Léčba projevů chronické žilní nedostatečnost v období epidemie COVID-19

Title in English Treatment of manifestations of chronic venous insufficiency during the COVID-19 epidemic
Authors

VEVERKOVÁ Lenka DOLEŽAL Petr REŠKA Michal VLČEK Petr HABR Jakub

Year of publication 2023
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Citation
Description Chronic venous insufficiency is an advanced chronic venous disease that leads to venous hypertension as a result of leading to specific changes in the skin or subcutaneous tissue of the lower extremities. The CEAP classification allows for a standardized classification of chronic venous disease. The basic diagnostic is colour duplex ultrasonography, which allows functional and morphological conclusions regarding specific venous changes and possible differential diagnoses. The therapy of chronic venous insufficiency focuses on to reduce or eliminate the underlying venous hypertension, namely both by conservative means and invasive methods, or surgery. Methodology We retrospectively analyzed data in a hospital-based system for the period 2013-2022. operated patients with a principal diagnosis of I83 (primary lower limb varicosity). We assessed the numbers in each year, age and sex of patients and their comorbidities. Results We found that of the 1722 patients operated on, more than two thirds were women. In our cohort, the proportion of women is 72.5% and 27.5% are men. The increasing trend of the average age of the patients operated on. The value of the average age in 2013 was 52 and in 2021 it was 59, last year the decrease was 56 years. In the cohort we analysed we also found a high incidence of cardiovascular disease, in almost half of the patients, 855 patients. had at least one cardiovascular disease disease, which is 49.65%. Discussion This finding correlates with the latest available studies. The association of pathophysiological mechanisms and a number of common risk factors for disease CVI and cardiovascular disease A common common denominator appears to be ongoing inflammation in which damage to the arterial or venous wall by monocytes/ macrophages and their products, mainly metalloproteinases. Both diseases are characterised by impaired function of the endothelium of the blood vessel The optimal treatment of chronic venous insufficiency is determined by precise identification and treatment of the source of venous reflux, which leading to the elimination of symptoms, prevention of recurrences and complications, as well as cosmetic improvement. In addition to appropriate surgical techniques for the treatment of lower limb varicosity, especially clinical stages C2, C5, C6, can be used conservative therapy, which has also been shown to provide good results. It is necessary to choose an effective combination of compressive therapy with effective veno-pharmaceuticals. This is very has worked very well in the last two years when the epidemic COVID-19. During the first wave of the pandemic, health services were less disrupted than in the EU in general, with only 16% Czechs reported that they had lost health care.7 The reality is appears otherwise. The COVID-19 epidemic led to the postponement of elective operations, fewer visits to emergency departments and less use of outpatient services, which affecting patients with acute but especially chronic disease. Chronic venous disease, as well as cardiovascular diseases represent a large and growing epidemiological burden due to the high prevalence and increase in relation to age and lifestyle, affecting the quality of the lives of the people concerned and represent a highly costly socio- economic problem for public health.

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