Varicose veins of the lower limbs – it is a chronic disease of the veins, which is characterized by a thinning of their walls, the expansion of the lumen, and also the formation of aneurysm-sicut nodes. Most often varicose disease affects the lower limbs; this is one of the most common diseases – from her suffering around 40% of women and 20% men.
Causes and risk factors
In the veins of the lower extremities, the blood flows up, this is her to overcome the force of gravity. This stream is ensured by the pressure, which is located in the vicinity of the veins tendons and the residual blood pressure. The movement of blood in the veins of the lower extremities, promotes a "muscle pump": when the movement of the muscles of the legs cut and squeezing the veins, placebat ei pulsare thereby which is in the blood go up, because the reverse current preventing venous valves.
Weakness of the muscle layers of the inflammation of the walls of the kidney and the valve apparatus are the reason that under the influence of the actions of the "muscle pump", the blood starts to flow in the opposite direction, i.e. down. This leads to increased pressure on the walls of blood vessels, further progression of the failure of the valves, the expansion of the lumen of the vein and the formation of knots. Muscle fibers inflammation of the vascular atrophy, disturbed nerve receptors, which regulate venous tone, which, in turn, even more intensifies the manifestations of venous insufficiency.
Risk factors for development of varicose disease of the lower extremities:
- hereditary predisposition;
- pregnancy;
- obesity;
- daily prolonged stay in a sitting or standing position;
- activities associated with lifting weights;
- the systematic wearing of tight clothing, corsets;
- an unhealthy diet with insufficient content in the diet of fiber and vitamins;
- a violation of hormonal status.
In the prevention of varicose disease is a significant role is assigned to the active pursuits: sport (swimming, cycling, fitness), dancing, hiking, and so sp
Forms of the disease
On the basis of the characteristics of clinical manifestations, issued the following forms of varicose veins of the lower limbs:
- segmental defeat intradermal and subcutaneous veins with the lack in them of the reverse flow of blood;
- segmental the defeat of the veins of the lower extremities, accompanied by a morbid flow of blood;
- frequent defeat of the blood vessels of the back-flow of blood into the superficial veins;
- frequent defeat of the blood vessels, accompanied by a morbidly disposal of blood on the system of deep veins.
Phase of the disease
In 2000, the Russian phlebologists were adopted classification of varicose disease of the lower extremities, which takes into account the form of the disease, the degree of venous insufficiency, presence or absence of complications. In accordance with her posing three stages of varicose disease of the lower extremities:
- Phase compensation. Ill not to allow any complaints. When carrying out an inspection on one or both feet are detected, the surface-active substances are found enlarged veins.
- Phase subcompensation. Patients complain of night cramps, disorders of skin sensitivity (paresthesia) in the legs, a feeling of fullness. In the evening are often observed swelling of the extremities, the ankles and the soles of the feet, disappearing after a night's sleep. Looking at the feet is evident in the dilated varicose veins.
- Phase of decompensation. The above represented the joins eczema, dermatitis. Skin with pigment spots, dry, shiny, tightly coupled with the subcutaneous fibres.
Symptoms
The clinical picture of varicose disease of the lower limbs is defined by the stage of the disease. So when you compensate for the stage, the only symptom of venous insufficiency – emergence on the legs, spider veins (telangiectasias).
The transition of the disease in the subcompensated phase is accompanied by pain in the legs, swelling of feet and ankles, cramps in calf muscles. After resting in a horizontal position with these symptoms ends.
The most striking clinical picture of varicose veins of the lower limbs is manifested when gekompenzovat the stage of the disease. Leg pain are permanent. Patients complain of itching of the skin, which is amplified in the evening and night hours. Over time arise dermatitis, eczema, hardhealed trophic ulcers. At the given stage there are many common symptoms are: dizziness, low blood blood pressure. Are associated with the agreement on the deposit in the enlarged venous network of the legs a considerable amount of blood.
Complications of varicose disease is phlebitis, thrombophlebitis, bleeding from varicose nodes, trophic ulcers, thromboembolism of the pulmonary artery.
Diagnosis
Diagnosis of varicose disease of the lower extremities, does not present any difficulties. This is done on the basis of characteristic clinical symptoms of the disease and the data of objective control.
For the evaluation of the severity of the violation of hemodynamics apply the instrumental methods of diagnosis:
- Doppler ultrasound of the veins of the lower extremities;
- duplex angioscanning;
- rheovasography of the veins of the lower extremities.
Treatment
In the treatment of varicose disease of the lower extremities on the testimony applies the following methods or their combinations:
- conservative therapy;
- sclerosing therapy;
- surgical intervention.
Conservative therapy of varicose disease of the lower extremities may be recommended to patients in the early stages of the disease, its aim is the prevention of progression of chronic venous insufficiency. Also used in subcompensated and gekompenzovat stages of the disease in the period of preparation of the patient on the operating intervention, or in cases where the use of other methods is contraindicated. Conservative therapy of varicose veins is based on the use of phlebotonics, the wearing of compression of the knitted fabric. In addition, patients are advised to regularly engage in physical therapy, avoid prolonged static load.
For varicose veins of the lower extremities, is not complicated by significant disturbances of hemodynamics, can be used compression sclerotherapy. The essence of the method is operated in the affected veins of the drug, which her spasm. After the leg put on pressure stockings or carried out by bandaging the leg elastic bandage that allows you to keep the walls of the veins in the dormientes condition. In a few days will begin the process of gluing the vein walls. A compression garment must be worn after sclerotherapy of not less than one and a half months, up to the time of occurrence between the wall of the vein enough dense adhesions.
In more advanced stages of varicose disease of the lower extremities, the most effective method – surgery. Methods surgical techniques are chosen, based on the stage of the disease, its shape, function, hemodynamic violation of the rules:
- laser coagulation;
- radiofrequency coagulation;
- miniphlebectomy;
- phlebectomy.
Possible complications and consequences
Complications of varicose disease develops basically in the stage of decompensation. These include:
- phlebitis (inflammation of the dilated veins);
- thrombophlebitis (inflammation of a vein with the formation in its lumen of blood clots);
- bleeding from the varicose knots;
- trophic ulcers;
- thromboembolism of the pulmonary artery (PE).
Most often varicose disease affects the lower limbs; this is one of the most common diseases – from her suffering around 40% of women and 20% men.
Weather
Prediction of varicose disease of the lower extremities with prompt treatment, the beneficial.
Prevention
In order to prevent varicose disease of the lower extremities is necessary to avoid long static load. If the work requires a long-term stay in the standing or sitting position, it is necessary to regularly take breaks for a little exercise or at least walking. After the working day is recommended to lie down, put your feet horizontally or exalted position.
In the prevention of varicose disease is a significant role is assigned to the active pursuits: sport (swimming, cycling, fitness), dancing, hiking, and so sp