Ignore peripheral blood circulation, be careful to face amputation crisis, and pay attention to these chronic diseases!
Huang, director of the Peripheral Vascular Center of Taipei Tzu Chi Hospital, said that the most common cause of poor peripheral blood circulation is diabetic foot, and other causes of poor blood circulation include smoking, renal dialysis, infection and immune diseases. In the early stage of vascular disease, many patients will mistake intermittent claudication for joint and muscle problems and ignore it. They won't go to the hospital until their limbs are numb and sore and infected. However, due to multiple blockages in blood vessels, they often face amputation.
However, Tzu Chi Hospital in Taipei adheres to the principle of "no one comes to see". Since its opening on 14, it has received more than 1000 patients. The peripheral vascular team used catheter technology to dredge patients' peripheral blood vessels. More than 600 feet have been treated/kloc-0, and the success rate is 96%. The rate of avoiding high amputation is 9 1%, which is equivalent to the achievements of international first-class medical centers.
Poor blood circulation in peripheral limbs = poor systemic circulation, easy to die of cardiovascular disease? Nutritional status, immunity and mobility are the key points.
In addition to sharing relevant data, Director Huang also mentioned that in the early days, it was generally believed that "patients with critical limb circulatory dysfunction should have poor systemic circulation, so the main cause of death after treatment should be cardiovascular disease." However, with the progress of medical treatment, cardiovascular nursing resources have been greatly improved, but the survival rate of patients has not been significantly improved.
In order to provide better care for patients with peripheral vascular ischemia and improve the overall survival rate, Director Huang led a medical team to follow up 936 patients with chronic peripheral vascular ischemia who received "dredging blood vessels" treatment from 2005 to the end of October/August. In these patients, * * * 1246 showed claudication (20%) and gangrene.
The results show that only about 40% of patients died of cardiovascular diseases within two years, while about 60% died of non-cardiovascular diseases, which subverts the previous medical cognition. Director Huang pointed out: "Nutritional status, immunity and mobility are the main factors that determine whether patients with severe limb ischemia can survive for a long time after treatment. After receiving vascular treatment, if the three conditions are not good, the patient may die of infection or sepsis, and the two-year survival rate is only 20%; However, the two-year survival rate of patients with these three diseases is as high as 80%. 」
The long-term research achievement on the prognosis of patients with peripheral blood vessels dredging, Contemporary Cardiovascular Prognostic Research-Interventional Treatment of Peripheral Circulation Diseases of Lower Limbs, was also published in the Journal of Taiwan Province Medical Association on September 20 19, which subverted the previous medical cognition that "most patients died of cardiovascular diseases after treatment" and gained wide response.
He was once suggested to amputate below the calf to clear the blocked blood vessels, with correct nutritional control, and narrow the scope of resection.
Director Huang also shared that Mr. Huang, a 60-year-old recently admitted, had heart disease and diabetes. Four years ago, the wound on the back of his left foot was so big that the deep myofascia was bloodless and his limbs were cold and painful that he was recommended by the medical center to amputate below the calf. After moving to Tzu Chi Hospital in Taipei, the blocked blood vessels of iliac artery and superficial femoral artery were dredged.
Considering that the patient had poor appetite at that time, the nutritional index albumin was too low and the immune ability decreased, so in addition to injecting nutritional injection; Nutritionists are also instructed to mix a high-protein diet with a diabetic diet to maintain adequate nutrition and immunity. At the same time, consult rehabilitation department and plastic surgery, and teach bedside rehabilitation, debridement and skin grafting.
After 9 months, Mr. Huang's inflammatory index decreased, albumin increased, and his nutritional status and immune ability tended to be normal. Only five toes were amputated due to ischemia. Four years later, through continuous rehabilitation and follow-up, Mr. Huang recovered well and was able to walk by himself with the aid of assistive devices.
The doctor reminded me:
Director Huang reminded patients that in addition to internal medicine and vascular treatment, they should supplement nutrition, promote nutrient absorption, improve immunity and implement exercise rehabilitation; Only five items are enough can we effectively improve the quality of life after treatment, maintain physical strength, and thus improve the overall survival rate. In addition, patients with chronic diseases such as diabetes and kidney disease are advised to keep moderate exercise and maintain blood circulation in limbs. If they feel unwell, they need to see a doctor as soon as possible so as not to delay their illness.
Director Huang of the Peripheral Vascular Center of Taipei Tzu Chi Hospital saw the photo, not the client. (Photo/provided by Taipei Tzu Chi Hospital) Director Huang's photo at the peripheral vascular center of Taipei Tzu Chi Hospital. (Photo/provided by Taipei Tzu Chi Hospital)