Varicose veins of the lower extremities or varicose veins of the lower extremities - the expansion of surface veins, accompanied by valve 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 of working age.
Risk factors for the development of varicose veins
Heredity and its role in the development of varicose veins are not found unambiguous confirmation.One of the main counterarguments of the presence of a genetic predisposition is the different frequency of varicose disease in ethnic Africans and their fellow tribesmen who emigrated to the United States and the countries of Western Europe.Moreover, in comparison with sedentary fellow tribesmen, the frequency of varicose veins, which does not exceed 0.5%, emigrants have a reliable incidence increase of 10-20%.In this regard, the conclusion is obvious about the varicose disease of environmental factors, the characteristics of the lifestyle and nutrition.
PregnancyIt is traditionally considered one of the main risk factors for the development of varicose veins, in particular, more frequent (3-4 times) damage to women.It is generally accepted that the main provoking moments are an increase in the BCC (volume of circulating blood) and the compression of the pregnant uterus of retroperitoneal veins.Meanwhile, the results of epidemiological studies indicate that only the second and subsequent 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 appear already in the 1st trimester of pregnancy, when a sharp increase in 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 the body weight index to 27 kg/m2 and above leads to an increase in the frequency of the disease by 33%.
The high frequency of varicose veins in industrialized countries is 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 plant fibers necessary for remodeling of the venous wall and chronic constipation, which cause permanent increase in intra -abdominal pressure.
LifeIt 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 proved.In Asian countries, the more frequent use of chairs and chairs in the Europeanized part of the population led to a reliable (3-4 times) increase in the frequency of varicose veins compared to people who are traditionally sitting in mats.
Special conditionsparticipate in the pathogenesis of varicose veins.Their role in recent years has progressively increasing, which is due to the wide use of hormonal contraception means, the popularization of hormone replacement therapy in the period in the treatment of osteoporosis.It is proved 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 picture of varicose veins
Varicose veins is a disease that is not indifferent to the beautiful sex.A varicose veins of the female veins are sick on average three times more often than men.
Signs of varicose veins are knotted extensions of subcutaneous veins, pain, severity in the legs, swelling of the foot and lower leg, fatigue in the legs by the end of the day.Varicose nodes are often prone to the formation of blood clots and infection.Flebitis may develop - inflammation of blood vessels or thrombophlebitis - inflammation of blood vessels complicated by blood clots.In the course of the veins there are hard, very painful cords.The skin changes, loses its elasticity and color-it becomes dense, dark brown.With easy injury, ulcers occur.A young woman can become a disabled person at the age of 40.
These are the symptoms should make you be alert - 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 trunks,
- General pain and ache in the legs.
- Swelling in the legs.
- A sense of bursting and heaviness in the legs.
- Skin changes.At first, the skin becomes dry, pigmentation appears - the skin of the legs darkens, covered with brownish “spots”.Later, various dermatitis, eczema and the so -called trophic disorders in the form of poorly healing wounds up to the formation of ulcers can join these symptoms.
- A convoluted, elongated varicose veins protruding above the surface of the skin 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, since the causes of their appearance are the same.
The earliest stages of the development of varicose veins are very difficult to detect and diagnosis, because in the very early stages of the disease there is no main feature - varicose veins.And the first and earliest symptoms of varicose veins, such as the sensation of the severity of the legs, moderate pain in the legs, increased fatigue, are also found with the initial stages of arterial diseases, flat feet, lumbar osteochondrosis.
In such difficult cases, it is impossible to make the correct diagnosis itself - you will need a consultation of a doctor or even several specialists - a phlebologist, a neurologist, a surgeon and a manual therapist.High -precision instrumental diagnostic methods, such as ultrasound or phlebography, will also be required.
The very first symptoms of varicose veins of the legs, along which you yourself can suspect the onset of varicose veins, is an increase in the vein pattern on the skin of the legs.This defect, as we have already noted, most often noted by young women: on the legs or hips they notice wreaths, which were not there before.There may not be other complaints at the beginning of varicose veins.
And often, such symptoms of a beginning varicose disease precede the appearance of pain and other unpleasant sensations.Often the first “finds” of veins are not accompanied by absolutely no unpleasant sensations.
The onset of development and progression of varicose veins is already manifested by protruding above the surface of the skinvaricose nodes.One or more.This is the main symptom of the beginning varicose disease.Varicose nodes can be detected most often on the inner surface of the legs or hips.With long walking or prolonged standing, such a symptom of varicose veins is manifested asfatigue, heaviness in the legs, a sense of bursting(often - in calves).These symptoms are especially clearly manifested with prolonged stay in a sitting or standing position.There is also aching or acute pain in places of varicose veins (dilated veins), convulsions in the calf muscles, especially in the evening, and sometimes at night.
The first signs of dysfunction in the veins are manifested andswelling of the legs to the end of the day.Edema usually occurs in the evening, especially after prolonged standing.After night rest, swelling completely disappear.
These symptoms of varicose expansion initially quickly pass, if you relax, especially if you lie down.However, the disappearance or significant decrease in these symptoms when walking and after night rest are very characteristic of varicose disease symptoms.
But varicose veins, if they are seriously not engaged, does not retreat,progressing.Over time, such symptoms of varicose veins asConquered dark blue intradermal veins, protruding above the surface of the skin of the legs and feet and similar to the clusters of red grapes.All this is accompaniedbursting with pain in the legs and calves, a feeling of heat in the legs, nightly convulsions in the calf muscles, swelling.Gradually join these symptomsskin changes.At first the skin becomes dry, it darkens, a pigment appears on it - brown spots.A little later the so -calledTrophic disorders: poorly healing wounds-explosions and even ulcers.
PainThey begin to bother more and more often, especially in the afternoon or in the evenings.
DIAGNOSTICS
Currently, the main affordable methods for diagnosing varicose veins are:
- Ultrasound dopplerography.The most common method of primary diagnosis of diseases of the veins of the lower extremities is today ultrasound dopplerography.This method is based on the effect of the doppler, which consists in the fact that ultrasonic waves passing through the fabrics are reflected from moving blood cells and change their frequency.Highly sensitive sensors, fixing these changes, reproduce them with a special device in the form of sound signals resembling the noise of the wind, or a graphic curve.
- The duplex (two -dimensional) scan allows you to record the image of a venous vessel on the monitor screen in a real time with the assessment of blood flow in it.Triplex (three -dimensional) scan, in addition to the above, allows you to get a color image of blood flow.
- Phlebography.Flebography is a radiopaque study of veins, which has been, and in some cases remains, the decisive diagnostic method of examining 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 is made up of the sequential implementation of the following tasks:
- Elimination of varicose veins;
- Elimination of signs of HVN;
- Prevention of progression and relapse of the disease.
Ways to treat varicose veins:
- Compression therapy;
- Conservative therapy;
- Surgical treatment (phlebectomy);
- Sclerotherapy.
First of all, they try to treat varicose veins with conservative methods.Strictly speaking, this is not a method of treating varicose veins.All conservative methods in the “treatment of varicose veins” are aimed, you first of all, at 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 refuses the surgical treatment of varicose veins.The radical elimination of varicose syndrome is possible only surgically, at the same time, the functional result of treatment is of great importance, which implies the elimination or minimization of the manifestations of HVN.
Treatment of varicose veins should be complex and individual, most often including conservative and surgical treatment.The doctor can only recommend the method of treating varicose veins based on his experience, but the decision always remains you