Treatment regimen for venous insufficiency. Chronic venous insufficiency: causes of development, symptoms and treatment

Venous insufficiency is a disease that develops in humans as a consequence of insufficiency of the deep vein valves. This disease occurs very often today, but in most cases the disease long time progresses undetected.

As evidenced medical statistics, chronic venous insufficiency affects approximately 60% of people of working age. But only a tenth of patients undergo adequate treatment for this disease. Mostly, patients with this problem turn to general practitioners. Therefore, it is very important that a specialist makes the correct diagnosis.

The mechanism of development of venous insufficiency

Venous valves are present as in deep , and in superficial veins . If a patient develops deep vein thrombosis, their lumen becomes blocked. And if after some time the lumen is restored due to the process recanalization . But if the lumen of the veins is restored, then their valves cannot be restored. As a result, the elasticity of the veins is lost and fibrosis develops. And due to the destruction of the valves of the veins, the patient’s normal blood flow stops.

Gradually, the patient develops chronic venous insufficiency. If damage occurs to the valves of the deep veins of the legs, then reverse blood flow in the veins occurs freely, since the main function of the valves is to prevent reverse blood flow through the veins of the legs. As a result, blood pressure increases, and plasma passes through the venous walls into the tissues that surround the vessels. The tissues gradually become denser, which contributes to compression of small vessels in the ankles and shins. The result of this process is , as a result of which the patient develops trophic ulcers which are considered one of the main symptoms venous insufficiency.

Stages of venous insufficiency

It is customary to distinguish three different stages of chronic venous insufficiency. This is the stage of compensation, subcompensation and decompensation. On first stage of the disease a person exhibits an exclusively cosmetic defect, that is, varicose veins and telangiectasias are visible. To diagnose the disease at this stage, instrumental research methods are used, and special tests are carried out. Such tests allow you to assess the condition of the valves and the patency of the deep veins. In addition, in the process of diagnosing this disease, phlebomanometry, venography, and ultrasound scanning are used.

On second stage of the disease (subcompensation) a person already exhibits trophic disorders, which at this stage are reversible. At this stage the patient complains of constant pain, manifestation of leg cramps, severe fatigue, itchy skin. Sometimes pigmentation of the skin occurs and may appear. Many patients at the subcompensation stage turn to doctors with complaints about cosmetic defects, since at this stage changes in the condition of the blood vessels are already noticeable.

On third stage of venous insufficiency (decompensation) trophic disturbances of an irreversible nature occur. A person suffers from elephantiasis and trophic ulcers. In this case, the patient’s medical history may include deep veins , varicose veins , .

There are also four different shapes venous insufficiency: varicose , swelling and pain , ulcerative And mixed . With each form, both general and characteristic symptoms venous insufficiency.

Causes of venous insufficiency

Due to the fact that the development of venous insufficiency is directly related to upright posture, the most common manifestation in people is chronic venous insufficiency lower limbs .

The global causes of the development of venous insufficiency are a number of life features modern people. First of all, this is total , constantly remaining in a sitting or standing position during daily work. In addition, the causes of the disease are certain congenital characteristics hormonal status And vascular system, which provokes a deterioration in the venous outflow of blood. The development of chronic venous insufficiency is often a consequence of the same factors that provoke the manifestation in humans , and deep veins of the legs.

It is important to take into account that the provoking factors for the development of venous insufficiency are smoking, as well as . The presence of varicose veins in close relatives should also alert you.

As a person ages, the risk of developing venous insufficiency increases: it most often develops in people over 50 years of age. The disease is more often diagnosed in women.

According to statistics, subcompensated And decompensated Approximately every seventh person in the world suffers from a form of chronic venous insufficiency. With chronic venous insufficiency, a person actually develops venolymphatic insufficiency, since due to increased venous pressure, the load on the lymphatic vessels also increases greatly.

Venous insufficiency can manifest itself in different ways. As a rule, a person complains of pain in the legs, a constant feeling of heaviness, and evening swelling of the legs, which disappear in the morning. With venous insufficiency, the patient’s usual shoes gradually become too small, as swelling is noted. The patient may be disturbed at night convulsions . The color of the skin on the lower leg also changes; the skin becomes not as elastic as before. Varicose veins are visible, although initial stages the disease may not manifest itself. In addition, the patient feels constant fatigue and anxiety.

Diagnosis of chronic venous insufficiency

In the process of diagnosing the disease, the doctor is guided by the fact that venous insufficiency is actually a symptom complex that is based on insufficiency of the valve and vessel wall in the superficial and deep veins of the legs. During the diagnostic process, it is important to determine exactly what stage of the disease is this moment occurs in the patient.

In addition, in the process of establishing a diagnosis, the form of chronic venous insufficiency is determined. Initially, the specialist pays attention to the presence of some signs of the disease: swelling of the legs, characteristic pain, night cramps in the calf muscles ah, the presence of pigmentation in the lower part of the leg, as well as eczema, dermatitis and trophic ulcers.

Mostly, ultrasound examination methods are used in diagnosis: duplex ultrasound scanning, Doppler ultrasound. To clarify the causes of chronic venous insufficiency, phlebography is possible.

Today, treatment of venous insufficiency is carried out using methods that are prescribed for other vascular diseases - varicose veins , postthrombophlebitic syndrome .

The goal of therapy for this disease is, first of all, to restore blood flow in the veins. As a result, the current is restored , trophic changes of a reversible nature disappear. The use of both conservative and surgical methods treatment of venous insufficiency.

Conservative therapy for venous insufficiency consists of using a number of physical methods, as well as medicines. With the combined use of these drugs, the effect of treatment will be the highest. In addition, it is important to determine which risk factors that directly influence the progression of the disease occur in each specific case. This could be pregnancy, weight gain, or specific stress at the workplace. Each patient should understand the possibility of further progression of chronic venous insufficiency and take measures to prevent this process.

In order to surgery was not needed for venous insufficiency of the lower extremities and in the future, it is important to adhere to all the rules of prevention further development venous insufficiency, apply compression therapy . Compression is carried out by bandaging the limbs with an elastic bandage and wearing special compression stockings. Compression hosiery should only be chosen after consulting a doctor, as there are four classes of such hosiery.

No less important is the course of treatment with phlebotropic drugs. Treatment with such drugs can significantly alleviate the patient's condition. For the drug treatment of chronic venous insufficiency, in most cases, they are prescribed drugs bioflavonoids . Their action is especially effective on early stages illness. Even if the patient takes such drugs for a long period, they do not have a negative effect on the body. If treatment is carried out at the compensation stage, then the course of therapy with such drugs lasts from one to two months and is repeated 2-3 times a year. At the subcompensation stage, the duration of treatment increases to four months. The third stage of venous insufficiency is treated with a six-month course of taking bioflavonoids, after which the dose is reduced by half.

Today, most often the treatment of this disease is carried out using drugs based on diosmina And . They are most effective when used simultaneously. In addition, diosmin is also used to prevent venous insufficiency.

Surgical methods of treating venous insufficiency are currently used only in 10% of cases, since conservative treatment methods can significantly improve the patient’s quality of life in most cases. However, very often surgical treatment required by those patients for whom it is important to eliminate a cosmetic defect - varicose veins.

There are several commonly used surgical methods for treating venous insufficiency. Thus, it is possible to remove a conglomerate of varicose veins, ligate the place where the saphenous vein of the thigh flows into femoral vein. According to another technique, an incision is made in the lower leg area and the perforating veins are ligated. This operation is performed if the patient is diagnosed with insufficiency of the valves of the perforating veins.

The so-called Babcock operation consists of making an incision at the beginning saphenous vein hips. After this, a probe with a round end is inserted into the varicose vein. Its end is brought out in the knee area along with the fixed vein.

When varicose veins develop in a patient with venous insufficiency, it is sometimes used sclerotherapy . This technique has been used for treatment since ancient times. The technique consists of introducing a special substance into the vein, which promotes a chemical effect on the walls of the vein and their subsequent adhesion and fusion. But this method is characterized by relapses of the disease and thromboembolic complications. Sclerotherapy is prescribed if the patient has varicose veins of small and medium caliber. The procedure is carried out using local .

Laser surgery is also used to treat chronic venous insufficiency. endoscopic removal varicose veins. The treatment method should only be suggested by a specialist after a detailed examination and diagnosis.

The doctors

Medicines

Prevention of chronic venous insufficiency

To prevent the development of chronic venous insufficiency, it is necessary to prevent the manifestation of those diseases that provoke its progression in the future. Methods for preventing such diseases involve the use of compression hosiery, daily physical activity with adequate loads, periodic elevated position of the legs, as well as regular breaks when working for long periods while sitting or standing. During the break, you should warm up or hold your limbs in an elevated, relaxed position for some time. In some cases, it is advisable to periodically take a course phlebotropic drugs . To avoid problems with blood vessels, you should always choose only comfortable, loose and stable shoes. Women should not wear very high heels all the time.

Complications of chronic venous insufficiency

The most common complications of chronic venous insufficiency are trophic disorders of the lower leg tissues which are progressive. Initially appears hyperpigmentation , which after some time progresses to deep trophic ulcers. In addition to local complications, the disease provokes distant reactions. Due to the fact that the volume of circulating blood in the veins of the legs becomes less, a patient with chronic venous insufficiency may develop heart failure. The presence of tissue breakdown products in the body provokes allergic reactions which cause dermatitis , venous eczema .

Diet, nutrition for venous insufficiency

List of sources

• Saveliev B.S. Phlebology. Guide for doctors. - Moscow. Medicine. - 2001;
• Yablokov E.G., Kirienko A.I., Bogachev V.Yu. Chronic venous insufficiency. - Moscow. - 1999;
• Konstantinova G.D., Zubarev L.R., Goadusov E.G. Phlebology. M: Vidar-M, 2000;
• Averyanov M.Yu., Izmailov S.G., Izmailov G.A. and others. Chronic diseases of the veins of the lower extremities: Textbook. Benefit. N. Novgorod. FGUIPP "Nizhpoligraf" 2002.

There is a common misconception among patients that chronic venous insufficiency of the veins of the lower extremities and varicose veins of the venous lines of the legs are the same pathology. However, this is not true.

CVI of the lower extremities is a syndrome that includes several pathological disorders: insufficiency of venous valves in the legs, impaired blood circulation, increased thrombus formation in the patient’s vascular bed and vascular anomalies, both congenital and acquired.

General ideas about pathology

The prerequisites for the development of this pathological condition are people’s ability to walk upright and a decrease in their physical activity every year.

In the absence of regular training of the calf muscles Negative influence The vertical position of the human body is aggravated, since it is the muscle fibers surrounding the venous lines that help maintain normal elasticity and tone of the vascular walls, acting as an anatomical “corset” for the veins.

The danger of CVI is that patients do not always focus on triggering pathogenic mechanisms and seek specialized help only when the pathology significantly worsens, when it becomes chronic and is characterized by severe insufficiency of the valve apparatus of the vascular lines. In this case, the development of the pathological process can be localized not only in the lower extremities, but also in the brain.

What can trigger the development of the disease

The causes of venous insufficiency of the lower extremities are the disruption of blood circulation in the vessels of the peripheral parts of the body and the formation of stagnation in them. Against the background of weakening muscle tone in the legs, the walls of the veins gradually weaken and are unable to maintain constant intravascular pressure.

Continuous influence high blood pressure inside the venous lines over time leads to deformation of sections of the veins and the formation of an expansion of the lumen in them. The veins become like a deformed rubber tube - thinned and elongated, unable to maintain a constant shape.

Due to availability stagnation the first signs of venous insufficiency of the lower extremities are a gradual increase in leg fatigue. Patients note in evening time heaviness in the legs, slight swelling may form on the feet. With absence specific treatment pathological disorders worsen over time, and they are accompanied by a violation of the trophism of the tissues of the lower legs.

The causes of venous insufficiency of the lower extremities are as follows:

• Thrombosis of deep venous lines of the lower extremities.
• Decompensated stage of varicose veins in the legs.
• Genetic predisposition to structural weakness of the vein walls or hereditary abnormalities of vascular development.
• Various leg injuries.
• Hormone therapy.
• Gender: pathology is diagnosed in women several times more often than in men. This is due not only to the increased content of certain hormones in the blood, but also to the functions assigned to female body- pregnancy and childbirth.
• Increased load on the venous lines of the legs, which increases significantly during pregnancy not only due to increasing body weight, but also as a result of compression of the vessels by the growing uterus.
• Excess body weight.
• Physical inactivity.
• Age-related changes affecting the condition and functionality of the vascular bed.
• Regular high physical overload both during sports and when performing heavy physical work.
• Tendency to constipation.
• Forced standing or sitting for a long time (at hairdressers, surgeons).

What forms of pathological condition exist

In the 90s of the last century, an attempt was made for the first time to systematize the pathologies of the veins of the lower extremities. After numerous modifications, the International Classification of Venous Insufficiency CEAP was created, which is used throughout the world when conducting differentiated diagnostics.

The abbreviation CEAP reflects the changes that occur in the vascular bed during the development of the pathological process:

C – clinical manifestations of the disease:

• Grade 0 is characterized by the patient having no visible signs of venous damage;
• at grade 1, abnormally dilated small vessels (venules and arterioles) form on the skin in the form spider veins or mesh;
• with grade 2 on the legs, upon examination, a specialist can identify areas of unstable dilated veins; when the patient’s position changes and the load on the lower extremities is reduced, the veins return to normal;
• at 3rd degree peripheral parts persistent swelling of the legs;
• at grade 4, signs of impaired tissue trophism appear in the lower parts of the legs;
• at grade 5, disruption of metabolic processes in the tissues of the peripheral parts of the lower extremities leads to the formation of healing ulcers;
• at grade 6, trophic ulcers are difficult to treat and do not heal.

E – etiology of the disease:

• EU – the disease is caused by genetic factors;
• EP – the causes of pathological disorders cannot be determined;
• ES – the provoking factor is a previous injury or a tendency to increased thrombus formation.

A – localization and depth of pathological changes:

• damage to the subcutaneous, connecting or deep veins;
• damage to the inferior vena cava or great saphenous vein.

P – pathophysiological changes accompanying the development of the disease:

• CVI with the presence of reflux;
• CVI with the development of obstruction;
• CVI, combining both of the previous symptoms.

In addition to the CEAP system, domestic phlebology has developed a systematization of venous insufficiency based on such characteristics as the severity of damage to the vascular bed and the nature of the development of the disease.

Depending on the stage of development of the pathological process and the presence/absence of complications, there are the following degrees of chronic venous insufficiency of the lower extremities:

• CVI grade 0 – despite the presence of telangiectasia, the clinical picture of disease progression is not determined.
• CVI stage 1 – increased fatigue of the legs develops, unstable swelling periodically occurs.
• Chronic venous insufficiency of the lower extremities of the 2nd degree - swelling becomes stable, the color of the skin of the legs changes, eczema may develop.
• Stage 3 CVI – the surface of the skin of the lower extremities becomes ulcerated. Complications arise in the form of bleeding of varying intensity and thrombophlebitis.

Depending on the nature of the pathological process, 2 types of pathology are distinguished.

Acute venous insufficiency – develops rapidly and consists of obstruction of the patency of deep veins. Specific symptoms include a change in the color of the skin of the affected leg to a very short time(they acquire a bluish tint), the appearance of permanent acute pain along the vein, the leg quickly swells. Relieving this form of venous insufficiency does not create difficulties. First aid is applying cold to the affected limb and urgent hospitalization in a specialized institution.

Chronic – Clinical signs They appear gradually and differ from patient to patient. When this venous insufficiency of the lower extremities develops, the symptoms are mainly the following:

• increased fatigue of the legs, pronounced heaviness in them after a forced long stay in vertical position;
• formation of persistent edema;
• the appearance of cramps in the calf muscles at night;
• change in skin coloration;
• the appearance of signs of impaired trophic tissue of the lower extremities - the skin dries out and loses its elasticity;
• ulceration of the surface of the skin;
• attacks of dizziness, possible loss of consciousness.

If a person notices at least one of the listed signs, he needs to contact a medical institution as soon as possible for consultation with a specialist.

Diagnostic measures

During differentiated diagnostics, the phlebologist prescribes the following laboratory and instrumental examination:

• clinical blood test - to determine, first of all, the properties of blood clotting;
• biochemical blood test;
• general urine analysis;
• ultrasonography venous lines of the lower extremities using Dopplerography;
• phlebography – contrast method X-ray examination;
• if necessary, appointment of consultations with related specialists.

Having the results of an in-depth examination of the patient, the phlebologist can develop individual health measures that have the maximum therapeutic effect.

Therapeutic measures

When diagnosing chronic failure treatment of venous lines of the lower extremities involves an integrated approach.

Drug therapy consists of the use of specific medications belonging to the group of venotonics:

• tablets for venous insufficiency of the lower extremities reduce the intensity of pain, eliminate swelling, increase elasticity vascular wall, produce an anti-inflammatory effect (Troxevasin Neo, Troxerutin, Flebonorm, Detralex and others);
• ointments for venous insufficiency of the lower extremities have the same properties as tablet forms of venotonics, but have a local effect and do not affect other human organs and systems (heparin, troxevasin ointments, Lyoton gel and others);
• other medications for venous insufficiency of the lower extremities are medications that improve the flow properties of blood (aspirin and its derivatives, for example, Cardiomagnyl), non-steroidal anti-inflammatory drugs (Meloxicam, coxibs), strengthening the immune system (multivitamin complexes);
• drugs for venous insufficiency of the lower extremities can be synthesized not only from chemical compounds, but also of plant origin (Antistax, Shungite balm).

Traditional medicine recommends the use of various fruits and herbs for venous insufficiency of the lower extremities (cinnamon, nutmeg, horse chestnut, nettle, hop cones, garlic). When choosing folk remedies for treatment, you should consult your doctor.

Nutrition for venous insufficiency of the lower extremities must be balanced, containing in sufficient quantities all the necessary useful material and microelements.

It is useful to include seaweed and chokeberry juice in your usual diet. Therapeutic diet provides for limiting the consumption of excessively fatty, hot, spicy, smoked foods, canned foods, marinades, alcoholic and carbonated drinks.

The use of physiotherapy and therapeutic exercises for health purposes helps to enhance the positive effect of conservative treatment. Physical exercises for venous insufficiency of the lower extremities are selected individually and help maintain the tone of the calf muscles, normalize blood circulation in the vascular bed, and eliminate stagnation in the peripheral parts of the legs.

In the absence of positive results from conservative treatment methods, specialists prescribe surgical treatment.

Preventive actions

Following certain recommendations can significantly reduce the risk of pathology of the venous vessels of the legs or slow down the development of an emerging pathological condition.

Prevention of venous insufficiency of the lower extremities is as follows:

• organizing a healthy lifestyle - normalizing work and rest schedules, allocating sufficient time for sleep, developing a balanced diet, getting rid of bad habits, etc.;
• conducting regular walking walks, performing specially selected physical exercise;
• selection of the right shoes - not too narrow, with low heels;
• refusal of tight clothing;
• limiting exposure to the open sun and visits to the solarium;
• constant wearing of individually selected compression hosiery;
• normalization of weight.

Timely contacting specialists to conduct a detailed examination and implement adequate therapeutic measures helps eliminate pathological manifestations in a relatively short time and prevent the formation severe complications. A patient’s visit at the early stages of the disease significantly increases the effectiveness of specific treatment.

Useful video: A specialist talks about venous insufficiency

Venous insufficiency is an extremely common problem. We can thank modern lifestyle for such disappointing statistics. Sedentary work, lack of physical activity, poor diet - all this negatively affects the functioning of the vascular system.

So what is this disease? What are its first symptoms? How dangerous can venous vessel insufficiency be? Are there effective methods treatment? These questions interest many patients.

What is this disease?

Venous insufficiency is a disease that some doctors jokingly call the penalty for walking upright. It's no secret that veins are vessels through which blood moves to the heart, and therefore against the force of gravity. Special venous valves prevent the backflow of blood. But with prolonged static loads (sitting, standing), the pressure on the valves and vessel walls is too great.

First, the valves stretch, after which so-called venous reflux is often observed - the reverse flow of blood from top to bottom. The additional volume of fluid puts pressure on the vessel wall, causing it to stretch and thin. Over time, plasma begins to leak through the thin vascular wall, which then accumulates in the soft tissues, forming edema. Thus, not only the structure of the blood vessels is disrupted, but also the nutrition of nearby tissues.

Latest statistical research showed that in developed countries at least 15-40% of the population suffers from venous insufficiency. Moreover, in most cases, the disease is diagnosed in people aged 20 to 50 years.

Unfortunately, most sick people go to the doctor at a very early age. late stages development of the disease. This is exactly what phlebologists consider the main problem. After all, the sooner the patient receives help, the easier it will be to eliminate the main symptoms and prevent the development of complications.

The main causes of the development of venous insufficiency of the lower extremities

In fact, chronic venous insufficiency of the lower extremities can develop under the influence of various factors. To begin with, it is worth noting that this disease often appears against the background of varicose veins. In addition, vascular insufficiency can be caused by certain congenital pathologies of the superficial or deep veins. This group of diseases includes hypoplasia, aplasia, as well as the presence of arteriovenous fistulas.

Quite often, failure is the result of a patient’s previous phlembothrombosis. Much less often, the disease develops after injury.

On the other hand, there are some risk factors that increase the likelihood of a person developing the disease. For example, some people have a certain genetic predisposition, which is associated with insufficiency connective tissue, as a result of which there is a deficiency of collagen - the walls of blood vessels in such patients are less elastic.

Risk factors also include long-term static loads, which is observed in people whose profession requires constant sitting or standing (salespeople, cashiers, office employees). Don’t forget about obesity, since extra pounds are an additional burden on the cardiovascular system.

Chronic venous insufficiency is diagnosed in women much more often than in men. This is due to constant fluctuations in estrogen levels, which is observed during pregnancy or taking hormonal medications. The risk of developing deficiency increases with age. In addition, people suffering from chronic constipation may be considered at risk.

Classification and severity of the disease

Actually in modern medicine there are several classification systems of this disease. For example, depending on the etiology, chronic venous insufficiency may be congenital (associated with certain anatomical features body), primary (the exact cause of the disease is unknown) or secondary (the disease developed as a result of injury, thrombosis or other venous disease).

Most often, phlebologists use the following classification system, which takes into account the presence and intensity of symptoms:

• Grade 0 - the person has no symptoms of the disease. This category of people was not chosen by chance, since the absence of signs does not always indicate complete health. Some patients who have been diagnosed with deficiency do not experience any discomfort, and there are also no external symptoms.
• In the first degree, periodic pain in the legs is observed, as well as night cramps and a feeling of heaviness, which intensifies with prolonged static loads. Swelling appears only from time to time.
• The second degree of severity is characterized by persistent swelling. Skin hyperpigmentation and areas of weeping or dry eczema can be replaced.
• At the third degree, trophic ulcers appear on the skin, which periodically open and heal.

Main signs of the disease

Surely in the life of almost every person there is at least one risk factor, under the influence of which venous insufficiency can develop. It is extremely important to know the symptoms of this disease, because the sooner a person notices a deterioration in health, the sooner he will see a doctor and receive quality treatment.

The first signs of venous insufficiency of the lower extremities are pain and swelling. As a rule, heaviness and pain in the legs appear in the late afternoon. Discomfort increases with prolonged stay in an upright position. Swelling also appears in the evening, and the swelling is noticeable only on the ankles and does not extend to the toes. In the morning, a person usually feels well, which is the most common reason for refusing medical consultation.

If left untreated, venous-lymphatic insufficiency moves to a new level - now the symptoms become more noticeable. A sick person suffers from constant bursting pain and burning in the legs. The swelling becomes persistent and can be noticed at any time of the day. Many patients complain of night cramps, which affect the quality of sleep.

Due to insufficient blood circulation, tissue trophism (nutrition) is disrupted. Hyperpigmented areas that appear as small spots may appear on the skin Brown. The skin over the affected vessels becomes thinner and begins to peel off - this is how eczema develops.

This is what venous insufficiency looks like. Her symptoms are getting worse every month. The third stage of the disease is characterized by the appearance of trophic ulcers. Such skin lesions form gradually. First, a dark-colored spot forms on the surface. Over time, a small compaction appears in its center, appearance which resembles a drip of paraffin. This area of ​​the skin is extremely sensitive to mechanical stress - any blow or injury leads to the opening of an ulcer, which will only increase in size over time.

This is not the only danger associated with venous insufficiency. The photo shows the appearance of a future trophic ulcer. Such an open area on the skin becomes an excellent gateway for infection. Often the ulcerative process is complicated by various bacterial and fungal inflammations.

Modern diagnostic methods

Of course, when the first symptoms of the disease appear, you need to go to the doctor. Only a specialist can correctly assess the condition of the patient’s body and make a diagnosis of “venous insufficiency.”

As a rule, the doctor suspects that there are problems with blood vessels even during the initial examination. However, the patient needs to undergo some examinations. The standard tests are biochemical studies of blood and urine samples. Is not specific tests, but they make it possible to determine the presence of inflammation and some concomitant diseases. General analysis blood test helps to determine the number of red blood cells, platelets and, accordingly, the blood viscosity indicator.

The most informative procedure is ultrasound examination of the vessels of the lower extremities. During the examination, the specialist can determine the presence of dilated areas of veins, nodules or clots.

In rare cases (if the ultrasound did not give an accurate result), the patient is prescribed more complex procedures. In particular, venography is considered a fairly accurate method. During the examination, the patient is injected intravenously with a special contrast agent, and then its progress is monitored. venous system.

Venous insufficiency of the lower extremities: treatment with conservative methods

When such a disease is identified, the question of therapy arises. How to treat venous insufficiency? To begin with, it is worth noting that this disease is chronic, so therapy in this case must be comprehensive and long-term.

The course of treatment is selected individually. Some patients take the medication for two months, while others require longer treatment. In most cases, doctors prescribe medications that can strengthen the venous wall and normalize blood flow. Medications are also used to help improve tissue nutrition - this prevents the appearance of trophic ulcers.

Special care is required for patients who have already developed an ulcerative process. Damaged areas of the skin should be regularly treated with various antiseptic and wound-healing solutions or ointments. Sometimes doctors prescribe anti-inflammatory drugs; in more severe cases, corticosteroids are needed. If there is a high risk of blood clots, heparin or some other blood thinning medication is prescribed.

This is exactly the kind of therapy that venous insufficiency requires. Treatment also includes various physical therapy techniques that speed up the healing process. To the most effective procedures include treatment magnetic fields, dynamic currents. Also, patients with this diagnosis often undergo electrophoresis. Laser therapy gives good results.

To normalize blood circulation, sick people are recommended to wear special compression stockings or tights. Such devices help get rid of swelling, partially restore blood circulation and prevent blood stagnation in soft tissues.

And, of course, therapeutic exercises are an integral part of quality therapy. Venous insufficiency of the lower extremities often develops against the background of a sedentary lifestyle. This risk factor can and should be eliminated. Naturally, those sports that involve heavy loads on the legs (football, basketball, weightlifting) are not suitable. But swimming or gymnastics will help improve your health.

Surgical treatment of CVI

Surgery is usually prescribed if conservative treatment turned out to be ineffective. There are many surgical procedures available today. And the choice here depends both on the severity of the disease and on the condition of the patient’s body, the presence of contraindications, etc.

At the first stage of the disease, sclerotherapy may be effective. During the procedure, a special drug is injected into the affected vessel, which blocks the lumen of the vessel and stops blood flow in this area of ​​the vascular network.

Unfortunately, this method cannot always cure a disease called chronic venous insufficiency. Treatment of the second and third degrees of the disease is an indication for more massive surgical intervention. Depending on the condition of the vascular system, either ligation or removal of the dilated section of the vessel is performed. Sometimes vascular plastic surgery is also required during the procedure - this makes it possible to normalize blood flow. Naturally, after the operation there follows a rehabilitation period. Some patients require an additional course of treatment various drugs. And, of course, it is extremely important in the future to maintain a healthy lifestyle and avoid exposure to risk factors, as the disease may return.

Possible complications of venous insufficiency

Venous insufficiency of the lower extremities is extremely dangerous condition, which should never be taken lightly. To begin with, it is worth noting that the accumulation of significant volumes of blood in the vessels of the legs negatively affects the functioning of the entire body. Because the nervous system does not receive enough oxygen and nutrients, then patients with this diagnosis often complain of constant dizziness, fainting, problems with mental stress. Cardiovascular failure is also a common complication.

These are not all the problems associated with venous insufficiency. The result of the disease can be phlebitis (inflammation of the venous walls) or thrombophlebitis (inflammation of the walls with the formation of blood clots). In turn, the detachment of a blood clot and its entry into the bloodstream can lead to pulmonary embolism- blockage of the pulmonary vessels in the absence of emergency assistance, as a rule, ends in death.

Treatment with folk remedies

Today many people different ages are faced with a diagnosis of “venous insufficiency of the lower extremities”. Treatment is a long and painstaking process. Of course, the doctor must choose the treatment for the patient. But there are also some traditional medicine recipes that can help speed up the body’s recovery process.

For example, traditional healers highly recommend horse chestnut extract, since the extract of this plant really strengthens the venous walls. Another effective remedy is hazelnut infusion. Both the bark and leaves of the plant are used as raw materials.

Kalanchoe is another useful plant that is used for compresses. To prepare, you need to grind 50 g of plant leaves and pour 500 ml of alcohol into them. The jar must be closed and kept in a dark place for seven days. After this, the infusion is ready for use. But you can disinfect the surface of trophic ulcers using Japanese Sophora extract.

In any case, it is worth understanding that treatment of venous insufficiency with folk remedies is possible only after prior consultation with a doctor. The above recipes can only be used as adjuvant therapy. Under no circumstances should you ignore your doctor's instructions.

Are there effective methods of prevention?

Today, many people are diagnosed with venous insufficiency. Treatment is a long and complex process. That is why it is much easier to try to prevent its development. Of course, there are no medications that can permanently protect against vascular insufficiency. However, compliance with some simple rules will help reduce the risk of developing the disease to a minimum.

Since the main risk factor in this case is a sedentary lifestyle, this is where you need to start. Not every person has the opportunity to change their lifestyle. But if you have to spend most of your work time in a sitting position, then be sure to take breaks from time to time to stretch your legs. Physical activity is also a prerequisite - do some gymnastic exercises from time to time, sign up for fitness or swimming courses, go for walks more often. fresh air, run in the morning, etc.

Be sure to pay attention to your shoes - they should be comfortable. If necessary, you can always purchase special orthopedic insoles. When resting or sleeping, try to keep your legs slightly elevated (for example, place a pillow under them). And, of course, watch your body weight, since extra pounds negatively affect not only the functioning of the vascular system, but also the condition of the entire body.

If you regularly take hormonal contraceptives, then be sure to undergo an ultrasound examination of the veins of the lower extremities from time to time. And, of course, at the first signs of illness you should definitely consult a doctor. In the early stages, the problem is much easier to eliminate.

Cerebral vascular insufficiency: what is it?

A common pathology today is venous insufficiency of cerebral circulation. This disease develops under the influence of many factors that can lead to disruption of the normal outflow of blood from the cranial cavity.

As a rule, the disease develops against the background of other pathological conditions. The main causes of cerebral vascular insufficiency include traumatic brain injury, cerebral edema, cardiovascular and pulmonary insufficiency, as well as brain tumors and pleurisy. Symptoms of the disease often appear in people who have had pleurisy or pneumothorax. Risk factors include hypertension, thrombosis and thrombophlebitis, as well as asthma. Sometimes the disease develops after asphyxia.

Venous insufficiency of the brain is sometimes asymptomatic. However, in most cases, patients complain of constant headaches. Pain, as a rule, increases with sudden turns of the head, changes in temperature or atmospheric pressure, as well as during severe stress or alcohol intoxication.

In addition to the headache, other symptoms are present. In particular, patients experience constant fatigue, apathy and muscle weakness. From time to time dizziness and tinnitus appear. Symptoms of venous insufficiency include sleep disorders, darkening of the eyes, mental disorders, and epileptic seizures.

In any case, it is worth understanding that cerebral circulatory insufficiency is an extremely serious problem. Lack of timely treatment can lead to dangerous consequences. Therefore, if you have symptoms, do not hesitate to visit a doctor. In this case, complex therapy is needed, which is aimed at reducing swelling, normalizing blood flow and improving the tone of the vascular walls.

Venous insufficiency- a set of symptoms that develop as a result of a violation of the outflow of venous blood. This diagnosis ranks first among vascular diseases. According to various statistical sources, up to 60% of people of working age, mostly women, suffer from impaired blood flow. Acute venous insufficiency is a condition that can lead to fatal outcome. The chronic form of the disease, constantly progressing, worsens the patient's quality of life. However, only every tenth sick person consults a doctor about the disease.

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Reasons for development

The high prevalence of venous insufficiency is due to human upright posture. This position of the body creates an ever-increasing load on the vessels of the lower extremities. Chronic venous insufficiency, having mild symptoms in the initial stages, is often attributed to fatigue. The danger of the condition lies in the fact that severe symptoms, which become the reason for contacting a specialist, develop only after late stages development of pathology.

Reasons for the development of venous insufficiency:

• postthrombotic syndrome;
• varicose veins veins;
• congenital vascular pathologies;
• phlebothrombosis;
• injuries;
• concomitant diseases: cirrhosis, metabolic disorders, neoplasms, drug poisoning can cause the development of acute venous insufficiency.

In addition, there is a group of secondary factors that do not directly cause the development of the disease, but significantly increase the likelihood of its occurrence and aggravate the course of chronic venous insufficiency:

• hereditary predisposition;
• being female (due to the high content of the hormone estrogen, women suffer from venous insufficiency three times more often than men);
• pregnancy;
• excess weight;
• atherosclerosis;
• metabolic disorders;
• excessive drinking and smoking;
• low physical activity;
• hard physical work;
• taking hormonal medications;
• elderly age;
• chronic constipation.

Based on the factors contributing to the formation of chronic venous insufficiency of the lower extremities, risk groups can be identified: professional athletes, people with relatives suffering from venous insufficiency, obese people, the elderly, and pregnant women.

Mechanism of disease development

Normal venous circulation is carried out in the direction from various parts of the body, including the lower extremities, to the heart. Cardiac output creates pressure, due to which blood flows through the vessels to the periphery. Under the influence of negative pressure that occurs when the heart muscle relaxes, blood flows back. There are additional mechanisms that help blood rise:

• the work of the valves of the veins prevents the blood from flowing back (regurgitation);
• vascular tone;
• muscle contraction creates pressure and promotes upward movement of blood.

Venous insufficiency of the lower extremities is formed as a result of certain processes occurring mainly in the vascular wall:

• stretching of the wall at the location of the valves leads to their loose closure;
• stagnant blood puts even more pressure on the vessel and stretches its walls, as a result it becomes deformed;
• decreased muscle tone aggravates blood regurgitation and changes in the structure of the venous wall;
• due to blood stagnation, it is created high pressure inside a blood vessel;
• the venous walls protrude, become damaged, their permeability increases, blood flows out, causing staining of the tissues surrounding the vessel.

As a result, the blood supply to the part of the body in the affected area is disrupted, cellular metabolic products accumulate, an inflammatory process occurs, an insufficient amount of oxygen enters the tissues, blood viscosity increases, and blood clots form.

Classification

Venous insufficiency can occur in acute (AVI) and chronic (CVI) forms. It is advisable to apply this distribution to pathology affecting the vessels of the lower extremities. Acute and chronic venous insufficiency differ in the location of the lesion, the cause of development, symptoms and possible complications.

In the chronic form of the disease, superficial veins are affected; acute failure occurs when the lesion is localized in the deep vessels of the lower extremities. This pattern is due to the specific structure of the circulatory system in these sections: when blocked superficial vein the blood flow is redirected along the branches (perforating veins), thanks to this process, the disruption of outflow in the first stages of the disease is compensated.

Two forms have various reasons occurrence. Chronic venous insufficiency often occurs under the influence of a hereditary factor: a genetically inherent predisposition, manifested by weakness of the venous wall, valves, and impaired muscle tone. The acute form occurs against the background of stagnant, inflammatory processes, with blood clotting disorders. With this type of pathology, a blood clot blocks the lumen of the vein.

Symptoms
In the early stages, chronic insufficiency has no symptoms, but as the disease progresses, the manifestations increase. Acute disturbance of venous outflow occurs rapidly, symptoms appear quickly.

Signs chronic disorder outflow:

• heaviness in the legs;
• bursting feeling;
• pain;
• formation of spider veins;
• edema in the initial stages occurs in the evening; as the disease progresses, edema persists throughout the day;
• convulsions;
• pigmentation (coloring) of the skin over the lesion;
• decreased elasticity, dry skin;
• formation of cracks, areas of weeping, necrosis and trophic ulcers.
• progressive congestion in the lower extremities causes a decrease in the volume of circulating blood, so the symptoms are general: shortness of breath, dizziness, fainting.

Acute venous insufficiency is manifested by pain, the affected limb changes color - from bluish to marbled, the temperature at the site of the lesion decreases, the general temperature, on the contrary, increases and can reach 37-40 degrees, severe swelling develops, and sensitivity is impaired. As the disease progresses, the pain becomes stronger and radiates to the groin.

Classification of CVI is based on determining the stage of the disease and the degree of damage to the vascular wall. As the pathology progresses, the patient’s well-being worsens, symptoms progress, and performance deteriorates.

Degrees of chronic venous insufficiency:

• 0 degree – no symptoms, quality of life is not impaired;
• 1st degree (compensation) - the first signs may appear: heaviness, cramps, swelling, pain in the legs in the evening, after rest the symptoms disappear. The ability to work is not impaired, the quality of life is at the same level.
• 2nd degree (subcompensation) - the manifestations are pronounced, in addition to the symptoms inherent in the 1st degree, pigmentation of the skin over the lesion is observed, the patient suffers from skin diseases. Actions associated with physical activity, difficult to perform. Working capacity, already reduced at this stage, is restored by conservative therapy.
• 3rd degree (decompensation) – severe metabolic disorders, the appearance of trophic ulcers, the patient is unable to work.

There are classifications of venous insufficiency according to CEAP (international classification chronic diseases veins):

Symptomatic:

• 0 – there are no visual signs of a person;
• 1 – spider veins;
• 2 – varicose veins;
• 3 – persistent swelling;
• 4 – trophic changes on the skin;
• 5 – changes on the skin in the presence of an already healed ulcer;
• 6 - changes on the skin in the presence of a fresh ulcer.

Etiological:

• EU – genetic predisposition;
• ER – unknown cause;
• ES – trauma, thrombosis.

Pathophysiological:

• HAN with reflux;
• CVI with obstruction;
• combined CVI.

A similar classification is used by phlebologists. It allows you to assess the extent and nature of the lesion. This is important for determining the stage of the disease and prescribing treatment.

Diagnostics

The main problem in diagnosing chronic venous insufficiency is low awareness of the population. Many patients consider the symptoms of the initial stage of pathology to be a sign of fatigue, not illness. As a result, a person does not see a doctor and chronic venous insufficiency is detected in the later stages, when large areas are affected.

To provide the necessary medical care, it is necessary to establish an accurate diagnosis, reflecting the location and lesions, the degree, presence and severity of symptoms. During the examination, the doctor pays attention to swelling of the legs, determines the presence of pain and night cramps, checks for changes in skin color, eczema, dermatitis and trophic ulcers.

When determining the patient’s condition, each symptom of venous insufficiency is assigned a score on a scale from 0 to 2 (0 – no sign, 1 – moderate manifestations, 2 – severe symptoms). In the same way, the duration of the disease and the occurrence of repeated episodes are assessed: absence - 0, duration of active symptoms less than 3 months or the presence of one relapse - 2 points, manifestations of pathology for more than 3 months and repeated recurrence - 2 points.

If, after a general examination, the doctor has reason to suspect the presence of venous insufficiency, the patient is sent for instrumental and laboratory tests:

• a coagulogram allows you to determine blood clotting indicators: prothrombin index, clotting time, platelet count;
• duplex examination of the veins of the lower extremities reflects the state of blood flow and valves;
• Ultrasound examination allows you to determine the presence of blood flow disorders, the extent of congestive processes, and the condition of blood vessels.

Treatment

Acute venous insufficiency requires step-by-step treatment. IN active stage disease, a cold compress should be applied to the site of the outbreak. The fabric is applied for 2 minutes, after which it is placed in cold water. The action should be repeated for an hour. After eliminating the inflammation, the second stage of therapy begins - normalization of blood circulation. Use ointments that reduce blood clotting.

When treating venous insufficiency of the lower extremities, it is important to understand that the disease is systemic in nature. The main goal is to restore blood flow and prevent relapses. Therapy includes a number of principles: treatment must be comprehensive, individual in nature, and may require several courses.

Complex treatment includes:

• drug therapy;
• compression therapy;
• physiotherapy;
• surgery;
• use of traditional medicine.

Drug therapy

Usage medicines is aimed at eliminating inflammation processes, normalizing blood flow, improving local circulation, influencing lymph flow, and increasing the tone of the vascular wall. The following groups of drugs are used to treat chronic venous insufficiency:

• Phlebotonics (Detralex, Antistax, Ginkor Fort). In the initial stages of the disease, these remedies are sufficient to eliminate the main symptoms. However, if the process is aggravated by inflammation or changes appear on the skin, the use of additional medications is required.
• Anti-inflammatory drugs (Meloxicam, Diclofenac).
• Antiplatelet agents (Dipyridamole, Clopidogrel).
• Antihistamines (Promestazine, Clemastine).
• Antioxidant agents (Emoxipin).
• Enzymes and antibiotics (fluoroquinolones, cephalosporins) are used to treat skin manifestations of venous insufficiency.

The use of these drugs should be appropriate and based on the existing symptoms. Treatment of venous insufficiency of the superficial veins includes the use of ointments, but this is only permissible if there are no complications on the skin. Are used:

• indomethacin ointment reduces pain syndrome and relieves inflammation;
• heparin ointment reduces blood clotting and prevents the formation of blood clots;
• Lyoton 1000 eliminates inflammation;
• Venobene reduces blood clotting, dissolves blood clots, and improves tissue trophism.

Treatment tactics using pharmacological drugs are selected based on the stage of development of the disease and the activity of symptoms. In the first degree of the pathological process, intravenous sclerotherapy is used - injection of the drug into the vessel. The result is a decrease in blood flow in the affected area of ​​the vein. The second degree requires the use of medications that improve tone and trophism in adjacent tissues. Results are achieved after 3-4 months of therapy, the course duration is at least six months.

At the third stage, treatment is required not only for symptoms, but also for existing complications; during this period, almost a whole range of drugs are prescribed: phlebotonics, anti-inflammatory drugs, anticoagulants, antiplatelet agents and antihistamines.

Compression therapy

Compression therapy occupies one of the key places in the treatment of chronic venous insufficiency. Wearing elastic knitwear is indicated for any severity of the disease, regardless of the causes of its occurrence. The effect is achieved as a result of the following factors:

• decrease in venous blood supply due to compression of perforating veins;
• improving valve function by narrowing the vein and increasing the speed of blood flow;
• improvement of resorption tissue fluid with increasing pressure in the area of ​​edema;
• improvement in fibrinolytic activity associated with increased production of plasminogen in tissues.

Compression therapy is performed using:

• bandages
• products made from compression knitwear (tights, stockings).

Compression hosiery has a number of advantages compared to bandages:

• products are manufactured in such a way that when used, a physiological distribution of pressure is achieved throughout the entire limb, and in distal sections maximum performance is achieved;
• better aesthetic properties;
• the ability to use a product of the required compression class;
• elastic knitwear is more comfortable and does not require assistance when using it;
• optimal temperature and water balance of the skin is maintained;
• With proper care, long-term use is possible (up to 8 months).

The choice of the degree of compression should be made by a doctor, taking into account the severity of the disease. The type of product: stockings, stockings or tights is determined based on the localization of the process. Necessary healing effect can only be achieved by using correctly selected knitwear that fits in size. Otherwise, the Products do not exert the necessary pressure on the lower limb or cause discomfort when worn.

Physiotherapy

Physiotherapy methods are used in the complex treatment of chronic venous insufficiency. Among them:

• Magnetic therapy is used at all stages and for all forms of the disease. The device “Polimag 01” is used. The duration of the procedure is 20-30 minutes, treatment is carried out daily, the course of therapy is 15 sessions.
• Darsonvalization can be used in the early stages of the disease, treatment is carried out using the Iskra-2 apparatus, the effect occurs for 10-15 minutes daily, the course consists of 10-15 procedures.
• Infrared therapy is carried out using the Mustang apparatus, the exposure time on the lesion is 128 seconds, treatment is carried out daily, in a course of 10 procedures.
• Intermittent pneumocompression is carried out with the Lymfa-E apparatus; during the procedure, the limb is covered with a cuff from the foot to the inguinal fold, the pressure is set in 7 sections, and gradual compression is created in the “traveling wave” mode. The cycle is 15 seconds, at each subsequent procedure the pressure increases, the duration of treatment is 40 minutes, the course is 10 days.
• Laser therapy involves the use of continuous radiation, the source is fixed above the lesion, the effect occurs for 6-8 minutes daily, the course of treatment is 10-12 minutes.
• After the inflammatory processes have subsided, electrophoresis can be used. Heparin, lidase, and, if necessary, antibiotics are used.

Surgery

The indication for surgical intervention is severe varicose veins in combination with pathological reflux. Surgery is also necessary in case of progression of trophic disorders and recurrence of varicothrombophlebitis. The indication is the ineffectiveness of conservative therapy and persistent progression of symptoms of venous insufficiency.

All surgical interventions can be divided into two types:

• surgical separation is carried out to eliminate blood reflux from deep vessels to superficial ones;
• removal of varicose veins.

The need for surgery is usually caused by the patient’s late presentation for medical care leading to the progression of the disease. At timely diagnosis In most cases, the symptoms can be controlled using conservative therapy.

Treatment using traditional medicine

One of the methods of treating venous insufficiency is the use of traditional medicine. However, such products should be used in parallel with medications and wearing compression stockings, since plant extracts alone are not able to cope with the cause of the disease.

Folk remedies are time-tested drugs for the treatment of chronic venous insufficiency at home, which help normalize blood flow, dilate the blood, and reduce thrombosis. The most commonly used recipes are:

• Kalanchoe tincture: 50 grams of crushed, washed leaves should be poured with vodka, left in a cool place for 10 days, used to rub the affected leg;
• Grind dry hazelnut bark and leaves, pour 200 milliliters of boiling water over 2 tablespoons of raw material, leave for 3 hours in a warm place, use 50 milliliters after meals;
• Pour 100 grams of dry rowan bark with 500 milliliters of boiling water, leave for 10 hours, take 2 spoons three times a day;
• Mix valerian roots, hop inflorescences, mint and trifoliate, pour a tablespoon of the resulting raw material with 2 cups of boiling water, put in a warm place for 1 hour, use a quarter cup 3 times a day;
• Pour crushed sweet clover leaves into a glass container, add vodka, leave for 2 weeks, consume 50 milliliters, after diluting it in 100 milliliters of boiled water;
• Pour 30 grams of crushed calamus roots into 500 milliliters apple cider vinegar, leave in a cool place for 3-4 days, take 1.5 tablespoons 2 times a day before meals.

When using traditional medicine, it is important to remember that they do not have a quick and pronounced effect. Only their long-term use can bring results. However, it is worth remembering that using them without consulting a doctor may cause allergic reaction or adversely affect the health of a patient suffering from concomitant diseases.

Possible complications of the disease

Venous insufficiency – dangerous disease, which needs to be taken seriously. The accumulation of large volumes of blood in the lower extremities negatively affects the entire body. As a result, the brain does not receive enough oxygen and nutrients. As a result, the patient feels dizzy, fatigue, sometimes fainting occurs. Cardiovascular failure often develops.

The nature of complications depends on the form of the disease. In case of acute insufficiency, thromboembolism may develop - blocking of the lumen pulmonary artery. This condition can be fatal. Chronic venous insufficiency provokes the development of varicose veins, periphlebitis (the tissue surrounding the vessel becomes inflamed), the formation of blood clots and the development of thrombophlebitis, the occurrence of necrosis and trophic ulcers.

Forecast

The prognosis for impaired venous outflow depends on the severity of the pathology at the time of diagnosis. In the early stages, the disease can be successfully stopped and complications can be avoided. The course of therapy ranges from 2.5 months to six months, repeated up to 2-3 times a year. Severe stages are less responsive to treatment and may result in patient disability.

Acute venous insufficiency is a pathology that occurs in 2-3% of cases; the prognosis for this condition depends on the timeliness of hospitalization and the success of dissolving the blood clot. The danger is that in some cases this condition occurs without symptoms and the first sign is pulmonary embolism.

Prevention

Despite the fact that chronic venous insufficiency is genetic, a number of measures can be taken to reduce the risk of its development. The main ways to prevent the disease:

• playing sports;
• diet;
• refusal of high-heeled shoes;
• limiting exposure to open sun;
• refusal to wear too tight underwear and socks;
• limiting prolonged stay in one position;
• usage contrast shower: washing feet alternately with hot and cool water;
• maintaining an ideal body mass index;
• wearing preventive compression stockings.

When preventing chronic venous insufficiency, special attention should be paid to the principles of nutrition and physical activity.

Diet

A diet for venous insufficiency, as well as a measure to prevent its development, should include split meals - at least 4-5 meals per day. This regimen normalizes metabolism and helps avoid gaining excess body weight. It is also important to monitor your water balance. At least 2-2.5 liters of fluid should be supplied per day. Water thins the blood and prevents the formation of blood clots. Fluid deficiency is fraught with serious disturbances in metabolic processes, hormone synthesis, and disruption of the structure of connective and muscle tissue.

Nutrition for venous insufficiency should comply with the following principles:

1. exclude fatty foods, processed foods, sausages, fatty dairy products, fried, canned foods, fast food and sweets;
2. eat fresh fruits and vegetables;
3. Fruit drinks and teas will also be beneficial;
4. You should avoid alcohol, carbonated drinks, strong tea and coffee;
5. the use of table salt should also be limited;
6. should be done once a week fasting days, in which the patient should eat only vegetables and fruits.

If the disease is at the initial stage of development, a properly adjusted diet in combination with the use of drugs for external use can completely stop the progression of the disease. In the case of an advanced stage, the diet will speed up the recovery and healing processes and reduce the risk of developing dangerous consequences.

Gymnastics

Gymnastics – important element complex therapy for venous insufficiency, allowing to prevent recurrence and complications of the disease. It is impossible to completely cure the disease using physical exercise, however, even in the most advanced cases, positive effects are achieved:

• improving the functioning of the cardiovascular system;
• improved regeneration;
• restoration of function of the lower extremities;
• reducing the risk of complications;
• reducing the risk of relapse.

Before starting a course of therapeutic exercises, you should consult a doctor who, based on the severity of the disease, will determine the presence or absence of contraindications.

Exercises used for venous insufficiency of the lower extremities:

• In a lying position, place a cushion under your feet so that they are elevated by 20 degrees. There should be no tension in the body. You should remain in this position for 10 minutes, as a result, the load is removed from the vessels of the lower extremities. You should begin and end the exercise complex with this exercise; you can do it several times a day if you feel tired and have pain in your legs.
• Lying on your back, twist your legs, as if riding a bicycle, changing direction. Perform the exercise with your legs raised 20 degrees until you feel slightly tired.
• The “scissors” exercise should be performed with raised legs for 1 minute, repeated 2-3 times.
• In a lying position, raise your straightened legs 90 degrees, perform rotations with your feet, bends, and alternately squeeze your toes.

After performing a set of exercises, the patient may feel slight fatigue in the legs, followed by a decrease in pain. This indicates the effectiveness of the exercises. It should be remembered that to treat impaired venous outflow, any one method is not enough. Only complex therapy will bring lasting positive effects.

Video: about CVI

Venous insufficiency (VI) is a complex clinical manifestations, which develop in the human body due to a violation of the outflow of blood in the venous system. This disease is one of the most common of its kind. About 15–40% of the population suffers from this circulatory failure.

The wide prevalence of acute and chronic venous insufficiency is due to upright posture, as this causes the load on the vessels of the legs to constantly increase. Most often, patients seek medical help in the last stages of the disease. This is where its greatest danger lies. People assume that the symptoms that have arisen are nothing more than the consequences of fatigue due to constant stress on the legs. The severity of the pathology is not objectively assessed by any patient who has it. Most often, venous insufficiency of the lower extremities is confused with, but these two conditions are not the same. The disease can also develop not only in the legs, but also in the brain.

Pathogenesis

The pathogenesis of the development of acute and chronic venous insufficiency is unique. When there is a long-term obstruction of the outflow of blood through the vessels (the reasons for poor circulation may be different), an optimal environment is created for increasing the pressure in the lumen of the vein.

Due to the expansion of the veins, insufficiency of the valve apparatus develops. Each vein in the human body contains valve flaps whose job is to regulate blood circulation. If for some reason the valves do not close tightly, then the blood will begin not only to move upward (back to the heart), but also to flow down to the limbs. This will be the first symptom of the development of venous insufficiency - a feeling of constant heaviness and fullness in the legs.

If treatment is not carried out in a timely manner, the pressure in the veins will gradually only increase and the walls of the vessels will lose their elasticity. Their permeability will increase. Regional edema of the lower extremities will develop. Later, trophic disturbances will occur. They develop due to compression of the tissues that surround the venous vessels and disruption of their normal nutrition.

Forms

• acute venous insufficiency (AVI). It develops quite sharply, due to the occlusion of the deep veins of the legs. Accordingly, the outflow of blood from them is immediately disrupted. This syndrome develops in people of advanced and working age. Its development is provoked by several reasons: acute forms, as well as injuries resulting in ligation of veins located in deep tissues. The pathological process affects only the deep veins; it does not extend to the superficial ones. Symptoms of AHF appear almost immediately - a person develops swelling of the legs, and the skin acquires a bluish tint. Distinctive feature the presence of OVN - the pattern of veins on the skin is clearly visible. A person feels severe pain in the direction great vessels. You can relieve pain with a regular cold compress. Its effect is due to the fact that cold helps reduce the volume of blood in the vessels;
• chronic venous insufficiency (CVI). The pathology is localized only in venous vessels located subcutaneously. It does not apply to deep ones. Only at first glance it may seem easy and harmless, but in fact, due to constant poor circulation, pathological changes develop in the trophism of the ankle joint. This form of deficiency has several stages. Not the first stage, blood flow disturbances appear on the skin at the site dark spots. If the patient does not seek help from a doctor in a timely manner, then gradually they become several times larger and grow into soft fabrics. As a result, trophic ulcers occur (they are difficult to cure conservatively). At the last stage of CVI, blood clots form and other vascular anomalies develop.

Causes

Venous insufficiency most often develops in the following conditions:

• postthrombophlebitic syndrome;
• varicose veins;
• congenital vascular pathologies;
• phlebothrombosis;
• limb injuries.

Negative factors that significantly increase the likelihood of progression of venous insufficiency of the lower extremities:

• drugs that contain hormones;
• genetic predisposition;
• female. In a woman’s body, the level of estrogen is quite high, so they are more likely to experience AVI and CVI. Also, during pregnancy and childbirth, the load on the venous vessels increases (venous insufficiency of both the legs and the brain may develop);
• obesity;
• weak motor activity;
• age. CVI is most likely to develop in older people, since their body has been affected by adverse factors for a longer period of time;
• static loads;
• chronic constipation;
• lifting weights (constant).

At-risk groups

Lymphovenous insufficiency develops in people during the most active period of their life - from 20 to 50 years. But only a few patients seek help from qualified doctors as soon as the first symptoms of the disease begin to be felt. There are some groups of people in whom pathology develops most often:

• athletes;
• people who have a genetic tendency to CVI;
• overweight people;
• pregnant women.

Classification

The most common classification of chronic venous insufficiency is the following:

• degree 0. In this case, there are no pronounced symptoms of the disease. The patient does not notice any changes. Functionality preserved;
• degree 1. This degree is characterized by the appearance of the first symptoms indicating the presence of a pathological process in the body. The patient feels pain in the lower extremities, a feeling of heaviness and fullness. Soon pronounced, persistent swelling and cramps appear (more pronounced at night);
• degree 2. The swelling does not disappear. On examination, eczema, hyperpigmentation, lipodermatosclerosis are noted;
• degree 3. Trophic ulcers form on the surface of the extremities. This condition is the most dangerous for the patient's health.

There is also an international classification of WHI and CVI - CEAP system.

Classification of venous insufficiency according to CEAP

According to the clinical picture:

• 0 – there are no visual signs of a person having pathology of the venous vessels;
• 1 – telangiectasia;
• 2 – varicose veins on the legs are visually noted;
• 3 – persistent swelling appears;
• 4 – changes appear on the skin;
• 5 – changes on the skin in the presence of an already healed ulcer;
• 6 - changes on the skin with a fresh ulcer.

Importance is given etiological classification, since the treatment of venous pathology largely depends on the causes that provoked chronic circulatory failure.

Etiological classification:

• EC – genetic predisposition;
• ER – unknown cause;
• ES – deficiency develops in a person due to injury, thrombosis, etc.

Anatomical classification according to the CEAP system makes it possible to display the level of the lesion, segment (deep, superficial or communicating), as well as the localization of the pathological process (inferior vena cava or great saphenous vein).

Classification of CVI according to the CEAP system, taking into account pathophysiological aspects:

• chronic insufficiency of venous circulation with reflux symptoms;
• CVI with manifestations of obstruction;
• Combined CVI (combination of reflux and obstruction).

The classification of acute and chronic circulatory failure is used in medical institutions by phlebologists to determine the stage of the disease, as well as its severity. This is necessary to prescribe appropriate effective treatment.

Symptoms

Symptoms of AHF appear quickly, as blockage of blood vessels occurs very quickly. Due to the impossibility of blood flow from the lower extremities, edema occurs. Along the course of the vessels, the patient notes the occurrence of severe pain, which does not go away when changing position or at rest. The skin takes on a bluish tint and a pattern of veins appears on it. This form of the disease is easier to treat. First aid is applying a cold compress and taking painkillers. Further treatment will be prescribed only by a phlebologist.

Symptoms chronic form diseases can be different. Therefore different people The clinical picture of chronic circulatory failure may differ slightly. In the first stages of development of the pathological process, either one or a complex of symptoms appears:

• most often a person begins to worry about heaviness in the legs, which increases significantly after a long stay in a standing position;
• formation of edema in the lower extremities;
• night cramps;
• hypopigmentation or hyperpigmentation of the skin;
• the skin loses its elasticity and becomes dry;
• in later stages, trophic ulcers form on the surface of the skin;
• Due to the deposition of a large amount of blood in the legs, a person experiences dizziness and fainting.

If you have at least one of the above symptoms, it is recommended to immediately seek emergency medical help at a medical facility. There, based on the data from the initial examination and diagnosis, the doctor will determine the severity of the disease (using an approved classification) and will also prescribe an appropriate course of treatment.

Diagnostics

• Ultrasound of the lower extremities. With its help, you can identify areas where the veins are dilated and blood circulation is impaired. The doctor can also detect the presence of blood clots and varicose veins. You should go for this examination as soon as the first symptoms of CVI appear;
• if ultrasound data are questionable, then venography is used.

Treatment

Acute venous insufficiency is eliminated in several stages. During the active phase of the disease, it is necessary to apply a cold compress to the location of the pathological process. The cooled cloth is applied for two minutes, after which it is placed in a container with ice and water to cool. It is recommended to repeat these steps for an hour. After the inflammation is relieved, the second stage begins - improving blood circulation. You can use ointments that contain substances that slow down blood clotting.

CVI It is much more difficult to treat than acute. When determining correct tactics treatment of chronic circulatory failure, it should be clearly understood that this pathological condition is a systemic process. The main goal of all therapeutic measures is to restore normal blood circulation in the venous system of the lower extremities, as well as to prevent the development of possible relapses.

• Treatment of the disease is carried out in several courses. It all depends on the severity of the symptoms and the severity of the pathology;
• treatment of venous insufficiency is selected strictly individually;
• drug therapy is combined with other methods of treating circulatory failure.

The greatest importance in the treatment of CVI is the use of synthetic drugs (phlebotropic drugs are prescribed), as well as elastic compression. Topical medications are also prescribed.

Surgical treatment is carried out to remove pathological venous discharge, as well as to remove areas of varicose veins.

Chronic cerebrovascular insufficiency

This disease deserves special mention, since it can develop in absolutely any person and is quite serious pathology. Chronic venous insufficiency of the brain can occur even with singing, physical stress, squeezing the neck with a too-tight collar, etc. As a rule, patients do not complain about deterioration for a long time general condition. This is explained by the fact that the brain has an amazing compensatory mechanism and a developed circulatory system. Therefore, even serious difficulties in the outflow of blood do not appear for a long time. This is the greatest danger of this condition.

Prevention

Despite the fact that venous insufficiency is a disease that is genetically inherent in a person, some measures can be taken that will significantly reduce the risk of its development:

• do not overheat in the sun;
• do not wear too tight underwear and clothes (the same rule applies to the prevention of CVI in the brain);
• do not sit or stand without moving for long periods of time;
• diet;
• refusal of high heels.

Acute and chronic venous insufficiency of the brain and lower extremities is a complex and insidious disease, which is sometimes completely asymptomatic and makes itself felt in the final stages. Its consequences can be very serious, including thromboembolism. Therefore, if a person feels constant heaviness in his legs and swelling appears in the evening, he should immediately visit a doctor to rule out venous insufficiency or confirm it.