Syndrome of lymphovenous insufficiency in diseases of the lower limb veins. View from the position of a lymphologist

Abstract

Purpose of the study: to assess the state of the lymphatic bed and develop methods of lymphatic influence to improve the results of treatment of diseases of the veins of the lower extremities.Material and methods. 692 patients with diseases of the veins of the lower extremities were examined, in whom special methods for studying phlebo- and lymphodynamics, microcirculation and regional immunity were carried out. Of these, 153 patients with acute superficial thrombosis; 154 - with deep vein thrombosis; 385 - with chronic venous insufficiency. The main group - 405 patients, using lymphological methods of treatment, the control group - 287 patients, using traditional treatment, according to clinical recommendations.Results. Radionuclide lymphoscintigraphy revealed that with thrombosis of the veins of the lower extremities at the onset of the disease, the rate of lymph flow increased by 1.2 times (p < 0.005), and the intensity of radionuclide absorption increased by 9.3% (p < 0.05) relative to healthy people. From 12-15 days of the disease, the rate of lymph flow decreased by 1.4 times (p < 0.05), and the intensity of radiopharmaceutical excretion decreased by 25% (p < 0.005). Chronic venous insufficiency is accompanied by impaired lymph flow of varying severity. The disorders increased as the degree of venous insufficiency increased. Against the background of the use of lymphological approaches in patients with lymphovenous insufficiency syndrome, at the level of statistically significant differences, the rate of lymph flow increased, microcirculation and regional immunity were restored, which contributed to a significant improvement in both immediate and long-term results of treatment. In patients with trophic ulcers, there was an acceleration in the timing of clearance, granulation and epithelialization compared with conventional treatment (p < 0.05).Conclusion. Diseases of the veins of the lower extremities, accompanied by phlebohypertension, already at the earliest stages of the disease lead to significant changes in the lymphatic system, with characteristic manifestations. The use of methods of conservative and surgical lymphogenous correction improves the results of treatment of the pathology in question.