1、雷诺病 Raynaud disease,更多医学精品 尽在医学吧,http:/ disease,Raynauds is a rare disorder that affects the arteries. Raynauds is sometimes called a disease, syndrome, or phenomenon. The disorder is marked by brief episodes of vasospasm (narrowing of the blood vessels). Vasospasm of the arteries reduces blood flow
2、 to the fingers and toes. In people who have Raynauds, the disorder usually affects the fingers. In about 40 percent of people who have Raynauds, it affects the toes. Rarely, the disorder affects the nose, ears, nipples, and lips.,返回,What Is Raynauds?,雷诺病Raynaud disease,In most cases, the cause of R
3、aynauds isnt known. Some of the reasons may be: The disorder of sympathetic nerve Vascular sensitivity Structure of blood vessel Genetic factors,返回,Causes of Raynauds,雷诺病Raynaud disease,返回,Pathophysiology,雷诺病Raynaud disease,People who have primary Raynauds can have attacks in response to cold temper
4、atures or emotional stress. Raynauds attacks usually affect the fingers and toes. Rarely, the attacks affect the nose, ears, nipples, or lips,Clinical manifestation,雷诺病Raynaud disease,During a Raynauds attack, the arteries become very narrow for a brief period. As a result, little or no blood flows
5、to affected body parts. This may cause these areas to: Turn pale or white and then blue Feel numb, cold, or painful Turn red, throb, tingle, burn, or feel numb as blood flow returns to the affected areas Raynauds attacks can last less than a minute or as long as several hours. Attacks can occur dail
6、y or weekly.,Clinical manifestation,雷诺病Raynaud disease,雷诺病Raynaud disease,Attacks often begin in one finger or toe and move on to other fingers or toes. Sometimes only one or two fingers or toes are affected. Different areas may be affected at different times. Severe cases of secondary Raynauds can
7、cause skin sores or gangrene. “Gangrene“ refers to the death or decay of body tissues. Fortunately, severe Raynauds is rare.,Clinical manifestation,雷诺病Raynaud disease,Medical history Physical exam The results from tests.,How Is Raynauds Diagnosed?,雷诺病Raynaud disease,Medical history :Change color or
8、feel numb or painful when theyre exposed to cold temperatures Turn white, blue, or both when theyre exposed to cold temperatures,雷诺病Raynaud disease,Physical exam: Look at fingers and toes to check the health of the skin and nails and to check blood flow to these areas. Cold Stimulation Test Clench T
9、est Nailfold Capillaroscopy,雷诺病Raynaud disease,Lab test: ESR CRP ANA Color doppler ultrasonography Arteriography,雷诺病Raynaud disease,Diognosis points: 1.Clinical manifestionagesexcold and stress can can trigger “Raynauds attacks.” bilateral involvement 2.At least 2 years 3.No causes to vasospasm,雷诺病R
10、aynaud disease,Raynauds RP Age 10-20y 30-40y Sex female male Severity less more Necrosis rare common Spread symmetry asymmetry Nailfoldcapillary normal abnormal Causes unknown disease, other factor,Differential Diagnosis,雷诺病Raynaud disease,The aims of treatment are to reduce the number and severity
11、of attacks and to prevent tissue damage and loss of tissue in the fingers and toes. Most doctors are conservative in treating patients with primary Raynauds phenomenon because they do not get tissue damage. For these patients, doctors tend to recommend nondrug treatments before moving onto medicatio
12、ns. For patients with secondary Raynauds phenomenon, medications are more often prescribed, because severe attacks with ulcers or tissue damage are more likely.,Treatment,雷诺病Raynaud disease,Treatment,In the most severe cases, Raynauds causes ulcers and serious tissue damage that does not respond to
13、medications. Doctors may use a surgical procedure called a digital sympathectomy with adventitial stripping (which involves removing the tissue and nerves around the blood vessels supplying the affected digits). Although this procedure may result in reducing symptoms and healing tissue, it only help
14、s temporarily and therefore is reserved for difficult cases.,雷诺病Raynaud disease,The most common treatments and self-help measures are described below. Take action during an attack. Keep warm. Dont smoke. Avoid aggravating medications. Control stress. Exercise regularly.,Treatment,更多医学精品 尽在医学吧,http:/
