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Варикозная болезнь: 20 лет спустя
Варикозная болезнь: 20 лет спустя
Кириенко А.И., Гаврилов С.Г., Золотухин И.А. Варикозная болезнь: 20 лет спустя. Consilium Medicum. 2015; 17 (12): 60–63. DOI:10.26442/2075-1753_2015.12.60-63
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Аннотация
В статье представлены сведения о достижениях в области диагностики и лечения варикозной болезни (ВБ) за последние 20 лет. Освещены новые данные о патогенезе и классификации заболевания, способах фармакотерапии, компрессионного лечения, флебосклерооблитерации. Большое внимание уделено вопросам современного хирургического лечения ВБ с использованием минимально инвазивных эндоваскулярных термических и эмболизационных методик. Авторами представлены тактические подходы в терапии ВБ, сочетающие комбинацию разных методов лечения в зависимости от класса хронической венозной недостаточности. Затронуты вопросы флеботропного и хирургического лечения ВБ таза.
Ключевые слова: варикозная болезнь, патогенез, классификация, диагностика, консервативное лечение, хирургическое лечение.
Ключевые слова: варикозная болезнь, патогенез, классификация, диагностика, консервативное лечение, хирургическое лечение.
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The article presents information on developments in the diagnosis and treatment of varicose veins (VV) over the past 20 years. When covering new data on the pathogenesis and classification of diseases, methods of drug therapy, compression therapy, phleboscleroobliteration. Much attention is paid to the issues of modern surgical treatment of VV using minimally invasive endovascular embolization and thermal techniques. The author presents tactical approaches in the treatment of the VV, which combine a combination of different treatments depending on the class of chronic venous insufficiency. The issues of phlebotropic and surgical treatment of pelvic VV are also covered.
Key words: varicose disease, pathogenesis, classification, diagnosis, conservative treatment, surgical treatment.
Key words: varicose disease, pathogenesis, classification, diagnosis, conservative treatment, surgical treatment.
Полный текст
Список литературы
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2. Klinicheskaia khirurgiia. Natsional'noe rukovodstvo. T. 3. Pod red. V.S.Savel'va, A.I.Kirienko. M.: GEOTAR-Media, 2010. . [in Russian]
3. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the "CEAP" classification. Mayo Clin Proc 1996; 71 (4): 338–45.
4. Gloviczki Р. Handbook of Venous Disorders: Guidelines of the American Venous Forum. Third Edition. Edward Arnold (Publishers) Ltd 2009.
5. Pittaluga P, Chastanet S, Rea B, Barbe R. Midterm results of the surgical treatment of varices by phlebectomy with conservation of a refluxing saphenous vein. J Vasc Surg 2009; 50: 107–18.
6. Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction. A review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs 2003; 63: 71–100.
7. Amsler F, Blättler W. Compression therapy for occupational leg symptoms and chronic venous disorders – a meta-analysis of randomised controlled trials. Eur J Vasc Endovasc Surg 2008; 35 (3): 366–72.
8. Saveljev V. Stripping of the great saphenous vein under micronized purified flavonoid fraction (MPFF) protection (results of the Russian multicenter controlled trial DEFANCE). Phlebolymphology 2008; 15: 45–51.
9. Nicholson T, Basile A. Pelvic congestion syndrome, who should we treat and how? Tech Vasc Interv Radiol 2006; 9 (1): 19–23.
2. Клиническая хирургия. Национальное руководство. Т. 3. Под ред. В.С.Савельва, А.И.Кириенко. М.: ГЭОТАР-Медиа, 2010. / Klinicheskaia khirurgiia. Natsional'noe rukovodstvo. T. 3. Pod red. V.S.Savel'va, A.I.Kirienko. M.: GEOTAR-Media, 2010. . [in Russian]
3. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the "CEAP" classification. Mayo Clin Proc 1996; 71 (4): 338–45.
4. Gloviczki Р. Handbook of Venous Disorders: Guidelines of the American Venous Forum. Third Edition. Edward Arnold (Publishers) Ltd 2009.
5. Pittaluga P, Chastanet S, Rea B, Barbe R. Midterm results of the surgical treatment of varices by phlebectomy with conservation of a refluxing saphenous vein. J Vasc Surg 2009; 50: 107–18.
6. Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction. A review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs 2003; 63: 71–100.
7. Amsler F, Blättler W. Compression therapy for occupational leg symptoms and chronic venous disorders – a meta-analysis of randomised controlled trials. Eur J Vasc Endovasc Surg 2008; 35 (3): 366–72.
8. Saveljev V. Stripping of the great saphenous vein under micronized purified flavonoid fraction (MPFF) protection (results of the Russian multicenter controlled trial DEFANCE). Phlebolymphology 2008; 15: 45–51.
9. Nicholson T, Basile A. Pelvic congestion syndrome, who should we treat and how? Tech Vasc Interv Radiol 2006; 9 (1): 19–23.
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2. Klinicheskaia khirurgiia. Natsional'noe rukovodstvo. T. 3. Pod red. V.S.Savel'va, A.I.Kirienko. M.: GEOTAR-Media, 2010. . [in Russian]
3. Kistner RL, Eklof B, Masuda EM. Diagnosis of chronic venous disease of the lower extremities: the "CEAP" classification. Mayo Clin Proc 1996; 71 (4): 338–45.
4. Gloviczki Р. Handbook of Venous Disorders: Guidelines of the American Venous Forum. Third Edition. Edward Arnold (Publishers) Ltd 2009.
5. Pittaluga P, Chastanet S, Rea B, Barbe R. Midterm results of the surgical treatment of varices by phlebectomy with conservation of a refluxing saphenous vein. J Vasc Surg 2009; 50: 107–18.
6. Lyseng-Williamson KA, Perry CM. Micronised purified flavonoid fraction. A review of its use in chronic venous insufficiency, venous ulcers and haemorrhoids. Drugs 2003; 63: 71–100.
7. Amsler F, Blättler W. Compression therapy for occupational leg symptoms and chronic venous disorders – a meta-analysis of randomised controlled trials. Eur J Vasc Endovasc Surg 2008; 35 (3): 366–72.
8. Saveljev V. Stripping of the great saphenous vein under micronized purified flavonoid fraction (MPFF) protection (results of the Russian multicenter controlled trial DEFANCE). Phlebolymphology 2008; 15: 45–51.
9. Nicholson T, Basile A. Pelvic congestion syndrome, who should we treat and how? Tech Vasc Interv Radiol 2006; 9 (1): 19–23.
Авторы
А.И.Кириенко*, С.Г.Гаврилов, И.А.Золотухин
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*rsmu@rsmu.ru
ГБОУ ВПО Российский национальный исследовательский медицинский университет им. Н.И.Пирогова Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
*rsmu@rsmu.ru
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A.I.Kirienko*, S.G.Gavrilov , I.A.Zolotukhin
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*rsmu@rsmu.ru
N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
*rsmu@rsmu.ru
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