First, the anatomical structure of lower limb veins
As we all know, there are two systems of blood circulation in human body, namely arterial system and venous system. The arterial system of lower limbs is to supply oxygenated blood to the organs of lower limbs, and the anaerobic blood after metabolism of organs is returned to heart by capillaries and then by veins.
There are deep veins and superficial veins in the lower extremities, just like from Beijing to Guangzhou, there is Beijing-Zhuhai highway and some provincial roads. Deep veins are equivalent to highways and superficial veins are equivalent to provincial highways. There are also extensive traffic branches between the deep and superficial veins. The lower limb is located in the lowest part of the body when the vein reflux has a device to prevent reflux in the inner wall of the vein, which we call the venous valve, the role of the venous valve is to make the blood that comes back up does not flow backwards down.
Otherwise, the blood is always difficult to transport back to the heart, but stasis in the lower extremities. Of course, maintain the lower extremity vein one-way heart reflux and the role of the heart’s contraction negative pressure absorption and contraction muscle pump of the lower extremity muscles.
Second, why varicose veins of lower limbs occur
Varicose veins of the lower limbs, also known as saphenous varicose veins, refer to the dilatation, tortuosity and even rupture of the superficial veins of the lower limbs (i.e. saphenous veins). The main cause of the disease is that the saphenous vein has a pair of valves to prevent blood flow back before it converges to the femoral vein (deep vein) is damaged and does not close together, causing the blood returning from the vein to flow back into the distal vein, resulting in high pressure in the vein, and over time the superficial vein expands and bends.
Third, what people are prone to varicose veins
One of them is the people who are engaged in standing jobs for a long time, and they have higher pressure in the veins of lower limbs, such as surgeons, teachers, hairdressers, salesmen and other standing workers.
In addition, women’s pregnancy due to the increase of the fetus compression of the deep pelvic veins caused by venous reflux obstruction.
Thirdly, some people have congenitally thin vein walls or underdeveloped valves, all of which are susceptible factors.
Fourth, varicose veins will have what clinical symptoms
First of all, it is a kind of heavy feeling of lower limbs when varicose veins are not found, and it can’t take a step and can’t lift the feet upstairs.
Then, it is found that the small superficial veins of the lower limbs dilate in a filamentous way, and further the superficial veins expand, bend and become heavier and heavier.
If still cannot be prevented and treated, the dilated veins will further expand and bend to form earthworm-like dilatation, and the serious ones will be like “dragon”, which will affect the beauty of the light and rupture and bleeding.
Long-term lack of oxygen venous blood stagnation in the subcutaneous produce lower limb skin nutrition change, appear purple-black plaque, serious venous ulcers for a long time, commonly known as “old rotten leg”, if the dilated veins rupture, the blood like a spring, difficult to control.
Five, varicose veins will have what consequences
Depending on the degree, the consequences are different.
1.Heavy lower limbs, difficult to walk.
2.Vinous tortuous pigmentation affects the appearance.
3, ulcer formation, long-lasting, affecting life.
4.Dilation and formation of thrombosis in the veins, local formation of lumps, painful and uncomfortable.
5.Seriously, the superficial veins spread along the blood vessels into the deep veins, and finally into the pulmonary artery that pulmonary embolism can occur life-threatening immediate death.
Ah! So varicose veins have such serious consequences, so how should we treat them?
Sixth, which cases of varicose veins need surgical intervention?
This question varies from person to person, men and women are different from urban and rural people, men don’t care about varicose veins even if they are very serious, women are anxious to treat them even if they have some bruises showing, rural people think varicose veins are commonplace and won’t see a doctor until they are in pain, have a thrombosed ulcer or are bleeding profusely.
But in general, once symptomatic varicose veins occur, they are difficult to heal themselves. Although conservative treatment can temporarily control the symptoms, it is difficult to eliminate the dilated and tortuous veins after all. Therefore, all symptomatic varicose veins need surgical intervention, especially those with ulcers, bleeding and thrombosis.
VII. What are the surgical treatment options?
According to the mechanism of varicose veins, it is known that varicose veins are distal veins that are dilated and curved due to damage to the valves of the saphenous vein, which cannot control the reflux. The classical treatment plan is to ligate and cut the saphenous vein from the valve into the femoral vein to block the regurgitation, and then strip the dilated and deformed superficial veins. Some viewers may be concerned that if the saphenous vein is ligated at the fossa and the distal superficial vein is removed, how will the patient’s lower extremity veins reflux? Will the lower limbs swell? Can you work in the future?
This is a very good question, I talked about it in the first part of venous anatomy, there are two systems of venous return in the lower limb, there are also traffic veins connected between them, if the superficial veins are gone, the deep veins can fully compensate for the superficial veins as long as they are open, just like the 107 national highway is blocked, but the Beijing-Zhuhai highway is still passable.
So don’t worry about the lower limbs will be swollen or can’t do anything in the future, although the classic surgery is very thorough, but traumatic bleeding and large scars. In addition, it is the minimally invasive surgical approach that has been advocated in recent years. For example, laser saphenous vein closure, radiofrequency saphenous vein closure, the principle of which is to reduce the dilated saphenous vein and close the meeting, in addition to not pumping off the saphenous vein, the saphenous vein valve at the high ligation, and saphenous vein shaving aspiration, also need to do high ligation, but also do the thigh trunk part of the pumping and calf subcutaneous saphenous vein shaving aspiration surgery, surgery is not small trauma.
What kind of surgery do you think is less invasive and more thorough?
At present, we use French disposable varicose vein aspiration catheter, which can aspirate the saphenous vein cleanly and thoroughly with a small incision, less trauma, less bleeding and shorter operation time, the fastest single-leg operation only takes 15 minutes, and it has been carried out in hundreds of cases and welcomed by patients. We call this surgery minimally invasive aspiration technique.
What maintenance is needed after the surgery?
The most important thing after saphenous vein aspiration is compression bandage for the lower limb, which can prevent bleeding and hematoma, and close the abducted traffic branch vein to prevent recurrence.
At present, there is a medical elastic stocking that can be worn after the stitches are removed, which is easy to use and effective. It takes 1~3 months to wear elastic stockings.
X. What are the conservative treatment methods if not surgery?
Surgery is not recommended for those with the following conditions.
1.The condition of the disease is very poor and cannot tolerate surgery;
2. Those who have mild symptoms and are not willing to undergo surgery
3.During pregnancy, the pelvic pressure is not lifted.
4. Those who have relapsed after surgery and are unwilling to undergo surgery.