Krampfadern Volkskrankheit mit zunehmender Tendenz


Venenerkrankungen gehören nach Erhebungen der Weltgesundheitsorganisation zu den häufigsten Krankheiten überhaupt, sie sind zu einer Zivilisationskrankheit geworden.
 Ein Artikel von Maria Riedler
Foto: perfectlab - fotolia.com

Foto: perfectlab – fotolia.com

Etwa 7.000 Liter Blut pumpt unser Herz täglich durch die Gefäße. Venenklappen helfen beim steilen Aufstieg, unterstützt von der Beinmuskulatur, die das Blut nach oben pumpt. Mit fortschreitendem Alter oder durch eine angeborene Bindegewebsschwäche, bei zu wenig Bewegung, zu langem Sitzen und Stehen oder bei Schwangeren schafft jedoch die Muskelpumpe ihre Arbeit nicht mehr richtig. Das Blut staut sich in den Venen und beschädigt dort die hauchfeinen Klappen, die dann nicht mehr richtig schließen. Immer mehr Blut bleibt deshalb in den Beinen, überdehnt die Gefäße und sucht sich Nebenwege.

Foto: mkrberlin - fotolia.com

Foto: mkrberlin – fotolia.com

Abklärung wichtig

„Es gibt große Studien, die besagen, dass etwa 70 Prozent der Menschen in Deutschland an einer venösen Erkrankung leiden“, so Michael Gerstorfer, Chefarzt der Capio Schlossklinik Abtsee. „Diese reichen von Besenreisern bis zum offenen Bein.“ Besenreiser entstehen im Endeffekt durch eine Bindegewebsschwäche, die aufgrund einer genetischen Veranlagung vorliegt. „Bei Besenreisern handelt es sich um ein oftmals störendes kosmetisches Problem, das jedoch keinen Krankheitswert im Hinblick auf die Entstehung einer Thrombose, einer Venenentzündung oder eines Geschwürs hat.“ Krampfadern oder Varizen, wie man sie in der medizinischen Fachsprache nennt, sollten nicht auf die Krampfadern sind erweiterte, oberflächliche und meist geschlängelte Venen.

Foto: Werner Fellner - fotolia.com

Foto: Werner Fellner – fotolia.com

Die knotigen und bläulich schimmernden Blutgefäße sehen nicht nur unschön aus, sie können auch für schmerzende Beine oder geschwollene Knöchel verantwortlich sein. Prinzipiell können sich alle Venen zu Krampfadern entwickeln, am häufigsten sind jedoch die oberflächlichen Venen der Beine betroffen. Frauen leiden dreimal so oft unter Krampfadern wie Männer. Krampfadern machen sich meist zwischen dem 30. und 40. Lebensjahr bemerkbar, können aber auch bei jüngeren Menschen und Jugendlichen auftreten. Unbedingt abgeklärt und eventuell behandelt werden sollten sie, wenn in tiefliegenden Venen Thrombosen entstehen. Das Gerinnsel verstopft die Beinvenen, was den Blutrückstrom aus dem Bein akut behindert. Das wichtigste Symptom ist eine Beinschwellung. Im schlimmsten Fall kann es durch ein Abschwemmen der Blutgerinnsel zur Lungenarterienembolie kommen.

Bei Auftreten von Symptomen wie Schweregefühl, Schwellung der Beine, abendlichen Schmerzen und/oder sichtbaren Seitenastvarizen sollte man einen Facharzt für Venenheilkunde oder Gefäßchirurgie aufsuchen, so Gerstorfer: „Dort wird neben einer körperlichen Untersuchung auch eine Farbduplexsonographie, eine Ultraschalluntersuchung der Gefäße, durchgeführt. Im Rahmen dieser Untersuchung kann relativ genau festgestellt werden, inwieweit eine konservative oder operative bzw. endovaskuläre Therapie notwendig ist.“

Besenreiser

Besenreiser finden sich bei gut 60 Prozent aller Frauen und Männer zwischen 20 und 29 Jahren. Sie sind also keineswegs nur ein Problem älterer Menschen. Sie treten gehäuft an den Beinen auf und verursachen in der Regel keine Beschwerden. Unter Besenreisern verstehen Venenspezialisten kleinste Adern in der Haut, die sich durch Elastizitätsverlust erweitert haben. Sie sind mit Blut gefüllt und daher durch die Haut als hellrote Gefäßbäumchen, dunkelblaue Äderchen oder rötliche Flecken sichtbar.  Sie können erste Anzeichen einer tiefer liegenden Venenerkrankung sein. Dies sollte vor der Behandlung von einem Venenspezialisten abgeklärt werden. Bei Besenreisern wird am häufigsten die Verödungstherapie eingesetzt, in Fachkreisen auch Sklerosierung genannt. Diese Behandlung wird meist ambulant durchgeführt; braucht jedoch zumeist einige Sitzungen. Da die Behandlung nur die oberste Hautschicht betrifft, spürt die Patientin oder der Patient nur kleine Einstiche in der Haut. Eine Betäubung ist meistens nicht nötig.

Foto: Robert Przybysz - fotolia.com

Foto: Robert Przybysz – fotolia.com

Wann und wie behandeln?

Ein Krampfaderleiden sollte operiert werden, so der Facharzt, bevor es zu einer Komplikation wie einem offenen Bein oder einer Venenentzündung mit unter Umständen anschließender Thrombose führt. Die Behandlungsmethoden sind dabei vielfältig. Sie reichen von konservativer Therapie wie Tragen von Kompressionsstrümpfen, regelmäßiger sportlicher Betätigung und eventuell nötiger Gewichtsreduktion bis zur operativen Therapie. Das kann etwa das sogenannte „Strippen“ sein, das heißt es wird eine „Rosenvene“ entfernt, bis hin zu modernen endovenösen Therapieverfahren wie dem Laser oder der Radiowelle. Hier werden durch eine Kathetertechnik die Krampfadern mit Hitze „von innen“ behandelt. Bei der Laserbehandlung etwa wird eine Spezialsonde in die erkrankten Venenpartien eingeführt. Bei bestimmten Stammvenenerkrankungen gibt man wiederum der Radiowellentherapie den Vorzug. Welche Methode angewandt wird bzw. sinnvoll ist, hängt stark von der individuellen Situation ab und sollte mit dem Arzt des Vertrauens genau besprochen werden.

Dr 


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. Michael Gerstorfer, Chefarzt der Capio Schlossklinik Abtsee Foto: Dr. Michael Gerstorfer“ width=“204″ height=“300″ /> Dr
. Michael Gerstorfer, Chefarzt
der Capio Schlossklinik Abtsee
Foto: Dr. Michael Gerstorfer

Warum leiden immer mehr Menschen an Venenerkrankungen?

„Zum einen deshalb, weil die Bevölkerung insgesamt immer älter wird und Alter ein Risikofaktor für eine Venenerkrankung ist, zum anderen, weil mehr als noch vor 20 Jahren viele Menschen Gewichtsprobleme haben und sich nicht ausreichend im Alltag bewegen.“

Kann man hier effektiv vorbeugen?

„Ein Großteil der Patienten bekommt Krampfadern aufgrund einer genetischen Disposition, d.h. das Krampfaderleiden ist vererbt. Liegt eine solche Anlage für das Krampfaderleiden vor, sollten Patienten regelmäßig Sport treiben bzw. Kompressionsstrümpfe tragen. Es gilt: lieber liegen und laufen statt stehen und sitzen.“

Wann ist die beste Behandlungszeit für Besenreiser und Varizen?

„Die beste Behandlungszeit für Besenreiser und Varizen ist im Grunde genommen immer. Die Jahreszeitabhängigkeit, die immer propagiert wird, ist medizinisch nicht bewiesen. Natürlich ist es für die Patienten im Winter angenehmer, die Kompressionsstrümpfe zu tragen als im Hochsommer, aber auch im Hochsommer spricht nichts gegen eine Krampfadernoperation.“


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