The varicose veins of the lower extremities or the varicose veins of the lower extremities: the expansion of the superficial veins, accompanied by valve failure and deteriorated blood flow.
This is the most common disease of peripheral vessels.According to epidemiological data, there are several forms of this disease in 26-28% of women and 10-20% of working men.
Risk factors for the development of varicose veins
The inheritance and their role in the development of varicose veins are not unequivocal confirmation.One of the main arguments of the presence of a genetic predisposition is the different frequency of varicose disease in ethnic Africans and their fellow tribes that emigrated to the United States and the countries of Western Europe.In addition, compared to sedentary tribes, the frequency of varicose veins, which does not exceed 0.5%, emigrants have an increase in reliable incidence of 10-20%.In this sense, the conclusion is obvious about the predominance of varicose veins in the pathogenesis of environmental factors, the characteristics of lifestyle and nutrition.
Pregnancy is traditionally considered one of the main risk factors for the development of varicose veins, justifying, in particular, the most frequent damage (3-4 times) to women.In general, it is accepted that the main provocative moments 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 second and posterior pregnancies lead to a reliable increase in the frequency of varicose veins by 20-30%.At the same time, the first signs of the disease already appear in the first trimester of pregnancy, when there is still a strong increase in BCC or an increase in pregnant uterus.
Obesity is a proven risk factor for varicose veins.At the same time, an increase in the body weight index at 27 kg/m2 and higher leads to an increase in the frequency of the disease by 33%.
The high frequency of varicose veins in industrialized countries is due, to some extent, due to nutritional characteristics.A high degree of food processing and reduction in the diet of raw vegetables and fruits led to a constant deficiency of the plant fibers necessary for the remodeling of the venous wall and chronic constipation, which cause a permanent increase in intra -abdominal pressure.
The lifestyle has a significant impact on the development and course of varicose veins.In particular, the adverse effect of long -term static loads with lifting weights or a motionless stay in the standing and sitting position has been demonstrated.In Asian countries, the most frequent use of chairs and chairs in the European part of the population led to a reliable increase (3-4 times) in the frequency of varicose veins compared to people who are traditionally sitting in the mats.
Hormonal disorders are involved in the pathogenesis of varicose veins.Its role in recent years has increased progressively, which is due to the wide use of hormonal contraception stockings, the popularization of hormonal replacement therapy in the period before menopause and the treatment of osteoporosis.It is demonstrated that estrogens and progesterone, as well as their derivatives, reduce venous wall tone due to gradual destruction of collagen and elastic fibers.
Clinical image of varicose veins
Varicose veins is a disease that is not indifferent to beautiful sex.A varicose veins of the female veins are sick on average three times more often than men.
The signs of the varicose veins are knotted extensions of subcutaneous veins, pain, severity in 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 prone to the formation of blood clots and infection.Flebitis can develop - inflammation of blood vessels or thrombophlebitis - inflammation of blood vessels complicated by blood clots.In the course of the veins there are hard and very painful laces.The skin changes, loses its elasticity and color, becomes dense, dark brown.With easy lesions, ulcers occur.A young woman can become a disabled person at the age of 40.
There are obvious symptoms that should make it alert.
Symptoms of varicose veins
- Pain.The causes of pain in the 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 trunks,
- General pain and leg pain.
- Swelling on the legs.
- A feeling of burst and heaviness in the legs.
- Skin changes.At first, the skin dries, pigmentation appears: the skin of the legs darkens, covered with "spots".Later, several dermatitis, eczema and trophic disorders called in the form of poorly healing wounds to the formation of ulcers can join these symptoms.
- A complicated and elongated varicose veins that stand out on the surface of the skin of the legs and feet, with a similar bag, cylindrical or mixed extensions.
- Vascular stars (tealesia).Yes, people with varicose veins are also included in the group of patients with the expansion of small veins, since the causes of their appearance are the same.
The early stages of the development of varicose veins are very difficult to detect and diagnosis, because in the early stages of the disease there is no main characteristic: varicose veins.And the first and first symptoms of varicose veins, such as the sensation of the severity of the legs, moderate pain in the legs, the increase in fatigue, also encounter the initial stages of arterial diseases, flat feet, lumbar osteochondrosis.
In such difficult cases, it is impossible to make the correct diagnosis in itself (you will need to consult a doctor or even several specialists, phlebologist, neurologist, surgeon and manual therapist. Also required high -precision instrumental diagnostic methods, such as ultrasound or phlebography.
The first symptoms of the varicose veins of the legs, along which you can suspect the beginning of the varicose veins, is an increase in the pattern of the vein in the skin of the legs.This defect, as we have already pointed out, more frequently indicated by young women: in the legs or hips they notice crowns, which were not there before.There may be no other complaints at the beginning of varicose veins.
And often, such symptoms of an initial varicose disease precede the appearance of pain and other unpleasant sensations.Often, the first "findings" of veins are not accompanied by absolutely any unpleasant feeling.
The beginning of the development and progression of varicose veins is already manifested by varicose nodes that stand out on the surface of the skin.One or more.This is the main symptom of the initial varicose disease.Varicose nodes can be detected more frequently on the internal surface of the legs or hips.With a long walk or prolonged position, a symptom of varicose veins such as fatigue, severity in the legs, a feeling of burst (often in calves) is manifested.These symptoms are especially manifested with a prolonged stay in a sitting or standing position.There is also painful or acute pain in varicose veins (dilated veins), seizures in calf muscles, especially at night and sometimes at night.
The first signs of dysfunction in the veins are also manifested by the swelling of the legs until the end of the day.Edema usually occurs at night, especially after a long position.After the night, the swelling disappears completely.
These symptoms of varicose expansion initially pass rapidly, if it relaxes, especially if you lie.However, the disappearance or significant decrease in these symptoms when walking and after the night rest are very characteristic of the symptoms of varicose disease.
But the varicose veins, if they are seriously involved, does not retire, progresses.Over time, such symptoms of the varicose veins seem convincing to the intradermal veins of dark blue, which stand out on the surface of the skin of the legs and feet and similar to the groups of mature red grapes.All this is accompanied by pain in the legs and calves, a sensation of heat on the legs, night seizures in the calf muscles, swelling.Little by little, skin changes bind to these symptoms.At first, the skin dries, darkens, a pigment appears: brown spots.A little later, the so -called trophic disorders begin to join: poorly healing explosions and even ulcers.
The pain begins to bother more and more often, especially in the afternoon or in the afternoon.
Diagnosis
Currently, the main affordable methods to diagnose the varicose veins are:
- Ultrasound dopplerography.The most common method of primary diagnosis of diseases of the lower extremities is today the ultrasound dopplerography.This method is based on the effect of the Doppler, which consists of the fact that the ultrasonic waves that pass through the fabrics are reflected from the blood cell movement and change their frequency.The highly sensitive sensors, setting these changes, reproduce them with a special device (dopplerography) in the form of sound signals that resemble the noise of the wind, or a graphic curve.
- The duplex angiography (two dimensional) allows you to register an image of a venous vessel on the real -time monitor screen with a Doppler evaluation of the blood flow in it.Triplex angiography (three dimensional), in addition to the previous one, allows you to obtain an color image of the blood flow.
- PhlebographyFlebography is a radiopaco vein study, which has been, and in some cases remains, the decisive diagnostic method to examine patients with veins and, mainly in the case 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;
- HVN signs elimination;
- Prevention of the progression and relapse of the disease.
Ways to treat varicose veins
- Compression therapy;
- Conservative therapy;
- Surgical treatment (phlebectomy);
- Sclerotherapy.
First, they try to treat varicose veins with conservative methods.Strictly speaking, this is not a method to treat varicose veins.All conservative methods in the "treatment of varicose veins" are directed, in the first place, in 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 rejects the surgical treatment of varicose veins.The radical elimination of varicose syndrome is only possible, at the same time, the functional result of the treatment is of great importance, which implies the elimination or minimization of HVN manifestations.
The treatment of varicose veins should be complex and individual, more frequently that includes conservative and surgical treatment.The doctor's doctobologist can only recommend the method of treating varicose veins based on your experience, but the decision always remains with you.