Файловый архив студентов. Файловый архив студентов.
1330 вузов, 5508 предметов.
/ Регистрация
FAQ Обратная связь Вопросы и предложения
Добавил:
kiopkiopkiop18@yandex.ru t.me/Prokururor I Вовсе не секретарь, но почту проверяю Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Ростовский Государственный Медицинский Университет
Предмет:
Медицина общая
Файл:

Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4087_Библиотеки_им_академика_М_И_Перельмана

.pdf
Скачиваний:
0
Добавлен:
13.10.2026
Размер:
3 Мб
Скачать
☆


Pagei
VaricoseVeins

Pageii
AbouttheAuthors
HaroldEllisisEmeritusProfessorofSurgeryatCharingCrossWestminsterMedicalSchool,UniversityofLondon.Hehasspecialisedinthetreatmentofvaricose
veinsforthirtyyearsandranthebusyvaricoseveinsclinicatWestminsterHospitalsince1962.HewasalsoamemberoftheCounciloftheRoyalCollegeof
SurgeonsofEngland.
Heiswellknownaroundtheworld,notonlythroughhisfrequentlecturetoursfortheBritishCouncilandotherorganisations,butalsoforhishundredsofpaperson
surgicaltopicsandhisnumerousmedicaltextbooks,includingClinicalAnatomy,LectureNotesonGeneralSurgeryandAnatomyforAnaesthetists.
ProfessorEllisismarriedandthefatheroftwochildren.HelivesinnorthLondonwherehischiefleisureinterestismedicalhistory.
PeterTaylorisaConsultantVascularSurgeonatGuy'sandSt.Thomas'Hospitals.HetrainedatGuy'sandSt.Mary'sHospital,Paddingtonandisamemberofthe
VascularSurgicalSociety,theEuropeanSocietyforVascularSurgeryandtheInternationalSocietyofEndovascularSurgery.Hehaswrittenmanypapersonvascular
surgery.

Pageiii
Acknowledgements
Thepublisherandauthorswouldliketothankthefollowingindividualsandorganizationsfortheirpermissiontoreproducephotographs:
DrCarolineWigley,forthephotomicrographonpage16.MediUKLtd,forthephotographsonpages48and49.Smith&NephewHealthcareLtd,forthe
photographsonpages100and107.
SaxonGraphicsLtd.,Derbyforallredrawncolourartwork.

Pageiv
©1999
GreenwichMedicalMedia
219TheLinenHall
162168RegentStreet
London
W1R5TB
ISBN1900151677
Firstpublished1999
Whiletheadviceandinformationinthisbookisbelievedtobetrueandaccurate,neithertheauthorsnorthepublishercanacceptanylegalresponsibilityorliabilityfor
anylossordamagearisingfromactionsordecisionsbasedinthisbook.Theultimateresponsibilityforthetreatmentofpatientsandtheinterpretationlieswiththe
medicalpractitioner.Theopinionsexpressedarethoseoftheauthorsandtheinclusionsinthisbookrelatingtoaparticularproduct,methodortechniquedoesnot
amounttoanendorsementofitsvalueorquality,oroftheclaimsmadeofitbyitsmanufacture.Everyefforthasbeenmadetocheckdrugdosages;however,itisstill
possiblethaterrorshaveoccurred.Furthermore,dosageschedulesareconstantlybeingrevisedandnewsideeffectsrecognised.Forthesereasons,themedical
practitionerisstronglyurgedtoconsultthedrugcompanies'printedinstructionsbeforeadministeringanyofthedrugsrecommendedinthisbook.
Apartfromanyfairdealingorthepurposesofresearchorprivatestudy,orcriticismorreview,aspermittedundertheUKCopyrightDesignsandPatentsAct,1988,
thispublicationmaynotbereproduced,stored,ortransmitted,inanyformorbyanymeans,withoutthepriorpermissioninwritingofthepublishers,orinthecaseof
reprographicreproductiononlyinaccordancewiththetermsofthelicencesissuedbytheCopyrightLicensingAgencyintheUK,orinaccordancewiththetermsof
thelicencesissuedbytheappropriateReproductionRightsOrganizationoutsidetheUK.Enquiriesconcerningreproductionoutsidethetermsstatedhereshouldbe
senttothepublishersattheLondonaddressprintedabove.
TherightofHaroldEllisandPeterTaylortobeidentifiedasauthorsofthisworkhasbeenassertedbyherinaccordancewiththeCopyright,DesignsandPatentsAct
1988.
Thepublishermakesnorepresentation,expressorimplied,withregardtotheaccuracyoftheinformationcontainedinthisbookandcannotacceptanylegal
responsibilityorliabilityforanyerrorsoromissionsthatmaybemade.
AcataloguerecordforthisbookisavailablefromtheBritishLibrary.
Distributedworldwide
byOxfordUniversityPress
ProjectManager
GavinSmith
Typesetby
SaxonGraphicsLtd.,Derby
PrintedinChina
https://t.me/med1917

Pagev
Contents
1.TheProbleminPerspective 1
2.WhatareVaricoseVeins? 5
3.WhatCausesVaricoseVeins? 19
4.ThePill,PregnancyandVaricoseVeins 29
5.Investigations 39
6.Treatment 47
7.LosingWeighttoHelpyourVaricoseVeins 77
8.ImprovingtheCirculationinyourLegs 85
9.ComplicationsandConditionsConfusedwithVaricoseVeins 97
10.QuestionsandAnswers 115
https://t.me/med1917

Page1
Chapter1—
TheProbleminPerspective
Varicoseveinsarecommonindeed,probablythecommonestsurgicalcondition.Therearemanymisconceptionsaboutthem,whichthisbookwillhelptocorrect,
andyou,thepatient,canbeofgreathelptoyourdoctorinyourtreatment.
https://t.me/med1917

Page2
Ifyoutalktopatientssittinginageneralsurgicaloutpatientclinicyouwillfindthatthreeproblemshavebroughtthevastmajorityofthemthere—hernias,pilesand,
ofcourse,varicoseveins.Thesethreeconditionsshareanumberoffeatures:theyarecommon,embarrassing,anuisanceandthereisnothingyetknowntomedical
sciencethatwillpreventanyofthem.
Unfortunately,therefore,thereisnothingyoucandotostopyourselffromgettingvaricoseveins,buttherearecertainthingsyoushouldknowaboutyourvaricose
veins,alongwiththethingsyoucandotopreventthemfromgettingworseandhowtohelpyourdoctortomakethembetter.
ExactlywhatvaricoseveinsareshallbedescribedfullyinChapter2.Mostpeoplehaveafairlygoodideaofwhattheylooklike.Indeed,theyareprobablythe
commonestreasonforpeopletobeadmittedtothegeneralsurgicaldepartmentsofhospitalsthroughouttheWesterncivilizedworld.InBritain,forinstance,one
personinfivealreadyhasorislikelytodevelopvaricoseveinstosomedegree;andwomenaremorelikelytosufferfromthemthanmen.
Don'tgettheWrongIdea
Becausevaricoseveinsaresocommon,itisnotsurprisingthatmanymistaken,evenincorrect,ideashavedevelopedaboutthem.Peoplewithalmostthefirstsignof
veintroublesbecomeworriedthattheymaydeveloptherathernastycomplicationsthatseemtoleadonfromthisconditionthebrownishblackstainknownas
pigmentation;theopen,slowtohealwoundofulceration;thrombosisorclotting;andsoon.
Asfarasthesecomplicationsgo,youcanbereassured.Inthefirstplace,nothinghappensquickly.Asmallvaricoseveinonthelegdoesnotsuddenlygrowintoa
massofgrapelikestructuresfromankletogroin.Infact,thetimespanforcomplicationstoariseismeasuredinmanyyears.Similarly,ifyoudevelopalittlepatchof
eczemaorpigmentationontheleg,youshouldregarditasawarningthattreatmentforvaricoseveinsisnecessary,butthepatchisnotsuddenlygoingtoturnintoa
hugevaricoseulcer.
Ifyoudiscoverthatyouhavevaricoseveinsdeveloping,thenreporttheiroccurancetoyourdoctor.Itmaywellbethattheywillnotgetanybigger,butitisadvisable
tokeepthemunderobservationtheymayneverneedanytreatment.Whentheveinsaremoremarkedinanotherwisehealthyandactiveperson,thentheyshould
certainlybetreated
https://t.me/med1917

Page3
andthiswillpreventthoseunpleasantcomplicationsfromoccurring.Ifyouhaveoldandinfirmrelativeswithvaricoseveins,theirtreatmentwillprobablyconsistonlyof
supportstockingswhichwillhelptokeeptheveinsundercontrolandtokeepthelegscomfortable.
Itisimportanttorememberthatjustbecauseyouhavevaricoseveinsitdoesnotmeanthateveryacheandpainorothersymptominthelegstemsfromthem.See
yourdoctorsothatyourlegcanbecheckedcarefullyforotherproblemssuchassciaticaorarthritisbeforedecidingthattheproblemisvaricoseveins.Also,there
maybeotherblemishesonyourskinthatyoumightthinkarevaricoseveins,butarenotvaricoseveinsatall.Yourdoctorshouldsoonputyourmindatrestabout
these.SomeofthemorecommonmisconceptionsaredealtwithinChapter8.
Treatment
Whataboutremovalofvaricoseveinsforcosmeticreasons?Mostpeopleliketolooktheirbest,andwhilemanyspendmuchtimeandeffortontheirappearance
(especiallythosewhoseprofessionskeeptheminthepubliceye),thepresenceofveryobviousanddiscolouredveinsintheirlegsisarealembarrassment.Evenif
thereisnoachingordiscomfort,thereisnoreasonwhytheveinsshouldnotbedealtwithforcosmeticreasons,andindeed,thisisoneofthemostfrequentreasons
fortheirtreatment.However,youmaynotbeabletohavethistreatmentontheNationalHealthService(NHS),asmanypurchasingauthoritiesregardthetreatmentof
varicoseveinsaslowpriority.YouwillhavetodiscusswithyourowndoctoraboutwhichtreatmentsareavailablefromtheNHSasthesevaryfromregiontoregion.
Nevertheless,thetreatmentandaftercareofvaricoseveinsisthesamewhetheryouhavehadtreatmentforhealthorcosmeticreasons.So,allisnotlostjustbecause
youhavevaricoseveins;thereismuchyoucando.Belowaresomecommonsensetipsthatmayallowyoutohaveahealthy,activelifeinspiteofvaricoseveins.
HelpYourselftoHealthyLegs
Exercise
Exercisewillimprovetheflowofbloodinyourlegsandwillalsohelptopumpthebloodfromyourlegsbacktoyourlungs.Jogging,swim
https://t.me/med1917

Page4
mingandcyclingareallfirstclassactivities,butwalkingisevenbetteritisasuperbexercisethatcanbecarriedoutbyalmostanybodyatanyage.Leaveyourcarin
thegarage,forgetaboutthebus,avoidtheelevator...andwalk!
Don'tStandAround
Learntoputyourlegsupwhenyouaresittingquietlyathomeandtoraiseyourlegsinbedatnight.Theseeasyactionswillhelptheveinstoemptysomewhatandwill
preventorreduceanypuffinessinyourfeet.Fewpeopleweartightgartersnowadays,butifyoudo(andespeciallyifyouhavevaricoseveins)youshouldthrowthem
away.
WatchyourWeight
Asurgeon'sheartsinkswhenheseesanobesepatientwithvaricoseveins.Thesurgeonknowsthattreatmentbyinjectionisgoingtobedifficultandthattherisksof
surgerywillbeincreased.Youwillhelpthesurgeonandyourselfifyoutrytolosesomeweightandslimdownyouwillalsolookandfeelbetter!
Itmaybethatyourveinshavealreadyreachedthestageofdiscolorationandulceration.Yoursurgeoncanhelpagreatdealwiththeseproblemsbutafterwardsyou
willhavealifetime'sresponsibilityforthecareofyourlegs.Thismeanselasticsupport,keepingyourlegsraisedatnight,activeexercisesandweightwatching.The
morevigilantyouareaftertreatment,thelesseryourchancesofanotherrecurrenceofvaricoseveins.
Sooncethedoctorand/orthesurgeonhavedonetheirpart,itislargelyuptoyoutohelpyourselftogetbetterandtostayhealthyandfreeofvaricoseveins.Asyou
readthroughthisbookyouwillbetakingthefirststepstothatend.Happyreading!
https://t.me/med1917
Соседние файлы в папке Библиотека им академика М.И. Перельмана
Помощь Обратная связь Вопросы и предложения Пользовательское соглашение Политика конфиденциальности