Varicose veins of the lower limbs or varicose veins of the lower limbs: the expansion of the surface veins, accompanied by failure of the valve and altered blood flow.
This is the most common disease of the peripheral vessels.According to epidemiological data, various forms of this disease are found in 26-28% of women and 10-20% of men in working age.
Risk factors for the development of varicose veins
The inheritance and its role in the development of varicose veins are not unequivocal confirmation.One of the main counter -arguments of the presence of a genetic predisposition is the different frequency of varicose disease in ethnic Africans and in their mates of tribes that emigrated to the United States and in the countries of Western Europe.In addition, compared to the companions of sedentary tribes, the frequency of varicose veins, which does not exceed 0.5%, emigrants have a reliable increase in 10-20%reliable impact.In this regard, the conclusion is evident on the varicose disease of environmental factors, on the characteristics of the lifestyle and nutrition.
PregnancyIt is traditionally considered one of the main risk factors for the development of varicose veins, in particular, more frequent damage (3-4 times) to women.It is generally accepted that the main stimulating moments are an increase in the BCC (volume of the circulating blood) and the compression of the pregnant uterus of the retroperitoneal veins.In the meantime, the results of epidemiological studies indicate that only the second and subsequent pregnancy lead to a reliable increase in the frequency of varicose veins of 20-30%.At the same time, the first signs of the disease already appear in the 1st quarter of pregnancy, when a strong increase in the BCC or an increase in the uterine in pregnancy does not occur.
Obesity- The proven risk factor for varicose veins.At the same time, an increase in body weight index at 27 kg/m2 and beyond leads to an increase in the frequency of the disease of 33%.
The high frequency of varicose veins in industrialized countries is to a certain extent due to nutritional characteristics.A high degree of transformation and reduction of food in the vegetable diet and raw fruits has led to a constant deficiency of vegetable fibers necessary for the remodeling of the venous wall and chronic constipation, which cause a permanent increase in intra -abdominal pressure.
LifeIt has a significant impact on the development and course of varicose veins.In particular, the negative effect of long -term static loads with lifting weights or a immobile stay in a standing and sitting position has been demonstrated.In Asian countries, the most frequent use of chairs and chairs in the Europeanized part of the population has led to a reliable increase (3-4 times) of the frequency of varicose veins compared to people who are traditionally sitting in rugs.
Special conditionsTake part in the pathogenesis of varicose veins.Their role in recent years has been progressively increasing, which is due to the wide use of means of hormonal contraception, the dissemination of hormonal therapy replacement in the period in the treatment of osteoporosis.Estrogen and progesterone has been shown, as well as their derivatives, reduce the tone of the venous wall due to the gradual destruction of collagen and elastic fibers.
Clinical image of varicose veins
Varicose veins are a disease that is not indifferent to the beautiful sex.A varicose veins of the female veins is sick on average three times more often than men.
The signs of the varicose veins are knotted extensions of subcutaneous veins, pain, severity in the legs, swelling of the foot and the lower part of the leg, fatigue in the legs by the end of the day.Varicoso nodes are often prone to the formation of blood clots and infection.Flebitis can develop - inflammation of the blood vessels or thrombophlebitis - inflammation of the blood vessels complicated by blood clots.During the veins there are hard and painful ropes.The skin changes, loses its elasticity and the dense, dark brown color.With easy injuries, ulcers occur.A young woman can become a disabled person at the age of 40.
These are the symptoms that should be vigilant: these are symptoms of varicose veins:
- Pain.The causes of pain in varicose veins are very, very numerous.A variety of pain in varicose veins is also very rich:
- Hot pulsating pain,
- Night cramps and itching in the muscles,
- Pain when walking
- Pain along venous trunks,
- General pain and leg pain.
- Swelling in the legs.
- A sense of burst and heaviness in the legs.
- Change the skin.Initially, the skin becomes dry, a pigmentation appears: the skin of the legs is dark, covered by brown "spots".Subsequently, various dermatitis, eczema and trophic disorders so called in the form of poorly curative wounds with the formation of ulcers can join these symptoms.
- A twisting and elongated varicose veins that protrudes the surface of the skin of the legs and feet, with cylindrical or mixed extensions.
- Vascular stars (telanciectia).Yes, people with varicose veins are also included in the group of patients with the expansion of small veins, since the causes of their appearance are the same.
The early stages of the development of varicose veins are very difficult to detect and diagnosis, because in the early stages of the disease there is no main feature: varicose veins.And the first and first symptom of varicose veins, such as the sensation of the severity of the legs, there are also moderate pain in the legs, an increase in fatigue, with the initial phases of arterial diseases, dishes, lumbar osteochondosis.
In such difficult cases, it is impossible to make the correct diagnosis itself: you will need a doctor's consultation or even several specialists: a phlebologist, a neurologist, a surgeon and a manual therapist.High precision instrumental diagnostic methods will also be requested, such as ultrasound or phlebography.
The first symptoms of the varicose veins of the legs, along which you can suspect the onset of varicose veins, are an increase in the vein model on the skin of the legs.This defect, as we have already noticed, most often noticed by young women: on the legs or hips they notice garlands, who were not before before.There may not be other complaints at the beginning of the varicose veins.
And often, such symptoms of an initial varicose disease precede the appearance of pain and other unpleasant sensations.Often the first "finds" of veins are not accompanied by absolutely unpleasant sensations.
The beginning of the development and progression of varicose veins occurs already protruding over the surface of the skinVaricosi nodes.One or more.This is the main symptom of initial varicose disease.Varicosis nodes can be detected more often on the internal surface of the legs or hips.With a long walk or a prolonged position, such a symptom of varicose veins manifests itself asfatigue, heaviness in the legs, a sense of burst(often - in calves).These symptoms occur particularly clearly with a prolonged stay in a sitting or standing position.There is also painful or acute pain in places of varicose veins (enlarged veins), convulsions in the calf muscles, especially in the evening, and sometimes at night.
The first signs of dysfunction are manifested in the veins eswelling of the legs until the end of the day.Edema usually occurs in the evening, especially after a prolonged position.After night rest, the swelling disappears completely.
These varicose expansion symptoms initially pass quickly, if you relax, especially if you lie down.However, the disappearance or the significant reduction of these symptoms when walking and after night rest are very characteristic of the symptoms of varicose disease.
But the varicose veins, if they are not seriously involved, do not withdraw,progressing.Over time, such symptoms of varicose veins such asDark blue intradermal veins conquered, protruding over the surface of the skin of the legs and feet and similar to red grape groups.All this is accompaniedburst with pain in the legs and calves, a feeling of heat in the legs, night convulsions in the calf muscles, swelling.Gradually join these symptomsChange the skin.Initially the skin dries, darkens, a pigment appears: brown spots.Shortly after the so -calledTrophic disorders: Scarcely healed wounds and even ulcers.
PainThey begin to disturb more and more often, especially in the afternoon or evening.
Diagnostics
Currently, the main convenient methods for the diagnosis of varicose veins are:
- Ultrasound dopplerography.The most common method of primary diagnosis of diseases of the lower limbs is today ultrasound dopplerography.This method is based on the effect of the Doppler, which consists in the fact that the ultrasound waves that pass through the tissues reflect from moving blood cells and change their frequency.Highly sensitive sensors, fixing these changes, reproduce with a special device in the form of sound signals that recall the noise of the wind or a graphic curve.
- The Duplex (two -dimensional) scan allows you to record the image of a venous ship on the monitor screen in real time with the evaluation of the blood flow in it.The Triplex scan (three -Dimensional), in addition to the above, allows you to obtain a color image of the bloodstream.
- Flebography.Flobography is a radiopaco study of the veins, which has been, and in some cases the decisive diagnostic method remains to examine patients with veins and, mainly in the case of their complications.
Treatment of varicose veins
The successful solution to the problem of the treatment of varicose veins is the sequential implementation of the following activities:
- Elimination of varicose veins;
- Elimination of HVN signs;
- Prevention of the progression and relapse of the disease.
Ways for the treatment of varicose veins:
- Compression therapy;
- Conservative therapy;
- Surgical treatment (phlebectomy);
- Sclerotherapy.
First of all, they try to treat varicose veins with conservative methods.Strict of terms, this is not a method for the treatment of varicose veins.All conservative methods in the "treatment of varicose veins" are aimed, first of all, to the prevention of the disease and its complications.Conservative methods are also the only possible therapy if the patient has serious contraindications to other treatment methods or if the patient refuses the surgical treatment of varicose veins.The radical elimination of varicose syndrome is possible only surgically, at the same time, the functional result of the treatment is of great importance, which implies the elimination or minimization of HVN events.
The treatment of varicose veins should be complex and individual, most of the time including conservative and surgical treatment.The doctor can only recommend the method of treatment of varicose veins according to his experience, but the decision always remains