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Abstract: The hot summer is here, but many people have to cover their long pants because of earthworm legs. The patient in this case is a cab driver who was diagnosed with varicose veins in the lower extremities 2 years ago and came to our hospital because he did not insist on wearing medical elastic stockings, and his symptoms worsened, not only with distension and pain in both lower extremities but also with a feeling of heaviness. After the diagnosis was confirmed and the preoperative examination was completed, surgery was given and the patient recovered well and the varicose veins disappeared after taking oral medication and using medical compression stockings.
Basic information】Male, 40 years old
Disease Type】Venous varicose of lower limb
Hospital】Heze Traditional Chinese Medicine Hospital
Date of consultation】May 2021
Treatment plan】Surgical treatment (high saphenous vein ligation + stripping + endovenous laser closure combined with foam sclerotherapy injection) + medication (pulse blood Kang + citrus flavonoid tablets + rivaroxaban tablets) + physiotherapy (elastic bandage + medical elastic stockings)
Treatment period】7 days of hospitalization, 12 days of postoperative review
Treatment effect】Disappearance of varicose veins in lower limbs
I. Initial consultation
It’s already summer and beauty lovers are already wearing shorts and skirts to show off their beautiful legs. But today, a male patient came to the clinic, wearing a pair of pants, short T-shirt, with a sad face, the patient complained that he is a cab driver, 2 years ago found himself with earthworm legs, at that time is not very serious, the exposure of veins is not very obvious, went to the local hospital after wearing medical elastic stockings for treatment, because it is too much trouble, did not insist on wearing, symptoms gradually aggravated, often feel the lower limbs sore, heavy, and sometimes also feel pain He was very worried now because his lower extremities were obviously bruised and exposed. After removing the pants, the patient found that the superficial veins of both lower extremities were significantly dilated along the direction of travel. A clear diagnosis was given: varicose veins of the lower extremities, and inpatient surgery was recommended.
II. Treatment process
After hospitalization, the patient was given a physical examination, blood tests for routine blood, five coagulation tests, liver and kidney functions, blood lipids, eight viruses, etc., and ultrasound examination of veins of lower limbs to exclude deep vein thrombosis, ultrasound examination of heart to exclude atrial defect and ventricular defect, ultrasound examination of abdominal large vessels to exclude abnormalities of deep vein inflow tract, etc., and electrocardiogram examination. We will actively improve the relevant examinations to exclude contraindications to surgery, and assess the penetrating branches of the deep and superficial veins of the lower extremities by ultrasound again in the preoperative department and label them, and mark the varicose vessels. The saphenous vein was treated with high ligation + stripping + intracavitary laser closure combined with foam sclerotherapy injection under lumbar anesthesia, and a compression bandage was applied at the end of surgery. Six hours after the operation, the patient was taken out of bed and had a normal diet. 12 hours after the operation, anticoagulant drugs were given to prevent thrombosis, and oral pulse blood Kang and citrus flavonoid tablets were taken to activate blood circulation and reduce swelling. The elastic bandage was removed 5 days after the operation to observe the wound of the lower limb, and there was no obvious sign of bleeding and infection, and the treatment was changed to medical elastic stockings, and the patient was discharged.
III. Treatment effect
The patient was treated surgically, and the wound was disinfected every other day, and under the pressure bandage and medication, the wound was observed 5 days after surgery and no obvious bleeding or infection was found, and then the treatment was changed to medical elastic stockings. The stitches were removed from the groin area 7 days after surgery, and the patient was granted discharge, and was instructed to take oral pulse blood Kang, citrus flavonoid tablets and rivaroxaban tablets for at least 2 weeks, and to come to the hospital for review 12 days after surgery for leg wound removal and disappearance of varicose veins in the lower limbs.
IV. Notes
We are glad that the patient’s symptoms were relieved and the varicose veins disappeared after active surgical treatment, but the following matters still need to be noted after varicose vein surgery in the lower limbs.
1. It is recommended that patients should not engage in heavy physical activities for 1 month after surgery and avoid standing or sitting for a long time to help blood circulation.
2, remember to follow the doctor’s instructions to use medication on time, and continue to wear medical elastic stockings for 3-6 months, which is conducive to the recovery of the disease.
3, usually you can often do the heel lifting, hook toe action to promote blood circulation, to prevent the occurrence of deep vein thrombosis.
4.Patients are advised to maintain a light and easily digestible diet for 2 weeks, avoiding spicy and stimulating foods and foods with high fat content.
V. Personal insight
From the viewpoint of the people who visit the clinic, there are more and more patients with varicose veins in the lower extremities, which is related to people’s living habits, and prolonged sitting or standing may lead to the occurrence of varicose veins in the lower extremities. Like the patient in this case, as a cab driver, prolonged sitting led to varicose veins in lower limbs, and the condition eventually worsened because he did not pay attention to it and did not insist on using medical elastic stockings. The serious disease will not only affect the beauty, but also appear pigmentation, eczema and ulceration on the foot and ankle, which will even affect people’s health. Therefore, we should pay attention to change our habits in life to prevent varicose veins in lower limbs, and if early diagnosis of varicose veins in lower limbs is confirmed, we must follow medical advice and treat them early, and actively use physical therapy to relieve symptoms so as not to aggravate the disease.