Sándor Tamás
Semmelweis Egyetem, Altalános Orvostudományi Kar, II. Sebészeti Klinika, Budapest.
Orv Hetil. 2010 Jan 24;151(4):131-9. doi: 10.1556/OH.2010.28790.
Chronic venous disease affecting one-third of the European population has a considerable socioeconomic impact. There is increasing evidence, that the structural remodelling of the vein wall is caused by two etiological factors: the disturbed flow patterns in cosequence of the high venous pressure and a progressive inflammatory cascade. In the microcirculation the trapping of the white cells and the leukocyte-endothelium interaction lead to skin changes and leg ulcer. The CEAP classification has been adopted world-wide to faciliate the uniform communication and the description of all classes of the disease. For the practising physician the duplex scan is a valuable instrument to provide correct diagnosis and to guide the treatment. This ultrasound technique gives lot of useful information about the venous system of the lower leg, helps to identify the presence and sites of the reflux and the potential occlusion of the proximal veins. The possible treatments are the followings: conservative basis therapy - including compression, venoactive drugs, venous excersises, giving advice to patients and health care - as well as surgery and sclerotherapy. New promising therapeutic procedures, such as endovenous operations with radiofrequency or laser and foam sclerotherapy are spreading rapidly all over the world.
慢性静脉疾病影响着三分之一的欧洲人口，具有相当大的社会经济影响。越来越多的证据表明，静脉壁的结构重塑是由两个病因引起的：高静脉压导致的血流模式紊乱和渐进性炎症级联反应。在微循环中，白细胞的滞留和白细胞与内皮细胞的相互作用会导致皮肤变化和腿部溃疡。CEAP分类已在全球范围内采用，以促进对该疾病所有类型的统一交流和描述。对于执业医生来说，双功超声扫描是提供正确诊断和指导治疗的宝贵工具。这种超声技术可提供许多有关小腿静脉系统的有用信息，有助于确定反流的存在和部位以及近端静脉的潜在闭塞情况。可能的治疗方法如下：保守基础治疗——包括压迫、静脉活性药物、静脉锻炼、为患者提供建议和医疗保健——以及手术和硬化疗法。新的有前景的治疗方法，如射频或激光静脉内手术和泡沫硬化疗法，正在全世界迅速推广。
