Deep vein thrombophlebitis: causes, symptoms and treatment
Mar 27, 2018
When penetrating the infection from any source into the inner surface of the vein of the foot and forming a thrombus at this site, the patient develops deep vein thrombophlebitis.
In this condition, there are necessarily two mandatory elements - local or generalized inflammation of the vascular wall and a clotting disorder that leads to the formation of a thrombus of various lengths. This pathological element is overwhelmingly attached to the venous valve, which is often already affected by some pathological process, and the thrombus spreads to the lower part of the affected vessel. Among the forms of thrombophlebitis distinguish:
- phlebothrombosis - in which a thrombus is attached to an intact vein and such a connection is very fragile. It is with this version of the disease often there are terrible complications - thromboembolism of the pulmonary artery, thrombosis of the vessels of the brain or other organs;
- Thrombophlebitis is a secondary condition in which a thrombus forms on a modified vein surface. This clot is attached to the wall of the vessel very firmly and causes pronounced violations of venous circulation in the area of the branches of the affected vein.
The causes of thrombophlebitis of deep veins
The most common causes that cause the development of deep vein thrombophlebitis are:
- traumatic damage to the vein wall;
- occurrence of venous stasis with excess weight, prolonged bed rest, pregnancy, pelvic tumors;
- getting a bacterial infection;
- period after childbirth;
- continued use of oral contraceptives;
- malignant neoplasms of different localization;
- disorders of blood clotting, including autoimmune diseases.
When the patient experiences thrombophlebitis of superficial veins, the first signs of the pathological process arise against the background of the existing varicose veins. Symptoms of the disease are acute and growing pain along the vein, a slight hyperthermia, swelling and redness of the skin of the affected limb.
In the case when the patient develops acute deep vein thrombophlebitis, the first signs of the disease appear suddenly, against a background of complete well-being with veins before, but with a provoking factor. Very often after prolonged bed rest with the expansion of motor activity, there is a sharp edema and a sharp increase in the volume of the shin( especially when compared with a healthy one), changes in the color of the affected limb( diffuse cyanosis develops), a sharp, often intolerable pain.
How Deep Vein Thrombophlebitis Is Produced
In the event that thrombophlebitis occurs, the first manifestations of the disease may be associated with segregated complications of this pathological process. In 45-60% of the first symptoms of severe vascular pathology is the emergence of a clinical picture of thromboembolism of the pulmonary artery or its branches.
Local symptoms of thrombophlebitis become the appearance of a growing sense of heaviness in the affected lower limb with the development of progressive edema of the shin or the entire limb below the site of the thrombus localization. Strong and unbearable pain makes the patient seek any remedy to improve his condition, but with such pathology, even narcotic analgesics are not always effective.
Simultaneously, body temperature rises to significant values (39-40 ° C) with heavy sweats and severe malaise. When examining the affected limb, the doctor can detect glossy skin with a clearly visible pattern of subcutaneous vessels, the spread of pain during palpation along the entire affected leg, the inability to flex the foot in the ankle joint, the coldness of the limb to the touch.
Diagnosis and treatment of thrombophlebitis
Treatment of deep vein thrombophlebitis will necessarily begin with the examination of the patient. For diagnostics is used:
- phlebography - examination of veins of the lower extremity with contrasting;
- ultrasound examination of the vessels of the affected limb with dopplerography;
- impedance plethysmography - used to study the features of blood flow and the exact localization of the process;
- scanning using a special substance - isotopically labeled fibrinogen;
Treatment of thrombophlebitis of superficial veins and deep thrombophlebitis is carried out according to one principle.
- Bed rest is prescribed - for deep vein thrombosis of the lower leg and superficial treatment is carried out at home. All other patients are hospitalized in the specialized vascular department. Bed rest should be observed for at least 10 days.
- Under the control of blood clotting activity, anticoagulants of direct action( heparin) are administered intravenously, and then the patient is transferred to indirect anticoagulants.
- Treatment is performed under constant laboratory and clinical control( to prevent bleeding).
- Surgical removal of the thrombus from the lumen of the vessels is possible.
- The appointment of venotonic, antispasmodic and analgesic drugs is carried out according to the indications.