Venous valve closure insufficiency causes venous blood backflow venous vasodilation
1, venous wall weakness and valve defects: the relative weakness of the venous wall, under the action of venous pressure can expand, the expansion at the valve sinus leads to the original venous valve without close closure, the occurrence of valve function is relatively incomplete, blood reflux. Valve dysplasia or absence, also can not play an effective role in preventing backflow, leading to the onset.
2, venous pressure persistently elevated: venous blood itself due to the role of gravity, a certain pressure on the valve, under normal circumstances will not cause damage, but when the venous pressure continues to rise, the valve will withstand excessive pressure, gradually relaxation, prolapse, so that the closure is incomplete. This is mostly seen in long-term standing work, heavy physical labor, pregnancy, chronic cough, long-term constipation, etc.
3, followed by age, gender: because the limb venous pressure only in the body length up to the highest when the highest pressure, the body before puberty is not high, so the caliber of veins is small, all can prevent venous dilation, so although there are suffering from serious varicose veins before 30 years old, but most of them are with age, the vein walls and valves gradually lose their tension, the symptoms increase forcing patients to seek medical attention.
Varicose veins are more common in women, probably because pregnancy can trigger or exacerbate them. However, in women without pregnancy, the incidence is also higher than in men, probably because of the wider pelvis, the excessive curvature of the vascular structures and the increased congestion of the veins in the pelvis during menstruation, pregnancy and menopause. Another reason why varicose veins are more likely to occur during pregnancy is because the tension of the superficial veins in the limbs is reduced during pregnancy, making them prone to dilation, a condition that can be restored after delivery.
Clinical symptoms.
Patients mostly have no local symptoms in the early stage, and gradually develop the following symptoms can appear: after standing for a long time, the legs are sore and uncomfortable, easily fatigued and weak; generally speaking, the symptoms are lighter when waking up in the morning, and the symptoms are aggravated at night after a busy day at work; some patients will have numbness and mild pain in the inner side of the ankle;.
1.The superficial veins of the affected limb bulge, dilate, become curved, or even tortuous or lumpy, more obvious when standing.
2. Swelling: slight edema may appear in the ankle and dorsum of the foot, and in severe cases, there may also be mild edema in the lower part of the calf.
Complications.
(1) Nutritional changes of the skin: thinning of the skin, flaking, itching, hyperpigmentation, eczema-like dermatitis and ulcer formation.
(2) Thrombotic superficial phlebitis: pain at the varicose veins, showing red, hard nodules and striae with pressure pain.
(3) Bleeding: acute bleeding due to trauma or spontaneous rupture of varicose veins or small veins.
Treatment
Treatment is based on surgery, which should be preferred if physical conditions allow and there are no obvious contraindications. For those who are not suitable for surgery, they can take oral Chinese medicine to relieve symptoms and wear sequential decompression stockings to prevent further development of the lesion.
The aim of surgical treatment is to eliminate the varicose veins and stop the backflow of blood. The traditional treatment method is to ligate the saphenous vein and remove the vein mass in the lower leg in sections. This surgical method is gradually replaced by some new treatment methods in recent years due to the shortcomings of more incisions, more damage, longer operation time, and affecting aesthetics. The minimally invasive laser+radiofrequency treatment of varicose veins that we are currently using is a newest technology at home and abroad, which means that the main trunk of the saphenous vein is treated and the recurrence of branch varicose veins is avoided. It is popular among patients (especially female patients) because of its simple method, small surgical incision, few complications, fast postoperative recovery, minimal trauma and aesthetic appearance.
Surgical methods.
(1) Traditional surgical style
(1) Simple saphenous vein (or small saphenous vein) high ligation, stripping plus traffic branch vein ligation. It is suitable for those who have no deep vein valve closure insufficiency and have simple saphenous vein (or small saphenous vein) varicose.
②Simple saphenous vein high ligation, stripping, traffic branch vein ligation and deep vein valve function repair. It is suitable for those who have deep vein valve closure insufficiency and superficial varicose vein.
(2) Minimally invasive surgical approach to varicose veins of the lower extremities (on the basis of the above-mentioned surgery) is used for varicose veins of the lower legs.
① varicose vein suture ligation.
(ii) varicose vein spinotomy.
③Laser treatment of varicose veins.
④Electrocoagulation of varicose veins.