Local therapy in the postoperative management of patients with lower limb varicose vein disease

I. N. Mokhamad
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Abstract

Introduction. Varicose veins of the lower extremities are one of the most common diseases, affecting 20 to 40% of the population. One of the most common treatment methods is endovenous laser coagulation (EVLC).Aim. To evaluate the effectiveness of local gel therapy based on escin, heparin and essential phospholipids in the postoperative administration of patients after endovenous laser coagulation.Materials and methods. A complex treatment of 53 patients with varicose veins of the lower extremities of classes C2-C3 according to the CEAP nomenclature was carried out. Patients were divided into 2 statically homogeneous groups with an equal number. All patients underwent endovenous laser obliteration of the trunk of the great saphenous vein in combination with miniphlebectomy of tributaries on the thigh and lower leg.Results. In both groups, the largest number were patients with incompetence of the GSV trunk up to the border in /3 and c/3 of the lower leg, with further discharge along the tributaries of the GSV along the medial surface of the lower leg. The failure of the GSV trunk to the level of the knee joint gap was accompanied by the presence of varicose-transformed tributaries along the anterior surface of the thigh, in the area of the knee joint. The addition of Detragel led to the relief of phlebitis and hematomas, a pronounced decrease in pain and edematous syndrome.Discussion. Transdermal drug delivery has great promise as an alternative to oral and intravenous treatment, especially for patients suffering from chronic diseases. The three-component composition allows you to influence all parts of the pathogenesis of the disease.Conclusion. The data obtained on the use of local gel therapy based on escin, heparin and essential phospholipids after EVLO of the GSV indicate the need for local therapy to improve the quality of life of patients, their rapid rehabilitation and improve immediate and long-term results.
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下肢静脉曲张患者术后治疗中的局部疗法
简介下肢静脉曲张是最常见的疾病之一,影响着 20% 至 40% 的人口。最常见的治疗方法之一是静脉腔内激光凝固术(EVLC)。评估静脉腔内激光凝固术后患者术后使用基于埃辛、肝素和必需磷脂的局部凝胶疗法的效果。根据 CEAP 术语,对 53 名 C2-C3 级下肢静脉曲张患者进行了综合治疗。患者被分为两组,每组人数相同。所有患者都接受了大隐静脉主干的静脉腔内激光湮灭术,同时对大腿和小腿的支流进行了微静脉切除术。在两组患者中,最多的患者是大隐静脉主干至小腿/3和c/3处边界不通,沿着大隐静脉支流进一步沿小腿内侧表面排出。GSV 主干在膝关节间隙处出现衰竭,同时在膝关节区域的大腿前表面出现曲张变形的支流。加入Detragel后,静脉炎和血肿得到缓解,疼痛和水肿综合征明显减轻。透皮给药作为口服和静脉注射治疗的替代疗法大有可为,尤其是对于慢性病患者。三组份成分可以影响疾病发病机制的各个环节。在 GSV EVLO 后使用以 escin、肝素和必需磷脂为基础的局部凝胶疗法所获得的数据表明,有必要使用局部疗法来改善患者的生活质量,使其快速康复,并提高近期和远期疗效。
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