Varicose veins (varices) is one of the most common, and oldest, of the diseases of the vascular system, which opened since the time of ancient Egypt. The Egyptian papyrus, the excavation was found a mummy with signs of varicose veins. The disease interested the famous ancient doctors: Hippocrates, Galen, and Avicenna, and later Troyanova, Trendelenburg. TIME yet the disease has not lost its significance in modern medical science. Definition of "Varicose" comes from the Latin word "varix", which means "extension", therefore, the disease is called "varicose veins." This disease is characterized by expansion and increasing the length of the peripheral veins in the serpentine tortuosity (deformations), as well as a violation of the outflow of blood, the resulting valve insufficiency and the weakening of the walls. The disease often affects the veins of the lower extremities, as the main burden of the blood outflow (large amount) falls on them, so I this part. Varicose veins occur in the 17 - 25% of the population. At a young age the disease occurs, similar to the boys and girls. The mature-aged women sick 2 - 3 times more often than men, due to hormonal changes in the female body (menstruation, pregnancy, menopause).
Causes and risk factors of varicose veins
The exact cause of the disease is not known, we only know that under the influence of a few factors, for developing weakening of the valves, the pressure increase in the loss of flexibility, the walls of the superficial connecting vessels. Risk factors:
- Genetic predisposition: the transfer of the varicose veins through inheritance, caused by mutation in the gene responsible for the structure of the vessel wall, the result of the mutation, children born with congenital weakness of the connective tissue, or muscle in the vessel wall, or lack of the valve (negative number) and, consequently, there is a weak point in the vessel wall and increased pressure in the veins.
- The hormonal changes (pregnancy, menopause): during pregnancy the hormonal changes the makeup of an organization (the extent of the increase in progesterone and decrease estrogen) which affect the formation of clotting factors (increase), to reduce the tone of the venous wall (as a result of destruction of the collagen, elastic fibers in the vessel wall) all this leads to the formation of blood clots, blockage of blood vessels, and deformation.
- Obesity : obesity leads to a sedentary lifestyle, which slow down the blood circulation, plus excess fat increases the intra-abdominal pressure, which violates the outflow of blood through the veins, so the development of stagnation in the veins and the possible development of the disease.
- Diabetes :chronic high blood glucose levels over time damage blood vessels, which is a favourable environment for the development of blood clots.
- Alcohol abuse : excessive alcohol consumption leads to dehydration, thickening of the blood, as a result of blood clots that clog the veins and compromise the blood flow.
- Weight lifting (suppliers),the long walk or the long work (sellers, managers): associated with decreased muscle tone, increased intra-abdominal pressure as a consequence of slows down, obstructs the blood flow to the heart, the development of the stagnation of the lower limbs.
- Congenital coagulation defects: congenital hyper-coagulation (excessive production of clotting factors in the blood) leads to the formation of blood clots and disruption of the blood through the vessels.
- Poor nutrition: a lack of certain vitamins in the diet (Vit.C, E, R, plant fibers role of the reinforcement to the vessel wall, improves blood circulation).
- Wearing tight underwear: wearing a permanent lead mechanical compression of the veins that obstruction of the venous outflow of the lower limbs.
- Chronic constipation : with frequent increase in abdominal pressure (during exertion) leads to difficult outflow of blood from the lower limbs.
- Common walk in high heels: lack of motion, the leg muscles, the development of stagnation.
- Hot season: frequent thirst leads to dehydration of the body occurs blood clots, the blood clots.
- Concomitant diseases of the cardiovascular system or diseases of the kidney: impaired outflow of venous blood (heart valve insufficiency, congenital abnormalities).
- Overdose of the drug increases the blood clotting: blood clots risk of blockage of blood vessels.
- The surgery, loss of a small amount of blood is not in a comfortable position on the operating table (the compression of certain blood vessels), which is the risk of blood clots forming.
Complications of varicose veins
- The formation of blood clots, as a result of the stagnation of the blood in the veins;
- detachment of the thrombus, occlusion of the vessel coincides with the diameter;
- thrombophlebitis (blood clots in the lumen of the vein to the inflammation of the walls);
- pulmonary embolism (detached blood clot the blood in the pulmonary artery, which is involved in the circulation, a small circle. If the clot diameter coincides with the diameter of the trunk of this artery, because of sudden death. If the clot is smaller in diameter, it passes on to the branches of the pulmonary artery, which is pulmonary infarction or edema).
- wounds or eczema of the legs caused by eating disorders (poor blood circulation leads to oxygen lack in the tissues, which is the main food of the tissues of the body);
- swelling different areas of the body as a result of stagnation in the veins (these are the soft, flexible, bluish color, education does not depend on the time of day, often in the form of the affected area);
- dermatitis (skin inflammation in the affected area) malnutrition due to the scene;
- change the color of the skin of the affected area;
- sealing subcutaneous fatty tissue in the affected area due to swelling.
Diagnosis of varicose veins
- The flagellum (functional) tests (defined in the obvious veins, the valves): Troyanova - Trendelenburg,Pratt, Chania, Del-per thee others. One of the most common test Troyanova - Trendelenburg, with which the patient to a horizontal position, lift the legs to 45 0, the doctor makes a stroking of the foot (as a result, the superficial veins emptied), then lays down, tourniquet, the upper thigh, ask the patient to stand normally, the filling of the veins of the lower leg should happen more than 15 seconds;
- Duplex ultrasound scanning of the veins (ultrasound angioscanning) the conference method, to evaluate the blood flow in the vessel, the vessel;
- Dopplerhophy - the method by which assess the blood flow in the vessel;
- Venography is the injection of a contrast material intravenously in the study of x-ray image;
- Phleboscintigraphy - after intravenous administration, the radiopharmaceutical, the observation of a special tool.
The treatment of varicose veins
The non-surgical treatment
- The traditional methods of treatment (as a complement to medical treatment): wearing compression hosiery (stockings); special exercises (swim, bike, skis, feet above your head, about 20 0 towards the bed, special exercises ("Bicycles" lying on your back, your breathing, imagine that the pedal Bike; alternately bend and straighten your leg, the ankle joint forward-backward) is used to enhance the outflow of blood, but only in the complicated cases); contrast shower (under running water to keep feet gradually reducing the temperature of the water reaches the cold); a foot bath (not a hot) decoction of oak bark, chestnut, chamomile, st. john's wort; alcohol tincture of flowers of acacia, the leaves of Kalanchoe, apple cider vinegar; thrombophlebitis treatment with leeches.
- The day: in the morning, slowly get up from the bed, (5-10 minutes), during sleep, place the pillow under the heel so as to lift the legs approximately 15 to 20 0 relative to the bed, the walk must be calm, not able to sit, legs crossed on the leg, bandaging the legs with elastic bandage of the legs, upper thighs, wearing medical stockings, good nutrition avoid boring movements, as well as a substance or factor that contributes to the thickening of the blood, with the exception the Smoking, the prevention of constipation.
- Diet : the body needs foods containing vitamin strengthens blood vessels, improves blood flow: vitamin C (contained in the citrus, tomato, rosehip, etc.), Vitamin E (legumes, liver, egg yolk, green onion), the vitamin R (grapefruit, walnut, black currant), the erection (dark cherry, sour cherry), copper (seafood). The corresponding daily fluid volume at least 1.5 liters. Limited to the use of alcoholic beverages, coffee, marinades, smoked products.
Phlebectomy:indications for removal of blood vessels: extensive varicose veins, vein saphenous abnormally dilated, nutritional disorders of the skin that are not suitable for the conservative treatment of acute thrombophlebitis, varicose saphenous veins is accompanied by violation of the general condition (severe fatigue, swelling of the legs) of the patient. Contraindications to the veins removal: coronary heart disease, severe infectious processes, the older age of the patient, the pregnancy, 2., 3. third, the inflammation in the legs (erysipelas, eczema). The advantages of the surgical treatment: the treatment only in severe cases, the only radical method of correction of the valves in the deep veins. Disadvantages of surgical treatment: traumatic (cosmetic error), does not require anesthesia, you need a couple of days in the hospital under the supervision of the surgeon. Laser therapy (endovascular microtermocoagulation) :Indications: a Combination of varicose veins, the following diseases: diseases of the circulatory system (coronary heart disease, high blood pressure), peripheral vascular disease (phlebitis, thrombophlebitis), respiratory diseases (asthma, bronchitis, pleurisy), the diseases of the digestive system (cholecystitis, gastric ulcer, duodenal ulcer), diseases of the nervous system (cranial trauma, neuroinfections), the diseases of the urogenital system (pyelonephritis, endometritis, salpingitis), skin diseases (dermatitis, Neurodermatitis), peritonitis, boils. Contraindications: people suffering from oncology diseases, diseases of the liver, the kidneys, the heart, the phase of the decompensation, cerebral sclerosis, pregnancy. Benefits: eliminates unpleasant vascular pattern, a quick procedure (about 15-20 minutes), do not require hospital treatment, it is safe, painless, does not harm the vessel tissue surrounding tissue. Cons: not available everywhere method expensive method, removes the larger ships possible thermal tissue damage, possible formation of scars, color (whitening) of the skin in the treated area. Radio-frequency coagulation (ablation) of varicose veins: Indications: varicose veins, a lesion of the trunk large and small saphenous veins, trophic ulcers as a result of varicose veins. Contraindications: acute thrombophlebitis of the subcutaneous veins, the impossible active walking, pregnancy, mental disorder. Advantages: there is no cosmetic defect, painless, does not require hospital treatment, does not violate the capacity. Disadvantage: the only disadvantage is the price. Varicose veins: Signs: small varicose veins, large varicose veins when duplex dopplerography of varicose veins in the early stages (if the damage is only to the superficial veins. Contraindications: pregnancy, lactation, allergic sclerosus, deep vein thrombosis, purulent-inflammatory diseases of the feet. Advantages: lower cost compared to a surgery, a quick time period restoration, not requiring a hospital stay (home), the best cosmetic result. Disadvantages:possible admission of the deep venous sclerosus, decreased efficiency due to the mixing sclerosus of the blood, are ineffective in advanced cases.