Of all known types of vascular pathology, the most common are varicose veins.Let's pay attention to the head of the article: the most common material is considered in this material, in turn, the location of "varicose", namely, the expansion of the veins in the legs.Other options are relatively common, however, in the field of vision of specialized and related specialists, they also fall constantly;These are, for example, the expansion of the veins of the esophagus, the seed, the small pelvis, etc.In other words, to associate the term "varicose expansion" only and exclusively with the lower extremities, which is practiced in everyday speech, it would be incorrect.However, in the professional environment, there is still a certain terminological variety: in some sources, the "varicose veins" are used in some sources, in others the "varicose expansion" is separated from the "varicose disease", etc.
The varicose veins of the lower extremities are a very unpleasant poly being disease, accompanied by notable external manifestations.The cosmetic defect in the legs generally progresses over the years, and many patients (mainly women) are much more concerned than hemodynamic disorders and organic changes in venous walls.These patients, or rather, patients tend to resort to a variety of intramedic methods and methods of "eliminating varicose veins", in the best case, and sometimes significantly aggravate the situation.Meanwhile, unreasonable and careless forms of venous pathology are full of more serious consequences, and in the first symptoms (see below), consult a doctor if possible if possible: just like the vast majority of other diseases, varicose veins are much better to treat the initial stages.
Returning to the question of prevalence, a wide range of published epidemiological evaluations must be taken into account.This is partly due to regional differences and age -related trends (the oldest the exam, the more the proportion of clinically significant cases in it), in part, the difference in diagnostic approaches, but the main reason for statistical ambiguity is, apparently, the design of studies carried out: in some cases, informing the medical documentation is analyzed (what is reflected, is not reflectedIt reflects, it is not reflected, it is not reflected, it is not reflected in the base, it is not said that the previous one in the prevalence, and the frequency is not reflected, the help, it is not reflected, in the essence, and it is not reflected in the base, and the prevention is not reflected.real of its appearance in the general population.Even if it rules out extreme evaluations, the situation with the varicose veins of the lower extremities is very depressing: in one degree or another, at least 55-65% of women and 15-25% of mature age men suffer.Such a deep imbalance between the 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 to "rejuvenate" such pathologies can only be disturbed by the average age of the appearance of the disease, most sources call the interval of 20 to 30 years, however, the cases of varicose veins in the feet of schoolchildren, including young men, increase from year to year: growing changes in lifestyle (reduction of activity) and dietary diets, chips, brothers and brothers, brothers and brothers, brothers and brothersothers are affected by serious serious).
Reasons
First, it should be taken into account that the varicose expansion is not diagnosed with respect to the arteries: this "curse" is found in the veins.The arteries, of course, are also vulnerable and predisposed to various pathological changes, but in this case, the aneurysms (local sculptures), atherosclerosis, various types of obstruction (narrowing of the lumen), thromboembolism (blockages), etc.They are observed more frequently.Compared to the arterial, venous walls are less durable and elastic, less resistant to stretching deformations under load or internal pressure;They are easier to be thinner and become partially permeable, as a result of which the blood sealing or its individual fractions can begin through the venous wall.The fact that varicose veins are more frequently observed in the lower extremities, many researchers consider one of the side effects of the evolutionary transition to rectitude (the other severe "tribute"That humanity pays the release of hands, is the pathology of the spinal column).All body weight is based on the legs, which creates an abnormally high load in the joints and the circulatory system.It is known reliably that people suffered from varicose veins already in ancient times;Then the dominant cause was, apparently, the constant transport of weights.However, this factor is relevant today (some types of sports and work activities), as civilization has been developed, especially in the last hundred or two years, the charges have often increased with the advent of the "sitting" and "standing" professions: any stagnant phenomenon for the vein is fatal.Direct risk factors include obesity, deficiency of plant foods in the diet, lesions (including surgical, for example, consequences of an orthopedic operation), congenital vascular anomalies, hereditary and gender predisposition (see above).Thrombosis of deep veins and concomitant inflammation (thrombophlebitis) leads to serious changes in the venous legs of the legs;So, as a separate form of expansion of varicose vegetables in western literature, post -pophytic syndrome is considered.A large group of provocative factors consists of diseases and conditions that determine greater intra -abdominal pressure: trend to constipation, chronic cough, etc.;In such cases, the expansion of varicosus is detected, as a rule, not only in the limbs.
Separately, it must be said about the course of tobacco, which is rightly called the "murderer of the veins."The connection is so obvious and narrow that many experts strongly establish the condition for a complete rejection of smoking before starting any treatment.The ethical aspects of this medical position can be argued (recently, the demagogic term "Chovinism of the non -hetero" has appeared), but in the fact that if this condition is not observed, the treatment becomes automatically meaningless and useless, there is no doubt.An avid smoker, which in this case requires the exercise of the right to medical assistance, is similar to a drug addict, which hopes 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 a normal opposite direction, which creates excessive pressure in the veins).Actually, with the study of the causes and mechanisms of the development of the dysfunction of the venous valve, with the development of the first methods of its surgical correction at the end of the 19th century, modern phlegology began as a medical science of diseases of the veins, methods of its treatment and prevention.
In general, it is necessary to admit that the abundance of the reasons described above, the importance of each of which is confirmed repeatedly and reliable by large -scale studies, does not yet form a single system.Then, in almost equal conditions, under absolutely the same, apparently combinations of risk factors, in a person, the varicose veins of the lower extremities develop and progress rapidly, and in the other vein for decades they remain intact.This suggests that today ethiopathogenesis has not been clarified until the end, and anyone, even the most effective of modern therapeutic strategies, remains, in fact, palliative.However, phlegology is developing extremely dynamically today, and "missing links" in our knowledge of varicose veins, in all likelihood, will be identified and studied in the predictable future.
Symptoms
Often, the heralds or the first symptoms of venous blood circulation disorders are subcutaneous stars or mesh of small blood vessels of extended, visible and visible.Then, swelling nodes, winding or located in the groups, are formed on calves.The legs with varicose veins swell and tire, many patients complain of frequent painful seizures in the legs (included at night), the feeling of itching, the heat, the tracking of "chicken skin", etc.In the absence of treatment, the varicose veins can be complicated by acute thrombosbophastic and drilling (sometimes (sometimes (sometimes the most mild mechanical wall exposure to exposure. Bleeding in this case can be very strong and lead to a massive loss of blood.
Diagnosis
An experienced phlebologist recognizes the varicose veins of the first superficial look.However, an additional exam, of course, is as necessary as a detailed history and complaints.There are a number of special functional samples, and from instrumental methods, the most important is the angiography with X -ray contract and ultrasound in the Dopplex Doppler scanning mode.
Treatment
In the previous decades, specialized "phlegology" was generally interpreted as a synonym for vascular surgery.Therefore, it was implicitly involved that there cannot be a non -surgical treatment of venous pathology.However, to date, the situation has changed dramatically, and the main changes are related to the last 15-20 years.The use course, whenever possible and shows, are few high -tech and microinvasive methods in all surgical specializations, and the treatment of varicose veins in the legs today does not necessarily imply a "large" operation.As a general rule, the therapy is comprehensive and begins with conservative measures, as indications are prescribed, the medications -enotonic, anticoagulants and anti -agentes, and anti -inflammatory medications.You can wear an elastic bandage or compression knitting only after consulting a doctor (in particular, the bandage technique must be explained in detail, starting from the fingers, with the mandatory heel capture and the gradual weakening of compression closer to knee).Therapeutic physical education, water procedures, diet (it is also necessary to normalize body weight) and hirudotherapy are effective.
However, varicose veins remain a surgical disease, that is, the radical effect can only be achieved by surgery.There are many specific phlebectomy techniques: the elimination of the vein, whose residual functional viability does not reach 10% of the standard.At the same time, the minimally invasive methods mentioned above are more widespread, which have several advantages (less traumatic, the possibility of an outpatient treatment "one day", the absence of cosmetic defects twisted, etc.).The most promising and effective methods include sclerotherapy (artificial breast, "stuck" venous walls with a special solution, which is administered by microeds), laser therapy (including intravenous), radiofrequency ablation (a thin probe is introduced into the vein, since the walls are "sealed").
It should be understood that the effectiveness of any treatment in this case depends directly on which stage the patient uses to obtain help.It is not necessary to bring the matter to "large" surgery: the varicose veins of the lower extremities are completely cured today, but this disease itself does not happen.