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Conservative treatment of thrombophlebitis of the superficial veins of the lower leg
Compressive elastic bandages are indicated, but they can cause severe pain in a person, so they are prescribed strictly individually.
Antibiotics are not always used to treat inflammation of superficial veins; in some cases, you can do without them (the doctor will decide this).
Drugs that reduce thrombus formation (anticoagulants) are not always used in treatment. The fact is that after 3-5 days the anticoagulant heparin can cause a decrease in the number of platelets in the patient, which are also responsible for blood clotting (there is a threat of bleeding). If there is a threat of further thrombus formation, then in a polyclinic, drugs such as dalteparin are prescribed, which usually does not cause a decrease in the number of platelets. These drugs can be administered once a day for up to ten injections, followed by even safer drugs that prevent blood clots.
There are ointments containing heparin (lioton gel, hepatrombin). They have fairly high doses of heparin, so they are sometimes used instead of injections. Ointment (or gel) hepatrombin has a strong antithrombotic effect, while, unlike Lyoton, it contains half as much heparin, but the additional components and essential oils of pine that are part of it have a pronounced anti-inflammatory effect. The ointment is applied to the affected areas 1-3 times a day.
Non-steroidal anti-inflammatory drugs (for example, nice) are also used in conservative treatment, which relieve inflammation and pain. They use drugs that increase the tone of the veins (for example, rutoside or detralex), which prevent their expansion.
Systemic enzyme therapy is also used, for example, with phlogenzyme (course of 1,5-2,5 months), which helps to reduce swelling, pain and heaviness in the legs (the effect appears only after 3-4 weeks of treatment and reaches a maximum after 1-2 months) … Preparations for systemic enzymopathy are a mixture of enzymes of plant and animal origin, they have anti-inflammatory, decongestant, anti-thrombus, analgesic and immune-restoring action.
Surgical treatment of thrombophlebitis of the superficial veins of the lower leg
The main indication for surgical treatment is the spread of the process above the middle third of the thigh or the presence of a thrombus in the lumen of large veins (should be confirmed by special studies – phlebogram or duplex scanning).
The operation usually takes place under local anesthesia, but general anesthesia is also possible. An oblique incision is made in the groin area, the trunk of the great saphenous vein is isolated, its lumen is opened (the patient or the anesthesiologist at this time holds his breath at the height of inspiration) and a thrombus is removed using a special technique. After that, the correct blood flow is checked and the vein is ligated. After 5-6 days, if necessary, the second stage of the operation is carried out – the removal of thrombosed varicose veins in order to avoid the development of gross trophic disorders in the future.
Remember! Thrombophlebitis is easier to prevent than to cure. But if signs of thrombophlebitis have already appeared, then it must be treated according to all the rules and only under the supervision of a surgeon!