「三高」令周邊血管硬化 新球囊減「翻塞」現象

腦血管或心血管硬化所衍生出來的腦中風或冠心病等嚴重疾病，讓大眾聞之色變。有外科專科醫生表示，隨着都市人「三高」（高膽固醇、高血壓、高血糖）日趨嚴重，加上吸煙及年紀老化等風險因素，實際上我們全身血管均有可能出現不同程度硬化現象，血管逐漸缺乏原有彈性，血管壁逐漸變厚、鈣化甚至閉塞。

外科專科醫生謝卓華表示，臨牀上，最常受影響的是下肢動脈，隨年紀增長，加上上述各高危因素，導致患者下肢血管壁逐漸變厚，血管亦因此變得狹窄，嚴重時甚至可完全閉塞，令血液供應不足，引起「間歇性跛行」，患者行走一段距離後便出現下肢疼痛：「此症最常出現於小腿肌肉，通常休息一會便可紓緩，但隨着病情惡化，走路距離會愈來愈短，甚至連靜止不動下肢亦感痛楚，嚴重者更可出現不愈之潰瘍及壞疽，若仍未有妥善處理，約5%患者最終可能因下肢壞死而截肢。」

統計顯示，60歲以上的人口中，有15%出現間歇性跛行情況，到了70歲，比率更上升至30%。外科醫生可根據患者的病情，安排合適的治療。早期個案，醫生可透過藥物改善病徵，再鼓勵病人透過適量運動，保持外圍並行血管的血流暢順，但已有問題的血管，仍然是閉塞或狹窄的。

微創治療恢復血液供應

因此病情中度至嚴重者需透過介入性治療處理，除傳統開放性手術，醫生亦可通過微創介入治療，以球囊或支架擴張狹窄或已閉塞血管，恢復腿部血液供應。對比於開放式手術，微創介入手術傷口細，可局部麻醉進行，復元較快。一般球囊透過導管進入目標血管內，靠壓力擴張狹窄段，使阻塞的血管恢復下肢血液供應；但因大部分病人血管已產生病變，有報告指約六至七成病人在12個月內會有「翻塞」現象。

現時較新式的「滲藥性球囊」，比一般球囊多一層藥物，會在擴張後在血管內壁內發揮藥效，目的是延長血管暢通及血液流動，從而達到直接改善下肢血液供應目的，減少復發。

謝卓華
外科專科醫生

資料來源:  http://www.metrohk.com.hk/?cmd=detail&id=303211
以上所提供的資訊僅作為教育及參考用途，如果你有任何醫療問題，
應向醫生查詢，而不應單倚賴以上提供的資料。

Causes of Goiter

Goiters are not equivalent to hyperthyroidism. Goiter describes hyperplasia of the thyroid gland which most commonly due to problems with the immune system. However, the increase in size of the thyroid gland does not have any relationship with the amount of hormone to be secreted.

In the more underdeveloped countries, goiters could be caused by iodine deficiency, as patients may not be able to intake enough iodine from seafood to fulfill their body needs. This causes the thyroid hormones T3 and T4 in the blood to be lower than normal, prompting the pituitary glands to continuously secrete TSH (Thyroid Stimulating Hormones), stimulating growth of the thyroid glands.

Amazing Seaweed – Nutritious, Low in Calorie and Prevent Goiter

 

Seaweed, which grows in the ocean, has excellent source of minerals especially iodine that can possess powers to prevent goiter. Goiter refers to over-production of thyroid hormones, leading to enlargement of the thyroid glands. Iodine is essential to maintain proper functioning of thyroid glands, which helps to regulate body’s metabolism, growth, temperature, heart rates etc., and deficiency in iodine can lead to a disease called goiter. Large and thick neck resulted from goiter that affects nearby organs such as esophagus and trachea may lead to dysphagia and breathing difficulty, while stunted growth and mental retardation can be seen in children with goiter due to hypothyroidism.

Seaweed is categorized into three main groups, and they are red, green, and brown seaweeds. Brown seaweed has the highest iodine content, with dry kelp contains 1500-8000 ppm (parts per million), while red and green seaweeds have lower contents, about 100-300 ppm in dried seaweed, but still considered as high when compared to other land plants. Adults and children who are actively growing are recommended to have a daily intake of 150 µg and 90-120 µg iodine respectively, which is actually covered by very little amount of seaweed, as only one gram of dried brown seaweed can already provide 500-8,000 µg of iodine. Thus, just a tablespoon of seaweed is already enough for recommended daily intake.

In addition to iodine, seaweed is also an excellent source of calcium and iron, which is especially suitable for vegetarians who avoid dairy and meat products. Therefore, seaweed is highly recommended to be included in our diet. This can be done by sprinkling kelp flakes onto a salad or soup, wrapping rice or vegetables using nori sheets or having seaweeds snacks during tea time. Although iodine intake may be related to the situation of Goiter, other factors can also lead to Goiter. Thus, it is recommended to seek a doctor immediately for medical check when the problem of thyroid enlargement arises.




Reference information: http://www.thyro.com.hk/goiter-thyroid.html
It is not intended as medical advice to any specific person. If you have any need for personal advice or have any questions regarding your health, please consult your doctor for diagnosis and treatment.