Varicose disease of the lower extremities is a chronic disease of the superficial veins of the legs, which is characterized by the elongation and deformation of some boats and the causes of chronic venal insufficiency, has been progressing. This is a common feature of pathology – suffers every fourth inhabitant. According to statistics, surgical interventions in hospitals, women suffer 6-7 times more often than men. However, some authors consider that this information is incorrect and to assume that men suffer from varicose veins in equality with women as, however, a cosmetic issue that concerns less, so they go to the doctor less often – only when there are pronounced symptoms of venous insufficiency chronic.
In our article, learn about the causes, mechanism of development of this pathology, symptoms, principles of diagnosis and treatment, including methods of physical therapy.
Varicose disease of the lower extremities can be primary (occurring due to congenital alterations of the structure of the wall of the vein or insufficiency of the valve is a disease) and secondary (develops as a complication of deep vein disease, for example, with PTS).
There are a number of factors that increase the load on the veins, reducing a tonus of the wall vein, thus increasing the likelihood of developing varicose veins. This:
Under the influence of the causal factors in venous vessels increases the hydrostatic pressure, which leads to an increase of its diameter and of the progression of the dysfunction of the valve apparatus. As a result, the output of blood through the veins surface is hard, the blood from the deep vein occurs on the surface – that are overflowing, too stretched, wriggled and in the form of extensions for different cylindrical, in the form of a bag, the hybrid. With the progression of the disease the blood stagnation leads to problems of nutrition (trophism) of the tissues of the lower parts of the extremities – the skin reddens, dries, there is dermatitis, eczemas, and in an advanced stage – trophic ulcer.
Scientists believe that varicose veins – a kind of "payback" human bipedalism.
In 3 of the 4 patients is determined by the extension of the main saphenous veins (trunk), the rest is diffuse dilatation (including intradermal). In 8 of 10 cases the lesion is determined in the basin of the great saphenous vein, the remaining 20% must defeat the small saphenous vein and mixed defeat equally.
Depending on the severity of the chronic insufficiency of venous function in varicose veins disease distinguish 3 stages:
In the first stage of the disease, the patients complain only cosmetic imperfections such as spider veins, serpentine deformation of the subcutaneous venous trunks, which appears in the vertical position of the patient, often after exercise or static loads, as well as in the night. Subjective sensations in this stage patients do not exist.
In the second phase of the complaints of the patients are added, which are symptoms of disorders of the regional circulation. Patients note:
After the patient some time he goes to bed with the limb affected was raised, he noted the relief – complaints "go away" or be less pronounced.
Visually, in the second stage varicose disease is determined by the significant expansion, the ornateness of the saphenous veins, which is the highest expressed in the patient to a standing position, that is to say, when the greater burden in the venous apparatus.
In the third stage, the veins are determined constantly have a constant swelling of the limb below the site of localization of the pathology. These symptoms are added, and disorders of trophism nutrition of the skin is dry and thin, very red; perhaps the appearance of ulcers, mainly in the anterior-medial (internal) surface of the lower third of the leg (often on the inside of the ankle).
Patients worried about fatigue severe heaviness in the limbs, especially noticeable in the upright position and during walking and inflammation.
Doctors to apply in your practice and the international classification of diseases, chronic venous insufficiency, a fully reflecting symptoms of the disease:
As a result of the damage thinned, the affected varicose veins which are welded, the skin can open the bleeding. While the outbreak of the host blood is poured out in the midst of the stream, which can lead to significant blood loss.
The second serious complication is acute thrombosis. It is manifested by the redness of the skin over the affected vein, painful seal in the form of a cord in the way. This is a condition that is dangerous because the clot or part of it can break through the vessel wall and the bloodstream to get in the blood vessels of the lungs or the brain, covering them.
To establish the diagnosis of varicose vein disease of a person skilled in the majority of cases, it is not easy. He can do it on the basis of complaints of patient, anamnesis of life and diseases, as well as the results of the evaluation, the goal of the state. It is important not only to accept the existence of this disease, and to determine the state of the valves of the veins, which is the vascular permeability – depends on tactics of treatment.
Assessing the state of the valves is to help the patient performs functional tests:
To evaluate the patency of deep veins will help show Pratt-1 and-be-pertise.
To describe the technique and the principle of the evaluation of the results of the samples that are not, because it takes the reader to the topic of the article.
Of great value in the diagnosis of varicose veins is ultrasound. Allows the maximum to characterize the pattern of blood flow. Apply:
In advanced cases of varicose veins apply a procedure particular to assess the state of the muscle-venous pump of the line.
There are 2 main types of treatment conservative and surgical. Conservative includes the normalization of life, the compression of the therapy, the treatment and sclerotherapy. Conservative treatment will not help to get rid of the disease, and is designed to slow down its subsequent evolution.
And as part of the conservative treatment, and in the phase of rehabilitation after surgery widely used the therapy of physical factors.
The patient should be in all senses of the word to take care of your veins:
In addition, if the weight of the body of the patient above the norm, has to be reduced. In the diet, it is recommended to limit the consumption of salt and hydration.
Elastic compression improves the blood flow in the deep veins and reduces it to the subcutaneous veins, prevents edema, activates the microcirculation and metabolism in tissues.
Apply bandages, elastic and stockings. It is important to choose an instrument with the patient requires a specific degree of compression. Equally important to know the patient, the technique of proper bandaging of the limb. Bandaging begin in the morning, before getting out of bed in the direction from the toes to the thigh, grabbing the heel and the ankle. Bandaging should be done in such a way that each subsequent half turn of the bandage overlaps the previous one.
Your doctor may prescribe the patient a course of use of this type of drugs:
Indications for the realization of sclerosing therapy are:
The essence of the method consists in the introduction into the affected vein of a substance that damages the inner lining of the vessel and leads to the development of inflammation of the vein with subsequent obliteration (obstruction) of the light. That is to say, after the treatment, Vienna, stops working.
Surgery is the main method of treatment of varicose veins of the lower extremities. It can be performed at any stage in the absence of contraindications. The essence of the intervention is to remove the affected saphenous veins with specially made individual cuts. In recent years, the use of endoscopic the procedure of removing diseased veins through an endoscope – a flexible tube with an optical device and tools on the end.
To reduce to a minimum the risk of a specific syndrome of all patients in the postoperative period should be carried out the rehabilitation activities. The main one is the overlay at the bottom of the leg and the foot of zinc-gelatin bandage. Made immediately after the surgery or if the patient has installed drainage, 24 hours after its period of 7-9 days, then removed and the suture is removed. The patient is prescribed massage, exercise therapy.
Methods of treatment of varicose veins is aimed at the strengthening of the wall vein and improve its tone, the improvement of blood rheology and outflow of the veins.
Increase the tone of the vein walls:
Improve the flow of blood and lymph of the extremities:
