Varicose veins of the lower extremities - a persistent and irreversible expansion and elongation of the veins that arise as a result of gross changes in their walls, as well as the lack of the valve apparatus due to a genetic defect.
The predisposition of women is due to a cyclical increase in the elasticity of the vein walls, valves become loose when increases the concentration of the hormone progesterone.
The primary factors in the emergence of varicose veins is an inherited weakness of the vascular wall.
In addition, of great importance in the pathogenesis is a way of life:
The risk of varicose veins of the lower limbs increases with age. But more and more patients under 30 years of age.
Most often varicose veins patients concerned about the feeling of heaviness, fullness, heat, itching of the skin, “anxiety” in my legs and the aching, throbbing pain in the calf muscles. A characteristic feature of these signs is their appearance after prolonged standing. Usually, discomfort completely disappear or their intensity is significantly reduced during walking, in lying position, after a night of rest or with the use of medical compression products.
An important feature of the disease are cramping in the calf muscles, which usually occur in night time.
Saphenous vein expand in the form of a crimped blue conglomerates in the Shin and thigh. Unfortunately, there is a perception that spider veins are a manifestation of varicose veins. But it is worth noting that this is not an absolute sign of disease and is largely a purely cosmetic problem. Such symptoms could be on skin with varicose veins, but for the most part occur in healthy people.
With the development of varicose veins, develop eating disorders of the skin of the Shin. Initially there are areas of excessive staining, later subcutaneous tissue and the skin are compacted, the latter acquires a characteristic "painted" look. In the center of the painted area of the skin in response to minimal trauma, there is a small white portion. This so-called white atrophy of the skin, followed by open trophic ulcer.
Malnutrition of the skin is a sign of chronic venous insufficiency, which also includes a symmetrical swelling in the legs.
Vein mapping ultrasound (color duplex scanning; triplex scanning) is the “gold standard” in the diagnosis of varicose veins of the lower extremities. Ultrasound specialist must inspect the vessels of the legs on both sides. He estimates the diameter, compressibility, characteristics of blood flow and the amount of reflux (reverse blood flow). Evaluation of venous valves performed in the patient lying down, but standing.
X-ray contrast venography was previously considered the main method of instrumental diagnosis of varicose veins, currently, however, they remained far in the past.
Treatment of varicose veins of the lower extremities same symptoms can be signs of different diseases, and the disease can occur not textbook. Do not try to be treated yourself — consult your doctor.
Modern treatment of varicose veins include surgery, sclerotherapy, compression therapy and use of various medicines.
Surgical treatment is the only method that allows to reliably improve the quality of life, reduce risks of complications and the likelihood of relapse. It consists in removing varicose veins and the elimination of the pathological factors. There are 2 types of interventions:
The article also provides sclerotherapy as a method of surgical treatment. It complements, and in some cases (initial stages of varicose veins) replaces surgery. The procedure involves injection of a special medication into the varicose vein that glues it inside.
Compression therapy is an essential component of any method of treatment of varicose veins and the most effective method of prevention.
For the implementation of the compression treatment, the most frequently used elastic bandages, which, depending on the degree of stretching is divided into 3 classes:
Classes mandatory indicate on the packaging of bandage, and they are essential characteristics for the correct selection of products.
Bandages long-stretch appropriate to use in the immediate postoperative period with the aim of stopping the blood and secure the bandage. To ensure optimal therapeutic compression mode is most suitable bandages short or medium elongation.
When using elastic bandage for legs should adhere to the following rules:
Most patients with varicose veins should use elastic belt throughout the day, applying it in the morning before rising from bed and taking off in the evening before the night's rest. For treatment of trophic ulcers can be applied multilayer compression bandages, do not remove for a long time, directly with the affected area of the skin of the drumstick in contact bandages soaked in medicinal substances. Additional fixation of the compression bandages is carried out using special bandages, which is especially necessary when using the bandage to the thigh.
Despite the high efficiency, compression treatment elastic bandages has obvious disadvantages – the infliction of physical and aesthetic discomfort, in addition to older people are very difficult to bandage themselves, observing all the rules.
The wide popularity of special compression knitwear. It's the Golf, stocking to the lower, middle and upper thirds of the thigh, and pantyhose (including special tights for pregnant women) of the four compression classes.
This knitwear made of cotton, natural rubber and synthetic rubber. Products made of natural fibers optimal for sensitive and affected (varicose eczema, dermatitis, trophic disorders) skin. With regard to synthetic fibers, the advantages of a small diameter and a variety of colors, allowing to produce medical hosiery with high aesthetic properties.
The main objectives of medical therapy are the elimination of subjective symptoms of venous insufficiency and in the prevention and reduction of severity of side effects after surgery.
The main drugs for the treatment of varicose veins serve veno active drugs. These should be taken only under the supervision of a physician. According to studies, the safety of using these drugs proved only for short courses of therapy. In the case of long term possible emergence of a mild but unpleasant side effects, such as gastrointestinal disorders.
One of the most commonly prescribed drugs are drugs with active ingredient diosmin. Usually a week after his admission there is a positive dynamics: are night cramps, pain, feeling of heaviness, and reduces swelling. It is believed that the minimum course duration should be at least 2 months. In severe forms of varicose veins, the drug can be continued for up to six months or more.
Ease of use and relative cheapness of ointments and gels make them very popular among patients and doctors. A serious drawback of the uncontrolled use of local drugs is the high frequency of skin complications in the form of peeling, dermatitis and eczema caused by the increase in sensitivity upon prolonged use of the same means.
Therefore, it is not recommended to use drugs local action (ointments, gels, creams) as prophylaxis and in the absence of symptoms of chronic venous disease.
Agents based on heparin - one of the most popular drugs. Apply 3-4 times a day. When you start using possible mild skin irritation and peeling phenomenon in the field of application of the drug.
Widespread physiotherapeutic treatment methods. To combat such symptoms of varicose veins of the lower limbs as pain and cramps in the calf muscles, you can use the method of electrical stimulation of leg muscles. Other methods of physical therapy have no evidence of the effectiveness of treatment of this disease.
Rational organization of work and rest is necessary for all patients with varicose veins. This category of patients is not recommended the work connected with long stay standing or sitting, heavy lifting, exposure to high temperature. At work and at home they need periodic rest is raised at an angle of 15-20 degrees (during sleep it is recommended to lift the foot end of the bed above the level of the heart), a balanced diet that excludes the consumption of spicy and salty foods as well as alcohol. Should strictly control the body weight because obesity leads to disease progression.
Under conditions of elastic compression of the allowed class mobile sports (skiing, Cycling), but the optimal conditions for venous outflow and muscle training of the lower extremities are provided with swimming.