下肢静脉曲张及膝骨关节炎患者慢性静脉功能不全的矫正

E. A. Shcheglov, N. N. Alontseva
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引用次数: 1

摘要

介绍。慢性静脉疾病,特别是下肢静脉曲张,是一个严重的医学和社会问题。目的探讨静脉流出障碍治疗对静脉曲张合并膝关节骨关节炎患者膝关节骨关节炎治疗效果的影响。材料和方法。该研究纳入了105例静脉曲张合并膝骨关节炎的患者,这些患者之前曾接受过膝关节骨关节炎的治疗,但没有接受过或接受过极不规律的静脉曲张治疗。随访期为12个月。从研究开始,患者接受第一个疗程的促静脉药物治疗2个月。然后每隔3个月重复两次。标准的促静脉药物为微粉化纯化的类黄酮组分。所有患者均推荐穿压缩针织品。绝大多数病例使用2级长袜或紧身袜,踝部压力为23-32毫米汞柱。骨关节炎的治疗包括使用非甾体类抗炎药、疾病调节剂(硫酸软骨素、硫酸氨基葡萄糖)和物理治疗。VCSS量表降低了临床组慢性静脉功能不全的程度。纳入研究时,临床组平均得分为7.1±1.9分,6个月后平均得分为6.1±1.5分,12个月后平均得分为6.0±1.2分。在对照组中,患者没有接受静脉曲张治疗,没有动态变化。静脉流出障碍矫正背景下关节综合征的结果- Leken和WOMAC指数值降低,视觉模拟量表疼痛综合征减轻。所有这些都导致患者服用镇痛药的需求减少。在100例关节病理患者中,68例被诊断为静脉曲张。这些疾病相互加重,但我们可以假设静脉病理是主要的。一个恶性循环开始了——骨关节炎的进展是由于静脉流出的紊乱,而静脉曲张是由于肌肉静脉泵功能的恶化。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic vein insufficiency correction in patients with lower extremities varicosity and knee osteoarthritis
Introduction. Chronic vein diseases in general and varicose veins of the lower extremities in particular represent a serious medical and social problem.The aim was to study the influence of the therapy of venous outflow disorders on the treatment results of osteoarthritis of the knee joints in patients with varicose veins in combination with osteoarthritis of the knee joints.Materials and methods. The study included 105 patients with varicose veins combined with knee osteoarthritis who had previously received treatment for osteoarthritis of the knee joints but had not received or had received extremely irregular therapy for varicose veins. The follow-up period for the patients was 12 months. The patients underwent the first course of phlebotropic drugs for 2 months from the start of the study. Then this course was repeated twice at 3-month intervals. The standard phlebotropic drug was a micronized purified flavonoid fraction. Compression knitwear was recommended in all patients. Class 2 stockings or tights with an ankle pressure of 23–32 mmHg were used in the vast majority of cases. Treatment of osteoarthritis included the use of nonsteroidal anti-inflammatory drugs, disease-modifying agents (chondroitin sulfate, glucosamine sulfate), and physical therapy.Results. The VCSS scale reduced the degree of chronic venous insufficiency in the clinical group. At inclusion in the study, the average score in the clinical group was 7.1 ± 1.9, after 6 months the result was 6.1 ± 1.5, and after 12 months – 6.0 ± 1.2 points. In the control group, where patients did not receive therapy for varicose veins, there were no dynamics. The results of joint syndrome against the background of correction of venous outflow disturbances – decrease of Leken and WOMAC index values, decrease of pain syndrome according to the visual analogue scale. All this led to a decrease in the patients' need for taking analgesics.Conclusions. Out of 100 patients with joint pathology, 68 patients were diagnosed with varicose veins. These diseases aggravate each other, but we can assume that the venous pathology is primary. A vicious circle is set in motion – progression of osteoarthritis due to the disturbances of venous outflow, and varicosity due to the deterioration of muscular-venous pump functioning.
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