The disease caused by a violation of the structure of the walls of the vessels, their thinning, with markedly impaired blood circulation processes, is called varicose veins. The disease usually affects the lower extremities, although it can be localized to the rest of the body. According to the International Classification of Diseases of the Tenth Amendment ICD 10, varicose veins are assigned code 183, which includes four headings describing the different manifestations of the disease.
How does varicose veins manifest?
The first mentions of varicose veins were found in ancient Greek papyri. History and confirmed scientific facts say that varicose veins of the lower extremities were found in Egyptian mummies found - it can be argued that this disease accompanies humanity throughout its history. its existence.
Prominent doctors - Avicenna, Hippocrates, Galen tried to treat varicose veins of the lower extremities. In the 19th century, treatments for pain and trauma were used, which included dissection of the tissues of the thigh and lower leg to injure the hemispheric veins, followed by bandaging. It is understood that in this way blood circulation can be stopped and varicose veins will be eliminated. However, these methods leave terrible scars on the patient's body, and contribute to damage to nerves and arteries and disrupt the flow of lymph.
Some time later, the history of the treatment of varicose veins received a positive breakthrough - in 1908, a metal probe was used for the first time as a minimally invasive means of vascular wall. blood. The discovery of radiography made surgical operations more precise and effective to remove varicose veins. Currently, when accurate diagnosis and treatment of this disease is needed, people will resort to duplex and triplicate scanning, powerful drugs, laser therapy, and sclerotherapy. Surgical intervention is used only in cases where it is not possible to save the varicose veins.
The main cause of the disease
Varicose veins are a great danger, the pathology is increasingly "rejuvenating" - previously mostly the elderly have, now varicose veins are diagnosed in young patients, extremely rarein children.
Causes of the disease:
- Genetic predisposition.
- Overweight, overweight, obese.
- Sedentary lifestyle.
- Improper diet, poor blood quality.
- Concomitant diseases of the cardiovascular system.
- Professional activities.
- Standing for a long time, exerting heavy effort.
- Pregnancy and hormonal changes.
- Distinctive features of the structure of the vascular system.
- Congenital diseases.
- Wear high heels and tight clothes.
- Heat treatments.
Any of the above reasons can provoke the development of varicose veins, the consequences of which are dangerous, including death.
The structure of the venous vessels
To understand what causes varicose veins of the lower extremities, you need to have an idea of the structure of the vascular system and its mechanism of action. It represents the totality of the main veins (deep and superficial) and the connection of the perforated veins (communication).
The small superficial veins begin in the area of the foot, extend along the back of the lower leg, branch below the knee into two branches, and join the jugular and deep femoral veins.
A large superficial hemispheric vein forms in the ankle area, runs along the surface of the lower leg and knee joint, and connects to the femoral vein. The deep veins are located along the branches of the arteries, and the entire venous system is connected by opaque vessels.
With normal blood flow, oxygenated blood flows directly to the heart, and special venous valves prevent backflow. Varicose veins of the lower extremities mean strong pressure, the diameter of the veins increases significantly, the valves do not take on the task, reflux occurs - backflow of blood. Improper blood circulation causes excessive dilation (stretching) of the vessel walls, thinning, blockage of veins and blood stasis. As a result - bloating, swelling of the veins, the formation of nodes.
Clinical Manifestations and Symptoms
Varicose veins can progress for a long time in a latent form, then the following signs appear:
- The formation of spider veins is the reticular accumulation of small dilated veins.
- Obvious morphology of congestive veins protruding under the skin.
- Formation of compression sites of blood vessels - varicose veins in the form of well-distinguished nodules on the legs.
- The normal color change of the skin, cyanosis, black appears, the upper layer (dermis) has a loose structure.
- Feeling pain, heaviness, swelling and fatigue in the legs, reduced mobility, difficulty walking.
- With varicose veins of the lower extremities, the formation of swelling of the soft tissues is possible.
Neglecting timely treatment leads to serious and dangerous consequences, when the patient can be cured only by immediate surgical intervention.
Classification of diseases
Varicose veins according to ICD 10 are classified as ulcerative, inflammatory, ulcerative and inflammatory disease, in the absence of these signs. According to the international classification of chronic venous diseases, created in 1994, varicose veins are classified into:
- In the skin, segmented. No pathological venous discharge was observed.
- Segmentation with retrograde blood flow, occurs through superficial veins and perforations.
- Delivered with counterflow of blood through superficial and perforated veins.
- Varicose veins with backflow of blood through the deep veins.
Usually, the disease is divided according to the additional signs of the clinical picture:
- On examination or palpation, there were no symptoms.
- Reticular veins are shown.
- Varicose veins are present.
- There is swelling of soft tissues.
- Violation of normal skin color.
- Exposed epidermal fibroids.
- There are ulcers that have healed.
- An active ulcer was revealed.
Symptoms are absent or subjective (patient's perception). In addition, varicose veins are classified for reasons: congenital, primary, secondary, with an unspecified factor causing the development of the disease.
Diagnosis of varicose veins
The primary way to identify varicose veins is by visual examination and palpation of the patient. In order to carefully determine the extent of the disease and choose the correct method of treatment, when studying the history and palpation, the doctor prescribes:
- A complete blood count is the primary standard for determining red blood cell counts and hemoglobin levels. According to the coagulation process, conclusions are drawn about the degree of development of the disease and the predisposition to thrombus formation.
- Doppler ultrasound. This method includes ultrasound diagnostics of the velocity and direction of blood particles. This allows you to establish in which direction the blood flow is taken, whether it is speed enough or not.
- Ultrasound scan agnioscanning. It is used to visually check the vessel walls, structure, direction and speed of blood flow in real time on the screen of the ultrasound machine.
- Computerized tomography. Diagnosis is based on the detection of resistance of the leg tissues. For proper traffic, the parameter should indicate the normal standard.
- Rheovasographic diagnosis. Based on the determination of tissue blood filling index. The rheological index helps determine the stage of varicose veins - compensatory, compensatory or decompensated.
The history of the disease and its study, obtaining comprehensive diagnostic data, allows the doctor to choose a method of treatment.
Conservative drug treatment
This method of treatment consists in the appointment of special drugs that have a positive effect on the course of the disease. Conservative treatment of varicose veins is effective in the early stages, used as an additional treatment in the formation of nodules, sores, eczema.
The main classes of drugs prescribed are:
- Phlebotonics and phleboprotectors. Venotonic drugs are standard, implying conservative treatment. Promotes the restoration of the structure of the vascular wall, strengthens and tones blood vessels.
- Effective means of blood thinning. They contribute to improved composition, faster blood flow through the veins, reduced risk of blood clots, restoration of normal blood circulation and pain relief.
- NSAIDs (anti-inflammatory drugs). Eliminate pain, anti-cramp, anti-inflammatory, effective swelling.
Careful treatment helps to prompt referral to a phlebologist, which, in the early stages, can affect the blood composition and state of the vessel walls. With complex forms of the disease, drastic measures are required.
Laser therapy
Laser therapy is recognized as the gentlest and least traumatic method for varicose veins in the legs to be treated as classified according to ICD 10 code 183. The idea of the method is to use a laser beam to positively affect the area. vessel walls and promote their adhesion. . An LED connected to a laser device is inserted into a vein by piercing the skin. The beam is selective and does not affect adjacent healthy tissue. Significant advantages of laser therapy in the treatment of varicose veins:
- Fast positive effect.
- No pain and injury.
- Stable results, long-term remission.
- Restore normal blood circulation.
Contraindications to use are thick or too thin vessel walls, large venous lumen, pregnancy, cancer and other serious concomitant diseases.
Varicose veins therapy
This method is based on the introduction into the vessels affected by varicose veins special liquid or foam preparations - sclerotherapy. They replace endothelial cells with fibrous tissues. To perform sclerotherapy, needles, syringes, and sclerotherapy are used.
Treatment techniques include the following steps:
- piercing of a pathological vein;
- pump out (remove) all blood from the vessel;
- administer a sclerosant preparation;
- the application of a suitable tape or knitted compression.
This method gives a lasting result. This procedure is painless, fusion of vascular tissue affected by varicose veins is an alternative to surgery.
Do an activity
The most painful and traumatic treatment for varicose veins is surgery. Indications for implementation will be extensive vascular lesions, the presence of varicose veins, dangerous consequences of the disease, for example, acute thrombophlebitis.
Resection of the varicocele is performed under local anaesthesia, pathological venous ligation, sufficient incisions required for resection, excision. The operation is recognized as an effective treatment, showing results in eighty percent of cases. But phlebotomy has some side effects: wound complications, injury to the lymph nodes, which, in severe cases, can damage deep nerves, possibly immobilization and disability.
To prevent dangerous complications of varicose veins, which manifest as: lymphadenopathy, ulceration, bleeding, thrombosis, pulmonary embolism and other serious consequences, right from the early stages of the disease. veins, you should see a doctor!