Многие слышали о варикозном расширении вен, но мало кто знает, что существует еще такой недуг, как ретикулярный варикоз. Это заболевание представляет собой венозную сетку, которая хорошо видна на коже нижних конечностей (сосудистые звездочки). Это еще не плотные синие вены, висящие гроздьями, но все же не очень приятное проявление варикозной болезни ног.
К сожалению, около 95% женщин подвержены данному заболеванию. О нем сейчас и поговорим. 
Почему болят вены под коленом сзади и как лечить варикоз под коленом.
Почему появляется заболевание: причины
Поскольку страдает чаще слабый пол, то и причины ретикулярного варикоза нижних конечностей связаны с особенностями женского организма:
- гормональные изменения;
- длительный прием гормональных контрацептивов;
- генетическая предрасположенность;
- ношение высоких каблуков и узкой одежды;
- длительное пребывание в неудобной обуви, малоподвижность;
- лишний вес.
Интересно, что существует также ретикулярный варикоз верхних конечностей.
Гормональные изменения могут быть и физиологическими (беременность, климакс), и патологическими – сбой в эндокринной системе. Принимать гормональные противозачаточные препараты не стоит курящим женщинам, они более подвержены развитию варикоза. 
Причины тромбофлебита нижних конечностей
Если у ваших родителей наблюдаются проявления варикозного расширения вен, будьте осторожны, ведь это заболевание передается по наследственности. Обратите внимание на профилактические методы. Нужно уделять внимание своему режиму работы и отдыха, питанию, физической нагрузке и гардеробу. На фото вы можете наблюдать, как выглядит ретикулярный варикоз нижних конечностей.
Механизм развития ретикулярного варикоза такой же, как и варикоза больших вен. Вся проблема — в слабости венозной стенки и повышенном давлении внутри сосуда.
Повышенное давление провоцирует расширение и удлинение вен, в дальнейшем они скручиваются и извиваются, выступают на поверхности кожи. При незначительных травмах они могут кровоточить.
Учителя, хирурги, стюардессы и другие профессии, которые связаны с длительным пребыванием в вертикальном положении, обладают большей вероятностью обзавестись таким неприятным недугом.
Как его лечить?
Как же бороться с этой коварной болезнью? В целом, это больше эстетическая проблема, она не несет угрозы для жизни. Но поскольку это тоже проявление варикоза – его нужно лечить. 
Лечебная гимнастика при варикозе на ногах
Лечение ретикулярного варикоза заключается в ношении сдавливающего белья 1, 2 и 3 степени компрессии, здорового образа жизни и лечебных манипуляций.
Микросклеротерапия
Наилучшим способом является микросклеротерапия. Она проводится исключительно при поражении мелких сосудов. Суть склеротерапии заключается во введении специального препарата, который вызывает воспаление венозной стенки с дальнейшим ее спаданием. Используются иглы небольшого диаметра, соответственно размеру сосуда. В скором времени пациент отмечает полное отсутствие расширенных венозных сеточек. При незначительном поражении достаточно одной процедуры, возможно проведение нескольких сеансов.
После манипуляции пациент отправляется домой и ведет привычный режим жизни, но с ношением компрессионного белья. Его, кстати, тоже нужно подбирать по консультации врача. 
Пенная склеротерапия варикозных вен и микросклеротерапия сосудистых звездочек
Еще одним популярным и безболезненным методом является лазерная коагуляция. Ее можно совмещать со склеротерапией для достижения наилучшего и стойкого эффекта. Операции проводят на венах большего диаметра.
Микрофлебэктомия
Это малоинвазивное оперативное вмешательство, в процессе которого через прокол на коже вводят крючок в сосуд. С его помощью вену вытягивают, перевязывают и пересекают. Значительный эффект наблюдается уже через пару недель после процедуры.
Используют также внутривенную лазерную и радиочастотную абляции. Принцип действия один и тот же, но воздействуют разными механизмами (лазер и высокочастотное напряжение). На внутреннюю стенку вены воздействуют определенным аппаратом, происходит ее сжигание. В течение года вена сама «растворяется». 
Флебэктомия — удаление варикозных вен хирургическим методом
Народная медицина вам в помощь
Перед проведением какого-либо самостоятельного лечения, лучше проконсультироваться с флебологом. Он поможет подобрать рациональное и эффективное лечение ретикулярного варикоза нижних конечностей, в том числе и народными средствами.
При незначительном проявлении сосудистых звездочек можно применять мёд. В течение некоторого времени систематически по 2-3 раза в день втирайте мед в пораженные участки, и скоро вы увидите, как улучшилось состояние вашей кожи.
Значительно улучшают тонус сосудов травяные чаи (из шишек хмеля, крапивы). Длительность приема лучше уточнить у доктора.
Рекомендуют проводить растирания яблочным уксусом, но при отсутствии заболеваний кожи и ран.
При наличии свежих листьев лопуха можно их использовать в качестве компресса: привязывайте листок к ноге на пораженные участки на всю ночь. Процедуру можно повторять 10-14 дней. В зимний период можно сделать настойку из лопуха и растирать ножки.
Медикаментозная терапия
Для лечения недуга назначают препараты для улучшения тонуса сосудов, снятия застойных явлений и болевых ощущений, профилактики осложнений. Используют: Детралекс, Флебодиа, Антистакс, Троксевазин, Венорутон. Но в основном все препараты запрещены беременным женщинам и кормящим грудью. Поэтому пациентам такой категории стоит побеспокоиться о профилактике.
Чем чревато отсутствие лечения ретикулярного варикоза?
Мы уже упоминали, что это заболевание протекает безболезненно и благоприятно, но при несвоевременном лечении может перерасти в хроническую венозную недостаточность и спровоцировать определенные осложнения:
Начальная стадия варикозной болезни
- внутрикожные кровоизлияния;
- гематомы;
- судороги;
- отеки нижних конечностей;
- кровотечение из пораженных вен.
Как избежать недуга – варианты профилактики
В первую очередь люди из группы риска должны придерживаться профилактических процедур. Откажитесь от вредных привычек: курение, алкоголь и жирная пища – первоочередные ваши враги. Займитесь спортом, даже незначительная, но регулярная нагрузка сделает вас здоровее и красивее. Заведите привычку принимать ежедневно контрастный душ. Это поможет поддерживать сосуды в тонусе. Обладателям пышных форм лучше все-таки от них избавиться. Лишний вес еще никому не принес пользу. Поэтому вовремя скорректированное питание и режим активности продлит вашу жизнь и приумножит здоровье.
Ретикулярный варикоз нижних конечностей – что это такое? Этим вопросом часто задаются женщины, ведь в 95% случаев патология регистрируется именно у них. Это такой тип варикоза на ногах, при котором поражаются тонкие подкожные вены диаметром до 3 мм.
Несмотря на то что в большинстве случаев пациентки обращаются за помощью из-за косметического дефекта, ретикулярный варикоз может доставлять сильные неприятности.
Что такое ретикулярный варикоз и в чем его причины
Причины ретикулярного варикоза, как и обычного, до сих пор не установлены, но ученые акцентируют внимание на наследственной склонности. Из-за генетических особенностей организма формируется недостаточно эластичная сосудистая стенка. Негативные факторы несут дополнительную нагрузку на слабые вены нижних конечностей. Отток крови ухудшается, статическое давление на стенку сосудов возрастает, она растягивается. В расширенной вене скапливается еще больше крови и патологическое кольцо замыкается. Появляются внешние симптомы заболевания.
К основным факторам, способствующим развитию ретикулярного варикоза конечностей, относятся:
- статическая работа в вынужденном положении – сидя или стоя;
- ношение обуви на высоком каблуке;
- тяжелый физический труд;
- гормональные заболевания;
- беременность;
- бесконтрольный прием гормональных препаратов;
- резкое увеличение массы тела;
- занятия тяжелыми видами спорта;
- частая травматизация ног.
Симптомы
Как уже упоминалось, ретикулярный варикоз у большинства пациентов в конечностях доставляет только косметический дискомфорт. Но это заболевание не такое безобидное, как кажется на первый взгляд, и отсутствие лечения может привести к серьезным осложнениям. Внешне варикоз имеет вид «сетки» синего цвета, расположенных в основном на боковых поверхностях бедер и на икрах. При пальпации нижних конечностей изменений не выявляется, но иногда можно прощупать уплотнение мягких тканей в зоне поражения.
При выраженных формах больные предоставляют следующие жалобы:
- зуд кожи в месте поражения;
- боль в расширенных сосудах и мышцах ног;
- отеки;
- ощущение тяжести в нижних частях тела;
- быстрая утомляемость;
- ночные судороги;
- появление внутрикожных кровоизлияний и формирование синяков;
- в тяжелых случаях – трофические изменения кожи и наружные кровотечения из варикозно измененных вен.
Из-за внешнего вида измененных вен нижних конечностей их еще называют телеангиэктазиями, что в корне неверно. Телеангиэктазии – изменение вен диаметром до 1 мм. Именно диаметр пораженных вен является ключевым показателем для этих двух определений.
Диагностика
Основной метод диагностики ретикулярного варикоза – осмотр пациента. Но для исключения поражения более крупных сосудов нижних конечностей пациенту предстоит пройти определенный диагностический алгоритм, который проводится поэтапно.
- Опрос пациента. На этом этапе собираются жалобы больного с обязательной их детализацией. Врач подробно расспросит об условиях появления и усиления жалоб, их характере, под влиянием каких факторов они исчезают. Также детально изучается история жизни – тип деятельности, условия работы, режим дня, спортивные увлечения, прием лекарственных средств и наличие сопутствующих заболеваний. Женщин расспрашивают о беременностях и их исходах.
- Осмотр пациента позволяет определить наличие пораженных вен нижних конечностей, их локализацию, размер и количество «сеток», состояние кожи конечностей и подкожной клетчатки в зоне
поражения. Попутно проводится общий осмотр, в ходе которого можно заметить варикозно расширенные вены ног, трофические изменения кожи и ее придатков, а также заподозрить другие сопутствующие заболевания. - Ультразвуковая диагностика позволяет оценить состояние вен нижних конечностей, работу венозных клапанов, наличие тромбов, проходимость сосудов. Метод помогает в ранней диагностике варикоза, планировании и оценке эффективности лечения.
Этих диагностических мер вполне достаточно, чтобы определиться с выраженностью патологического процесса ретикулярного заболевания. По индивидуальным показаниям могут проводиться дополнительные исследования – КТ, МРТ, и другие.
Способы лечения
Лечение ретикулярного варикоза нижних конечностей проводится консервативно и оперативно. Консервативное лечение направлено на повышение эластичности сосудистой стенки и улучшение кровотока.
Условно их можно разделить на следующие группы:
Общеукрепляющие меры – самый простой и доступный метод профилактики и лечения ретикулярного варикоза. Он не требует больших финансовых затрат, а результат не заставит себя ждать.
Единственное, что нужно от пациента – выполнять нехитрые предписания:
- обратить внимание на обувь – высокий каблук сменить более низким, узкие туфли – обувью более свободного фасона;
- если ваша работа требует длительного пребывания в вынужденном положении, не забывайте о перерывах. Делайте их каждый час;
- отдыхайте с приподнятыми нижними конечностями;
- ополаскивайте ноги холодной водой, принимайте контрастный душ;
- регулярно выполняйте лечебные упражнения.
Подобные мероприятия очень уместны на раннем этапе, когда они способны замедлить прогрессирование в нижних конечностях ретикулярной болезни. Но и на более поздней стадии они актуальны.
Когда у пациентов появляются жалобы, есть смысл начать прием медикаментозных препаратов. Фармацевтический рынок предлагает большое количество лекарств, повышающих тонус вен. Они хорошо справляются со своей задачей, поэтому широко назначаются врачами всех уровней. К наиболее распространенным из них относятся:
- Детралекс (подробно о нем говорится на этой странице);
- Флебодиа (больше об это лекарстве в этой статье);
- Нормовен;
- Антистакс;
- Венорутон.
Дозировка, схема и длительность приема определяются индивидуально, под контролем эффективности.
Если лечение не приносит ожидаемого результата или же имеет место выраженный косметический дефект, прибегают к оперативному лечению.
Это может быть:
- лазеротерапия;
- склеротерапия;
- микрофлебэктомия.
При проведении лазеротерапии в пораженную вену нижней конечности вводится проводник. Под контролем УЗД на стенку сосуда воздействуют импульсами с заданной мощностью и частотой. В результате стенки вены спаиваются между собой, кровоток в них прекращается. Внешне это проявляется исчезновением сосудистой «сетки». Подробно об лазеротерапии говорится вот тут.
Склеротерапия заключается в введении в сосуд специальных препаратов – склерозантов. Подобно лазеру, они склеивают стенки сосудов, препятствуя кровообращению в пораженных венах. О всм процессе, подготовке и особенностях склеротерапии говорится в этой статье.
Микрофлебэктомия – операция, суть которой – в механическом удалении измененной вены. Доступ к сосуду обеспечивается через минимальные разрезы, а само вмешательство выполняется при помощи специального инструментария, что обеспечивает минимальную травматичность и дает возможность пациенту восстановиться в минимально-короткие сроки. Ходе операции и послеоперационный период подробно описан на этой странице.
Отдельного внимания требует ношение на нижних конечностях компрессионного трикотажа. При ретикулярном варикозе показан трикотаж первого или второго класса компрессии. В зависимости от распространенности процесса выбирается тип изделия – носки, гольфы, чулки или колготки. Они увеличивают пропульсивную способность мышечно-сосудистого насоса, тем самым улучшая кровоток и уменьшая нагрузку на сосуды. Трикотажные изделия показаны практически всем пациентам с ретикулярным варикозом, а также тем, у кого отсутствуют симптомы болезни, но имеет место отягощенный семейный анамнез или воздействуют факторы риска.
Лечение ретикулярного варикоза народными средствами
Многих пациентов, имеющих ретикулярный варикоз нижних конечностей, лечение народными средствами интересует не меньше, чем традиционные методы. Это объясняется тем, что народные средства в первую очередь доступны, просты в применении, не токсичны, а по эффективности не уступают дорогостоящим препаратам.
Конский каштан
Залейте цветы конского каштана спиртом в соотношении 1:10. Настаивайте в сухом прохладном месте в течении двух недель, ежедневно перемешивая настойку. По истечении указанного времени лекарство процедите, принимайте по столовой ложке трижды в день, до еды. После недели приема необходимо сделать 14 дней перерыва.
Конский каштан применяется не только в народной медицине, а и в современной фармакологии. Большинство лекарственных препаратов, применяемых для лечения варикоза, содержат его в своем составе. Много народных рецептов и описание лекарств на его основе находится в этой статье.
Мускатный орех
Для получения эффективного народного средства от ретикулярного варикоза конечностей измельчите несколько орехов. Чайную ложку порошка смешайте с таким же количеством меда. Добавьте стакан кипятка. Через полчаса настой можно выпить. Процедуру необходимо проводить за час до завтрака. Первые результаты будут видны через месяц, но курс лечения должен длиться в течении года.
Хмель
Для приготовления отвара для варикозных нижних конечностей измельчите шишки хмеля, залейте стаканом кипятка и подержите на паровой бане 15 минут. Принимать отвар по стакану, трижды в день.
Каланхоэ
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Ретикулярный варикоз может служить первым сигналом о более серьезной патологии. Поэтому не игнорируйте его проявления, даже если они совсем вас не беспокоят. Обязательно обратитесь к специалисту, ведь вовремя начатое лечение только улучшит ваш прогноз.
Ретикулярным (сетевидным) варикозом, называется видимое на глаз увеличение мелких внутрикожных и подкожных вен. Проблеме ретикулярного варикоза в современной флебологии уделяется немалое внимание.
Это "косметический" тип варикоза, который чаще наблюдается у женщин и проявляется расширением внутрикожных вен и появлением телеангиэктазов по боковой поверхности ноги и реже по внутренней ее части. Ретикулярный варикоз, ничего кроме как косметического дискомфорта, не доставляет. Не опасно, но не радует глаз.
Причины ретикулярного варикоза могут быть врожденными, иногда он проявляется после длительного приема гормональных препаратов, видимые варикозные ретикулярные венки могут появляться после избыточной физической нагрузки. Ретикулярный варикоз может быть так же признаком хронической венозной недостаточности и сопровождаться тяжестью в ногах, отеками, ночными судорогами.
Ретикулярный варикоз это видимые глазу подкожные вены. Они больше, чем капилляры на сосудистой сетки, но меньше варикозных вен. Вены где-то 1-3 мм в диаметре, типично плоские (не выступают над кожей) и менее скрученные или выпуклые, чем варикозные и часто играют роль «питающих вен» для сосудистых звездочек. Они обычно имеют синий или пурпурный цвет и чаще всего располагаются на ногах, хотя иногда встречаются и в других частях тела, даже на лице.
Чаще всего ретикулярные вены представляют собой косметическую проблему, а не проблему со здоровьем. Это связано с тем, что видимые вены малы или имеют средний размер, не создают медицинских симптомов у большинства пациентов или каких-либо осложнений. Однако если их наличие сопровождается болью или дискомфортом следует обратиться к специалистам.
Методы лечения в Инновационном сосудистом центре
В нашем центре лечение ретикулярного варикоза занимаются наиболее опытные эстетические флебологи. У нас большой опыт и сотни вылеченных женщин, которые имели косметические флебологические проблемы.
В нашей клинике мы используем наиболее современные методы удаления ретикулярных вен — трансиллюминационную склеротерапию и криосклеротерапию. Современные методики безболезненны, дают хороший косметический эффект и безопасны. С помощью микросклеротерапии под контролем можно добиться полного исчезновения венозной сетки на длительное время.
Что вызывает ретикулярный варикоз?
Увеличение вен происходит из-за давления, присутствующего в венах. Основные причины ретикулярных вен такие же, как у сосудистых звёздочек и варикозных вен: слабые или поврежденные небольшие венозные клапаны. Одноходовые клапаны в венах предотвращают обратный ток крови. Однако, когда эффективность этих клапанов и эластичность стенок вены нарушены, это приводит к обратному течению и объединению крови венах. Кровь возвращается в вены (рефлюкс) и заставляет крошечные вены на поверхности кожи расширяться и становиться видимыми.
Как правило, ретикулярные вены проявляются на ногах, потому что вены в нижних конечностях должны преодолевать гравитацию и выдерживать наибольшее давление, чтобы переместить кровь обратно в сердце.
Распространенной причиной ретикулярного варикоза является наследственный фактор. Если у вас есть ближайшие члены семьи, у которых есть сосудистая сетка или варикоз, то есть вероятность, что у вас тоже может развиться подобная проблема. Варикозная болезнь является наследственной.
Ретикулярный варикоз может развиваться на фоне более серьезных венозных поражений — варикозной или посттромботической болезни.
Женские гормоны, такие как эстроген и прогестерон, могут вызывать образование сеточек. Наиболее часто гормоны используются как оральные контрацептивы (противозачаточные таблетки), заместительная гормональная терапия и лекарства от бесплодия. Уровень прогестерона становится очень высоким во время беременности. Прогестерон расслабляет мышцы в стенках вен, что позволяет им растягиваться. По этой причине многие женщины отмечают большое количество новых видимых вен во время беременности.
Варианты ретикулярного варикоза
Чаще всего ретикулярные вены видны как маленькие синие вены под кожей. Они имеют небольшие одноходовые клапаны, и когда эти клапаны перестают работать эти вены начинают расширяться. Проблемные ретикулярные вены имеют плохой кровоток, скручиваются и деформируются из-за повышенного венозного давления, приводящего к образованию красных или пурпурных паутинных вен (сосудистых звездочек). Когда ретикулярные вены имеют диаметр не менее 3 мм и начинают выпирать над поверхностью кожи, то становятся варикозными.
Существует три типа видимых ретикулярных вен: линейные (образуют линии на поверхности кожи), звёздчатые (от более темного центра отходят лучи, похоже на паутину или сетку) и древовидные (вены имеют ветвящийся вид).
Симптомы
Обычно симптомы отсутствуют. Ретикулярные вены могут стать симптоматическими или могут кровоточить спонтанно по мере расширения.
Помимо их специфического внешнего вида, ретикулярные вены могут иметь физические симптомы, такие как:
- Дискомфорт в ногах,
- Зуд в пораженной области,
- Ощущение жжения вокруг вен
- Боль по ходу вен
- Ощущение пульсации
- Усталость в ногах
Профилактика и прогноз
Профилактические меры включают поддержание здорового веса, ограничение воздействия солнца на кожу, избегание длительных периодов стояния или сидения и подъем ног во время отдыха.
Ретикулярный варикоз успешно лечиться склеротерапией и имеет хороший прогноз на выздоровление, однако требуются неоднократные сеансы склеротерапии.
Опасных последствий для здоровья ретикулярный варикоз не имеет.
Основным методом диагностики ретикулярного варикоза является осмотр флеболога. При осмотре специалист оценит ситуацию с внутрикожными венами стоя и лежа. Обязательно проводится общий и сосудистый осмотр. Необходимо сказать доктору, если вы принимаете оральные контрацептивы, если были проблемы с печенью или онкологические заболевания.
После осмотра флеболога обязательно проводится ультразвуковая диагностика вен, которая позволяет исключить проблемы с магистральными подкожными и глубокими венами, так как ретикулярный варикоз нередко бывает симптомом настоящей варикозной болезни или посттромбофлебитического синдрома.
Термография внутрикожных вен осуществляется с помощью прибора VeinViewer. При этом можно выявить из какой области заполняются ретикулярные вены, с какими сосудистыми звездочками они связаны.
Подробнее о диагностике:
Лечение ретикулярного варикоза преследует исключительно косметическую цель, поэтому технологии должны отличаться щадящим характером и не влиять на трудоспособность пациента.
На сегодняшний день самым популярным методом устранения венозной сетки является криосклеротерапия под контролем веновизора. Смысл лечения заключается в введении жидкого или пенного склерозанта внутрь ретикулярной вены. Процесс введения контролируется специальным тепловизором. Для обезболивания и спазма внутрикожных сосудов используется обдув кожи в месте инъеции холодным воздухом из специального аппарата.
Кроме склеротерапии в арсенале наших флебологов имеется специальный гибкий радиочастотный зонд для коагуляции ретикулярных вен. Он представляет собой тончайший провод, который проводится в ретикулярные вены и разрушает их с помощью нагрева. Данный метод обладает лучшими косметическими показателями, чем традиционная склеротерапия, однако стоит несколько дороже.
Подробнее о методах лечения:
Клинический случай успешного лечения варикозной болезни с помощью лазера и минифлебэктомии в Воронеже
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