Varicose veins
Introduction
Introduction Varicose veins are the most common diseases of the venous system. The main reason for the formation is that they rarely change in the same posture for a long time. The blood accumulates the lower limbs, and the venous pressure is broken under the condition of accumulating the venous valve for a long time, resulting in varicose veins. Varicose veins occur mostly in the lower extremities. The skin of the legs is red or blue, twisted blood vessels like spider webs, sputum, or hard nodules like tree tumors. The veins are abnormally enlarged and swelled. Varicose veins are an irreversible phenomenon because the body does not have the mechanism to repair the membrane itself, but it can still prevent the expansion of varicose veins by conservative treatment (such as the use of elastic socks, exercise, diet and changes in lifestyle). Reduce its symptoms. Mild movements such as walking, swimming, and cycling can reduce the rate of new varices, in addition to improving circulation. In terms of diet, you should eat a high-fiber, low-fat diet and enhance the supplement of vitamins C and E. In daily life, you should control your weight, avoid taking birth control pills, avoid wearing tight clothing and high heels, squatting legs and avoid sedentary or standing for a long time. Raise your legs for a period of time before going to bed every day, and sleep on the left side while sleeping to reduce the pressure on the pelvic veins. Smoking can cause blood pressure to rise and arteries and veins to be damaged. Patients with varicose veins should quit smoking immediately.
Cause
Cause
Due to the small change in the same posture for a long time, the blood accumulates in the lower limbs, and the venous pressure is broken under the condition of accumulation of the venous valve, resulting in varicose veins. The cause of varicose veins is also due to standing work for a long time, blood is deposited in the veins of the lower extremities, and blood circulation is not smooth. The best way to prevent varicose veins is to exercise more. Running can increase leg muscle activity and squeeze blood in the veins to make it flow more smoothly. Long-term adherence, varicose veins will heal.
Examine
an examination
Related inspection
Deep vein patency test
Clinical manifestations:
1. There are no obvious symptoms at the beginning, some patients often feel heavy limbs, pain, fatigue, and can be relieved after rest.
2. The superficial veins of the affected limbs gradually bulge and expand, and sometimes they can be curled into a mass or a sac, especially after standing, and disappear after raising the legs.
3. The elderly with the disease, pigmentation, itching and eczema in the lower leg and ankle. Some patients may have thrombophlebitis, local redness and lumps, tenderness. The varicose veins are easily damaged by bleeding, or the infection forms an ulcer. The symptoms of varicose veins, the expansion, bending, and prolongation of the varicose veins are called varicocele. More common in young people, mostly between 16-25 years old, the incidence rate is about 15%, 99% occurred on the left side, about 1% on both sides.
Diagnosis
Differential diagnosis
Diagnostic criteria:
First, there is a long history of standing and raising the abdominal pressure, or a family history of varicose veins.
Second, the patient's lower extremity veins are obviously distorted and expanded, which is more obvious when standing.
Third, deep vein patency, great saphenous vein valve insufficiency, may have traffic venous valve insufficiency. Fourth, ultrasound Doppler or venography showed large saphenous vein tortuous expansion, valve insufficiency. Fifth, may be associated with pigmentation, ulcers, thrombotic superficial phlebitis, bleeding, ulcers and other complications. Peripheral vascular disease is a general term for peripheral vascular disease, including varicose veins, thrombophlebitis, vasculitis, arteriosclerosis obliterans, deep vein thrombosis, Budd-Chiari syndrome, Raynaud's syndrome, and so on. The varicose veins mainly include the following:
1. varicocele (one of the male testicular diseases, also known as scrotal varicose veins, testicular varices):
Is the testicular varicose veins is not standardized, in fact, is varicocele, also known as scrotal varicose veins. According to different factors of the disease, varicocele is generally divided into primary varicocele and secondary varicocele.
(1) Primary varicocele occurs mostly between 15 and 30 years old. It is speculated that the scrotum and its contents are rich in blood supply during this period, and sexual desire is strong. Excessive local stimulation can reflexively cause pelvic and spermatic vein venous congestion. This leads to the occurrence of varicocele. In some patients, varicocele can disappear or be alleviated after marriage.
(2) Secondary varicocele is caused by compression of the spermatic vein on the way back, mostly in the 35-year-old. Common compression diseases are: kidney tumor, ureteral tumor, retroperitoneal tumor, hydronephrosis, Perirenal empyema, vagus blood vessels, iliac vein obstruction and so on.
2. Lower extremity varicose veins:
Varicose veins of the lower extremities are the most common diseases of the venous system. The main reason for the formation is to maintain the same posture for a long time, blood accumulation in the lower limbs, long days, high venous pressure, venous valve damage, abnormal expansion of the veins and varicose veins.
3. Upper extremity varicose veins:
Upper extremity varicose veins are rare and should not be varicose veins. Because when the upper limb is in the drooping position, the venous return is relatively slow, and the vein is more obvious. However, some people have natural veins. The veins you can see are between the skin and the muscles. The veins are obviously not related to the muscles, but the muscles are well developed, the blood supply is abundant, and the veins are more obvious when the reflux venous return is more. Such as bodybuilders. Thin skin will only show subcutaneous capillaries, which is obviously not related to veins.
Another symptom of this is venous syndrome:
Venous Syndrome (SVCS), a group of syndromes caused by obstruction of blood flow through the superior vena cava, can cause complete or incomplete upper vena cava obstruction by different causes, causing blood flow to be blocked and triggering a series of syndromes. Most of the reasons are mediastinal tumor or hilar tumor and mediastinal inflammation, and a small number is due to superior vena cava thrombophlebitis.
Common symptoms of SVCS include:
1. Facial edema on the face, neck, upper torso and upper extremities.
2. Jugular vein filling, superficial collateral varicose veins and skin bun in the chest and upper abdomen.
3. Laryngeal, tracheal and bronchial edema cause cough, difficulty breathing, hoarseness and wheezing, and the above symptoms are exacerbated when lying down or bending over.
4. Pharyngeal edema, causing difficulty in swallowing.
5. Periorbital edema, combined with membrane congestion, may be accompanied by eyeballs.
6. Brain edema and intracranial hypertension, causing headache, dizziness, convulsions and visual and conscious disturbances.
7. The peripheral venous pressure is increased, the venous pressure of the upper limbs is higher than that of the lower limbs, and the anterior venous pressure is often raised to 30-50 cmH2O. The presence and severity of the above symptoms depends on the degree of superior vena cava obstruction, the rate of development, and the collateral circulation.
4. Pelvic varicose veins:
The symptoms of pelvic congestion syndrome (pelvic varices) are mainly lower abdominal pain, low back pain, sexy discomfort, extreme fatigue, blood stasis and premenstrual breast pain.
5. Penile varicose veins:
Penile varicose veins refer to the venous blood of the penis that can be returned to the superficial venous venous via the superficial vein of the penis, and then injected into the saphenous vein. It can also return to the pelvis with the deep vein of the penis and then into the genitals. The internal vein is returned to the heart. If it is a simple penile varicose vein, it may be caused by the inferior penile vein or the deep vein of the penis.
6. Stomach varices:
Gastric varices are caused by the formation of collateral circulation caused by "portal hypertension". The root of the disease is in the liver, such as advanced cirrhosis and liver cancer. After esophagogastric varices, it is easy to rupture due to food stimulation, resulting in upper gastrointestinal bleeding. Treatment is not effective, surgery can be performed, the main trunk of the esophagus and gastric veins can be ligated, or a more advanced "portal shunt" "", reduce the pressure in the varicose veins, thereby reducing the chance of bleeding.
7. Chronic varicose ulcers:
Long-term varicose veins can lead to chronic varicose ulcers. Patients with varicose veins and chronic calf ulcers are more difficult to heal. In addition to actively treating lower extremity varicose veins, infection should also be controlled. Local or systemic antibiotics should be applied to clean the sores and reduce secretions. Promote the healing of skin lesions, Chinese medicine to distinguish this syndrome as qi deficiency and blood stasis, cure Yiqi Huoxue Shengshen method, choose Buyang Huanwu Tang.
