Calf edema

Introduction Calf edema refers to excessive accumulation of body fluids in the interstitial space of the calf, and the edema is enlarged, the volume is enlarged, and the color is pale. Under the microscope, the edema fluid is accumulated between the cells and the fibrous connective tissue or in the cavity. Common calf edema can be divided into four types, including lack of exercise, poor muscle endurance, and leg fat, sweaty "leg-like", and calf gastrocnemius muscle development, personality is easy to strain " The radish legs, as well as the lack of curves and lack of gas in the calves.

Cause

1, heart failure and leg phlebitis are the two main causes of chronic (long-term) swelling of the legs. According to clinical practice, phlebitis only causes the patient to swell on one leg, and heart failure that causes congestion can cause both legs to swell; phlebitis can cause pain, and swelling caused by heart failure does not hurt; Swelling diseases have different pathogenesis and characteristics.

2, heart disease, high blood pressure, viral infection or heart valve disease and other diseases make the myocardium weak and weak, then the heart can not smoothly send blood into the lungs, the blood will begin to flow into the vein, and then will flow into the vein The liver below the heart, the liver, causes the liver to become congested and swollen. If the situation does not improve, the blood will eventually flow back into the veins of the legs to form a swelling of the legs.

3. People with severe kidney disease will have swelling all over the body. The legs, face or fingers are not spared. The reason why systemic swelling occurs is because the protein is lost too much from the urine. To.

4, the liver disease in the later stage is more serious, it will cause swelling of the legs due to two mechanisms. One is because the liver cells are damaged and cannot produce enough protein, and the result is the same as that caused by the loss of protein caused by kidney disease; in order to balance the protein content in the blood vessels and peripheral tissues of the blood vessels, the liquid in the blood will flow into the tissue. Internally caused tissue swelling. The other is that the liver has scars (crust), so that blood flowing from the legs to the heart cannot pass through the liver, causing blood to flow back. In addition, swollen glands or tumors in the abdominal cavity may also compress the veins, causing swelling of the legs.

5, hunger caused by abdominal swelling and leg phenomenon is because the lack of protein in the diet, causing the blood in the blood to seep out of the blood vessels, into the body's tissue, when the abdomen is swollen, the abdominal cavity contains such liquid, this The same as when the kidney and liver develop lesions.

6, severe hypothyroidism can also cause systemic body edema, of course, including the legs. The reason for the formation of such symptoms is the same as in the case of the above-mentioned kidney and liver lesions, in order to balance the content of proteins in blood vessels and tissues, so that the liquid flows out of the blood vessels and enters the tissue to cause swelling.

7, the drug causes swelling of the legs: methyltestosterone (Testosterone, most commonly used as a drug for the treatment of impotence); long-term use of steroids (for the treatment of arthritis, asthma, cancer, etc.); estrogen; oral contraceptives; some antidepressants (sulphuric acid Benzene Nardil; a blood pressure lowering agent, AIdomet; and a newly invented calcium ion blocker for treating cardiovascular disease and the like.

8. The pericardium is infected by a virus or other infection, or after a heart surgery. It becomes thick and hard, just like wearing a set of armor for the heart. This situation can hinder the normality of the myocardium. Shrink and relax. As a result, the blood cannot flow back to the right ventricle and back into the vein, causing swelling of the veins and abdomen of the neck, and finally swelling of the legs.

9. If both the face and the leg are swollen at the same time, it may be due to: insufficient thyroid function, some allergic reactions leading to general malaise, pericardial lesions and oppression to the heart, and eating of Trichinella infection. Trichinella infection (chiarocaosis) caused by improper cooking of meat, or kidney disease.

10. If the swollen leg has brown pigmentation, especially if the location of the deposit is around the ankle, the swelling is usually caused by a long-term disease caused by chronic varicose veins. Brown pigmentation is formed by the passage of blood through the walls of the blood vessels into nearby tissues.

an examination

Related inspection

Blood routine electromyography electrocardiogram serum sodium (Na+, Na)

Diagnostic puncture tissue fluid analysis: analysis of subcutaneous edema tissue fluid helps differential diagnosis of difficult cases. The protein content of lymphedema fluid is usually very high, generally 1.0-5.5 g/dl, and the edema tissue fluid protein content of simple venous stasis, heart failure or hypoproteinemia is 0.1-0.9 g/dl. The examination is usually used for chronically large swollen limbs, which can be operated with only a syringe and a fine needle. The method is simple and convenient. However, it is impossible to understand the location and function of lymphatic vessels.

Differential diagnosis

The diagnosis should be differentiated from the following symptoms:

1. Ankle and foot edema: The edema of the ankle and foot is a clinical manifestation of lymphedema. Lymphedema is slower onset, and it is more common to swollen the back of the foot.

2. Acupressure edema before fistula: Acupressure edema is one of the clinical manifestations of primary deep venous insufficiency of the lower extremity. Primary deep venous insufficiency is caused by Kistner ( 1980) The new category of venous lesions first proposed is mainly due to the free edge elongation, relaxation, and sagging of the valve in the deep vein, so that when the blood flows backward under gravity, the two opposite leaflets cannot be tightly aligned in the middle of the lumen. Combined, resulting in deep venous reflux disease, resulting in lower extremity venous system congestion and high pressure, leading to a series of clinical signs and symptoms.

3. Diffuse edema of the extremities: diffuse edema of the lower extremities means that the edema begins first from the lower extremities and is diffuse.

4. Lower extremity edema: divided into physiological edema and pathological edema. Lower extremity edema is common in clinical practice and is mainly seen in the following diseases.

1 heart edema, suffering from a variety of heart disease patients, when the heart is insufficiency, systemic circulation disorders, so that the lower extremity veins return to the heart and blood volume, causing edema.

2 hepatic edema, after various liver cirrhosis, due to the reduction of liver synthesis of albumin, resulting in hypoproteinemia, decreased plasma osmotic pressure, can cause plant limb edema.

3 renal edema, acute and chronic, nephritis or nephrotic syndrome patients, glomerular filtration function is reduced, causing water retention in the body, in addition to a large amount of proteinuria, resulting in hypoproteinemia, resulting in edema.

4 hypothyroidism edema, hypothyroidism, the patient's dermis layer of mucopolysaccharide deposition, accumulation of a large amount of transparent garden, chondroitin sulfate and water, can cause lower extremity edema.

5 lower extremity deep venous edema, lower extremity deep phlebitis or lower limb venous insufficiency, due to venous return obstruction, patients may have lower extremity edema.

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