Contents
What is thrombophlebitis?
Thrombophlebitis – this is inflammation of the venous vessels, which is accompanied by the formation of a blood clot in their lumen. A thrombus is a blood clot. If the thrombus has just begun to form, and the venous wall has not yet undergone inflammation, this disease is called phlebothrombosis.
Thrombi can form not only in the superficial but also in the deep veins, but it is the superficial veins that most often suffer. This disease is called superficial thrombophlebitis. An injury to the vessel can provoke the development of the disease. The fact is that veins do not have muscles, so blood clots that have formed once continue to grow in them without breaking off. In this case, a certain area of uXNUMXbuXNUMXbthe lower limb will suffer from circulatory disorders.
If a thrombus forms in deep veins, then there is a risk of its separation, since pressure drops affect the state of such vessels. This can lead to the fact that a detached blood clot will begin a “journey” through the vein system, will break up into small particles that can clog vessels located in the brain, lungs, and heart. Such thrombosis leads to serious consequences for health and can cause death of a person from an embolism.
Famous people who suffered from thrombophlebitis:
Thrombophlebitis spares neither the poor nor the rich. Famous people such as Richard Nixon (former US President) and Dan Kuyle (former Vice President) suffered from this disease.
Kate Winslet suffered thrombophlebitis in 1995 while filming Sense and Sensibility as Marianne Dashvoot.
Mario Lanza suffered from thrombophlebitis, who died from blockage of the pulmonary vessels by an embolus.
Cartoons, films and TV shows whose characters suffered from thrombophlebitis:
The famous character of the animated series The Simpsons in one of the episodes received a deuce, as a result of which the school nurse suspected he had phlebitis.
In the sitcom Everyone Loves Raymond, P. Boyle’s character was ill with thrombophlebitis, or pretended to be ill in order not to fulfill his duties.
Mentions of thrombophlebitis Mr. Strickland, the hero of the animated series “King of the Hill.” This happens while visiting the pool with Luanna, where he takes a Bible study course.
In the series Hospital, Colonel Potter suffers from acute thrombophlebitis.
In Futurama, Richard Nixon’s head recalls his “glorious Republican body riddled with thrombophlebitis”
The symptom is thrombophlebitis
Thrombophlebitis affecting superficial veins does not begin acutely. First, the patient has a seal and slight hyperemia in a certain area of uXNUMXbuXNUMXbthe leg. Then the inflamed area becomes larger, capturing the affected vein. In this case, you can feel a painful seal that repeats the shape of the vessel. It is also possible to involve small vessels in the process of inflammation, in which case the affected veins will look like a spider network.
Sometimes, even with a severe development of the disease, the symptoms are mild. Manifestations of superficial thrombophlebitis can be reduced to redness of a certain area of the skin, which becomes hot to the touch and gives pain on palpation.
Most often the legs suffer from thrombophlebitis. In the area of inflammation, redness and hyperthermia occur. The venous pattern becomes more pronounced. Sometimes a blood clot can severely disrupt blood circulation in the affected leg. In this case, her skin turns blue.
Pain in the leg begins to disturb not only during movement, but also during complete rest. Skin itching appears at the site of inflammation. The pain has a burning and throbbing character. It becomes stronger with a sharp change in the position of the legs, for example, when a person lay down for a long time and then quickly got up.
As the disease progresses, body temperature begins to increase, which most often stays at a level of no more than 38 ° C. Women should definitely pay attention to such an increase in temperature in the first 10 days after the birth of a child. It is during this period that the risk of developing thrombophlebitis is considered high.
If the inflamed part of the vein becomes infected, then the pain becomes unbearable, the skin turns very red, an abscess with suppuration may develop.
Symptoms of deep vein thrombophlebitis include the following:
Red skin over the inflamed area of the vein. Sometimes it can take on a blue tint or become pale.
Local increase in body temperature.
Swelling of the limb.
Pain in the affected area.
If deep veins are affected, then the edema will be very pronounced. Comparison of two limbs (sick and healthy) will allow you to assess the degree of edema intensity. The muscles of the sore leg will be very tense.
Symptoms of acute thrombophlebitis
The acute form of thrombophlebitis is manifested by pronounced symptoms. First of all, a person experiences severe pain in the area of the affected vein. The skin becomes cyanotic, blood vessels dilate, become. The temperature of the body as a whole rises, and the leg may remain cold to the touch. The pain is bursting, to reduce it, the person lifts the leg up.
If a person has symptoms of thrombophlebitis, it is necessary to consult a doctor as soon as possible. The patient himself until the arrival of doctors should remain in bed. It is strictly forbidden to take any measures aimed at eliminating the symptoms of the disease. Applying ointments, rubbing the affected limb, using compresses – all these manipulations are unacceptable. Otherwise, a thrombus can be provoked, which often leads to the death of the patient.
Acute thrombophlebitis is associated with the risk of complications that can begin quite quickly. These include blue and white phlegmasia, ischemic thrombophlebitis and gangrenous thrombophlebitis. The pain intensifies every minute, the edema grows “before our eyes”. The skin at first becomes pale, the loan is purple. The sooner the victim receives medical assistance, the easier the consequences of the transferred inflammation will be.
Symptoms of chronic thrombophlebitis
Chronic thrombophlebitis is often hidden. Pain in the lower extremities occurs from time to time, can intensify after physical exertion. At rest, pain may not bother a person at all. The edema of the affected limb is not too intense, it can be barely noticeable, so the patient is in no hurry to seek medical help.
Therapy of the chronic form of the disease is reduced to the use of special ointments. The patient should wear elastic stockings, do therapeutic exercises, undergo physiotherapy.
Causes of thrombophlebitis
Damage to the vascular wall threatens the development of thrombophlebitis. Injuries to the veins can lead to the placement of a catheter or needle to perform intravenous infusions. Thrombophlebitis of the legs can be the result of varicose veins.
The causes of deep thrombophlebitis can be as follows:
Low physical activity of a person. If hypodynamia is a habitual way of life, then one should not be surprised at the diagnosis of thrombophlebitis. The longer a person is without movement, the larger the blood clot will become. In the future, it will lead to serious violations in the process of blood circulation of the limbs.
The venous wall can be affected by a catheter, a needle, as a result of a soft tissue injury, against the background of infectious diseases, or chemicals.
Violations in the process of blood clotting. These disorders can be acquired or congenital.
Risk factors for the development of thrombophlebitis:
Prolonged sitting with limited mobility of the lower body. Often, blood clots begin to form during long trips, during air travel, in bedridden patients.
Overweight.
Taking hormonal drugs and smoking. If these two factors affect the body at the same time, then the risk of blood clots increases.
Carrying a child. The uterus, as it grows, compresses the veins of the small pelvis. This increases the risk of thrombus formation.
Alcoholism.
Cancers in the body.
Injury to the lower extremities.
Risk groups
There are certain categories of people who are at risk for the development of thrombophlebitis of the veins of the lower extremities.
Among those:
People whose work involves prolonged sitting. For example, this applies to drivers.
People who are immobilized after surgery or due to another disease.
People with varicose veins.
Women who have recently given birth.
People with phospholipid syndrome, or HHC, in which the blood clots faster than normal.
Patients with obesity.
Older people who lead a sedentary lifestyle.
thrombophlebitis during pregnancy
Varicose veins and thrombophlebitis are two diseases that often manifest during childbearing. The reason for the start of these diseases is an increase in intra-abdominal pressure and changes in the composition of the blood. It is dangerous if thrombophlebitis develops in the postpartum period. The fact is that during childbirth, the vessels experience an enormous load, which can lead to the separation of a blood clot.
Intra-abdominal pressure during childbirth increases by 2-3 times.
During passage through the birth canal, the child presses the veins of the pelvis with his head. At the same time, the veins that penetrate the lower limbs lose their tone, which leads to their expansion. Violation of blood flow entails the formation of blood clots.
If a woman has a tendency to varicose veins, then she can detect the first signs of the disease during the second trimester of pregnancy, when there is a significant weight gain. First, spider veins appear on the skin, which are located on the thighs, ankles, legs. Then the veins begin to increase in size, by the evening the legs become swollen, seizures may occur.
If a pregnant woman notices such symptoms in herself, then she needs to consult a doctor. A phlebologist deals with diseases of the veins. The doctor will examine the patient and give her recommendations that will help avoid serious health complications in the future.
Complications and consequences
Thrombophlebitis of the deep veins of the lower extremities can be complicated by the development of chronic venous insufficiency. The legs will constantly swell, suffer from malnutrition. As a result, the development of such conditions as: eczema, lipodermatosclerosis, trophic ulcer (one or more) is possible. A blood clot can also cause sepsis.
The most formidable complication of deep vein thrombophlebitis is pulmonary embolism. In this condition, pieces of a detached thrombus with blood flow spread through the vein system, reach the pulmonary artery and block its lumen. This complication is called pulmonary embolism. If the blood flow in the lungs is disturbed, the patient quickly develops heart and respiratory failure, which can cause his death. If a particle of a blood clot enters a small branch of the pulmonary artery, then a pulmonary infarction develops.
In order to prevent the separation of a blood clot and its penetration into the lungs, special thrombus traps are installed in people with diagnosed thrombophlebitis. They are called kava filters. Such filters are a wire structure shaped like an umbrella. It opens in the place of the vein where it is needed and stays there forever. Enter the filter through the vein system. This device is designed to delay large blood clots. However, installing cava filters comes with a number of risks. Catching a blood clot, the filter itself may become blocked, which will lead to the spread of edema to the second lower limb. As a result, the patient will suffer from severe venous insufficiency in both legs, which threatens the development of post-thrombotic disease with the further formation of trophic ulcers. Sometimes thrombosis can spread above the place where the cava filter is installed.
Therefore, six months after the episode of acute thrombophlebitis, the patient is shown an operation to remove blood clots. It is called a thrombectomy. If it was performed qualitatively, then post-thrombotic disease does not threaten a person.
What is the difference between varicose veins and thrombophlebitis?
Thrombophlebitis by varicose type is one of the most common diseases. In this case, a person suffers from severe pain, and redness of the skin over the veins of the lower extremities can penetrate the leg along its entire length, reaching the inguinal zone. At the same time, the leg swells strongly, the tone of its muscles increases. As the thrombus forms, the edema spreads to the deep veins, which is a condition that threatens the development of serious complications. While walking, a person experiences pain. Discomfort is given to any touch to the leg. A person’s body temperature rises, weakness increases.
Varicose veins and thrombophlebitis are two diseases that have a close relationship. Varicose veins can cause blood clots to form in the deep veins and in the superficial veins of the lower extremities. Thrombophlebitis can be a complication of varicose veins, since with the latter disease, blood flows slowly through the veins. Thrombophlebitis, in turn, can cause much more serious complications, such as: pulmonary embolism and post-thrombophlebitis syndrome.
For the treatment of thrombophlebitis, which developed against the background of varicose veins, the patient is prescribed anti-inflammatory drugs. They not only reduce the inflammatory response, but also allow you to eliminate pain in the legs. For this purpose, ointments with a hormonal component, semi-alcohol compresses, and candles with NSAIDs in the composition are used.
To prevent thrombophlebitis of superficial veins from spreading to deep veins, the patient should use elastic stockings and tights, or wrap his legs with elastic bandages. Preparations Detralex and Antistax can reduce the severity of edema and relieve the inflammatory reaction.
Diagnosis of thrombophlebitis
Modern medicine has sufficient capabilities to accurately diagnose thrombophlebitis. To begin with, the patient must visit a phlebologist, who will examine the patient, conduct tourniquet tests, a march test. These studies will allow him to assume that a person has thrombophlebitis.
To assess blood flow in deep veins, it is possible to use methods such as:
duplex scanning.
Phlebography.
Ultrasound of the veins of the lower extremities.
Radionuclide scanning.
To assess blood microcirculation, rheovasography of the lower extremities is performed.
Thrombophlebitis treatment
Thrombophlebitis of the superficial veins of the lower extremities does not require any global treatment. The disease often goes away on its own. The main thing is to control its development, which is easy to do at home.
In acute thrombophlebitis, the patient is prescribed anti-inflammatory drugs, and it is also necessary to maintain the lower limb in an elevated position. To increase vascular tone, reduce swelling and improve blood supply to the leg, you can use special ointments. Warm compresses can also be applied to the legs.
Aspirin, ibuprofen, or another NSAID can relieve pain and prevent blood from clotting. In addition to oral administration of these funds, you can use ointments based on them. These include Fastum gel, Diclofenac, Ortofen, etc. Be sure to wear elastic stockings with superficial thrombophlebitis.
Wearing elastic underwear and bandages allows you to keep the veins in good shape and prevent the progression of the disease. Stockings put pressure on the veins, preventing them from expanding and preventing blood clots from coming off.
Stockings of different lengths can be used depending on where exactly the thrombus is located. They make it possible to prevent the development of deep vein thrombosis, which means that the risk of thromboembolism is minimal. Within a few weeks of wearing elastic underwear and receiving anti-inflammatory treatment, the clot will dissolve.
Antibacterial drugs are prescribed only in the case when the fact of infection has been identified. Otherwise, antibiotics can be harmful to health.
In addition to ointments with NSAIDs, preparations with Heparin are used to treat thrombophlebitis. It could be Lyoton or Hepatrombin. Sometimes the application of such ointments allows you to refuse the injection of drugs based on Heparin. As part of the drug Gepatrombin there is also an anti-inflammatory component, so its use has a complex effect.
Deep vein thrombophlebitis requires anticoagulant therapy. The affected limb must be in an elevated position throughout the entire treatment process. The first priority is to prevent the development of pulmonary embolism. For therapy, the patient is hospitalized.
Sometimes, in addition to the use of anticoagulants, doctors prescribe thrombolytic drugs to patients with deep thrombophlebitis, which are designed to dissolve a blood clot. The time of therapy in this case is significantly reduced, but the risk of thrombus separation increases. If there is a need to use thrombolytics, Enoxaparin (Lovenox) is administered subcutaneously or intravenously to the patient, which quickly dissolves the thrombus.
To control the treatment carried out with Warfarin, it is required to monitor the INR index, which is determined during the blood coagulogram. It characterizes the clotting capabilities of the blood. The analysis is taken daily while the patient is in the hospital.
Drugs for auxiliary treatment are angioprotectors – Venoruton and Troxevasin. You can also use venotonics – Phlebodia and Detralex. Their use allows you to stop further damage to the vascular wall, relieve inflammation and prevent the progression of thrombophlebitis. Preparations from this group are recommended to be taken in the form of tablets, since ointments can irritate the skin.