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Chronic venous insufficiency

最后审阅: 21 Sep 2025
最后更新: 23 Jul 2025

小结

定义

病史和体格检查

关键诊断因素

  • corona phlebectatica (malleolar flare or ankle flare)
  • ankle swelling
  • hyperpigmentation (brawny edema)
  • lipodermatosclerosis
  • atrophie blanche
  • leg ulcers
完整详情

其他诊断因素

  • leg fatigue, aching, and/or discomfort
  • heavy legs
  • leg cramps
  • telangiectasias
  • reticular veins
  • dilated tortuous veins
  • dry and scaly skin
  • skin burning and itching
  • unilateral leg swelling
完整详情

危险因素

  • increasing age
  • family history
  • smoking
  • deep vein thrombosis
  • orthostatic occupation
  • female sex
  • obesity (waist circumference)
  • ligamentous laxity
完整详情

诊断性检查

首要检查

  • duplex ultrasound
完整详情

需考虑的检查

  • ascending phlebography
  • CT venography
  • magnetic resonance venography
  • CT abdomen and pelvis
  • abdomen and pelvis ultrasound
  • intravascular ultrasound
  • air plethysmography
完整详情

治疗流程

持续性治疗

all symptomatic patients

撰稿人

作者

Joseph L. Mills Sr, MD

Professor and Chief

Division of Vascular Surgery and Endovascular Therapy

Michael E. DeBakey Department of Surgery

Baylor College of Medicine

Houston

TX

利益声明

JLM declares that he has no competing interests.

David G. Armstrong, DPM, MD, PhD

Professor of Surgery

Director of Southwestern Academic Limb Salvage Alliance (SALSA)

Keck School of Medicine of University of Southern California (USC)

Los Angeles

CA

利益声明

DGA declares that his work is partially supported by grants from the National Institutes of Health and the National Institute of Diabetes and Digestive and Kidney Diseases.

同行评议者

Anahita Dua, MD, MS, MBA, FACS

Assistant Professor of Surgery

Massachusetts General Hospital/Harvard Medical School

Boston

MA

Declarações

AD declares that she has no competing interests.

Paul Tisi, MBBS, MS, FRCSEd

Medical Director/Consultant Vascular Surgeon

Bedford Hospital

Bedford

UK

Declarações

PT declares that he has no competing interests.

Créditos aos pareceristas

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Referências

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Principais artigos

Lurie F, Passman M, Meisner M, et al. The 2020 update of the CEAP classification system and reporting standards. J Vasc Surg Venous Lymphat Disord. 2020 May;8(3):342-52. Resumo

De Maeseneer MG, Kakkos SK, Aherne T, et al. Editor's choice - European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. Eur J Vasc Endovasc Surg. 2022 Feb;63(2):184-267.Texto completo  Resumo

Bergan JJ, Schmid-Schönbein GW, Smith PD, et al. Chronic venous disease. N Engl J Med. 2006 Aug 3;355(5):488-98. Resumo

American Vein and Lymphatic Society (American College of Phlebology). Treatment of superficial venous disease of the lower leg. Feb 2016 [internet publication].Texto completo

Artigos de referência

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