Dystrophic edema

Introduction Nutritional edema (also known as hypoproteinemia) is a special manifestation of nutritional deficiencies. Due to the long-term negative nitrogen balance, plasma protein is reduced, colloid osmotic pressure is reduced, and systemic edema is present. feature. It is characterized by the often weight loss and weight loss before edema occurs. The tissue loss caused by the reduction of subcutaneous fat, the tissue pressure is reduced, and the edema of the edema fluid is aggravated. Edema often spreads throughout the body from the foot. The treatment of the cause of the disease and the adjustment of nutrition at the same time.

Cause

Cause:

1, protein absorption disorders: long-term diarrhea, chronic dysentery and intestinal tuberculosis, etc. in the cause of the disease. These disorders affect both appetite and protein absorption. Edema can also occur in individual infants due to long-term vomiting due to pyloric fistula or obstruction, or the inability to utilize protein in food due to the lack of trypsin.

2, excessive consumption of protein: empyema, lung abscess, ascites, massive blood loss, surgical wound drainage and severe burns can cause a large loss of protein in the body. Chronic infectious diseases such as tuberculosis, malaria, etc., cause excessive decomposition of proteins in the body, which can cause dystrophic edema.

3, protein synthesis disorders: the liver can synthesize various plasma proteins, such as: albumin, fibrinogen, prothrombin, can also synthesize part of globulin. Liver diseases such as cirrhosis and hepatitis all reduce liver function. Although the supply and absorption of protein are normal, the function of synthetic proteins is lowered, so that plasma protein is low, and symptoms such as edema and ascites occur.

an examination

Related inspection

Amino Acid Examination Vitamin A Alcohol Binding Protein Serum Butanol Extraction Iodine Vitamin A Vitamin A (VitA)

There are symptoms of malnutrition before the onset of edema, such as poor growth and development, muscle wasting, slack, pale, weak, cold, lack of energy or irritability, first bulimia, then anorexia. If the food is chronically deficient in protein, edema gradually develops, but in children with diarrhea, edema can occur in a short period of time, and the shortest is only ten days. Edema is the main sign of this disease, bilaterally symmetrical, first seen in the lower limbs, especially the foot back is significant. For a longer period of time, the femoral head, lumbosacral region, external genitalia, and even the back and arms of the hands showed significant edema. In severe cases, edema can occur in the abdominal wall, face, eyelids, and conjunctiva. Most of the facial edema is edema and no depression. The edema of the lower extremities is significant, and it is suitable for comparison with the thinness of the chest and upper limbs. Ascites and pleural effusion are only occasionally seen in extremely severe cases. Mild edema in infancy, often due to skin elasticity is very good, not easy to recognize, must pay attention to the sudden increase in weight, a few hundred grams a day, is a reliable sign of edema.

Other symptoms: often showing general weakness and depression, and lack of anti-infective ability. The skin is dry and cool, scaly, or chicken-like, loses its elasticity, is prone to acne, and the wound heals slowly. The hair is dry and yellow, and it is easy to fall off. Nail growth is slow. Reduced urine output. The pulse and blood pressure are reduced, and the voltage of each wave of the electrocardiogram is low.

Differential diagnosis

Differential diagnosis:

(1) Cardiac edema: In the case of right heart dysfunction, exudative or constrictive pericarditis, edema is caused by increased venous pressure in the systemic circulation and increased capillary filtration pressure. Cardiac edema is characterized by edema that first occurs in the ptosis, often throughout the body from the lower extremities, and ascites or pleural effusion can occur in severe cases. Edema is formed at a slower rate. The edema is solid and less mobile. The main basis for the diagnosis of cardiogenic edema is the history and signs of heart disease. Determination of a significant increase in venous pressure is an important indication for diagnosis.

(2) Hepatogenic edema: cirrhosis often has mild edema of the lower extremities before the appearance of ascites, which first occurs in the ankle and gradually spreads upward. The head and face and upper limbs are often edema. Ascites and pleural effusion occur in severe cases. A variety of chronic liver disease history and signs of liver damage and laboratory indicators are the basis for diagnosis.

(3) drug-induced edema: refers to the clinical fluid imbalance caused by the application of certain drugs in the clinical, body fluid retention in the interstitial space and systemic or local swelling.

(4) Systemic edema for other reasons: 1 mucinous edema: hypothyroidism, when the condition is severe, due to skin infiltration by mucin and mucopolysaccharide, producing characteristic non-depressed edema, called mucinous edema. Often occurs in front of the face and cheekbones. 2 drug edema: the application of certain drugs can cause edema, which is characterized by mild edema after medication, gradually disappear after stopping the drug. The more common drugs are adrenocortical hormone, testosterone, estrogen, insulin, etc., and the dose of Rauvolfia, thiourea and licorice can also cause edema. 3 premenstrual tension syndrome is also one of the common causes of edema, which is characterized by mild edema of the eyelids, ankles and hands 7 to 14 days before menstruation, which may be accompanied by breast tenderness and pelvic heaviness, urinating after menstruation. As the amount increases, edema and other neurological symptoms gradually subsides. 4 idiopathic edema: mainly in the sagging part of the body, more common in adult obese women, often associated with emotional and mental changes, accompanied by fatigue, dizziness, headache, anxiety, insomnia and other neurasthenia manifestations, vertical position water test is positive .

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