The varicose veins of the lower extremities are a continuous and irreversible extension and extension of the veins, which occurs as a result of gross changes in their walls, as well as the insufficiency of their valve apparatus due to a genetic defect.
Women's predisposition is explained by a cyclical increase in vein wall extension with an increase in the concentration of hormone progesterone.
Reason
The main factors of varicose veins are the inherited vascular wall weakness.
Moreover, human lifestyle is of great importance in pathogenesis:
- long, standing or sitting;
- lack of regular physical exercise;
- lifting weight;
- The reception of estrogen -containing medicines.
The risk of varicose veins of the lower extremities increases with age.But more and more patients are younger than 30 years old.
The manifestations of varicose veins
Most often, with varicose veins, patients are concerned about the feeling of severity, explosion, heat, itching, "anxiety" in the legs and pain, pulsating pain in the beef muscles.A characteristic feature of these signs is their appearance after prolonged posture.As a rule, unpleasant sensations are completely passing or their intensity decreases significantly when walking, in a lie position, after a night's rest or when using medical compression products.
An important sign of the disease is cramps in the calf muscles, which usually occur at night.
The subcutaneous veins are expanding in the form of convincing blue conglomerates along 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 they are found in healthy people.
As varicose veins develop, violations of the skin of the lower leg develop.Initially, excessive coloring areas occur, a little later the subcutaneous tissue and the skin are compressed, the latter gain a characteristic "varnished" appearance.In the center of the painted skin area, in response to minimal injury, a small white area resembles stars.This is the so -called white skin atrophy, after which a trophic ulcer opens.
Violation of the skin of the skin is a sign of chronic venous deficiency, which also includes symmetrical edema in the legs.
Troubleshooting
Ultrasound scan (Duplex color scan; triple scan) - "golden standard" in diagnosing varicose veins of lower extremities.An ultrasound specialist must necessarily examine the foot vessels by both sides.It evaluates their diameter, compressibility, blood flow characteristics and reflux value (reverse blood flow).The evaluation of the work of the VA valves is performed not only in the position of the patient while lying, but also on foot.
Treatment of varicose veins of lower extremities
The same symptoms can be signs of various diseases, and the disease may not occur according to the textbook.Do not try to treat yourself - consult your doctor.
Modern varicose vein treatment includes surgical intervention, sclerotherapy, compression treatment and the use of various medicines.
working
Surgical treatment is the only method to reliably improve the quality of life, to reduce the risks of complications and the possibility of relapse of the disease.It consists of removing varicose veins.There are 2 types of interventions:
- Thermal prison - the method of minimum invasive treatment (without cuts) using a laser sensor or radio frequency;
- Traditional surgical intervention involves removing varicose veins.Currently, the technique of such interventions has been properly processed and allows you to get a good functional and cosmetic result.
Separately examined sclerotherapy as a method of surgical treatment.It complements successfully, and in some cases (the initial stages of varicose veins) replace the operation.The procedure is to introduce a special medicine into a varicose vein, which glues it from the inside.
Treatment of Varicose vein compression
Elastic bandage: the good and the bad of
Compression therapy is a mandatory component of any varicose vein treatment method and the most effective method of preventing it.
For the treatment of compression, elastic bandages are most often used, which, depending on the degree of stretch, are divided into 3 classes:
- short (overlapping a bandage no more than 70 % of the initial size);
- average (growth range in the initial length with extension in the range of 70-140 %);
- Long expansion (140 % and higher).
The classes are mandatory shown in the bandage packaging, and they are the characteristics needed for the right choice of the product.
It is advisable to use long -range bandages in the nearest period after surgery in order to stop blood and reliable bandage fixation.To ensure the optimal therapeutic compression mode, short and medium stretch bandages are more appropriate.
When using elastic bandages, the following rules should be followed:
- The bandage is applied, before -stretcing the foot "over itself", to prevent the formation of folds in the area of the foot, which can damage the skin when moving;
- Binting always start from the toe joints and catch the heel;
- The bandage pressure should be smoothly weakened by the ankle in the thigh;
- The rolling of the bandage is blurry while it is near the skin;
- Modeling the limb cylindrical profile is achieved by deciding that foam or latex pads.
Most patients with varicose veins should use an elastic bandage throughout the day, applying it in the morning before getting out of bed and shooting in the evening before night break.For the treatment of trophic ulcers, multi-layer compression bandages can be used, which are not removed for a long time, while directly with the affected area of the lower leg are contacted by fasters saturated with drug substances (zinc-wewatin and other clothes).
Despite high efficiency, treatment of compression with elastic bandage has obvious disadvantages - causing physical and aesthetic disturbances, in addition, it is very difficult for older people to do themselves, observing all the rules.
Knitwear
The wearing of special compression knitwear gain widespread popularity.It is represented by socks in the lower, medium and upper thighs, as well as tanga (including special tanga for pregnant women) of four compression classes.
Such knitted dress is made of cotton, natural rubber - elastan and synthetic rubber.Natural strands 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 a variety of colors that allow a medical knit with high aesthetic properties.
Varicose vein therapy
The main goals of medication therapy are the elimination of subjective symptoms of venous insufficiency, as well as preventing and reducing the severity of the side effects after surgical interventions.
One of the most prescribed medicines is medicines with the diosmin of the active substance.Usually, a week after its waiting, a positive dynamic appears: night cramps, pain, passage of severity, decreased swelling.It is believed that the minimum duration of the course should be at least 2 months.In severe forms of varicose veins, taking the medicine can continue for up to six months or more.
Ointments and gel
The simplicity of use and relative freedom of ointments and gels make them very popular among patients and doctors.A serious disadvantage of uncontrolled use of local medicines is a high frequency of skin complications in the form of peel, dermatitis and eczema caused by increased sensitivity with prolonged use of the same medicine.
Therefore, it is not extremely recommended to use local medicines (ointments, gel, cream) as a prevention and in the absence of symptoms of a chronic vein disease.
Heparin -based products are some of the popular medicines.Used 3-4 times a day.At the beginning of use, slight skin irritation and peel phenomenon in places of use of the medicine is possible.
Extra
In the Russian Federation, physiotherapeutic treatment methods are widespread.To combat such symptoms of varicose veins of the lower extremities such as pain and cramping in the calf muscles, you can use the method of stimulating the electrical muscles.Other methods of physiotherapy have no evidence of the effectiveness of treating this disease.
Preventing veins with varicose
Rational organization of work and rest is needed for all patients in varicose veins.This category of patients is not recommended for work related to a long standing in the standing or landing position, lifting weights and the effects of high temperature.At work and at home, they need a periodic break with 15-20 degrees raised at an angle of 15-20 degrees (during sleep it is recommended to raise the bottom of the bed above heart level), rational nutrition, excluding consumption of spicy and salty foods as well as alcohol.Body weight should be strictly controlled, as overweight leads to the progression of the disease.
In resilient compression conditions, removable sports (ski, cycling) are allowed, however, optimal conditions for venous outlet and lower extremity training are provided by swimming.