Treatment of the varicose veins of the legsIt is a difficult task for both the doctor-photologist and the patient himself.This is due to different forms and stages of the disease, which require significantly different therapeutic measures.An important role is played by the principle of minimal injury and the fastest rehabilitation of the patient.Effective and, at the same time, saved therapeutic procedures are high technology and require modern medical equipment and qualified-photobologist specialists.
Ways to treat varicose veins:
- Conservative events
- Sclerotherapy
- Surgical methods
Almost always, treatment methods are used together, successfully combined and complemented with each other.
Conservative treatment of varicose veins.
This is a set of measures aimed at reducing the risk of complications of varicity and improving the patient's quality of life.This method does not eliminate varicose veins and, therefore, requires constant use.
- Lifestyle correction-Mebrases destined to train the so -called muscular and venous bomb.The venous bombMuscle is a type of pump that provides a venous blood outlet from the lower extremities.The operation of this pump is possible thanks to the joint work of muscles and veins of the legs.With muscle contraction, the veins are compressed, passing between and inside the muscles, so the blood moves towards the heart.Training includes several exercises, dynamic sports loads.Swimming, classes on an exercise bike, walking Scandinavo, running skiing are very useful.It is necessary to exclude long static legs.To improve the venous output flow, the pastoral drain called so is useful during the day, that is, the adoption of the pose in which the legs are in a high position, which contributes to the venous output flow.For example, the appearance of a "cowboy pose", when a person sitting in a chair puts his legs on the table.Respiratory gymnastics is useful, because adequate deep breath stimulates the venous flow of blood.It is recommended to exclude the overheating of the body, since the tone of the veins falls significantly.The venous stagnation that arises from this is a factor that damages the wall of the veins.
- DietIt is an important component of therapy.Food should contain a sufficient amount of vitamins and trace elements.Proper nutrition contributes to regular physiological outputs.In the absence of constipation and frequent swelling of the abdomen, a normal venous blood exit remains from the lower extremities, and the probability of varicose veins is reduced.
- Compression therapyIt includes the use of several bandages, bandages, knitting, mechanical devices.On the surface of the legs, pressure is created, which is transmitted to deeply located tissues and has a therapeutic or preventive effect.
The main value in compression is currentlyMedical compression knit garments.The elastic leg transmission is now used much less frequently.The advantages of compression point products on bandages are obvious: the simplicity and ease of doing while maintaining the necessary and physiologically dosed pressure.The binta of the legs is used in special cases: in a special form of the legs, in cases of a complex course of venous trophic ulcers, in certain stages of surgical treatment of varication.The appropriate bandage is a complex process carried out only under the supervision of a doctor.
The selection of the type, the shape and class of point garments must be made by a specialist.This is due to the fact that there are certain contraindications to use compression medical devices.For example:
- Severe cardiopulmonary failure is a contraindication for leg compression.
- The greatest efficiency of a particular product in a particular patient is important.
- In the treatment of chronic veins diseases, in particular the advanced cases of varicose veins, which are accompanied by significant venous edema, the compression variable called SO, created using the dynamic pneumocompression apparatus.
- In the pharmacological treatment of varicose diseaseFlebotropic drugs called SO (Synonyms are the main importance of active drugs, phleboprotector).This is a large group of drugs that can reduce the severity of chronic venous edema and other manifestations of chronic veins.Unfortunately, phlebotropic drugs do not restore the varicosity changed by veins.The medications of this group are prescribed in the form of courses for 2-4 months.These funds are effective only when oral administration.
- The most effective method of varicose veins of physiotherapy isElectric muscle stimulation of the lower extremities.This method can be used when medications and compression knitted clothes are contraindicated for several reasons.Like other conservative measures, this method does not eliminate varicose veins, but reduces manifestations of concomitant venous insufficiency.There are modern individual portable devices for independent electrical stimulation.
Sclerotherapy
Sclerotherapy: the main method without varicose survey treatment.The essence of the method is very simple: a special drug is introduced into varicose through the syringe, and compression applies to the feet.As a result, the closure (occlusion) of the sick area of the boat is produced.In the future, the varicose vein disappears completely.Blood moves through healthy veins, blood circulation in the leg improves.At the same time, not only expanded veins disappear, but also the clinical manifestations of the disease: pain, swelling, cramps, leg severity.The procedure for a long time, and often for life, guarantees good treatment and cosmetic result.Low cost, minimum risk of injury, a combination of a good functional result with a high cosmetic effect are the distinctive characteristics of this method.
ModernSclerotherapy large varicose veinsAnd the trunks of the subcutaneous veins are carried out by means of a foam form under the control of an echo of echo of ultrasound scanner (foam shape).Micro sclerotherapy "vascular stars" is performed under the control of a special apparatus: the transilumenant.
Sclerotherapy as an independent therapeutic procedure is performed with:
- Isolated varicose expansion of subcutaneous veins;
- Reticular varicose ("vascular grid");
- Tulangiectasia.
In several patients, to reduce operational lesion and increase the cosmetic result, sclerosis is carried out after a certain time after surgical intervention.FleboscleroticIt is used to treat relapse varicish to stop and avoid bleeding through varicose veins, as well as in some forms of congenital angiodisplasia.
Contraindications for the use of sclerotherapy:
- Serious systemic diseases (heart or pulmonary failure, liver failure, etc.)
- Thrombophlebitis
- Local or general infection
- The need to meet bed rest
- Expressed allergic manifestations
- Pregnancy and breastfeeding period
- Conditions in which leg compression therapy is contraindicated
Surgical methods to treat varicose veins
Surgical interventions with varicose veinsThe legs are the most radical treatment method.The vast majority of modern transactions can be performed in an outpatient basis or in surgical hospitals of a one -day stay.
Scientific and technological progress caused revolutionary changes in the treatment of varicose veins of the lower extremities.After the introduction of high energy lasers in the clinical practice of phlebologists,Endovasal laser obliteration (ELO)It has become a small invasive treatment of varicity.The essence of Elo is the destruction of varicose veins with a laser beam.This technique is not an operation in the traditional sense.No incisions are required, all manipulations are carried out through micro punctures.The intervention is carried out in an outpatient basis under local anesthesia and hospitalization in the hospital does not require.All manipulations are carried out under visual ultrasound control.Through a small puncture at the bottom of the thigh or the upper leg from the bottom of the leg, a thin flexible laser light is introduced into the vein.After that, a solution of anesthesia for pain relief around the vein is administered.In the operating mode, strictly dosed thermal energy is supplied through the Svetovod, which causes a complete closure (occlusion) and an additional prison ("overloaded").
The patient retains a fairly active daily routine with minimal discomfort.Elo in terms of efficiency and at the same time the least possibility of injuries significantly exceeds the existing methods of classical operations.
There are restrictions for the use of ELO:
- Extremely neglected varicish with significant expansion and main subcutaneous veins.In such cases, combined phleubectomy is shown.
- Repeated interventions in subcutaneous veins.In these cases, the possibility of using ELO is specified individually in each patient with an in -depth exam.
Great expanded varicity of the trunk trunk are currently eliminated using a savings procedure such asAmbulatory Mini Fleubectomy.This intervention is performed under local anesthesia with special tools through micro.As a general rule, it is done immediately after ELO or is used as an independent method.No hospitalization is required in a hospital and anesthesia.Pain and discomfort in the postoperative period are minimal.With large varicose veins, a cosmetic result is often higher than with sclerotherapies.
Classic operations
Classic operations are shown in casesvast neglected varicose lesions.As a general rule, hospitalization is required in a specialized hospital for vascular surgery.Interventions are performed using anesthesiological manuals: anesthesia or regional anesthesia (spinal).These operations include combined phleubectomy, endos -surgical dissection of perforating veins.This group of operations has a long rehabilitation period, often a unsatisfactory cosmetic result.Often there are complications in the form of thrombophlebitises, damage to healthy tissues, nerves, early relapses of varication.
In conclusion, it should be said that, despitea complex integrated approach in the treatment of varicose veins,This pathology is treated successfully.