Varicose disease of the lower limbs is extremely common, and if the past patients of the doctor was older, now that time often affects aged 25-45. Its symptoms, according to different statistics, was observed in 66% of men and 90% of the women population in developed countries. The disease is progressive in nature, and it can be combined with venous insufficiency.
Varicose disease of the lower extremities associated with abnormal enlargement of the superficial veins, which is caused by a failure of venous valves, and is accompanied by a significant violation of blood circulation. In the future this pathology can exacerbate thrombosis, leading to increased risk of phlebothrombosis and pulmonary embolism (PE).
The first starting mechanism in the development of this pathology of the lower limbs veins is a malfunction of the venous valves, leading to reflux of blood. As a result, slow down the blood flow to react with endothelial cells and are white blood cells that activate the inflammatory process of the vascular wall, spread through venous channels. Simultaneously with inflammation of the disturbed functions of the endothelial layer of the veins, and then all the layers of the venous wall.
In the first place and particularly acute in the above-mentioned pathological processes, there is a valve system in the veins. The first is usually the affected area max load: at the entrance to the great and small saphenous veins or large perforations-vessels. In the future, because of the overflow venous event hyperextension of venous wall, and the amount of venous blood in the superficial venous vessels of the lower extremities increases. Still, this exceeded flow, in particular the system of deep veins and stretch them. They later develops dilatation and insufficiency of venous valves.
These pathological changes lead to horizontal reflux (reflux of blood in the subcutaneous venous network) and the work of the venous pump to completely lose its effectiveness. Develop venous hypertension leads to venous insufficiency. Initially, patients swelling, and then in the bloodstream into the soft tissues and penetrate into cells from the blood, which leads to hyperpigmentation and skin. With the progression of the disease on the surface of the skin shows trophic ulcers, which may be complicated by secondary infection.
Doctors often refer to reasons that may cause pathological disorders in the functioning of the venous system. They are divided into two main categories:
Genetic predisposition to varicose veins can be determined for both men and women despite the fact that in most cases, this pathology is found in women. The disease may for a long time does not manifest itself, but under certain circumstances (for example, intensive physical exertion) failure of venous valves.
Doctors identify a number of harmful factors that can cause varicose veins:
Varicose veins in most cases develops slowly and gradually. Early on she manifested little and non-specific symptoms, which can be grouped into a "syndrome of heavy legs":
The most important and the first sign of incipient varicose veins become appeared cylindrical part dilated superficial veins. This symptom is associated with fatigue of the lower extremities, burning and swelling in the region of the passage of the veins and the constant feeling of heaviness in the legs. Dilated vessels become round and start to push above the surface of the skin of the feet and lower leg, and after a long walk, or intense exercise, they become more visible. Also a person can have swelling, which is especially clearly manifested in the evening the ankles, lower Shin and the top of the foot. At night the patient may have convulsions. And in the later stages of the disease due to insufficient blood flow to the skin in the feet may deteriorate.
In some cases, the first signs of varicose veins are manifested only so-called "spider veins" (spider web varicose veins not thicker than 0.1 mm), and the patient for a long time unaware of the beginning of the disease. Some women consider this to be a symptom than just a cosmetic defect, and the men simply do not notice it. Despite the absence of other signs of varicose veins is the "spider veins" are the first and, in some cases, the only symptom of varicose veins and treatment to the doctor at this stage of the disease can help patients significantly slows the progression of the pathological vein.
Most often, doctors use a kind of classification, varicose veins, proposed in 2000, which takes into account the form of the disease and the degree of chronic venous insufficiency:
Varicose veins can be:
Also, prevention of varicose veins in the legs to determine the tactics of treatment it is important to consider the extent to which chronic venous insufficiency:
In the first stage of development of varicose disease significantly impairs the quality of life of the patient and give him some unpleasant moments in the form of a noticeable cosmetic problem. In the future, with the progression of the disease, the limbs may be formed ulcers, which are often complicated by a secondary infection. First, the surface of the skin that looks (usually the lower third of the foot) areas thinning, dry, hard and glossy surface. Later, they appear on areas of hyperpigmentation and develops small cuts, increases in size and produces pain. In the future, its edges will become more dense, and the bottom is covered with a touch of a dirty color, and sometimes bleeding. Small injuries to its borders has increased significantly, and the wound becomes inflamed.
At untimely or incorrect treatment of varicose veins of the lower limbs can be complicated by thrombosis or thrombophlebitis. These diseases arise suddenly and is not related to subject to external adverse factors (eg. hard physical exertion). Patients have significant and quickly spread to the entire leg edema, which involves severe pain expander nature. Some areas of the skin can appear local pain, redness or cyanosis. When you move the detached blood clot in the blood vessels of the lungs can develop a serious complication of thrombosis of the lower extremities, pulmonary embolism.
In general, the diagnosis "varicose disease" occurs, the phlebologist of the first examination of the patient. After examining the patient's complaints, inspection of the lower limbs and holding a number of special samples, the doctor will prescribe a number of studies that confirm the diagnosis and determine the tactics of further treatment:
The main objectives of treatment of varicose veins of the lower extremities, which was intended to stabilize and restore the normal outflow of venous blood, improve the quality of life of the patient and prevention of complications caused by venous insufficiency. Therapeutic measures may include:
Conservative methods of treatment of varicose veins includes the following activities:
