下肢静脉曲张医学课件

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1、VaricoseveinofLowerLimb承德卫生学校外科教研室　李树东VaricosityVaricoseveinsarecommonLocation:●varicocele●esophagealvarices●hemorrhoids●legvaricesVaricosityoflowerlimb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。greatsaphenousveinAnatomyandpathophysiologyTherearetwovenoussystemsinthelegs:◆deepveins◆superficialveins◆perfo

2、ratingveinsPerforatingveinsVeinvalvesInthenormalsituation,valvesintheveinwallkeepbloodflowingtowardtheheart(greenarrows).Whenthevalvesaredamaged,bloodcanflowbackwards(redarrows)dilatingtheveinandpoolingintheleg.Classification:primaryandsecondaryPrimaryvaricoseveins(superficialveinsvaricose)◆veinwal

3、l:defect→diminishedelasticity◆valvularincompetenceSecondaryvaricoseveins(secondarytodeepveins)◆destructionordysfunctionofvalvesbytrauma,deepvenousthrombosis,ornontraumaticproximalvenousobstruction(pregnancy,pelvictumor).◆Whenvalvesofthedeepandperforatingveinsaredisrupted,chronicvenousstasischangesm

4、ayaccompanysuperficialvaricosities.AggravatefactorsPregnancyProlongedstandingObesityStraining:Chronicconstipation,urinaryretention,chroniccoughsurgeryortraumatotheleg:Theseconditionsinterruptthenormalbloodflowchannels.Age:mostelderlyindividualsshowsomedegreeofvaricoseveinoccurrence.Clinicalfeatures

5、Mostvaricoseveinsareasymptomatic.Dilated,tortuoussuperficialveinsinthelowerextremitiesThelegsoftenacheand feelheavyanditchy.Onemayhaveseverepainuponstandingorevenhavecrampsinthelegsatnight.Mildankleedema.Symptomscanintensifyafteralongdayofstandingonone'sfeet.Symptomsrelievedbylegelevation.Pigmentat

6、ion,ulceration,andedemaofthelowerlegsuggestsecondaryvaricoseveins五期SuperficialthrombophlebitisVaricoseveinsarepronetodevelopingsuperficialthrombophlebitis,whichisabloodclotalongwithinflammationofasegmentofvein.Tendernessandpaininthevaricosevein,alongwithrednessandswelling.Feelhardorfirm.Complicatio

7、sPain,heaviness,inabilitytowalkorstandforlonghours.DermatitisBleeding :lifethreateningbleedfrominjurytothevaricoseveinUlcer:nonhealingvaricoseulcercouldthreatenlimbamputation.Developmentofcarcinomainlongsta