В конце 2017 года в Тюмени открылась крупнейшая в России специализированная клиника по лечению варикоза и отеков ног — «Центр Флебологии». На вопросы о профилактике и современных методах лечения варикозной болезни, преимуществах лечения в специализированной клинике порталу Недугамнет.ру ответил главный врач клиники «Центр Флебологии» в Тюмени, кандидат медицинских наук, хирург-флеболог Олег Алексеевич Виноградов.
— Олег Алексеевич, ваш центр специализируется на лечении сосудистых заболеваний, в частности на лечении варикоза вен. Насколько это распространенное заболевание?
— По оценкам специалистов, всего в нашей стране примерно 38 млн человек поражены варикозом, причем у каждого четвертого — осложненная форма заболевания. По статистике, сегодня с варикозом сталкиваются треть женщин и более 10 % мужчин, причем болезнь заметно молодеет. Все чаще она проявляется не у сорокалетних, а у двадцатипяти — тридцатилетних людей.
— При каких симптомах следует задуматься о том, что пора обратиться к флебологу?
— Прежде всего, поводом обращения к флебологу являются внешние проявления варикоза: появление расширенных вен на ногах, сосудистых звездочек. Кроме того, хотя бы раз посетить флеболога рекомендуется женщинам во время беременности.
— Кто еще находится в группе риска развития варикозной болезни?
— Консультация флеболога необходима, если к концу дня отекают ноги, беспокоят боли, чувство тяжести, судороги в ногах в вечерние и ночные часы. Также показаться врачу стоит тем, у кого работа связана с постоянными статическими нагрузками. Ну и, конечно же, важно посещать флеболога, когда у кого-то из родственников есть варикозная болезнь. Наследственность имеет наибольшее значение для оценки вероятности развития варикоза.
— Многие женщины считают, что сосудистые звездочки — это не варикозная болезнь, а всего лишь косметический дефект, поэтому не всегда торопятся с лечением. Как быстро развивается варикоз от «несерьезной» звездочки или чуть-чуть распухшей вены до неприятных «гроздей» на ногах?
Сосудистые сеточки — проявление варикоза, так называемого ретикулярного типа, поэтому их не стоит недооценивать. В 90% случаев эти проявления являются первыми симптомами варикозной болезни и первым сигналом обратиться к флебологу. Скорость прогрессирования варикозной болезни крайне индивидуальна и во многом зависит от провоцирующих факторов: наследственность, женский пол, беременность и роды, работа, связанная с подъемом тяжестей, длительная работа на ногах, прием гормональных средств.
Действительно, бытует мнение, что варикоз — несерьезное заболевание, эстетический недостаток, который можно не лечить. Но оно ошибочное, и может привести к очень серьезным последствиям.
Само по себе наличие расширенных вен уже является показанием к лечению, даже если они не беспокоят. В таких венах клапаны не работают, кровь застаивается, и вена теряет свою функцию. Чем дольше «выращиваются» вены, тем больший объем лечения понадобится, кроме того при наличии расширенных вен есть риск тромбозов и трофических язв. Намного проще и безопасней решить проблему на начальной стадии, чем доводить до операции.
— Олег Алексеевич, как давно существует «Центр Флебологии»? Почему было принято решение об открытии именно специализированного медицинского центра?
— «Центр Флебологии» имеет целую историю. Наш коллектив начал формироваться с 1993 года в Москве. Дело в том, что в начале 1990-х годов этим направлением просто никто не занимался; людям, страдающим от варикозной болезни, негде было получить квалифицированную медицинскую помощь. Наши специалисты одни из первых в России успешно применили безоперационные методы лечения во флебологии.
Все это время клиника активно развивалась. Сегодня в состав клиники входят три отделения в Москве, два в Санкт-Петербурге, филиалы в Екатеринбурге, Нижнем Новгороде, Калининграде и Тюмени. За долгие годы работы мы накопили большой практический опыт в лечении пациентов с варикозной болезнью и ее осложнениями.
— От чего зависит успешный результат лечения варикозной болезни?
— В медицине часто бывает так, что правильный диагноз поставить гораздо сложнее, чем провести эффективное лечение. Ошибка, допущенная на этапе диагностики, может направить лечение по неправильному пути и не только не добиться положительного результата, но и вызвать осложнения. В нашей клинике особое внимание уделяется диагностике. Пациентам проводится дуплексное ангиосканирование вен врачами УЗИ, специализирующимися на венозной патологии.
Дело в том, что внешние проявления варикоза могут быть неявными, при том, что болезнь уже прогрессирует. Поэтому необходимо изучить состояние и поверхностных, и глубоких вен, оценить, насколько эффективно они работают, установить, есть ли варикоз и насколько далеко зашло заболевание.
Также важная особенность клиники «Центра Флебологии» – совместная работа флеболога и врача УЗИ на первичном приеме.
Это позволяет с высокой точностью поставить диагноз и подобрать оптимальный метод лечения и очень удобно для пациента — не нужно отдельно записываться на прием и на УЗИ.
— Олег Алексеевич, расскажите подробнее о методах лечения, которые применяются в «Центре Флебологии».
— В нашем арсенале есть все современные методы лечения варикоза в соответствии со стандартами Всемирной ассоциации флебологов (UIP). У каждого метода есть свои показания и ограничения по применению. И только опытный и квалифицированный флеболог может правильно подобрать индивидуально метод лечения или их комбинацию.
На начальной стадии варикоза, на венах не очень большого диаметра, врачи проводят лечение пенной склеротерапией. Это достаточно эффективная медицинская процедура, которая проводится амбулаторно и занимает 5-10 минут, после чего человек может спокойно идти по своим делам. Эффект от склеротерапии — исчезающие вены или капилляры, вы сможете увидеть практически сразу.
На более крупных сосудах проводится лечение с помощью лазерных и радиочастотных технологий. При использовании этого метода поврежденная вена не склеивается, а заваривается изнутри. В случае, когда не обойтись без операции, применяется малоинвазивная хирургия.
Хотелось бы отметить, что в лечении в большей степени мы придерживаемся традиций, дорожим своим накопленным опытом, «не гоняемся за медицинской модой». Главное не новые методы, а клиника, которая может оказать качественную медицинскую помощь каждому пациенту. При этом могут сочетаться безопасные проверенные годами методы лечения с новаторским подходом.
— Варикоз может появиться вновь после проведенного лечения?
— Если говорить отдельно о каждом методе лечения — склеротерапии, эндовазальной коагуляции, оперативном лечении, то повышение вероятности возникновения рецидивов связано в основном с применением этих методов лечения «у всех подряд», поскольку на сегодняшний день не существует четких показаний, при каком диаметре вены можно применять тот или иной метод лечения. Чаще всего рецидив варикозной болезни может произойти вследствие неадекватного выбора метода лечения или вследствие технических ошибок при операции, а также из-за наличия анатомических особенностей.
— С 90-х годов шагнула далеко вперед и государственная медицина. По полису ОМС проводятся малотравматичные операции, есть современное оборудование, хорошие специалисты, тем не менее, зачастую пациенты с варикозом обращаются именно в вашу клинику. Почему?
— В случае с варикозом искать нужно не хорошего врача, а хорошую клинику. Флеболог- одиночка — это нонсенс. Один врач просто физически не в состоянии провести эффективное лечение самостоятельно.
Лечение варикоза лучше проводить в специализированной флебологической клинике, где есть и хорошие хирурги, и опытные диагносты, и современная техническая база. Главное, не новые методы, а клиника, которая может оказать качественную медицинскую помощь каждому пациенту.
— Посоветуйте самые эффективные способы профилактики варикозной болезни.
— Основной профилактикой варикоза является ношение компрессионного трикотажа. Можно сказать, что компрессионная терапия — это то, что 100 % помогает пациенту в качестве профилактики, особенно при синдроме тяжелых ног.Подбор необходимого изделия для каждого пациента должен делать специалист — лечащий врач или опытный консультант в специализированном салоне.
Но важно понимать, что трикотаж не способен убрать или вылечить варикоз. Если вена уже расширилась, то в нормальное состояние она никогда не вернется, трикотаж лишь улучшает отток крови, механически сдавливая вены. Однако это действительно самое эффективное средство, чтобы замедлить развитие варикозной болезни.
Также с профилактической целью надо больше двигаться, можно заниматься спортом, но без тяжелых физических нагрузок. Лучше, если это будет плавание, велосипед, аквааэробика, ходьба.
— Помимо варикозной болезни, с какими еще проблемами к вам обращаются пациенты?
— Мы также занимаемся лечением лимфатических отеков – лимфедемы. Эта проблема оказалась очень актуальной, причем и с медицинской, и с социальной точки зрения. Как показывает российский и зарубежный опыт, около 10 % населения страдает отечным синдромом с лимфатическим компонентом. Эти люди часто выпадают из социума, и физически это заболевание приводит к страданиям.
«Центр Флебологии» — это первая клиника, которая начала развивать направление оказания медицинской помощи пациентам с лимфатическими отеками верхних и нижних конечностей. В России до сих пор не существует общепринятых стандартов лечения этого заболевания. Ни в государственной медицине, ни в коммерческих клиниках никто не занимался этой проблемой. Поэтому мы стали изучать зарубежный опыт, в частности немецкой специализированной клиники по лимфологии доктора Шингале. Уже более 15 лет в «Центре Флебологии» успешно работает отделение лимфологии и ХВН.
Пациентам с лимфедемой проводится комплексная противоотечная терапия (Compleх Decongestive Therapy, CDT) в соответствии с европейскими стандартами лечения.
— Олег Алексеевич, какие рекомендации вы бы дали нашим читателям, чтобы они оставались здоровыми? Что в понимании врача-флеболога здоровый образ жизни?
— Больше двигайтесь. Лучшей защитой от варикозной болезни являются регулярные динамические нагрузки на мышцы ног. Большую поддержку венам приносит ходьба, бег, плаванье, езда на велосипеде. Словом, чем больше работают ваши ноги, тем меньше шансов, что возникнут проблемы с венами.
На работе старайтесь периодически вставать из-за стола и немного ходить. Не сидите за столом нога на ногу. В общем, постарайтесь свести к минимуму неподвижность, разбавляйте ваш рабочий день движением. Можно лишний раз подняться вверх по лестнице — это тоже очень полезно для вен. Дома отдыхайте с подушкой или валиком под вытянутыми ногами — по 15–20 минут несколько раз в день. Старайтесь поднимать ноги как можно чаще, когда читаете книги или смотрите телевизор. Не злоупотребляйте горячими ваннами и не увлекайтесь банями и саунами. Очень полезно принимать контрастный душ для ног, особенно летом.
Носите компрессионный трикотаж (гольфы, чулки, колготки). Использование лечебного трикотажа, который подбирается врачом по индивидуальным меркам, является одним из наиболее эффективных способов защиты от варикоза. Также трикотаж следует носить во время занятий спортом.
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заболеваний вен
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Лицензия № ЛО-72- 01–02608 от 26.10.17 г.
Про «Центр флебологии на Одесской улице»
В наше время важно следить за своим здоровье и сразу обращаться к врачу при первых признаках недомогания. Центр флебологии на Одесской улице предлагает своим пациентам качественную и быструю медицинскую помощь по доступным ценам.
Специалисты медицинского центра имеют богатый опыт работы, постоянно совершенствуют свои знания и делятся навыками с иностранными коллегами. Они проведут необходимый осмотр, назначат диагностику и после всех исследований подберут индивидуальный план лечения.
Клиника специализируется на лечении заболеваний вен верхних и нижних конечностей, отеков. Пациенты могут пройти УЗИ на современном аппарате, который поможет выявить все дефекты на ранней стадии.
В медицинском центре используют инновационную методику лечения варикоза с помощью лазерной коагуляции. Также здесь предложат радиочастотную абляцию вен, противоотечную терапию и многое другое. Все манипуляции проводятся в соответствии с медицинскими нормами и под контролем лечащего врача.
Записаться на консультацию, ознакомиться с полным перечнем услуг и ценами можно по телефону. Администратор клиники ответит на все интересующие вас вопросы.
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