As we can see from the introduction of what varicose veins of the lower extremities are and the classification of varicose veins of the lower extremities, the diagnosis and classification of varicose veins of the lower extremities is not an independent disease, and the diversity of clinical manifestations also determines the diversity of treatment, and the standardization of diagnosis and classification helps to further rationalize the choice of treatment for venous disease.
The treatment of varicose veins in the lower extremities has only really developed in the last hundred years, and with the increasing understanding of varicose veins in the lower extremities, there has been a significant change in the treatment methods. From the earliest compression bandage recommended by Hippocrates to the minimally invasive treatment widely carried out at home and abroad in the last decade, all of them are developed according to the process of re-understanding varicose veins.
The treatment of varicose veins in lower extremities includes two parts: non-surgical treatment and surgical treatment. It has always been believed that surgical treatment is the main treatment for varicose veins, but with the new understanding of varicose veins, the methods and measures of non-surgical treatment are more and more and gradually re-recognized by people, and non-surgical treatment is not only an important part of varicose vein treatment in lower extremities, but also an indispensable part after surgical treatment. Non-surgical treatment is not only an important part of varicose vein treatment, but also an indispensable part after surgery.
1.Pressure therapy
It is also known as the use of medical graduated elastic compression (GEC) or external elastic bandage with compression bandage. Compression therapy is to counteract the increase of venous pressure caused by various reasons with external pressure, prevent the deep venous blood flow from reversing into the superficial veins through the traffic branches and promote the venous blood return, so as to control and delay the development of the disease, improve the local skin malnutrition, reduce local edema, prevent the formation of ulcers or promote the healing of ulcers.
Elastic bandages are generally used for compression therapy after varicose vein surgery and also for ulcer patients after medication changes, but are not commonly used in daily life.
Progressive decompression stockings, also known as compression stockings or varicose veins stockings, are more commonly used in daily life. It was in the 1850s that a doctor with venous ulcers found relief for his legs when standing in swimming pool water, so he designed gradient compression stockings to simulate the hydrostatic pressure of being in a swimming pool and invented the pressure gradient compression method. To this day, gradient compression stockings are still the basic treatment for varicose veins and chronic venous insufficiency in the lower extremities.
(1) Who is suitable for treatment with these compression stockings?
a, those with a small range of varicose veins in the lower extremities, with a mild degree and without obvious symptoms.
b.Compression therapy after varicose vein surgery.
c.Those who feel sore and heavy in the lower limbs due to venous system diseases.
d, those who travel long distances or exercise.
e.Pregnant women (there are many such patients whose symptoms will be reduced or disappear on their own after delivery due to the decrease of abdominal pressure)
f, poor general condition, can not tolerate surgery, or other reasons such as advanced age, refuse surgery (many people refuse surgery, but do not refuse conservative treatment well, after all, the quality of life is increasingly important)
g, sedentary or sedentary people, such people have a higher risk of developing varicose veins (various office workers, teachers, medical care, police officers, etc., should pay attention to prevention).
(2) Who are not suitable to wear elastic stockings?
a. People with infected legs and feet or sluggish sensation, patients with acute skin infections or dermatitis of the lower limbs should use elastic stockings after the symptoms are controlled.
b. Patients with arteriosclerosis or arterial ischemic diseases, which may aggravate the distal ischemia of the lower limbs and cause skin necrosis or even amputation in severe cases.
c, patients with congestive heart failure or renal insufficiency, for edema of both lower limbs caused by cardiac insufficiency or other medical system diseases, the primary disease should be controlled.
d. The acute phase of deep vein thrombosis of the lower limbs.
e. Those who are allergic to the material of compression stockings.
f.Some other special cases, to listen to the professional doctor’s advice.
g. How to choose compression stockings?
h. Therapeutic compression stockings are designed with four different types of pressure, each with a clear therapeutic range.
Low pressure (preventive type 18mmHg): for daily care and prevention of varicose veins in the lower limbs, venous edema, sedentary and high prevalence of people.
Primary pressure (therapeutic type 20-30mmHg): suitable for the treatment of superficial varicose veins of the lower limbs, mild edema of the lower limbs and after varicose vein surgery.
Secondary pressure (30～40mmHg) and tertiary pressure (40～50mmHg) therapeutic type: obvious varicose veins of lower limbs, severe varicose veins in pregnancy, post-thrombotic syndrome of deep veins of lower limbs, irreversible lymphedema, etc.
So many socks on the market, many sell socks do not know these oh, you have to know, instantly will feel high, ha ha.
(3) How to wear elastic socks?
To slowly flatten against the body, be gentle, and smooth the feet upwards.
Note: The best time to wear elastic socks is when you get up in the morning, it is recommended to elevate the legs first to reduce blood flow in the superficial veins, then put on the socks and take them off every night after going to bed, remember to take them off at night, and also keep your nails trimmed often, so expensive socks, it would be a pity to scratch them, the tycoons can ignore this article.
Proper bed rest, avoid prolonged standing and sitting, elevate the affected limb at the appropriate time. According to the condition, choose suitable medical elastic stockings to promote venous reflux and reduce the symptoms of distension and pain of the affected limb.
With the development of modern technology, there are more and more related products on the market, which make the application of compression therapy more and more widespread and convenient, but it must be pointed out that compression therapy cannot achieve the purpose of curing varicose veins.
2.Medication
In recent years, the use of drugs to treat varicose veins has also made great progress. Generally speaking, varicose veins in the lower extremities are often troubled by the discomfort of the lower extremities, such as pain, soreness and swelling, in addition to the “unattractive” appearance. In some hot climates, where wearing compression stockings is unbearable during certain seasons of the year, medication is especially important. Medications that promote venous return can improve venous function and relieve symptoms.
The main active ingredient extracted from the seeds of the horse chestnut tree is hesperidin, the representative drug of which is Maidenhair, produced by the German pharmaceutical company Lida.
Diosmin is a flavonoid extracted from plants, the composition of which is mainly a semi-synthetic product made from hesperidin. The micronized diosmin is well absorbed by the small intestine and has a good bioavailability. The clinical efficacy of the drug has been significantly improved by making the drug particles with a diameter of 60 microns into particles of less than 2 microns. The representative drug is Avelan, produced by Schweizer in France.
And so on, there are other drugs.
Non-surgical treatment, which is usually called conservative treatment, can only relieve the progress of superficial varicose veins and reduce the symptoms, but not cure them.
The specific treatment of various procedures is described in the individualized treatment of varicose veins of the lower extremities (surgical treatment).