Thrombophlebitis of the veins of the lower extremities: symptoms and treatment, prognosis, consequences

  • Thrombophlebitis of the veins of the lower extremities: symptoms and treatment, prognosis, consequences

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    What it is? Thrombophlebitis - a disease that is characterized by inflammation of the venous wall, a violation of the outflow of blood and is accompanied by the formation of blood clots( thrombi) in the lumen of the vein.

    leads to a deterioration in the quality of life and serious complications up to the death, unless you seek medical help.

    Causes of thrombophlebitis

    Why does the disease occur and what is it? Thrombophlebitis can develop in any part of the venous system, but its most frequent localization on the lower extremities. On the upper limbs, the pathological process develops in the case of a prolonged catheter in the vein or as a result of intravenous administration of antibiotics, multiple punctures for the administration of drugs.

    Among the main causes of thrombophlebitis development can be identified:

    • infectious diseases;
    • allergy;
    • hereditary predisposition;
    • long static loads on the legs;
    • change in the physicochemical composition of the blood;
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    • cardiovascular disease;
    • injury and injury;
    • disorders of neural regulation of venous vessels;
    • pregnancy;
    • decrease in the reactivity of the body;
    • varicose veins;
    • oncological diseases;
    • obesity;
    • sedentary lifestyle;
    • hormonal disorders;
    • hemorrhoids;
    • surgical intervention.
    Provoking factors are many, but it has been established that thrombosis in the vein occurs against the background of a slowing of the blood flow, changes in its composition and damage to the vascular wall. These are three mandatory conditions for the development of thrombophlebitis, among which the latter has the greatest weight.

    Read also how to treat atherosclerosis of the vessels of the lower extremities.

    Symptoms of deep vein thrombophlebitis of the lower extremities

    By the nature of the course, thrombophlebitis can be acute and chronic. There are also thrombophlebitis of the superficial and deep veins. From its location and the clinical symptoms depend.

    The most common pathological manifestations occur in the upper and middle of the shin, as well as in the thigh, in its lower third.

    Acute thrombophlebitis appears suddenly with a bursting pain in the gastrocnemius muscles along the veins and a rise in temperature with chills. When palpation, the densified vein and the same subcutaneous tissue are palpated. Painful sensations increase when trying to lower the shin down.

    When the surface veins are affected, painful seals occur along the veins and reddening of the skin. Often this is the result of varicose veins. The temperature rises to 38 ° C, there is a swelling of the skin over the affected area. Touching the swollen and hard thrombosed vein causes severe pain. Gradual growth of the described changes can be noted during several days.

    In case of damage to the deep veins, swelling of the extremity develops( as a result of a sudden breakdown in venous outflow), which is most noticeable in the ankles and on the shin. The skin temperature rises. The pain is localized in the calf muscles and intensifies the attempt to move the foot in the ankle joint. After a few days, the pain decreases and a venous seto appears.

    Symptoms of deep thrombophlebitis:

    1. 1) Symptom of Moses. When squeezing the lower leg from the sides, there is no pain, but it will be observed when trying to do this in the anteroposterior direction;
    2. 2) The symptom of Homans is manifested by pain and discomfort in the calf muscles when the foot is bending the foot in the joint;
    3. 3) The symptom of Louvel. Pain sensations in the lower limb appear when coughing or sneezing;
    4. 4) The Lovenberg symptom occurs when the pressure level in the cuff of the sphygmomanometer is raised to about 150 mm Hg. The cuff is located on the middle third of the shin, below this level there is a pain in the calf muscles.
    There is also a chronic course of thrombophlebitis with periods of periodic exacerbations and remissions. Symptoms are not severe. Pains are disturbed only after a load, edemas are almost absent. But during periods of exacerbations there is a clinical picture of acute thrombophlebitis.

    After relief of the main signs, the pathological process ceases for a while. Chronic thrombophlebitis is fraught with the appearance of trophic ulcers of the lower leg. This is the result of clogging the blood vessel with a thrombus and disturbing the venous circulation.

    Diagnosis of thrombophlebitis

    Diagnosis consists of a superficial examination by a phlebologist, during which the doctor collects an anamnesis and makes a preliminary diagnosis, as well as in instrumental and laboratory studies.

    Specialist consultation required:

    • for women planning pregnancy and pregnancy;
    • to people who are obese;
    • if the robot is associated with a constant stay on the feet( waiters, hairdressers, cooks);
    • to people, often lifting weights( movers);
    • to the elderly.
    Instrumental survey methods:

    1. 1) Duplex scanning of lower limb vessels. Refers to the ultrasound method of research, allows you to obtain objective information about the nature of blood flow in the arteries and veins of the extremities.
    2. 2) Rheovasography is a non-invasive method for studying pulsatile blood filling of organs and tissues, according to the results of which it is possible to judge the violation of blood circulation, deviations in the vascular wall.
    3. 3) Ultrasonic dopplerography of vessels is performed to detect the affected vessels at early stages, to determine the condition of the vein walls and the nature of the blood flow of the upper and lower extremities.
    From laboratory methods, coagulogic blood tests( tests for the diagnosis of the homeostasis system) are shown, allowing to observe the process of thrombus formation in plasma or blood. The general analysis of the blood shows only not very pronounced signs of the inflammatory process, therefore in this case it is not informative.

    Treatment of thrombophlebitis of the lower extremities veins

    Treatment depends on the form and stage of the disease. In many cases, it goes conservatively in an outpatient setting, but it does not exclude the surgical way of solving the problem.

    Conservative therapy is aimed at the removal of inflammatory and topical thrombotic processes. The use of anticoagulants( heparin), non-steroidal anti-inflammatory drugs( diclofenac, ketoprofen), enzymes, plant phlebotonics( diosmin, escuzan, antistax) is shown. If suspected of purulent thrombophlebitis, antibiotics are prescribed.

    In an acute period, it is necessary to observe bed rest and keep the affected limb in an elevated position. You should also use compression knitwear or bandage the limb with an elastic bandage.

    So the initial stage of thrombophlebitis is treated, but these measures can not completely stop the development of varicose veins, as the disease recurs. After relieving the inflammatory process, surgical intervention is prescribed. Apply vein ligation, veinectomy and dissection. From physiotherapy methods are recommended: a sun-lamp, ultraviolet irradiation, infrared rays.

    Consequences and prognosis of

    The most common consequences of thrombophlebitis include postthrombophlebitic syndrome, and the most dangerous is the separation of the thrombus and its entry into the lungs through the pulmonary artery( thromboembolism), which often results in death.

    Also to the consequences of thrombophlebitis include:

    • infectious-toxic shock;
    • trophic ulcer;
    • gangrene;
    • persistent edema of the limbs;
    • thrombus suppuration;
    • sepsis;
    • muscular and bony atrophy.
    Thrombophlebitis is well amenable to therapy, but without the necessary treatment leads to disability. The defeat of deep veins is more severe than the superficial forms of the disease. Venous insufficiency accompanied by pain may develop, which is why the quality of life decreases.

    See also, symptoms of lower limb lymphostasis and its treatment.


    The main preventive measure is the timely treatment of diseases that cause thrombophlebitis. To improve the functioning of the venous pump and blood flow in the limbs, you need to move enough.

    You can practice swimming, practice running, cycling or doing special loads for your legs. If you are standing in a standing position for the purpose of prevention, you should use compression knitwear.

    Fat, smoked and salty foods should be used less. The risk of thrombophlebitis is increased in people with obesity and overweight, so you need to monitor the weight.

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