下肢静脉曲张医学课件课件.pptVIP

* 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 varicose vein, along with redness and swelling. Feel hard or firm. * Complicatios Pain, heaviness, inability to walk or stand for long hours. Dermatitis Bleeding?: life threatening bleed from injury to the varicose vein Ulcer?: non healing varicose ulcer could threaten limb amputation. Development of carcinoma in long standing venous ulcers. Coagulation of blood in varicose veins cause superficial thrombosis, deep vein thrombosis (DVT), Pulmonary Embolism (PE) * * Test Brodie-Trendelenburg test(大隐静脉瓣膜功能试验）：greater saphenous and perforating veins Perthes (深静脉通畅试验）： * Diagnositc studies duplex ultrasound venography * a duplex ultrasound examination to focus specifically on the problem veins. * Treatment principle Relieve discomfort prevent or ameliorate the complications of venous stasis improve the appearance of the extremity, and if possible, eliminate the cause of the varicosities to prevent progression of the disease. * Nonoperative management Improve venous return and reduce pressure in varicose superficial veins ●Encourage walking ● Avoiding prolonged sitting and standing ● Elevated the leg ●wearing of graduated compression stockings * Stocking * Vein gymnastics in the barefoot park. * Injection sclerotherapy Produces permanent fibrotic obliteration(管腔闭塞） of collapsed veins. 3% sodium tetradecyl sulfate (十四烷基硫酸钠 ) * * Radio frequency closure(radiofrequency ablation ) the surgeon inserts a catheter into the varicose vein through a small puncture. The catheter is used to deliver radio frequency energy to the wall of the vein, which causes the vein to contract and seal itself shut. The nearby veins then take over the flow of venous blood from the legs. Complications: bruising, burns, paraesthesia, clinical phlebitis, slightly higher rates of deep vein thro