Primary lower extremity venous insufficiency

Overview lower extremity venous insufficiency is a common disease, more durable in manual or standing staff, farmers, hairdressers, athletes, surgeons and other populations age. Lower extremity venous insufficiency joint mainly produces heavy limbs, tingle, fatigue and may have a superficial varicose veins, pigmentation, dermatitis, swelling and prolonged unhealed ulcer patients not only somewhat painful and affect labor. Etiology of congenital vein weak, and the expansion of vein valve defects lasting intravenous pressure increased, and the elderly and vein valve degeneration of lower extremity venous insufficiency of the main reasons . Full weight of Labor and prolonged standing were prone to cause lower extremity venous insufficiency. Loading increased intra-abdominal pressure, lower extremity venous obstruction, and lasting standing less leg muscle contraction and influence venous return. Vein valve and congenital weakness, additional factors mentioned above can be addressed to the lower extremity venous insufficiency. Pathological changes due to congenital vein weak, coupled with long-term blood stagnation, the increase in venous pressure, Early muscle and elastic fibers compensatory thickening later, weak muscle fibers and fiber atrophy force disappeared, were replaced by connective tissue, the vein due to expansion and thinning, venous the elastic fibers are degraded. Although the valve-like film was no deep phlebitis after signs of valve thickening, but valvular regurgitation, two valve leaflets close to a no, resulting in valvular regurgitation, blood from the two drooping leaves flap between the current downward. Deep static valvular regurgitation, blood flow to the distal deep venous reflux, increased venous pressure, dilated vein lumen, wall thinning, so that the capillary congestion, long-limb edema in the state, lymphatic obstruction may be secondary, edema fibrosis limb swelling worse. Sustained deep venous pressure and perforating venous insufficiency support so deep vein blood into the superficial vein reflux. caused great saphenous vein secondary varicose veins. Return leg blood slows down and countercurrents, resulting in lower limb blood flow stagnation, blood oxygen level, and the capillary wall increased overall, Vascular permeability to RBC, hemoglobin metabolites hemosiderin deposition in the skin, and often caused adequate boots has brown skin pigmentation black porphyritic. Local tissue hypoxia occurred because of malnutrition, reducing resistance, easy complications of measles-like dermatitis, lymphatic and ulcers. A diagnosis. Most of the long-standing and strong manual, or the great saphenous vein stripping operation, the symptoms have not been improved or made only short-term recurrence. 2. Limb swelling, long immediate expansion appeared severe pain. Simple varicose leg with the symptoms and signs. 3. Determination of venous pressure and directional Doppler ultrasound examination to the diagnosis. 4. Venography ?٠antegrade angiography. Deep vein was BARREL expansion, the loss of bamboo-shaped formation of the valve fuzzy video, accompanied superficial vein expansion. ?ڠretrograde pyelography. Valve can be identified : first grade-valve sound, calm breathing without contrast agent to the distal flow; II - mild valve insufficiency, a slight contrast agent turned back, no more than the proximal thigh; III. Level 4-moderate valve dysfunction, contrast agent turned back, respectively knee and below-the-knee, but there is still quite a contrast agent back to the Han; ??vere valvular insufficiency, most or all of contrast agent backlash, direct ankle. Clinical manifestations of patients often feel heavy leg, tingle, easy walk fatigue. Some can be accompanied by leg muscle cramps. Some patients may be no obvious discomfort. The limb, especially leg-medial superficial vein uplift, expansion, winding and tortuous, and even curled into a corporation was changed tumor-like vein, standing as obvious. A longer duration, in particular calf skin is often ankle nutritional changes, pigmentation, scaling, even eczema formed. Generally have less leg swelling, which usually indicates the event is not only superficial venous insufficiency with a deep venous insufficiency. Deep venous leg swelling syndrome light generally better than contralateral Week 2 ~ 3cm grown up, with little more than 4cm. Varicose vein thrombosis complicated by phlebitis, when the varicose vein pain, redness hard cable show, tenderness. As the limb tissue hypoxia, subcutaneous fibrosis, blood leaking from metabolites, local resistance greatly reduced, and therefore, Even in a minor injury and infection, can cause stubborn unhealed ulcer. According to the statistics he Hoave rule by the 800 cases of patients with varicose veins, a 10% combined with venous ulcer stagnation. The most common ulcer on the foot above the minimum due to location, the tower at the highest venous pressure. Department of soft tissue was small, and often near the incompetence of coarse perforating veins, nutrition obstacles are the most serious. Ulcer generally single, have a few different locations. Ulcer bottom of the dark red unhealthy granulation tissue, a thin surface stinky odors 46, pigmented tissues around, edema or stiffen, like eczema or dermatitis. If prolonged unhealed ulcer and edge upwards, as craters or flower-like Levin, hard bottom rugged, easy bleeding, Odor bloody secretions, with mucus, presentation may be malignant, and very rarely see. Varicose vein injury due to other reasons, can cause acute hemorrhage. Often occurred in adequate boots, shrinking the Sony CD-skin paper, visible under high pressure is computed small vein, minor injury can cause bleeding. In addition ulcer bottom often penetrating support vein, also often caused by traumatic hemorrhage.