The varicose veins of the lower extremities are a persistent and irreversible expansion and stretching of the veins, which occurs as a result of gross changes in their walls, as well as the insufficiency of your valve device due to a genetic defect.
The predisposition of women is explained by a cyclic increase in the extension of the vein walls with an increase in the concentration of the progesterone hormone.
Reasons
The primary factors of varicose veins are the hereditary weakness of the vascular wall.
In addition, the human lifestyle is of great importance in pathogenesis:
- Long work, standing or sitting;
- Lack of regular physical effort;
- weight lifting;
- Reception of drugs containing estrogen.
The risk of varicose veins of the veins of the lower extremities increases with age.But more and more patients are under 30 years old.
Varicose veins manifestations
Most of the time, with varicose veins, patients are concerned with the feeling of severity, repulsion, heat, skin itching, “anxiety” in the legs and painful and pulsating pain in the calf muscles.One feature of these signs is their appearance after a prolonged position.As a rule, unpleasant sensations are passing completely or their intensity is significantly reduced when 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 calf muscles, usually occurring at night.
The subcutaneous veins are expanding 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 is worth noting that this is not an absolute sign of the disease and, in many ways, a purely cosmetic problem.Such signs may be on the skin with varicose veins, but most of the time they are also found in healthy people.
As varicose veins develop, the violations of the skin of the leg skin develop.Initially, there are areas of excess blemishes, a little later of fabric and subcutaneous skin are compacted, the latter acquires a characteristic appearance "laid".In the center of the painted area of the skin, in response to a minimal lesion, a small white area looks like Starin's falls.This is white skin atrophy and so called, after which a trophic ulcer opens.
Skin skin violation is a sign of chronic venous deficiency, which also includes symmetrical edema in the legs.
Diagnosis
Ultrasound Examination (Duplex color scanning; Triplex scan) - “Gold Standard” in the diagnosis of varicose veins of the veins of the lower extremities.An ultrasound expert must necessarily examine the leg vessels on both sides.It evaluates its diameter, compressibility, characteristics of blood flow and reflux value (reverse blood flow).VA valve work assessment is performed not only in the patient's position while lying down, but also standing.
Treatment of veins veins from the lower ends
The same symptoms may be signs of various diseases, and the disease may not occur according to the book.Do not try to be treated - consult your doctor.
Modern varicose vein treatment includes surgical intervention, sclerotherapy, compression treatment and use of various medications.
Operation
Surgical treatment is the only method for safely improving quality of life, reducing the risks of complications and the likelihood of disease relapse.It consists of removing the varicose veins.There are 2 types of interventions:
- Thermal prison - minimally invasive treatment method (without cuts) using a laser or radio frequency sensor;
- Traditional surgical intervention involves the excision of varicose veins.Today, the technique of such interventions is sufficiently elaborated and allows you to get a good functional and cosmetic result.
Considered separately sclerotherapy as a method of surgical treatment.Successfully complements and, in some cases (the early stages of varicose veins) replaces surgery.The procedure is the introduction of a special drug into a varicose vein that places it inside.
Varicose vein compression treatment
Elastic bandages: pros and cons of
Compression therapy is a mandatory component of any varicose vein treatment method and the most effective method to prevent it.
For compression treatment, elastic bandages are more used, which, depending on the degree of stretching, are divided into three classes:
- Short (overlapping of a dressing not exceeding 70 % of the initial size);
- Average (range of increase in initial length with stretching in the range of 70 to 140 %);
- Long extensibility (140 % and higher).
Classes are mandatory indicated in the packaging of the dressing and are the necessary characteristics for the correct choice of the product.
It is advisable to use long extensibility bandages in the nearest post -operative period in order to interrupt blood and reliable dressing.To ensure the ideal therapeutic compression regime, short and medium extensibility bandages are more appropriate.
When using elastic bandages, the following rules should be followed:
- The dressing is applied, pre -marking the foot "in itself", to avoid the formation of folds in the ankle area, which can damage the skin when moving;
- Binte always begins in the fingertips of the foot and captures the heel;
- The dressing pressure should gently weaken from the ankle to the thigh;
- The bandage roll is diverted while in the immediate vicinity of the skin;
- Modeling the member's cylindrical profile is achieved by placing the foam or latex pillows.
Most patients with varicose veins should use an elastic bandage throughout the day, applying it in the morning before leaving the bed and shooting at night before rest at night.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 leg skin are contacted by bandages impregnated with drug substances (zinc and other prisoners).
Despite high efficiency, compression treatment with elastic bandages has obvious disadvantages - causing physical and aesthetic inconveniences, and it is very difficult for older people to stand out, observing all the rules.
Compression mesh
Special compression meshes gain wide popularity.It is represented by socks in the lower, medium and higher thighs, as well as fair pants (including special pants for pregnant women) of four compression classes.
Such meshes are made of cotton, natural rubber - elastan and synthetic rubber.Natural fibers are ideal for sensitive and affected (eczema varicosis, dermatitis, trophic disorders) of the skin.As for synthetic fibers, its advantages are a small diameter and variety of colors that allow a medical mesh with high aesthetic properties.
Varicose veins drug therapy
The main objectives 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 is drugs with active substance diosmine.Generally, a week after the beginning of its reception, a positive dynamic appears: night cramps, pain, passage of gravity, swelling.The minimum duration of the course is believed to be at least 2 months.In serious forms of varicose veins, taking the medicine can be continued up to six months or more.
Ointments and gels
The simplicity of use and relative relationship of ointments and gels make them very popular between patients and doctors.A serious disadvantage of uncontrolled use of local medications is a high frequency of skin complications in the form of peeling, dermatitis and eczema caused by increased sensitivity with prolonged use of the same remedy.
Therefore, it is not extremely recommended to use local medications (ointments, gels, cream) as a prevention and 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, it is possible to irritate light skin and phenomenon of peeling in the places of drug use.
Additional therapy
In the Russian Federation, the physiotherapeutic methods of treatment are widespread.To combat these symptoms of varicose veins of the lower extremities such as pain and cramps in the calf muscles, you can use the electrical muscle stimulation method.Other physiotherapy methods have no evidence of the effectiveness of treatment of this disease.
Prevention of varicose veins
The rational organization of work and rest is necessary for all patients in varicose veins.This category of patients is not recommended for the work associated with a long stay in the standing or sitting position, raising 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 raise the end of the bed of the bed above the heart level), rational nutrition, excluding the consumption of spicy and salty foods, and alcohol.Body weight should be strictly controlled as obesity leads to the progression of the disease.
Under elastic compression conditions, moving sports (skiing, cycling) are allowed, however ideal conditions for venous output and muscle training of the lower extremities are provided by swimming.