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Четверг, 21 Мая 2015 г. 22:41 + в цитатник
Советы хирурга, отказавшегося от скальпеля, кандидата медицинских наук Василия Никитовича Капралова
Когда моей матери было 24 года, доктора поставили ей диагноз: «Гангрена. Жизнь может спасти только срочная ампутация ступни». Отец не жалел денег на самых известных врачей, но все они повторяли одно и то же: «гангрена… ампутация…» Ее вылечил народными средствами один земский врач. Мама прожила до семидесяти лет, родила четверых детей, в том числе и меня, никогда не жаловалась на ногу, которой когда-то был вынесен столь безнадежный приговор.
Я посвятил медицине всю свою жизнь, учился у замечательных педагогов, работал бок о бок со светилами хирургии. Однако рядом со мной всегда был тот безвестный сельский доктор. Он не давал мне покоя, заставлял искать и искать. Ведь ампутировать конечность проще простого. А вот как сохранить ногу, если ее уже коснулась гангрена? Как избавить человека от тяжелой инвалидности?
Ни один из современных способов лечения нарушения кровообращения нижних конечностей не исключает в дальнейшем применения скальпеля. Вердикт хирургов: если имеются трофические изменения ткани с изъязвлением, вопрос стоит об ампутации.
Однако резервы консервативного способа лечения остаются неисчерпанными. Дело в том, что мы не учитываем особенностей кровообращения в конечности, а именно тот факт, что из общего объема крови только 10% приходится на крупные артерии и 10% на крупные вены. Остальные же 80% — на артериолы, венулы и капилляры. Эти резервы, не участвующие в кровообращении при ишемии конечностей, я и использую при лечении. Оно позволяет сохранить конечность, пораженную даже гангреной 2-й степени, а всего их четыре.
Первый звоночек болезни
Гангрена, к счастью, заявляет о себе рано. Все было хорошо, но вдруг переохлаждение, или царапина, или стресс открывают неблагополучие сосудов ног. Особенно разрушительное действие оказывает стресс. В это время холестериновые бляшки как бы прикипают к стенкам сосудов и кровь перестает поступать к ногам. Сначала возникает жжение подошв, затем появляются боли в большом пальце стопы, ноги начинают мерзнуть даже в теплом помещении, при ходьбе появляются боли в икроножных мышцах, вздувается стопа, большой палец чернеет…
Хирургия, как правило, предлагает ступенчатую операцию. Сначала снимают ноготь большого пальца, потом удаляют сам палец, затем ступню, затем половину голени… Что делать, чтобы избежать этого пути?
Узнайте врагов в лицо
Если хотите сохранить конечность, немедленно нужно изменить образ жизни, и прежде всего разобраться с питанием. Надо отдавать себе отчет, что у вас есть враги, которые усугубляют вашу болезнь. Это жирное, острое и соленое. Проводились исследования, которые наглядно доказали, что после приема такой пищи жизненно важные элементы крови перестают проходить через капилляры. Внимательно следите за работой кишечника. Запор — это еще один опасный враг при венозной патологии.
Позаботьтесь о терапии, разжижающей кровь. В течение первого месяца лечения принимайте два раза в день по 0,5 таблетки отечественного аспирина, растирая его в порошок. Потом для профилактики достаточно четвертинки на ночь. Это хорошая профилактика против тромбов. Отлично разжижает кровь ананас — достаточно маленького кусочка в день. А также топинамбур — в любом виде. Плюс диета для сосудов: ежедневно 1 десертная ложка чесночной настойки (3 зубчика чеснока раздавить и залить кипяченой водой (в соотношении 1:1) и 1 десертная ложка оливкового масла.
Массаж — великий реаниматолог
При больных венах массаж противопоказан, а вот при гангрене он жизненно необходим. Вы должны его делать сами, своими руками. Каждый день не менее десяти минут. Причем классический: поглаживание, разминание, растирание, пощипывание, поколачивание и снова поглаживание. Бояться ничего не нужно, все просто. При поглаживании возбуждаются нервные окончания кожи, при разминке затрагивается слой подкожной клетчатки, при растирании — непосредственно сосуды. Поэтому буквально вонзайтесь пальцами в голень, где проходят крупные сосуды.
Никогда не парьте ноги!
Мне приходилось очень много консультировать больных с ишемией конечностей, осложненной гангреной. И что характерно, на вопрос, как вы лечитесь, большинство отвечало: горячими ванночками. Ноги мерзнут — и их пытаются отогреть в горячей воде. Это роковая ошибка! Потому что горячая вода усугубляет процесс образования тромбов.
Ванночки для ног должны быть 37°, не больше. Приучите себя делать их каждый день. Неделю — с горчицей (1 ст. ложка на 2 л воды), неделю — с морской солью (1 десертная ложка на 1 л воды). При этом в течение 20 минут, пока принимаете ванночку, не переставайте массировать пальцы на ногах, они у нас самые несчастные — дальше всех отстоят от сердца, и потому испытывают дефицит кислорода и питательных веществ.
Еще для улучшения кровообращения ноги каждый день нужно мыть в холодной воде и хорошо растирать полотенцем. Кроме того, важно позаботиться об удобной, просторной обуви.
Возьмите хозяйственное мыло…
Важнейшая процедура — аппликации с травяным настоем. Запаситесь терпением, они должны продолжаться в течение месяца-двух. Перед наложением аппликации приучитесь тщательно готовить ногу, халтурить тут нельзя. В течение двух минут промывайте кожу теплой водой с хозяйственным мылом. Почему именно с хозяйственным? Любое другое мыло, вплоть до самого дорогого, оставляет на коже водонепроницаемую пленку. А нам нужен доступ к порам, чтобы через них внутрь, к больным сосудам, могло легко проникнуть лекарство.
Для приготовления травяного настоя потребуются клевер красный донник желтый, мать-и-мачеха, омела белая, календула, листья и стебли ревеня. Возьмите травы в равных пропорциях, 1 ст. ложку смеси заварите 1 л кипятка, держите 10 минут на водяной бане, затем снимите с огня, дайте настояться, процедите. Непосредственно перед процедурой настой должен иметь температуру 37°.
Марлю и кусок бинта 20-25 см, сложенный пополам, смочите настоем и слегка отожмите, чтобы повязка получилась не слишком сухой и не слишком влажной. Между средними слоями проложите мелко покрошенные лук и чеснок. Бинт проложите между пальцев так, чтобы остались два конца. Один, расправив, уложите на пальцы сверху, а другой — снизу. Затем ступню и часть голени оберните марлей. Сколько слоев марли необходимо? Это зависит от возраста больного. Чем он старше, тем слоев меньше. Тридцатилетнему потребуется не меньше шести, сорокалетнему — пять, пожилому — достаточно четырех, а в преклонном возрасте — только три. Сверху аппликация в обязательном порядке покрывается компрессной бумагой, затем оборачивается двумя — тремя слоями старых простыней. Наконец, поверх всего надевается «чулок», сшитый из старых полотенец, который бинтом можно прикрепить к поясу на талии.
В идеале аппликация накладывается дважды в день на 4 часа с перерывом на воздушные ванны не менее двух часов и одна на ночь. Аппликацию надо делать на ту ногу, которая наиболее поражена болезнью. На обе сразу нежелательно — это дополнительная нагрузка на сердце.
В менее пораженную конечность травяной настой следует втирать, набрав его на ладонь (обязательно — предварительная промывка кожи с хозяйственным мылом). Причем сверху вниз, не спеша, заканчивая массажем пальцев и межпальцевой области. Между пальцев можете проложить бинт, смоченный в травяном отваре. Затем наденьте на ногу хлопчатобумажный носок. При гангрене для усиления циркуляции крови можно и нужно больше ходить. Если человек лежит, надо выполнять «искусственную ходьбу», поднимая и опуская стопу.
Все резервы хороши
Помогать в спасении конечности вам будет сам организм, поскольку он имеет природный запас прочности. Наша задача — не пренебрегать ни малейшей возможностью. Так, хорошо массировать ребром ладони область печени и селезенки (правое и левое подреберье), помогая тем самым кровяному депо качать кровь.
Перед самым сном (не перед ужином!) можно принимать по 50 г водки. Это улучшает кровообращение и помогает справиться с природными колебаниями сердечного ритма, происходящими примерно в три часа ночи.
Сосудистые препараты для улучшения кровообращения в ногах могут использоваться при наличии диагностированных патологий, а также для их профилактики. Они способствуют улучшению тонуса кровеносных сосудов, что позволяет избежать таких проблем, как тромбоз, варикозное расширение вен и иных болезней ног.
Общее описание препаратов
При нарушении кровотока в ногах страдать из-за недостатка питания полезными веществами начинают не только нижние конечности, но и все органы. Это приводит к нарушению в их функционировании и развитию заболеваний, в том числе хронических.
Описанные ниже препараты позволяют разогнать кровь в сосудах, повысить их эластичность, снизить проницаемость капилляров, устранить отечность и усталость.
С учетом воздействия активного вещества все медикаменты специалистами разделены на три группы.
- Оксид азота. Медикаменты расслабляют мышцы, снимая спазмы и боль. Особенно хорошо помогают при большой вероятности развития инфаркта, стенокардии и постоянных спазмов нижних конечностей.
- Сульфат магния. Снижает подвижность ионов кальция, что устраняет спазмы и боль, улучшают кровоток. Лучший эффект оказывают при введении в кровоток через вену.
- Спазмолитики. Оказывают воздействие на гладкую мускулатуру по всему организму. Это снимает боль, спазм, повышает скорость кровотока, благодаря чему нормализуется кровоток.
Подбирать лекарственный препарат может только врач.
Это необходимо для того, чтобы учесть весь анамнез и не допустить приема медикаментов при наличии противопоказаний.
Показания и противопоказания
Принимать лекарственное средство можно при наличии следующих патологий и проблем:
- частое образование тромбов или большой шанс их возникновения;
- варикозное расширение вен;
- проблемы с артериальным давлением;
- заболевания нервной системы, что отражается на кровеносных сосудах;
- атеросклероз нижних конечностей;
- сердечная недостаточность;
- травмы нижних конечностей, которые привели к нарушению кровотока;
- постоянное сидение на работе с минимальными физическими нагрузками;
- частая отечность ног, проблемы с сердцем.
С большой осторожностью медикаменты для улучшения кровообращения принимаются при сахарном диабете.
Вначале требуется привести показатели крови в норму и только после этого переходить в терапии. Также следует внимательно подходить к назначению доз и конкретных медикаментов людям, страдающим от кровотечений или при высоком шансе их развития.
Иные противопоказания должны базироваться на анамнезе больного и рассматриваться в каждом отдельном случае грамотным специалистом.
Анна Поняева. Закончила нижегородскую медицинскую академию (2007-2014) и Ординатуру по клинико-лабораторной диагностике (2014-2016).Задать вопрос>>
Обзор
Воздействующие на ПНС
Большая группа лекарственных средств, положительно воздействующих на проблему с кровообращением при болезнях нервной системы.
Они соединяются с адреналином и норадреналином, благодаря чему выравнивается давление в сосудах.
К таким медикаментам относятся:
Вазодилататоры
Эта группа медикаментов направлена на расслабление гладкой мускулатуры, благодаря чему восстанавливается нормальный просвет в венах и сосудах. При использовании вазодилататоров нормализуется артериальное давление и выравнивается пульс.
К этой группе относится две подгруппы медикаментов – антагонистов кальция и альфа-адреноблокаторов.
Антагонисты кальция
Препараты этой группы нормализуют пульс и частоту сокращений сердца. Они благотворно воздействуют на крупные и мелкие сосуды, снижают повышенное напряжение в мышце миокарде.
Альфа-адреноблокаторы
Медикаменты этой подгруппы напрямую связываются с адреналином и норадреналином, благодаря чему исключается вероятность развития серьезного спазма сосудов и вытекающих из этого последствий.
Ингибиторы РАС
Эта группа медикаментов направлена на подавление развития атеросклеротических бляшек, выравнивание артериального давления, улучшение питания тканей органов.
Не следует использовать эту группу медикаментов при стенозе почечных артерий, перенесенном ангионевротическом шоке, повышенном количестве калия в крови.
Не назначаются ингибиторы при беременности и лактации.
Биогенные стимуляторы
Эти препараты имеют натуральное происхождение, они созданы из сырья, взятого у животных. Биогенные стимуляторы позволяют расширить сосуды, улучшить в них кровообращение, снять тяжесть и усталость.
Мази и гели
Воздействуют местно, сразу проникая в очаг заболевания.
Благодаря такому воздействию нормализуется ток крови в ногах, снимается усталость, уходит чувство тяжести.
Препараты при обострении патологий
Если заболевание осложняется и переходит в стадию обострения, упомянутые выше медикаменты окажутся бессильны и потребуется назначение более мощных препаратов.
Они относятся к классам тромболитиков и антикоагулянтов.
Приведенные препараты не используются при риске кровотечения, выраженных патологиях почек и печени, сахарном диабете, желтухе, эндокардите бактериального типа и артериальной гипертензии тяжелого типа.
Другие медикаменты для улучшения кровообращения
Для улучшения иммунитета и усиления полезных свойств описанных выше препаратов можно применяться гомеопатические, улучшающие кровоток и объем крови средства.
Пользуясь этими медикаментозными средствами удается улучшить кровообращение не только в ногах, но и конечностях рук и мозге.
Такое воздействие препаратов – дополнительная профилактика инсульта и инфаркта.
Посмотрите видео с рекомендациями по улучшению кровообращения
Профилактическое применение
В качестве профилактического использования следует выбирать препараты щадящей направленности, лучше всего для этого подойдут мази и гели. Они воздействуют местно с минимальным попаданием в кровоток.
Применять лекарственные средства требуется людям, находящимся в группе риска: постоянно занимающимся тяжелым физическим трудом, имеющим травмы ног, страдающим от заболеваний сердца, имеющим статическую работу.
Дополнительно применение лекарства требует правильного питания и посильных физических нагрузок. В рационе должно быть достаточное количество овощей, постного мяса и минимум жирных продуктов, солений и консервов.
Препараты, улучшающие кровообращение нижних конечностей, являются фактически единственной возможностью для лечения серьезных нарушений в виде варикоза и тромбоза, а также их профилактики.
Для быстрого получения терапевтического эффекта требуется точно соблюдать дозировки медикаментов, пройти полное обследование для подтверждения диагноза и соблюдать иные рекомендации в лечении. При правильном подходе к терапии результат будет достигнут за 1-2 курса с учетом сложности состояния пациента.
Если у человека нарушается кровообращение, то это чревато развитием большого количества заболеваний, причем некоторые из них являются очень серьезными. Происходит поражение головного мозга, сосудов, сердца, а через некоторое время и в других органах возникают проблемы. Нарушение кровообращения ног может указывать на скрыто протекающие заболевания, а человек даже не догадывается об этом. Такое патологическое состояние влечет за собой различные последствия. Так как улучшить кровообращение в ногах? Попытаемся выяснить это.
Признаки артериальной и венозной недостаточности
К нарушению кровообращения в нижних конечностях приводит поражение вен и артерий (атеросклероз), эндартериит, варикозное расширен вен, сужение просвета сосудов холестериновыми бляшками, воспаление стенок сосуда или его спазм. Если вдруг на ноге появились синие «звездочки» или сеточки из тонких сосудов, то это признаки развития варикоза, который может проявлять себя болью и тяжестью в ногах, ночными судорогами, отеками, узлами и вздутиями на пораженных сосудах.
Кожа на ногах может краснеть и истончаться. Нарушение кровообращения в нижних конечностях проявляется распирающими болями в икрах, тяжелыми ногами, перемежающейся хромотой. Более серьезными признаками являются тромбозы, трофические язвы, указывающие на развитие тромбофлебита.
Причины патологии
Основной причиной, приводящей к нарушению обращения крови в нижних конечностях, является малоподвижный образ жизни. Большинство людей по роду своей деятельности часто находятся в сидячем положении, что приводит к застою крови в венах. Появляется боль в ногах, они начинают быстро уставать и становятся холодными.
Многие люди, особенно пожилые, постоянно испытывают небольшую зябкость, но после непродолжительной прогулки им становится жарко. Объясняется это тем, что даже такая небольшая физическая нагрузка усиливает циркуляцию крови, избавляя от синдрома холодных ног.
Как улучшить кровообращение в ногах? В этом случае никакого специального лечения не требуется, достаточно лишь немного изменить свой образ жизни. Если начать побольше двигаться, то недуг способен пройти самостоятельно, а несложная утренняя зарядка поможет улучшить общее состояние организма.
К нарушению циркуляции крови в нижних конечностях могут привести и другие причины, причем не такие безобидные. Такое патологическое состояние может быть признаком неправильной работы какого-либо органа. Именно поэтому бывает нелегко разобраться в том, что конкретно способствовало развитию недуга и какое лечение требуется.
Выделяют следующие самые распространенные причины нарушения кровообращения в ногах:
- алкоголь и курение;
- возрастные изменения;
- большое содержание холестерина в крови;
- ишемия, атеросклероз;
- диабет;
- гипертония;
- избыточный вес;
- варикоз, тромбоз и стеноз артерий.
Способы борьбы с нарушением кровообращения
Если не принимать никаких мер для борьбы с нарушением кровообращения, то результатом этого через определенный промежуток времени будут изуродованные синими узелками и перевитыми вздувшимися венами ноги. Также велика вероятность поражения глубоких внутренних вен. К сожалению, патологические изменения, коснувшиеся периферических сосудов, являются хроническими и без лечения не проходят.
У врачей, занимающихся лечением сосудов, находятся в распоряжении различные средства, улучшающие кровообращение в ногах. С помощью лекарственных препаратов и физиотерапевтических процедур происходит уменьшение или устранение патологического состояния вен и артерий нижних конечностей. Если эти способы окажутся неэффективными, то прибегают к такому радикальному методу, как операция с удалением, прижиганием или склерозированием пораженного участка сосуда. Но такое оперативное вмешательство является достаточно болезненным, а в итоге причина деформации вен до конца не устраняется.
Медикаментозное лечение
Препараты, улучшающие кровообращение в ногах, должен назначать только врач. После опроса и внешнего осмотра пациента его направляют на обследование. Опираясь на полученные результаты, доктор назначает необходимые препараты для нормализации циркуляции крови в нижних конечностях. Так как улучшить кровообращение в ногах? Для этого используют следующие средства:
- Ангиопротекторы. Необходимы они для улучшения микроциркуляции, а также нормализации проницаемости сосудов, благодаря чему стенкам возвращается нормальная обменная деятельность. К ним относят «Курантил», «Персантин», «Трентал», «Флекситал», «Докси-Хем», «Пентоксифиллин», «Радомин», «Вазонит».
- Лекарства низкомолекулярного декстрана. Благодаря таким препаратам происходит поступление дополнительного объема крови из межклеточного пространства в кровяное русло. В результате текучесть крови значительно улучшается. К этой категории относят следующие медикаментозные средства: «Реомакродекс» и «Реополиглюкин».
- Препараты с содержанием простагландина Е1 («Вазапростан»). Благодаря им улучшается кровоток и нормализуется микроциркуляция. Эти препараты также способствуют расширению кровеносных путей и нормализации артериального давления.
- Блокаторы кальциевых каналов, которые воздействуют даже на сосуды головного мозга. К ним относятся: «Кордафен», «Кордафлекс», «Адалат», «Стамло», «Норвакс», «Плендил», «Форидон», «Лаципил».
- Спазмолитики миотропного действия. С помощью таких лекарственных средств расширяются сосуды, и кровь начинает свободно циркулировать. Кроме этого они хорошо снимают спазмы. Такими медикаментозными препаратами являются «Мидокалм», «Кавинтон», «Эуфиллин», «Галидор».
Другие лекарственные средства
Как улучшить кровообращение в ногах? Для этих целей используют и другие лекарственные препараты.
Биофлавоноиды способствуют повышению эластичности эритроцитов, что улучшает текучесть крови. Ганглиоблокаторы расширяют венулы, артериолы и мелкие вены и равномерно распределяют объем крови в нижних конечностях. К таким препаратам относятся «Димеколин», «Камфоний», «Пахикарпин», «Темехин», «Пирилен».
Также эту проблему решают такие лекарственные средства, как альфа-адреноблокаторы. Они комплексно воздействуют на весь организм, расширяя сосуды не только в нижних конечностях, но и во внутренних органах.
Использование мазей
Мазь, улучшающая кровообращение ног, помогает снимать только отек нижних конечностей, но причину ее возникновения устранить не в силах. Самыми популярными средствами являются следующие наружные препараты:
- гепариновая мазь;
- «Венитан»;
- «Эссавен-гель»;
- «Троксевазин» и другие.
Средства народной медицины
Как улучшить кровообращение в ногах? Народные средства способны помочь решить эту проблему только в том случае, если недуг имеет легкую степень. В более серьезных случаях необходима помощь врача.
Наибольший эффект приносят спиртовые настойки цветов сирени или каштана. Для этого цветки помещают в пол-литровую банку, почти доверху наполнив ее, и заливают водкой или спиртом, разбавленным наполовину. Банку закрывают пластмассовой крышкой и на две недели помещают в темное место. В течение этого времени жидкость приобретает темно-коричневый цвет. Ее следует процедить, после чего растирают ею внутреннюю поверхность бедер и ниже.
Для этих целей также используют плоды каштана, которые предварительно расплющивают. Приготовление и употребление настойки осуществляется таким же образом.
Как улучшить кровообращение в ногах пожилым людям? Все вышеперечисленные способы являются эффективными для людей всех возрастов.
Вывод
Таким образом, существует много способов, помогающих улучшить циркуляцию крови в нижних конечностях. Лечение будет успешным в том случае, если у человека для этого будет воля, настойчивость и желание. Чтобы избежать подобного патологического состояния, следует использовать меры профилактики.
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