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慢性下肢静脉疾病的临床表现

Authors
Patrick C Alguire, MD, FACP
Barbara M Mathes, MD, FACP, FAAD
Section Editors
John F Eidt, MD
Joseph L Mills, Sr, MD
Deputy Editor
Kathryn A Collins, MD, PhD, FACS
Translators
倪冷, 主治医师

引言

慢性下肢静脉疾病是最常见的血管疾病[1]。慢性静脉疾病是指存在长期形态(即静脉扩张)或功能性(如静脉反流)异常，并表现出提示需进一步检查或治疗的症状及体征的疾病[2]。

慢性静脉疾病包含临床—病因学—解剖学—病理生理学(Clinical-Etiology-Anatomy-Pathophysiology, CEAP)分级中C0到C6级的所有体征和症状(表 1)，而术语“慢性静脉功能不全”通常只指较严重(即C4到C6级)的疾病[3]。因此，没有皮肤改变的静脉曲张不提示慢性静脉功能不全。

初始临床表现的差异性很大，最常见的症状包括下肢疼痛或不适。体格检查结果包括：异常静脉扩张(即毛细血管扩张、网状静脉及静脉曲张)、水肿、发炎、皮炎或溃疡。慢性静脉功能不全可导致慢性失能、生存质量下降和卫生保健成本高[4-8]。

慢性静脉疾病的临床评估总结在此。慢性静脉疾病的分类、诊断性评估和治疗将在别处讨论。(参见“下肢慢性静脉疾病的分类”和“下肢慢性静脉疾病的概述和治疗”)

对患者的认识

慢性下肢静脉疾病的诊断主要依靠临床表现。初始评估包括全面的病史及体格检查，并根据CEAP标准对疾病严重程度进行临床分级(表 1)[2]。CEAP分级有助于记录初诊时静脉疾病的严重程度和病情随着时间的变化。CEAP临床分级将在别处详细讨论。(参见“下肢慢性静脉疾病的分类”和‘按CEAP分级的临床体征’)

               

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Literature review current through: 2017-06 . | This topic last updated: 2017-04-10.
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