Гематома — это патологическое скопление крови в результате повреждения кровеносных сосудов из-за сильных ушибов, недоразвитой кровеносной системой, проблемами со свёртываемостью крови, ломкостью сосудов, разницей в давлении между внешней средой и маткой, характеризующееся появлением синяков, отёчности тканей, болевых ощущений.
Причины
Причин возникновения гематом на ноге у ребёнка может быть несколько.
- К основной причине появления гематомы можно отнести ушибы, удары, падения, травмы. Появление синяка при ушибе обычно не требует врачебного вмешательства.
- Появление гематом без видимой причины. Это может свидетельствовать о плохой свёртываемости крови, болезни крови, болезни внутренних органов.
- Недостаток аскорбиновой кислоты, витамина К и Р. Аскорбиновая кислота укрепляет сосудистые стенки, витамин К нужен для свёртываемости крови, витамин Р – предотвращает образование сосудистых бляшек, мешающих нормальному течению крови по сосудам.
- В результате нехватки селена, кобальта, кальция. Эти элементы необходимы для придания сосудам эластичности и прочности.
- Появление тромбоцитопении и гемофилии. Последняя чаще всего наблюдается у мальчиков.
- В результате повышенной ломкости сосудов.
- В результате образования опухоли.
- Послеоперационная гематома.
Их название говорит об их локализации – под кожей. Возникают из-за травм мягких тканей (ушиб мягких тканей). Встречается чаще всего.
Образуется в результате патологического скопления крови в пространстве под фасцией. Появляется в результате травмирования бедра, стопы, голени.
Образуется при сильных ударах, травмах, в местах уколов. Местом её локализации является мышечная ткань.
Симптомы
Первые признаки появления гематомы появляются сразу же после травмы. Чаще всего это боль в области ушиба, появляется синяк. Затем развивается отёк. После его спадания наблюдается гиперемия повреждённого участка кожи. Цвет гематомы варьируется от красного до тёмно-красного. При этом малыш будет чувствовать:
- Болевые ощущения в ушибленном месте;
- Возможна пульсация в области гематомы;
- Возникновение разлитой гематомы;
- Повышение местной температуры;
- Скованность в движениях ноги при обширной гематоме.
При наличии проблем со свёртываемостью крови, ломкостью сосудов гематомы будут образовываться без причины и в большом количестве. Возможны и внутренние кровотечения.
Если гематома на ноге образовалась в результате травмы с повреждением мягких тканей, то при несвоевременной и неправильной обработке раневой поверхности, может попасть инфекция. Это приведёт к нагноению, началу воспалительного процесса, а в запущенном варианте – сепсис.
При всём этом общее состояние ребёнка будет ухудшаться. Возможно повышение температуры тела.
Существует три типа гематом мягких тканей. К ним можно отнести:
- Гематома лёгкой степени тяжести проявится через 24 часа после травмы. Её можно опознать по наличию несильной боли в повреждённом месте. На функциональную способность ноги эта гематома не влияет. Рассасывается самостоятельно без врачебного вмешательства.
- Гематома средней степени тяжести образовывается через несколько часов после повреждения. Её признаками будут: образование болезненного отёка. Происходит нарушение в функционировании повреждённой конечности.
- Гематома тяжёлой степени тяжести появляется через час после удара. Для этого типа характерна сильная, резкая боль. Ребёнок не может ходить, опираясь на повреждённую ногу. Формируется разлитой отёк.
Если гематома образовалась в мышечной ткани, то обнаружить её будет сложнее. При этом происходит увеличение ноги в объёме, болезненность. Отёк находится глубоко, а потому его тяжело пальпировать.
Диагностика гематомы на ноге у ребёнка
Чтобы диагностировать подкожную гематому достаточно визуального осмотра, пальпации повреждённого участка, сбора анамнеза. Для внутримышечных гематом необходимо помимо этого сдать анализ крови. Её проверяют на свёртываемость, выявляют количество тромбоцитов. При их увеличенном количестве можно говорить о кровопотерях, при малом количестве тромбоцитов – говорят о плохой свёртываемости крови. При обширных гематомах используют аппаратные методы диагностики:
- Наиболее информативной является магнитно-резонансная томография;
- Рентген-диагностика;
- УЗИ-диагностика (для детей до 3 лет).
Осложнения
При лёгкой и средней степени тяжести гематомы осложнения и последствия наблюдаются редко.
Часто встречаемыми последствиями тяжёлой степени являются:
- частичное рассасывание гематомы с последующим её рубцеванием;·
- занесение инфекции, сепсис, гнойные процессы.
Лечение
Что можете сделать вы
При обнаружении у ребёнка гематомы на ноге стоит внимательно расспросить сорванца о механизме её образования, причинах травмы. Если гематома небольшая и не сопровождается повреждением кожных покровов, то достаточно просто приложить холод на незначительное время, а затем на 5 минут убрать и снова приложить. Такая техника позволит избежать «замерзания» тканей.
Если образованию гематомы на ноге крохи способствовала рана, то обязательно обработать раневую поверхность антисептиком, а только затем прикладывать холод.
Если гематома на ноге появилась из-за внутренних болезней или без явно выраженных причин, то стоит обратиться к врачу за консультацией и обследованием.
Что делает врач
Для того, чтобы назначить лечение и поставить диагноз, врач должен:
- Провести осмотр повреждённого участка на ноге ребёнка;
- Опросить подробно самого малыша и его родителей о причине повреждения и развития клинических признаков;
- Назначить анализы и обследование;
- Проанализировать полученные данные и поставить диагноз.
- Назначить лечение.
Лечение будет зависеть от локализации, глубины, распространённости и причин её вызвавших. При тяжёлых вариантах гематомы или в результате повреждения кожных покровов с последующим занесением инфекции, выписываются антибиотики широкого спектра действия, антисептики, витамины. При сильном отёке – диуретики.
Профилактика
Профилактические методы могут быть самыми разнообразными и включать в себя:
- Приём витаминов, микро- и макроэлементов;
- Рациональное и сбалансированное питание;
- Соблюдение ребёнком режима дня;
- Не злоупотреблять употреблением лекарственных средств, могущих повлиять на свёртываемость крови;
- Активные прогулки;
- Внимательность при играх, активном отдыхе;
- Использование средств защиты при катании на велосипеде, беговеле, ролика, скейте и так далее;
- Обувь должна быть удобной.
У всех детей периодически появляются синяки на разных частях тела, и это абсолютно нормальная ситуация, поскольку дети активные и у них часто случаются травмы.
При возникновении синяка достаточно приложить холод для сужения сосудов и уменьшения размера гематомы.
Однако в некоторых случаях синяки у ребенка на ногах могут появляться сами по себе.
Что это, мимолетное явление или повод для обращения к врачу? Стоит ли паниковать в таком случае? Чем это грозит и, что нужно предпринять в такой ситуации, разберемся в статье.
Причины и симптомы заболевания
Среди причин появления синяков на ногах ребенка может быть ушиб или самостоятельное появление, которое не зависит от внешних факторов.
Что касается ушиба, то тут ситуация вполне понятная. Через некоторое время от гематомы не останется и следа.
Самопроизвольное появление синяков – это тревожный симптом, который нельзя игнорировать. Гематомы, которые появляются сами по себе, могут говорить о наличии таких заболеваний:
- Авитаминоз – одна из основных причин, по которым появляются синяки на ногах у детей. Такой эффект дает недостаток витаминов К и Р, а также аскорбиновой кислоты. Витамин С отвечает за то, чтобы стенки сосудов были прочными и эластичными, при его нехватке сосуды лопаются и происходит небольшое кровоизлияние, что и является гематомой.
- Недостаточное количество витамина К существенно влияет на свертываемость крови, при его нехватке останавливается кровотечение значительно дольше, поэтому синяки могут иметь значительные размеры.
- Витамин Р предупреждает появление в крови бляшек, которые серьезно влияют на нормальную циркуляцию крови в организме. При его недостатке могут появляться патологические синяки.
Чтобы избежать возникновение синяков из-за авитаминоза, важно уделять должное внимание питанию ребенка. Его рацион должен быть разнообразным, насыщенным разными витаминами и минералами.
В критических ситуациях врач назначает лечение с помощью комплекса витаминов и минералов.
При правильном подходе в лечении синяки перестанут появляться на ногах ребенка в короткие сроки.
Генетические заболевания также могут стать причиной появления синяков. К сожалению, генетически ребенку могут передаться большое количество разнообразных болезней, которые наблюдались у его близких или даже дальних родственников. К генетическим заболеваниям, которые могут спровоцировать появление синяков относят тромбоцитопению и гемофилию.
Частая причина синяков — травмы и ушибы
Гемофилия – достаточно опасное заболевание, при котором даже небольшая травма может закончиться летальным исходом. Таких детей с самого рождения наблюдают врачи – специалисты, которые и подбирают индивидуально поддерживающую терапию.
Часто у ребенка возникают проблемы с венами и их эластичностью. Сейчас даже у детей часто диагностируется варикозное расширение вен, которое и ведет к таким последствиям.
В любом случае, если у вашего малыша появляются синяки, без видимых на то причин нужно, как можно скорее обратиться за помощью к специалисту. Врач, после диагностики определит причину такого состояния малыша и назначит правильное лечение.
Что делать, если у ребенка появляются синяки
Если у ребенка на ногах появляются синяки, родителям нужно, как можно скорее обратиться за помощью к врачу.
Дополнительными симптомами могут быть:
- Ребенку стало сложно самостоятельно передвигаться, либо ходьба доставляет определенный дискомфорт или болевые ощущения
- Малыш выглядит уставшим, постоянно хочет спать, наблюдается апатия, начал плохо реагировать на происходящее вокруг него
- Небольшой, незначительный ушиб приводит к обширной и болезненной гематоме
- Повышение температуры тела, даже незначительное
После получения травмы родителям лучше всего приложить холод к месту ушиба. Это поможет сузить сосуды и не допустить появлению большой гематомы. Если у вас под рукой находится только лед, то его следует завернуть в полотенце или другую тряпку.
Меры профилактики
Для того, чтобы не допустить подобных заболеваний, можно использовать различные меры профилактики.
Ребенок обязательно должен быть подвижным. Если ваш малыш не очень любит играть во дворе с друзьями – отдайте его в спортивную секцию. При этом не важно, каким именно спортом будет он заниматься, главное это физическая активность, которая не позволяет застаиваться крови в венах. Именно нормальная циркуляция крови не позволит появиться проблемам с кровью и венами.
Появление синяков без причин — повод поспешить к врачу
Внимательно относитесь к выбору обуви для ребенка. Помните, у любой обуви должен быть прочный задник, который плотно облегает ногу и имеет несколько застежек. Таким образом, нога прочно фиксируется и искривления или другие проблемы, практически исключены.
Следите за рационом малыша – он должен быть максимально разнообразным: включать в себя мясо и рыбу, яйца, свежие и термически обработанные овощи и фрукты. Только в таком случае все необходимые витамины и микроэлементы смогут поступать в организм в правильном соотношении и усваиваться.
Если предпринимать такие меры профилактики, то болезни, описанные выше, для вашего ребенка нестрашны.
Кроме этого, старайтесь показывать собственным примером основные принципы здорового образа жизни: правильно питайтесь, вместо лифта поднимитесь домой по ступенькам, прогуляйтесь по аллее вместо поездки на общественном транспорте. Это не только даст ребенку понятие о том, как правильно себя вести, но и обеспечит здоровье еще и вашим ножкам.
Синяки на ногах – это нормальное состояние здорового и подвижного ребенка. Однако, если гематомы на ногах появляются сами по себе, без видимых на то причин – это повод посетить врача. Только специалист сможет определить причины ухудшения здоровья ребенка, и найдет выход из сложившейся ситуации.
На видео — больше о синяках:
Что такое синяк
Гематома (синяк) – это разрыв кровеносных сосудов, который приводит к скапливанию крови в полости или пропитыванию ею мягких тканей.
По тяжести кровоизлияния на коже бывают:
- Первой степени. Пятно появляется в течение суток. При нажатии немного побаливает.
- Средней степени. Происходит травмирование мышц. Чувствуется боль даже без прикосновения к синяку, который появляется уже через три часа.
- Тяжелая степень. Образуется опухоль, чувствуется сильная боль.
Период, за который проходят синяки у детей на ногах, зависит от площади и области повреждения. Процесс восстановления тканей и мышц на конечностях малыша обычно длится около тридцати дней.
Не стоит считать, что только ушиб может быть причиной появления кровоизлияния. Существует большое количество проблем и болезней, вызывающих разрыв сосудов. В дальнейшем они могут негативно сказаться на здоровье ребенка. Вот поэтому о них сейчас и будем вести речь.
Нехватка витаминов и микроэлементов
Этот фактор вызывает появление пятнышек без видимых причин. Катастрофическая нехватка витаминов C, K, P не может сделать стенки сосудов крепкими и устойчивыми к травмам. Малое количество витамина K вызывает нарушение свертываемости крови, а нехватка витамина Р вызывает сбой в системе кровообращения, и причина тому – образование бляшек.
Иногда, если у ребенка появляются синяки на ногах, внимание следует обратить на питание малыша.
Не стоит забывать о микро- и макроэлементах. Особо важными считаются: кальций, кобальт, селен. Если в организме ребенка их не хватает, теряется эластичность и прочность сосудов, а это ведет к появлению кровоизлияний. В этом случае появление синяков на ножках у ребенка — явление не редкое.
Вот поэтому родители должны составлять для малыша меню так, чтобы в организм ребенка попадало необходимое количество витаминов, микро- и макроэлементов.
Генетические факторы
Синяки на ногах у ребенка без причины могут появляться в том случае, если у малыша существуют проблемы на генном уровне. Речь ведется о таких заболеваниях, как гемофилия и тромбоцитопения. В этом случае частое беспричинное появление пятен, можно считать нормой. Гемофилия — болезнь, которая характеризуется сильными подкожными кровоизлияниями. Их очень трудно остановить. Это и является причиной появления гематом не только под кожей, но и на внутренних органах. Бороться с этой болезнью трудно. Постоянно надо наблюдать за малышом. Он не должен падать и травмироваться.
Гемофилию вылечить невозможно. Этот недуг передается по наследству, и чаще всего мальчикам.
Тромбоцитопения характеризуется резким снижением тромбоцитов в крови. При норме 180 тысяч их количество уменьшается до 50. Это, в свою очередь, является одной из причин появления гематом.
Причина — аутоиммунное заболевание
Синяки на ногах у ребенка могут быть вызваны болезнью Шенлейна-Геноха. Характеризуется данный недуг тем, что стенка кровеносных сосудов воспринимается иммунной системой как «враг». В организме начинают вырабатываться вещества, которые пытаются ее уничтожить. Стенки сосудов постепенно истончаются, увеличивается их ломкость и проницаемость. В связи с этим в окружающие ткани выходят форменные элементы и часть крови. Это заболевание легко спутать с авитаминозом, но существуют отличительные признаки:
- Гематомы появляются по всему телу, а не только на ногах.
- Подтек правильной формы и возвышается над здоровыми тканями. При надавливании не исчезает.
- Пятна появляются симметрично (в районе голеностопных суставов, голени, коленей).
- После того как появились гематомы, начинают болеть крупные суставы.
- Перед появлением пятен у ребенка могут начаться боли в животе и рвота. Через пару дней эти симптомы пропадают.
Лекарственные препараты и нарушение работы внутренних органов
Их тоже можно отнести к причинам появления гематом на ножках ребенка. Часто, для того чтобы сбить температуру, малышу дают аспирин. Именно это средство способно разжижать кровь. И если кроха в этот период совсем легонько ударился, может появиться синяк. Жидкая кровь свертывается очень плохо. Такой эффект можно получить при использовании любого препарата, способного уменьшить вязкость жидкой ткани организма.
Еще одна причина, вследствие которой на ножках ребенка появляются пятна, — нарушение работы внутренних органов, особенно печени. Именно в ней вырабатывается витамин K, который способствует свертываемости крови. Болезни почек, хронический тонзиллит способствуют появлению гематом без видимых причин.
Болезни кровеносной системы, гипертония, ревматизм тоже могут спровоцировать появление гематом.
Только врач сможет определить фактор, способствующий появлению кровоизлияний на ножках, если не было ушиба или падения.
Первая помощь
Вы заметили у ребенка синяки на ногах. Причины – падение и ушиб. Любимое чадо плачет, родители не знают, что делать. Конечно, следует успокоить малыша. К травмированной области приложите что-нибудь холодное. Для этих целей можно использовать: ткань, смоченную холодной водой, кубики льда, кусок замороженного мяса. Если вы заметили ранку на месте ушиба, то ее необходимо промыть, используя антисептическое средство. После этого поврежденные ткани можно заклеить антибактерицидным пластырем или забинтовать стерильным бинтом.
Через несколько дней для рассасывания пятна место ушиба прогревается компрессами. В этом случае можно применять специальные мази или гели.
Такая помощь пригодится, если синяк получен вследствие ушиба, а если он появился без всяких на то причин, то постарайтесь, не откладывая в долгий ящик, посетить врача. Может быть, это первый признак того, что с ребенком не все в порядке.
Лечение
Способ избавления от гематомы зависит от ее размеров и факторов появления. Если синяки у детей на ногах обширные, с массивным кровоизлиянием, то в некоторых случаях может понадобиться хирургическое вмешательство. После процедуры ребенку необходимо будет давать антибиотики. Повязка сменяется ежедневно.
Небольшое пятно лечится консервативно. Используются мази: гепариновая и троксевазин. Благодаря им уменьшается отек, и гематома быстрее рассасывается.
Если же причиной появления синяка является ломкость сосудов, то следует начинать лечение от авитаминоза. В этом случае родители должны обратить внимание на питание малыша. Оно должно быть правильным и содержать необходимое количество витаминов и минералов.
Говоря о народных средствах, можно заострить внимание на кашице из лука. Она прикладывается к травмированному месту и крепится бинтом.
Противовоспалительным и обезболивающим средством являются листья подорожника. Их надо истолочь и приложить к больному месту.
Профилактические мероприятия
Не стоит поддаваться панике, если синяки у детей на ногах появляются в период желания крохи научиться ходить. В этот период малыш постоянно спешит, ему хочется забраться повыше, и больше всего от этого страдают конечности.
Если возникают пятна без всяких на то причин, то, скорее всего, организм ребенка начинает предупреждать родителей о возникновении серьезных проблем со здоровьем чада.
Без всяких промедлений следует отправиться к специалисту, если:
- Большая гематома образуется при несильном ударе.
- Ребенку трудно ходить.
- У малыша повышается температура.
- Кроха не падает и не травмируется, а у него на ножках часто появляются синяки.
Специалист осмотрит ребенка, поставит диагноз, назначит лечение, если в этом будет необходимость. Родителям останется только наблюдать за малышом и следовать всем инструкциям врача.
Вот и вся профилактика. Только правильно поставленный диагноз и своевременное лечение является спасение от серьезных проблем.
Заключение
Как видите, причин появления гематом у малыша большое количество. Чаще всего фактором, вследствие которого появляются синяки на ногах у ребенка (фото тому доказательство), является ушиб. В этом случае родителям переживать не стоит. Пожалейте кроху, приложите на больное место холод, купите что-нибудь вкусненькое — и все образуется. Если же синяков у малыша много и появляются они часто без всяких причин, то поспешите на прием к врачу. Он сможет помочь вашему чаду и то только тогда, когда вы будете следовать его рекомендациям. К здоровью малыша надо относиться серьезно, дабы потом ни о чем не пожалеть.
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