Varicose veins of the lower extremities is a disease of chronic, which is characterized by the thinning of the wall vein, increase of the lumen of vascular and formation of the knobby extensions.
The disease is diagnosed in about 15-17% of the adult population. In adulthood, the disease is more frequently diagnosed in women that is because of the hormonal changes in the body (menopause, pregnancy, menstruation).
Varicose veins in the legs manifested an extensive clinical. Patients complain of heaviness and discomfort in the extremities, fatigue, ankle swelling, cramps at night, where the blue of the veins. For pathology on the background of the lack of appropriate treatment leads to complications.
Causes and risk factors of varicose veins of the lower extremities
Varicose veins of the lower extremities in the majority of the paintings is the result of a genetic predisposition. Cause: the immaturity of the functions of the valves of the veins and the immaturity of the connective tissue element of blood vessels. This leads to an increase of the load on the inside of the blood vessels and the appearance of varicose veins.
The aetiology is due to factors innate, which are associated with hypercoagulability – increased blood clotting. In the background of violations of forming blood clots, which violates the full flow in the legs, leads to a pathological expansion of the venous lumen.
A frequent cause of the disease in women is a hormonal imbalance. It is based on the change in the concentration of sex hormones in the blood. Associated with the start of the menopause and pregnancy.
Causes of varicose veins in the legs:
- Weight. Obesity has mechanical effects on the wall vein, which are especially pronounced on the background of abdominal type. As a result, the patient increased venous pressure;
- Diabetes. As a result of a complex set of disorders of the metabolic processes associated with chronically high levels of sugar in the blood to a relative insufficiency of insulin, a decrease in the elasticity of the venous walls with its further extension;
- Alcohol dependence. The alcoholism, the body does not have fluids, the blood becomes thicker, which leads to an alteration of the circulation of the blood;
- Professional factors (a constant finding in vertical position, excessive physical activity, lack of exercise);
- Wearing shoes uncomfortable, for example, high heels;
- Serious pathology of the cardiovascular system, manifested by circulatory failure.
Cause of varicose veins in the legs can chronic disease of the genital organs. In particular, the inflammation of the gland of the prostate in men and adnexa in women.
The mechanism of the disease is based on the involvement in the inflammatory process, the smallest of the veins, which causes inflammation and obstruction of blood flow.
Signs and symptoms of varicose veins
Varicose veins of the legs manifests itself in different symptoms. Let's start with the external changes. Thus, the most obvious sign, with indication of the appearance of the disease, this transformation the contour and shape of the subcutaneous vessels of the legs. Manifested bloating, nodular thickening. The glasses are dark colors, revealing the veins and the veins.
Venous ulcers are considered from two sides. Part of doctors attribute the wounds to the symptoms and other complications of the disease, to bear witness to the last, the most advanced of the pathological process.
Classification of varicose veins in the legs
Varicose veins of the legs is diagnosed more often in older women than men of this age. At an early age, the disease in boys and girls manifests itself with the same frequency. In accordance with the classification, the disease can be primary and secondary in nature. In the first case, the pathological changes correspond to the surface of the ships. Violations of the structure and the structure of deep vessels do not exist.
Secondary varicose veins is a complication of abnormalities of the deep veins, resulting in the negative observed changes in the surface of the vessels of the legs. This image is displayed on the background of congenital abnormalities of the venous system, and also as a consequence of phlebothrombosis.
Also of the disease is classified on clinical forms. These include varicose veins of the lateral vessels of the legs and thighs form reticular and varicose veins telangiectasia. Consider these forms:
- Varicose veins lateral veins sometimes to be independent of the disease, and in combination with other diseases. Reverse venous reflux of the liquid occurs in a deep vein through the saphenous and its surrounding ships.
- Mesh (reticular form) is manifested as an independent disease. Not lead to venous insufficiency, it represents only a default aesthetic.
- Telangiectasia varicose veins are also a default aesthetic.
In recent years, surgeons distinguish venous insufficiency idiopathic forms. It is characterized by the increase of tone venous, with a clear reason of violation cannot be detected. The clinical manifestations of the disease do not differ from the classical clinic.
Stage and the extent of the varicose veins
Varicose veins of the legs varies depending on the stage and extent. For the establishment of these take into consideration the clinic of the patient. The chronic diseases of various stages, which have some differences:
| Stage | Function |
| Compensation | Pain syndrome weakly expressed or not. Patients complain of discomfort of the feet due to the long date. It is worth noting the presence of vascular spiders in the skin, sometimes manifested by swelling of the ankle, it passes quickly after the holidays. |
| Subcompensation | Visual inspection of the lower extremities of the patient visible veins with abnormal clearance. Patients have a lot of complaints. In particular, he complains of persistent pain of the enlargement of the nature, fatigue, heaviness in the legs. Often, at night there is twitching in the muscles, "run goose bumps" on the skin. Swelling, after a night's sleep in 90% of cases leveled independently. |
| Decompensation | The most difficult stage of varicose veins. Shows the changes in the skin. He becomes too dry, the hair loss on my feet. In addition, it revealed hyperpigmentation, which leads to thickening abnormal subcutaneous tissue. Cracks and scratches on the legs, to cure for a long time, is able to transform into sores. Swollen feet constantly, rest and sleep do not help. Swelling tend to rise higher on the legs. |
When a girl or a boy come to the doctor with the complaints of the described symptoms, the doctor performs a visual examination, prescribes laboratory and instrumental methods of diagnostics. On the basis of the received results speak about the form, the scenario and the extent of the disease.
The degree of varicose veins of the legs are defined by numbers. The Zero (0) in the clinic is not identified, external changes do not exist; And – the bloating, the fatigue of the limbs; II – constant swelling accompanied by hyperpigmentation, abnormal seal subcutaneous tissue; III – pain that does not pass swelling of the legs, trophic ulcers.
Complications of venous insufficiency
Varicose veins is a chronic incurable disease, so the treatment has a specific purpose – to stop the progression and prevent complications. If the treatment assigned is incorrect or the patient turns for help to a medical professional, to develop complications of the disease.
Thrombophlebitis – inflammation of the vein walls in the presence of a blood clot. In the inflammatory process may involve the surrounding blood vessels and soft tissues. There are several forms. Can be acute (lasts about 30 days), subacute – duration up to six months and chronic.
Migratory thrombophlebitis is rare. It is characterized by inflammation that occurs in different parts of Vienna quickly.
Symptoms include:
- Visually there is a clear scheme of the inflammation of the vessels.
- Acute pain, on palpation the pain is getting stronger.
- Swelling of nodules, which protrude above the skin.
- The increase of temperature local.
Thrombophlebitis with varicose veins of the legs can lead to other complications. For example, periphlebitis is inflammation of the surrounding tissues, wet gangrene of the extremities, deep venous thrombosis. In the propagation of inflammation occur the complications that go beyond the limb – embolism-and sepsis.
Deep vein thrombosis is a common complication of varicose veins of the legs. The pathology is characterized by the formation of dense blood clot that partially or completely occludes a blood vessel that disrupts the blood circulation in its entirety. In this complication there is a risk of death due to detachment of the thrombus.
Trophic ulcers appear in severe cases. Often joins infectious process, to compose the clinical picture. The wounds can affect not only the fabric, but also the deeper layers of the muscles. Cure for a long time. Requires a comprehensive treatment.
Varicose eczema is characterized by these symptoms:
- Inflammatory hyperpigmentation of the skin purple or bright red in color;
- Microvesicles are formed, which are opened independently;
- Severe swelling of the legs;
- Itching, which is observed constantly;
- The moisture that after drying scabs;
- Thickening abnormal the skin.
Varicose eczema can go into a chronic course, resulting in a manifest hardening of the skin and subcutaneous tissue.
In adherence to the infection eczema complicated by trophic ulcers.
Conservative treatment of varicose veins of the legs
Conservative treatment of varicose veins involves both medication and wearing compression underwear. The compression stockings of different compression class purpose is for the prevention and treatment of the disease. Tights, stockings and socks should choose a doctor based on specific characteristics. The underwear gives the desired result.
The prescribed drugs. Perfect effective of the medicines that affect all the pathological elements of the disease does not exist. We recommend the use of systemic medications – tablets and local media – gels, balms, creams and ointments.
In addition to the prescribed physiotherapy – magnetotherapy, electrophoresis; special exercises. You can use folk remedies – recipes with medicinal herbs may help to reduce the severity of the symptoms.
Sometimes it is recommended to hirudotherapy – treatment with leeches.
Methods of surgical treatment
When conservative methods give a small result, the disease progresses, it is recommended to carry out the operations. Often practiced sclerotherapy. In the vein injected a substance special which glues the affected ship. With time, it is replaced by connective tissue.
Radio-frequency ablation. While the surgical intervention is performed "welding" of the blood vessel (patient) by means of a probe, which radiates the waves. The probe heats the walls, which leads to stenosis. After the intervention of some time, it will be necessary to wear a compression garment.
The choice of the method of the patient for surgery depends on many criteria. The doctor takes into account the stage of the disease, the patient's state of health, presence of chronic diseases, which may be a contraindication for the use of the intervention.
Other types of surgical treatment:
- Phlebectomy the doctor removes the affected veins and vessels. Through a small puncture of the skin introduction of the tool with the hook, which pulled the boat. This technique is a combined use of surgical intervention and the use of the laser.
- The most effective way of treatment is considered laser coagulation of the veins of the lower extremities. The technique of the operation is performed with minimal incisions and injuries. Through a small incision in the skin into the vessel is injected with the best of the transactions that emits waves of the frequency desired. In the area of impact of the warming observed. The walls are fused, which allows to attack the problem.
The Extraction is performed through a small probe that is inserted through the incision and glue to the affected part of the vein. Cryostripping in the pathological vessel, the liquid nitrogen is introduced, which leads to the degradation of the region, followed by a function.
Prevention
The preventive measures are of great importance. A prognosis is favourable depends on the correct appointments with the doctor and the treatment, the patient must change their way of life, to strictly follow the recommendations of the phlebologist.
So, it is necessary to wear compressive underwear or bandaging the limb with a bandage stretchy. For reviews of patients, the first option is more convenient. Even after the surgery requires constant physical activity, but without an excess of tension in the body.
During sleep it is recommended that the legs be given the high position. To do this, the limb placed on a pillow or folded blanket. If the work involves constant sitting or standing, every 60-80 minutes to do some stretching to stimulate circulation of the blood in the body.
Women must not wear high-heel shoes. The maximum height of the heel should be 5 cm for All patients who have to choose comfortable shoes to leave the clothes, which puts pressure on the limbs.
Varicose veins – a serious disease that requires multifaceted treatment approach. Only a complex impact consisting of drugs, compression garments, physiotherapy, physical activity and proper nutrition will result in a positive outcome and sustained remission.