Varicose veins of the lower limbs is a chronic disease of the veins, which is characterized by a thinning of their walls, the extension of the light, as well as the aneurysm-sicut nodes. Most often, the varicose disease affects a lower extremity; it is one of the pathologies most common she suffers about 40% of women and 20% men.
Causes and risk factors
In the veins of the lower extremities the blood which is flowing to the top, is that it must overcome the force of gravity. This current is supplied to the pressure close to the veins, the tendons, and the residue of the blood pressure. The movement of blood in the veins of the lower limbs and helps with "muscle pump": when the movements of the muscles of your legs are reduced and compress the veins, placebat ei pulsare and finding in them the blood up, because the reverse current preventing venous valves.
The weakness of the muscular layer of the venous wall and the failure of the valve of the device become for the reason that, under the influence of the action of the muscle pump," the blood begins to flow in the opposite direction, that is, towards the bottom. This leads to an increase of the pressure on the walls of the blood vessels, the continuation of the progression of the insufficiency of the valves, the expansion of the lumen of the veins and the formation of nodes. The muscle fibers of the vein wall atrophy, disrupted the nerve receptors governing the venous tone, which, in turn, further strengthens the manifestations of the venous insufficiency.
Risk factors for development of varicose veins of the lower limbs:
- a hereditary predisposition;
- of pregnancy.
- obesity;
- daily of a long stay in a sitting or standing position;
- activities related to lifting heavy objects;
- systematic wearing of tight clothing, corsets;
- a poor diet with lack of content in the diet of dietary fiber and vitamins;
- the violation of the hormonal status.
In the prevention of the varicose illness, not an active role of activities: sport (swimming, cycling, fitness), dancing, hiking, etc ..
The forms of the disease
Based on the clinical features, distinguish the following forms of varicose veins of the lower limbs:
- segmental defeat intradermal and saphenous veins to a lack of them reverse from the bloodstream;
- segmental the defeat of the veins of the lower limbs, accompanied by a pathological state current of the blood;
- spread the defeat of the vessels against the current of blood through the superficial veins;
- spread the defeat of the vessels, accompanied by a pathological rejection of blood through the system of deep veins.
The stage of the disease
In 2000, the Russian phlebologists has adopted the classification of varicose veins of the lower extremities, taking into account the form of the disease, the extent of the venous insufficiency, the presence or absence of complications. According to it, there are three stages of varicose veins of the lower limbs:
- Stage of compensation. The patients don't have any complaints. At the completion of the visit on one or both feet are detected superficially located veins dilated.
- The stage subcompensation. The patients complain of night cramps, disorders of skin sensitivity (paresthesia) in the legs, sensation of bloating. In the evening, often, there is a swelling of the calves and ankles and feet, which disappears after a night's sleep. During the examination of the feet visible, advanced varicose veins.
- The phase of decompensation. The above described feature together with the eczema, dermatitis. Skin with blemishes, dry cleaning, shining, closely related to the subcutaneous fiber.
The symptoms
The clinical presentation of varicose veins of the lower limbs will be determined by the stage of the disease. Thus, when compensated stage the only symptom of venous insufficiency – the appearance of spider veins on legs (telangiectasias).
The passing of the disease in subcompensated phase is accompanied by the appearance of pain in the legs, swelling of feet and ankles, cramps in the calves. After a rest in a horizontal position, these symptoms stop.
The most vivid, the clinical presentation of varicose veins of the lower limbs occurs as a result of the decompensated stage of the disease. The pain in the legs become permanent. The patients complain of itching of the skin, which is enhanced in the evening and at night. With the time, face dermatitis, eczema, trudnozazhivayuschie ulcers trophic. On that phase, there are general symptoms: dizziness, hypotension. They are linked to a deposit in the venous network of the legs of considerable quantities of blood.
A complication of the varicose disease is phlebitis, thrombophlebitis, bleeding of varicose veins nodes, ulcers trophic, pulmonary embolism.
The diagnosis
The diagnosis of varicose veins of the lower limbs is not difficult. It is carried out on the basis of characteristic clinical signs of the disease and the data of the physical examination.
For the assessment of the severity of hemodynamic impairment, apply the instrumental methods of diagnosis:
- Doppler ultrasound of veins of the lower limbs;
- duplex angioscanning;
- reovazografija the veins of the lower limbs.
Treatment
In the treatment of varicose veins of the lower limbs indications apply the following methods or a combination of:
- conservative treatment;
- sclerosing therapy;
- a surgical intervention.
Conservative treatment of varicose veins of the lower limbs may be recommended for patients in the early stages of the disease, it has for objective the prevention of the progression of chronic venous insufficiency. Thus, it applies at the subcompensated and decompensated stages of the disease in the period of preparation of the patient to the surgical intervention or in cases where the use of other methods of contra-indicated. Conservative treatment of varicose veins is based on the application phlebotonics, the wearing of compression hosiery. In addition, the patients, it is recommended to do regular physiotherapy to avoid long static loads.
Varicose veins of the lower limbs is not complicated with significant violations of hemodynamics, can be used compression sclerotherapy. The essence of the method is administered in the vein of the drug, calling her spasm. After that, the leg put on socks, compression or exercise bandage of the leg elastic, which helps keep the walls of the veins in dormientes state. In a few days begins the bonding process of the vein wall. A compression garment must be worn after sclerotherapy for at least a month and a half, until the time of the formation between the walls of the vein rather dense adhesions.
In the stages of varicose veins of the lower limbs, the most efficient method and the surgery. The operating methods of a technician are chosen, depending on the stage of the disease, its form, characteristics, hemodynamic disorders:
- laser photocoagulation;
- frequency of coagulation;
- miniphlebectomy;
- the phlebectomy.
The possible complications and consequences of the
The complications of the varicose disease are developed primarily in the phase of decompensation. These include:
- phlebitis (inflammation extended vienna);
- thrombophlebitis (inflammation of the veins of the education in its distal blood clots);
- the bleeding varicose veins of the nodes;
- ulcers trophic;
- pulmonary embolism (pe).
Most often, the varicose disease affects a lower extremity; it is one of the pathologies most common she suffers about 40% of women and 20% men.
Forecast
Prediction of varices of the lower limbs, when the early treatment is favorable.
Prevention
In order to prevent varicose veins of the lower limbs, you need to avoid long static loads. If the job requires a long stay in a standing or seated position, it is necessary to regularly take breaks of a small gym or at least walking. After a day of work, it is recommended to lie down, the legs to the horizontal or the exalted position.
In the prevention of the varicose illness, not an active role of activities: sport (swimming, cycling, fitness), dancing, hiking, etc ..