[Clinical assessment of phlebopathy severity by specification of leg heaviness symptom].
The paper presents the first attempt to differentiate phlebopathy severity on the basis of subjective information, which serves a key parameter of decompensation assessment reflecting individual range of daily living activity and functional load. Phlebopathy is defined as structural and functional insufficiency of venous wall, decreased ability to maintain stable volume both of particular veins and leg venous system as a whole during prolonged orthostasis. From 1995 to 2001 different forms of leg varices were diagnosed and treated in 583 patients. The most common complaint expressed by 567 patients (97.0%) was the heaviness and bursting pain in legs caused by daily orthostasis. Four clinical groups were clearly defined: 0 grade - no heaviness in legs; 1 grade - episodes of heaviness after excess daily load; 2 grade - regular heaviness in legs not demanding obligate evening rest with updrawn legs; 3 grade - permanent heaviness in legs demanding rest with legs updrawn. Permanent symptom (the last 2 groups) can be subdivided according to timing of symptom onset: a) in the afternoon, b) in the forenoon. The data analysis demonstrated that the symptom of leg heaviness during orthostasis caused by increased creep of venous walls was be a subjective equivalent to phlebopathy severity. The time of symptom onset and degree of manifestation correlated with the severity of venous wall incompetence. This method can be used to evaluate functional status of leg venous circulation both during initial assessment and for treatment or rehabilitation monitoring.
Tsukanov
Iu T
IuT
Department of Surgical Diseases Omsk Medical Academy, Phlebological Ambulatory Center, Russia. yutsoukanov@mail.ru
Tsukanov
A Iu
AIu
D005260:Female; D006801:Humans; D007024:Hypotension, Orthostatic / Q000150:complications; D007866:Leg / Q000098:blood supply*; D008297:Male; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis; D014689:Venous Insufficiency / Q000150:complications / Q000175:diagnosis*