Varicose veins of lower extremity

Introduction The vast majority of superficial varicose veins of the lower extremities are large saphenous varices (a small number of small saphenous varicose veins or varicose veins of the size), which is very common in clinical practice. About 25% of women and 15% of men worldwide suffer from such diseases. The incidence is often related to genetic factors, and long-term standing and heavy physical labor can be the cause. Increased pressure in the superficial vein, such as pregnancy. The wall of the vein is relatively weak, and can be expanded under the action of venous pressure. The expansion of the valve sinus causes the original venous valve to be not tightly closed, and the valve function is relatively incomplete and the blood is reversed.

Cause

Causes include: more common in people who are engaged in long-term manual labor or standing work. Mainly manifested as superficial vein expansion of the lower extremities, elongation, distortion, resulting in soreness, fatigue, heavy and other symptoms of the affected limbs, severe cases often accompanied by complications such as calf ulcer or superficial phlebitis.

(1) The vein wall is weak.

(2) venous valve insufficiency leads to blood reflux.

(3) Increased pressure in superficial veins, such as pregnancy.

an examination

Related inspection

Central venous pressure measurement (CVP) Determination of plasma heparin content Traffic vein valve function test Deep vein patency test protein S antigen

The diagnosis of simple varicose veins of the lower extremities is not difficult. The diagnostic criteria are summarized according to clinical practice as follows.

1. A family history of long-term standing and elevated abdominal pressure, or varicose veins of the lower extremities.

2. The patient's lower extremity vein is obviously distorted and expanded, and it is more obvious when standing.

3. Deep vein patency, saphenous vein dysfunction, may have venous valve insufficiency.

4. Ultrasound Doppler or venography showed that the saphenous vein was distorted and the valve was insufficiency.

5. May be associated with pigmentation, ulcers, thrombotic superficial phlebitis, bleeding, ulcers and other complications.

Differential diagnosis

1. How does the varicose veins of the lower extremities differentiate from the syndrome of lower extremity venous thrombosis?

The patient had a history of sudden lower extremity swelling and swelling. In the late stage of deep vein thrombosis, superficial varicose veins of the lower extremities occurred, with the branch veins and varicose veins of the calves. The swelling of the affected limb was obvious, accompanied by heavy limbs, pain and discomfort. After the activity and standing, the symptoms were aggravated. After bed rest, it could not be completely relieved. The anterior and ankle were depressed edema, and the skin nutrition disorder was obvious. Doppler ultrasonography, suggesting that deep venous blood flow is not smooth, and there is blood backflow.

Lower extremity venography showed that the wall of the deep vein was rough, the venous lumen was irregularly narrow, and some veins showed expansion. Traffic branch venous insufficiency and superficial varices.

2. How to diagnose the varicose veins of the lower extremities and the diagnosis of Budd-Chiari syndrome

Budd-Chiari syndrome refers to a clinical syndrome in which the hepatic vein or the inferior vena cava of the hepatic segment is partially or completely blocked, resulting in damage to the organ tissue caused by venous blood flow disorder. The main clinical manifestations are splenomegaly, massive and intractable ascites, esophageal varices often with hemorrhage, thoracic wall varices, both lower extremity edema and varicose veins, skin pigmentation, ulcers and so on. B-ultrasound showed: liver volume and caudate lobe increased, liver morphological abnormalities, hepatic vein stenosis and occlusion. In the clinical work, according to the patient's medical history, physical examination and B-ultrasound examination are performed carefully, and if necessary, vena cava cannulation can be performed for definite diagnosis.

3. How does the varicose vein of the lower extremity and the differential diagnosis of venous malformation?

Venous malformation of bone hypertrophy syndrome is characterized by limb growth, thickening, superficial venous anomalies and varicose veins, cutaneous hemangioma triad, lower extremity venography can be found that partial venous malformations are partially absent, branching disorders and more, superficial varices Wait. In clinical work, it is easier to identify according to the patient's medical history and its characteristics.

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