Of all known types of vascular pathology, the most common is varicose veins.Let's pay attention to the title of the article: the most common material is considered in this material - on the other hand, the localization of "varicose veins", namely the expansion of the veins in the foot.Other options are relatively less common, however, in the field of viewing of specialized and connected specialists, they also fall continuously;These are, for example, the expansion of the veins of the esophagus, seed, small pelvis, etc.In other words, to accompany the term "varicose expansion" only and exclusively with the lower limbs, which is practiced in everyday speech, would be incorrect.However, in the professional environment, there is still a certain terminological variety: in some sources, "varicose veins" are used in some sources, in others "varicose expansion" is separated by "varicose disease", etc.
The varicose veins of the lower extremities are a very unpleasant polysymptical disease, accompanied by obvious external manifestations.Cosmetic foot defect usually progresses over the years, and many patients (mainly females) are much more concerned than hemodynamic disorders and organic changes in the venous walls.Such patients, or more precisely, patients tend to use a variety of intramedian methods and methods of "eliminating varicose veins", at good harmful, and sometimes significantly exacerbated the situation.Meanwhile, untreated, neglected forms of venous pathology are filled with the most severe consequences, and in the first symptoms (see below), consult a doctor should be advised if possible: like most other diseases, varicose veins are much better to treat the initial stages.
Return to the issue of prevalence, a wide range of epidemiological estimates should be emphasized.This is partly due to regional changes and age -related tendencies (the older the examination, the more part of the important clinical cases in it), partly the change in diagnostic approaches, but the main reason for statistical uncertainty, it seems not in particular for studies:Characteristic and then appreciated the true frequency of their appearance in the general population.Even if you dismiss extreme estimates, the situation with the varicose veins of the lower extremities is very depressing: at one scale or another, at least 55-65% of women and 15-25% of mature men suffer.Such a deep imbalance between the floors is due to anatomical and hormonal changes, as well as the reproductive function of a woman (pregnancy, childbirth), which in many cases becomes a direct prerequisite for the development of venous disorders.
The tendency to "renew" such pathologies cannot be disturbed by the average age of the onset of the disease, most resources call the range of 20 to 30 years, however, cases of varicose veins at schools of school, including young men, are increasing year by year: increasing lifestyle changes (reduction of physical activity) and other dietary diet).
Reason
First of all, it should be noted that varicose extension is not diagnosed with regard to the arteries: this "curse" lies in the veins.The arteries, of course, are also tangible and predisposed to various pathological changes, but in this case, aneurysms (local sculles), atherosclerosis, different types of obstacles (lumen narrowing), thromboembolism (blockages), etc.Compared to the arterial, the venous walls are less durable and elastic, less resistant to stretch deformities under load or internal pressure;They are easier to become thinner and become partially permeable, as a result of which the blood signature or its individual fractions can begin through the venous wall.The fact that varicose veins are most often observed in the lower extremities, many researchers consider one of the side effects of evolutionary transition to direct (the other "heavy" tribute that pays mankind for releaseof the hands, is the pathology of the spinal column).All body weight is based on the foot, which creates an abnormally high load on the joints and the circulatory system.It is certain that people suffered from varicose veins already in ancient times;Then the predominant reason was, apparently, keeping weights constantly.This factor is important today (some types of sports and work activity), however, as civilization has developed, especially in the last one or two years, the loads have increased many times with the arrival of "sitting" and "standing" professions: any stagnant vein phenomenon is fatal.Direct risk factors include overweight, lack of plant food in diet, damage (including surgical, eg, the consequences of an orthopedic surgery), congenital vascular abnormalities, inherited predisposition and gender (see above).Deep vein thrombosis and associated inflammation (thrombophlebitis) lead to severe changes in the venous system of the legs;So, as a special form of expanding varicose vegetables in Western literature, posttrombophlebitis syndrome is considered.A large group of provocative factors is composed of diseases and conditions that determine the increase in intra -abdominal pressure: tendency for constipation, chronic cough, etc.;In such cases, varicose extension is detected, as a rule, not just in the limbs.
Separately, it must be said about the tobacco course, which is rightly called the "vein killer".The connection is so obvious and upset that many experts strongly decide the situation for a complete refusal of smoking before starting any treatment.The ethical aspects of such a medical position can be argued (recently, the demagogic term "chauvinism of non" has even appeared), but in the fact that if this condition is not observed, treatment automatically becomes meaningless and useless, there is no doubt.A thirsty smoker, who in this case requires the exercise of the right to medical help, is similar to a drug addict, who expects to eliminate addiction and withdrawal syndrome but will continue to take drugs.
At the organic, anatomical level, the main cause of varicose veins is the failure of the venous valves, which should exclude reflux (blood flow in a normal opposite direction, which creates excessive pressure in the veins).In fact, with the study of the causes and mechanisms of development of venous valve dysfunction, with the development of the first methods of its surgical correction in the late 19th century, modern phlebology began as a medical science of vein diseases, their treatment and prevention methods.
In general, it is necessary to acknowledge that the abundance of the reasons described above - the importance of each of which is repeatedly and reliably confirmed by large -scale studies - still does not form a single system.So, in almost equal conditions, under absolutely the same, the seemingly risk factors combinations in one person, the varicose veins of the lower extremities develop and progress quickly, and in the other veins remain intact for decades.This suggests that today Ethiopathogenesis has not been clarified to the end, and any, even more effective of modern therapeutic strategies, remains, in fact, palliative.However, phlebology is developing extremely dynamic today, and the "missing links" in our knowledge of varicose veins, will most likely be identified and studied in the predictable future.
Symptoms
Often harbingers or the first symptoms of venous bloodstream disorders are subcutaneous stars or mesh of small blood vessels of the elongated and visible and visible.Then, the swelling joints, winding -pounds or placed in clusters, formed on the calves.The legs with varicose veins swell and tired, many patients complain of frequent painful leg convulsions (including at night), itching, heat, crawling "goosebumps", etc.In the absence of treatment, varicose veins can be complicated by the rapid thrombophilic of the veins of the thrombus and thin veins of the vein thin veins, outside);Bleeding in this case can be very strong and lead to massive blood loss.
Troubleshooting
An experienced phlebologist recognizes varicose veins from the first cursor view.However, an additional examination, of course, is as necessary as collecting a story and detailed complaints.There are a number of special functional samples, and the most important of instrumental methods is X -ray and ultrasound angiography in the duplex doppler scan.
Treatment
In the previous decades, the "phlebology" specialty was usually interpreted as a synonym of vascular surgery.Thus, it implicitly implied that there can be no non -operative treatment of venous pathology.However, so far, the situation has changed dramatically, and the main shifts have been related to the last 15-20 years.Course for use - wherever possible and indicated - there are some high methods -tech - and microinvasive are stable in all surgical specializations, and treatment of varicose veins today does not necessarily mean "large" operation.As a rule, therapy is comprehensive and begins with conservative measures -according to indications, medicines -enotonics, anticoagulants and anti -agents, and anti -inflammatory drugs are prescribed.You can use an elastic bandage or compression knit clothing only after consulting a physician (in particular, the bandage technique should be explained in detail - starting from the fingers, the mandatory heel capture and the gradual weakening of the knee compression).Physical therapeutic education, water procedures, diet (it is also necessary to normalize body weight), and hirudotherapy are effective.
However, varicose veins still remain a surgical disease, ie.The radical effect can only be achieved by surgery.There are many specific phlebectomy techniques - vein removal, whose remaining functional durability does not reach 10% of the rate.At the same time, the minimum invasive methods mentioned above are more widespread, which have some advantages (less traumatic, the possibility of "one day" outpatient treatment, lack of crooked cosmetic defects, etc.).The most promising and effective of these methods include sclerotherapy (artificial spraying, "climbing" venous walls with a special solution, administered by the microeds), laser therapy (including intravenous), radio frequency ablation (a thin probe is inserted into veins, after the walls "sealed").
It should be understood that the effectiveness of any treatment in this case depends directly on the stage that the patient returns for help.It is not necessary to bring the issue to the "big" operation: the varicose veins of the lower extremities are completely cured today, but this disease itself does not pass.