In the modern he althcare system, all diseases are grouped according to certain symptoms, severity of the course and other signs. Pathologies of the lower extremities are no exception. In our article, we will consider what classification of venous diseases exists.
Why encrypt the diagnosis?
Many ordinary people find it incomprehensible why introduce classification at all? Looking at their medical records, patients see solid codes there. Whether it was before, in black and white, doctors wrote down all the main and accompanying diagnoses of their patients, which could be easily read at any time. So, why did modern he althcare introduce coded labels for various pathologies?
- Encrypted names of diseases can only be read by a specialist, which is very important for keeping confidential information.
- With the advent of computer technology, most of the information for the convenience of their systematization, and in addition, analysis is entered into programs in the form of alphanumeric codes.
- Internationalunification, along with the standardization of disease codes, makes it possible to decipher the diagnosis, even if it was made in another country.
Classification of diseases can be international or adopted within the he althcare of a particular country.
Using an ICD-10 medical document
The main document used by doctors around the world is the so-called ICD-10, which is the latest revised and updated version of the classification system for various diseases. The number "10" suggests that the World He alth Organization has revised and refined the version ten times already.
According to this document, diseases of the veins are included in the ninth class under the title: "Pathologies of the circulatory system." This list contains the widest list of diagnoses with and without various complications that can be diagnosed when varicose veins appear. For example, varicose diseases of the lower extremities can be found under number 183:
- Code 183.9 refers to varicose veins that resolve without complications in the form of trophic ulcers or inflammation.
- Code 183.1 suggests varicose pathology of the legs with the development of an inflammatory process.
- Designation 183.2 indicates a varicose disease with the presence of necrotic trophic ulcers and inflammatory processes.
- Code 183.0 reports varicose disease, which is accompanied by trophic ulcers.
Sodiagnosis according to the ICD-10 classification greatly facilitates the determination of clarifying information about the disease of the veins of the lower extremities. As part of this, more serious complications are encrypted under other codes:
- Classification code 180.0 reports complications in the form of phlebitis, and, in addition, thrombophlebitis, which are localized in certain areas.
- Code 181 indicates the development of an embolism and thrombosis of blood vessels in a patient.
- 184.0 suggests the presence of various types of hemorrhoids with associated complications and thrombosis.
- Code 186.2 means varicose veins of the small pelvis and perineum.
Thrombophlebitis
What can be diseases of the veins in the legs? A significant part of varicose complications is represented by all kinds of deep vein lesions, especially thrombophlebitis. This stage is accompanied, as a rule, by inflammatory processes in the venous walls, as a result of which blockages are formed in the lumen of the vessels. Of course, this greatly impairs blood flow. In this regard, thrombophlebitis is a condition that threatens to break off a blood clot, which can lead to blockage of vital blood vessels.
To diagnose thrombophlebitis, a cipher is used, which makes it possible to clarify the nuances of ongoing processes, for example, the localization area, the presence of flotation and the severity of the flow. Thus, the classification of thrombophlebitis is carried out according to the following criteria:
- Type of pathological process, for example: acute (up to one month), subacute form(up to three months), chronic. Chronic thrombophlebitis is diagnosed after three months from the onset of the first symptoms of venous disease.
- The type of origin of the pathological process, for example, varicose veins began against the background of complications associated with pregnancy, childbirth, hormonal failure, allergies or an infection.
- Localization of chronic venous disease - a process that captures the superficial or deep veins of the legs and pelvis.
- The nature of the flow. According to this criterion, the course of the disease may be non-purulent or purulent.
All listed classification types are included in the ICD-10 document under numerical codes from 100 to 199. These values are included in the category under the general name "Pathologies of the circulatory system". On the basis of alphabetic and numeric encryption, other classifications of ailments have been created in the he althcare system.
Classification by forms
In addition to the international classification, there are also special ones that have been developed and used by physicians from different countries. For example, in Russia, its own clarifying classification of vein diseases was created directly according to their form. This method includes the following several stages in the development of pathologies associated with veins:
- Formation of segmental varicose veins without reflux.
- Development of segmental varicose vascular disease with pathological discharge of fluid, which occurs along the surface, and, in addition, communicantveins.
- The appearance of a pronounced varicose disease with pathological discharge of fluid that occurs through deep veins.
The presented classification makes it possible to clarify exactly how the pathology develops, in addition, a characteristic is given of diseases of the veins of the lower extremities and blood vessels, as well as pathological disorders of blood flow.
Degrees of venous insufficiency
According to the same classification, there are four following degrees of chronic venous insufficiency:
- Zero degree indicates the absence of chronic venous insufficiency.
- The second degree indicates the presence of heaviness in the legs, which turns into swelling.
- The third degree of disease of the veins of the lower extremities indicates persistent and persistent edema, sclerosis of the vascular walls, and in addition, hyperpigmentation of the skin and dermatitis.
- The fourth degree implies the appearance of trophic tissue changes and ulcers.
It is customary to add certain complications during therapy to the diagnosis. For example, complications in the form of various bleeding from the veins, the appearance of blood clots, inflammation of the lymph nodes, bacterial infections, necrosis, trophic changes in adjacent tissues, eczema, and so on.
Classification according to Savelyev
Sufficiently in demand today among domestic physicians is the Saveliev classification system, which characterizes the degree of blood flow disturbance in the limbs:
- The stage of compensation, which is characterized by the almost complete absence of symptoms of the disease, with the exception of discomfort in the area of vein damage.
- The stage of subcompensation, which is the time during which the symptoms of the disease intensify, visually manifesting themselves in the form of a reticular pattern, and symptomatically in the form of edema along with tingling, itching, heaviness, cramps and other phenomena of varicose pathology of the extremities. At the same time, stagnation in the tissues is greatly intensified, and normal blood circulation is disturbed.
- The stage of decompensation is marked by the appearance of a serious violation of blood flow, which is accompanied by hyperpigmentation and inflammation of adjacent tissues. Symptoms at this time can intensify and develop into regular pain. The appearance of necrotic tissue lesions and trophic ulcers is not excluded.
Anatomical localization
There is a classification system according to the anatomical location of the affected limb veins, which is extremely important in making the correct diagnosis:
- The process of varicose veins of the great saphenous vein.
- The process of varicose veins of the small saphenous vein.
- The process of varicose veins of the great and small saphenous veins.
- The process of varicose veins of the lateral vein.
CEAP classes
There is an international classification of vein diseases, which is based on the symptoms and signs of pathology. It is called CEAR, where:
- "C" stands forclinical picture of the disease.
- "E" reports the etiology of the disease.
- "A" carries information about the anatomy of the position of the affected veins.
- "P" denotes the mechanisms of development of varicose veins.
Clinicians most often use section "C", which, in turn, is divided into grades from zero to six. Thus, each stage of the clinical picture of leg vein disease has its own class:
- Zero class carries information about the absence of any obvious manifestations of varicose veins of the extremities. But at the same time, patients may complain of heaviness and fatigue of the legs.
- The first class implies that you can notice the appearance of a reticular pattern (asterisks, meshes). At the same time, patients suffer from night cramps.
- The second class indicates the appearance of obvious dilations of veins and vessels, which can be clearly distinguished by the eye.
- The third class reports that patients suffer from swelling of the limbs, pastosity of tissues and other symptoms of varicose veins that do not disappear after rest.
- The fourth class indicates pronounced varicose veins and veins, as well as hyperpigmentation and inflammation of the adjacent skin.
- The fifth grade is marked by the occurrence of ulcerative lesions, and in addition, symptoms of thrombophlebitis and necrotic changes.
- The sixth grade is accompanied by the formation of non-healing necrosis. In addition, patients may experience deep trophic ulcers.
Throughclassification of sections "E" and "A" it is possible to establish a diagnosis against the background of lesions of deep and superficial veins, as well as to clarify the etiology of the disease. Section "P", in turn, makes it possible to clarify the presence of various refluxes in the affected areas of the venous bed.
Disability Scale
As part of the diagnosis of varicose veins, it is important to take into account the number of ulcerative changes, size and time during which the pathology exists. The presence of relapses and their total number are also taken into account. Among other things, information on the working capacity of patients suffering from varicose veins should be clarified, which is carried out on a scale of reduced working capacity:
- "Zero" indicates an asymptomatic course of the disease of the veins of the extremities, which does not require limitation of working capacity.
- "One" suggests symptoms of the disease that do not require disability.
- "Deuce" reports the presence of symptoms of the disease, which do not allow the patient to work more than eight hours, while corrective therapy is mandatory.
- "Three" indicates complete disability.
So, thanks to the classification, it is possible to specify the state of the disease at a certain point in time, especially in cases where it progresses or, on the contrary, does not manifest itself in any way. The existing classification system makes it possible to more fully formulate the diagnosis of a particular patient, specifying the presence of various complications, and so on.
The presented CEAP system characterizes vein diseases in sufficient detail, but differs in a large number of different points, which, in turn, is reflected in the final cipher. Thus, any classification of problems with veins is, first of all, a list of relevant diseases, which makes it possible to most accurately not only determine, but make a diagnosis.
Treatment of vein diseases
Therapy for these pathologies is different, depending on the degree of development.
Sclerotherapy is used to remove small nodes or extensions.
As a traditional treatment, patients are recommended special stockings with high elasticity, as well as special exercises with legs raised high. It will be effective for varicose veins as well as chronic vein disease.
Surgery is indicated if there is no proper effect from previous methods, various complications occur during the course of the disease (ulcers or severe bleeding).
Medications may also be needed, especially if it is an advanced form of the disease or the development of complications.
To minimize risks, you need to devote time to your feet and their he alth. You should regularly warm up your legs, make alcohol compresses, use herbal decoctions, and perform a special set of physical exercises.
