Varicose veins and lower limbs – it is a chronic disease of the veins, which is characterized by thinning of their walls, the extension of the lumen, as well as the education of the aneurysm-like nodes. Most frequently varicose veins disease hitting the bottom part; it is one of the most common representatives – from her suffering around 40% of women and 20% men.
Causes and risk factors
Is lower extremities veins the blood flowing up, then it must overcome the force of gravity. This current is guaranteed to pressure are located next to the veins with the tendons and the remainder of the arterial pressure. The movement of blood in the lower extremities of the veins promotes and "muscle pump": if the movement jalalihas are cut and squeeze the vein, placebase not pulsar of this context, which is vital to, since the reverse flow preventing venous valves.
Weakness, muscle layer of the veins walls and failure of the valve apparatus will become the reason that under the effect of the measures, the "muscle pump" the blood will flow and in the opposite direction, i.e. down. This leads to growing pressure on the vascular walls, further progression of valve insufficiency, to expand the lumen of the veins and nodes formation. Lihasrakud the veins and the walls atrophy, disturbed nervous system receptors, which regulate venous tone, which in turn further increases the manifestations of venous insufficiency.
Risk factors for varicose disease of the lower extremities:
- hereditary predisposition;
- pregnancy;
- obesity;
- daily long-term stay in position while sitting or standing;
- the activity, which is related to the difficulty of lifting;
- systematic wearing tight clothing, corsets;
- wrong diet, insufficient contains food fiber and vitamins;
- disorders of the hormonal status.
Prevention of varicose disease of the large role played in active pursuits: sports (swimming, riding bike, fitness), dance, Hiking walks and defects.
Form diseases
On the basis of the characteristics of clinical, emit the following forms are varicose veins is the lower extremities:
- segmendipõhine capture the intradermal and the subcutaneous veins have the opposite blood flow;
- segmendipõhine to capture the lower extremities of the veins, accompanied by a there shock in the blood;
- common loss of blood vessels reverse the flow of blood to follow the superficial veins;
- widespread vascular damage, which involves the unhealthy the approval of the blood system in the deeper veins.
The stage of the disease
2000. in the year of the Russian phlebologists is adopted, the classification of varicose disease of the lower extremities, which takes into account the disease form, the extent of venous insufficiency, presence or absence of complications. According to this distinction between the three stages of varicose disease of the lower extremities:
- Phase compensation. Ill not submit any complaints. In carrying out the control of one or both feet are detected in the superficial enlarged veins.
- The stage of subcompensation. Patients complain of night cramps, disorders of skin sensitivity (paraesthesia) in legs, feeling of abundance. During evening time, often observed swelling to the shins, ankles, and stop, disappear after a night sleep. If look feet well visible in the enlarged varikoossed veins.
- Stage of decompensation of heart. In addition to the above-described objects align eczema, dermatitis. Skin pigment spots, dry, glossy, tight connected with subcutaneous fiber.
Symptoms
The clinical picture of varicose disease of the lower extremities is determined by the stage of disease. So, if the compensatory stage, the only symptom of venous insufficiency – the emergence of the feet on the vascular number of stars (telangiectasias).
The transition from diseases of the subcompensated phase comes with the emergence of pains in the legs, swollen stop and ankles, cramps in the calf muscles. After resting in a horizontal position, these symptoms end.
Most vividly the clinical picture of varicose veins is the lower extremities publish gekompenseeritavad the stage of the disease. Pains in feet are constantly changing. Sick complain of itching of the skin, which is amplified in the evening and night hours. Over time, there are dermatitis, eczema, hardhealed trophic ulcers. The above-mentioned phase of the frequent the common symptoms: dizziness, low blood pressure. They are related to the deposition of extended venous network of the legs to collect in quantity in the blood.
Complication of varicose disease is phlebitis, thrombophlebitis, bleeding prevent varicose nodes, trophic ulcers, thromboembolism of pulmonary arteries.
Diagnostics
Diagnostics of varicose disease of the lower extremities does not constitute a hardship. It takes place on the basis of characteristic clinical signs of the disease and the data of objective examination.
To assess the severity of the infringement hemodynamic use instrumental methods of diagnosis:
- Doppler ultrasound is performed in the lower extremities of the veins;
- duplex angioscanning;
- rheovasography of the lower extremities veins.
Treatment
To treat varicose disease of the lower extremities according to the testimony of the application of the following methods or their combination:
- conservative treatment;
- sclerosing therapy;
- surgical intervention.
Conservative treatment of varicose disease of the lower extremities may be recommended to patients with the disease at an early stage, its purpose – to prevent the disease in chronic venous insufficiency. This also applies when subcompensated and gekompenseeritavad stages of the period to prepare the patient, prompt intervention, or in cases when using other methods are contraindicated. Conservative treatment of varicose veins the underlying application phlebotonics, wearing a compression cast. In addition, patients are advised to regularly deal with medical exercise, avoid long static loads.
If varicose of the lower extremities varicose veins, do not complex significant violations hemodynamic, can be used for compression sclerotherapy. The main method is retained is dirty in the vein of a medication, calling him spasm. After this leg to put the packing, storage, or bandaging the leg elastic bandage, which allows to maintain the walls of the veins are dormiente possible. A few days after the onset of the bonding process, the walls of the veins. Packing laundry must be worn after sclerotherapy for at least one and a half months, until the moment of education between the walls of the veins are sufficiently tight joints.
Advanced stage of varicose disease of the lower extremities the most effective method – surgical. The methods operate, the technician will be selected on the basis of the stage of the disease, its shape, the characteristics of hemodynamic disorders:
- laser coagulation;
- radiofrequency coagulation;
- miniphlebectomy;
- phlebectomy.
Possible complications and consequences
Complications of varicose disease developing mainly in the stage of decompensation of heart. These are:
- phlebitis (inflammation of the enlarged veins);
- thrombophlebitis (inflammation of veins in the education of its lumen to the blood clots);
- bleeding prevent varicose sites;
- trophic ulcers;
- thromboembolism of pulmonary arteries (PE).
Most frequently varicose veins disease hitting the bottom part; it is one of the most common representatives – from her suffering around 40% of women and 20% men.
Forecast
Forecast varicose disease of the lower extremities, timely treatment favorable.
Prevention
With the aim of avoiding varicose disease of the lower extremities should be avoided for long static loads. If the work requires a long-term stay standing or sitting, should be periodically considered breaks a little gymnastics or even just walking. After the working day is recommended to lie down, giving the feet a horizontal or sublime situation.
Prevention of varicose disease of the large role played in active pursuits: sports (swimming, riding bike, fitness), dance, Hiking walks and defects.