Varicose veins, or varicose veins of the lower limbs is the primary varicose veins, the transformation of the surface of the veins of the lower limb, they appear as "bumps" or "knots" on her legs.
Varicose veins is very common around the world. The frequency of which amounted to 60 % of the adult population, depending on the country. Oddly enough, the people of the continent of africa, and the Asia-Pacific region are suffering from varicose veins much less than of the inhabitants of the countries of europe and in the united states.
The lack of a concrete cause of varicose veins of the lower extremities, agreed to talk to you about your risk factors for t. e. increases the likelihood of developing this disease (the property or characteristic of the body of a human to have any impact on the body). The generally accepted risk factors for the disease, believe of age, female sex, obesity, and heredity. For a typical "picture" of a patient with the symptoms of varicose veins, the woman is in a state of menopause, overweight, body mass index, which have multiple pregnancies and deliveries in the story.
The symptoms of varicose veins in the legs
In the vast majority of cases, the varicose veins, the disease may be recognized, even if it has not special medical education. A goal is a sign of pathology — is the formation of a "cone" or "us" in the lower extremities, with the curtains of the skin, they usually do not differ in any color. Blue veins, as a rule, it is not a disease in the literal sense, even though it often brings the patients (usually women), some of the shortcomings of aesthetic.
However, in the case of varicose veins may be accompanied by a change in the color of the skin due to eczema, venous, and that manifests itself in various itchy rashes (pimples, lumps, and redness.
These features, along with the swelling in my feet, that it does not go away for a good night's sleep, and the witness of the formation of chronic venous insufficiency.
As regards the subjective symptoms in varicose veins disease, it should be noted, the non-specific. Complaints that may indicate a disease, and it can be a sign of an overload of the venous system of the lower limbs. More often than not, the patients are concerned about the severity of the feeling of flatulence, and neLocalitannth dognoMELPth excruciating pain in the calves. At times, they appear with complaints of pain in the area of the varicose veins and increased fatigue of the foot.
A burning sensation, tingling, muscle contractions during the night, or the syndrome of the legs are very (unpleasant sensations in the legs at rest, when it is necessary for the movement, in order to alleviate the discomfort), the most commonly encountered in the pathology and neurology, for example, KOReskova syndrome, and it should not be taken with some caution.
The pathogenesis of the varicose veins in the legs
The pathogenesis of varicose veins of the lower limbs) is sufficiently complex and multi-faceted. The role of the parent is not a mechanism for the development of the disease plays a the damage to the wall, and the valves of the veins. As a result of a malfunction in the form of current in the return of blood flow, then, is the removal of the endothelium (the inner floor of the vessel), which is accompanied by inflammation.
Next, the pathological process is included in the middle, and the inner layer of the wall of the vein: this is the growth of the connective tissue in the meusAECOM layer, vienna, and, after shrinking, which leads to a gradual destruction of the collagen and the steel reinforcement of the vessel. This violates the transport properties of vienna, contribute to the increase in the light and espiralenoednnomtem the grip length. Simultaneously, these changes are observed in the venous valves.
It should be noted that as soon as the venous leg of the "bumps" and "us" are usually the result of the existence of the invisible source of the varicose veins — the great beneath the skin of the city. In the vast majority of cases is large, at least to a small subcutaneous vienna. The ѕeyenoInnospacepope changes in the pool in these veins and lead to varicose veins disease.
Complications of varicose veins in the legs
The complications of the varicose veins, treatment should be given trophic violation of (venous leg ulcers), stroke, varicose veins, altered veins, (thrombo-phlebitis), bleeding varicose veins, "large", and "we".
Trophic violations that are the consequence of the progression of the disease, in the absence of treatment, this is why they often fail in the years and decades to come. They start off with the skin manifestations of hyper pigmentation (brown spots), eczema, venous, and lipídioseDe RMAtosclerosa (seals, fur).
The primary location of these changes in check, even though the eczema, venous and may occur in any area with varicose veins, including in the hip. Depending on the source of the varicose veins (the big and small hypodermic veins) trophic disorder, it will be LocalitatSya, either from the inside or the outside surface of the lower third of the leg, respectively. The result of the violation of the power of the soft tissues, and serves for the education of an ulcer at the site of an earlier change. Ulcers are single or multiple contours to the correct, smooth edges and a flat, smooth bottom. Notice sparse, tear, and often purulent in nature. The appearance of the ulcer is accompanied by severe itching and pain. For venous leg ulcers it has been created before you dig in to the existence of time (in months) and frequently return.
Thrombo-phlebitis, or thrombosis of the supercial veins are not to be confused with a stroke, be in a deep vein. In the second case, the situation is even more serious. However, when the trombotICHeish the defeat of the varicose veins, the symptoms can be very unpleasant. In the area of tRnombeRnonoannnoth in vienna, formed a painful WntemRnonoednnoe the seal, it is characterized by redness, increased local temperature and an increase in the sensitivity to the times, the fence restricts the movement of the arm. The clinical Picture is more similar to an ulcer or wound.
Thrombo-phlebitis, can be particularly dangerous if you take your character up and go through the the surface of the system in-depth. In this case, it may be implemented as a pulmonary embolism embolism, and deep vein thrombosis.
The bleeding of the varicose veins look really scary, because, due to the high pressure of the jet of blood is strong enough to do it. In some cases, this can lead to a significant krobopoteRe.
Diagnosis of varicose veins in the legs
The diagnosis of varicose veins of the lower limb, it generally doesn't cause too much trouble. A key feature of the disease is that the veins "lumps," and/or "we / us". Even when there is an excess of development of subcutaneous fat from the limbs to see them, it can be a difficult task.
To confirm the diagnosis, using a variety of diagnostic instruments, one of which is the ultrasound duplex scan (USDS). It allows you to quickly, accurately and safely determine the source of the varicose veins, and to assess the size and structure of the vessel, the function of the venous valves, the range of the distribution of the return current of blood to detect for the presence of blood in the blood. Simultaneously, OsmatRenoAyutXia, and the deep and surface venous system. To carry out the research must be in the upright position, or, if the patient's condition does not allow, in a sitting position with his pants down to the bottom of the legs. The research is in the supine position, can lead to errors in the determination of the low water, and the blood in the blood.
For the evaluation function of the valve, and the length of the path of the return current of the blood, characterised by:
- the compression of the specimen, with the pressure on various segments of the lower limbs;
- experimentation with the allocation of the testing Of the cavity of the valsalva);
- the simulation of a foot;
- the reception is in the state of Paraná — is easy to attempt to remove the patient to a state of equilibrium, with the purpose of the call, the tension in the muscles of the calf.
The Total ultrasound duplex study of the arteries of the lower extremities should also be in the form of results and the drawing of the map. The results of this study are a valuable aid in the planning of further treatment. However, they should be considered in conjunction with the clinical data, as changes in the ultrasonic image, and if there are no objective signs of disease (varicose vein) should be considered as a functional of t. e. is not associated with the pathology of the arteries). It is important to note that in the scan, ultra-sonic-do not need to make a clear diagnosis and if the patient does not plan for the treatment of varicose veins and the disease.
There are additional methods of diagnosis:
- machine, ultrasonic doppleRnogRAFeEu — Doppler ultrasound (not to be confused with USDS);
- PLetezmnogRAFeEu;
- RentgenparanontRecomtneEu FLeBogRAFeEu;
- RegenoFLeBogRAFeEu;
- computed tomography (CT);
- magnetic resonance imaging (MRI);
- thermography;
- coagulation intravenous coagulopathy ultrasound (IVUS) is a new method.
The treatment of varicose veins in the legs
The main goal in the treatment of varicose veins of the lower extremities is the solution to all of them correctly to the execution of the veins. This can only be achieved by using an invasive intervention. There are three different ways.
- To remove it from the combined FLede voltatOmiya short comtReppeng, meneFLede voltatOmiya, submucosal peRfnoRentns the veins;
- "Sticking" — comKLeRnoteRepeEu, mexennoxemICHecnomparaeEu piece, TSeennoeparaReletneEu piece;
- "ZeineReinenee" — ePDnoinepnozpeEu laser and radiofrequency obliteration.
To achieve the goal of the treatment, it is necessary to perform two main tasks: to solve the source of the varicose veins (this is called a vertical flow and to clean up the varicose veins in the advanced world. For a long time, the most commonly used method is the combined FLede voltatOmiya. To run the technique involves two stages.
- Full comnotemcomtrd the addition of a large fabric, of vienna, with a total of a vein in the femoral artery (paraRnocomcomeparatOmiya);
- The removal of a stump of tissue from vienna, and with the help of a probe (comtReppeng).
This procedure is different than the Redeparaelünnocomtd, and it has a number of disadvantages that are inherent in any operation, with the frequent need to neRparanoze, in the presence of the incisions and the sutures for a period of rehabilitation, and the increase, in comparison with the other methods, the risk of developing complications.
However, about twenty years ago, there was a "FLeBolnogICHecomparaeEu the revolution". It has been made possible by the widespread deployment of ultra-sound scanning and the emergence of the mastery of technique — endnoinennoznnoth heat obrigaçõesteReTSeeth. Its essence is the impact of high temperatures on the wall of the vein from the inside to the outside. This is achieved by means of laser radiation (EVLO), or the exposure to radio frequency (RFO), "zeineReineyuschegno" the lumen of the vein.
Vienna-when you do this, immediately stop the operation and then gradually RecomcomecomsineetXia. This method allows, without cutting, in a fast, efficient, safe, and aesthetically pleasing, to resolve the vertical flow, without the need for a longer rehabilitation. As a representative of "office surgery", ePDnoinepnozpeEu heat of the piece, since for the past ten years, it is considered to be the best method of treatment for varicose veins, disease around the world.
SKLeRnoteRepeEu (glue affected for the vienna, by way of introduction to the inside of it a special substance, it has also found wide application is the solving of the varicose veins. However, in order to achieve the desired result requires a careful selection of the patients, due to the high risk of the recurrence of the disease.
The conservative methods of treatment, including the paranompRecomcomenonnth therapy, FLeBotRnopnse local medicines and dosage strengths and forms (gels, ointments), are intended only to assist nature, by acting primarily on the symptoms of varicose veins, it is not by eliminating the source of it.
Forecast. Prevention
Taking into account the modern methods of treatment, and estimate when the varizesm the expansion of the arteries to be positive. Even when it seems to be less in the case of the resolution of the varicose veins tRencomfnoRmeRnoinenns of the arteries leads to a rapid improvement in the health status of the patient.
However, when you are planning your treatment, it is very important to carry out an assessment of its own risks, since any type of intervention also carries within itself the potential for effects to last. The duty of the physician to reduce the likelihood. Prior to any manipulation, you should discuss this with the patient at all times in relation to intervention, and to obtain his or her signature, under-the-know.
The waste of all the phenomena that can be divided into risks related to operational policy, including anesthesia, and the risk to the patient.
The risk can be small, such as, for example, inflammation (phlebitis) in the "zeineRenns" or comKLeRnozeRnoinenns the veins, which is accompanied by a label in its status of an armbar syndrome. They may appear in patches of skin with reduced sensitivity, and skin hyperpigmentation on the complexion. All of these phenomena, a temporary and usually pass through very quickly without any consequences.
The major complications related to thrombosis in the deep veins, allergic reactions and toxic reactions in the enecomtezeRthuee drugs. They are extremely rare, however, for the individual patient, what has happened is similar to the complication of the case, and it is 100% the same, even when all the statistics are at 1 in 10,000 of all the operations.
Prevention of venous thrombosis first of all, it is based on the count and the risk of what is called a scale-point system using the table of Caprini. It contains within it many of the risk factors, which have to a degree. The accounts of each factor, and excretion, and the total points determine the level of risk and, consequently, its prevention. The principal means for the prevention of venous thromboembolic complications in the following:
- the minimization of the tReinmetICHnnocomte operation.
- prior to the revival of the patient.
- mesh compression;
- drug prevention, t. e., assignment of readings, from the oral anticoagulant drugs, thinning of the blood.
With regard to the prevention of varicose veins, the disease, then it simply doesn't exist, because it is not yet clear, the main reason for the disease, which can be hit and, therefore, prevent the onset of disease. This is very frequent recurrences of the varicose veins after any type of intervention. However, taking into account all of the benefits of the minimally-invasive treatment, this is not a significant problem. Keep your child's feet in order to pretty simple to do, the most important time to consult with the FLeBolnogtem