The predisposition of women is explained by a cyclical increase in the extension of the walls of the veins and the softening of the valves with an increase in the concentration of the hormone progesterone.
Causes:
The primary factors of varicose veins - hereditary weakness of the vascular wall.
In addition, the way of human life is of great importance in the pathogenesis:
- long -term work, standing or sitting;Estrogen -containing drugs.
- 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.
- Manifestations of varicose veins:
- Most often, with varicose veins, the feeling of severity, bursting, heat, itching of the skin, “anxiety” in the legs and aching, pulsating pain in the shameful muscles are concerned.A characteristic feature of these signs is their appearance after prolonged standing.As a rule, unpleasant sensations are completely passing or their intensity is significantly reduced when walking, in the position of lying down, after a night's rest or when using medical compression products.
An important sign of the disease is cramps in the calf muscles that usually occur at night.
The subcutaneous veins expand in the form of convoluted blue conglomerates on the lower leg and thigh.Unfortunately, there is an 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 respects a purely cosmetic problem.Such signs can be on the skin with varicose veins, but for the most part are also found in healthy people.
Важным признаком заболевания являются судороги в икроножных мышцах, возникающие обычно в ночное время.
Подкожные вены расширяются в виде извитых синих конгломератов по голени и бедру. К сожалению, бытует мнение, что сосудистые звездочки являются проявлением варикозного расширения вен. Но стоит отметить, это не абсолютный признак заболевания и во многом чисто косметологическая проблема. Такие признаки могут быть на коже при варикозе, но по большей части встречаются и у здоровых людей.
As varicose veins develop, violations of the skin of the skin of the lower leg develop.Initially, areas of excess staining occur, a little later subcutaneous tissue and skin are compacted, the latter acquires a characteristic “lacquered” look.In the center of the painted area of the skin, in response to a minimum injury, a small white area appears, resembling Starin's Subtle.This is the so -called white skin atrophy, after which a trophic ulcer opens.
Disruption of the skin of the skin is a sign of chronic venous insufficiency, which also includes symmetrical edema on the legs.
Diagnostics:
ultrasound (colored duplex scanning; triple scan) - “golden standard” in the diagnosis of varicose veins of the lower extremities.An ultrasound specialist must necessarily examine the vessels of the legs on both sides.He evaluates their diameter, compressibility, characteristics of blood flow and the value of reflux (reverse blood flow).The assessment of the valves of the veins is carried out not only in the position of the patient lying, but also standing.
X -ray and contrast phlebography were previously considered the main methods of instrumental diagnosis of varicose veins, but at present they have remained far in the past.
Treatment of varicose veins of the lower extremities:
The same symptoms can be signs of various diseases, and the disease may not proceed according to the textbook.Do not try to be treated yourself - consult your doctor
Modern treatment of varicose veins includes surgical intervention, sclerotherapy, compression treatment and use of various drugs.
Operation
Surgery is the only method to reliably improve the quality of life, reduce the risks of complications and the likelihood of a relapse of the disease.It consists in removing varicose veins and eliminating pathological reverse currents.There are 2 types of interventions:
- Thermal prison - a minimally invasive (without cuts) method of treatment, which consists in the “adhesion” of the vein from the inside with a laser or radio frequency sensor.
- Traditional surgical intervention involves excision of varicose extended subcutaneous veins.Currently, the technique of such interventions is sufficiently worked out and allows you to get a good functional and cosmetic result.
Separately considered sclerotherapy as a method of surgical treatment.It successfully complements, and in some cases (the initial stages of varicose veins) replaces surgery.The procedure consists in the introduction of a special drug into a varicose vein, which glues it from the inside.
Compression treatment of varicose veins
Elastic bandages: Pros and cons
Compression therapy is a mandatory component of the treatment of varicose veins and the most effective method of its prevention.
For compression treatment, elastic bandages are most often used, which depending onThe degrees of stretching are divided into 3 classes:
- short (a bandage of a bandage not more than 70 % of the original size),
- average (the range of increase in the initial length with stretching in the range of 70–140 %),
- long (140 % and higher) stretchability.
The classes are mandatory indicated on the packing of the bandage, and they are the necessary characteristics for the proper choice of the product.
Bints of long extensibilityIt is advisable to use in the nearest postoperative period in order to stop blood and reliable fixation of the bandage.To ensure the optimal therapeutic compression regime, bandages of short and medium extensibility are most suitable.
When using the elastic bandage, the following rules should be followed:
- The bandage is applied by previously stretching the foot “on themselves”, to prevent the formation of folds in the ankle area, which can damage the skin during movement.
- Binting always start from the joints of the fingers and capture the heel.
- The bandage pressure should smoothly weaken from the thigh.At the same time, it is in the immediate vicinity of the skin.
- Modeling of the cylindrical profile of the limb is achieved by laying foam or latex pads.
- Most patients with varicose veins should use the elastic bandage throughout the day, applying it in the morning before lifting from bed and taking off in the evening before night rest.For the treatment of trophic ulcers, multi-layer compression bandages can be used that are not removed for a long time, while directly with the affected area of the skin of the lower leg, bandages impregnated with drug substances (zinc-dimensional, zinc oxygen, etc. Dressings).Additional fixation of compression bandages is carried out with the help of special sticky bandages.
Despite the high efficiency, compression treatment with elastic bandages has obvious disadvantages - causing physical and aesthetic inconvenience, in addition to the elderly, it is very difficult for the older people to bint themselves, observing all the rules.
Compression knitwear
A special compression knitwear is gaining wide popularity.It is represented by stockings to the lower, middle and upper thighs, as well as tights (including special tights for pregnant women) of four compression classes.
Such knitwear is made of cotton, natural rubber - elastan and synthetic rubber.Natural fibers are optimal for sensitive and affected (varicose eczema, dermatitis, trophic disorders) of the skin.As for synthetic fibers, their advantages are a small diameter and variety of colors that allow medical knitwear with high aesthetic properties.
Drug therapy of varicose veins
The main goals of drug therapy are the elimination of the subjective symptoms of venous insufficiency, as well as the prevention and reduction of the severity of side effects after surgical interventions. The main drugs.For the treatment of varicose veins, drugs similar in their properties serve.They should be taken only under the control of the attending physician.According to research, the safety of the use of such drugs has been proved only for short therapy courses.In the case of use in longer terms, it is possible to appear not severe, but unpleasant side effects, for example, gastrointestinal disorders.
Основными препаратами для лечения варикозного расширения вен служат сходные по своим свойствам препараты. Их следует принимать только под контролем лечащего врача. Согласно исследованиям безопасность применения таких лекарств доказана лишь при коротких курсах терапии. В случае применения в более длительные сроки возможно появление не тяжелых, но неприятных побочных эффектов, например, желудочно-кишечных расстройств.
Usually, a week after the start of its reception, a positive dynamics appear: night cramps, pain, severity pass, swelling decrease.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 be continued up to six months or more.
Ointments and gels
Simplicity of use and relative cheapness of ointments and gels make them very popular among patients and doctors.A serious disadvantage of the uncontrolled use of local drugs is the high frequency of skin complications in the form of peeling, dermatitis and eczema caused by increasing sensitivity with prolonged use of the same remedy. Therefore, it is extremely not recommended to use local drugs (ointments, gels, cream) as a prevention and in the absence of symptoms of chronic veins.
.At the beginning of use, mild skin irritation and peeling phenomenon in the places of use of the drug are possible.
Additional therapy
Physiotherapeutic treatment methods are widespread in some countries.To combat such symptoms of varicose veins of the lower extremities as pain and cramps in the calf muscles, you can use the method of electrical stimulation of the muscles of the legs.Other methods of physiotherapy have no evidence of the effectiveness of the treatment of this disease.
Prevention of varicose veins:
rational organization of labor and relaxation is necessary for all patients in varicose veins.This category of patients is not recommended for work associated with a long stay in the standing or sitting position, lifting weights, and the effects of high temperature.At work and at home, they need a periodic vacation with 15–20 degrees raised at an angle of 15–20 degrees (during sleep it is recommended to raise the foot end of the bed above the level of the heart), rational nutrition, excluding the consumption of spicy and salty foods, as well as alcohol.The body weight should be strictly controlled, since obesity leads to the progression of the disease.
In conditions of elastic compression, it is allowed to do with mobile sports (skiing, cycling), however, optimal conditions for venous outflow and muscle training of the lower extremities are provided by swimming.