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a change in the veins expressed in sacculate dilation, increase in length, and the formation of convolutions and nodular glomeris. The disease most often affects veins of the lower extremities and rectum and, more rarely, the veins of the spermatic cord and the esophagus. Women are affected three times more frequently than men. Most significant in the occurrence of varicose veins are congenital weakness of the venous walls, blood-vessel anomalies, changes in the elasticity of the muscle layer, and valvular insufficiency. Velocity of blood flow in the dilated veins slows, which often leads to formation of thrombi in them. Difficult outflow of blood resulting from thrombosis of the veins or constipation and pressure on the veins of the small pelvis from a tumor or, in women, from the pregnant uterus promote the development of the disease. Varicose veins often occur with flat feet. Sometimes they develop in persons who engage in heavy physical labor (blacksmiths, stevedores) or in those whose occupations involve long hours of standing (cooks, barbers, waitresses, and so on). With varicose veins of the lower extremities, the surface (subcutaneous) veins are the ones predominantly affected. The disease develops gradually. Patients complain of a sensation of heaviness in the affected leg, of rapid fatigue, and puffiness—at first passing and in later stages constant. Sometimes a varicose ulcer develops on the affected leg. Dilated veins are usually readily visible through the skin. Treatment depends on the degree of evidence of symptoms and on the extent of the pathological process. In early stages of varicose veins that are not severely manifested, treatment consists of binding the legs with an elastic bandage or the wearing of rubber stockings. Severely manifested varicose veins necessitate surgical treatment. Prophylaxis, when there is a hereditary predisposition to varicose veins, consists of general strengthening measures (therapeutic exercise, vitamin therapy, air and sea baths, and so forth). For women during pregnancy, beginning with the first two to three months, at the first signs of varicose veins of the extremities elastic bandaging should be used and continued into the first months postpartum.
REFERENCESTal’, I. M. Varikoznoe rasshirenie ven nizhnikh konechnostei. Leningrad, 1961.
Mamamtavrishvili, D. G. Bolezni ven. Moscow, 1964.
R. S. KOLESNIKOVA