Problem description:

Female, over 50 years old, her calves and hands are swollen. Press her calf and you will find a deep pit.

What method is used for treatment?

Thank you very much

Analysis:

Edema of lower limbs is a common symptom of the elderly. The appearance of this kind of edema often suggests that you have some kind of disease, so you should go to the hospital to check the cause in time. The doctor checks whether a person has edema of lower limbs. Generally, fingers are used to press the front inner side of the patient's calf or near the medial malleolus. If there is obvious depression after pressing here, it is considered as edema. The deeper the depression, the heavier the edema. This kind of edema is also called "concave edema" to distinguish "non-concave edema" caused by hypothyroidism. This topic mainly introduces concave edema.

The edema of lower limbs is mostly bilateral, and a few are unilateral. The degree of bilateral edema of both lower limbs is more symmetrical. The common main reasons are as follows:

One is heart disease. Patients with coronary heart disease, hypertensive heart disease, cor pulmonale and other heart diseases. If the disease develops to the stage of heart failure (mainly right heart failure), there may be edema of lower limbs. The severity of edema is often related to the severity of the disease, and patients will feel flustered and short of breath. These heart diseases can be diagnosed by measuring blood pressure, electrocardiogram, cardiopulmonary X-ray, etc. , combined with medical history and physical examination.

The second is liver disease. Mainly liver cirrhosis (caused by hepatitis, schistosomiasis and other diseases), due to the decrease of albumin (albumin is composed of liver cells) in the blood, patients may have edema of lower limbs. At this time, liver function often appears abnormal, such as zinc turbidity increase, albumin decrease, globulin increase and serum protein electrophoresis gamma globulin increase. In addition, liver cancer often appears edema of lower limbs, which can be diagnosed by B-ultrasound and liver scanning.

The third is kidney disease. Such as chronic nephritis, nephrotic syndrome and chronic pyelonephritis. These diseases are due to the excretion of a large amount of albumin in urine, which leads to the decrease of albumin in blood and can cause edema of lower limbs. Urine routine examination is protein positive, and there may be red blood cells, white blood cells and casts. Blood urea nitrogen and creatinine increased, and creatinine clearance rate decreased significantly.

Other less common causes are elephantiasis caused by anemia and filariasis, chronic venous obstruction of lower limbs and malnutrition edema. Unilateral lower extremity edema is not common in the elderly. The reason is that the vein or lymphatic vessel on this side of the lower limb is blocked or compressed, such as lymphangitis, venous thrombosis or thrombophlebitis, and malignant tumor compresses the larger vein on this side. The diagnosis can be made by doing the corresponding examination in the hospital.

In addition, there is a so-called "idiopathic edema" with unknown reasons, which is more common in middle-aged and elderly women. It is generally believed that it is caused by endocrine dysfunction. Although the patient has undergone a series of examinations, there is no evidence of edema of the lower limbs mentioned above.

It is recommended to go to the hospital for examination, find out the cause, treat actively, and never take medicine indiscriminately. Leg edema is more common in the elderly, but sometimes the specific cause cannot be detected. At this time, if diuretics are given, the situation may not be improved, and other problems may be caused. Because of their advanced age, the elderly usually sit more and exercise less. Leg edema is mostly physiological and can be improved after rest at night. It may be beneficial to increase activities appropriately.