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脚上长紫癜 - Henoch-Schonlein purpura on foot

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脚上长出来紫癜的情况还是比较多见的,尤其是有些人们总是不注意自己的个人卫生问题,这样的话就会使得这种情况变得越来越容易发生的,而且还有一些患者是本身就由于遗传因素所导致的,若是如此的话在治疗上面可能相对来说就会更加困难一些,那么就需要先进行相关的治疗才可以。

脚上长紫癜 - Henoch-Schonlein purpura on foot

(一)遗传性出血性毛细血管扩张症

遗传性出血性毛细血管扩张症目前尚无根治办法,主要为对症疗法。

治疗方法主要分为以下几个步骤:

1、止血

体表出血以压迫止血为主,内脏出血者考虑用卡巴克洛(安络血)以助小血管收缩,用垂体后叶素降低内脏血管内压力。

2、输血

仅用于大量失血者,但不宜过量,避免血压过高而使出血难止。

3、补充铁剂

适用于慢性失血性贫血患者。

脚上长紫癜 - Henoch-Schonlein purpura on foot

4、其他

肝动脉栓塞可用于治疗肝动静脉瘘,β受体阻滞剂可改善高动力循环状态,降低肝血流量,使分流量减少。

但由于肺动静脉瘘危险,即使无症状,也应该彻底检查有没有此问题,以便做大发排列3官网性栓塞治疗。在未能栓塞消除肺动静脉瘘之前,任何手术或牙科治疗都应该加用大发排列3官网性抗生素,以避免脑脓肿。对可接触到的毛细血管扩张病变(如皮肤,或经内镜进如鼻或消化道),可直接压迫,也可行激光摘除术、手术缝合、切除病变或用局部止血剂等。动静脉瘘可行外科切除或栓塞疗法。

需反复输血者,注意大发排列3官网乙型肝炎。大多数患者需长期使用铁剂,以补充黏膜反复出血所丧失的铁,某些患者需消化道外补铁。肝动脉栓塞可用于治疗肝动静脉瘘。β受体阻滞剂可改善高动力循环状态,降低肝血流量,使分流量减少。

(二)过敏性紫癜

1、消除致病因素

防治感染,清除局部病灶(如扁桃体炎等),驱除肠道寄生虫,避免可能致敏的食物及药物等。

2、一般治疗

(1)抗组胺药

如盐酸异丙嗪、氯苯那敏(扑尔敏)、阿司咪唑(息斯敏)、去氯羟嗪(克敏嗪)、特非那定(敏迪)等,亦可用葡萄糖酸钙静脉注射。

(2)改善血管通透性药物

维生素C、曲克芦丁等。

3、糖皮质激素

糖皮质激素有抑制抗原一抗体反应、减轻炎症渗出、改善血管通透性等作用,故对减少出血和减轻症状有效,对关节症状及腹痛在部分患者中有一定疗效,但对皮肤紫癜与肾炎疗效不明显。

脚上长紫癜 - Henoch-Schonlein purpura on foot

4、对症治疗

腹痛较重者可予阿托品或山莨菪碱口服或皮下注射;关节痛可酌情用止痛药;呕吐严重者可用止吐药;伴发呕血、血便者,可用奥美拉唑等治疗


Article reading guidance

Purpura on the feet is still relatively common, especially some people always do not pay attention to their personal hygiene problems, which will make this situation more and more prone to occur, and some patients themselves are caused by genetic factors, if so, in the treatment may be more difficult, then need Relevant treatment is required first.

脚上长紫癜 - Henoch-Schonlein purpura on foot

(1) Hereditary hemorrhagic telangiectasia

Hereditary hemorrhagic telangiectasia has not yet been cured, mainly symptomatic treatment.

Therapeutic methods are mainly divided into the following steps:

1, hemostasis

Compression hemostasis is the main method for surface hemorrhage. For visceral hemorrhage patients, carbaclo (Anluoxue) is used to help small vessels constrict and pituitrin is used to reduce visceral vascular pressure.

2. Blood transfusion

It is only used for massive bleeding, but not excessive, to avoid high blood pressure and make bleeding difficult to stop.

3. Iron Supplementary

It is suitable for patients with chronic hemorrhagic anemia.

脚上长紫癜 - Henoch-Schonlein purpura on foot

4, others

Hepatic artery embolization can be used to treat hepatic arteriovenous fistula. Beta blockers can improve hyperdynamic circulation, reduce hepatic blood flow and reduce shunt volume.

However, due to the danger of pulmonary arteriovenous fistula, even asymptomatic, it should be thoroughly checked for this problem in order to do preventive embolization treatment. Preventive antibiotics should be added to any operation or dental treatment before pulmonary arteriovenous fistula can be eliminated by embolization to avoid brain abscess. For accessible telangiectasia lesions (such as skin, or endoscopy, such as nose or digestive tract), direct compression can also be performed, such as laser excision, surgical suture, resection of lesions or local hemostasis. Arteriovenous fistula can be treated by surgical resection or embolization.

Those who need repeated blood transfusion should pay attention to the prevention of hepatitis B. Most patients need long-term use of iron to supplement iron lost by repeated mucosal bleeding. Some patients need iron supplementation outside the digestive tract. Hepatic artery embolization can be used to treat hepatic arteriovenous fistula. Beta blockers can improve hyperdynamic circulation, reduce hepatic blood flow and shunt volume.

(2) Henoch-Schonlein purpura

1. Elimination of pathogenic factors

Prevention and treatment of infections, removal of local lesions (such as tonsillitis, etc.), removal of intestinal parasites, avoid food and drugs that may cause sensitization.

2. General treatment

(1) Antihistamines

For example, promethazine hydrochloride, Chlorphenamine (chlorphenamine), asmidazole (sismin), dechlorhydroxylzine (chlorpromazine), terfenadine (mindi), etc., can also be intravenously injected with calcium gluconate.

(2) Drugs to Improve Vascular Permeability

Vitamin C, troxerutin, etc.

3. Glucocorticoid

Glucocorticoids can inhibit antigen-antibody reaction, alleviate inflammation exudation and improve vascular permeability. Therefore, they are effective in reducing bleeding and alleviating symptoms. They have certain effects on joint symptoms and abdominal pain in some patients, but have no obvious effect on skin purpura and nephritis.

脚上长紫癜 - Henoch-Schonlein purpura on foot

4. Symptomatic treatment

Patients with severe abdominal pain may be given atropine or anisodamine orally or subcutaneously; painkillers for joint pain may be used as appropriate; antiemetic drugs may be used for those with severe vomiting; omeprazole may be used for those with hematemesis or hematochezia.

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