Thrombophlebitis: Symptoms and Treatment
Thrombophlebitis is a disease characterized by an inflammatory process of the venous walls and the development of thrombosis (the formation of dense blood clots inside the vessels that make microcirculation difficult). According to statistics, signs of thrombophlebitis occur in 10% of the world’s population, while in 5% of patients the disease progresses rapidly, is accompanied by deep vein thrombosis and often leads to pulmonary artery occlusion (embolism) — a condition that requires immediate treatment and often leads to the patient’s death.
Description of the disease
Thrombi in the human body are formed quite often. In most cases, the cause of their development are pathological changes in the vascular walls, but sometimes they arise on their own. Most of the blood clots dissolve over time, but those that are the largest size, are able to detach from the vascular walls and migrate through the circulatory system, which is fraught with clogging of small vessels (arteries, veins) and the development of thrombophlebitis. In view of the high likelihood of developing complications that threaten the life of the patient, acute thrombophlebitis often requires immediate surgical intervention.
Etiology of the disease
In most cases, this disease occurs against the background of varicose veins, but in addition, the development of thrombophlebitis can lead to:
- disruption of the integrity of the venous wall (occurs with the installation and prolonged use of the catheter)
- gynecological surgery, abortion
- hereditary predisposition to increased thrombosis
- taking certain hormonal drugs (eg, contraceptives)
- Breaking the blood clotting process.
Sometimes there is a development of thrombophlebitis in pregnancy, as well as on the background of cancer or infectious diseases of the blood.
The inflammatory process of the vascular walls, accompanied by thrombosis, can occur in any part of the venous system, so doctors classify thrombophlebitis, the symptoms of which can be different, in three ways:
- by the nature of the inflammation — purulent and non-purulent (in the event that the inflammation is accompanied by pus, it should be treated with antibiotic therapy)
- localization of the pathological process — distinguish deep vein thrombophlebitis, which is relatively rare (only 10% of patients), and superficial, most often there is thrombophlebitis of the lower extremities and pelvic organs, less often the disease affects the collar, hollow or hepatic vein,
- downstream — thrombophlebitis, subacute and chronic (the latter develops a few months after the transfer of acute thrombophlebitis).
Clinical picture of the disease
Symptoms of thrombophlebitis depend on the localization of the inflammatory process and the nature of the course of the disease, but the main signs of the disease include a short-term increase in body temperature to 37-38 degrees and edema of the lower limbs. If thrombophlebitis of the lower extremities develops, the skin over the thrombosed veins becomes hyperemic and on it appear condensed areas, the size of which depends on the diameter of the inflamed veins.
Acute thrombophlebitis of deep veins is accompanied by severe pain and edema of the affected limb. The skin on the course of the inflammation of the vein becomes pale, shiny and acquires a cyanotic shade (this is a very dangerous symptom that indicates a serious blockage of the vessel, so it is necessary to start treating this condition as soon as possible). If the disease develops against the background of the infectious process in the body, the inflammation acquires a purulent character, which is characterized by the formation of multiple abscesses along the course of the inflamed vessel. All these symptoms of thrombophlebitis can indicate the development of phlegmon — acute purulent inflammation of the subcutaneous fat, so at the first manifestation of them you should immediately go to the doctor.
Typical symptoms of thrombophlebitis of the large saphenous vein are pain and redness of the skin throughout the lower limb, and if the pain is localized in the knee or ankle region, then this indicates the inflammation of the walls of the small saphenous vein.
The signs of chronic thrombophlebitis include the sudden appearance of painful nodular neoplasms in the veins (the skin in such places swells up and becomes denser) and a periodic short-term rise in body temperature.
Basic diagnostic methods
Whatever thrombophlebitis treatment of this pathology should begin with a doctor’s visit and diagnostic activities, it is not recommended to treat such a disease, because it can lead to the development of serious complications. Among all the instrumental methods of diagnosing the pathologies of the venous system, ultrasound angioscanning of the veins (helps to identify deep vein thrombophlebitis of the lower extremities) and radiopaque phlebography is of maximum informativeness. Laboratory methods of investigation (general blood test, thrombodynamics test) are used for additional diagnosis.
All the patients (especially those who are diagnosed with «acute thrombosis»), it is recommended to make a chest X-ray, it will help in time to detect pulmonary embolism.
How to treat?
Treatment of thrombophlebitis can be conservative or surgical, however, only an experienced phlebologist can select the optimal type of therapy. Conservative therapy is aimed at arresting the inflammatory process in the veins. To this end, the patient is assigned to bandage the affected limbs with elastic bandages, wearing a special bandage and compression linen — golfs, stockings, pantyhose.
Conservative treatment of thrombophlebitis involves the combined use of funds for external and internal therapy. Topically to the patient assigned UHF therapy and dressing with heparin ointment (promotes resorption thrombus) and as preparations for internal reception physician may prescribe NSAIDs (diclofenac), anticoagulants, derivatives of rutin (Rutoside) flebotoniki vegetable origin or antibiotics.
By conservative treatment of thrombophlebitis, one should not forget that in some cases the disease can progress. To avoid the development of complications throughout the entire period of therapy, the physician must conduct a dynamic control of the course of the disease.
Surgical treatment of thrombophlebitis is prescribed if conservative therapy does not yield any results. It involves bandaging or removing all inflamed and varicose veins.
A properly formulated diet with thrombophlebitis helps to cope faster with the treatment of the disease and reduces the likelihood of complications. The goal of the diet is to eat those foods that improve blood microcirculation and reduce its viscosity.
Diet thrombophlebitis involves the use of restriction food salty, sugary and fatty (butter, fatty meat varieties, sausage) food, as they increase the blood concentration of cholesterol and impede lymphatic drainage. the patient’s diet should consist of seafood, fruits (especially berries, which thin the blood), buckwheat, dark rice, herbs, natural plant oils, turkey, beef or chicken and fresh vegetables.
How to treat thrombophlebitis in pregnant women?
About the basic principles of treatment of thrombophlebitis in pregnancy should be told separately, because the intake of most drugs prescribed to other patients, pregnant is contraindicated, and therefore therapy should be carried out as sparingly as possible. First of all, it is assigned to wear compression linen and compresses with phenylbutazone or heparin ointment. Mandatory diet is prescribed for thrombophlebitis, which the woman will have to follow and after childbirth. If these methods do not help, the doctor prescribes oral administration of small doses of anti-inflammatory drugs or phlebotonics, as well as electrophoresis.
The prognosis of thrombophlebitis treatment is favorable if all the recommendations of the doctor are observed. In order to prevent the development of relapses, it is necessary to adhere to a diet and to take an oral phleboprotector course two or three times a year.