Cardiovascular Diseases / / August 12, 2017
thrombophlebitis of superficial veins of the lower extremities - a very common disease that often develops in varicose veins.In connection with degenerative changes in the walls of blood vessels, expansion, and tortuosity of a sharp slowdown in blood flow in the varicose veins of the lower limbs creates favorable conditions for thrombus formation.
Causes and clinical picture of thrombosis
thrombophlebitis varicose veins can develop during pregnancy, postpartum, after surgery, resulting in hypothermia, injuries.Often it is a complication of high blood loss, myocardial infarction, stroke, and other serious conditions.Thrombotic events contribute to increase blood clotting, injured veins and surrounding tissues, purulent and septic diseases.Of great importance in the development of thrombosis given sensitization, autointoxication, allergic reactions.The incidence of thrombosis is increased by the use of serums, vaccines, antibiotics, blood transfusions, sore throat, flu,
When varicose disease complicated by ulcers and epidermal tissue defects in the limbs gets an infection, but infection and septic thrombophlebitis is rare.The reason for the latter are close to the vein suppurative foci.Thrombosed vein, usually within 2-3 months.rekanaliziruyutsya.After recanalization veins become even more untenable, walled up in the surrounding tissue scarring, their walls thicken rapidly, become irregular, the valve unit is destroyed.
thrombophlebitis unexpanded saphenous veins is rare, it mostly has an infectious origin (osteomyelitis, cellulitis, erysipelas, tinea pedis).Small spread is and migratory thrombophlebitis occurs when malignant tumors of internal organs, or peripheral artery disease.
thrombophlebitis varicose saphenous veins violates little overall health.The trunks of the veins turn into dense painful threadlike strands that accession periflebita become motionless, soldered infiltrated with darkened or reddened skin.Most often affects the lower part of the tibia and femur, less pathological process extends to the groin.Acute
vein thrombosis is a condition in which the affected portion of the vessel, usually combined inflammation, thrombosis, and venous spasm jet.The basis of the disease in the first place are the changes in the blood coagulation system.For the clinical picture of acute thrombophlebitis of superficial veins of the lower extremities is typical expression of local inflammation.
thrombophlebitis occurs most often in the great saphenous vein and its tributaries.The disease usually develops gradually.The first manifestation of it is moderate pain in the thrombosed vein area, sometimes around the vessel.Then, during a compacted touch vein appears redness, passing on the adjacent tissue.Palpation painful thrombosed area.Gradually, the inflammatory process involved and the tissue surrounding the vein, develops a characteristic picture periflebita.Swelling of the limb is rarely expressed.Shin and ankle region moderately swollen, sometimes increasing the inguinal lymph nodes.Movement in the diseased limbs are free, but moderately painful.The body temperature rises to a low grade.
In marked inflammation of the symptoms are manifested most clearly: the body temperature of 39 degrees and above, headache, chills, sweating.The affected area limb swells, becomes painful, the skin - hot, red.Due periflebita formed painful infiltration zones, the patient walks with difficulty.Dramatically increasing the inguinal lymph nodes.Picture peripheral blood depends on the severity of the disease and the severity of inflammation in the surrounding tissues.
acute thrombophlebitis can go to the sub-acute in a few days.The duration of the pathological process when not treated acute thrombophlebitis of the lower limbs superficial veins does not exceed 3-4 weeks.The outcome of the disease is either recanalization, the upcoming 2-4 months, or complete obliteration of the thrombosed vein area.In the former site of inflammation is hyperpigmentation of the skin.
Symptoms of thrombophlebitis unexpanded vein similar to that of thrombophlebitis varicose veins.But it is not clear strands compacted thrombosed veins, and therefore the diagnosis can be difficult.Often there is a network of dilated saphenous veins, sore leg muscles.For migratory thrombophlebitis thrombosis is characterized by a plurality of lesions in saphenous veins of the limbs.the patient's general condition is not violated, the body temperature is normal, there is moderate pain during limb movements and palpation.Seals in 1-3 weeks.disappear on their own and without consequences.After some time, thrombophlebitis may recur, but in other parts of the limbs.
thrombophlebitis thrombophlebitis varicose veins diagnosis difficult.It must be differentiated from deep vein thrombosis, which is alien to the painful subcutaneous bands and seals along the trunks of the subcutaneous vessels.For thrombosis deep vein thickening characterized by sharp, cyanosis or paleness limbs, loosening limbs arterial pulsation, which does not happen at a thrombophlebitis of superficial veins.In doubtful cases the diagnosis to be confirmed by a venography, flebomanometrii and other research methods.
unexpanded vein thrombophlebitis should be distinguished from periodontitis, lymphangitis, erysipelas, erythema nodosum, oleogranulemy, lipogranulemy and other diseases of the skin and subcutaneous fat.In these diseases nodes have a rounded shape, kept for years, and for the thrombosis is characterized by an acute course and presence tyazheobraznyh seal along the veins.Thrombophlebitis alien to large areas of skin redness, fever, throbbing or burning pain;in the presence of such manifestations should be suspected erysipelas, lymphangitis.
septic suppurative thrombophlebitis may be complicated by subcutaneous abscess or cellulitis limbs, metastatic abscess and sepsis.Thrombophlebitis varicose veins sometimes extends to the deep veins, and the rapidly deteriorating condition of the patient and the threat of pulmonary embolism occurs.
Treatment of thrombophlebitis
Treatment should always be strictly differentiated.It depends on the clinical presentation and extent of the thrombotic process.Radical treatment of thrombophlebitis of varicose veins of the lower extremities is a surgical operation: it only reliably prevents the spread, complications and recurrence of this dangerous disease.Surgery provides a persistent cure in 90% of cases.Resort to it for all acute thrombophlebitis of superficial varicose veins.Thrombophlebitis arising in previously modified veins often treated conservatively.It should be said that the operation in thrombophlebitis varicose veins has significant advantages over conservative therapy: it allows you to eliminate not only the thrombophlebitis, and varicose veins, dramatically reduces the time of treatment and prevents severe complications of the disease.Hold it better after decrease in acute manifestations periflebita.Contraindications to surgical treatment of acute thrombophlebitis of the superficial veins are the obstruction of deep vein, decompensated heart disease, myocardial infarction, inflammation of the lungs, abdomen, acute diseases of the skin and limbs, etc.Advancing age was also a relative contraindication to surgery.
In cases of acute inflammation in a few days before the operation is carried out conservative treatment (bed rest with the elevated position of the limbs, sulfa drugs and anti - phenylbutazone, reopirin, aspirin, aminopyrine, venoruton et al.).
In the absence of redness and infiltration wide, approaching the thrombus to the mouths of large and small saphenous vein shows the urgent, after a short preparation, the operation - phlebectomy.Operating wound sutured tightly impose any active suction drainage through the extra hole.At the end of the operation the limb compressive bandage is applied.On the 2nd day the patient is allowed to vnachalё lower legs off the bed, and then walk around the room.The limb bandaged with elastic bandages.The bed is attached to the limb elevated position.Postoperatively shown anticoagulants and antibiotics under the control of prothrombin index.In the presence of contraindications to surgery should be conservative therapy fibrinolytic drugs and anticoagulation action.
Conservative treatment is not always effective thrombophlebitis: thrombophlebitis may recur, and varicose veins after thrombophlebitis progresses.Said treatment is carried out with the patient does not agree to surgery for advanced inflammatory process.In the acute stage of the disease is shown to bed with the elevated position of the limbs;apply cold.After calming down of the acute inflammation it is allowed to go, but the leg must be bandaged with elastic bandage.It accelerates blood circulation and prevents the danger of the spread of thrombosis in the subcutaneous and deep veins.Many patients with thrombophlebitis with contraindications to surgery can be treated outpatient.
Medication thrombophlebitis diverse.Antibiotics are prescribed for suppurative thrombophlebitis.In such cases, abscess incision is made and the excision of the affected veins above the hearth.When aseptic thrombophlebitis antibiotics are not prescribed, because they increase blood clotting.Heparin and other anticoagulants fenilin can not dissolve the clots, they only prevent the spread of thrombosis.They are prescribed for increased prothrombin index and to prevent retrombosis after thrombectomy of the mouths of deep vein thrombosis (under the control clotting time and prothrombin index).
- Doppler ultrasound or toes
- Folk medicine for heart disease
- Varicose veins: causes, symptoms, diagnosis, treatment
- How to get rid of varicose veins
Effective infusion of 1% solution of nicotinic acid (both intramuscular and intravenous).Assign also nikoshpan, Nikoverin (1-2 tablets 3 times a day after meals).Nicotinic acid reduces blood clotting and activates fibrinolysis, accelerates blood flow.Papaverine, no-spa, andekalin, komplamin, troksevazin et al. Removed secondary spasm of the arteries and improve microcirculation.To accelerate resorption of blood clots apply compresses with heparin and butanedioic ointments Vishnevsky ointment.Good results give paravenoznye blockade 0.25-0.5% solution of novocaine with heparin (000 IU 5000-10).
important place in the conservative treatment of thrombosis is given physiotherapy (UHF, diathermy, electrophoresis with proteolytic enzymes, with trombolitinom, potassium iodide, heparin).Physiotherapy contribute to the expansion of the arteries, improve hemodynamics affected limb, accelerate resorption infiltrates and blood clots.
When thrombophlebitis varicose veins do not use antibiotics, anti-inflammatory and anti-allergic agents, physiotherapy;less operative treatment.Conservative treatment was successfully performed in outpatient settings.Migrating thrombophlebitis usually be cured with the help of anti-inflammatory therapy.
after surgical and conservative treatment of thrombosis patients unable to work longer than after phlebectomy about uncomplicated varicose veins.They are subject to dispensary observation, and sometimes translated into an easy job.
12 Aug, 2017
12 Aug, 2017