Varicose veins of the lower legs

　　1. Weak venous wall and valve defects:The venous wall is relatively weak and can expand under the action of venous pressure. The expansion at the valve sinus leads to the original venous valves not closing tightly, resulting in relative incomplete valve function and blood reflux. Malformed or missing valves cannot effectively prevent reflux, leading to the onset of the disease.

　　2. Persistent elevation of venous pressure inside the vein:The venous blood itself exerts a certain pressure on the valves due to gravity, and normally it does not cause damage. However, when the pressure inside the vein is continuously elevated, the valves may bear excessive pressure, gradually relax, prolapse, and fail to close properly. This is often seen in long-term standing work, heavy physical labor, pregnancy, chronic cough, and long-term constipation, etc.

　　3. Next is age and gender:Since the pressure in the limb veins only reaches its highest when the body length is at its maximum, the body is not tall before puberty, so the venous caliber is small, which can prevent venous expansion. Therefore, although severe varicose veins may occur before the age of 30, most cases are due to the gradual loss of tension in the venous wall and valves with age, which intensifies the symptoms and forces patients to seek medical attention.

　　Varicose veins are more common in women, which may be due to pregnancy that can induce or exacerbate varicose veins. However, in women without pregnancy, the incidence rate is also higher than that in men (male: female = 1:3). The reason may be that women have wider pelvises, overly curved vascular structures, and increased pelvic venous congestion during the menstrual period, pregnancy, and menopause. Another reason for the increased incidence of varicose veins during pregnancy is the reduced tension of superficial veins in the limbs during pregnancy, making them more prone to expansion. This condition can be restored after childbirth.

　　(1) Nutritional changes of the skin: The skin becomes thin, flaky, itchy, hyperpigmented, eczematous dermatitis, and ulcer formation.

　　(2) Thrombophlebitis of the superficial veins: Pain at the site of varicose veins, presenting as red, swollen, hard nodules and cord-like substances with tenderness.

　　(3) Bleeding: Acute bleeding may occur due to trauma or spontaneous rupture of varicose veins or small veins.

　　(4) Secondary infection: Due to weakened resistance, secondary infections are prone to occur. Common ones include thrombophlebitis, erysipelas, acute cellulitis, elephantiasis, etc.

　　1. The affected limb often feels acid, heavy, painful, and easily fatigued, with a lack of energy.

　　2. The superficial veins of the affected limb are prominent, dilated, and curved, sometimes even tortuous or in nodular masses, which are more obvious when standing.

　　3. Swelling: Mild swelling may occur at the ankle and on the top of the foot, and in severe cases, the lower part of the calf may also have slight swelling.

　　(1) Appropriate physical exercise should be carried out to strengthen the overall physical condition and strengthen the venous wall.

　　(2) Workers who have been engaged in standing work or heavy physical labor should wear elastic stockings to protect themselves, so that the superficial veins can be in a collapsed state.

　　(3) Workers who have been engaged in standing work for a long time should emphasize doing work exercises or be able to move around frequently, at least doing more plantar flexion and extension activities of the ankles.

　　1. Deep vein patency test

　　2. Great saphenous vein valve function test

　　3. Transverse venous valve function test

　　Auxiliary examination

　　1. Laboratory examination

　　2. X-ray examination

　　3. Non-invasive examination

　　Provide a diet rich in vitamins, high in protein and calories, and low in fat, and avoid spicy, sweet, and greasy foods to prevent increased blood viscosity and aggravation of the condition. Provide liquid or semi-liquid light diet for patients to prevent hard, salty, and spicy foods that may damage and irritate the oral mucosa. Avoid drinking stimulating drinks such as coffee and strong tea before going to bed, and drink warm milk or listen to light music to relax the brain and promote sleep. Keep the bowels regular to avoid straining during defecation, which may cause a sudden increase in abdominal pressure and lead to thrombosis detachment.

　　The treatment methods for lower limb varicose veins include wearing elastic stockings, injecting hardening agents, and surgical excision. For incomplete deep vein valve function, valve repair surgery and endoscopic ligation of communicating branches can be performed. Lower limb varicose veins may also indicate the existence of other diseases, and the primary disease should be treated actively; if the deep vein回流 is not smooth, the operation to deal with superficial veins should be more cautious..

　　High-tension solutions (such as high-concentration saline or hardening agents) are injected into the varicose veins to destroy the vascular endothelium, causing it to close and disappear after healing. However, it can only treat small varicose veins, and there may be severe pain, pigmentation, even inflammation, swelling, ulceration, and other sequelae during treatment, and there is a problem of easy recurrence and difficulty in handling recurrence, so it is only suitable for a few patients.