The word "varicose veins" is derived from Latin varix, varicis - bulge. The first mention of the treatment of varicose veins is found in ancient Greek papyri paper.
Varicose veins are the most common disease. Up to 40% of the adult population suffers from chronic diseases of the lower extremities. Its complications in the form of dermatitis, cellulitis, bleeding, thrombosis, and trophic ulcers often lead to long-term disability, sometimes disability.
Structure and work of the venous system
The way our veins work is a complicated process. To understand this, you need to have an initial knowledge of the structure of the veins. The vein wall consists of three layers. Endothelial - endothelial, represented by a layer of cells on the connective tissue membrane. The middle class is muscle. It is mainly composed of circular smooth muscle cells housed in a frame of collagen fibers. The superficial veins contain a thicker layer of muscle than the deep veins. The outer layer of a vein, called Adventitia, is a dense tissue of collagen fibers. If we compare the structure of the vein and artery, it must be said that the ratio of the lumen to its wall thickness in the vein is much greater than in the artery. Veins have much less elastic fibers than arteries.
The main feature of the veins, which in turn affects the blood flow indicators, is the great scalability of the wall. In particular, with the increasing pressure in the veins, the veins dilate and tend to have a magnetic circular shape like a slit. The degree of varicose veins is quite rapid and depends on many other things. It is this factor that does not allow the use of rigorous mathematical formulas to calculate the movement of blood along them. The thickness of the vein wall in the leg vessels is much greater than that in the neck.
An venous valve comes from its side. Normally they consist of two valves, oriented towards the heart. In the area where the valve is attached to the wall, the diameter of the vein is slightly larger. Normally, when the valves close, blood from the upper part cannot seep into the lower part. When this happens, the condition is called reflux. Reflection is also controversial. It can be relative, (some call it physiological) and absolute. The main difference is the reflux time in functional tests. There is also an opinion that should not be reflux with normal valves. The valves are not evenly distributed across the veins. There are many places of them the most pronounced mechanical pump action - that is, in the lower legs.
The main venous system of the lower extremities is represented by the following groups:
- veins of the foot;
- deep veins of the legs and thighs (deep vein system);
- large and small saphenous veins (superficial system of veins);
- clear (perforated) veins - provides communication between superficial and deep veins.
Deep vein systems and shallow veins together form a "sponge", from which, when walking, blood will rush to the heart. The work of this system is aided by the work of a muscle pump located in the lower leg, which creates discontinuous pressure in the veins.
These systems move the blood column upward and the valves inside the veins stop backflow.
Blood flows from the lower limbs through uneven shallow, deep veins. About 85-90% of the blood flow through deep veins and only 10-15% through the subcutaneous veins. Thus, in healthy people, blood outflow is carried out by deep, subcutaneous, and vascular systems.
Varicose veins are a serious problem
To say varicose veins is "the disease of the twentieth century or XXI" means false truth. Varicose veins have bothered people for a long time. Even in the ancient medical treatises there is a description of varicose veins, in ancient Rome it was bandaged with "bandages" of the skin to avoid varicose veins.
If your legs are constantly tired, this could be the first sign of a new venous system disease beginning. A discomfort at night, accompanied by swelling in the feet and ankles, especially after a long stay on the legs, are obvious signs of a venous obstruction. Unfortunately, you discover varicose veins first. The altered veins form a blue or red "pattern" on your leg, the "star", the "spider web" of capillaries (telangiectasias) and, finally, the veins dilate and the nodes dilate.
Severity, burning, tingling and itching, pain and swelling, "stars", swelling of the veins of the legs - an urgent signal for urgent action to save the beauty and well-being of the couplefoot.
If you have questions about the condition of your veins, you should quickly ask the specialist - a specialist, who studies and treats veins.
Varicose veins start out harmless but can become a serious problem if left untreated.
Causes of varicose veins
So far, a large number of theories have been put forward to explain the cause of varicose veins. Most commonly due to genetics, mechanics, hormones, etc. v. However, they mainly reflect factors that contribute to the development of the disease or accelerate the appearance of clinical signs of the disease.
Both lower extremities are more commonly affected. However, at first, dilation of the veins appears on one side, and after a while - on the other. Varicose veins are more common in the right leg.
Varicose veins of the lower extremities only occur in humans. This is due to the vertical position of the body, the effects of hydrostatic and hydrodynamic pressure on the valve apparatus and the venous wall of the limbs. With weakening of the venous wall and impaired function of the valve apparatus in the main veins, occurs with congenital weakness, pathological backflow occurs. The most common causes of varicose veins:
- Hormonal changes (pregnancy, menopause, puberty, use of hormonal contraceptives, etc. ) - affects the structure and tonicity of the vessel wall with impairment and destructiongradual destruction.
- Pregnancy is one of the main risk factors for the development of varicose veins. In addition to the hormonal changes, the enlarged uterus and fetus compress the pelvic veins and significantly impede blood flow from the lower extremities.
- Obesity has been shown to be a risk factor for varicose veins. This is due to the increasing load on the venous system of the lower extremities.
- Lifestyle: people suffering from prolonged static loads (hairdressers, teachers, chefs, surgeons) are more likely to suffer.
- Wear tight-fitting underwear that presses the main veins across the folds of the groin. Women wearing high heels.
- Heavy physical activity (carrying, lifting weights).
- Thermal tricks (sauna and bathing), overusing them can also cause varicose veins.
The essence of varicose veins is that as a result of the above reasons, the lumen of the veins is gradually dilated and punctured, leading to the action of the valve apparatus (the valve leaves do not closeOK). Pathological reflux (return) of blood occurs both from top to bottom and horizontally through destroyed turbid veins.
Diagnosis of varicose veins
For many years, the hand was the doctor's only tool to check patients for varicose veins. X-rays have been supported by surgeons for the past century. However, an intravenous contrast X-ray is a rather complicated procedure, requires cumbersome equipment and is expensive, X-ray contrast itself is not safe for the body. With the development of microelectronics and computer technology, previously unavailable diagnostic methods emerged: ultrasonic Doppler ultrasound, angiograms, computed tomography. The advent of double-sided scanning has provided new information to give fresh insight into the problems that cause the development of varicose veins, and to understand the complexity of the disease process. physical.
Doppler Ultrasound
This is an ultrasonic diagnostic technique that allows you to determine the speed and direction of movement of the elements (in this case, blood cells) in the body. Therefore, the doctor can find out the direction and speed of blood flow in the vessels of the lower extremities. And when performing some physiological and state tests of the valve apparatus of the lower limb vein. Knowledge of the structure of blood flow in the veins of the leg is a key requirement for treatment options.
Ultrasound angiography
The essence of this method is that images of the blood vessel walls and the blood flow flowing through them are formed on the screen of the ultrasonic scanner in real time. The doctor has the opportunity to observe the shape of the vessel, the structure of the wall, the state and direction of the blood flow through this vessel. This method is highly informative and much safer than the X-ray method, but it is quite expensive, so it is only used in difficult cases and during scientific research.
Photograph of the pleura
This is a diagnostic method based on determining the resistance of the tissues of the lower extremities. Its essence lies in the fact that the total resistance of the tissues in the human body is directly dependent on the amount of blood flowing in and out of them and changes over time with each heartbeat. Pleural imaging is used to diagnose the general functional state of the blood flow in the lower extremities, is used to monitor drug therapy for venous or arterial insufficiency, in the treatment of nutritional disorders andRate the degree of venous insufficiency.
Of course, all these techniques do not preclude the doctor from examining the patient directly, clarifying the patient's medical history and identifying the patient's complaints. Based on the overall picture of the disease, the doctor chooses the treatment method.
Treatment of varicose veins
A qualitative leap in the treatment of varicose veins, as in other medical disciplines, has occurred over the past 50 years. Over the past decades, a variety of drugs have been developed and continue to improve for the treatment of chronic venous insufficiency. The surgical treatment of varicose veins has been significantly improved. The compression sclerotherapy technology has been developed and completed in practice.
Nowadays, the so-called chiropractic surgery is gaining popularity all over the world. Cervical vertebrae is a smart combination between surgical treatment and sclerotherapy. It is well known that fibrosis therapy can be used only for the initial and uncomplicated forms of varicose veins. Varicose vein surgery is also not without a problem, vein removal surgery is quite painful, requires hospitalization and long rehabilitation time. The sensible combination of these two methods allows you to minimize trauma during treatment and achieve exceptionally high quality of treatment.
Drugs for treating varicose veins
Quite often there are cases where patients practically do not have varicose veins or their numbers are very small. However, people with severe leg pain, pain, swelling. All of these are signs of chronic venous insufficiency. In these cases, as well as when the varicose veins are significantly larger, it is necessary to take medications that improve blood circulation in the legs. Currently, in the arsenal of a vein doctor, there are several dozen drugs aimed at combating varicose veins.
Treatment of varicose veins and chronic venous insufficiency should only be selected by a doctor. Despite the apparent simplicity of choosing a toxicant, only a doctor can determine the full range of treatments and suitability of using a particular drug.
Compression therapy
Compression therapy has been considered as an adjunct to drug or surgical treatment for many years. Compression therapy for varicose veins has been around since ancient times, and it is only in the last decade that elastic compression has begun to be considered a separate and independent treatment -compression therapy. Compression therapy involves the use of medical elastic bandages of many different brands and special medical compression hosiery.
The global industry produces three types of elastic bands: short, medium and high elastic. High elongation bandages (more than 140% elongation) are used to prevent thrombotic complications in the postoperative period after surgery to the abdominal and pelvic organs, as well as to immobilize the posterior joints. and to prevent sports injuries. Short elastic bandages (elongation less than 70%) are used to treat complex forms of chronic venous insufficiency, deep vein thrombosis, post-thrombotic syndrome, and lymphatic failure. Moderate elastic bandages (elongation between 70% and 140%) are used in the treatment of varicose veins, chronic venous insufficiency and compressive fibrosis therapy.
Medical pressed knitwear including medical press socks, tights, knee-high socks. Many people have mistakenly considered the "anti-varicose" and "support" coat with different increased densities for treatment. To begin with, it should be determined that medical compression products are never marked in DENs. DEN is a knitted fabric specification that is indirectly related to the pressure exerted by the product.
Medical tops are classified into multiple layers of functional compression. A product's grade is determined by the pressure the product exerts on the ankle and on the lower 1/3 of the lower leg. A person with varicose veins was shown to use compressed metal 2 textiles. These knee-length tights or pants will put 23-32 mm Hg pressure on the affected leg. Artistry, ie completely balancing pressure in varicose veins and eliminates venous insufficiency. Furthermore, the medical compression products create the so-called dispersion pressure. The pressure they create decreases as the leg moves from the bottom up to 25-30%, contributing to effectively push the blood and lymph out.
It should be noted immediately that medical gowns are never thin and transparent, creating such high pressures requires a large amount of elastic fibers, and therefore thick knitted fabrics. It must also be said that lingerie is never cheap. The technology of knitting a particular knitted fabric is much more complex, where it is also necessary to model the cross-section of the foot to create the distribution pressure.
The ideal method of compression therapy is the patient's frequent and generous use of elastic bandages and / or knitwear. For example, wearing an elastic band every day for a month roughly corresponds to the effectiveness of taking effective monthly pills. The use of compressed needles is especially effective to prevent the development and recurrence of varicose veins. The advantage of using compressed products is that they are absolutely safe for health, compared to the best drugs and about the same price.
Prevention of varicose veins
If you have early signs of varicose veins, then obeying fairly simple rules will slow down and in some cases it will avoid further growth. First of all, do not take hot baths, saunas, and sun for too long. All of the above reduces venous tone, leading to blood stasis in the lower extremities. Don't wear tight clothing, socks, or socks with an elastic band too tight as this will compress your veins. Excess body weight and sports involving large static loads on the legs (tennis, weightlifting, bodybuilding) increase venous pressure. High heels (over 4 cm) - our veins don't like it. Take care of the veins, don't injure them.
If you feel heavy in your legs at night after a day's work, keep your feet up while you sleep and rest. If your job involves sitting at a table or standing for a long time, then you should change the position of your legs more often, step in place and rotate the foot. There are special exercises for venous diseases. After showering or bathing, rinse feet with cold water. There are good sports - swimming first, but walking, cycling, and skiing are also possible. Don't ignore folk remedies as a precaution. Useful infusions of reishi leaves, St. seaweed. John, cranberry, rose hip. A plant-based diet should be followed. Your doctor may also prescribe a drug called phlebotonic to increase venous tone and improve microcirculation. Recently, compression methods for the prevention and treatment of varicose veins have also become quite successful, due to the emergence of high quality medical products on the market.
A special word about prevention for pregnant women. Progressive varicose veins during pregnancy, especially when it is not the first time and pregnancy of a baby under 1 year of age does not contribute to good vascular function. The basis for prevention is wearing special compressed knitwear, the use of tonics both during pregnancy and after childbirth. Don't forget to mention your veins to your gynecologist when you are prescribed hormonal drugs, as these drugs interfere with the way the veins work, reducing their tonicity.
Don't self-medicate. Talk to your doctor about what is best done with your veins. This disease is treated by doctors - vein doctors.