thrombophlebitis - is vascular disease, which is characterized by inflammation of the venous wall with the formation of a blood clot, partially and fully blocks a vein.Thrombophlebitis localized mainly in the lower extremities and strikes usually veins, under the skin or deep into muscle tissue.Thrombophlebitis is a consequence of complications infectious disease process, which goes to the veins of the wounds, and as a result hypercoagulable and impaired venous wall structure.Often, however, on the development of thrombophlebitis affects the pathology varicose veins as a result of varicose veins.
In addition, those blood clots that form during the disease process, not only can clog vein and thereby disrupt blood flow, but also in the case of separation, to cause severe complications and even death.
considering several variants of the thrombophlebitis.It can be characterized by acute symptoms of the current, as well as subacute and chronic.Furthermore, flow in purulent and
The disease is considered to be very dangerous and requires immediate professional examination and the appointment of adequate treatment to prevent complications such as thrombosis of the deep-seated veins, pulmonary embolism and sepsis.
for this disease is characterized by phlebitis (inflammation of the venous wall) and periphlebitis with the formation of intravascular blood clots or thrombi.Most patients suffering thrombophlebitis limbs, mainly lower.Are superficial leg veins that lie under the skin and deep, which are connected to each other by anastomoses, ie perforating veins.All these veins include valves that provide blood flow in one direction and continuous in the main veins from the peripheral parts towards the center, and on the perforating - of a deep-seated saphenous veins.
thrombophlebitis limb refers to polietilogichekoy pathology.In his appearance affects destroying the integrity of the veins and the factors of an infectious nature.The venous wall may be infected by nearby tissues or get an infection of the lymphatic system, as well as through blood.In the development of thrombophlebitis certainly not the last role played by existing human cavities, pneumonia, tuberculosis, tonsillitis, that is present in the body pathological infection.Of course, an important role in the occurrence of this disease is given varicose veins, poor heart function, prolonged bed rest, t. E. Slow down the process flow;changes in the blood and increased its coagulating properties.By the predisposing factors of thrombosis are reduced reactivity and disorders of the nervous and endocrine systems.
Typically, a blood clot that has formed in a vein, largely resorbed and patency of the vessel is gradually recovering, but this can not happen, then the image flebolity (venous stones).Furthermore, in some cases, there purulent fusion of a blood clot or even its separation, and even transfer, for example, to the lungs.Thus, developing thromboembolism LA to produce a heart attack.
thrombophlebitis is an infectious etiology and aseptic.In the first case, the pathological process of developing postpartum or after suffering an abortion;typhus, erysipelas, influenza, abscess;for tuberculosis and septicopyemia.Aseptic thrombophlebitis varices formed when migrating phlebitis, at squeezing veins, wounds and heart disease, as well as blood vessels.
thrombophlebitis of extremities may occur during the acute (purulent and purulent character), subacute and chronic forms as in the defeat of the veins on the surface and deep-seated.In addition, there is a process of relapse in chronic thrombophlebitis flowing.
thrombophlebitis of veins under the skin, in the acute form is characterized by sudden onset, accompanied by a slight rise in temperature.In patients with pain in the affected areas of the veins that are amplified in certain movements of the limbs, patients experience a general malaise.This limb swelling gets, and the veins are characterized by their density, morbidity with cord infiltration.The skin on them becomes congested, cyanotic shade, they are painful on palpation.The pathological process lasts up to four weeks.
Quite often manifest themselves symptoms of subacute and chronic stage.With a significant edema of the limbs, it can be assumed that the thrombosis moved to deep-seated muscle veins.This type of thrombophlebitis or phlebothrombosis develops as a consequence of the previous complications.Thus in patients with rapidly rises to high levels of temperature, they begin to shiver.The disease is characterized by severe pain in the limbs, which are particularly aggravated by coughing, there is tachycardia and symptoms of Mahler.Rinse the affected limb swells rapidly, gradually fades, it becomes bluish-hue marble while it is cold to the touch and definitely tense.On palpation marked characteristic Rocker pain in the heel area.And while squeezing the muscles of the lower leg and bending the rear foot pain appear strong character.On the side of the affected limb pulse considerably weakened or absent.Lymph nodes are regional nature grow in size, and cause some pain.On average, such thrombophlebitis lasts from two to three months, which in some cases can be cured, but mainly becomes subacute or chronic.
Without appropriate treatment acute thrombophlebitis flowing, the disease may go into purulent pathology.As a rule, it is considered a complication of suppurative disease process surrounding the vein tissue.In this case, septic thrombi are melted and thus develop multiple abscesses and cellulitis, resulting septicopyemic.And with reduced immunity poorly treated or not finished the cure thrombophlebitis of the extremities can lead to dermatitis, eczema, trophic ulcers, flebektiziyam, pitting vessels flebosklerozu, thromboembolism, lymphadenitis, lymphangitis, sepsis and ischemic neuritis.
addition, thrombophlebitis may be initially characterized by subacute.Clinically, it manifests itself with a slight appearance of edema pain aching, aggravated by stress of the affected limb.The temperature is not increased, and the veins are dense with small infiltrates in some areas.Moreover, they are almost painless bluish-brown color.At this stage of thrombophlebitis, which takes up to four months, patients can carry out minor work without much physical exertion.
thrombophlebitis of extremities becomes chronically leaking stage in the disease varicose veins, t. E. When varicose veins.This stage is characterized by severe fatigue of the lower limbs even after walking.In the course of the affected veins, palpation determined compacted strand with clear nodes.Then, the limb becomes pasty and strong edema does not disappear after a night's rest.In the case of a long course of thrombophlebitis can be observed on a limb trophic disorders, skin induration and ulceration.
patients with thrombophlebitis, which affects the deep-seated veins, always present in the diseased leg heaviness and aching pain with a certain puffiness.
relapse in chronic thrombophlebitis may be associated with lower limb trauma, infections or other adverse effects.It manifests all the symptoms of a local nature as a result of inflammation and changes in the general condition of the patient.
After the insufficient treatment of thrombophlebitis, the valve unit is destroyed and disrupted blood flow, which leads to the development of post-thrombotic syndrome in the presence of chronic venous insufficiency, which is characterized compensated, decompensated stage subcompensated and flow.
vein wall inflammatory process in the presence of infection near a superficial vein, which is accompanied by the formation of a blood clot in it and is a pathological disorder as superficial thrombophlebitis.This vascular pathology can develop as a result of various diseases of infectious origin, trauma, surgery, malignant tumors (paraneoplastic syndrome) and allergic disorders.Very often superficial thrombophlebitis develops against the background of varicose veins.But duplex ultrasound shows that almost 20% of patients suffering superficial thrombophlebitis coupled with phlebothrombosis.
acute course of the disease is extremely rare and is considered a pathology of mechanical damage of veins as a result of intravenous drugs and catheterization;purulent focus on the surface;trauma;Education minor cracks between toes.
pathogenesis of thrombus formation are of great importance in the structure of vein disorders, slowing the blood flow and hypercoagulability (Virchow's triad).
The basis of superficial thrombophlebitis symptoms are pain, the appearance of redness, threadlike seal with soreness all over the affected vein thrombus, the appearance of puffiness little tissue in the inflamed area.
patient feels satisfactory with little low-grade fever.Very rarely observed condition characterized by purulent melting thrombus formation and cellulite.
When superficial thrombophlebitis extends up to the groin area, on a large vein under the skin, thrombophlebitis develops rising character.The same spread of the disease in the iliac veins leads to the formation of rolling or floating thrombus, which is a real threat of separation and pulmonary embolism.Similar complications occur when a small vein thrombophlebitis under the skin, as a result of getting a blood clot in a vessel popliteal vein.
characteristic severity of the disease manifests itself septic thrombophlebitis purulent nature, which can join complications of limb cellulitis, sepsis, metastatic abscess in some organs such as the lungs, kidneys and brain.
Usually, holding diagnose superficial thrombophlebitis is not much problem.To clarify the boundaries of the proximal thrombus formation appointed duplex scanning.This allows you to find out the true boundaries of the thrombus, because they can not match the palpable borders.The site of the vessel with the presence of venous thrombus is characterized by rigidity, the heterogeneity of the lumen without blood available.It is important to be able to carry out the differentiation of the disease from limfangiitom.
Outpatient superficial thrombophlebitis with conservative therapy is possible only at the border of the proximal thrombus, without going beyond the shin.In this case, prescribe drugs that improve the properties of the blood, affect platelets (Trental, acetylsalicylic acid, and Troxevasin Curantil).And those that reduce inflammation of the vein wall (Ibuprofen, Reopirin, Ortofen and Phenylbutazone) and preparations allergen action (diphenhydramine, Tavegil, Suprastin).If necessary, use antibiotics.Besides a superficial thrombophlebitis prescribe heparin cream and ointment with nonspecific nonsteroidal anti-inflammatory drugs (Ortofen, Phenylbutazone, Indomethacin).It is mandatory on the affected lower limb elastic bandage is applied.In addition, the recommended dosing in a certain walking.
in severe thrombophlebitis flowing surface treatment is carried out in the hospital with the additional use of heparin and antibiotics in the event of the accession of infection.
after decrease inflammation appoint electrophoresis with heparin, potassium iodide, trypsin and diathermy.A surgical treatment was started at an ascending thrombophlebitis.
mainly affects thrombophlebitis varicose veins under the skin of the lower extremities (varikozotromboflebit) and is a complication of varicose disease or pathology postthrombophlebitic.
Furthermore, thrombosis can be formed in veins on the surface that are visually characteristic changes.In this case, particularly if the observed relapses, especially preclude paraneoplastic syndrome.Among the processes blastomatous nature takes the leading place with pancreatic cancer.
thrombophlebitis may also be characterized by the emergence of a result of iatrogenic factors, such as therapeutic catheterization, and even single puncture of the vein, if this was introduced irritating or concentrated solution, for example, 40% solution of glucose.
Varicose veins are fertile ground for the formation of thrombosis due to degenerative changes in the vessel wall and slowing the blood flow, which are major contributors to the development of thrombophlebitis.The saphenous veins are located in the lower extremities, there is the whole set of conditions for the formation of blood clots that contribute to the vulnerability of the state of the vascular wall, over a statistical nature, expansion and deformation of the veins, poor functioning of the valves.With appropriate changes in the composition of blood and plasma in the background of stagnation and impaired blood flow in the veins are easily formed clots.
immediate cause of thrombosis in the balance in favor of activity of the two systems, such as coagulation and anticoagulative, as well as the condition of the endothelium and active laminar flow of blood.Therefore, there are many factors that can make disturbances in this balance.A significant place was given to the states of thrombophilic character as congenital and acquired etiologies, which are caused by deficient or defective clotting inhibitors in the fibrinolytic system.And these "mistakes" or defects in hemostasis only accumulate with age.So people after forty-five years increases the probability of developing thrombosis.
The factors that provoke the formation of thrombi in veins on the surface, under the skin, and the deep-seated include surgery, especially in the lower extremities and pelvis organs.Also, various injuries of bone, immobilization, physical inactivity after surgery, paralysis, observance of bed rest after myocardial infarction, malignant tumors and paresis are contributing factors in the occurrence of thrombophlebitis.
initiation of the disease contribute to preparations containing estrogen, which is accepted as a contraceptive purpose, and sometimes as a replacement.At the same time there is a shift hypercoagulable hemostatic properties.
Very often during pregnancy, after childbirth and abortion is characterized by complications in the form of thrombophlebitis, since in addition to hormonal changes, reduced fibrinolytic activity of the blood and increase of fibrinogen appears dilated veins, venous stasis and release into the bloodstream of thromboplastin tissue afterplacenta.Furthermore, various renal diseases, intestinal diseases, liver disturb the balance of inactivation, synthesis, and removal of products of blood clotting.
addition, thrombophlebitis is caused by tissue injury, and insect bites as a consequence of the surface location of the veins after a minor trauma.Also, the processes of change in the veins under the skin, endothelial damage and venous stasis only progress if the duration of varicose veins.A violation of the blood flow, a way of life at a small activity, obesity, prolonged stress statistical nature only increase the percentage of the disease.