RESUMEN
The authors analysed the results of comprehensive examination and treatment of a total of 40 patients presenting with lower limb chronic venous insufficiency at the stage of trophic disorders (class C6), including 28 (70%) patients with varicose disease of lower extremities and 12 (30%) patients with post-thrombotic disease. Studying the microcirculatory blood flow by means of laser Doppler flowmetry showed a statistically significant (p<0.05) baseline decrease in the index of microcirculation in patients (12.2±2.4 perf. units for varicose disease and 10.8±1.8 perf. units for post-thrombotic disease) as compared with the control group of apparently healthy volunteers (20.4±1.5 perf. units). All stages of treatment included the program of stimulation of reparative processes and normalization of microcirculation by means of sulodexide. Conservative measures were independent therapeutic procedures in 31 patients. Of these, trophic ulcers completely epithelialized in 9 patients and decreased by half of its initial surface in 22 patients. The study of the microcirculatory blood flow in dynamics suggested improvement of microcirculation during treatment. Hence, comprehensive therapy using sulodexide in patients with venous trophic ulcers is accompanied by an endothelium-protecting effect and leads to improvement of the indices of microcirculation of the skin of the crus.
Asunto(s)
Endotelio Vascular , Glicosaminoglicanos/administración & dosificación , Microcirculación/efectos de los fármacos , Úlcera Varicosa , Insuficiencia Venosa , Cicatrización de Heridas/efectos de los fármacos , Adulto , Anciano , Anticoagulantes/administración & dosificación , Endotelio Vascular/efectos de los fármacos , Endotelio Vascular/fisiopatología , Femenino , Humanos , Flujometría por Láser-Doppler/métodos , Extremidad Inferior/irrigación sanguínea , Masculino , Persona de Mediana Edad , Síndrome Postrombótico , Resultado del Tratamiento , Úlcera Varicosa/tratamiento farmacológico , Úlcera Varicosa/etiología , Úlcera Varicosa/fisiopatología , Insuficiencia Venosa/complicaciones , Insuficiencia Venosa/diagnóstico , Insuficiencia Venosa/tratamiento farmacológico , Insuficiencia Venosa/fisiopatologíaRESUMEN
The authors assessed the effect of a micronized purified flavonoid fraction (MPFF) on the course of the postoperative period after endovenous thermal ablation (EVTA). The patients of the Study Group matching by the main studied parameters to the Control Group patients were given the MPFF according to the suggested regimen for 7 days. The obtained results were analysed by means of questionnaires (CIVIQ, VCSS, VAS) and ultrasound angioscanning. The obtained findings were statistically processed by means of the program Statistica 6.0 and reliability of the results was assessed with the help of the Student t-test. Patients of the both groups showed complete stable obliteration of the target veins. No statistically significant differences of the items of the questionnaires CIVIQ and VCSS at the beginning of the study and at the last examination were revealed, differences were noted on days 2-14 after EVTA and were not statistically significant (p>0.05). Phlebotrophic therapy in the postoperative period after EVTA helps to decrease phlebitic alterations in the coagulated vein, to improve motor activity and mental psychoemotional state of the patients.