asurgeryАмбулаторная хирургияAmbulatornaya khirurgiya = Ambulatory Surgery (Russia)2712-87412782-2591ООО «ГРУППА РЕМЕДИУМ»asurgery-34Research ArticleФЛЕБОЛОГИЯ | АНГИОЛОГИЯPHLEBOLOGY | ANGIOLOGYКонсервативное лечение хронических заболеваний вен. Обсуждаем новые рекомендации Европейского общества сосудистых хирурговDiagnosis and treatment of chronic venous diseaseБогачевВ. Ю.BogachevV. Y.noemail@neicon.ruЛобановВ. Н.LobanovV. N.noemail@neicon.ruДженинаО. В.DzheninaO. V.noemail@neicon.ruГБУ ВПО РНИМУ им. Н.И. Пирогова; Первый флебологический центрРоссияN.I. Pirogov Russian NationaL Research MedicaL University; First PhLeboLogy CentreRussian Federation20162006201601-22528Copyright © Богачев В.Ю., Лобанов В.Н., Дженина О.В., 20162016Богачев В.Ю., Лобанов В.Н., Дженина О.В.Bogachev V.Y., Lobanov V.N., Dzhenina O.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.a-surgeon.ru/jour/article/view/34

Нехирургические (консервативные) методы лечения хронических заболеваний вен (ХЗВ) разных клинических классов имеют непреходящее значение благодаря своей универсальности и доступности. Говоря о консервативном лечении ХЗВ, в первую очередь подразумевают компрессионную терапию, которая по-прежнему остается краеугольным камнем, на котором базируются все другие лечебные и профилактические опции.

An overview of the new guideLines of the European Society for VascuLar Surgery. Non-surgicaL (conservative) treatments of chronic venous diseases (CVD) of various cLinicaL cLasses are of paramount importance due to their versatiLity and affordabiLity. Compression therapy is primarily impLied when speaking about conservative treatment of CVD. It stiLL remains the cornerstone on which aLL other therapeutic and preventive approaches are based.n overview of the new guideLines of the European Society for VascuLar Surgery. Non-surgicaL (conservative) treatments of chronic venous diseases (CVD) of various cLinicaL cLasses are of paramount importance due to their versatiLity and affordabiLity. Compression therapy is primarily impLied when speaking about conservative treatment of CVD. It stiLL remains the cornerstone on which aLL other therapeutic and preventive approaches are based.

хронические заболевания венконсервативное лечениевеноактивные препаратымикронизированная очищенная флавоноидная фракцияДетралексchronic venous diseaseconservative treatmentveno-active drugsmicronized purified flavonoidfractionDetralexReferencesMartinez MJ, BonfiLL X, Moreno RM, Vargas E, CapeLLa D. Phiebotonics for venous insufficiency. Cochrane Database Syst Rev, 2005: CD003229.Martinez MJ, BonfiLL X, Moreno RM, Vargas E, CapeLLa D. Phiebotonics for venous insufficiency. Cochrane Database Syst Rev, 2005: CD003229.RameLet AA, Boisseau MR, ALLegra C, NicoLaides A, Jaeger K, Carpentier P et aL. Veno-active drugs in the management of chronic venous disease. An internationaL consensus statement: current medicaL position, prospective views and final resoLution. Clin Hemorheol Microcirc, 2005, 33: 309-319.RameLet AA, Boisseau MR, ALLegra C, NicoLaides A, Jaeger K, Carpentier P et aL. Veno-active drugs in the management of chronic venous disease. An internationaL consensus statement: current medicaL position, prospective views and final resoLution. Clin Hemorheol Microcirc, 2005, 33: 309-319.PittLer MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev, 2012, 11: CD003230.PittLer MH, Ernst E. Horse chestnut seed extract for chronic venous insufficiency. Cochrane Database Syst Rev, 2012, 11: CD003230.Barbe R, AmieL M. Pharmacodynamic properties and therapeutic efficacy of DafLon 500 mg. Phlebology, 1992, 7: 41-44.Barbe R, AmieL M. Pharmacodynamic properties and therapeutic efficacy of DafLon 500 mg. Phlebology, 1992, 7: 41-44.BLume J, Langenbahn H, de ChampvaLLins M. Quantification of oedema using the voLometer technique: therapeutic appLication of DafLon 500 mg in chronic venous insufficiency. Phlebology, 1992, 7: 37-40.BLume J, Langenbahn H, de ChampvaLLins M. Quantification of oedema using the voLometer technique: therapeutic appLication of DafLon 500 mg in chronic venous insufficiency. Phlebology, 1992, 7: 37-40.GaLLey P, ThioLLet M. A doubLe-bLind, pLacebo-controLLed triaL of a new veno-active fLavonoid fraction (S 5682) in the treatment of symptomatic capiLLary fragiLity. Int Angiol, 1993, 12: 69-72.GaLLey P, ThioLLet M. A doubLe-bLind, pLacebo-controLLed triaL of a new veno-active fLavonoid fraction (S 5682) in the treatment of symptomatic capiLLary fragiLity. Int Angiol, 1993, 12: 69-72.GiLLy R, PiLLion G, FriLeux C. EvaLuation of a new veno-active micronized fLavonoid fraction (S5682) in symptomatic disturbances of the venoLymphatic circuLation of the Lower Limb. A doubLe-bLinded, pLacebo-controLLed triaL. Phlebology, 1994, 9: 67-70.GiLLy R, PiLLion G, FriLeux C. EvaLuation of a new veno-active micronized fLavonoid fraction (S5682) in symptomatic disturbances of the venoLymphatic circuLation of the Lower Limb. A doubLe-bLinded, pLacebo-controLLed triaL. Phlebology, 1994, 9: 67-70.ALLaert FA. Meta-anaLysis of the impact of the principaL venoactive drugs agents on maLLeoLar venous edema. Int Angiol, 2012, 31: 310-315.ALLaert FA. Meta-anaLysis of the impact of the principaL venoactive drugs agents on maLLeoLar venous edema. Int Angiol, 2012, 31: 310-315.Jantet G. Chronic venous insufficiency: worLdwide resuLts of he RELIEF study. RefLux assEssment and quaLity of Life mprovEment with micronized FLavonoids. Angiology, 2002, 53: 245-256.Jantet G. Chronic venous insufficiency: worLdwide resuLts of he RELIEF study. RefLux assEssment and quaLity of Life mprovEment with micronized FLavonoids. Angiology, 2002, 53: 245-256.GoheL MS, Davies AH. PharmacoLogicaL agents in the treatment of venous disease: an update of the avaiLabLe evidence. Curr Vasc Pharmacol, 2009, 7: 303-308.GoheL MS, Davies AH. PharmacoLogicaL agents in the treatment of venous disease: an update of the avaiLabLe evidence. Curr Vasc Pharmacol, 2009, 7: 303-308.Rabe E, Jaeger KA, BuLitta M, Pannier F. CaLcium dobesiLate in patients suffering from chronic venous insufficiency: a doubLe-bLind, pLacebo-controLLed, cLinicaL triaL. Phlebology, 2011, 26: 162-168.Rabe E, Jaeger KA, BuLitta M, Pannier F. CaLcium dobesiLate in patients suffering from chronic venous insufficiency: a doubLe-bLind, pLacebo-controLLed, cLinicaL triaL. Phlebology, 2011, 26: 162-168.Rabe E, Stucker M, Esperester A, Schafer E, OttiLLinger B. Efficacy and toLerabiLity of a red-vine-Leaf extract in patients suffering from chronic venous insufficiency e resuLts of a doubLe-bLind pLacebo-controLLed study. Eur J Vasc Endovasc Surg, 2011, 41: 540-547.Rabe E, Stucker M, Esperester A, Schafer E, OttiLLinger B. Efficacy and toLerabiLity of a red-vine-Leaf extract in patients suffering from chronic venous insufficiency e resuLts of a doubLe-bLind pLacebo-controLLed study. Eur J Vasc Endovasc Surg, 2011, 41: 540-547.JuLL AB, ArroLL B, Parag V, Waters J. PentoxifyLLine for treating venous Leg uLcers. Cochrane Database Syst Rev, 2012, 12: CD001733.JuLL AB, ArroLL B, Parag V, Waters J. PentoxifyLLine for treating venous Leg uLcers. Cochrane Database Syst Rev, 2012, 12: CD001733.DaLe JJ, RuckLey CV, Harper DR, Gibson B, NeLson EA, Prescott RJ. Randomised, doubLe bLind pLacebo controLLed triaL of pen-toxifyLLine in the treatment of venous Leg uLcers. Br Med J, 1999, 319: 875-878.DaLe JJ, RuckLey CV, Harper DR, Gibson B, NeLson EA, Prescott RJ. Randomised, doubLe bLind pLacebo controLLed triaL of pen-toxifyLLine in the treatment of venous Leg uLcers. Br Med J, 1999, 319: 875-878.FaLanga V, Fujitani RM, Diaz C, Hunter G, Jorizzo J, Lawrence PF, et aL. Systemic treatment of venous Leg uLcers with high doses of pentoxifyLLine: efficacy in a randomized, pLacebo-controLLed triaL. Wound Repair Regen, 1999, 7: 208-213.FaLanga V, Fujitani RM, Diaz C, Hunter G, Jorizzo J, Lawrence PF, et aL. Systemic treatment of venous Leg uLcers with high doses of pentoxifyLLine: efficacy in a randomized, pLacebo-controLLed triaL. Wound Repair Regen, 1999, 7: 208-213.NeLson EA, Prescott RJ, Harper DR, Gibson B, Brown D, RuckLey CV. A factoriaL, randomized triaL of pentoxifyLLine or pLacebo, four-Layer or singLe-Layer compression, and knitted viscose or hydrocoLLoid dressings for venous uLcers. J Vasc Surg, 2007, 45: 134-141.NeLson EA, Prescott RJ, Harper DR, Gibson B, Brown D, RuckLey CV. A factoriaL, randomized triaL of pentoxifyLLine or pLacebo, four-Layer or singLe-Layer compression, and knitted viscose or hydrocoLLoid dressings for venous uLcers. J Vasc Surg, 2007, 45: 134-141.Layton AM, Ibbotson SH, Davies JA, GoodfieLd MJ. Randomised triaL of oraL aspirin for chronic venous Leg uLcers. Lancet, 1994, 344: 164-165.Layton AM, Ibbotson SH, Davies JA, GoodfieLd MJ. Randomised triaL of oraL aspirin for chronic venous Leg uLcers. Lancet, 1994, 344: 164-165.Ibbotson SH, Layton AM, Davies JA, GoodfieLd MJ. The effect of aspirin on haemostatic activity in the treatment of chronic venous Leg uLceration. Br J Dermatol, 1995, 132: 422-426.Ibbotson SH, Layton AM, Davies JA, GoodfieLd MJ. The effect of aspirin on haemostatic activity in the treatment of chronic venous Leg uLceration. Br J Dermatol, 1995, 132: 422-426.deL Rio SoLa ML, Antonio J, Fajardo G, Vaquero Puerta C. Influence of aspirin therapy in the uLcer associated with chronic venous insufficiency. Ann Vasc Surg, 2012, 26: 620629.deL Rio SoLa ML, Antonio J, Fajardo G, Vaquero Puerta C. Influence of aspirin therapy in the uLcer associated with chronic venous insufficiency. Ann Vasc Surg, 2012, 26: 620629.WiLkinson EA, Hawke CI. Does oraL zinc aid the heaLing of chronic Leg uLcers? A systematic Literature review. Arch Dermatol, 1998, 134: 1556-1560.WiLkinson EA, Hawke CI. Does oraL zinc aid the heaLing of chronic Leg uLcers? A systematic Literature review. Arch Dermatol, 1998, 134: 1556-1560.O'Meara S, AL-Kurdi D, OLogun Y, Ovington LG. Antibiotics and antiseptics for venous Leg uLcers. Cochrane Database Syst Rev, 2010: CD003557.O'Meara S, AL-Kurdi D, OLogun Y, Ovington LG. Antibiotics and antiseptics for venous Leg uLcers. Cochrane Database Syst Rev, 2010: CD003557.Andreozzi GM. SuLodexide in the treatment of chronic venous disease. Am J Cardiovasc Drugs, 2012, 12: 73-81.Andreozzi GM. SuLodexide in the treatment of chronic venous disease. Am J Cardiovasc Drugs, 2012, 12: 73-81.Leach MJ, Pincombe J, Foster G. CLinicaL efficacy of horsechest-nut seed extract in the treatment of venous uLceration. J Wound Care, 2006, 15: 159-167.Leach MJ, Pincombe J, Foster G. CLinicaL efficacy of horsechest-nut seed extract in the treatment of venous uLceration. J Wound Care, 2006, 15: 159-167.GuiLhou JJ, Dereure 0, Marzin L, Ouvry P, ZuccareLLi F, Debure C et aL. Efficacy of DafLon 500 mg in venous Leg uLcer heaLing: a doubLe-bLind, randomized, controLLed versus pLacebo triaL in 107 patients. Angiology, 1997, 48: 77-85.GuiLhou JJ, Dereure 0, Marzin L, Ouvry P, ZuccareLLi F, Debure C et aL. Efficacy of DafLon 500 mg in venous Leg uLcer heaLing: a doubLe-bLind, randomized, controLLed versus pLacebo triaL in 107 patients. Angiology, 1997, 48: 77-85.GLinski W, Chodynicka B, Roszkiewicz J, Bogdanowski T, Lecewicz-Torun B, Kaszuba A, et aL. The beneficiaL augmentative effect of micronozed purified fLavonoid fraction (MPFF) on the heaLing of Leg uLcers: an open, muLicentre, controLLed randomised study. Phlebology, 1999, 14: 151-157.GLinski W, Chodynicka B, Roszkiewicz J, Bogdanowski T, Lecewicz-Torun B, Kaszuba A, et aL. The beneficiaL augmentative effect of micronozed purified fLavonoid fraction (MPFF) on the heaLing of Leg uLcers: an open, muLicentre, controLLed randomised study. Phlebology, 1999, 14: 151-157.RoztociL K, Stvrtinova V, Strejcek J. Efficacy of a 6-month treatment with DafLon 500 mg in patients with venous Leg uLcers associated with chronic venous insufficiency. Int Angiol, 2003, 22: 24-31.RoztociL K, Stvrtinova V, Strejcek J. Efficacy of a 6-month treatment with DafLon 500 mg in patients with venous Leg uLcers associated with chronic venous insufficiency. Int Angiol, 2003, 22: 24-31.ScaLLon C, BeLL-Syer SE, Aziz Z. FLavonoids for treating venous Leg uLcers. Cochrane Database Syst Rev, 2013, 5: CD006477.ScaLLon C, BeLL-Syer SE, Aziz Z. FLavonoids for treating venous Leg uLcers. Cochrane Database Syst Rev, 2013, 5: CD006477.CoLeridge-Smith P, Lok C, RameLet AA. Venous Leg uLcer: a meta-anaLysis of adjunctive therapy with micronized purified fLavonoid fraction. Eur J Vasc Endovasc Surg, 2005, 30: 198208.CoLeridge-Smith P, Lok C, RameLet AA. Venous Leg uLcer: a meta-anaLysis of adjunctive therapy with micronized purified fLavonoid fraction. Eur J Vasc Endovasc Surg, 2005, 30: 198208.Wittens C, Davies AH, Baekgaard N et aL. Management of Chronic Venous Disease. CLinicaL Practice GuideLines of the European Society for VascuLar Surgery (ESVS). Eur J Vasc Endovasc Surg, 2015, 49: 678-737.Wittens C, Davies AH, Baekgaard N et aL. Management of Chronic Venous Disease. CLinicaL Practice GuideLines of the European Society for VascuLar Surgery (ESVS). Eur J Vasc Endovasc Surg, 2015, 49: 678-737.

The authors declare that there are no conflicts of interest present.