Venous insufficiency
Contents:
Description:
Venous insufficiency – the disease connected with insufficiency of valves of deep veins. A disease very frequent and familiar to many people, however, suffering from a lack of attention to himself as from the patient, and until recently from medicine, arose as payment of the person for bipedalism. Features of modern life - the hypodynamia, long sitting and standing at work, and also some inborn features of vascular system and the hormonal status lead to problems of venous outflow of blood.
The main substrate of chronic venous insufficiency is as it is already told above, insufficiency of venous valves. Valves are available both in deep veins, and in superficial. At a deep vein thrombosis of the lower extremities their gleam is corked. However, over time their gleam is recovered. There is it thanks to a so-called rekanalization. However after such recovery of a gleam of veins there is no recovery of their valves. Veins become inelastic, there comes their fibrosis. Valves of veins collapse and the normal blood stream stops.
Symptoms of Venous insufficiency:
The main manifestation of chronic venous insufficiency are:
* Hypostases of the lower extremities
* The dull arching aches amplifying at long standing and decreasing at rest
* Spasms in gastrocnemius muscles at night
* A xanthopathy in the field of the lower part of a shin
* Dermatitis, eczemas
* Trophic ulcers, generally in anklebones
Reasons of Venous insufficiency:
The mechanism of chronic venous insufficiency is as follows. The damaged valves of deep veins of legs cannot interfere with a retrograde blood flow in them. It leads to substantial increase of pressure of blood. Owing to what a liquid part of blood – plasma – begins "to transude" through walls of veins in surrounding fabrics. It leads to hypostasis, consolidation of fabrics. Hypostasis squeezes small vasculums of skin in a shin. Especially anklebones. It leads to their ischemia therefore trophic ulcers – one of the main signs of venous insufficiency develop. Can result factors which promote development of a varicosity of legs (primary or secondary), to a deep vein thrombosis of legs, and also primary insufficiency of valves of deep veins of the lower extremities in chronic venous insufficiency.
Treatment of Venous insufficiency:
Treatment of venous insufficiency consists practically in the same actions which are used at a posttromboflebitichesky syndrome and a varicosis.
Let's list these methods of treatment:
* Compression therapy is applied both a varicosis, and a posttromboflebitichesky syndrome and chronic venous insufficiency. Elastic bandage are applied to compression therapy, but special compression jersey is more often. Depending on the created pressure it is divided into four classes. Action of compression jersey is based that when superficial veins of legs clench, outflow of blood from deep veins in system of superficial veins becomes impossible.
* Sclerotherapy. This method of treatment of a varicosis is known since the time of Hippocrates. In due time in our country the method was unfairly rejected. However abroad this method developed successfully and applied. J. Fegan is considered the founder of a method. Its technique of sclerotherapy is known since 1967. This technique is still known as compression sclerotherapy. The method is that special substances which irritating an internal wall of veins are entered into a vein lead to its corrosive burn. It leads to adhesion of walls of veins and their fusion. Now to a vachestvo of such drugs – sklerozant - it is used фибровейн, этоксисклерол and тромбовар. After introduction of a sklerozant to a vein it contracts a latex small pillow then it is bandaged. Thus all veins are sclerosed. As a result the lower extremity becomes bandaged. Instead of bandage compression stockings will more often be applied now. The compression of veins proceeds up to three months. It should be noted that this method is not deprived of shortcomings, namely, it does not guarantee against a varicosity recurrence.
* Surgical methods. Troyanov-Trendelenburga operation – a technique consists in bandaging of the place of falling of a saphena of a hip into a femoral vein, and also at a distance a conglomerate of varicose veins. For this purpose in a hip on length of all varicose vein the section becomes.
Linton and Kokket's operation – it a technique is that the section in a shin is carried out, and perforantny veins tie. At the same time at Linton's operation they tie tie under a fascia, and at Kokket's operation – over a fascia. This operation is effective at insufficiency of valves of perforantny veins, at a so-called posttromboflebitichesky syndrome. Now these operations are modified in such a way that bandaging of these veins is carried out from the minimum section. It is so-called technology of remote crossing of perforant. Besides, also the endoscopic equipment is for this purpose used. It is the so-called low-invasive equipment.
Bebkok's operation – is that at the beginning of a saphena of a hip the section becomes. The hypodermic varicose vein is excreted. The flexible probe which other end is removed since other end of a varicose vein, at area of a knee is entered into a gleam of a vein. On the end of the probe roundish education is had. Vienna is fixed to it and brought by the probe. Now the technique of stripping and miniphlebectomies which in effect are modifications of operation of Bebkok will be applied, but at the same time instead of a section the thick puncture after which there is practically no hem left is used.
