Acute phlebothrombosis of the lower extremities. Phlebothrombosis: deep veins of the lower extremities, superficial, lower leg, inferior vena cava

Pathological condition circulatory system, characterized by an increase in thrombotic masses in the lumen blood vessels, in ICD 10 is positioned as phlebothrombosis. Partial or complete obstruction of the vessel occurs with an enlarging thrombus.

The danger of the syndrome lies in its long-term asymptomatic course. Thrombi are not always tightly fixed to the endothelium, so deep vein phlebothrombosis gives frequent complications in the form of TELA. The pathological process begins to develop in any vein, often this occurs in blood vessels lower limbs, iliac zone.

Phlebothrombosis, affecting mainly the veins of the lower extremities, is considered serious illness. The type of lesion is different high frequency development is fatal dangerous complications, high mortality rate.

The etiology of the disease includes vascular inflammation (thrombophlebitis), trauma, and venous congestion. The share reaches 95% of the number of thromboses described and registered in international classification diseases 10 revision (ICD 10).

Women who are in reproductive age. Complications of the disease are PE syndrome, chronic insufficiency in the venous bed, changes in the trophism of the skin of the lower extremities.

Provoking factors causing thrombophlebitis and, as a consequence, phlebothrombosis - advanced age, pregnancy, taking hormonal contraceptives, childbirth by operation caesarean section, excess body weight, sedentary image life, previous injuries, operations, smoking.

If phlebothrombosis affects the superficial vessels of the leg, there are no pathognomonic symptoms, the course long time will be latent. When the pathological process covers the deep veins, the symptoms are violent and characteristic.

When bending the leg in ankle joint bursting occurs Blunt pain in the area of the calf muscles (Homans sign). On palpation, the calf hurts (Moses symptom), the pain radiates to the medial surfaces of the lower extremities.

Acute form of the disease

Phlebothrombosis in acute form characterized by a sudden onset, two months after thrombophlebitis develops, and a rapid manifestation of symptoms. Dangerous option development - phlebothrombosis, affecting deep vessels - femoral, popliteal, iliac vein, veins of the leg. A common occurrence may be a blood clot that is not firmly fixed to the wall of the vein, but can break off at any minute and move into the arterial bed, causing pulmonary embolism.

Phlebothrombosis is divided according to the principle of localization into central and peripheral forms. The first is observed when the iliac and inferior vena cava are involved in the process. The second form is diagnosed if thrombus formation originates in the deep vessels of the lower extremities.

The main symptoms observed with phlebothrombosis are difficulty in outflow venous blood while maintaining the functions of the arterial bed.

Diagnostically significant are massive swelling of the extremities, lower part abdominal wall, cyanosis of the skin, severe bursting pain upon palpation of the calf muscles of the lower extremities. Pain is observed during movement and at rest. Developing thrombophlebitis causes an increase in the temperature of the affected leg.

Main clinical manifestations

Phlebothrombosis remains asymptomatic for a long time. Caused by incomplete closure of the lumen of the vessel. With the gradual growth of a blood clot, the first place is played by characteristic symptoms hemodynamic disorders. Upon examination, cyanosis of the skin, increased venous pattern of the thigh and lower leg, and swelling of the soft tissues are revealed.

Signs of phlebothrombosis and thrombophlebitis can be confirmed by diagnostic studies:

The localization of the thrombus and the degree of its mobility will be determined by ultrasound duplex scanning.
It will allow you to diagnose thrombophlebitis x-ray method using a contrast agent.
To exclude the embolus from entering the branches of the pulmonary artery, X-ray diagnostics are used.

Exodus past illness There are several types depending on the timely, accurate diagnosis, how adequately the treatment was prescribed:

Complete dissolution of the blood clot;
Partial dissolution of thrombotic masses, complications in the form of postthrombophlebitis syndrome;
Progression pathological process;
Re-formation of a blood clot;
Separation of the thrombus from vascular wall, moving it into the riverbed pulmonary artery.

Main directions of therapy

Treatment of phlebothrombosis is aimed at dissolving the blood clot, secondary prevention formation of blood clots, prevention of the development of the inflammatory process (thrombophlebitis). When prescribing therapy, the etiology and pathogenetic mechanisms are taken into account.

Treatment of pathology of superficial veins is carried out on an outpatient basis. Damage to deep vessels is an indication for inpatient treatment. Hope for treatment folk ways not worth it.

Patients with phlebothrombosis are prescribed bed rest, bandaging the lower extremities with an elastic bandage for the purpose of compression. Apply bandages to the legs and thighs in the morning without getting out of bed.

It is important that treatment is prescribed on time, is comprehensive, using a variety of therapeutic measures.

Conservative therapy

Treatment using direct and indirect anticoagulants performed on patients with a reliably confirmed diagnosis.

The dosage of heparin is calculated based on the patient's weight. The prescribed dose is 450 units per kilogram of body weight. The drug is administered by intravenous infusion according to the following scheme: first, a bolus of 5000 units is administered, the remaining amount is added intravenously during the day. The duration of the therapeutic course is 10 days. Blood clotting functions are monitored daily and APTT is determined.

Low molecular weight fractions - Fraxiparine, Clexane - serve as a replacement for unfractionated heparin. Thanks to the convenient method of use, small quantity side effects drugs are widely used in medical practice. Daily dosage distributed twice. Heparin is injected under the skin of the anterior abdominal wall.

6 days after the start of heparin administration therapeutic regimen anticoagulants are administered Not direct action. This group of drugs shows activity from the third day after the start of use. The drug of choice is Warfarin, prescribed at a dose of 6 mg once daily. On average, treatment with warfarin takes 6 months.

Contraindications for use: advanced age, pregnancy, alcohol addiction, viral hepatitis.

Treatment with thrombolytic drugs is prescribed for massive forms of the disease and acute course. The course of therapy is no more than 7-8 days. The enzyme streptokinase is prescribed, daily dose— 500 thousand units.

The technique of regional thrombolysis has become widespread. In this case, streptokinase is administered to the site of attachment of the blood clot. When thrombophlebitis develops, treatment with non-steroidal anti-inflammatory drugs is prescribed. Diclofenac is used in the form intramuscular injections, rectal suppositories.

When thrombophlebitis has developed, it is prescribed antibacterial therapy. IN recovery period Physiotherapy, exercise therapy, and possibly local treatment with folk remedies are used.

Surgical methods

Has become widespread surgical treatment endovascular method. Such operations are performed in the presence of a floating thrombus that can break off and lead to the development of thromboembolism of the branches of the pulmonary artery.

The following interventions are often performed:

Installation of a vena cava filter. Special filters are inserted into the lumen using a probe femoral vein. The filter is installed no higher than the location of the renal arteries.
Thrombectomy is performed in a retrograde manner through the femoral vein or veins of the leg.
Plication of the inferior vena cava is performed when other operations are not possible. Using special metal staples, the wall of the inferior vena cava is sutured.

After the postponed surgical intervention patient with secondary for preventive purposes Antiplatelet agents and heparin are prescribed.

In combination, treatment with local anti-inflammatory, heparin ointments, and folk remedies is possible.

Phlebothrombosis should not be confused with a disease such as thrombophlebitis. Thrombophlebitis is characterized by the occurrence of inflammation of the wall of a venous vessel with the development of necrosis and inflammation of the soft tissues of the leg and foot.

The greatest danger of phlebothrombosis of the deep veins of the lower extremities lies not only in violations of the trophism of soft tissues as a result of stagnation venous blood, but also in the fact that the formed blood clots can break off and be transported with the blood flow to other organs, for example, to the heart or lungs, which leads to embolism, heart attack or stroke.

A feature of the pathology is that the patient can, throughout long period not even suspect that he has this pathology in his body. In the event that the color skin remains normal and its sensitivity does not change, then at one moment he may be faced with the fact that numerous severe complications, the culprit of which is the formation of a blood clot on the vascular wall of a venous vessel.

Blood clots can form and become fixed in many venous vessels. But most often the development of this pathology is observed in the cavity venous vessels lower extremities.

A thrombus can completely block the lumen of a vein, which leads to health problems.

Classification of the main types of disease

There are several types of phlebothrombosis. Modern medicine proposes to classify varieties depending on the nature of localization, degree of development and appearance blood clot

Depending on the nature of the localization, doctors distinguish ileofemoral phlebothrombosis, which forms in the area of the iliac and femoral vein, pathology in the area of the muscular venous vessels of the leg, and phlebothrombosis of the perianal zone - hemorrhoids.

Of these varieties, only the first two types of pathology belong to phlebothrombosis of the vessels of the lower extremities.

Depending on the degree of development, they distinguish acute phlebothrombosis, the development of such a disease lasts for no more than two weeks and the subacute form of the disease, the period of progression of this form lasts from two months to several years.

Depending on their appearance, the following types of blood clots are distinguished:

occlusive - formations are stretched throughout the vessel;
wall;
floating, such thrombi are capable of attaching to only one area on the vascular wall or moving along the entire length of the vessel.

Treatment of the pathology largely depends on the type of disease and the area of its localization.

Causes of pathology

Treatment of the pathology depends not only on the type of disease developing, but also on the reasons that provoked the appearance of the disorder in the patient’s body.

Most often, this disorder of circulatory processes is detected in elderly patients. But this does not mean that the disease cannot progress in young people. Women are more susceptible to this disease than men.

The entire range of causes that provoke the appearance of disorders can be divided into three large groups.

Such groups of reasons are a slowdown in the speed of blood flow in the lumen of a venous vessel and the occurrence of blood stagnation in the vessels of the lower extremities, impaired blood viscosity and the occurrence of damage to the vascular wall.

A slowdown in the speed of blood flow in the venous vessels of the lower extremities may be due to the following reasons:

Prolonged stay of the patient in a supine position after major surgical interventions or when receiving a serious injury.
Impaired functioning of the valves of venous vessels in patients suffering from varicose veins veins
Pathologies affecting hemodynamics in the lower extremities in patients with severe swelling of the lower leg and foot, resulting from the progression of heart failure or kidney pathologies.

Violations of blood viscosity can be provoked as a result of the presence of congenital diseases of the blood system that increase the viscosity of the composition or prolonged use steroid hormones and combined contraceptives.

Damage to the vascular wall can be caused by: injury to a venous vessel as a result of surgery or prolonged exposure to a vein intravenous catheter or frequent intravenous injections.

pregnant women, in the second and third trimester;
patients with overweight bodies;
older people with a sedentary lifestyle;
patients with oncological pathologies;
women after caesarean section;

Also at risk are patients with severe pathologies in the cardiovascular system.

Characteristic symptoms of the disease

Most often, the development of phlebothrombosis occurs unnoticed by the patient and, for example, the presence of a disorder cannot be determined from a photo, which is due to the absence of visual manifestations of pathology on initial stage its development.

The diagnosis can be made by the attending physician after conducting a series of studies of the body’s condition. At the initial stage, the patient is examined by a phlebologist or surgeon.

After conducting an initial examination and interviewing the patient, the doctor prescribes a whole range of studies through laboratory and instrumental examination.

The standard procedure for conducting a human health examination involves the use of.

Laboratory tests is:

general analysis blood;
biochemical analysis blood;
blood test for coagulation and some others.

As the disease progresses, the patient experiences the appearance of more serious symptoms indicating the development of pathological changes.

With phlebothrombosis of the superficial veins of the leg, the patient notes the appearance of sudden pain and swelling of the foot area. There is a change in the color of the skin and a characteristic venous network on the skin of the lower extremities.

In the event of a pathology affecting deep veins To indicated symptoms emerging pain in calf muscles when performing flexion movements of the foot and painful sensations when palpating muscles.

Treatment methods for phlebothrombosis

If you first suspect that there is a disorder in your body, you should immediately consult your doctor. In any case, if a pathology is detected, immediate hospitalization of the patient in the surgery department is required for further diagnostics and prescribing adequate and timely treatment.

To treat the disease, drug and surgical treatment methods are used. The choice of method is carried out by the attending physician in accordance with the data of the examination and individual characteristics the patient's body.

Drug therapy involves the use of drugs with anticoagulant properties during treatment. This group medicines has the ability to prevent the formation of blood clots. This group of medications includes Heparin and Warfarin. Heparin is used in the first 5-7 days by implementing subcutaneous injections in the abdominal area. Injections are carried out 4 times during the day.

In the future, the patient must take Warfarin tablets for a long period of time.

As surgical methods The following treatment methods are used:

Introduction of a vena cava filter.
Creation of artificial occlusion.
Partial removal of the damaged vein.

The introduction of a vena cava filter today is the best method TELA warnings. This is due to the fact that such a device can effectively capture a blood clot on its way from the limb to the vessels of the lungs.

The vena cava filter is a wire structure resembling an umbrella. This design ensures unhindered blood flow and effective capture of blood clots. This device can be installed in the body for a period of time or for permanent use.

The creation of artificial occlusion of the affected vessel is achieved by applying a small clip to the vein. This procedure is used to create obstacles for the blood clot to break off and transport it to vascular system lungs.

An operation to remove part of a venous vessel is used when a vein is damaged by thrombosis over an extended area. In such a situation, removal of part of the vein is used, followed by prosthetics of the removed area.

The main contraindication to the use of this surgical method is elderly age the patient, the period of gestation and serious condition sick.

Complications, prognosis and prevention of phlebothrombosis

Most dangerous consequence with the development of pathology, pulmonary embolism occurs, which consists of detaching a blood clot and transporting it from the site of attachment to the vascular system of the lungs, followed by blockage of blood vessels.

The main symptoms of this complication are the appearance of shortness of breath at rest and its intensification when walking and the patient’s body is in a lying position; cyanosis of the skin of the face and fingertips may develop.

Treatment of complications is carried out by taking antiplatelet agents such as, for example, Heparin or Fraxiparin. The drugs are used in the form of subcutaneous injections. In progress further treatment a transition is being made to oral forms of drugs - Xarelto, Phenilin, Warfarin and Aspirin.

Another complication of the pathology is the development of postthrombotic syndrome. The main symptom of the complication is the appearance of swelling and pain in the affected area of the limb. With the development of this complication, the appearance of varicose veins is observed. The main method of treating complications is the use of compression hosiery and venotonic agents, which are Phlebodia,

Phlebothrombosis is the formation of a blood clot (thrombus) in the vessels of the lower extremities. It is noteworthy that in 80% of cases the disease is asymptomatic, which ultimately leads to pulmonary embolism. The latter often leads to fatal outcome.

Official statistics say that every fourth person on the planet is affected by the disease. Most often, the disease affects women - they suffer from phlebothrombosis 6 times more often than men. People over 40 who suffer from excess weight also have a significant risk of getting sick.

Etiology

There are three etiological groups:

congenital;
oncological;
hormonal.

The following etiological factors can be attributed to the congenital group:

insufficiency of venous valves;
pathological disorders elastic membrane of veins.

Such pathological disorders in the lower extremities lead to the disruption of natural blood circulation in the human body. As a consequence of this process, the formation of one or more blood clots.

The oncological pathology group includes the following factors:

malignant formations in the pelvic organs;

Since chemotherapy is often used to treat such diseases, this leads to the destruction of the walls of blood vessels. Moreover, such patients lead sedentary lifestyle life, which disrupts the natural movement of blood throughout the body. Also drugs for the treatment oncological diseases lead to deterioration of blood clotting. All this can ultimately lead to phlebothrombosis of the lower extremities.

It is worth noting that with such an etiological picture, inflammation of the walls of blood vessels often occurs.

To the group hormonal disorders The following etiological factors can be attributed:

hormonal imbalances during pregnancy;
application oral contraceptives without a doctor's recommendation;
pathological disorders in the reproductive system.

In addition, the following factors can provoke the disease:

fractures;
, ailments associated with metabolic disorders;
infectious diseases;
paraplegia;
consequences of severe operations.

The main risk group is people over 40 years of age, smokers, and leading a sedentary lifestyle.

Pathogenesis

As a result of injury, disease or other pathological processes, the inner lining of the vein is destroyed. This damage leads to thrombin entering the blood. This substance increases blood viscosity. As a result of this, normal blood circulation is disrupted and a blood clot is formed, which ultimately leads to phlebothrombosis of the deep veins.

General symptoms

On initial stage the development of phlebothrombosis, practically no symptoms are observed. As the pathological process develops, the clinical picture may appear as follows:

feeling of heaviness in the legs, especially towards the end of the day;
coldness in the lower extremities;
swelling, noticeable increase in leg volume (especially in the knee area);
on the affected areas the skin becomes bluish and pale;
bursting pain in the area inside shins;
unstable temperature, sometimes up to 39 degrees.

IN chronic stage development of phlebothrombosis of deep veins, the skin in the affected areas may become glossy. In this case, the veins in the lower extremities are clearly visible, and the sore leg is much colder than the healthy one.

Classification

Phlebothrombosis is distinguished by the nature of localization, the degree of development and the appearance of the thrombus.

By the nature of localization:

ileofemoral phlebothrombosis – in the area of the iliac and femoral vein;
muscle veins of the leg;
phlebothrombosis of the perianal zone ().

Phlebothrombosis of the lower extremities includes only the first two subtypes.

By degree of development distinguish:

acute phlebothrombosis (the development of the disease lasts no more than two weeks);
subacute form of the disease (development of the disease from two months to several years).

By appearance These types of blood clots are distinguished:

occlusive (thrombi are stretched throughout the vessel);
wall;
floating (can attach to only one site on a vessel or move along the entire length of the artery).

Treatment of the disease depends on what type of disease is diagnosed.

Diagnostics

Laboratory diagnostic methods are practically not the main ones. A doctor can prescribe such tests only if there are prerequisites for this - you need to establish your blood type, check your blood for infection, and so on.

Initially, a personal examination is carried out by a phlebologist or surgeon. After clarifying the medical history, the patient is prescribed instrumental tests. The standard program includes the following:

angiography;
Dopplerography;
Homans test;
marching test;
Mayo-Pratt test.

Based on the above tests, the doctor can diagnose accurate diagnosis and prescribe the correct treatment.

Treatment

Treatment is prescribed only by a competent specialist after diagnosis and precise setting diagnosis. If a patient is diagnosed with phlebothrombosis of the lower extremities, then hospitalization with strict bed rest is required.

As part of drug treatment, drugs with the following spectrum of action are prescribed:

indirect anticoagulants;
thrombolytics;
hemorheological active drugs;
anti-inflammatory local application(ointments).

In combination with drug treatment, it is prescribed non-drug therapy– the affected leg is bandaged with an elastic bandage. This helps reduce pain and makes it possible to move more or less normally.

If conservative treatment does not give positive result or the patient has already developed thrombophlebitis, then it is used surgical intervention. A special clamp is placed in the vein to prevent blood clots from reaching the heart or lung.

If the clinical picture allows, then surgery is performed. complete removal thrombus from a vessel.

Also complex treatment implies special diet. As part of this diet, you should adhere to the following recommendations:

drink at least 2 liters of fluid daily;
eat foods rich in antioxidants;
limit consumption of fatty and spicy foods;
Alcohol is completely excluded.

Forecast

If treatment is started in a timely manner, no significant complications are observed. But, provided that the patient complies with the regimen proper nutrition, lead moderate physical activity. Otherwise, thromboembolism may form. And this often leads to death. Therefore, at the first symptoms, you should urgently seek medical help.

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Diseases with similar symptoms:

Venous stagnation is a pathology characterized by the presence of obstructed outflow of venous blood with normal arterial inflow. The cause of the disease is problems with the elasticity of the walls of blood vessels and high blood viscosity.

Phlebothrombosis is a disease characterized by the appearance of a blood clot in the lumen of a vein, which is fixed to the vessel wall with the development of an inflammatory reaction and can cause serious complication in the form of pulmonary embolism as a result of blood clot detachment.

Rice. 1. Thrombus in the lumen of the femoral vein
right lower limb

There are several reasons that can cause thrombosis of the deep venous system:

increased blood clotting;
trauma to the vessel wall;
slowing down blood flow in the lumen of the vessel.

There are also a number of factors leading to the occurrence of this pathology:

congenital disorder of hemostasis - thrombophilia;
pregnancy and childbirth (as a result venous stagnation in the system of the inferior vena cava, which is compressed by the enlarged uterus);
presence of a fracture or surgery performed;
overweight;
physical inactivity (sedentary lifestyle);
long flights;
reception hormonal drugs and medications that affect blood clotting (including oral contraceptives);
oncological diseases.

Classification:

1. According to the degree of fixation to the vessel wall:

occlusive;
floating.

2. According to the localization of the thrombotic process:

phlebothrombosis of the leg;
femoral;
ileofemoral;
subclavian.

3. By timing of occurrence:

spicy;
subacute

As a result of a number of reasons, a blood clot, the so-called thrombus, appears in the lumen of the vessel, which is fixed to its wall. The thrombus either lines the entire lumen of the vein or partially fills it. Subsequently, thrombotic masses increase, and in the area of least fixation of the thrombus, partial fragmentation and separation may occur, which inevitably leads to the development of pulmonary embolism.

The first few days (3-4 days) risk possible complication very high, since the thrombus is still too weakly fixed to the vessel wall. Only after the inflammatory reaction has occurred does the blood clot become fixed, approximately 7-10 days after the onset of the disease.

Symptoms of phlebothrombosis of the lower limb

Select a row typical symptoms, characteristic of this disease:

heaviness in the leg (with slight physical activity and even at rest) and sharp pain(most often occurs acutely, without apparent reason);
pronounced edema lower leg or thigh (depending on the location of the process, maybe even the entire limb) (Fig. 4);
change in skin color (bluish tint, which decreases with an elevated position of the limb).

Diagnosis of phlebothrombosis of the lower limb

Consultation with a vascular surgeon.
Duplex scanning vessels (Fig. 5).
Phlebography (used when there is doubt about the results of duplex scanning).

Treatment of phlebothrombosis of the lower limb

1. Conservative therapy(V acute stage disease requires hospitalization of the patient):

strict bed rest for 5-10 days;
semi-alcohol compresses at night;
anticoagulant therapy (administration of Heparin or indirect anticoagulants);
taking Warfarin under INR control (therapeutic window from 2 to 3);
elastic compression of the lower extremities during physical activity;
exalted position legs while resting.

2. Surgical treatment (must be performed if a floating thrombus or recurrent pulmonary embolism is detected):

performing ileocavagraphy and, if necessary, installing a vena cava filter in the inferior vena cava;
plication of the vein above the thrombosed area to prevent possible complications.

Essential drugs

There are contraindications. Specialist consultation is required.

Heparin sodium (direct anticoagulant). Dosage regimen: intravenous bolus - 80 units per 1 kg of body weight, initial infusion rate - 18 units per 1 kg of body weight per hour (not less than 1250 units/hour). Next, dose selection is carried out by determining the APTT. The duration of administration of sodium heparin should be 5-7 days. (with a gradual transition to NACG). When transferring a patient to NACG, the latter are prescribed 4-5 days in advance. before the expected withdrawal of UFH. The administration of UFH is stopped only when the INR value reaches 2.0-3.0.
(indirect anticoagulant). Dosage regimen: orally in a dose of 2.5-10 mg 1 time per day at the same time. The initial dose for patients who have not previously used warfarin is 5 mg per day (2 tablets) for the first 4 days. On the 5th day of treatment, MHO is determined and, in accordance with this indicator, a maintenance dose of the drug is prescribed.

The disease is characterized by the formation of a blood clot in the deep veins. The thrombus partially or completely blocks the blood flow in the vessel, disrupting both normal blood circulation and causing tissue necrosis.

Localization of blood clots most often occurs in the deep veins in the lower leg area.

Phlebothrombosis of the lower extremities is characterized by weak fixation of the blood clot. This disease is considered deadly, because it is extremely difficult to predict the rupture of a blood clot along with simultaneous inflammation of the vein.

In addition, the disease often has a hidden course, accompanied by complications:

Pulmonary embolism.
Thromboembolism coronary vessels hearts.
Thromboembolism of renal vessels.
Phlebothrombosis of the perianal zone.
Thromboembolism of cerebral veins.

Types of phlebothrombosis

The subacute form is characterized by a long and almost imperceptible course of the disease. The disease can develop from a month to several years. It is complicated by the formation of multiple blood clots in the deep veins in different places.

This disease is diagnosed on late stages when the expense is not on health, but on life. After all, the manifestation dangerous symptoms leads to immediate hospitalization. Diagnostics and proper bed rest are the main assistants for the patient.

Acute phlebothrombosis is accompanied by violent clinical picture: increased body temperature, swelling of the extremities, which is accompanied by simultaneous redness.

Acute phlebothrombosis of the femoral, tibial and popliteal vein is mortally dangerous for the reason that at any moment a blood clot can break off and provoke pulmonary embolism.

Symptoms

The first symptoms, often mild, may occur periodically. You can ignore it for a long time danger signs, believing that this is another exacerbation of varicose veins. It is this attitude that leads to complex and even fatal outcomes of the disease.

Nagging pain, which is most often localized under the knee, gradually spreading to the inner or outer part of the thigh and foot.
Pain while walking or doing exercises. Difficulty walking and severe pain occur when the foot flexes.
Systematic pain in the area of the vascular bundle.
Heaviness and swelling of the legs in the evening, especially in the lower leg area.

Vein occlusion and simultaneous worsening of blood flow in the legs are accompanied by inflammatory processes in the deep venous wall.

At the same time, tissue nutrition is disrupted, and the etiology of the disease becomes more pronounced. Symptoms become constant.

The difference between thrombophlebitis and phlebothrombosis

Patients often confuse thrombophlebitis and phlebothrombosis and do not understand the difference between venous pathologies. Both diseases are characterized by the formation of a blood clot in the veins, disrupting both the patency of the veins and causing more complex diseases, are accompanied by changes in blood movement.

However, if thrombophlebitis is considered acute illness superficial veins with inflammation of the vessel walls, then phlebothrombosis affects deeper veins without characteristic inflammation vascular wall.

In addition, the latter condition can provoke death, while thrombophlebitis provokes inflammatory process and the simultaneous occurrence of secondary infection.

Diagnostics

Timely treatment dangerous condition perhaps only after correct diagnosis. It is important not only to determine the degree of pathology, but also to determine the location of the blood clot.

If you suspect the development of deep vein pathology, consultation with a vascular surgeon is important. Based on a complex of studies, anamnesis data and analysis of the patient’s complaints, an accurate diagnosis is made.

A general blood test is taken from the finger. The laboratory technician counts the number of platelets, their clotting time, and the duration of bleeding.

Graphic determination of coagulability and thrombin generation test allow identifying thrombus-forming factors. An APTT (blood clotting indicator) and a biochemical blood test are also additionally prescribed. They can also assign:

Doppler examination: lower leg, iliofemoral region.
Ultrasound of organs abdominal cavity and pelvis.
Venography.
MRI, if positive biochemical research blood.

Dangerous clinical conditions

In case of phlebothrombosis of the left leg or renal veins, the main danger is the separation and migration of a blood clot through the pulmonary arteries.

This condition leads to cardiac arrest within a few minutes, and therefore there are dangerous clinical conditions that require immediate treatment and hospitalization.

Cardiopalmus, increased sweating And arterial pressure, swelling of the extremities, increased body temperature, shortness of breath and It's a dull pain in the chest area - these are signs of a dangerous course of the disease.

It is important to understand that main danger in this state represents any movement. The patient must be completely immobilized and placed on a firm base in vertical position, absolutely no movement.

The slightest movement can break a blood clot and lead to death. Compresses and taking medications without a doctor’s advice are strictly prohibited!

Treatment methods

Phlebothrombosis – dangerous disease, which remains practically asymptomatic for a long time. At the same time, life-threatening complications remain - blood clot rupture. It is for these reasons that it is important to approach the process of treatment and prevention comprehensively, but in no case self-medicate.

Taking blood thinning medications without a doctor's prescription can cause severe blood thinning, and, as a result, the separation of an already formed blood clot. This situation is fraught with death.

Treatment of pathology combines methods that are aimed at comprehensively eliminating the cause of the disease and preventing complications in the future.

Conservative

This treatment involves taking medications based on data obtained through research. As part of drug treatment, the doctor may prescribe:

Indirect anticoagulants. They reduce the production of proteins C and S and impede the formation of the hormone prothrombin - phenylin - in the liver.
Thrombolytics. Administered intravenously, they help soften and destroy the formed blood clot without risk to health: Aspirin, Curantil, Trental, Warfarin, Heparin, Dextran.
Hemorheological active preparations contain diquertin and ascorbic acid, affect blood rheology.
Anti-inflammatory ointments for local use. They are characterized by insignificant permeability with a weaker effect, used for local treatment long-term: Heparin ointment, Venolife, Lyoton, Laventum, Trombless.

Conservative treatment also includes correct intake balanced food. It is important to completely exclude fatty foods, fried foods, alcohol, carbonated drinks, vinegar, carbohydrate foods (bread, baked goods), meat, and sea fish. Eat more fiber, fruits, and vegetables. Increase the amount of water depending on the patient’s height and weight.

Gymnastics is completely contraindicated if there is a risk of blood clot migration. Against the background of such treatment, a decision is also made on continuous monitoring of the disease.

It is important for the doctor to see the results of the treatment, how effective and efficient it is. Otherwise, a decision may be made to apply radical treatment– surgical intervention.

During conservative treatment, it is recommended to apply elastic bandage. This not only helps reduce pain and swelling, but also allows you to move around.

Physical activity, use of steps, sauna and taking thinning medications are strictly prohibited! Prescription of certain drugs only from a doctor!

Surgical

If conservative treatment does not produce results, the attending physician decides to perform surgical intervention.

During the operation, a special clamp-clamp is inserted into the damaged vein, which does not allow the blood clot to detach from the vessel walls during the operation.

With the appearance of purulent phlebothrombosis, gangrene of the vessel, the development of ascending thrombosis, embologenic thrombosis, increasing occlusion large vessel applies exclusively surgery. Otherwise, life counts on the clock.

Disease prognosis

Timely treatment and correct diagnosis help not only prolong the quality of life, but also reduce the risk of developing more complex clinical condition– thromboembolism.

It is also important to follow a proper diet and drink water, at least 2.5 liters per day. The risk of complications is minimal provided that the patient engages in moderate physical activity.

Therefore, at the first symptoms dangerous disease Seek emergency medical help immediately!