Abstract: Differential diagnosis and treatment of lower limbs swelling caused by venous hypertension        XIN Shi-jie*, LI Feng-he. *Department of Vascular Surgery/Thyroid Surgery, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
Corresponding author：XIN Shi-jie, E-mail:sjxin@cmu.edu.cn
Abstract    Lower limb venous hypertension is the pathophysiological basis of chronic venous disease.Lower limb swelling is the most common clinical manifestation of venous diseases that caused by lower limb venous hypertension.The main etiology of lower limb venous hypertension are venous regurgitation and venous reflux obstruction.And the most common diseases causing venous high pressure include deep venous valve incompetence，deep vein thrombosis，iliac vein compression syndrome，and post-thrombotic syndrome.The causes of venous hypertension and swelling of the lower extremities are different，and the intervention methods are also different：（1）Change the lifestyle，avoid sitting for a long time，raise the affected limb when lying supine，and move the ankles and calves regularly.（2）Compression therapy，including compression stockings，elastic bandages and pneumatic pump compression therapy.（3）Drug therapy，such as oral flavonoids，aescins，horse chestnut seed extract and other intravenous active drugs.（4）Use long-acting penicillin and other anti-inflammatory drugs for long-term anti-inflammatory treatment.

Key words: lower limb venous hypertension, lower limb swelling, chronic venous disease

摘要： 下肢静脉高压是慢性静脉疾病的基础病理生理改变，而下肢肿胀是下肢静脉高压所致静脉疾病的常见病理改变及临床表现。从发病机制看，能诱发下肢静脉高压而导致下肢肿胀的疾病主要分为“血液倒流性病变”和“回流障碍性病变”两类病变。包括原发性深静脉瓣膜功能不全、下肢深静脉血栓形成、髂静脉压迫综合征、血栓形成后综合征等。引发下肢静脉高压肿胀病因不同，其干预手段也有所不同：（1）改变生活方式，避免久坐久站，平卧时抬高患肢，规律活动踝关节和小腿。（2）加压治疗，包括弹力袜、弹力绷带气压泵加压治疗。（3）药物治疗，如口服黄酮类、七叶皂苷类，马栗树籽提取物等静脉活性药物。（4）应用长效青霉素等抗炎药物进行长期抗炎治疗。

关键词: 下肢静脉高压, 下肢肿胀, 慢性静脉疾病