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靜脈曲張｜Varicose Veins

靜脈曲張的6個階段

The 6 stages of varicose veins

靜脈曲張六個階段：蜘蛛網狀血管、曲張、水腫、皮膚變化及潰瘍示意圖
C1 · 蜘蛛網狀血管Spider or reticular veins
C2 · 曲張靜脈Varicose veins
C3 · 水腫Edema
C4 · 皮膚變化Skin changes
C5 · 已癒合潰瘍Healed venous ulcer
C6 · 活動性潰瘍Active venous ulcer
靜脈曲張6個階段示意圖｜原創醫療示意圖

中文版

CEAP是醫師用來描述慢性靜脈疾病外觀與嚴重度的共同語言。從C1的小血管，到C6仍未癒合的靜脈潰瘍，共有六個有臨床表徵的階段。

分級不是要嚇你，也不是數字越大就一定只能開刀。症狀、超音波與生活影響，仍要一起評估。

  • C1蜘蛛網狀血管
  • C2曲張靜脈
  • C3水腫
  • C4皮膚變色或變硬
  • C5已癒合靜脈潰瘍
  • C6活動性靜脈潰瘍

1.C1–C2：血管外觀改變

  • C1：細小蜘蛛網狀或網狀血管。
  • C2：皮下靜脈明顯變粗、彎曲、突出。
  • 外觀不一定和不舒服的程度完全一致。

2.C3–C4：水腫與皮膚變化

  • C3：腳踝或小腿水腫，常在傍晚更明顯。
  • C4：皮膚可能變成棕褐色、發炎、變硬或萎縮。
  • 出現皮膚變化時，建議儘早評估。

3.C5–C6：靜脈潰瘍

  • C5：曾經有靜脈性潰瘍，目前已癒合。
  • C6：目前仍有活動性、未癒合的靜脈潰瘍。
  • 除了傷口照護，也要處理背後的靜脈高壓。

💡 CEAP C1–C6快速對照

階段主要表徵建議
C1蜘蛛網狀／網狀血管依外觀與症狀討論
C2明顯曲張靜脈可安排超音波評估
C3腳踝或小腿水腫找出靜脈及其他原因
C4色素沉著、濕疹、皮膚變硬建議儘早治療評估
C5已癒合靜脈潰瘍預防傷口復發
C6活動性靜脈潰瘍傷口與靜脈問題一起處理

⚠️ 溫馨提醒：若已出現C4皮膚變化、C5已癒合傷口或C6活動性潰瘍，不建議只觀察，請安排血管與傷口評估。

ENGLISH

CEAP is a shared clinical language for describing chronic venous disease. C1 begins with spider or reticular veins, while C6 represents an active venous ulcer.

The stage does not decide treatment by itself. Symptoms, ultrasound findings and impact on daily life should be considered together.

  • C1 spider or reticular veins
  • C2 varicose veins
  • C3 edema
  • C4 skin changes
  • C5 healed venous ulcer
  • C6 active venous ulcer

1.C1–C2: visible vein changes

  • C1: small spider or reticular veins.
  • C2: enlarged, twisted, prominent subcutaneous veins.
  • Visible appearance and symptom severity do not always match.

2.C3–C4: swelling and skin changes

  • C3: ankle or lower-leg edema, often worse later in the day.
  • C4: pigmentation, eczema, induration or skin atrophy.
  • Earlier assessment is advisable when skin changes appear.

3.C5–C6: venous ulcers

  • C5: a previous venous ulcer that has healed.
  • C6: a current active venous ulcer.
  • Wound care and underlying venous hypertension both need attention.

💡 CEAP C1–C6 at a glance

StageMain findingSuggested step
C1Spider or reticular veinsDiscuss appearance and symptoms
C2Varicose veinsConsider ultrasound
C3EdemaAssess venous and other causes
C4Pigmentation, eczema or indurationSeek earlier treatment advice
C5Healed venous ulcerPrevent recurrence
C6Active venous ulcerTreat the wound and venous disease

Note: C4 skin changes, a healed C5 ulcer or an active C6 ulcer deserves vascular and wound assessment.

作者／Author：梁筑鈞醫師｜Dr. Chu-Chun Liang
血管外科專科醫師｜Vascular Surgeon

References

  1. De Maeseneer MG, et al. ESVS 2022 Clinical Practice Guidelines. Eur J Vasc Endovasc Surg. 2022;63:184–267. 查看來源

本文提供一般衛教，不取代個別診斷或治療。若有急性不舒服，請先就近就醫。

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