THE POTENTIAL OF CONSERVATIVE THERAPY AND SURGICAL TREATMENT OF MICROCIRCULATORY DISTRESS IN CHRONIC VENOUS INSUFFICIENCY OF THE LOWER EXTREMITIES IN A STAGE OF TROPHIC DISORDERS

Yu.M. Stoiko, N.A. Yermakov, V.L. Pastushenkov, Ye.V. Shaidakov
The State Institution "National Medicosurgical Center, RF Ministry of Public Health", Moscow, Russia;
Military Medical Academy, Sankt-Peterburg, Russia

The present work describes the results of an all-round examination and treatment of 120 patients suffering from different forms of chronic venous insufficiency (CVI) of the lower extremities with trophic disorders of soft tissues. Of these, varicosis was present in 91 (75.8%) patients and postthrombotic disease – in 29 (24.2%), patients. Hemomicrocireulation was examined by laser Doppler flow-metry. Assessment was made of the functional activity of neutrophilic granulocytes of the microcirculatory bed. The data were obtained indicating the decrease of skin perfusion and activation of neutrophils in the hemomicrocirculatory bed of the involved extremity at venous outflow decompensation. Of the 120 persons, conservative treatment was provided to 23 patients, in 45 patients, the conservative measures represented a stage in the preoperative preparation. Ninety-seven patients were operated on. The studies of hemomicrocirculation carried out at different times after treatment have demonstrated that conservative treatment produces a beneficial effect on hemomicrocirculatory disorders in the lower extremities of patients with CVI. However, the effects of conservative therapy are unstable and not long-lasting. Surgical correction of the venous outflow in patients with decompensated forms of CVI of the lower extremities leads to a stable improvement of the functional parameters of microcirculation.

KEY WORDS: chronic venous insufficiency of lower extremities, hemomicrocirculation.

P. 75-80

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