Varicose veins of the lower extremities are a persistent and irreversible expansion and extension of the veins, which occurs due to gross changes in their walls and the inadequacy of their flap apparatus due to a genetic defect.
The disposition of women is explained by a cyclical increase in the expansion of the vein walls with an increase in concentration of the hormone profiteron.
Reasons
The main factors for varicose veins are hereditary weakness of the vessel wall.
In addition, the human lifestyle in the pathogenesis is of great importance:
- long work, stand or sit;
- Lack of regular physical exertion;
- Weightlifting;
- Reception of estrogen -containing medication.
The risk of varicose veins of the veins of the lower extremities increases with age.But more and more patients are younger than 30 years old.
Manifestations of varicose veins
Most of the time, patients in varicose veins are concerned about the feeling of severity, bursting, heat, itching, "fear" in the legs and painful, pulsating pain in the calf muscles.A characteristic feature of this sign is their appearance after a long standing.As a rule, unpleasant sensations are completely passed or their intensity is significantly reduced when walking, in a lying position, after sleep or using medical compression products.
An important sign of the disease are cramps in the calf muscles that normally occur at night.
The subcutaneous veins expand in the form of convincing blue conglomerates along the lower leg and the thigh.Unfortunately, there is an opinion that vascular stars are a manifestation of varicose veins.However, it is worth noting that this is not an absolute sign of the disease and a purely cosmetic problem in many ways.Such signs can be on the skin with varicose veins, but mostly can be found in healthy people.
When varicose veins develop, violations of the skin of the lower leg develop.First, areas with excess color occur, subcutaneous tissue and skin are compressed a little later, the latter are a characteristic "painted" look.In the middle of the painted skin area, a small white area is similar in response to a minimal injury.This is the so -called white skin atrophy, according to which a trophic ulcer opens.
A violation of the skin of the skin is a sign of a chronic venous deficiency, which also includes symmetrical edema on the legs.
Diagnosis
Ultrasound scanning (color duplex scanning; triplex -scanning) -"gold standard" when diagnosing varicose veins of the veins of the lower extremities.An ultrasound specialist must necessarily examine the vessels of the legs on both sides.It evaluates its diameter, compressibility, blood flow and the value of the return flow (reverse blood flow).The work of VA valves is not only evaluated in the position of the patient in lies, but also standing.
Treatment of varicose veins of the lower extremities
The same symptoms can be signs of different diseases, and the disease cannot occur according to the textbook.Don't try to be treated yourself - consult your doctor.
The modern treatment of varicose veins includes surgical intervention, sclerotherapy, compression treatment and the use of various medicines.
Operation
Surgical treatment is the only way to reliably improve the quality of life, reduce the risk of complications and the likelihood of relapse to the disease.It is to remove varicose veins.There are 2 types of interventions:
- Thermal prison - Minimal invasive (without cuts) treatment method using a laser or radio frequency sensor;
- The traditional surgical intervention includes the excision of varicose veins.The technology of such interventions is currently being developed sufficiently and enables you to achieve a good functional and cosmetic result.
Separately regarded as sclerotherapy as a method of surgical treatment.It successfully complements and replaces the operation in some cases (the initial stages of varicose veins).The procedure is the introduction of a special drug in a varicose vein that is from the inside.
Compression treatment of varicose veins
Elastic associations: advantages and disadvantages of
Compression therapy is a mandatory component of a method for the treatment of varicose veins and the most effective method for preventing.
Elastic bandages are most frequently used for compression treatment, which are divided into 3 classes depending on the stretch:
- In short (overlap of an association no more than 70 % of the initial size);
- Average (increase in initial length with stretch in the range of 70–140 %);
- Long (140 % and higher) expandability.
The classes are mandatory in the packaging of the association and they are the necessary features for the right choice of the product.
It is advisable to use bandages with long expandability in the next postoperative period to stop the blood and reliable fixation of the association.In order to ensure the optimal therapeutic compression regime, the associations of short and medium extensions are best suited.
When using elastic bands, the following rules should be followed:
- The association is used to curb the foot "on itself" to prevent the formation of wrinkles in the ankle area that can damage the skin when moving.
- Büten always start from the fingers of the fingers of the foot and catch the heel.
- The pressure of the association must be gently weakened from the ankle to the thigh;
- The association role is not swiveled while it is in the immediate vicinity of the skin;
- The modeling of the cylindrical profile of the limb is achieved by placing foam or latex cushions.
Most patients with varicose veins should use an elastic bandage all day long and use it in the morning before it lifts out of bed before the night's sleep and shoots in the evening.For the treatment of trophic ulcers, multi-layered compression bands can be used that have not been removed for a long time, while directly with the affected skin area of the lowerland are contacted by bandages that are impregnated with drug substances (zinc-wewatin and other dressings).
Despite the high efficiency, compression treatment with elastic bandages has obvious disadvantages - which leads to physical and aesthetic inconvenience.In addition, it is very difficult for older people to breed themselves and watch all the rules.
Compression knitting pathways
Special compression knitting paths gain great popularity.It is shown by stockings to the lower, medium and upper thighs and tights (including special tights for pregnant women) by four compression classes.
Such knitting goods consist of cotton, natural rubber - elastan and synthetic rubber.Natural fibers are optimal for sensitive and affected (KramiKse eczema, dermatitis, trophic diseases) of the skin.With regard to synthetic fibers, their advantages are a small diameter and a variety of colors that enable medical knitting with high aesthetic properties.
Pharmaceutical therapy of varicose veins
The main objectives of drug therapy are the elimination of subjective symptoms of venous insufficiency as well as the prevention and reduction of the severity of the side effects according to surgical interventions.
One of the most frequently prescribed drugs are medicines with the diosmine of active substance.Usually a week after the start of reception, a positive dynamic occurs: night cramps, pain, severity passport, swelling.It is believed that the minimum duration of the course should be at least 2 months.In severe forms of varicose veins, taking the drug can continue for up to six months or more.
Ointments and gels
The simplicity of use and the relative cheapness of ointments and gels make you very popular in patients and doctors.A serious disadvantage of the uncontrolled application of local medicinal products is a high frequency of skin complications in the form of peeling, dermatitis and eczema, which are caused by increasing sensitivity when used for a longer period of use.
Therefore, it is extremely not recommended to use local medication (ointments, gels, cream) as prevention and in the absence of symptoms of chronic vein disease.
Heparin -based products are some of the popular medication.Used 3-4 times a day.At the beginning of use, light skin irritation and the peel phenomenon to the consumers of the drug are possible.
Additional therapy
Physiotherapeutic treatment methods are widespread in the Russian Federation.In order to combat such symptoms of varicose veins of the lower extremities such as pain and cramps in the calf muscles, you can use the method of electrical muscle stimulation.Other methods of physiotherapy have no evidence of the effectiveness of the treatment of this disease.
Prevention of varicose veins
The rational organization of work and calm is required for all patients in varicose veins.This category of patients is not recommended for work that are associated with a long stay in the standing or seating position, lifting weights and the effects of the high temperature.At work and at home you need a regular vacation with 15 to 20 degrees, which is increased at an angle of 15 to 20 degrees (while sleep is recommended to increase the foot end of the bed above the level of the heart), rational nutrition without consuming spicy and salty foods and alcohol.The body weight should be strictly controlled because obesity leads to the progress of the disease.
Under the conditions of elastic compression, however, mobile sports (skiing, cycling) may be provided optimal conditions for venous drainage and muscle training of the lower extremities by swimming.