Varicose veins of the lower extremities or varicose veins of the lower extremities - the expansion of the surface veins, accompanied by flap failure and impaired blood flow.
This is the most common disease of peripheral vessels.According to epidemiological data, various forms of this disease are found in 26-28% of women and 10-20% of men in work.
Risk factors for the development of varicose veins
The inheritance and its role in the development of varicose veins are not found any clear confirmation.One of the most important counter -arguments for the presence of a genetic predisposition is the different frequency of disease diseases in ethnic Africans and their fellow shadows who emigrated to the United States and the countries of Western Europe.In addition, emigrants have a reliable incidence of 10 to 20%compared to seated tribal members, which do not exceed 0.5%.In this regard, the conclusion of the disease disease of environmental factors, the characteristics of lifestyle and nutrition are.
pregnancyIt is traditionally regarded as one of the main risk factors for the development of varicose veins, especially more often (3-4 times) damage to women.It is generally recognized that the most important moments are an increase in the BCC (volume of the circulating blood) and the compression of the pregnant uterus retroperitoneal veins.In the meantime, the results of epidemiological studies show that only the second and subsequent pregnancy leads to a reliable increase in the frequency of varicose veins by 20-30%.At the same time, the first signs of the disease already occur in the 1st trimester of pregnancy if a strong increase in the BCC or an increase in the pregnant uterus does not yet occur.
obesity- The proven risk factor for varicose veins.At the same time, an increase in body weight index leads to 27 kg/m2 and above it 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 features.A high degree of food processing and reduction in the diet of raw vegetables and fruit led to a constant lack of plant fibers, which was necessary for the redesign of the venous wall and chronic constipation, which leads to a permanent increase in the intra abdominal pressure.
LifeIt has a significant influence on the development and course of varicose veins.In particular, the adverse effect was proven by long-term static loads with lifting weights or a motionless stay in the standing and seating position.In Asian countries, the more frequent use of chairs and chairpersons in the European part of the population led to a reliable (3-4 times) increase in the frequency of varicose veins compared to people who traditionally sit in mats.
Special conditionsTake part in the pathogenesis of varicose veins.Her role in recent years has increasingly increased, which is due to the broad use of hormonal contraceptives.The popularization of hormone replacement therapy in the time in the treatment of osteoporosis.It has been proven that estrogens and progesterone as well as their derivatives reduce the tone of the venous wall due to the gradual destruction of collagen and elastic fibers.
Clinical image of varicose veins
Varicose veins are an illness that is not indifferent to the beautiful gender.A varicose veins of the female veins are sick on average three times more often than men.
Signs of varicose veins are notted extensions of subcutaneous veins, pain, severity in the legs, swelling of the foot and lowerbone, tiredness in the legs until the end of the day.Cramp nodes are often susceptible to the formation of blood clots and infections.Flebitis can develop - inflammation of blood vessels or thrombophlebitis - inflammation of blood vessels that are complicated by blood clots.In the course of the veins there are hard, very painful cables.The skin changes, loses its elasticity and it becomes tight, dark brown.Urbanities occur in simple injuries.A young woman can become a disabled person at the age of 40.
These are the symptoms you should draw attention - 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 when walking
- Pain along the venous tribes,
- General pain and pain in the legs.
- Swelling in the legs.
- A feeling of bursts and heaviness in the legs.
- Skin changes.First, the skin becomes dry, pigmentation appears - the skin of the legs darker, covered with brownish "stains".Later, various dermatitis, eczema and the so -called trophic disorders in the form of poorly healing wounds to the formation of ulcers can combine these symptoms.
- A tangled, elongated varicose veins that protruded over the skin surface 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 earliest stages of the development of varicose veins are very difficult to recognize and diagnosed, since there is no main feature in the very early stages of the disease - varicose veins.And the first and earliest symptoms of varicose veins, such as the feeling of the severity of the legs, moderate pain in the legs, increased tiredness, are also found with the early stages of arterial diseases, flat feet, lumbar osteochondrosis.
In such difficult cases, it is impossible to make the right diagnosis yourself.It is also necessary for instrumental diagnostic methods with high diagnostics such as ultrasound or phlebography.
The very first symptoms of varicose veins of the legs, on which you can assume the inserting of varicose veins, are an increase in the vein pattern on the skin of the legs.This defect, as we have already determined, mostly found mostly young women: They notice wreaths on their legs or hips that were not previously present.There may be no other complaints at the beginning of the varicose veins.
And often such symptoms of an initial disease disease are preceded by the occurrence of pain and other unpleasant sensations.Often the first "finds" of Venen are not accompanied by absolutely no unpleasant sensations.
The beginning of the development and progress of varicose veins is already manifested by standing out above the skin surfaceCramp.One or more.This is the main symptom of the beginner's disease.Frares can most often be detected on the inner surface of the legs or hips.With long walking or a long look, such a symptom for varicose veins manifests itself asFatigue, heavy in the legs, a feeling of bursting(often - in calves).These symptoms manifest themselves particularly clearly with a longer stay in a seated or standing position.There is also painful or acute pain in places of varicose veins (extended veins), cramps in the calf muscles, especially in the evening and sometimes at night.
The first signs of a functional disorder in the veins are manifested andSwelling of the legs until the end of the day.Edema usually occurs in the evening, especially after a long standing.After the night's rest, swelling disappears completely.
These symptoms of disease extension go through quickly when they relax, especially if they lie down.However, the disappearance or a significant decrease in these symptoms when walking and after the night's sleep are very characteristic of symptoms of disease diseases.
But varicose veins, if they are seriously not engaged, do not withdrawProgress.Over time, such symptoms of varicose veins have asConquered dark blue intradal veins, excellent above the skin surface of the legs and feet and similar to the clusters red grapes.All of this is accompaniedburst in pain in the legs and calves, a feeling of heat in the legs, nightly cramps in the calf muscles, swelling.Gradually tie up these symptomsSkin changes.At first the skin becomes dry, it darkens, a pigment appears on it - brown spots.A little later is the so -called soTrophic disorders: Bad healing wound explosions and even ulcers.
painThey start to disturb more and more, especially in the afternoon or in the evening.
Diagnosis
The most important affordable methods for diagnosing varicose veins are currently:
- Ultrasonic topping.The most common method for the primary diagnosis of diseases of the veins of the lower extremities is today ultrasound dopperography.This method is based on the effect of the Doppler, which is that ultrasound waves that flow through the fabrics are reflected from the movement of blood cells and their frequency.They reproduce highly sensitive sensors that fix these changes with a special device in the form of sound signals that are similar to the noise of the wind or a graphic curve.
- With the duplex (two -dimensional) scan you can record the image of a venous vessel on the monitor screen in real time with the evaluation of the blood flow.With triplex (three -dimensional) you can also get a color image of the blood flow.
- Phlebography.Flebography is a radiopaque study with veins that and in some cases the decisive diagnostic method for examining patients with veins and mainly in the event of their complications.
Treatment of varicose veins
The successful solution to the problem of treating varicose veins consists of the sequential implementation of the following tasks:
- Elimination of varicose veins;
- Elimination of signs of HVN;
- Prevention of progress and relapse of the disease.
Possibilities for treating varicose veins:
- Compression therapy;
- Conservative therapy;
- Surgical treatment (phlebectomy);
- Sclerotherapy.
First, try to treat varicose veins with conservative methods.Strictly speaking, this is not a method for treating varicose veins.All conservative methods in the "treatment of varicose veins" are initially aimed at the prevention of the disease and their complications.Conservative methods are also the only possible therapy if the patient has serious contraindications for other treatment methods or if the patient rejects the surgical treatment of varicose veins.The radical elimination of the cramp syndrome is only possible surgically, at the same time the functional result of the treatment of great importance, which implies the elimination or minimization of HVN manifestations.
The treatment of varicose veins should be complex and individual, mostly conservative and surgical treatment.The doctor can only recommend the method for treating varicose veins based on his experience, but the decision always remains you