The varicose veins of the lower extremities is a persistent and irreversible expansion of the veins, which occurs as a result of gross changes in its walls, as well as the insufficiency of its valve apparatus due to a genetic defect.
The predisposition of women is explained by a cyclical increase in the extension of the walls of the veins with an increase in the concentration of the hormone progesterone.
Reasons
The primary factors of varicose veins are the hereditary weakness of the vascular wall.
In addition, human lifestyle is of great importance in pathogenesis:
- long work, standing or sitting;
- lack of regular physical effort;
- weightlifting;
- Reception of drugs containing estrogens.
The risk of varicose veins of the veins of the lower extremities increases with age.But more and more patients are under 30 years.
Manifestations of varicose veins
Most of the time, with varicose veins, patients are concerned about the sensation of gravity, burst, heat, skin items, "anxiety" in the legs and pain hurt and pulsating in the calf muscles.A characteristic feature of these signs is their appearance after a long position.As a general rule, unpleasant sensations pass completely or their intensity is significantly reduced when walking, in a liar position, after a night of rest or when using medical compression products.
An important sign of the disease are cramps in the calf muscles, which generally occur at night.
The subcutaneous veins are expanding in the form of convincing blue conglomerates along the lower part of the leg and thigh.Unfortunately, there is the opinion that vascular stars are a manifestation of varicose veins.But it is worth noting that this is not an absolute sign of the disease and, in many ways, a purely cosmetic problem.Such signs can be on the skin with varicose veins, but for the most part they are also found in healthy people.
As the varicose veins develop, the skin's skin rapes are developed at the bottom of the leg.Initially, areas of excess staining are produced, they are compacted a little later in the subcutaneous tissue and the skin, the latter acquires a characteristic "lacquered" appearance.In the center of the painted area of the skin, in response to a minimum lesion, a small white area resembles creepy drops.This is the atrophy of the white skin that is called that, after which a trophic ulcer is opened.
The rape of skin skin is a sign of chronic venous deficiency, which also includes symmetrical edema in the legs.
Diagnosis
Ultrasound scan (color duplex scan; triplex scan): "gold standard" in the diagnosis of varicose veins of the veins of the lower extremities.A ultrasound specialist must necessarily examine the legs of the legs on both sides.Evaluate its diameter, compressibility, characteristics of the blood flow and the value of the reflux (reverse blood flow).The evaluation of valves is carried out not only in the patient's position while lying, but also standing.
Treatment of varicose veins of the lower extremities
The same symptoms can be signs of various diseases, and the disease may not occur according to the textbook.Do not try to be treated to yourself, consult your doctor.
Modern treatment of varicose veins includes surgical intervention, sclerotherapy, compression treatment and the use of several medications.
Operation
Surgical treatment is the only method to reliably improve the quality of life, reduce the risks of complications and the probability of relapse of the disease.It consists of eliminating varicose veins.There are 2 types of interventions:
- Thermal prison: minimally invasive treatment method (without cuts) using a radiofrequency laser or sensor;
- Traditional surgical intervention implies the splitting of varicose veins.Currently, the technique of such interventions is sufficient and allows you to obtain a good functional and cosmetic result.
Considered separately sclerotherapy as a method of surgical treatment.It is successfully complemented, and in some cases (the initial stages of the varicose veins) replace surgery.The procedure is the introduction of a special drug in a varicose vein, which hits it from the inside.
Compression treatment of varicose veins
Elastic bandages: pros and cons of
Compression therapy is a mandatory component of any method to treat varicose veins and the most effective method to prevent it.
For compression treatment, elastic bandages are used more frequently, which, depending on the degree of stretching, are divided into 3 classes:
- short (overlap of a bandage no more than 70 % of the initial size);
- average (increase in the initial length with stretching in the range of 70-140 %);
- Long extensibility (140 % and more).
Classes are mandatory in the bandage packaging, and are the characteristic necessary for the correct choice of the product.
It is advisable to use long extensibility bandages in the nearest postoperative period to stop the blood and reliable fixation of the bandage.To guarantee the optimal therapeutic compression regime, short and medium extensibility bandages are more appropriate.
When using elastic bandages, the following rules must be followed:
- The bandage applies, preferring the foot "on yourself", to avoid the formation of folds in the ankle area, which can damage the skin when moving;
- The phrases always begin from the fingertips of the foot and capture the heel;
- The pressure of the bandage must weaken gently from the ankle to the thigh;
- The bandage roll is not observed, while it is immediate of the skin;
- The cylindrical profile modeling of the limb is achieved by placing foam or latex pads.
Most patients with varicose veins should use an elastic bandage throughout the day, applying it in the morning before lifting from bed and shooting at night before the nighttime.For the treatment of trophic ulcers, multi-layer compression bandages can be used, they cannot be removed for a long time, while directly with the affected area of the lower leg skin, they are contacted with impregnated bandages with drug substances (Zinc-Wewatin and other dressings).
Despite high efficiency, compression treatment with elastic bandages has obvious disadvantages, which causes physical and aesthetic inconveniences, in addition, it is very difficult for older people will be transferred, observing all rules.
Point clothes
Special compression knit garments gain wide popularity.It is represented by means of lower, medium and upper thighs, as well as means (including special means for pregnant women) of four compression classes.
Such knitting is made of cotton, natural rubber: elastan and synthetic rubber.Natural fibers are optimal for sensitive and affected eczema (varicose eczema, dermatitis, trophic disorders) of the skin.As for synthetic fibers, their advantages are a small diameter and a variety of colors that allow medical knitwear with high aesthetic properties.
Pharmacological therapy of varicose veins
The main objectives of pharmacological therapy are the elimination of subjective symptoms of venous insufficiency, as well as the prevention and reduction of the severity of side effects after surgical interventions.
One of the prescription medications are most commonly medications with the active substance Godmine.Usually, a week after the beginning of its reception, a positive dynamic appears: night cramps, pain, gravity, pass, swelling.It is believed that the minimum duration of the course must be at least 2 months.In severe forms of varicose veins, taking the medication can continue up to six months or more.
Ointments and gels
The simplicity of use and the cheap relative of the ointments and the gels make them very popular between patients and doctors.A serious disadvantage of the un controlled use of local medicines is a high frequency of skin complications in the form of peeling, dermatitis and eczema caused by the increase in sensitivity with prolonged use of the same remedy.
Therefore, it is not recommended to use local medications (ointments, gels, cream) as prevention and in the absence of symptoms of a chronic vein disease.
Heparin -based products are some of the popular medications.Used 3-4 times a day.At the beginning of use, it is possible clear skin irritation and peeled phenomenon in the places of use of the medication.
Additional therapy
In the Russia Federation, physiotherapeutic treatment methods are widespread.To combat such symptoms of the varicose veins of the lower extremities such as pain and cramps in the calf muscles, you can use the electrical muscle stimulation method.Other physiotherapy methods have no evidence of the effectiveness of the treatment of this disease.
Varicose veins prevention
The rational organization of work and rest is necessary for all patients in varicose veins.This category of patients is not recommended for the work associated with a long stay in standing or sitting position, peso lifting and the effects of high temperature.At work and at home, they need a periodic vacation with 15-20 degrees high at an angle of 15-20 degrees (during sleep it is recommended to raise the end of the foot of the bed above the heart level), rational nutrition, excluding the consumption of spicy and salty foods, as well as alcohol.Body weight must be strictly controlled, since obesity leads to the progression of the disease.
In elastic compression conditions, mobile sports (skiing, cycling) are allowed, however, optimal swimming conditions provide optimal conditions for the output of venous flow and muscle training of lower extremities.