Varicose veins is not only an aesthetic problem. We talk about the serious threat to the health and even life. The first sign of the disease should consult a doctor and start treatment.
Let's see what nurse can provide medicine.
The modern approach to the treatment of varicose veins
It is difficult to underestimate the prevalence of this disease, because according to statistics, it affects about 75% of women and 60% men. And it is only among the inhabitants of developed countries. In order to explain the cause of varicose veins, you should have an idea of the structure of the veins of the lower extremities. Venous blood in our legs constantly moving upward, to overcome the force of gravity, to implement this process, the veins are equipped with special valves that prevent the liquid to fall down between the jolts of the heart. Disruption of this mechanism provokes the reverse current of venous blood, and because of the greater number of veins to dilate, reducing their tone.
In the first stage of varicose veins usually passes without special symptoms, except that accompanied by mild discomfort in the legs, and "heaviness" in the evening. You may notice that my feet are tired even after a short walk. The second part of the compensation stage, these features are enhanced and appear aching pain, swelling, tingling in the legs, cramps.
Third, the de-compensatory stage is characterized by irreversible changes in the skin of the shins:
- swelling, which are not fully converge even after sleep;
- hyperpigmentation;
- indurata — seals exposed skin.
Thus the skin becomes easily vulnerable, potential varicose eczema, and as a finale trophic disorders, ulcers. Ignoring the disease is also facing such complications, such as thrombosis and thromboembolism.
The sooner treatment begins, the more hopeful is the prognosis. But after success, you need to change your way of life, leaving time for preventive procedures.
Suspected varices should be a reason for early visits to the doctor, which helps to identify the disease and determine its stage.
Diagnosis — the first step to recovery
In particular, the doctor will interview the patient is necessary to collect the anamnesis. Still the standard inspection and palpation of the affected areas. More detailed and accurate diagnostic use angio ultrasound duplex scanning color mapping of blood flow. The procedure is so simple ultrasound the only difference is that in addition to the two-dimensional images the doctor sees the speed and direction of movement mapping blood flow through the vessels. Modern ultrasound machines can accurately determine the idle valve in the vein segment abnormal direction of blood flow, just mark the projection on the skin.
When the diagnosis is clarified, it is time to begin to take steps to get rid of varicose veins.
Conservative treatment of varicose veins
Non-surgical methods can prevent, inhibit or alleviate the disease. The main method of treatment they are used only in the case that the action is not possible.
Conservative methods include:
- Compression therapy, i.e. the use of special compression underwear or elastic bandages. Their effect constricts blood vessels, which facilitates the operation of the valve and improve blood circulation. The effectiveness of compression therapy has been proven in many studies. It is only after their atherosclerosis, aortoarteritis, inflammatory skin diseases and others.
- Drug therapy involves the use of medications, such as oral and local applications (in the form of creams). A group of medications for the treatment of varicose veins in the legs are venotonic and anti-inflammatory medicines, anticoagulants (blood thinners). The necessary medicines the doctor prescribes individually. It is important to remember that everything is just. For example, most tablets venotonic can not be taken during early pregnancy and if breast-feeding. And when anticoagulants need regular blood tests to check blood clotting.
The primary treatment without any obstacles and contraindications to appoint one of the options for surgical treatment.
Traditional surgery (venectomy)
Currently used only in certain cases, related to the specific structure of the veins or complicated course of the disease, for example, various forms of acute thrombophlebitis.
The operation consists of ligation of the confluence of the frame affects the saphenous vein deep in the system (crossectomy) and further mechanical removal of the barrel. Manipulation is performed under general anesthesia or spinal anesthesia and lasts 1-2 hours. Because of the high incidence of postoperative complications — hematomas places remove-frame, long-term pain, skin neuralgia and paresthesias (numbness) in recent years, the traditional surgical procedure to give way to modern methods. These include endo-venous laser photocoagulation.
After surgery we recommend regular exercise is not a significant load for one and a half months shows compression therapy.
In addition, this form of treatment, there are other, more gentle ways to get rid of varicose veins in the legs.
Minimally invasive techniques
There are several different minimally invasive methods to treat varicose veins. On the basis of information about the patient and the features of the disease by the attending doctor makes the decision about whether to perform one of the procedures.
Endo-venous laser photocoagulation
The action of endo-venous laser treatment has become the method of treatment of varicose disease of any severity. Neither the severity of venous insufficiency or the thickness of the lumen of venous trunks currently are no limits for endo-venous laser treatment. This was possible thanks to the use of the following tools:
- two-wave lasers one of the wave absorption by hemoglobin and other blood vessel wall;
- the radial fibers, thereby machining the entire circumference of the inner surface of the vessel;
- automatic pump that allows the pump to anesthesia solution around the vein to provide pain relief, reduce the diameter of the vein, and protection of adjacent tissues.
Special preparation for endo-venous laser treatment is not necessary. Before surgery is necessarily performed ultrasound duplex scanning. It is also necessary to give the blood a standard set of preoperative tests: General, biochemistry, coagulogram.
During the procedure, the doctor will puncture the affected vein, and then add a thin (1 mm thick) catheter, which has a light-guide. This whole process, as well as position-light guide in Vienna and still "brewing" Vienna is controlled by intraoperative ultrasonic devices. The operation lasts about 40 minutes and requires only local anesthesia.
After surgery spent in the hospital is not required, the patient must wear a compression garment for 3 to 5 days, and in a couple of weeks the recommended daily relaxing walks.
Radio frequency ablation
The operation is substantially similar to laser coagulation. The only difference is that the walls of the veins to his "closure" and subsequent resorption the effect of radio frequency radiation. Special training, in addition to the standard before the surgery, is not needed.
Currently, in connection with the improvement of laser systems, not in the interests of endo-venous laser photocoagulation, radiofrequency ablation is not. However, the procedure is more expensive, because of the high price of the waveguides.
Operation can not be done during pregnancy and lactation, atherosclerosis of the arteries of the lower extremities and the inability to later exercise.
Possible complications and complicated corrective measures during the rehabilitation period is similar to the previous procedure.
Mini-phlebectomy
The principle of operation is to remove the tributaries and parts of the vein through a hole or incision in the skin using special tools. It is used isolated varicose tributaries or as an additional procedure after laser coagulation, radiofrequency ablation, and surgical phlebectomy.
The training is similar to the previous procedures — a standard set of tests and ultrasound of the veins. Contraindications pregnancy and lactation, acute infectious disease, thrombophlebitis, impaired motor activity, pathological blood clotting.
The duration of the mini-phlebectomy is 20-40 minutes, during rehabilitation it is necessary to use compression stockings.
Sclerotherapy
Non-surgical methods of varicose vein treatment is suitable for advanced varicose veins, and for aesthetic reasons — the destruction of vascular "stars" and "veins".
Topics include thrombosis, Allergy, infection, pregnancy and lactation, the inability to perform accurate injections.
Sclerotherapy involves the injection of a puncture using a special substance that "glues" the vascular wall subsequent to its degradation. One of the latest innovations — method of foam-a foam which involves the use of a foam form of the drug. Thus it is at least to wash off the blood, which makes it possible to reduce the concentration and amount of substance is the higher the efficiency. The procedure is performed without anesthesia, so when a puncture is needed only a thin insulin needle.
Side effects of sclerotherapy include pigmentation, which, of course, sklerozirovanie Vienna. In some cases, incomplete bonding of Vienna, which will require re-treatments.
After sclerotherapy, you need to wear a compression garment and avoid strenuous activities and high temperatures (for example, when you visit a sauna).
The price of sclerotherapy depending on the volume. Removal of large varicose trunks sclerotherapy is now almost never used. And sclerotherapy of small nodes or venous nets pay 7000 to 20,000 rubles.
With the development of medicine to fight varicose veins in the legs have moved into the category of "hundred years war" in the category of "quick wins". Advanced surgical techniques have given way to minimally invasive procedures that are safer and effective. Today varicose veins is not a sentence, but the only reason to see a specialist.