Of all known types of vascular pathology, the most common are varicose veins.Let's pay attention to the title of the article: The most common material is considered in this material - in turn, the location of "varicose veins", namely, the expansion of veins in the legs.Other options are relatively less common, however, in the field of vision of specialized and related experts, they also fall constantly;These are, for example, the expansion of esophagus veins, seed, small pelvis etc.In other words, to associate 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, a certain terminological variety is still observed: in some sources, the "varicose veins" are used in some sources;In others, "varicose expansion" is separated from "varicose disease", etc.
The varicose veins of the lower extremities are a very unpleasant polysympomatic disease, accompanied by perceptible external manifestations.The cosmetic defect in the legs usually progress over the years, and many (mainly female) patients are much more concerned than hemodynamic disorders and organic changes in the venous walls.These patients, or rather patients tend to resort to a variety of intrathyic methods and methods of "eliminating varicose veins" at best, and sometimes significantly aggravate the situation.Meanwhile, unreed and neglected forms of venous pathology are full of more serious consequences and, in the early symptoms (see below), consulting a doctor should be consulted, if possible: Like the vast majority of other diseases, varicose veins are much better for treating early stages.
Returning to the issue of prevalence, a wide range of published epidemiological evaluations should be canceled.This is partly due to regional different and active Trends (the Older the Examination, The More the Share of Clinically Significant Cases in It), Partly the Difference in Diagnostic Approaches, But the Main Reason for Statistical Ambiguity Is, The Design of the Conducted Studies: In Adove Cases, Cases,Reporting Medical Documentation is Analyzed (Which is Reflected, In Essence, Not Reflected, Not In Essence, Not the Prevalence, and the Frequency of Calls for Help with this disease), in others, certain population categories are especially examined, during which characteristic symptoms are recorded, and then the actual frequency of their occurrence in the general population is evaluated.Even if you rule out extreme evaluations, the situation with the lower extremities varicose veins is very depressing: at least 55-65% of women and 15-25% of mature men suffer.Such a deep imbalance between floors is due to anatomical and hormonal differences, 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 of "rejuvenating" of such pathologies cannot but be disturbed by the average age of the beginning of the disease, most sources call the interval of 20 to 30 years, however, cases of varicose veins of the feet of school -age children, including young men, young people are increasing from one year to the year when changes in lifestyle (reduction of physical activity) and small foods, which are increasing, the increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasing, which are increasingOne year for the year when men and food are more food.
Reasons
First of all, it should be noted that varicose expansion is not diagnosed in relation to the arteries: this "curse" is in the veins.The arteries, of course, are also vulnerable and predisposed to various pathological changes, but in this case aneurysms (local sculctions), atherosclerosis, various types of obstruction (lumen narrowing), thromboembolism (blockages) etc.are more often observed.Compared to arterial, venous walls are less durable and elastic, less resistant to stretching deformations under load or internal pressure;They are easier to become thinner and more partially permeable as a result of which blood sealing or its individual fractions through the venous wall can begin.The fact that varicose veins are most often observed at the lower ends, many researchers consider one of the side effects of transitionEvolutionary to the right (the other serious "tribute" that humanity has paid for the release of the hands, is the pathology of the spine of the spine).All body weight is based on the legs, which creates an abnormally high load in the joints and the circulatory system.It is reliably known that people suffered from varicose veins already in ancient times;So the dominant cause was apparently the constant transport of weights.Today, this factor is relevant (some types of sports and labor activities), however, as civilization has developed, especially in the last hundred or two years, loads have often increased with the advent of "seated" and "permanent" professions: any stagnant phenomenon for veins is fatal.Direct risk factors include obesity, dietary food deficiency, lesions (including surgical, for example, consequences of an orthopedic operation), congenital vascular anomalies, hereditary predisposition and gender (see above).Deep vein thrombosis and concomitant inflammation (thrombophlebitis) lead to severe changes in the venous leg system;Thus, as a separate form of expansion of variced vegetables in the western literature, the post -influxophlebitic syndrome is considered.A large group of thought -provoking factors is composed of diseases and conditions that determine increased intra -abdominal pressure: tendency to constipation, chronic cough, etc.;In such cases, varicose expansion is detected, as a rule, not just in the limbs.
Separately, one must say about tobacco, which is precisely called the "murderer of the veins."The connection is so obvious and tight that many experts have strongly established the condition for a complete rejection of smoking before starting any treatment.The ethical aspects of this medical position can be argued (recently, the term demagogic "non -smoking chauvinism" appeared) until), but in the fact that if this condition is not observed, treatment will become automatically meaningless and useless, there is no doubt.An avid smoker, who in this case requires the exercise of the right to medical care, is similar to a drug addict, who expects to eliminate dependence and withdrawal syndrome, but will continue to take drugs.
At the organic and anatomical level, the main cause of varicose veins is the failure of venous valves, which should exclude reflux (blood flow in the normal direction, which creates excessive pressure on the veins).In fact, with the study of the causes and mechanisms of the development of venous valve dysfunction, with the development of the first methods of its surgical correction in the late nineteenth century, modern phlegology began as a medical science of vein diseases, treatment and prevention methods.
In general, it is necessary to admit that the abundance of the reasons described above - whose importance of each of which is confirmed repeatedly and reliable by large -scale studies - still does not form a single system.Therefore, under almost equal conditions, under absolutely the same, apparently combinations of risk factors, in one person, the varicose veins of the lower extremities develop and progress rapidly and, in the other vein, remain intact.This suggests that today etiopatogenesis has not been clarified until the end, and any of the most effective therapeutic strategies actually remains palliative.However, phlegology is developing extremely dynamically today, and the "absent links" in our knowledge of varicose veins sell, with all probability, will be identified and studied in the near future.
Symptoms
Often, precursors or first symptoms of venous blood circulation disorders are subcutaneous stars or mesh of the small blood vessels of the extended, visible and visible.Then the swelling nodes, wrapped or located in clusters, are formed in the calves.The legs with varicose veins swell and get tired, many patients complain of frequent painful seizures in the legs (including night), itching sensation, heat, shiver the goose -ups ", etc. In the absence of tensions, varicose veins are complicated by acute thrombuses and that to sequined woods (sometimes outside); bleeding in this case can be very strong and lead to a huge loss of blood.
Diagnosis
An experienced phlebologist recognizes the varicose veins of the first superficial look.However, an additional examination, of course, is as necessary as the collection of a history and detailed complaints.There are several special functional samples and, from instrumental methods, the most important is angiography and X-ray contract ultrasound in Doppler Dupplex scan mode.
Treatment
In previous decades, the specialty "phlegology" was generally interpreted as a synonym for vascular surgery.Thus, it was implicitly implicit that there can be no non -surgical treatment of venous pathology.However, so far, the situation has changed dramatically and the main changes are related to the last 15 to 20 years.The course for use - whenever possible and shown - are few high -tech and microinvasive methods are supported in all surgical specializations, and the treatment of varicose veins today does not necessarily imply a "large" operation.As a rule, therapy is comprehensive and begins with conservative measures -according to indications, -enotonic, anticoagulants and anti -agents and anti -inflammatory drugs are prescribed.You can use an elastic dressing or compression mesh only after consulting a doctor (in particular, the bandage technique should be explained in detail - starting with the fingers, with the mandatory capture of the heel and the gradual weakening of the closest compression of the knee).Physical Education Therapeutic, 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 residual functional viability does not reach 10% of the standard.At the same time, minimally invasive methods mentioned above are more widespread, which have several advantages (less traumatic, the possibility of outpatient treatment "one day", the absence of crooked cosmetic defects, etc.).The most promising and effective of these methods include sclerotherapy (artificial pinch, “gluing” venous walls with a special, microed -managed solution), laser therapy (including intravenous), radio frequency ablation (a thin probe is introduced into the vein, as the walls are “sealed”).
It should be understood that the effectiveness of any treatment in this case depends directly on the stage where the patient turns to help.It is not necessary to bring the subject to "large" surgery: the varicose veins of the lower extremities are completely healed today, but this disease itself does not pass.