even in summer, rainy weather, finger skin color will change. By the warmth of the body, the skin color is still not returned to normal, that mirrors the artery has been organic change.
Raynaud's phenomenon Raynaud's disease skin color changes often have three characteristics, (1) start with a finger to start. Of the order 4, 5, 3, 2 finger; while the thumb blood circulation, skin color changes appeared only in a serious condition. ② gradually extended to the All-Share Index and the palm of your hand from the fingers of the distal, but rarely more than the carpal region, the ⑧ generally occurs in the fingers and symmetrically. Hines and other reports 100 cases of all two-handed involvement. Cofford and other statistics of 407 cases, only four cases of the onset of the foot. Very few patients, ear and lip refers to arterial spasm also appear cyanotic color. In 1965 Johnoton report of 43 cases, 17% of patients 6-24 years after the onset of finger skin sclerosis, manifested as skin thinning, tight, hard and tough, accompanied by joint stiffness, flexion limited mobility. Fingertip skin may be secondary to a small superficial ulcer or gangrene, and accompanied by severe resting pain: the formation of point-like skin ulcer healing scar. Nail growth is slow, rough and occurrence of ingrown nail disorder may occur A week of inflammation and trigger gangrene factors.
Patients is a nervous type, often the central nervous system imbalances, easy excitement and emotion, suspicious, depressed, or sad, as well as insomnia, dreams, pain-free performance of the fixed place, and general malaise neurosis.
Raynaud's disease - pathological diagnosisRaynaud's disease - diagnosis of Raynaud's disease there is no uniform standard, domestic and foreign experts and scholars to develop diagnostic criteria, if they meet the following various criteria before Raynaud's disease, there is no unified standard, with reference to domestic and foreign experts and scholars to develop diagnostic criteria, if they meet the following articles of the criteria for diagnosis. Even so, there are individual cases, Raynaud's phenomenon 12 years later, the show scleroderma change, and therefore carefully to find the cause.A. Occur in the 20-40 year-old introverted women.Two. Cold or emotional and can induce the onset of Raynaud's phenomenon.3. With bilateral involvement.4. Suffering from district arterial pulse normal.5 General non-tissue necrosis, performance, or only in the late minimal refers to subcutaneous necrosis, usually confined to the fingertips.6. No other system disease can explain.7. Course of the disease in more than 2 years. Even so, there are individual cases, Raynaud's phenomenon 12 years later, the show scleroderma change, and therefore carefully to find the cause.
Raynaud's disease - differential diagnosis
(1) hand, foot and cyanotic disease: disease of unknown cause, more common in female adolescence. The clinical features of hand-foot skin was persistent cyanosis, a wide range, were gloves and socks shape, uniform color, delicate skin, skin temperature is significantly reduced. His hands symptoms than heavy foot, cyanosis in the low temperature increase, and upper limbs drooping in a warm environment, or relieve symptoms after upper limb lift. Continued to massage the skin cyanosis fades back to normal, the above-mentioned skin color changes and Raynaud's disease is clearly different. Thus both identification easier.
(2) livedo reticularis: the patient's skin in the cold stimulation, due to the accumulated impact, small artery spasm, small veins with secondary expansion and retention of blood, so the skin surface of livedo reticularis. Such skin changes may occur in the limbs, head and neck and trunk, more widely, especially prevalent in the lower limbs, severe cases can involve the entire limb, rarely occur alone in the hand, foot. Primary livedo reticularis in addition to the chills and unhappy green grouper, no other symptoms: secondary, primary diseases of wheat now. According to these characteristics, it is not difficult with Raynaud's disease be differentiated.
(3) Erythromelalgia: This is an expansion of peripheral arteries and on warm-sensitive diseases of unknown etiology. Clinical performance is characterized by hand-foot-four symptoms of paroxysmal redness, swelling, pain, heat. Hand, foot and can occur, but is more common in the two-legged and obvious. Mostly symmetry. Foot temperature, and often a sense of burning unbearable. Therefore, the patient is afraid of the heat hi cool, prefer bare feet and the foot soaked in cold water to relieve symptoms. Symptoms of the disease and Raynaud's disease is different, so easy to identify.
(4) frostbite: it is a cold seasonal disease, more common in children and women. Peripheral vascular cold sensitive is the main factor. Generally occur in the hands, feet, ears, nose, especially prevalent in the back of the hand and ear shell. Frostbite early local skin color is pale, then red and swollen and red, purple or purple boundary of small lumps, press the fade, especially prevalent in the back of the outside. When heated, often congestion, and mild burning itching. Severe cases, blisters can form ulcers heal slowly, often left atrophic scars. After frostbite in temperatures warming up gradually, Qu can recur. Years of recurrence, both hands skin was purple, the shape of hand, foot and cyanotic disease. Raynaud's disease patients are more sensitive to cold, rarely occurs due attention to protection, frostbite, so is not difficult to identify.
Raynaud's disease - treatment of diseaseRaynaud's disease - Drug treatment of the past two decades, no satisfactory progress for the pathophysiology of Raynaud's disease and clinical research. The view of some new drugs and methods in medical treatments, but not yet make treatment significantly improved. Thus cure of the disease, mainly to combination therapy, especially for critically ill patients, monotherapy is often difficult to obtain satisfactory and lasting results.Many patients are nervous type. Excitable mood, anxiety or fear; disease often nervous and intrinsic factors to induce the disease attacks. Should comfort the patient, dawn to disease-related knowledge, to lift the burden of their thoughts, about 10% of the patient's condition can be naturally causes remission or cure. Approximately 40% of patients after treatment. The condition can be stabilized and improved. The spirit of excessive tension and neurasthenia, insomnia and other patients, to the spirit of stability, Librium, Gu-dimensional disordered and brain Ling Su and other stabilizers and adjust the central nervous system dysfunction drugs.
A. Raynaud's disease - drug treatmentDrugs cure is the main way to treat the disease. The Giffard report 474 cases, 84% of patients treated with drug therapy. Japanese statistics, Heng Chuan, 80% of patients receiving drugs cure more to get better results. Drug treatment is generally better for early patient can only temporarily relieve symptoms of terminally ill patients, while difficult to achieve all the more.
To treat the disease of drug to relieve arterial spasm of various compounds, including the role of adrenergic receptors, adrenergic nerve endings, such as dilation of blood vessels drug. Because of the general treatment method (oral, intramuscular or intravenous administration) of drug acting on the blood vessels, and Raynaud's disease involving only the acral blood vessels, and there was a chronic process. Therefore, drug therapy has certain difficulties. Dose symptoms is not easy to eliminate: to increase the dosage can cause low blood pressure, heart rate and other side effects, in particular, does not apply to existing cardiac or cerebral insufficiency patients. In addition, oral administration of large doses of vasodilator drugs can often cause gastrointestinal reactions and skin reactions and other adverse effects.
This could be replaced by selective intra-arterial injection method increased the concentration of drug in the local intravascular However, repeated arterial puncture injection can cause local inflammation and scarring (fibrous tissue) proliferation, which it can contribute to arterial spasm or narrowing. Arterial administration can only be short-term or intermittent use.
Commonly used drugs are as follows:(1) Tolazoline: also known as benzyl imidazoline, in addition to a papaverine-like direct relaxation of vascular smooth muscle, blocking the sympathetic a-receptor, thus easing the epinephrine and norepinephrine vasoconstrictor role. Peak vasodilator effect after taking the drug 40-100min after injection, 30-60min, and continued for several hours. Since 1939, Hartman et al report Tolazoline pharmacological effects, has been commonly used drugs to treat the disease. The dose is 25-50mg, 3-4 times a day oral administration. Gradually increase the amount should be based on patient tolerance. In order to reduce the gastrointestinal tract stimulation after a meal oral, or 25-50mg the 20m1 venous or arterial injection of saline a day 1-2 times, but also intramuscular injection. There has been a long-term advent Tolazoline, can reduce the number of drugs and dose.
Le Jiting (2) the Le Jiting (Regitine): also known as phentolamine, chemical structures and pharmacological effects of the drug Tolazoline is a-blocker punishment. Anti-epinephrine and norepinephrine strong, with a lower peripheral vascular resistance and increase the role of local blood circulation, especially the role of small arteries becomes more apparent. Intramuscular or intravenous injection 5mg. 1-2 times daily. Intravenous suitable for each per minute 0.3mg 5mg. The oral dose is 25-l00mg 4 times a day.(3) white benzene Qi Lin (Dibenzyline,): also known as phenoxybenzamine, and the role of Le Jiting only excreted slowly, more lasting effect. Excretion of approximately 50% after intravenous 12h, 24h excretion of about 80%, or even a week when there is still a small amount of retention in the body. This drug oral absorption rate of about 20-30%, it should increase the dose. Beginning of 10-20mg, once daily, after the maintenance dose of 20-60mg daily l-2 times. This drug on the soft tissue there is a strong irritant, it is not subcutaneous or intramuscular injection. Slow static point dose daily 0.5--1mg/kg weight.
(4) reserpine (Reserpine): is a commonly used antihypertensive drugs, allows sympathetic nerve conduction medium (norepinephrine and catecholamine) consumption, the expansion of peripheral vascular effect. For a long time, it is commonly used drugs to treat the disease. Generally 0.5-1mg injection of 1 4d. Commonly used oral dose of 0.25mg, 3-4 times a day.
(5) Pentoxifylline: a new peripheral vasodilator and can improve the degeneration of red blood cells flexible and filtration, to reduce fibrinogen and inhibit platelet aggregation, thereby improving the flow properties of blood to increase peripheral arterial blood flow. Has become one of the commonly used drugs for the treatment of vascular diseases shoulder. This drug is rapidly absorbed after oral administration. Each oral :100-200mg, 3 times a day, 6 - 8 weeks for a course.
(6) nicotinic acid: a better role in the dilation of blood vessels, oral effective upon, but with a short role. Dose of 50-100mg, 1 3-6 times a day. Skin flushing, itching and gastrointestinal reactions, may also be some damage to the liver function.
Accompany it amines (7): This drug is the chemical structure and pharmacological effects similar to histamine, allows visceral vasoconstriction and reduced blood flow, leaving the peripheral vascular resistance and blood flow. Its role in the speed and dose-related. The lh within the drug after oral administration of gastrointestinal absorption, 72h urine from 50% in accordance with national clinical data, it is a variety of peripheral vascular insufficiency diseases, to good effect by about 60%. The oral must be at the dinner, using the incremental approach. 3d began a daily undertaking of 4-6d 2 a day, 7-9d 3 a day, 10d should be a day 4 after treatment for at least two months. Accompany it amines not with monoamine oxidase inhibitor combination. Suffering from atherosclerosis or hypertension, must be taken by the increment method.
Two. Raynaud's disease - treatment by Chinese medicine(1) herbal therapy: Raynaud's disease is the the Arthralgia areas belonging to the Chinese medicine. Five internal organs to generate articles. Lying come forward to the wind, HI dry skin Bi ". Pathogenesis, internal injuries in fear anger inverse gas six Yu barrier, not temperatures, and leave the blood Yun, the incidence of such syndromes is due to emotional discomfort, physically weak, chills, business health disorders, yang can not Sida, cold off Blockage and meridians caused by poor gas as the commander of blood, blood of the mother of qi. The blood line of the gas line, qi stagnation hemagglutination "theory, the composition can very according to the the Zhongjing Astragalus Gui Zhi Wu Wu Tang in the" Golden Chamber "addition and subtraction cure. Prescription, Astragalus 75g, the Guizhi 20g, white peony root 20g Ginger 5, jujube 12, earthworm 15g, Salvia 20g, safflower 10g, licorice 10g, water simmer in water.
(2) acupuncture; commonly used body acupuncture points, taken within the customs of the upper extremity lesions, Qu pool and gu, lower extremity disease to take the full three years, Sanyinjiao once a day.
Thoracic sympathetic ganglion resection. Thoracic sympathetic ganglion resectionThe sympathetic nervous system of patients with Raynaud's disease more than in the excited state, resection of the thoracic sympathetic ganglion reflection contact is cut off blood vessels and nerves, thereby lifting the limb peripheral arterial spasm, improving the ischemic state of the fingers, and to promote ulcer healing. Various scholars indications for such surgery, surgical operation and removal, as well as to determine the efficacy standards are inconsistent, so the evaluation of surgical treatment is not the same. Some reported efficacy of up to 90%, and some reported ineffective. Generally reported good efficacy for about 60%.Thoracic sympathetic ganglion block technique (the stellate nerve block) for the cure for Raynaud's disease, but its efficacy is short-lived, and the need to repeatedly block. May have serious complications, such as anesthetic mistakenly injected into the spinal cavity within the vertebral artery or injury of the brachial plexus, so chess this method.
The traditional open thoracic sympathetic ganglion resection of four kinds of pathways, each has its advantages and disadvantages, should be based on the experience of the patient and the surgeon to choose.
(1) The axillary pathways: the advantages of simple operation, less damaged tissue and reveal the good, now more frequent use. Surgery under endotracheal anesthesia. Bilateral surgical staging completed. In cases of severe pleural adhesions or heart, pulmonary insufficiency should not take this path.
(2) the supraclavicular path: the advantages of surgery under local anesthesia without thoracotomy, on both sides of the surgery can be completed in one. The disadvantage is that the supraclavicular fossa anatomy more complex, smaller field of vision, removal of the third thoracic sympathetic ganglia revealed due to the full. In the event of bleeding, bleeding is more difficult, and possible injury of the brachial plexus, the thoracic duct and pleural. Use this path gradually reduced. Only can not take the other path when the choice.
(3) the advantages and disadvantages of the axillary path this path through the chest path. Surgery under endotracheal anesthesia. The patient's thorax was barrel, the greater the difficulty of operation.
(4) back path surgery requiring endotracheal anesthesia. Both sides of the thoracic sympathetic ganglion resection, but the trauma, revealed poor. The patient prone, to increase the anesthetic management sleepy heap. Damage the pleura may be more disadvantages, by becoming less.
Thoracoscopic thoracic sympathectomy surgery:
Thoracoscopic thoracic sympathectomy surgery just under the armpit 2 the size of the keyhole incision to complete the surgery. The surgery is completed on a television monitor zoomed four times, experienced doctors can clearly find the nerve to do a variety of sympathetic surgery.This surgery trauma tiny, little pain, quick recovery, is the world's widely accepted surgical methods.
The effect of surgery is poor and recurrence of symptoms, in addition to the levy to avoid surgery Houhuo Na occurred. Only part of the stellate ganglion excision, may be left dominate the upper extremity vascular sympathetic, may also have the following reasons:
(1) sympathetic variation (Kuntz, nerve). Incomplete resection, especially smaller and section and nerve branch is missing, the reasons for early recurrence.
(2) are not identified from the contralateral cross-sympathetic. Late recurrence may be due to other neurological bypass, especially the formation of the spinal vertebrae or by axonal bud collateral, channel.
Raynaud's disease - Note
Note schematic Raynaud's disease refers to the cold stimulation, emotional or mental stress and other factors, the fingers of the arteries at the end of paroxysmal cramps acral skin color pale - bruising - flushing - normal gap changed. The disease is more common in women of 20-30 years old, occur in the cold season. Arterial pulse does not diminish the attack. When such symptoms should be excluded from scleroderma, lupus erythematosus, dermatomyositis, and arterial occlusive disease. In addition to the medication must strive to avoid the role of these incentives.
1, be taken to avoid freezing, keep the body and limbs warm.
2, daily life can drink a small amount of alcoholic beverages, to dilate blood vessels, reduce the disease. To stop smoking, smoking can make vasoconstriction, aggravate the condition. Usually to be careful to protect the fingers from injury.
3, to feel comfortable. The disease is benign and does not cause disability.
4, according to the doctor to take vasodilators.
In short, to avoid a variety of predisposing factors, winter keep warm, to prevent the limbs, partial exposure to the cold environment, to keep the sick room temperature between 72-74F. Avoid the application of vasoconstrictor drugs, and blockers, to avoid trauma, and actively encouraged to stop smoking, to avoid irritating diet and aggressive treatment of various diseases caused by vascular injury.
Good psychological care to the patients made it clear that the relationship between mental factors and the disease, and to avoid mental stress and emotional. Observed (toe) side of skin condition and blood circulation, when the patients (toe) side, pale skin, pain and numbness and other symptoms, may be soaked in warm water, to strengthen the massage, if necessary, (toe) end local Tu nitrate glycerin ointment, each retaining one hour after the dry. Active treatment-induced Raynaud's phenomenon, a variety of diseases, such as systemic lupus erythematosus, dermatomyositis.
(3) sympathetic nerve regeneration.(1) sympathectomy the blood vessels to epinephrine and norepinephrine-sensitive reaction (Cannon, doctrine).
(5) finger blood vessels have organic disease.
(6) of neglect finger after weatherization.
5 Fingers of local processing
A week of infection or manicure injury, often severe pain and ulcers, gangrene expanding. Only a dry gangrene of the fingers should be kept local cleaning, exposure or with sterile gauze bandage to prevent the formation of wet gangrene. Be improved blood circulation and gangrene of boundary separation after resection. A pericoronitis concurrent A infection, should try to pull a. Until the blood circulation to improve healing of ischemic ulcers, it is appropriate absorbent dressings protection.
