The varicose veins of the lower limbs or the varicose veins of the lower limbs - the expansion of the surface veins, accompanied by a failure of the valve and an alteration of the blood flow.
It is the most common disease of the peripheral vessels.According to epidemiological data, various forms of this disease are in 26 to 28% of women and 10 to 20% of working age men.
Risk factors for the development of varicose veins
Heredity and its role in the development of varicose veins is not unambiguous confirmation.One of the main counter-arguments in the presence of a genetic predisposition is the different frequency of varicile disease in ethnic Africans and their tribes colleagues who have emigrated to the United States and in Western European countries.In addition, in comparison with the other members of the sedentary tribe, the frequency of varicose veins, which does not exceed 0.5%, emigrants have a reliable incidence of 10 to 20%.In this regard, the conclusion is obvious to the variciary disease of environmental factors, the characteristics of lifestyle and nutrition.
PregnancyIt is traditionally considered to be one of the main risk factors for developing varicose veins, in particular more frequent (3-4 times) damage to women.It is generally accepted that the main moments caused are an increase in the BCC (volume of circulating blood) and the compression of the pregnant uterus of the retroperitoneal veins.Meanwhile, the results of epidemiological studies indicate that only the following seconds and pregnancies lead to a reliable increase in the frequency of varicose veins of 20 to 30%.At the same time, the first signs of the disease already appear in the 1st trimester of pregnancy, when a clear increase in BCC or an increase in pregnant uterus does not yet occur.
Obesity- The risk factor proven for varicose veins.At the same time, an increase in the body weight index to 27 kg / m2 and more leads to an increase in the frequency of the disease by 33%.
The high frequency of varicose veins in industrialized countries is to a certain extent due to nutritional characteristics.A high degree of food processing and reducing raw vegetables and fruits has led to a constant deficiency in the vegetable fibers necessary to reshape the venous wall and chronic constipation, which leads to a permanent increase in intra-abdominal pressure.
LifeIt has a significant impact on the development and course of varicose veins.In particular, the undesirable effect of long -term static loads with lifting weights or a motionless stay in position of position and seated has been proven.In Asian countries, the more frequent use of chairs and chairs in the Europeanalized part of the population has led to a reliable increase (3-4 times) of the frequency of varicose veins compared to people who are traditionally seated in carpets.
Special conditionsParticipate in the pathogenesis of varicose veins.Their role in recent years has gradually increased, which is due to the broad use of hormonal contraception, the popularization of hormone therapy replaced in the period of the treatment of osteoporosis.It is proven that estrogens and progesterone, as well as their derivatives, reduce the tone of the venous wall due to the progressive destruction of collagen and elastic fibers.
Clinical image of varicose veins
Varicose is a disease that is not indifferent to beautiful sex.The varicose veins of female veins are sick on average three times more often than men.
The signs of varicose veins are extensions of subcutaneous vein, pain, severity of the legs, swelling of the foot and the bottom of the leg, fatigue in the legs at the end of the day.Varicose nodes are often subject to the formation of blood clots and infection.Flebititis can develop - inflammation of blood vessels or thrombophlebitis - Inflammation of blood vessels complicated by blood clots.During the veins, there are hard and very painful cords.The skin changes, loses its elasticity and its color becomes dense and dark brown.With an easy injury, ulcers occur.A young woman can become a disabled person at the age of 40.
These are the symptoms should make you alert - these are symptoms of varicose veins:
- Pain.The causes of pain in varicose veins are very, very numerous.A variety of pain in varicose veins is also very rich:
- Hot pulsating pain,
- Night cramps and itching in the muscles,
- Pain while walking
- Pain along the venous trunks,
- General pain and pain in the legs.
- Swelling in the legs.
- A feeling of bursting and heaviness in the legs.
- Skin changes.At first, the skin becomes dry, pigmentation appears - the skin of the legs darkens, covered with brownish "spots".Later, various dermatitis, eczema and trophic disorders so called in the form of poorly healing injuries until the formation of ulcers can reach these symptoms.
- An elongated and elongated elongated varicose vein exceeding above the surface of the skin of the legs and feet, with cylindrical or mixed extensions.
- Vascular stars (telangioectasia).Yes, people with varicose veins are also included in the group of patients with the expansion of small veins, because the causes of their appearance are the same.
The first stages of varicose vein development are very difficult to detect and diagnose, because in the first stages of the disease, there is no main characteristic - varicose veins.And the first and first symptoms of varicose veins, such as the feeling of the severity of the legs, moderate legs of the legs, increased fatigue, are also found with the initial stages of arterial diseases, flat feet, lumbar osteochondrosis.
In such difficult cases, it is impossible to make the right diagnosis itself - you will need a consultation of a doctor or even several specialists - a phebologist, a neurologist, a surgeon and a manual therapist.High instrumental diagnostic methods, such as ultrasound or phlebography, will also be necessary.
The very first symptoms of varicose veins of the legs, along which you can suspect the start of varicose veins, is an increase in the venous pattern on the skin of the legs.This defect, as we have already noted, most often noted by young women: on the legs or hips, they notice crowns, which were not there before.There may not be other complaints at the start of varicose veins.
And often, such symptoms of a beginning varicos disease precede the appearance of pain and other unpleasant sensations.Often, the first "discoveries" of veins are not accompanied by not being unpleasant.
The beginning of development and the progression of varicose veins is already manifested by salient above the surface of the skinvaricose nodes.One or more.This is the main symptom of beginner varicos disease.Varicose nodes can be detected most often on the inner surface of the legs or hips.With a long step or a prolonged position, such a symptom of varicose veins manifests itself asfatigue, heaviness in the legs, feeling of burst(often - in calves).These symptoms are particularly clear with an extended stay in a sitting or standing position.There are also painful or acute pain in places of varicose veins (dilated veins), convulsions in the muscles of the calf, especially in the evening, and sometimes at night.
The first signs of dysfunction in the veins appear andswelling of the legs until the end of the day.Edema generally occurs in the evening, especially after a prolonged position.After night, swelling disappears completely.
These symptoms of expansion varicose veins quickly pass, if you relax, especially if you lie down.However, the disappearance or a significant decrease in these symptoms when walking and after night rest are very characteristic of the symptoms of varicose disease.
But varicose veins, if they are not seriously committed, do not withdraw,progress.Over time, such symptoms of varicose veins such asDark blue intradermal veins, protruding above the surface of the skin of the legs and feet and similar to the clusters of red grapes.All this is accompaniedBrilliant pain in the legs and calves, a feeling of warmth in the legs, night convulsions in the muscles of the calf, swelling.Gradually join these symptomsSkin changes.At the beginning, the skin becomes dry, it darkens, a pigment appears on it - the brown spots.A little laterTrophic disorders: Poorly healed-explosions and even ulcers.
PainThey are starting to disturb more and more often, especially in the afternoon or evening.
Diagnosis
Currently, the main affordable methods to diagnose varicose veins are:
- Ultrasound dopplerrography.The most common method of primary diagnosis of diseases from the veins of the lower limbs is today ultrasound dopplerography.This method is based on the effect of doppler, which consists in the fact that ultrasonic waves passing through tissues are reflected in the displacement of blood cells and change frequency.Very sensitive sensors, fixing these changes, reproduce them with a special device in the form of sound signals resembling the sound of the wind, or a graphic curve.
- The duplex scan (two dimensions) allows you to record the image of a venous ship on the monitor's screen in real time with the evaluation of the blood flow.The Triplex scan (three dimensions), in addition to the above, allows you to obtain a color image of the blood flow.
- Phlébography.Flurling is a radio-opti-optation of the veins, which has been, and in some cases remain, the decisive diagnostic method of examining patients with veins and, mainly in the case of their complications.
Varice treatment
The successful solution to the problem of treatment of varicose veins consists of the sequential implementation of the following tasks:
- Elimination of varicose veins;
- Elimination of HVN signs;
- Prevention of progression and relapse of the disease.
Ways to treat varicose veins:
- Compression therapy;
- Conservative therapy;
- Surgical treatment (phleectomy);
- Sclerotherapy.
First of all, they try to treat varicose veins with conservative methods.Strictly speaking, it is not a method of treatment of varicose veins.All conservative methods in the "treatment of varicose veins" are intended, you are first of all, for the prevention of the disease and its complications.Conservative methods are also the only possible therapy if the patient has serious contraindications to other treatment methods or if the patient refuses surgical treatment of varicose veins.The radical elimination of Varique syndrome is only surgically, at the same time, the functional result of treatment is of great importance, which implies the elimination or minimization of HVN manifestations.
The treatment of varicose veins should be complex and individual, including most often a conservative and surgical treatment.The doctor can only recommend the method of processing varicose veins according to his experience, but the decision always remains