Varicose veins of the lower extremities is a persistent and irreversible expansion and lengthening of 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.
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 hormone progesterone.
Reasons
Primary factors of varicose veins are hereditary weakness of the vascular wall.
In addition, human lifestyle is of great importance in pathogenesis:
- long work, standing or sitting;
- lack of regular physical exertion;
- weight lifting;
- Reception of estrogen -containing drugs.
The risk of varicose veins of the veins of the lower extremities increases with age.But more and more patients are younger than 30 years old.
Manifestations of varicose veins
Most often, with varicose veins, patients are concerned about the feeling of severity, bursting, heat, itching of the skin, “anxiety” in the legs and aching, pulsating pain in the calf muscles.A characteristic feature of these signs is their appearance after prolonged standing.As a rule, unpleasant sensations are completely passing or their intensity is significantly reduced when walking, in a lying position, after a night's rest or when using medical compression products.
An important sign of the disease is cramps in the calf muscles, usually occurring 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 are also found in healthy people.
As varicose veins develop, violations of the skin of the skin of the lower leg develop.Initially, areas of excess staining occur, a little later subcutaneous tissue and skin are compacted, the latter acquires a characteristic “lacquered” look.In the center of the painted area of the skin, in response to a minimum injury, a small white area resembles Starin drops.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 include symmetrical edema on the legs.
Diagnostics
Ultrasound scanning (color duplex scanning; triplex scanning) - “gold standard” in the diagnosis of varicose veins of the veins of the lower extremities.An ultrasound specialist must necessarily examine the vessels of the legs on both sides.He evaluates their diameter, compressibility, characteristics of blood flow and the value of reflux (reverse blood flow).Assessment of the work of VA valves is carried out not only in the position of the patient while lying, but also standing.
Treatment of varicose veins of the 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 be treated yourself - consult your doctor.
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 the quality of life, reduce the risks of complications and the likelihood of relapse of the disease.It consists in removing varicose veins.There are 2 types of interventions:
- Thermal prison - minimally invasive (without cuts) treatment method using a laser or radio frequency sensor;
- Traditional surgical intervention involves the excision of varicose veins.Currently, the technique of such interventions is sufficiently worked out and allows you to get a good functional and cosmetic result.
Separately considered sclerotherapy as a method of surgical treatment.It successfully complements, and in some cases (the initial stages of varicose veins) replaces surgery.The procedure is the introduction of a special drug into a varicose vein, which glues it from the inside.
Compression treatment of varicose veins
Elastic bandages: pros and cons of
Compression therapy is an obligatory component of any method of treating varicose veins and the most effective method of preventing it.
For compression treatment, elastic bandages are most often used, which, depending on the degree of stretching, are divided into 3 classes:
- short (overlapping of a bandage not more than 70 % of the initial size);
- average (range of increase in the initial length with stretching in the range of 70–140 %);
- Long (140 % and higher) extensibility.
Classes are mandatory indicated on the packing of the bandage, and they are the necessary characteristic for the correct choice of the product.
It is advisable to use bandages of long extensibility in the nearest postoperative period in order to stop blood and reliable fixation of the bandage.To ensure the optimal therapeutic compression regime, bandages of short and medium extensibility are most suitable.
When using elastic bandages, the following rules should be followed:
- The bandage is applied, pre -stretching the foot “on yourself”, to prevent the formation of folds in the ankle area, which can damage the skin when moving;
- Binting always start from the joints of the fingers of the foot and capture the heel;
- The pressure of the bandage must smoothly weaken from the ankle to the thigh;
- The bandage roll is untwisted, while it is in the immediate vicinity of the skin;
- Modeling the cylindrical profile of the limb is achieved 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 lifting from bed and shooting in the evening before night rest.For the treatment of trophic ulcers, multi-layer compression bandages can be used, not removed for a long time, while directly with the affected area of the skin of the lower leg are contacted by bandages impregnated with drug substances (zinc-wewatin and other dressings).
Despite the high efficiency, compression treatment with elastic bandages has obvious disadvantages - causing physical and aesthetic inconvenience, in addition, it is very difficult for older people to bint themselves, observing all the rules.
Compression knitwear
Special compression knitwear gain wide popularity.It is represented by stockings to the lower, middle and upper thighs, as well as tights (including special tights for pregnant women) of four compression classes.
Such knitwear is made of cotton, natural rubber - elastan and synthetic rubber.Natural fibers 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 variety of colors that allow a medical knitwear with high aesthetic properties.
Drug therapy of varicose veins
The main goals of drug therapy 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 are drugs with the active substance diosmine.Usually, a week after the start of its reception, a positive dynamics appear: night cramps, pain, severity pass, swelling decrease.It is believed that the minimum duration of the course should be at least 2 months.In severe forms of varicose veins, taking the drug can be continued up to six months or more.
Ointments and gels
The simplicity of use and the relative cheapness of ointments and gels make them very popular among patients and doctors.A serious disadvantage of 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 a prevention and in the absence of symptoms of a chronic vein disease.
Heparin -based products are some of the popular drugs.Used 3-4 times a day.At the beginning of use, light skin irritation and peeling phenomenon in the places of use of the drug is possible.
Additional therapy
In the Russian Federation, physiotherapeutic methods of treatment are widespread.To combat such symptoms of varicose veins of the lower extremities as pain and cramps in the calf muscles, you can use the method of electrical muscle stimulation.Other methods of physiotherapy have no evidence of the effectiveness of the treatment of this disease.
Prevention of varicose veins
The rational organization of labor 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 the standing or sitting position, lifting weights, and the effects of high temperature.At work and at home, they need a periodic vacation with 15–20 degrees raised at an angle of 15–20 degrees (during sleep it is recommended to raise the foot end of the bed above the level of the heart), rational nutrition, excluding the consumption of spicy and salty foods, as well as alcohol.The body weight should be strictly controlled, since obesity leads to the progression of the disease.
In conditions of elastic compression, mobile sports (skiing, cycling) is allowed, however, optimal conditions for venous outflow and muscle training of the lower extremities are provided by swimming.