Varicose veins of the lower limbs is a chronic disease veins, which is characterized by a thinning of their walls, the extension of the level, and even the formation of aneurysm-sicut nodes. Most often varicose veins disease affecting the lower limbs; it is one of the most common diseases – you suffer from about 40% women and 20% men.
Causes and risk factors
In the veins of the lower limbs, the blood that flows towards the top, i.e. it must overcome the force of gravity. This current is supplied pressure located near the veins of the tendons and the residual pressure of the blood. The movement of blood in the veins of the lower limbs and promotes a "muscle pump": during the movement of the muscles of the legs contract, and tightening the veins, placebat ei beating is in their blood at the top, because they prevent the backflow venous valves.
The weakness in the muscular layer of the venous wall and valvular insufficiency of the machine becomes the cause of what is under the influence of actions "muscle pump," the blood begins to flow in the opposite direction, i.e. towards the bottom. This leads to an increase of the pressure on the walls of the blood vessels, further progression of the insufficiency of the valves, the expansion of the lumen of the veins and the formation of knots. The muscle fibers of the vein wall atrophy, disrupted nervous receptors which regulate venous tone, which, in turn, still more solicitous manifestations of venous insufficiency.
The factors of risk of development of varicose disease of lower limbs:
- hereditary predisposition;
- pregnancy;
- obesity;
- daily long stay in a sitting position or standing;
- activities associated with the lifting of heavy loads;
- systematic wearing of tight clothing, corsets;
- the wrong food with insufficient content in the diet of dietary fiber and vitamins;
- the violation of hormonal level.
In the prevention of varicose vein disease significant active role activities: sport (swimming, cycling, fitness), dance, hiking, etc
Forms of the disease
On the basis of the characteristics of the clinical manifestations, distinguish the following forms of varicose veins of the lower limbs:
- segmental defeat intradermal and subcutaneous veins with the absence in them of reversing the flow of blood;
- segmental defeat of the veins of the lower limbs, accompanied by a pathological current of the blood;
- the town of the defeat of the blood vessels with the reverse current of blood in the surface veins;
- municipality of defeat of blood, accompanied by a pathological rejection of blood to the deep venous system.
The initial phase of the disease
In 2000, the russians called phlebologists is adopted the classification of varicose vein disease of the lower extremities, taking into account the form of the disease, the degree of venous insufficiency, the presence or absence of complications. According to her, there are three stages of varicose disease of lower limbs:
- The phase of payment. The sick do not have any complaints. During the course of an inspection of one or both legs, found the surface located on the advanced of vienna.
- The Stage subcompensation. Patients complain of nocturnal leg cramps, impairment of sensitivity (paresthesia) in the legs, feeling of fullness. In the evening there is often swelling of the legs, ankles and feet, disappears after a night of sleep. During the inspection of the feet clearly visible, advanced varicose veins.
- Phase of decompensation. As described above, in the present, unite eczema, dermatitis. Skin stains, dry, shiny, closely connected with the subcutaneous tissue.
The symptoms
The clinical picture of varicose disease of the lower limbs determined stage of the disease. So, when the stadium is plywood the only symptom of venous insufficiency – the appearance of varicose veins on legs (telangiectasias).
The passage of the disease in subcompensated stage is accompanied by the emergence of leg pain, swelling stop, and ankles, cramps in the calf of the leg. After resting in the horizontal position, these symptoms stop.
The more clearly the clinical presentation of varicose veins of the lower limbs is manifested in decompensated initial phase of the disease. Leg pain become permanent. The patients complain of itching of the skin, which intensifies in the evening hours and into the night. With the passage of time to occur dermatitis, eczema, hardhealed wounds. Called to the stage there are the most common symptoms: dizziness, low blood pressure. They are associated with a deposit in advanced of the venous network of the legs, a considerable quantity of blood.
Complication of varicose vein disease is phlebitis, tromboflebita, bleeding of the varicose veins and nodes, sores, pulmonary embolism.
Diagnostics
The diagnosis of varicose vein disease of the lower limbs is not difficult. She is made on the basis of specific clinical signs of the disease, and data of objective inspection.
To assess the severity of the violations of hemodynamics, techniques of instrumental diagnostics:
- Doppler ultrasound of the veins of the lower limbs;
- duplex angioscanning;
- rheovasography of the lower limb veins.
Treatment
In the treatment of varicose vein disease of the lower limbs according to the testimony, the following techniques or a combination of them:
- the conservative therapy;
- sclerosing therapy;
- surgery.
Conservative therapy of varicose disease of the lower limbs may be recommended for patients in the early stages of the disease, with the aim of preventing the progression of chronic venous insufficiency. It is also used when subcompensated and decompensated stages of the disease in the period of preparation of the patient for surgery or in those cases, when the use of other methods is contraindicated. Conservative therapy of varicose veins is based on the application of phlebotonics, wear compression stockings. In addition, patients are advised to do regular physical therapy to avoid long static loads.
For varicose veins of the lower limbs, not complicated significant hemodynamic impairment, can be used in the compression, sclerotherapy. The essence of the method is managed in the skin vienna of the drug, its spasm. Then on the leg to wear compression stocking or make the leg wrap of an elastic bandage, which allows you to keep the walls of the veins in dormientes degree. In a few days begins the process of bonding the walls of the veins. Compression underwear to wear after sclerotherapy is not less than a month and a half, up to the time of the formation between the walls of the vein enough dense adhesions.
In the execution of the initial stages of varicose disease of the lower limbs, the most effective method of surgery. The operating technical technical evaluated, on the basis of the stage of the disease, its form, the characteristics of the hemodynamic violations:
- laser coagulation;
- radiofrequency coagulation;
- miniphlebectomy;
- flebectomia.
The possible complications and consequences
Complications of varicose vein disease develop mainly in the phase of decompensation. These include:
- phlebitis (inflammation extended of vienna);
- thrombophlebitis (inflammation of a vein with the formation in its lumen, of blood clots);
- bleeding of the varices and of the nodes;
- sores;
- pulmonary embolism (PE).
Most often varicose veins disease affecting the lower limbs; it is one of the most common diseases – you suffer from about 40% women and 20% men.
Forecast
The prognosis of varicose vein disease of the lower limbs during the treatment in a timely manner a good omen.
Prevention
With the aim of preventing varicose veins of the lower limbs is necessary to avoid long static loads. If the job requires a long stay in the upright or sitting position, periodically take breaks in a small gym, or at least walk. After a day of work it is recommended that you lie down, giving the foot a horizontal or elevated position.
In the prevention of varicose vein disease significant active role activities: sport (swimming, cycling, fitness), dance, hiking, etc