下肢静脉曲张医学ppt课件.ppt

Varicose vein of Lower Limb 承德卫生学校 外科教研室　李树东 Varicosity Varicose veins are common Location: ●varicocele ●esophageal varices ●hemorrhoids ●leg varices Varicosity of lower limb 是指下肢浅静脉，因血液回流障碍而引起的静脉扩张和迂曲为主要表现的一种疾病。 great saphenous vein Anatomy and pathophysiology There are two venous systems in the legs: ◆deep veins ◆superficial veins ◆perforating veins Vein valves In the normal situation, valves in the vein wall keep blood flowing toward the heart (green arrows). When the valves are damaged, blood can flow backwards (red arrows) dilating the vein and pooling in the leg. Classification: primary and secondary Primary varicose veins(superficial veins varicose) ◆vein wall: defect→diminished elasticity ◆valvular incompetence Secondary varicose veins(secondary to deep veins) ◆destruction or dysfunction of valves by trauma, deep venous thrombosis, or nontraumatic proximal venous obstruction( pregnancy, pelvic tumor). ◆ When valves of the deep and perforating veins are disrupted , chronic venous stasis changes may accompany superficial varicosities. Aggravate factors Pregnancy Prolonged standing Obesity  Straining: Chronic constipation, urinary retention, chronic cough surgery or trauma to the leg: These conditions interrupt the normal blood flow channels. Age: most elderly individuals show some degree of varicose vein occurrence. Clinical features Most varicose veins are asymptomatic. Dilated, tortuous superficial veins in the lower extremities The legs often ache and?feel heavy and itchy. One may have severe pain upon standing or even have cramps in the legs at night. Mild ankle edema. Symptoms can intensify after a long day of standing on ones feet. Symptoms relieved by leg elevation. Pigmentation, ulceration, and edema of the lower leg suggest secondary varicose veins Superficial thrombophlebitis Varicose veins are prone to developing superficial thrombophlebitis, which is a blood clot along with inflammation of a segment of vein. Tenderness and pain in the var