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The lymphostasis (other name – a limfedema) is an inborn or acquired disease which arises owing to disturbances in the course of outflow of a lymph from peripheral absorbent vessels and lymphatic capillaries in legs, hands, and also other bodies to the main lymphatic collectors and a chest channel. Owing to such disturbance there is hypostasis of fabrics in view of bad outflow of lymphatic liquid. Such liquid is produced in fabrics and evacuated through lymphatic system and veins. The chronic illness of lymphatic system which not only breaks natural outflow of lymphatic liquid is an origin of a lymphostasis, but also there is a disturbance of balance of a lymph in an organism that promotes that the sizes of the struck body considerably increase.
Most often women of young age complain of manifestations of a lymphostasis. When progressing this illness provokes developing of psychological injuries, physical inconvenience and sufferings, and even the invalidism is possible later.
Kinds of a lymphostasis
The main functions of lymphatic system is participation in reaction of an immune response and in ensuring transportation from 2 to 4 liters of liquid which collects owing to an exchange in an organism. As symptoms emergence of trophic disturbances on integuments is possible. Most often there is a damage of the lower and upper extremities, in more exceptional cases defeat of generative organs takes place. Being guided by disease origins, the lymphostasis can be divided into two groups:
1. The lymphostasis is primary. At such type of a disease insufficiency of lymphatic system is shown because of the lack of absorbent vessels which is inborn. This pathology can be found after the birth, however generally it proves during the teenage period and at the subsequent young age.
2. The lymphostasis is secondary. The illness is shown if lymphatic system is developed normally, but at the same time the certain injuries or diseases provoking disturbances in its work take place. So, staphylococcal and parasitic infections, injuries during which lymph nodes and vessels of lymphatic system (damages, burns, radiation) are injured can become the reasons of similar disturbances. Also work of lymphatic system is influenced by emergence in it both malignant, and benign tumors, removal during operation of lymph nodes.
Distinguish the following stages of a lymphostasis:
The lymphostasis is passing. The disease can pass almost imperceptibly and disappear without treatment. The patient has a small puffiness, it progresses hardly considerably, therefore, the patient gets used to hypostasis and practically does not notice it. There is practically no pain.
First stage of a lymphostasis. At the patient soft spontaneous hypostasis is observed. If the illness progresses, swelled to become more noticeable, the patient notices that the extremity considerably increased. At the same time during a morning time hypostasis is almost not swept up, but by the evening it again strongly increases. At such stage of a disease of the patient, as a rule, does not ask for medical assistance, but it is already forced to use an elastic roller for the swelled extremity, to apply folk remedies. On condition of the advice of the specialist got in time hypostasis can be cured by means of the elementary means, development of connective tissue growths is not characteristic of the first stage of a lymphostasis. As a rule, at this stage of a course of a disease the specialist advises the patient to complete a course of manual limfodreniruyushchy massage and to pick up suitable compression jersey.
Second stage of a lymphostasis. At this stage of an illness emergence of spontaneous irreversible hypostasis is observed. In view of growth of connecting fabrics later skin becomes firmer, after pressing hypostasis on it the pole is visible. The patient constantly feels, is how elastic skin is tense on site hypostasis, when strengthening a tension of skin pains can be felt. Because of pain most of patients at this stage of an illness address the specialist. If the lymphostasis reached this stage of development, then to treat an illness already much more difficult. For effective results both the doctor, and the patient have to show many efforts. So, carrying out a course of limfodreniruyushchy massage, constant carrying correctly picked up bandage and an elastic compression is necessary. If to exercise in treatment judgment, then results of therapy will be positive.
Third stage of a lymphostasis. At the patient with this stage of a disease irreversible hypostasis, cysts, fibrosis is observed. In view of growth of the changed fabrics the extremity on which the tumor was formed has no contour any more. The so-called stage of elephantiasis is so shown. The extremity can grow heavy to such an extent that at the patient mobility and functions of the affected extremity can significantly be broken. If disturbances in outflow of a lymph reached this stage, then at the patient a number of complications, the majority of which can not disappear throughout all his life, is shown. So on condition of lack of suitable effective therapy the patient has an erysipelatous inflammation, cellulitis, mycosis, eczema. In more exceptional cases transformation of a tumor — a limfoangiosarkom appears. Because a lymphostasis it is very frequent to become the phenomenon accompanying other diseases it is necessary to see a doctor, having noted the first symptoms of an illness.
Diagnosis of a lymphostasis
At the address to the doctor with complaints to the above described symptoms of the patient, first of all, consults with the specialist phlebologist, in parallel passing ultrasonic research of veins. Also in the course of diagnosis results of ultrasonography of bodies of a small pelvis and an abdominal cavity are important if the tumor of the lower extremities takes place. If the patient complains of damage of upper extremities, then the specialist carefully studies bodies of a chest cavity. Also at statement of the diagnosis the doctor is guided by the results received in the course of laboratory analyses: clinical and biochemical analysis of blood, general analysis of urine. To find out the level of passability of absorbent vessels, the limfografiya and a limfostsintigrafiya is carried out. If the specialist suspects that the patient has other diseases, then doctors of a certain profile are involved in research.
Treatment of a lymphostasis
For effective treatment of a lymphostasis it is necessary to direct effort to overcoming of progressing and directly hypostasis, and its possible complications. For positive results determinal factors is the timely address of the patient to specialists, and also his subsequent relation to the solution of problems with health. Conservative treatment which purpose is improvement of outflow of lymphatic liquid from space between cells of fabrics is appointed generally sick for which the lymphostasis is diagnosed. Treatment is aimed at providing increase in quantity of sideways of transportation of a lymph. For this purpose the patient, first of all, needs to change a usual rhythm of life and work. For two weeks to the patient recommend to adhere to a semi-bed rest. It is important that the patient spent the most part of days in lying situation, holding extremities it is horizontal also in the raised look.
Also for treatment the method of a manual lymphatic drainage is appointed. It is very careful massage by the affected extremity tumor which has to promote movement of proteins in a gleam of lymphatic capillaries. Also massage movements stimulate reductions of absorbent vessels. As a result outflow of a lymph becomes more dynamic. This procedure should be carried out to the patient staying in a prone position. The massage movements are carried out so that they influenced directly skin. The session of massage continues from 15 to 30 minutes. It is necessary to consider that this procedure cannot be carried out in the presence of acute infections, vein thromboses, malignant tumors, general diseases in a decompensation stage.
To the patient carrying out a variable pneumatic compression can be appointed. This procedure promotes increase in level of pressure in fabrics, accelerates outflow of liquid from intercellular space. Therefore, hypostasis decreases. Procedure is carried out with use of the pneumatic device with a large number of cameras.
It is very important to pick up special medical compression jersey and to carry it regularly. Patients should consider that the wrong imposing of an elastic roller can negatively affect a state. The compression jersey is selected depending on a disease stage. Such clothes should be put on in the morning, in twenty minutes after the patient was roused. It is necessary to remove it approximately in two hours prior to a dream.
As medicamentous therapy the sick lymphostasis appoints peroral flebotonik who make limfotoniziruyushchy impact. Also effectively limofdrenazhny drugs which accept orally influence in the course of treatment or enter in the form of injections. The ointments and gels reducing hypostasis are applied to local use. In the course of treatment the result is influenced directly by restrictions in food which promote reduction of volume of intersticial liquid in an organism. So, it is important to consume restrictedly salt, and also proteinaceous products. If conservative treatment does not bring due results, it is necessary to address surgical methods. Carrying out a microsurgery for creation of a limfovenozny anastomosis is possible, change of full-fledged lymph nodes is also carried out.
Prevention of a lymphostasis
As the main measures of prevention of developing of this disease allocate the following. It is very important to look after constantly carefully nails to reduce risk of entering of an infection. With the same purpose during performance of work as hands (for example, works in agriculture) it is necessary to put on surely gloves for protection. At its getting injured it is necessary to process very carefully and correctly. To prevent emergence of hypostases, it is important to wear free and convenient clothes and shoes. It is necessary to consider that obesity therefore it is important to follow the rules of healthy food can become the reason of a lymphostasis and to receive a regular exercise stress.
If operation was performed on the patient, then it is very important to exclude considerable power loads of the operated hand or leg. At the same time the patient has to carry out constantly the gymnastic exercises recommended by the attending physician, carry out massage. The compression clothes are also an efficient method of prevention.
Section: Diseases of vessels