Priollet P, Franceschi C, Lazareth I, Laurian C
Service d'Hypertension Artérielle et de Médecine Vasculaire, Hôpital Saint-Joseph, Paris.
Ann Cardiol Angeiol (Paris). 1994 May;43(5):275-7.
Varicose veins are not the only symptomatology of chronic venous insufficiency of the lower limbs, which has other clinical manifestations: purely symptomatic problems, varicosities, edema and trophic skin lesions. The management of varicose veins is base upon thorough clinical examination. Doppler and ultrasonography are useful in cases of varicose veins in which radical treatment is envisaged. Ultrasound investigation is essential in the presence of cutaneous ulceration in order to avoid mistaking a trophic lesion due to incompetence of deep veins, most often of post-thrombotic origin, for a varicose ulcer. The treatment of varicose veins varies according to the precise nature of the preoccupations of the patient concerned. Elastic support is useful regardless of the clinical form of the disease. Vasculoprotective and venotonic drugs can be used when venous insufficiency is symptomatic. Radical treatment of varicose veins, whether by sclerosing injections or surgery, depends upon the anatomical nature of lesions, the degree of venous incompetence and the extent of signs, but also the wishes of the patient, properly informed of the advantages and limitations of each technique.
静脉曲张并非下肢慢性静脉功能不全的唯一症状表现，该病还有其他临床表现：单纯的症状性问题、静脉曲张、水肿和营养性皮肤病变。静脉曲张的治疗基于全面的临床检查。对于考虑进行根治性治疗的静脉曲张病例，多普勒检查和超声检查很有用。在存在皮肤溃疡的情况下，超声检查至关重要，以避免将因深静脉功能不全（最常见的是血栓形成后起源）导致的营养性病变误诊为静脉曲张溃疡。静脉曲张的治疗根据相关患者所关注问题的确切性质而有所不同。无论疾病的临床形式如何，弹性支撑都很有用。当静脉功能不全出现症状时，可使用血管保护和静脉张力调节药物。静脉曲张的根治性治疗，无论是通过硬化剂注射还是手术，都取决于病变的解剖性质、静脉功能不全的程度和体征范围，也取决于患者的意愿，患者应充分了解每种技术的优缺点。
