How does the human blood circulate in the body? There are two types of blood vessels in the human body, one is the arterial blood vessels, which emanate from the heart and are the vascular channels responsible for supplying nutrients and oxygen to all tissues and organs in all parts of the human body, and this is the blood vessel that we can feel beating from the surface parts of the human body, such as the front of the ear, the side of the neck, the elbow, the wrist, the root of the thigh, the back of the foot, etc. Chinese medicine often relies on touching the radial artery in the human wrist to diagnose diseases. The blood flowing in the artery is called arterial blood, which contains a lot of nutrients and oxygen for the tissues to use and is bright red in color (because of the high amount of oxygen it contains). After the tissues and organs of the body have absorbed the nutrients and fresh oxygen in the arterial blood, the used blood flows back to the heart through the vein, which is a “pressurized pump” to the lungs and reabsorbs oxygen, then the venous blood becomes arterial blood and returns to the heart, where it is pumped into the arterial blood again. The blood is then turned into arterial blood and returned to the heart, which is again pumped through the heart into the arterial blood vessels to all parts of the body. This is the blood circulation. The blood that flows in the veins is called venous blood and is used by tissues and organs and is low in nutrients and oxygen. The blood is dark red in color. Why do varicose veins in the lower extremities occur in humans? Humans are upright animals and walk standing up, the heart is located in the chest of human body, its position is high and down, and with the strong power of heart, it is easier to supply blood to various parts of human body such as abdomen and both lower limbs. On the other hand, the blood that has been utilized by the organs (i.e., venous blood) flows back to the heart, because it goes from low to high, it is much more difficult compared with the arterial blood supply, on the one hand, it depends on the thrust of the heart’s ventricular power system (i.e., the contraction force of the heart muscle) to push the arterial blood from the heart to the tissues and organs of the body through the arterial vessels, and at the same time, the blood that has been utilized by the tissues and organs is “pushed” into the veins. “On the other hand, we have to rely on the strong suction force of the atria of the heart to suck this blood back to the heart; together with the negative pressure of the chest cavity formed by human beings during breathing, and the squeezing of the muscle tissue of the lower limbs when we walk or other exercises, the blood accumulated in the lower limbs is squeezed back to the heart. Therefore, compared to the arterial system of the human body, the venous system of the human body’s lower extremities is subjected to greater pressure, and this is one of the important mechanical factors that make the veins of the human lower extremities susceptible to varicose. But “God” in the creation of human beings, in order to help all the venous blood of the lower extremities as soon as possible back to the heart, specially to the human lower extremities of more than 2 mm diameter veins in the “installation” of “one-way valve “This “one-way valve” only allows the venous blood to flow back towards the heart and does not allow backflow. But ~ in reality this God does not exist, but is the result of continuous evolution since the existence of humans and walking upright. As mentioned above, this unified form of arterial and venous vascular system is more stable during the evolution of human beings, so most people do not develop varicose veins in their lower extremities. Who is more likely to develop varicose veins in the lower extremities? There are two groups of veins in the lower extremities of human body, one is the deep vein, which is located deep and close to the bone and cannot be seen by the naked eye; the other is the superficial vein, which is located shallow and can be seen by the naked eye in most of the people with thin body (especially men). There are two superficial veins in the lower limbs, one is the saphenous vein, which starts from the foot and ends at the root of the thigh, and the direction of blood flow starts from the inside of the foot, passes through the inner calf, inner thigh, and finally flows into the deep iliofemoral vein system at the root of the thigh; the other one is called the small saphenous vein, which starts from the foot and travels upward through the back of the calf and enters the deep vein system at the N fossa. The saphenous vein and the small saphenous vein are superficially located, if for some reason the diameter of the veins in the deep or superficial group of the lower extremity widens, and the venous valves that act as one-way valves lose their function, then too much blood accumulates in the venous system of the lower extremity, so that the saphenous vein or small saphenous vein in the superficial group of the lower extremity expands, lengthens, twists into a mass, or forms a large venous ball, which is elastic to the touch. The deep group of veins can squeeze the blood in the deep group of veins back to the heart at any time due to the squeezing effect of the muscles when humans walk upright, plus the power of the heart and the negative pressure formed in the chest cavity when breathing, so the deep varicose veins usually do not appear. However, clinically, there are also deep veins widen due to overload work, resulting in incomplete closure of deep vein valves and difficulty of venous blood return to heart, which indirectly cause superficial vein dilatation and incomplete closure of valves. Since the superficial veins are located under the skin and lack the pumping effect of muscle movement around them, it is not surprising that they dilate, lengthen and twist into clusters. The clinical incidence of saphenous varicose veins is about 9%, while the incidence of small saphenous varicose veins is relatively much lower. So who is more likely to develop saphenous varicose veins? The reason for this is that on the one hand, it occurs in families, accounting for 40-60%, and on the other hand, it is also common in people who have to stand or sit for long periods of time. Individual occupations such as teachers, cooks, shop salesmen, bank clerks and manual laborers. Its higher incidence has seriously affected people’s health. Of course, there are other rare causes such as primary deep vein insufficiency, sequelae of lower limb deep vein thrombosis, traumatic or congenital arteriovenous fistula, congenital venous malformation bone hypertrophy syndrome, Buga’s syndrome, etc. What are the clinical symptoms of saphenous varicose vein? Saphenous varicose veins can occur unilaterally or bilaterally in the lower extremities. Due to the loss of venous valve function, a large amount of venous blood that has been used by tissues and organs accumulates in the lower extremities, with the most affected being the lower and middle calves. Most of the patients feel heavy and tired after walking for a period of time, sore and swollen, legs and feet are swollen and painful; due to the high pressure in the lumen of the veins, the tiny end of the veins rupture, causing subcutaneous stasis of blood in the lower legs, and the colored components of the blood accumulate in the subcutaneous, from the initial yellowish color to black gradually, just like skin tattoos that cannot fade for many years, which is unusually ugly; because this part of the blood is the venous blood that has been used by various tissues and organs of the body. Because this part of the blood is used by the body’s tissues and organs of venous blood, its oxygen and nutrients are very little; and because the tissues and organs in the absorption of nutrients and oxygen at the same time also produced a large number of metabolic products; coupled with the pressure in the venous cavity, but also affect the normal nutrient absorption and oxygen absorption of tissues and organs, and so on, this many factors, so that the patient’s lower limbs lack of nutrients, oxygen content is reduced, and over time it causes itching of the lower leg skin (eczema-like Because of the high pressure inside the vein cavity, if the superficial vein is exposed due to trauma or ulcer, it can cause the varicose superficial vein to rupture and bleed, and the bleeding speed is like a child playing with a squirt gun, if not treated in time, it can be life-threatening; because Because of the slow blood flow in varicose veins, the blood is easy to clot and thrombophlebitis can occur repeatedly; also because of the difficulty of blood flow back to the heart in the twisted veins, which affects the absorption of lymphatic fluid, the patient’s sick leg will not only have reticulolymphangitis (i.e., dermatitis) repeatedly, but also bruised edema or lymphoedema of the lower limbs at the same time. How to prevent saphenous varicose vein early? The key to preventing saphenous varicose veins is to use your legs in a healthy way. In other words, people who need to stand or sit for a long time should not stay in one position for a long time without moving. For example, teachers, salesmen, chefs, etc. should walk back and forth from time to time to move their legs or change their posture. In addition, cycling, brisk walking, running can prompt the calf muscle contraction, the role of this mechanical pump can speed up the venous blood return, to relieve the pressure in the veins. Normally, when you watch TV, you can cross your legs high in order to make the venous blood return to the heart of both lower limbs easily. What are the treatment options for saphenous varicose veins? Early mild superficial varicose veins usually choose conservative treatment. The blood in the varicose veins protruding from the skin surface is pressed back to the deep group of veins by wearing medical compression stockings. The deep group of veins are much easier to return to the heart than the superficial veins because of the squeezing effect of the muscle mechanical pump. During the war years, soldiers and officers used wide strips of cloth to tie their legs, so that both lower limbs felt lighter and more convenient when marching in a hurry. The elastic stockings are made according to the physiological pressure gradient of the lower limbs, thus protecting the superficial veins of the lower limbs when standing; usually the affected limbs are elevated to avoid prolonged standing or sitting. For the treatment of moderate to severe varicose veins in the lower extremities, surgery is the only effective treatment method. There are many surgical methods for varicose veins, including sclerotherapy injection, traditional high saphenous vein ligation and stripping, laser, microwave, radiofrequency, electrocoagulation closure and shaving aspiration, etc. As for some advertisements that a topical medicine can cure the varicose veins by rubbing it on the veins, it is purely a fraudulent nonsense and I hope you don’t believe it. Sclerotherapy injections are generally used for patients with mild varicose veins or residual varicose veins after surgery, or mild varicose veins that have been operated on years ago and are now recurring. Since the drug is injected into the varicose vein with a syringe, only the needle hole is visible, and there is no incision. It is less invasive, less expensive and can be performed on an outpatient basis. It is especially popular among young women who love beauty. However, it is not suitable for more serious patients. It is not currently used as the treatment of choice for varicose veins in the lower extremities in our country or in other countries around the world. The traditional high saphenous vein ligation and dissection is performed with a small incision to remove the main trunk of the saphenous vein and a punctiform incision (about 3 mm long) to remove the twisted mass of veins. In all patients who underwent the procedure in our hospital, one leg usually took about 1 hour because of the small incision and the absence of stitches. There is less bleeding (10-15 ml), less time spent, complete healing, and fewer recurrences. Since the minimally invasive incision is particularly small, in about six months after the surgery, the diseased leg basically leaves no traces and does not affect the aesthetics, which both young and old patients like; Some new methods derived from this surgical method, such as laser, microwave, radiofrequency, electrocoagulation, etc. are used to cauterize and coagulate the varicose veins through thermal effectiveness to close them, unlike the traditional surgical method of cutting off the superficial varicose veins in order to cure the purpose of the disease. The advantage is that it is less invasive, but the cost of treatment is also high. In addition, some patients have difficulty inserting the treatment catheter used in laser, microwave or radiofrequency into the entire length of their twisted veins because the main trunk of the saphenous vein is so severely twisted that other minimally invasive surgical methods are required to remove all of the numerous varicose veins. Despite the many methods, the end result of the treatment is the same. At this point, some patients may ask, “After you cut out my superficial veins or cauterize them through thermal potency, what do I rely on for the return of blood from the veins of my lower extremities to my heart? Well, let me tell you, as long as your deep group venous system] is obstructed, your condition will be carefully evaluated by a specialist after you are admitted to the hospital. As long as the diagnosis is clear and the indications are properly chosen, any of the surgical methods described above are safe and the results are good. Can varicose vein patients with ulcers on their lower legs undergo surgery? Then the answer is yes. For patients with varicose veins in the lower extremities, their calf ulcers tend to occur slowly, small at first, gradually increasing in size, with the largest ones reaching more than 10 centimeters in diameter. The time of existence is a few months or decades, and it never heals, commonly known as “old rotten leg”, which brings great inconvenience to people’s life and work. Our hospital recently received an elderly male patient in his 70s, who had suffered from varicose veins for more than 30 years and varicose ulcers for nearly 20 years. I joked in front of his partner, “How did your wife allow you to go to bed with your stinky feet for so many years?” His wife said, “The stench, the stench all over the house! Especially in summer, no one wants to go to his bedroom. What can we do? Buy incense!” From the economic point of view, even if the medication is changed twice a week, it will cost 8-10 times a month, which will cost at least 3000 RMB a year. What should we do for such a patient? The answer is yes: surgery. Surgery is the only option. The classic surgical procedure is “Saphenous vein ligation and stripping”, or based on it, the surgical procedures “laser”, “microwave”, “radiofrequency”, “radiofrequency”, and “radiofrequency”. “radiofrequency”, “electrocoagulation closure”, “planar aspiration”, etc.”, each of them has its own advantages and disadvantages, and the doctor will choose carefully according to the patient’s different conditions; for those with mild signs and symptoms, as well as lighter patients with recurrence after surgery, sclerotherapy can be performed. In large tertiary hospitals, there is usually a relatively independent vascular surgery department, with a strong academic atmosphere, complete medical equipment, rigorous specialist knowledge, skilled surgical operations, and positive postoperative results.