The varicose veins of the lower limbs are a persistent and irreversible expansion and extension of the veins, which occur as a result of coarse changes in their walls, as well as the insufficiency of their valve device due to a genetic defect.
The predisposition of women is explained by a cyclical increase in the extension of the walls of the veins with an increase in the concentration of the progesterone hormone.
Reasons
The main factors of varicose veins are the hereditary weakness of the vascular wall.
In addition, human lifestyle is of great importance in pathogenesis:
- Long, standing or seated work;
- lack of regular physical effort;
- Halterophilia;
- Reception of drugs containing estrogens.
The risk of varicose veins of the lower limbs increases with age.But more and more patients are under 30 years old.
Varice manifestations
Most often, with varicose veins, patients are concerned with the feeling of gravity, bursting, heat, itching skin, "anxiety" in the legs and pulsating pain and pain in the calf muscles.A characteristic of these signs is their appearance after a prolonged position.As a rule, unpleasant sensations completely pass or their intensity is considerably reduced during walking, in a lying position, after a night of rest or when using medical compression products.
An important sign of the disease is cramps in the muscles of the calf, generally occurring at night.
The subcutaneous veins develop in the form of convincing blue conglomerates along the leg and thigh.Unfortunately, there is an opinion that vascular stars are a manifestation of varicose veins.But it should be noted that this is not an absolute sign of the disease and in many ways a purely cosmetic problem.Such signs can be on the skin with varicose veins, but most of them are also in healthy people.
As varicose veins develop, violations of the skin of the skin of the lower leg develop.Initially, the excess coloring areas occur, a little later, a subcutaneous tissue and the skin are compacted, the latter acquires a characteristic "lacquered" appearance.In the center of the painted area of the skin, in response to a minimum injury, a small white area resembles startin drops.This is the atrophy of white skin if called, after which a trophic ulcer opens.
The skin of the skin of the skin is a sign of chronic venous deficiency, which also includes symmetrical edema on the legs.
Diagnosis
Ultrasonic scanning (coloring of the color duplex; triplex scan) - "Gold Standard" in the diagnosis of varicose veins of the veins of the lower limbs.A specialist in ultrasound must necessarily examine the vessels of the legs on both sides.It assesses their diameter, their compressibility, their characteristics of the blood flow and the value of the reflux (reverse blood flow).The evaluation of the work of the valves is carried out not only in the patient's position during the lie, but also.
Treatment of varicose veins of lower limbs
The same symptoms can be signs of various diseases and the disease may not occur depending on the manual.Do not try to be treated yourself - consult your doctor.
The modern treatment of varicose veins includes surgical intervention, sclerotherapy, compression treatment and the use of various drugs.
Operation
Surgical treatment is the only method to reliably improve quality of life, reduce the risk of complications and the probability of relapse of the disease.It consists in eliminating varicose veins.There are 2 types of interventions:
- Thermal prison - poorly invasive treatment method (without cuts) using a laser or radiofrequency sensor;
- Traditional surgery implies the excision of varicose veins.Currently, the technique of these interventions is sufficiently elaborate and allows you to obtain a good functional and cosmetic result.
Considered sclerotherapy separately as a surgical treatment method.It completes successfully and, in some cases, (the initial steps of varicose veins) replaces surgery.The procedure is the introduction of a special drug in a vein varicose vein, which glues it from the inside.
Varice compression treatment
Elastic bandages: advantages and disadvantages of
Compression therapy is a compulsory component of any method of treatment of varicose veins and the most effective method to prevent it.
For compression treatment, elastic bandages are most often used, which, depending on the degree of stretching, are divided into 3 classes:
- short (overlap of a bandage no more than 70% of the initial size);
- Average (increase in the initial length with stretching in the beach of 70 to 140%);
- Long extensibility (140% and more).
The classes are compulsory indicated on the bandage packaging, and they are the characteristic necessary for the right choice of the product.
It is advisable to use bandages of a long extensibility in the nearest postoperative period to stop the blood and the reliable fixing of the bandage.To guarantee the optimal therapeutic compression diet, short and medium extensibility bandages are the most suitable.
When you use elastic bandages, the following rules should be followed:
- The bandage is applied, pre-sewn the foot "on yourself", to prevent the formation of folds in the ankle area, which can damage the skin during the movement;
- The shovels always start from the finger joints of the foot and capture the heel;
- The pressure of the bandage must gently weaken from the ankle to the thigh;
- The bandage roll is not cut, while it is in the immediate vicinity of the skin;
- The modeling of the limid profile of the limb is carried out by placing foam or latex pads.
Most patients with varicose veins should use an elastic bandage throughout the day, applying it in the morning before getting up from bed and shooting at night before night.For the treatment of trophic ulcers, multilayer compression bandages can be used, not removed for a long time, while directly with the affected area of the lower leg skin are contacted by bandages impregnated with drug substances (zinc-wewatine and other dressings).
Despite the great efficiency, compression treatment with elastic bandages has obvious drawbacks - causing physical and aesthetic drawbacks, it is also very difficult for the elderly of flexible, observing all the rules.
Compression knitting
Special compression knits gain popularity.It is represented by stockings with lower, medium and upper thighs, as well as by tights (including special tights for pregnant women) of four compression classes.
These knittings are made of cotton, natural rubber - elastan and synthetic rubber.Natural fibers are optimal for sensitive and affected (Varic eczema, dermatitis, trophic disorders) of the skin.As for synthetic fibers, their advantages are a small diameter and a variety of colors that allow medical knitting with high aesthetic properties.
Varicose drug therapy
The main objectives of the drug are the elimination of subjective symptoms of venous insufficiency, as well as the prevention and reduction of the severity of side effects after surgical interventions.
One of the most commonly prescribed drugs is drugs with active substance diosmine.Usually, a week after the start of its reception, a positive dynamic appears: night cramps, pain, gravity passage, decrease in swelling.It is believed that the minimum course of the course should be at least 2 months.In serious forms of varicose veins, taking the drug can be continued up to six months or more.
Nails and gels
The simplicity of use and the relative cheap of ointments and gels make them very popular among patients and doctors.A serious drawback of the uncontrolled use of local drugs is a 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 prevention and in the absence of symptoms of a chronic vein disease.
Heparin products are some of the popular drugs.Used 3-4 times a day.At the start of use, a phenomenon of irritation and light coat in places of use of the drug is possible.
Additional therapy
In the Russian Federation, physiotherapeutic treatment methods are widespread.To fight against these symptoms of varicose veins of the lower limbs such as pain and cramps in calf muscles, you can use the electrical muscle stimulation method.Other physiotherapy methods have no evidence of the effectiveness of the treatment of this disease.
Varice prevention
The rational organization of work and rest is necessary for all patients in varicose veins.This category of patients is not recommended for work associated with a long stay in a standing or sitting position, lifting weights and the effects of high temperature.At work and at home, they need periodic holidays with 15 to 20 degrees raised at an angle of 15 to 20 degrees (during sleep, it is recommended to lift the end of the foot above the level of the heart), rational nutrition, excluding the consumption of spicy and salty foods, as well as alcohol.Body weight must be strictly controlled, because obesity leads to the progression of the disease.
Under elastic compression conditions, mobile sports (skiing, cycling) are however authorized, optimal conditions for venous flow and muscle training of the lower limbs are provided by swimming.