慢性静脉功能不全
Chronic venous insufficiency (CVI) is a condition that occurs when valves within the leg veins are damaged allowing blood to leak backwards and pool in these veins. 当你站着, the blood in your leg veins has to be pushed up against gravity to return to your heart.
Your leg muscles actually act as a pump by squeezing the veins deep in your legs and pushing blood back toward your heart. Every step you take works the pump to push blood up against gravity. Series of one-way valves throughout your veins keep blood flowing upward. Sitting or standing for extended periods can result in the blood in your leg veins pooling and the pressure inside the veins increases. This increase in pressure can stretch the walls of the veins and damage the valves. Failure of the valves to hold blood against gravity leads to sluggish movement of blood out of the veins, 导致肿胀, 累了腿.
慢性静脉功能不全有哪些症状?
慢性静脉功能不全 may begin with mild nuisance symptoms. 然而, left untreated it can progress permanent skin changes with darkened discoloration and thickened skin to a more serious medical condition involving complicated wounds and skin infections.
- Swelling in the lower legs and ankles, especially after extended periods of standing or sitting
- 腿部感到沉重、疲倦、不安或疼痛
- 静脉曲张
- Leathery-looking, flaking or itching skin on the legs or 脚
- 腿部皮肤变色(红色、棕色)
- 流脓的疮或溃疡
慢性静脉功能不全的危险因素有哪些?
- 静脉曲张或有静脉曲张家族史
- 肥胖
- 下肢既往创伤
- 怀孕
- 不活动
- 吸烟
- 长时间站立或坐着
- 女性性
- 50岁以上
- 深静脉血栓(DVT)
CVI commonly occurs in people who have a history of phlebitis and deep vein thrombosis. Phlebitis occurs when a superficial or deep vein becomes swollen and inflamed. This inflammation can cause a blood clot in the deep veins of the legs, 一种叫做深静脉血栓形成的疾病. 血凝块阻止血液流向心脏, so the blood pressure is increased in the vein resulting in damage to the valves. Chronic venous insufficiency that develops as a result of DVT is also known as post-thrombotic syndrome.
如何诊断CVI?
A vascular specialist evaluates your medical history and any lifestyle issues that may be contributing to your symptoms. The physician will make a vascular assessment and examine the skin on your lower legs and any varicose veins. 影像学检查通常用于详细评估:
- Duplex Ultrasound is a standard test performed to evaluate the integrity of your vascular system and rule out any blood clots.
- Venography or Intravascular Ultrasound are additional studies that may be used to assess for blockages in the veins.
如何治疗慢性静脉功能不全?
Early intervention and prevention of complications of wounds and wound infections are the goal of treatment. Treatment plans are aimed at decreasing the blood pressure in the veins to reduce swelling and symptoms and increasing the return blood flow back to the heart. More serious cases of CVI may be treated or with surgical procedures. Fewer than 10 percent of people with CVI require surgery to correct the problem.
- 避免长时间站立或坐着: 如果你正在旅行并且要坐很长时间, 弯曲和伸展你的腿, 脚, and ankles about 10 times every 30 minutes to keep the blood flowing in the leg veins. 如果你能站起来走路，就这样做. 站立时，保持腿部肌肉活动. Wear compression stockings prescribed by your physician to improve venous circulation.
- 抬高你的腿 while sitting and lying down with your legs elevated above the level of your heart (blood runs down hill).
- 定期锻炼. 走路可以锻炼腿部肌肉泵.
- 戒烟.
- 保护皮肤: Keep your skin clean, moisturized, and free of open wounds that can increase your risk of infection.
- 减肥 如果你超重了. Excess weight increases the pressure your veins have to work against.
压缩袜子: In most people with CVI, compression stockings are essential to the treatment plan. Compression stockings are elastic stockings that squeeze your veins and assist the leg muscle pump in pushing blood back up toward the heart to decrease swelling. They are available in different compression strengths and lengths and should be prescribed by your vascular specialist according to your medical needs. 许多保险公司会给他们开处方. There are brands available that are remarkably stylish and will blend well into any wardrobe. They should be worn regularly during the day, and removed at night. 经常使用它们可以减轻肿胀症状, 疼痛, 慢性皮肤刺激, 帮助治愈和预防静脉淤积溃疡.
结扎和剥离 通常是结合在一起的. Vein ligation is a procedure in which a vascular surgeon cuts and ties off the problem veins. Stripping is the surgical removal of larger veins through two small incisions.
静脉旁路 is used for treatment of CVI in the upper thigh or pelvis and only in the most severe cases, 当其他治疗方案无效时. 它涉及到移植, or a transplanted vein from elsewhere in your body to reroute blood around the blocked vein that is causing CVI.
血管成形术和支架植入 是打开狭窄或阻塞的静脉的手术吗. Angioplasty uses a tiny balloon to push open a narrowed or blocked area in a vein. The stent is a tiny metal mesh tube that is placed inside the vein to prevent it from narrowing again. The procedure is performed through a small needle puncture in the back of the knee, or in the groin. A contrast dye is used to help the surgeon see the blood vessels on x-ray and direct the balloon and stent into the correct positions.