Title Kirurško liječenje varikoznih vena
Author Janko Rožić
Mentor Miljenko Kovačević (mentor)
Committee member Igor Medved (predsjednik povjerenstva)
Committee member Aldo Ivančić (član povjerenstva)
Committee member Alen Ružić (član povjerenstva)
Granter University of Rijeka Faculty of Medicine (Department of Surgery) Rijeka
Defense date and country 2016-09-23, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Surgery
Abstract Varikozne vene su proširene, izduljene, tortuozne vene smještene u subkutisu, veličine 3mm u promjeru ili više. Patogeneza varikoznih vena je složena. U početku istraživanja, najveća važnost je pripisana inkompetentim venskim zaliscima. Daljnjim istraživanjima, otkriveni su molekularni mehanizmi oštećenja venskog zida, koji doprinose razvoju venske hipertenzije i venskog refluksa. Varikozne vene su čest problem u odrasloj populaciji, gotovo 30% ljudi je zahvaćeno. Bolest može biti asimptomatska ili simptomatska. Simptomi koji se susreću su bol, težina nogu, edem, oticanje gležnjeva i umor, svrbež, noćni grčevi, nemirne noge i kozmetski defekt. Napretak kronične venske bolesti vodi do kronične venske insuficijencije i razvoja ozbiljnijih formi bolesti, C3-6 u CEAP klasifikaciji, poput edema, lipodermatoskleroze ili ulkusa. Temeljit fizikalni pregled i DUS kao zlatni standard u procjeni morfologije vena i smještaja venskog refluksa su esencijalni za postavljanje točne dijagnoze. Liječenje se obično započinje sa konzervativnim opcijama, i cilj mu je smanjiti simptome i poboljšati izgled ekstremiteta. Uvjeti za intervencijsku terapiju su prolazak 3 mjeseca neuspješne konzervativne terapije uz pozitivan venski refluks, ili stanje po pregledu koje zahtijeva intervenciju, poput krvarenja iz varikoznih vena. Ugrubo, intervencijsku terapiju možemo podijeliti na otvorenu kirurgiju i endovenozne ablativne procedure. Prednosti otvorene kirurgije su potpuno uklanjanje varikoznih vena, čime se eliminira problem rekanalizacije. Nedostaci su mogućnost nastanka hematoma i ekhimoza, te dulji period oporavka. Moderni trendovi terapije varikoznih vena preferiraju upotrebu endovenoznih ablativnih procedura, međutim otvorena kirugija ostaje kao izvrsna metoda za liječenje.
Abstract (english) Varicose veins are widened, elongated, tortous vein located in subcutis, their size being 3mm in diameter or more. Pathogenesis of varicose veins is complex. In the research beginnings, largest importance was attributed to incompetent venous valves. In further research, mollecular mechanisms of venous wall damage were discovered, which contribute to development of venous hypertension and venous reflux. Varicose veins are common problem in adult population, almost 30% of people are affected. The disease can be asymptomatic and symptomatic. Encountered symptoms are pain, leg heaviness, edema, itching, night cramps, restless legs and cosmetic defect. Advancement of chronic venous disease leads to chronic venous insufficiency and development of severe forms of the disease, C3-6 in CEAP classification, such as edema, lipodermatosclerosis or ulcers. Thorough physical exam and DUS as golden standard in assessment of venous morphology and location of venous reflux are essential in appointing the correct diagnosis. Treatment usually begins with conservative options, and its goal is to alleviate symptoms and improve the extremity appearance. Requirements for intervention therapy are the passing of 3 months of unsuccessful conservative therapy with positive venous reflux, or a state during examination which requires intervention, such as varicose vein hemorrhage. In rough, intervention therapy can be divided in open surgery and endovenous ablative procedures. Benefits of open surgery are complete removal of varicose veins, with which the problem of recanalization is eliminated. Shortfalls are the possibility of creating hematomas and ecchymoses., and longer recovery period. Moderns trends of varicose vein therapy prefer usage of endovenous ablative procedures, however open surgery remains as an excellent method of treatment.
Keywords
varikozne vene
kronična venska insuficijencija
venski refluks
DUS
ligacija
stripping
radiofrekventna ablacija
endovenozna laserska ablacija
skleroterapija
Keywords (english)
varicose veins
chronic venous insufficiency
venous reflux
DUS
ligation
stripping
radiofrequency ablation
endovenous laser ablation
sclerotherapy
Language croatian
URN:NBN urn:nbn:hr:184:879672
Study programme Title: Medicine Study programme type: university Study level: integrated undergraduate and graduate Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2016-10-20 11:57:02