Varicose veins of the lower extremities is a chronic disease of the veins, and by a thinning of the walls, the enlargement of the lumen, as well as the formation of aneurysm-sicut node. The most varikoznaya the disease on the lower extremities; it is one of the most common pathologies, of which 40% suffer almost of the women and 20% men.
Causes and risk factors
Through the veins of the lower extremities, the blood upwards flows, that is, to overcome the force of gravity. This current is due to a pressure close to the veins, sinews and the rest of the blood pressure. Movement of blood through the veins of the lower limbs and promotes a "muscle pump": the movements of the muscles of the legs are reduced and compressed, the veins, placebat ei pulsare so that in them the blood up, as Reverse to prevent current valves of the veins.
The weakness of the muscular layer of the walls of the venous insufficiency and of the apparatus, to flow under the influence of the effect of the "muscle pump" the blood starts to and in the opposite direction, i.e. downwards. This leads to increased pressure on the blood vessels, the progression, the further the insufficiency of the valves, the extension of the lumen of the veins and formation of nodes. The muscle fibers of the walls of the venous atrophy, impaired nerve receptors, the regulation of the venous tone, which in turn reinforces even more the symptoms of venous insufficiency.
Risk factors for varices of the lower extremities:
- hereditary predisposition;
- Pregnancy;
- Obesity;
- daily longer stay in the sitting or standing;
- Activities with lifting;
- systematic wearing tight clothing, corsets;
- improper diet, lack of roughage in the diet, and vitamins;
- Disorders of the hormonal Status.
In the prevention of varicose veins a significant role in active pursuits: Sport (swimming, Cycling, Fitness), dancing, Hiking, etc.
Forms of the disease
On the basis of the peculiarities of the clinical manifestations are the following forms of varicose veins of the lower extremities:
- segmental lesion intra cutaneous and subcutaneous veins are missing in the Reverse flow of blood;
- segmental venous disease of the lower extremities, accompanied by pathological blood flow;
- widespread vascular disease with reversed flow of blood through the superficial veins;
- widespread vascular disease, accompanied by an abnormal discharge of blood, according to the System of deep veins.
The stage of the disease
In 2000, the Russian phlebologists accepted classification of varicose veins of the lower extremities was called, taking into account the Form of the disease, the degree of venous insufficiency, the presence or absence of complications. In accordance with your there are three stages of varicose veins of the lower extremities:
- The stage of compensation. Patients make no complaints. In the implementation of the inspection on one or both legs, lying varicose veins found to be superficial.
- Phase subcompensation. The patients complain of night cramps, violation of the sensitivity of the skin (paresthesia) in the legs, bloating. In the evening hours often observed, swelling of the legs, ankles and feet, disappear after a night's sleep. On examination, the legs are visibly more advanced varicose veins.
- The Phase of decompensation. To contact the above-described sign of eczema, Dermatitis. Skin with pigment spots, dry, shiny, closely connected with the skin.
Symptoms
The clinical picture of varicose veins of the lower extremities stage of the disease. So, if the compensated stage, the only Symptom of venous insufficiency occurs in the legs, spider veins (telangiectasia).
The transition of the disease in the subcompensated Phase accompanied by the appearance of pain in the legs, swelling of the feet and ankles, cramps in calf muscles. To stop after resting in the horizontal position of these symptoms.
Clearly, the disease is a picture of varicose veins of the lower extremities is shown in the decompensated stage of the disease. Pain in the legs permanently. The patients complain of itching of the skin, which intensifies in the evening and night hours. With time, Dermatitis, eczema, hardhealed ulcers. At that stage, common General symptoms: dizziness, low blood pressure. In connection with the landfill in the enlarged venous network of the legs, significant amounts of blood.
A complication of varicose veins is Phlebitis, thrombophlebitis, bleeding from varicose veins, trophic ulcers, pulmonary embolism.
Diagnosis
Diagnosis of varicose veins of the lower extremities is not difficult. It is done on the basis of the characteristic clinical symptoms of the disease and the data of the objective examination.
For the assessment of the severity of hemodynamic disorders used instrumental methods of diagnosis:
- Doppler ultrasound of lower limb veins;
- Duplex angioscanning;
- rheovasography of the lower extremities veins.
Treatment
In the treatment of varicose veins of the lower extremity according to the statements of the following methods or a combination thereof, apply:
- conservative therapy;
- primary sclerosing therapy;
- surgical Intervention.
Conservative therapy of varicose veins of the lower extremities may be recommended for patients in early stages of the disease, your goal – the prevention of the Progression of chronic venous insufficiency. It also applies in the case of subcompensated and decompensated stages of the disease at the time of the preparation of the patient for surgery, or in cases where the use of other methods are contraindicated. Conservative therapy of varicose veins is based on the use of phlebotonics, wear compression stockings. In addition, patients are advised regular physiotherapy, avoiding long static loads.
In the case of varicose veins of the lower extremities, complicated significant disturbances of hemodynamics, compression can be well sclerotherapy used. The essence of the method consists in the leadership in the affected vein injected drug, causes her to spasm. Then on the leg kompressionniy pull the stocking or bandage performed legs with an elastic bandage, whereby the walls of the veins dormientes. In a few days, the process of bonding the walls of the veins begins. Compression clothing is not less than one and a half months to be worn after sclerotherapy prior to the establishment of between the walls of the veins rather dense adhesions.
In advanced stages of the varicose veins of the lower extremities is the most effective method – surgically. Techniques surgical techniques selected, starting from the stage of the disease, its forms, functions, hemodynamic disorders:
- Laser coagulation;
- the radio-frequency coagulation;
- mini-phlebectomy;
- Phlebotomy.
Possible complications and consequences
Complications of varicose veins develop mainly in the stage of decompensation. These include:
- Phlebitis (inflammation of the enlarged veins);
- Thrombophlebitis (inflammation of veins with formation of the upper light blood clot);
- Bleeding from varices;
- trophic ulcers;
- Pulmonary Embolism (Pulmonary Embolism).
The most varikoznaya the disease on the lower extremities; it is one of the most common pathologies, of which 40% suffer almost of the women and 20% men.
Prediction
Prognosis varicose veins of the lower extremities in the event of timely treatment is favorable.
Prevention
For the purpose of prevention of varicose veins of the lower extremities, avoid long-term static loads. If the Job requires a longer stay in the stand or sit, you should make periodic breaks to get a little exercise or at least walk. After a day of work, it is recommended to lie down, the legs horizontal or high storage.
In the prevention of varicose veins a significant role in active pursuits: Sport (swimming, Cycling, Fitness), dancing, Hiking, etc.