介绍:
varicose veins 静脉曲张
【Overview】
Varicose veins are gnarled, enlarged veins. Any vein may become varicose, but the veins most commonly affected are those in your legs and feet. That's because standing and walking upright increases the pressure in the veins of your lower body.
For many people, varicose veins and spider veins — a common, mild variation of varicose veins — are simply a cosmetic concern. For other people, varicose veins can cause aching pain and discomfort. Sometimes varicose veins lead to more-serious problems.
Varicose veins may also signal a higher risk of other circulatory problems. Treatment may involve self-care measures or procedures by your doctor to close or remove veins.
【概述】
静脉曲张是指静脉扭曲，膨大。任何静脉都可能发生曲张，腿和足部的静脉更容易受累。因为垂直的站立和行走增加了身体低位静脉的压力。
对许多患者而言，静脉曲张和蜘蛛样静脉（一种常见且较轻微的静脉曲张类型），通常只会引起他们外观方面的关注。但在另外一部分的患者，静脉曲张可造成疼痛和不适，甚至导致更严重的问题。
静脉曲张也可能是一个循环系统机能紊乱的一个高危的信号。治疗措施包括自我家庭保健或者到医院就诊，闭合或切除曲张静脉。
Symptoms
Varicose veins may not cause any pain. Signs you may have with varicose veins include:
Veins that are dark purple or blue in color
Veins that appear twisted and bulging; often like cords on your legs
When painful signs and symptoms occur, they may include:
An achy or heavy feeling in your legs
Burning, throbbing, muscle cramping and swelling in your lower legs
Worsened pain after sitting or standing for a long time
Itching around one or more of your veins
Bleeding from varicose veins
A painful cord in the vein with red discoloration of the skin
Color changes, hardening of the vein, inflammation of the skin or skin ulcers near your ankle, which can mean you have a serious form of vascular disease that requires medical attention
Spider veins are similar to varicose veins, but they're smaller. Spider veins are found closer to the skin's surface and are often red or blue.They occur on the legs, but can also be found on the face. Spider veins vary in size and often look like a spider's web.
【症状】
静脉曲张也许不会引起任何疼痛，此时提示可能患有静脉曲张的症状包括：
静脉呈现暗蓝色或暗紫色。
可像绳子一样扭曲和扩张
若出现疼痛的症状和体征则包括以下：
腿部疼痛或沉重的感觉
下肢烧灼感、抽搐、肌肉筋挛和肿胀
久坐或长期站立后疼痛加重
静脉曲张区域瘙痒
静脉曲张出血
静脉条索样改变，伴有疼痛和皮肤红肿。
踝部附近皮肤色素沉着、静脉硬化、皮炎或溃疡形成，意味着你可能有严重的血管疾病，需要立即就诊。
蜘蛛样静脉扩张类似静脉曲张，但较细小。蜘蛛样扩张静脉一般较表浅，常呈红色或蓝色。多出现于小腿，也可出现于面部。蜘蛛样静脉扩张大小各异，外观如蜘蛛网。
Risk factors
These factors increase your risk of developing varicose veins:
Age. The risk of varicose veins increases with age. Aging causes wear and tear on the valves in your veins that help regulate blood flow. Eventually, that wear causes the valves to allow some blood to flow back into your veins where it collects instead of flowing up to your heart.
Sex. Women are more likely to develop the condition. Hormonal changes during pregnancy, premenstruation or menopause may be a factor because female hormones tend to relax vein walls. Taking hormone replacement therapy or birth control pills may increase your risk of varicose veins.
Family history. If other family members had varicose veins, there's a greater chance you will too.
Obesity. Being overweight puts added pressure on your veins.
Standing or sitting for long periods of time. Your blood doesn't flow as well if you're in the same position for long periods.
【危险因素】
以下因素可增加静脉曲张发生的风险：
年龄 静脉曲张的风险随年龄增长而增加，帮助血液回流的静脉瓣膜随着年龄增长而磨损破裂，最终这种磨损会导致瓣膜功能不全。
性别 女性比男性更容易患静脉曲张。妊娠期、月经期或是更年期激素的变化、可能是一个影响因素，因为雌激素可以松弛静脉壁，激素替治疗或口服避孕药可能会增加静脉曲张的风险。
家族史 如果家族成员中有静脉曲张患者，静脉曲张的风险会增加。
肥胖 超重可增加下肢静脉的压力。
长时间站立或久坐 长时间保持同一种姿势时血液回流不畅。
【Complications】
Complications of varicose veins, although rare, can include:
Ulcers. Extremely painful ulcers may form on the skin near varicose veins, particularly near the ankles. Ulcers are caused by long-term fluid buildup in these tissues, caused by increased pressure of blood within affected veins.A discolored spot on the skin usually begins before an ulcer forms. See your doctor immediately if you suspect you've developed an ulcer.
Blood clots. Occasionally, veins deep within the legs become enlarged. In such cases, the affected leg may swell considerably. Any sudden leg swelling warrants urgent medical attention because it may indicate a blood clot — a condition known medically as thrombophlebitis.
Bleeding. Occasionally, veins very close to the skin may burst. This usually causes only minor bleeding. But, any bleeding warrants medical attention because there's a high risk it can happen again.
【并发症】
静脉曲张的并发症虽然罕见，但可包括：
溃疡：曲张静脉周围的皮肤溃疡疼痛极为剧烈，尤其是脚踝附近。溃疡是由于受累的静脉内压力增高导致长期局部组织内“水储留”的结果。褐色皮肤色素沉着是皮肤溃疡的前期症状，一旦出现溃疡，应立即就医。
血栓：少数情况下，下肢的深静脉也可出现扩张，在这些患者，受累的下肢可能会明显肿胀。任何突发的下肢肿胀都需要急诊的处理，因为这种情况提示可能出现血栓形成，医学上称为血栓性静脉炎。
静脉曲张破裂出血：偶尔，表浅的静脉可能会破裂，通常只引起少量出血，但是，任何出血都需要医疗处理，因为再次发生破裂出血的风险很高。
【Prevention】
There's no way to completely prevent varicose veins. But improving your circulation and muscle tone can reduce your risk of developing varicose veins or getting additional ones. The same measures you can take to treat the discomfort from varicose veins at home can help prevent varicose veins, including:
Exercising
Watching your weight
Eating a high-fiber, low-salt diet
Avoiding high heels and tight hosiery
Elevating your legs
Changing your sitting or standing position regularly
【预防】
没有办法可以完全防止静脉曲张。但是通过改善血液循环和肌肉张力可以减少发生静脉曲张的风险，家庭保健措施包括：
锻炼
低盐和高纤维饮食
不穿高跟鞋和紧身衣裤
抬高下肢
经常改变坐姿和站姿
【language points】
1.varicose veins
Varicose 来源于拉丁词根：varix，意为“扭曲”
2.Gnarled /nɑ:ld/ 扭曲的
3.Mild 轻微的
Severe 严重的
Eg. 轻症急性胰腺炎 MAP （mild acute pancreatitis）
重症急性胰腺炎SAP（severe acute pancreatitis）
中度重症胰腺炎MSAP（ moderately severe acute pancreatitis）
4.bulging /ˈbʌldʒɪŋ/ 膨胀
5.muscle cramping 肌肉痉挛
6.Ulcer /ˈʌlsə(r)/溃疡
Bgm-safe and sound
撰稿讲解：福建医科大学 淑铉铉铉
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