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Register a new userClinical manifestations and morphologic changes in varicose lower limbs
التظاهرات السريرية و التغيرات الشكليائية لدوالي الطرفين السفليين
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Tishreen University ورقة بحثية
Publication date
2013
fields
Medicine
and research's language is
العربية
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Shamra Editor
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تصيب أوردة الدوالي حوالي 10-59% من السكان. الدوالي انعكاس سريري للقصور المترقي في أوردة الطرفين السفليين. سبب القصور الوريدي هو الخلل البنيوي في جميع طبقات جدار الوريد. من هنا أهمية الدراسة الشكليائية و الإحصائية لأوردة الطرفين السفليين و مقارنتها مع الطبيعي. أجرينا عمليات جراحية لدوالي 43 مريضاً، تمّ الفحص التشريحي المرضي لعينات الدوالي و الأوردة الطبيعية المأخوذة من ثلاثة مرضى. متوسط أعمارهم 40,58 سنة. تمت الدراسة النسيجية و العيانية بأخذ مقاطع نسيجية مختلفة لأوردة الدوالي و الأوردة الطبيعية، تم استعمال ملونات روتينية و خاصة من أجل كشف تغيرات العناصر التركيبية لجدار الوريد. توصلنا إلى الاستنتاجات و التوصيات التالية: وجود تغيرات مؤكدة نوعية و كمية في جميع العينات المرضية طالت عناصر النسيج الضام و الألياف العضلية الملساء تتوزع في جميع طبقات جدار الوريد بشكل قطعي. ضرورة بدء علاج الدوالي أبكر ما يمكن من أجل تفادي تطورها و الوصول إلى الاختلاطات. من المفيد محاولة دراسة العلاقة بين ظهور الدوالي و الزمرة الدموية للمرضى.
Varicose veins affects about 10-59% of the population. Varicose is a clinical reflection of the progressive failure in the veins of the lower limbs. Venous insufficiency is caused by structural imbalances in all layers of the wall of the vein, hence, the importance of morphologic and statistical studies of the varicose veins of the lower limbs and comparison with normal veins. We had surgery for varicose 43 patients. We examined all samples of varicose veins and normal veins of three patients with pathological studies. Average age was 40.58 years. The study was done macroscopically and microscopically, taking different histological sections of varicose and normal veins. Routine and special Dyes were used, in order to detect changes in the compositional elements of the vein wall. We reached the following conclusions and recommendations: the presence of certain changes in the quality and quantity in all pathologic samples along connective tissue elements and smooth muscle fibers, distributed in all layers of the wall of the vein definitively; the need to start treating varicose veins early as possible in order to avoid its development and access to complications; it is useful to attempt to study the relationship between the appearance of varicose veins and blood group of the patient.
Artificial intelligence review:
Research summary
تناولت الدراسة التظاهرات السريرية والتغيرات الشكلية لدوالي الطرفين السفليين، حيث تصيب الدوالي حوالي 10-59% من السكان. تعتبر الدوالي انعكاسًا سريريًا للقصور الوريدي التدريجي في أوردة الطرفين السفليين، والذي ينتج عن خلل بنيوي في جميع طبقات جدار الوريد. أجرى الباحثون عمليات جراحية لدوالي 43 مريضًا، وتم فحص العينات النسيجية لأوردة الدوالي والأوردة الطبيعية باستخدام ملونات روتينية وخاصة للكشف عن التغيرات في العناصر التركيبية لجدار الوريد. توصلت الدراسة إلى وجود تغيرات نوعية وكمية مؤكدة في جميع العينات المرضية، مما يستدعي بدء علاج الدوالي في مراحل مبكرة لتجنب تطورها والوصول إلى الاختلاطات. كما أوصت الدراسة بضرورة محاولة دراسة العلاقة بين ظهور الدوالي والزمرة الدموية للمرضى.
Critical review
دراسة نقدية: تعتبر هذه الدراسة من الدراسات الهامة التي تسلط الضوء على مشكلة شائعة تؤثر على نسبة كبيرة من السكان. ومع ذلك، يمكن الإشارة إلى بعض النقاط التي قد تحتاج إلى مزيد من التوضيح أو البحث المستقبلي. على سبيل المثال، العلاقة بين الزمرة الدموية وظهور الدوالي لم يتم توضيحها بشكل كافٍ، وقد يكون من المفيد إجراء دراسات مستقبلية تركز على هذا الجانب. بالإضافة إلى ذلك، يمكن تحسين الدراسة من خلال زيادة حجم العينة لتشمل مجموعة أكبر من المرضى، مما يمكن أن يعزز من دقة النتائج ويجعلها أكثر تمثيلاً للسكان بشكل عام.
Questions related to the research
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ما هي نسبة انتشار دوالي الطرفين السفليين بين السكان؟
تتراوح نسبة انتشار دوالي الطرفين السفليين بين 10-59% من السكان.
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ما هو السبب الرئيسي للقصور الوريدي في دوالي الطرفين السفليين؟
السبب الرئيسي للقصور الوريدي هو الخلل البنيوي في جميع طبقات جدار الوريد.
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ما هي التوصية الرئيسية للدراسة بشأن علاج الدوالي؟
توصي الدراسة ببدء علاج الدوالي في مراحل مبكرة لتجنب تطورها والوصول إلى الاختلاطات.
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هل هناك علاقة بين الزمرة الدموية وظهور الدوالي؟
توصي الدراسة بمحاولة دراسة العلاقة بين ظهور الدوالي والزمرة الدموية للمرضى، ولكن لم يتم توضيح هذه العلاقة بشكل كافٍ في الدراسة الحالية.
References used
GOLDMAN M.P. FRONEK. A. Anatomy And Pathophiology Of Varicose Veins. J Dermatol Surge Oncol No 15 1989 138-145
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Superficial Veins Thrombosis(SVT)on ground of varicose vein lower extremities. the
study achieved at AL-Assad hospital (Latakia) in the period between January 2005 to
Decemb
er 2011. Criteria of inclusion were incompetence (by Duplex investigation ), a
tender indurated cord a long superficial vein, and indurated and heat in the affected area.
Exclusion criteria were obesity, cardiovascular or neoplastic diseases, non-ambulatory
status, SVT without varicose vein. 60 patients ( 41 females, 19 males) included in the
study, 61.6% were between(31–50) years, left lower limb was affected in 48,3 %, Right
40%, and in 11,7 the both, The GSV was affected alone in all cases. Primary surgical
choice was decided almost in all patients, secondary was in 4patients after 1-4 weeks of
medical treatment. The extension level in the GSV determined by color duplex ultrasound
was similar to surgical findings, and above clinical extension level in (5-14) cm. All
surgical intervention was achieved under spinal anesthesia, with no major technical
difficulties. Short term results were good, no(DVT, PE, acute cardiac ischemia, death ),
complications related to surgery(hematoma, seroma5%, wound infection3.3%, wound
necrosis1.7%, lymphatic discharge3.3%) show no difference to un complicated varicose
surgery.
Conclusion: Primary surgical approach can be used with thrombosis of GSV above
knee in varicose patients safely and effectively , color duplex ultrasound scans is
recommended to determine extension of SVT.
varicose veins particularly the spider veins or reticular and isolated are important medical problem as well as cosmetic harmful for women. there are wide arguments about therapeutic methods for varicose veins. the therapies range from traumatic surg
ical to conservative through laser ablation, and radiofrequency ablation. sclerotherapy may serve as minimally invasive alternatives, we had done therapeutic studying for 35 patients in ALAssaad university hospital in Lattakia between 2014 to april 2015. every patient had been treated by sclerotherapy several sessions, interval between sessions was 2-3 weeks. all patients had been followed up for 6 months after treatment. the treatment had been successfully finished for all patients. but non-dangerous complications had appeared in 54.3% of patients. we had done medical management for them. the sclerotherapy for spider veins or reticular and isolated veins gave excellent results in all patients.
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