小腿無力的警號

五十多歲、有多年吸煙習慣的周先生，前陣子走路時總感到腳麻無力，多走兩步便痛得一拐一拐，特別在上樓梯或斜路時更痛，要不時停下休息，待痛楚減退後才繼續上路。


他最初以為「腳痛醫腳」便可，但情況一直無好轉，後來醫生發現他的下肢脈搏非常微弱，轉介給我治療後，終發現周先生患「間歇性跛行」(Intermittent Claudication)，即腳痛成因是血脂積聚於動脈壁，導致血管狹窄或閉塞，帶氧血液不能暢通流到腿部。

該病的典型病徵是患者在靜止時無異樣，每當行走若干路程後，下肢肌肉才開始疼痛，甚至劇痛至不能行走，稍事休息後痛楚會逐漸消卻，但再行走一定距離後腳痛再現，主要痛處亦多在小腿。若患者忽視治療，有研究指，約三成病人的走路距離會愈來愈短，有半成可惡化至潰瘍、壞疽，甚至需要截肢。

一旦證實因動脈血管阻塞致腳痛，透過適量的帶氧運動有助擴張周邊較細的血管，刺激血管增生，改善病情。不過，當運動與藥物治療均無效，病人便須考慮接受「微創血管腔內手術」，方法是在患者下肢開一個小洞，放入長導管以擴張及打通原來收窄或阻塞的血管，有需要時會用到支架來維持血管暢通；至於嚴重阻塞情況，便需要「搭橋」，植入人造血管使血液繞過原來的血管阻塞處。

周先生在局部麻醉下接受了微創手術，術後兩天便如常活動，1個月後已可做運動了。雖然手術成功，但周先生必須馬上戒煙，防止血管健康繼續受損。


外科專科醫生謝卓華

資料來源: 東網
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。

What problems and sign and symptom do Peripheral Arterial Disease causes?

It is commonly happened in the lower limb arteries. The decreased blood flow due to the narrowed arteries, can lead to the lower limbs pain, numbness, muscle fatigue or cramp. At the early stage of this disease, sign and symptom often occurred during walking, but when stop, the sign and symptom will disappear. This is called “Intermittent Claudication”.

If it is untreated, the blood flow will be nearly or completely blocked due to the plaque is being enlarged by accumulating fat or cholesterol on the inner wall of the affected artery. Limited blood supply will make the surrounding tissue dead, causing gangrene foot, and so increasing the infection risk of the affected limbs. At the late stage, critical ischemic limb can be as serious as amputation is required, in order to saving life under the critical situation. 

                                                                                                      

Those diabetic patients often suffer from Peripheral Arterial Disease. Their nerves are damaged due to diabetes, making patient’s sensation and vision poor. The foot problem is not able to discover easily at the early stage. Ultimately, critical ischemic limb (diabetic foot), one of the Peripheral Arterial Disease also happened on the diabetic patients.

 Reference information: http://veno.com.hk
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.