- Causes of varicose veins and risk factors
- Varicose veins of the lower extremities: symptoms
- Complications of varicose veins
- Classification of varicose veins
- Varicose veins of the lower extremities: diagnosis
- Varicose veins of the lower extremities: treatment
- Prevention of varicose veins
This is primarily due to the difference in blood pressure on the walls from the inside.
The middle layer of arteries is represented by dense collagen fibers that prevent the vessel from breaking.
In the middle layer of the vein, smooth muscle fibers that are located spirally prevail. In addition, single muscle fibers are also present in the inner layer of the vein, forming, together with the endothelium, special folds - valves. Valves are defined mainly in the veins of the lower extremities.
The peculiarity of the structure of the veins helps to redistribute blood during exercise and not to reverse the movement of blood.
The loss of elasticity of the vessel wall of the venous type, with the expansion of its lumen, with the development of insufficiency of vascular valves, leading to disruption of the normal blood flow - received a separate nosological unit in the form of a disease called varicose veins or varicose veins from the Latin varix.
In the walls of the affected vessels develop sclerotic-degenerative changes due to their stretching, thinning, with the subsequent formation of spherical extensions (nodes) in its length. The valves of the initial stages of the disease are still preserved, but the complete closure of the vessel lumen does not occur with their help. Later on, when local inflammation and thrombosis join, the valves disappear, aggravating the clinical picture of venous insufficiency.
The disease is quite common: the average "coverage" of the population - 10-18%, with a predominance in females (2-3 times more often).
Most of all varicose changes are subject to the veins of the lower extremities. However, varicose veins can be observed in the vessels of the walls of the large and small pelvis. Practically this disease does not occur in the vessels of the upper extremities.
Expansion of the lumen of the veins, as a manifestation and complication of other diseases of the internal organs, can be observed in the submucous veins of the esophagus in diseases of the liver, rectal mucosa with hemorrhoids, in the veins of the seminiferous tubule and testicle in the varicocele . The overlap of the lumen of a large venous vessel with a growing tumor from neighboring organs may also cause varicose veins, with localization uncharacteristic of this disease.
Causes of varicose veins and risk factors
Observed with genetically determined, transmitted in the genus, functional immaturity of the valvular apparatus and the underdevelopment of the connective tissue component of the vascular wall. This leads to an increase in pressure inside the vessels and the development of varicose veins already in early childhood, with the appearance of the first physical exercise.
2. Disorders of blood coagulation.
This group includes congenital factors associated with hypercoagulation. Formed in these cases, blood clots, create obstacles to the normal flow of blood, followed by expansion of the vessel lumen.
3. Changes in hormonal levels.
This factor is most pronounced in women due to changes in the level of sex hormones during pregnancy and during menopause. A decrease in estrogen with a simultaneous increase in progesterone, under physiological and dysfunctional conditions, increases the production of blood clotting factors. In addition, this hormonal background leads to changes in protein-lipid metabolism with a decrease in the synthesis of elastic and collagen fibers with a subsequent decrease in the tone of the wall of the venous vessel. The overall result is a reduction in blood flow with the formation of blood clots and insufficiency of the valve apparatus.
4. Increased body weight.
General obesity has a mechanical effect on the wall of the veins, especially this is observed with its abdominal type, causing an increase in venous pressure below the compression zone. In addition, the occurring dysmetabolic and dyshormonal changes with extreme degrees of obesity distort the normal rheological properties of the blood. This again leads to mechanical blockage of blood vessels from the inside (thrombosis). A sedentary lifestyle for obesity also helps to slow blood circulation.
As a result of complex metabolic disorders, due to hyperglycemia, with relative insulin deficiency, there is a decrease in the elasticity of the vein wall with a subsequent expansion of its lumen.
Permanent dehydration, observed in alcoholism, increases blood clotting with subsequent violation of bleeding.
7. Professional factors associated with increased physical activity and a long vertical position.
This applies to loaders, conductors, salespeople, surgeons, hairdressers, production line maintenance workers, etc. The risk of developing varicose veins in these people is due to stagnation of blood in the lower extremities due to constant high intra-abdominal pressure, which prevents blood from being delivered to the heart.
8. Mechanical compression of veins with close underwear .
Observed with the constant wearing of this type of clothing.
9. Frequent constipation.
They lead to an increase in intra-abdominal pressure during straining, followed by a logical chain of development of varicose vein lumen.
10. Wearing high heel shoes.
First of all, it is dangerous to restrict movements in the ankle joint, and therefore to reduce the muscles of the lower leg, which help the blood to move upwards.
11. Climatic factors.
Staying in conditions of elevated ambient temperature without a corresponding replacement of fluid loss - becomes the cause of thrombus formation with subsequent violation of the venous outflow.
12. Unreasonable prescription and uncontrolled medication with a main or side effect in the form of accelerated blood clotting.
13. Previously carried out abdominal surgery.
Dangerous are the increased risk of small and large venous thrombus formation, resulting in impaired outflow of blood from the extremities.
14. Severe cardiovascular diseases with symptoms of circulatory failure, as a consequence of a decrease in the contractile function of the myocardium.
15. Previously injured limbs and surgical interventions on them.
There are important cicatricial processes that prevent the outflow of blood.
16. Constitutional features.
There is a predisposition to varicose veins in tall people, especially in combination with overweight.
The development of varicose veins is mainly observed in the Caucasoid race.
18. Chronic inflammatory processes of the pelvic organs.
As a rule, this applies to diseases of the internal genital organs (prostatitis in men and inflammation of the appendages in women). The mechanism is due to the involvement of small venules in the inflammatory process. The resulting edema of their inner lining, complicates the outflow of blood, forcing the disclosure of communicative vessels, combining arterial and venous bed. Blood enters veins with a significant increase in intravascular pressure and volume. Following this, the previously described mechanism is repeated: dilatation of the veins and insufficiency of the venous valves.
Varicose veins of the lower extremities: symptoms
1. External changes of the saphenous veins .
The veins acquire a focal uniform or saccular thickening of the diameter, with the formation of peculiar knots and tangles of blood vessels. Altered vessels are stained in dark purple or blue. Small, previously undetermined veins show through the contours in the form of intracutaneous venous "reticulums".
Most often, such changes are the veins of the feet and tibia. As the process progresses, a similar pattern is revealed in the venous vessels of the thighs.
2. The pain .
Patients noted early fatigue, heaviness in the legs. There is a dull pain arching character in the calf muscles. Over time, the pain becomes more intense, with the possible occurrence of cramps in the muscles of the leg. It is noted that after finding some time for the legs in a horizontal position, the described symptoms subside for a while, so that later, when going into a vertical state, it will resume again (orthostatic kralralgia). The pain increases with palpation of the leg. In the absence of changes in the surface veins, in this situation, the presence of varicose changes in the deep veins of the limb should be suspected.
3. Edema of subcutaneous tissue.
There is edema of the feet (pastoznost) with the spread to the lower third of the leg, accompanied by itching of the skin in the projection of the lesion. If during the night pastoznost from the subcutaneous tissue at the level of the ankles of the ankle joint does not disappear, then you should think that the phenomena of venous insufficiency have passed into the stage of decompensation. In these situations, the addition of a secondary infection and the debut of a trophic ulcer should also be excluded.
4. Itchy skin.
It may appear before the manifestation of bright clinical symptoms of varicose veins, but most often occurs already with symptoms of pronounced disorders of venous outflow of blood.
Arises already with the expanded clinical picture of the disease. The skin becomes darker in the course of the altered veins and perifocal from them, in places of mechanical damage with bruises. In the future, all the skin in the distal extremities acquires a bluish color (induration). The surface epithelium becomes thinner, the subcutaneous structures atrophy.
6. Hypothermia of the limb end sections.
Palpation of the skin of the extremities is cold. Patients also feel the constant "freezing" of limbs.
7. Trophic ulcers.
Some clinicians regard this symptom as a complication of varicose veins. Another part considers the appearance of defects in the skin in the form of open ulcers against the background of indurationally modified areas - the last stage of the disease.
Complications of varicose veins:
- Thrombophlebitis .
- The accession of a secondary infection (most often erysipelas) to the existing trophic ulcers and with the development of wet gangrene of the limb.
- Deep vein thrombosis followed by deadly thromboembolism of the pulmonary veins.
- Eczema (dermatitis).
- Bleeding from damaged varicose veins.
Classification of varicose veins
The changes relate primarily to the superficial veins. The violation of the structure of the deep veins and the change in the performance of the functions assigned to them are initially absent.
It develops as a complication of primary diseases of the deep veins, after which changes occur in the superficial veins of the lower extremities. This occurs in the presence of congenital defects of the venous system (vascular dysplasia, fistula), as well as the outcome of a deep vein phlebothrombosis previously transferred. Causes of blood clots in the veins were discussed above.
In addition, there is a division of varicose disease according to clinical forms.
- Varicose lateral (lateral) veins of the thigh and lower leg.
- Reticular varicose veins.
- Varicose telangiectasia.
Varicose disease of laterally located veins of the lower extremity occurs both independently and when combined with other clinical varieties. Reverse discharge of venous blood is carried out in the deep vein of the thigh through the subcutaneous and surrounding veins.
Reticular (reticular) and in the form of telangiectasias (nodules of the intracutaneous capillary vessels) varicose veins, in their isolated variants, do not lead to the development of venous insufficiency. These forms of varicose veins deliver only cosmetic discomfort.
Recently, angiosurgeons have begun to allocate more and idiopathic venous insufficiency (IVN). Veins in this disease, unlike other forms of the disease, have initially increased venous tone for no particular reason. Symptoms in IVN is no different from the classic manifestations of varicose veins.
The widespread assessment of the stage of varicose disease has received a classification according to V.S. Saveliev.
Stage of compensation .
The pain is minimal or absent. Determined discomfort in the legs with a long sitting or upright position. In the superficial parts of the skin, small vascular stars are detected. Periodically there are minor swelling of the feet and ankles. They quickly pass after the adoption of a limb horizontal position.
Even with a superficial glance at the limbs, the presence of veins with an extended lumen draws attention to itself.
Complaints of patients with more specific: the pain in the legs arching nature, fatigue. At night, cramping of the muscles of the leg occurs suddenly or against the background of the "goosebumps" (paresthesia) sensation. Edema in the lower third of the leg and on the feet is more pronounced, but after a night's sleep, they disappear.
Stage of decompensation.
The clinical picture is exacerbated by local changes in the skin: it takes the form of a dry and smooth surface, hair loss, hyperpigmentation of the skin, followed by induration of the underlying fiber is observed.
Edemas take on the character of permanent, rise higher.
Frequent minor intradermal hemorrhages make the pigmentation more intense due to the loss of hemosiderin (blood pigment). Minor wounds and abrasions heal for a very long time, gradually passing into ulcerative defects.
In 2000, the Russian phlebologists proposed a pathogenetic classification of varicose disease. And she also received widespread recognition.
- Partial (segmental) changes in the subcutaneous and intracutaneous veins of a limb without reverse current (reflux).
- Segmental dilatation of the veins with reflux in the communicative and / or superficial vessels.
- Total varicose veins with reflux of blood into superficial and communicative veins.
- Varicose veins with reflux of blood through deep veins of the extremities.
Degree of chronic venous insufficiency
0 - no manifestations revealed.
I - swelling that occurs when the symptoms of fatigue of the legs.
II - persistent edema with symptoms of skin pigmentation, consolidation of the consistency of subcutaneous tissue, the appearance of eczema.
III - formation in the skin of ulcers of trophic origin.
The same classification requires separate mention of the complications that have arisen.
The CEAP-classification used throughout the world takes into account the clinical indicators of the disease stage (C), its causes (E), anatomical areas of damage (A), developmental mechanism (P).
C - clinic.
C0 - when viewed from the skin, no changes were detected.
С1 - changes in the intracutaneous veins, expressed in the formation of vascular "stars" (telangiectasia), capillary "reticulums" (reticular type) are determined.
C2 - determined by the expansion of the lumen of the deeper, saphenous veins, with the formation of large nodes.
C3 - to the symptomatology joins edema of the subcutaneous tissue.
С4а - hyperpigmentation of the skin around the altered vessels with changes in the characteristics of its surface: dry cracks accompanied by obsessive itching (otherwise: venous eczema).
С4b - discoloration of the skin around the vessels, with simultaneous compaction of the underlying subcutaneous tissue (otherwise: lipodermatosclerosis, white skin atrophy).
C5 - along with the described changes in the skin is determined healed ulcer.
C6 - existing ulcers with no signs of healing.
E - etiology (origin).
Ep is a primary varicose veins, which arose for no apparent reason and prior vein thrombosis.
Ec - congenital varicose veins.
Es - secondary varicose veins after suffering phlebothrombosis.
En - the reason can not be clarified due to insufficient historical data.
And - localization of varicose veins.
An - changes in venous vessels were not detected.
As - changes observed in superficial veins.
As1 - capillary (reticular) intradermal veins are affected.
As2 - varicose veins of the great saphenous femoral vein.
As3 - changes in the great saphenous vein.
As4 - short saphenous vein affected.
As5 - affected large, but not the main vein.
Ad - varicose lesion of deep veins (cavities of the body and lower extremities): lower hollow, iliac, pelvic (including uterine and gonad), femoral and muscles of the leg and foot.
Ap - varicose perforating (communicative) veins of the thigh and lower leg.
P - according to the mechanism of pathophysiological changes.
Pn - changes in the bloodstream are not detected.
Po - obturation (obstruction) of the vein by a thrombus.
Pr - detection of reverse blood flow (reflux) due to insufficiency of the venous valve apparatus.
Pr, o - combination of reflux and thrombosis. This occurs when long-term venous thrombosis, when, as a result of inflammatory-sclerotic processes, small through-vessels appear in them, connecting the lumen of the veins before and after occlusion.
In addition to this, methods for diagnosing varicose veins using the index L are encrypted.
LI - external examination and / or dopplerography of venous vessels was the basis.
LII - examination and ultrasound duplex scanning became the basis for the diagnosis.
Varicose veins of the lower extremities: diagnosis
1. Inspection with the detection of external signs.
2. Survey with clarification of subjective feelings, previous diseases and conditions that could contribute to the development of the disease.
It should also clarify the presence of concomitant diseases of the bone (osteochondrosis, heel spurs, arthrosis and flatfoot), as well as the connective tissue system (systemic collagen infections, panniculitis). They can not only cause similar complaints and local changes, but also indirectly, by reducing motor activity and other mechanisms, contribute to the occurrence of varicose veins.
3. Functional tests.
Probe Brody - Troyanova - Trendelenburga. With its help determine the functional state of the valve apparatus of the veins. The patient lies on a couch with a raised leg. After some time, when the venous blood leaves the limb, the greater saphenous vein is pinched in the upper third of the thigh. You can use a finger, but you can not impose a tight, venous harness. After that, the patient is asked to get up. The harness is relaxing. In the presence of insufficiency of venous valves, you can clearly observe the flow of blood waves in the lumen of the veins in the direction of the distal limb.
A number of samples allow us to assess the patency of the deep veins of the limb.
The patient in the prone position slowly raise the straightened leg up. As a rule, before reaching the 45 ° angle, the vein contour drops. It is necessary to remember this indicator. Further, already in the vertical position of the patient, after filling the veins, a venous cord is applied on the border of the upper and middle third of the thigh to cross-clamp the lumen of the superficial veins. The patient is again invited to take a horizontal position and slowly raise his leg. If deep veins are sufficiently held, the saphenous and intracutaneous veins will collapse at about the same angle index level.
Probe Del'e - Perthes.
In the standing position, in the upper third of the thigh, the venous cord or cuff from the tonometer with a slight air injection is applied to the patient. After that, the patient is invited to walk on the spot or around the room. In the case of normal patency of deep and communicative veins - after some time, the enlarged superficial veins will subside.
Probe Mayo - Pratt. An elastic bandage is superimposed on the entire limb in rather dense rounds. About the sufficient permeability of the deep veins says the fact of the absence of complaints of arching pain and signs of edema of the subcutaneous tissue for 30 minutes. At this time, the patient should be in an upright position, making the usual load or walk.
To reveal the insufficiency of communicative veins and to determine their localization will help the three-gigantic test of VISheynis.
The harnesses overlap the thigh at the top and middle third. The last harness is fixed in the popliteal area. After that, the patient is invited to get up and walk around the room. With successive removal of the harnesses, it is possible to determine the insufficiency of the communicators due to the characteristic protrusion of the veins below the clamping area. The output of the affected large communicative veins can be determined by palpation, if the patient is asked to strain the muscles of the lower leg (become “on tiptoe”).
4. Ultrasound diagnosis.
Used in two variations: Doppler phlebography and duplex scanning.
Ultrasonic Doppler phlebography allows you to specify:
- patency of the deep veins of the limb;
- functional usefulness of valves;
- presence of affected communicative veins and clarify their location;
- the possibility of reflux in the superficial vein;
- insufficiency of the osteal valve (in the place of fistula of the large femoral and subcutaneous veins).
Under normal conditions, it can be confined to this study to determine the level of surgical intervention.
Ultrasound duplex scanning provides more detailed information on the valves of the femoral vein (localization, shape). In addition, you can get information about changes in the vascular wall of the femoral vein, the diameter of its lumen, the possible presence of blood clots. The particular value of this study is in obtaining accurate hemodynamic parameters: retrograde wave velocity and retrograde blood flow duration, linear and volumetric blood flow velocity.
It implies the administration of intravenous radiopaque substance, after which several radiological images are taken with a certain interval.
Yielding ultrasound, due to the presence of the preliminary preparation of the patient and conducting allergic tests on a contrast agent, phlebography, however, remains relevant to clarify the presence of:
- varicose veins of the lower leg (ascending phlebography);
- valvular insufficiency of the femoral vein (pelvic phlebography);
- diagnostics of congenital hypoplasias and aplasias of deep veins (ascending and pelvic phlebography);
- diagnostics of postthrombotic syndrome (ascending and pelvic phlebography).
In contrast to ultrasound, phlebography immediately gives the overall spatial architectonics of a limb affected by varicose veins.
6. Radionuclide phlebography.
At present, this method has more historical significance, as compared with classical venography and ultrasound data, it does not provide any fundamentally new information. In the organizational sense (working with radionuclides and staying in a gamma camera), this method also presents certain difficulties. The principle is based on the observation of the passage of an isotope injected into the foot vein through the venous system of the limb. Superficial and deep vessels are well enough visualized, which gives an idea of venous outflow.
Varicose veins of the lower extremities: treatment
Includes medication and compression correction.
1. Wearing compression knitwear (socks, tights, stockings).
There are therapeutic and prophylactic compression knitwear. Medical linen is marked into four classes, where each division denotes a certain level of uniform compression of the limb in mm. Hg Art. and depends on the clinical stage of the disease:
Grade 1 - discomfort and pain in the limbs without visual manifestations.
Grade 2 - the first visual changes in the superficial veins.
Grade 3 - the appearance of vascular plexus (nodes).
Grade 4 - the stage of complications.
Underwear of preventive type is strongly recommended for people who experience prolonged physical exertion, as well as in a sitting position for most of the working day. For these purposes, use compression tights and stockings.
Uniform compression of the lower extremities by compression underwear helps to maintain blood circulation at the level of physiological parameters, helping outflow. The basic principle is the creation of an external framework for maintaining the tone of weakened venous-type vessel walls.
Preventive compression hosiery delays, or even completely neutralizes, the risk of varicose veins. In cases where the first clinical manifestations of varicose veins have already become disturbed, it is recommended to urgently consult a doctor in a clinic or a specialized medical center.
With an already developed disease, medical linen reduces the risk of thrombosis and embolism, reduces the manifestations of venous insufficiency, thereby stabilizing the patient's condition.
2. Medicinal preparations.
At present, there is no ideal medicine that affects all pathogenetic links in the development of varicose disease. It is necessary to combine them. Partial suspension of the process at the initial stages with the help of drugs is possible, however, the reverse development of the already existing nodes during isolated drug treatment is not observed.
The most commonly prescribed physicians are the following: Troxevasin, Troxerutin, Venorutin, Venitan, Phlebodia 600, Detralex, Antistax, Lioton-gel. Their main action is aimed at bringing the venous wall to the proper tone, removal of venous stasis with subsequent improvement of microcirculation in the tissues. Each of these funds has its own clear indications for use and a certain dosage of the reception. Their use should be monitored by your health care provider. Self-medication is unacceptable here, as complications such as dermatitis and allergic reactions cause additional suffering and are difficult to heal.
Other drugs prescribed for varicose veins, are aimed at changing the rheological properties of blood for the prevention and treatment of thrombosis. These are such well-known drugs as Trental, acetylsalicylic acid, Curantil. In the same Lioton-gel, Trombofob, Venolayf enters heparin, perfectly thinning blood.
In order to anesthetize, relieve edema and relieve inflammation, non-steroidal anti-inflammatory drugs are used, often diclofenac in the form of a gel.
The forms of application of drugs are different: tablets, solutions for injection, ointment.
3. Folk remedies for the treatment of varicose veins.
It is important to understand that their use, for the most part, is aimed at relieving the symptoms of complications, in particular thrombophlebitis, and not at treating the underlying disease. The use of these methods at the present stage should not replace drug therapy at the initial stages of the development of varicose veins and, especially, surgical treatment with a developed clinical picture.
Consider and list some of the most appropriate folk remedies.
Hirudotherapy - treatment by applying medical leeches to varicose veins. It is used only for thrombophlebitis. The method is dangerous for the risk of attaching secondary infections and the development of bleeding from the nodes. The use of a medical analogue - heparin ointment in the initial stages of the disease can be an excellent alternative. For the prevention of thrombosis, you can apply it in the later stages, avoiding contact with trophic ulcers.
Apple Cider Vinegar
Used in the form of rubbing or wrapping the legs with a rag or gauze soaked in a solution.
Tincture of horse chestnut .
Use peeled green skin fruit. Pre-grinding them, pour vodka at the rate of 10 grams. (two teaspoons) chestnut per 100ml. vodka. Infused for two weeks in a dark place and applied for about a month 3 times a day, 30 drops.
Tincture of Kalanchoe.
The crushed leaves of Kolanchoe fill a half-liter jar to the middle, then in a separate container filled with vodka in a half-liter volume. After 3-4 weeks, the resulting solution produces rubbing at night of the affected areas.
1. Classic operating manual.
- with the formed and widespread varicose veins of the superficial veins with the involvement of the great and small saphenous veins;
- with the defeat of varicose veins of communicative veins and the detection of valvular insufficiency of the deep veins of the thigh and lower leg with persistent, uncorrectable manifestations of venous insufficiency or with the manifestation of complications of varicose veins (bleeding, thrombophlebitis).
If the manifestations of venous insufficiency are minimal, then the classical surgical intervention is performed with prophylactic purposes, as the patient should know.
The scope of the operation is determined on the basis of the presented results of ultrasound. In addition to the mechanical removal of varicose veins, the task is to normalize the blood circulation of the limb by eliminating the increased venous discharge of blood from the superficial vessels to the deep ones. Otherwise, repeated surgical procedures will be required.
2. Combination of sclerotherapy with minimal surgical procedures.
It is used for varicose veins of the lower extremity before the formation of vascular nodes: at the stage of telangiectasia, segmental changes of the veins of the leg, with reticular varicose veins, in addition to the surgical treatment of the remaining altered vessels after removal of the veins with eye-shaped changes.
The essence of the technique: removal of the veins from the blood circulation by completely closing their lumen and then replacing them with connective tissue when exposed to chemicals (ethoxy sclerol, fibrovain).
3. Isolated phlebosclerosis treatment.
The substance is injected into the modified vessels with the help of various technical approaches by puncture or with the help of venous catheters. Then the limb is bandaged with tight elastic bandages. After some time, the vessel is "turned off" from the blood circulation.
4. Radio frequency ablation.
With this technology, thermal “welding” of the vessel takes place using a special intravascular probe emitting radio-frequency waves. Under their action, there is an isolated heating of the walls of the vessels and their compression. After the operation, compression knitwear continues for some time.
5. Endovenous laser treatment.
A special venous catheter with radiation of energy impulses causing “sealing” of the vessel lumen affects the vessel walls.
6. Transluminal phlebectomy.
Удаление измененных сосудов с помощью специального всасывающего устройства под оптическим контролем, через специальный разрез в коже.
Необходимо помнить и знать, что любое оперативное лечение имеет чёткие показания. Потому что, наряду с выздоровлением, каждая хирургическая манипуляция несёт определённые риски общего (осложнения анестезии, вторичная инфекция и т.д.) и специфического характера, связанные с конкретной операцией.
Профилактика варикозного расширения вен
- Ношение компрессионного белья.
- Оптимальная физическая активность при любом возможном случае, без чрезвычайного утомления.
- Использование компрессионного белья.
- Для сохранения венозного тонуса полезно применение контрастного душа при соблюдении гигиены ног.
- Профилактика запоров путём нормализации диеты с повышенным содержанием продуктов, богатых растительной клетчаткой.
- При продолжительных статических нагрузках с вертикальным или сидячим положением, рекомендовано каждые полтора часа производить несложное упражнение: в положении стоя перенести нагрузку с пяток на носки, приподнимаясь вверх 15-20 раз. Этим самым, запускается в ход своеобразный «мышечный насос», усиленно прогоняющий застоявшуюся кровь в направлении сердца. В этих же ситуациях полезно несколько раз в день принимать горизонтальное положение. При невозможности, хотя бы на 15-20 минут запрокидывать ноги в сидячем положении на соседний стул. В дополнение к этому — несколько раз поприседать.
- Реже использовать обувь на высоких каблуках. Каблуки не должны превышать 5 см.
- Одежда должна быть свободной и не стеснять движений.
- Рекомендовано во время сна придавать ногам приподнятое положение путём подкладывания валика или поднятия края кровати.
- Полезно после сна не сразу подрываться с постели, а сделать несколько упражнений для ног: круговые движения для стоп, имитация велосипедных движений.
- При долгих путешествиях в самолётах или автобусах необходимо «разминать» ноги – периодически вставать, производить круговые движения стопами. В этих же ситуациях необходимо избегать употребления алкоголя и пить больше питьевой воды. Полезно в дорогу одевать компрессионный трикотаж.
- Варикозное расширение вен малого таза: симптомы, лечение
- Варикозное расширение вен пищевода
- Как лечить варикоз вен на ногах
- Как подобрать компрессионное белье при варикозе
- Тромбофлебит глубоких вен нижних конечностей: симптомы, лечение