The blood clot came off. Causes symptoms

• Blood clots form more quickly in areas where blood flow is slow due to a large accumulation of thrombin.
• An increase in blood clots leads to inflammation and fibrosis.
• Thrombophlebitis of deep veins, as a rule, occurs due to damage to the epithelium, accelerated blood clotting, and reduced blood flow.
• The risk group includes people who have been on bed rest for a long time, patients after injury, surgical operations, childbirth, after using hormonal contraception.
• Progression of deep vein thrombophlebitis can lead to pulmonary embolism and death.
• Among the causes of thrombophlebitis of the superficial veins, trauma should be noted, infectious diseases, frequent use of an intravenous catheter, irritation from frequent diagnostic venipunctures.
• Thrombophlebitis of the superficial veins limits the patient's movement, but rarely leads to pulmonary embolism.

• Check your pulse.
• Check vital signs, including temperature, and note the presence or absence of fever.
• Examine the sore spot - skin color, temperature.
• Some patients have no symptoms of thrombophlebitis. If you suspect inflammation of the deep veins, it is necessary to determine the presence of the following signs of the disease:
• Local pain.
• Fever.
• Chills.
• Malaise.
• Swelling and cyanosis of the affected arm or leg.
• Homan's sign (J. Homan, 1877-1954) is pain in the calf muscles upon palpation.
• If you suspect inflammation of the superficial veins, check for the following symptoms of the disease:
• Pain.
• A tumor in a damaged area.
• Redness of the skin.
• Tissue compaction along the vein.

• Place the patient in bed and warn that bed rest must be observed. Elevate your sore arm or leg.
• Apply warm lotions to the area of ​​inflammation.
• Use analgesics, anti-inflammatory drugs (if it is superficial vein thrombophlebitis), heparin, thrombolytics (for acute, extensive, deep vein thrombosis).

• If deep vein thrombophlebitis is suspected, prepare the patient for Dopplerography, plethysmography, and venography.
• If deep vein thrombophlebitis is caused by complete venous occlusion, prepare the patient for surgery (ligation, vein plication, or clipping).
• Prepare the patient for embolectomy and insertion of a hollow tube or filter into the vein.
• Pay close attention to changes occurring in the injured area of ​​the arm or leg.
• Monitor for signs of pulmonary embolism.
• After the acute period of the disease has passed, use anti-embolic dressings, thanks to which the patient will be able to move independently again.
• Give warfarin.
• Monitor anticoagulant therapy, use heparin, prothrombin.
• Monitor for bleeding symptoms.

• After some surgical procedures (especially abdominal and pelvic), prophylactic doses of anticoagulants may reduce the risk of thrombophlebitis and pulmonary embolism.
• To prevent thrombophlebitis in patients at risk, it is necessary to perform simple exercises, massage, and use anti-embolic bandages with the patient on bed rest.

Probably many of us have heard about the concept of “thrombus”, thrombosis.” Unfortunately, for last years Cases of diagnosing thrombosis among the population have greatly increased. It is worth noting that if proper assistance is not provided when a blood clot breaks off, this leads to instant death of the body. Therefore, each person must imagine how to properly help the victim before the doctors arrive.

What are blood clots and why do they form?

A thrombus is a pathological formation of a blood clot in human blood vessels. Its location is very specific. Quite often, the blood clot is localized directly in the heart or in the lumen of a blood vessel.

Causes of blood clot formation

Experts distinguish several main factors that contribute to the formation of blood clots:

1. Damage to the wall of a blood vessel as a result of mechanical stress, inflammatory processes, damage to the internal walls by bacteria, viruses.
2. High blood viscosity. This pathology occurs due to the presence of oncopathologies and autoimmune diseases.
3. Violation of blood clotting function.
4. Slow blood circulation resulting from compression of blood vessels, too thick blood.
5. Cardiovascular disease and sedentary lifestyle.

Types of blood clots

There are several classifications of blood clots based on their composition, etiology, location in the blood vessel and directly in the body, as well as the mechanism of formation.

Classification by composition:

This classification corresponds to the previous one.

Separation of types of thrombus by etiology

1. Marantic is formed due to weakening of the body due to dehydration and hemoconcentration. Most often, such a clot is diagnosed in elderly people in the dura mater.
2. Tumorous: occurs as a result of growth malignant tumor into the lumen of the vessel and its further growth. This leads to blockage of blood vessels.
3. A septic thrombus is formed as a result of various purulent diseases.

According to the location of the thrombus in the vessel

1. Parietal thrombi (located at one end of the wall);
   Long-lasting (a type of parietal thrombus, but longer);
2. Lining thrombi (occupies almost the entire surface of the wall, which disrupts blood flow, leaving a small gap);
3. Central thrombi (as the name suggests, occupy a central place in the vessel);
4. Occlusion thrombi (close the entire lumen of the blood vessel).

By location in the body

1. Venous thrombi affect both deep and superficial veins;
   Arterial ones are formed in deep and superficial arteries, respectively;
2. When a clot breaks off and moves throughout the body, the thrombus is considered to be wandering;
3. Microcirculatory: formed only in the system of the same name.

Signs

It is worth emphasizing that the signs of thrombosis are based on the location of the thrombus (which vessel and its blood supply):

First aid

The rupture of a blood clot is a rather dangerous condition, which is a strong impetus for the development of serious complications from the outside of cardio-vascular system, central nervous system and even to the death of the body.

Providing first aid for a blood clot

It should be said right away that it is difficult to provide full medical care to the victim at home. Thus, when the first symptoms appear, you should call an ambulance. Only emergency hospitalization and subsequent treatment in the hospital.

When providing first aid for a blood clot, you should do everything quickly and save time, because a person’s life can end in a matter of minutes.

Often, emergency treatment for blood clot rupture involves administering anticoagulants. Heparin or its analogues, as well as fibrinolytics (Thromboflux, Fibrinolysin), have such properties. If necessary in emergency situations, the clot is removed with a catheter.

But it is worth noting that such drugs should be used only on the recommendation of the attending physician and in medical institution. When prescribing medications, the doctor must take into account the patient's individual tolerance to prevent internal bleeding.

Diagnostics

When blood vessels are clogged, a series of diagnostic procedures, such as:

1. Vascular ultrasound. As a rule, this study is carried out if there is a suspicion of a blood clot in a blood vessel. lower limbs. This way you can identify the location, size of the clot and the state of blood flow in the affected vessel.
2. Phlebography. Intended for examining the vessels of the upper and lower extremities. The essence of the method: taking an x-ray with a contrast component.
3. CT and MRI.
4. X-rays of light.
5. ECG and ECHO-cardiography.
6. Ultrasound of organs.

However, on early stages It will be enough to do thromboelastography, a test for the generation of thrombin protein, check thrombodynamics, and a test for prothrombin time. Such procedures are useful even in the absence of suspicion; especially in the risk group, it is recommended to check for blood clots from time to time.

Treatment

Therapy for thrombosis should be carried out strictly under the supervision of an experienced specialist in a hospital. There are several ways to treat thrombosis:

1. Drug therapy: administration of medicinal substances with anticoagulant properties. When they are administered, a thinning and decreased blood clotting is observed;
2. Surgical treatment of thrombosis is carried out only in severe cases of the disease;
3. Vascular bypass and installation of vena cava filters;
4. Therapeutic activities (massage, exercise therapy);
5. Prescribing a low cholesterol diet.

Any surgical intervention on blood vessels carries the risk of new blood clots appearing in the future. Accordingly, it is necessary not only to regularly carry out prevention vascular diseases, but also treat them in a timely manner in order to reduce the risk of blood clots.

It is worth noting that treatment directly depends on the type of blood clot, its size and location. Oxygen therapy is also used to increase the concentration of oxygen in the blood. To prevent the disease, it is recommended to lead an active life, exercise regularly, and adhere to a diet.

Nutrition for thrombosis

Besides drug therapy a person must adhere to a therapeutic diet. So, if blood clots appear, it is recommended to follow a vegetarian diet and include more blood thinning foods in your diet. Similar qualities are inherent in oatmeal, prunes, lemons, ginger, honey, and avocado. Also, seafood, fish and fish fat, cashew nuts, wheat. Freshly squeezed juice from vegetables promotes intake useful substances into the body.

Blood flows from the internal organs and tissues and rushes to the heart through the veins. There are deep and superficial veins, large-caliber veins and small venules.

The walls of these vessels have valves that prevent blood from flowing back and stagnating in them.

Even with the slightest damage vascular wall Inflammation occurs in it, blood flow slows down, and wall thrombi form.

It is these changes in the lumen of the veins that are characteristic of.

Causes

• Damage to the venous wall
• Insufficiency of the valve apparatus of the deep veins
• Increased blood viscosity and tendency to excess

The venous wall of superficial veins is most often damaged by external influences.

With concomitant varicose veins of the saphenous veins, the thinned and dilated venous wall is damaged several times more often.

External damaging factors include such manipulations as intravenous injections, placement of cubital infusions of solutions, examinations with intravenous use radiological contrasts, leading to the development of post-injection thrombophlebitis.

Of the most reliable and minimally invasive instrumental methods for diagnosing thrombophlebitis, Doppler ultrasound of the lower and lower vessels is used.

This method helps to assess not only the condition of the vascular wall of deep and superficial veins, but also to identify abnormalities in the valves of the veins and the presence of parietal thrombi in them.

In addition to the ultrasound diagnostic method, venography is used. This x-ray method examination of veins using a contrast agent.

Video:

Treatment

The treatment algorithm is based on what thrombophlebitis is and how to treat it.

Treatment should be prescribed by a doctor after confirmation of the diagnosis by laboratory and instrumental methods examinations.

The treatment regimen for thrombophlebitis includes drugs from several groups.

1. Indirect anticoagulants. These include heparin and its analogues. Drugs in this group are prescribed for the purpose of intravascular dissolution of a parietal thrombus.
2. Drugs that improve microcirculation. Such as "Pentoxifylline", "Trental". They improve blood circulation in tissues, activate collateral circulation, which leads to a decrease in swelling and a decrease in blood viscosity.
3. Venotonics. These drugs strengthen the vascular wall, reduce the risk of damage, and increase the elasticity of the vein valves, which promotes proper blood flow without backflow. For example, “Troxevasin”, “Detralex” are used externally as an ointment and internally in tablets and capsules.
4. Antiplatelet agents. These include drugs containing. Constant use of antiplatelet drugs protects against the formation of blood clots, thereby reducing the likelihood of developing a heart attack, stroke, etc. In cases where treatment and first aid begin with these drugs.
5. Products that improve regeneration. The most popular drug is Actovegin. Due to its pronounced healing and strengthening effect, it helps eliminate damage to the vascular wall of veins.

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Treatment with folk remedies

Popular ones are based on the use of plants and natural substances that help reduce inflammation and strengthen the vascular wall.

1. Compresses with honey and cabbage leaves. On inner side Apply a small amount of honey to the cabbage leaf. Apply a compress to the area of ​​the hardened vein and secure with a bandage. Additionally, wrap with warm material. This compress is applied once a day.
2. Garlic tincture. Peel 2 - 3 medium heads of garlic, place in a liter jar and fill with vodka. Infuse for 25 days in a dark place.

Take 5 drops before each meal. This infusion perfectly cleanses blood vessels, reduces the likelihood of blood clots and thins the blood.

Surgical treatment

It is performed in cases where conservative treatment methods do not produce positive results.

In emergency cases where there is risk and blockages pulmonary artery or, surgical treatment is carried out immediately.

It involves removing a blood clot from a vein and restoring its patency.

A kind of “” (thromboextractor) is inserted into a large vein and advanced to the level. Then the mural thrombus is simply removed from the vein.

Surgical treatment of inflammation is most often carried out under ultrasound guidance.

The operation consists of removing a blood clot from a deep vein.

Disease prevention

It consists in the possible elimination of risk factors for the development of thrombophlebitis of the extremities.

• Change your lifestyle to a more active one. Regular walks, physical exercise, and visiting the pool reduce congestion in the legs and prevent the development of blood clots in the veins.

If a person spends most of his working time sitting, then it is necessary to change his body position every hour and perform simple exercises for the legs:

1. Circular rotational movements in the ankle joints. 10 – 15 times in each direction.
2. Rolling from toes to heels. 10 – 15 times.
3. Simulation of running. Without lifting your feet completely off the floor, try to “run” for several minutes.

• Proper nutrition. Including fresh vegetables and fruits and herbs in the diet helps strengthen blood vessels and normalize blood viscosity. Cholesterol can be deposited on the walls of blood vessels, which leads to the development of hypertension. When the pressure in the vessels increases, they expand, and chronic vascular insufficiency of the veins and thrombosis develop.

• Loss of body weight. By reducing weight, the load on the lower limbs is reduced. At the same time, blood flow in the veins improves and pathological thrombus formation in this case is unlikely.

• Treatment of varicose veins of the extremities. In case of severe varicose veins, it is necessary to resort to surgical treatment– venectomy. This will reduce the likelihood of developing thrombophlebitis and its complications.

First aid for thrombophlebitis of the extremities

The first should be provided in the first minutes of the development of the clinic of acute thrombophlebitis. Absolute rest should be provided to the affected limb.

If a vein of the lower limb is inflamed, the patient should be placed with his leg elevated. You can use a pillow or folded blanket for this.

The main thing is that the sore leg is in an elevated position.

For vein thrombosis upper limb it is necessary to fix the arm to the body in a functionally advantageous position.

For example, bent in elbow joint and the limb pressed to the body is suspended on a wide bandage or scarf.

Before the ambulance arrives or you go to the hospital yourself, you can take an aspirin tablet and any pain reliever.

It is strictly prohibited to use without a doctor's prescription, as this can cause even greater harm to health.

An article on the topic: “emergency care for thrombophlebitis” as the most important information about the disease.

Symptoms

It is not difficult to recognize thromboembolism: it occurs suddenly, very sharply strong pain throughout the entire limb, then it gradually decreases and practically disappears, but a feeling of numbness appears in the limb, it becomes as if “alien”, “not our own”, the skin of the limb becomes very pale, “marbled”, with a bluish tint, and its the temperature drops very quickly - the limb becomes cold to the touch.

With thrombosis, the symptoms are less pronounced: the pain increases gradually, at the same time sensitivity gradually disappears, first the pain from tingling with sharp objects disappears, then the sensation from a simple touch is lost, and eventually motor function is gradually lost. The temperature of the limb also decreases and it becomes cold to the touch.

Pulmonary embolism. vessels of the kidneys, liver and other internal organs manifests itself in sharp and severe pain in the area of ​​the affected organ and complete shutdown of its function. With thromboembolism of the cerebral arteries, a cerebral infarction develops.

First aid for thrombosis and thromboembolism

The first thing to do in case of thrombosis and thromboembolism is to take painkillers (analgin, pentalgin, paracetamol - whatever is at hand) and antispasmodics (papaverine, no-spa, trimedat and others).

Under no circumstances should you warm the affected limb: this can only worsen the situation. You can even, on the contrary, apply ice to it.

And most importantly, you need to immediately call an ambulance, if possible, a specialized cardiology team. Or, if possible, go on your own to the nearest hospital that has a vascular department.

Time is of the essence: with embolism, irreversible tissue damage occurs within approximately 6 hours from the time the embolism develops; In case of thrombosis, it is highly advisable to perform surgical intervention in the first day or two from the onset of the disease.

Deep vein thrombosis. First aid for deep vein thrombosis.

Although deep vein thrombosis(DVT) is common (1 case per 1000 population per year), swelling of the lower extremities is usually a consequence of other causes.

History and Clinical signs help assess the likelihood deep vein thrombosis. Need to pay Special attention for the following points:

Risk factors for deep vein thrombosis.

Bilateral or unilateral swelling?

Bilateral edema suggests systemic pathology, such as heart failure, hypoalbuminemia, or inferior vena cava obstruction.

What is the degree and extent of swelling?

Unilateral swelling extending above the knee is characteristic of DVT.

Skin redness?

Redness only along the vein is characteristic of DVT, but if it spreads beyond the veins and is painful on palpation, cellulite is more likely.

Signs of heart or liver failure?

Trauma as a cause of swelling?

History of injury.

Limited swelling with bruising.

Are there signs of pulmonary embolism?

When clinically probable deep vein thrombosis this diagnosis must be confirmed.

Ultrasound and venography are the most widely used.

Treatment of deep vein thrombosis

If diagnosis of deep vein thrombosis confirmed, initial therapy includes:

Bed rest with the lower limb elevated for 24-48 hours or until the swelling subsides.

Compression stockings to reduce the risk of post-thrombophlebitis syndrome.

Pain management using NSAIDs if necessary.

Give intravenous heparin or subcutaneous low-molecular-weight heparin.

For recurrent thromboembolism, lifelong therapy may be indicated (MHO must be maintained at 3.0-4.5).

Why did this patient develop deep vein thrombosis?

In women with unexplained DVT or PE, it is necessary to examine the mammary glands and pelvic organs; if pathology is present, an additional ultrasound of the pelvic organs is performed.

In men, a digital examination of the prostate should be performed and the content of a specific prostatic antigen should be determined.

Patients under 50 years of age or with DVT/PE in first-degree relatives should be evaluated for thrombocytopathy: consult a hematologist.

Causes of swelling of the lower limb:

Venous/lymphatic.

Deep vein thrombosis.

Thrombophlebitis of superficial veins.

Obstruction of the inferior vena cava (eg, tumor).

First aid for acute thrombophlebitis

Under acute thrombophlebitis understand inflammation of the vein with subsequent formation thrombus in it. In the vast majority of cases, the cause of thrombophlebitis is an infection.

Factors contributing to the development of thrombophlebitis are:

Slowing blood flow

Increasing its coagulability after surgery ( postoperative thrombophlebitis),

The presence of varicose veins,

The presence of metabolic disorders in certain diseases.

Thrombophlebitis can occur acutely and chronically. Depending on the location there are different thrombophlebitis of superficial and deep veins. Also found migratory thrombophlebitis .

Clinical picture and symptoms of thrombophlebitis. Thrombosed vein can be felt in the form of a dense, painful cord. At superficial thrombophlebitis pain appears along its course, and often throughout the entire limb. In mild cases, these pains occur when moving the limbs, and in severe cases they occur at rest. A constant sign deep vein thrombophlebitis is swelling of the limb due to obstruction of the outflow of venous blood.

In addition to these main symptoms, acute thrombophlebitis often causes increased body temperature and increased heart rate.

Acute thrombophlebitis lasts about three weeks and can progress to subacute. which, when deep veins are affected, lasts up to two, and sometimes lasts up to 4-6 months. In the future, thrombophlebitis may go away completely or turn into chronic form . In this case, a dense thrombosed vein remains, painful to the touch.

The duration of chronic thrombophlebitis can be calculated in years. Over time, a blood clot formed in a vein can organize (grow with connective tissue elements), recanalize (channels passable for blood can form in the thickness of the blood clot), harden (soak mineral salts), soften and dissolve - this is the most favorable outcome.

First aid. When the first symptoms of acute thrombophlebitis appear, the patient needs to create maximum rest, give an elevated position to the diseased limb, immobilize it and hospitalize the patient in the surgical department.

Transportation must be careful (risk of embolism due to blood clot rupture due to shaking).

Materials from the book by M.S. were used. Bruckman "First aid for acute surgical diseases and accidents."

Osteoarthritis of the knee joint. Part 1.

Acute venous thrombosis is a disease characterized by the formation of thrombotic masses in the lumens of the veins. The most commonly observed are subcutaneous thrombophlebitis and deep vein thrombosis of the lower extremities and pelvis, much less often - thrombosis of the inferior or superior vena cava. There are no significant differences in the pathogenesis of “phlebothrombosis” and “thrombophlebitis”. Traditionally, “thrombophlebitis” refers to the localization of the thrombotic process in the saphenous veins, since in this case signs of a local inflammatory process are clearly visible. The term “phlebothrombosis” is used to refer to damage to the deep veins, the diagnosis of which is made on the basis of indirect signs of acute occlusion of the main venous outflow pathways. In both cases, the process is aseptic.

The main risk factors for phlebothrombosis:

■ surgery and trauma; ■ cancer; ■ pregnancy and childbirth; ■ long-term immobilization; ■ taking estrogen; ■ congenital and acquired thrombophilias; ■ chronic venous insufficiency; ■ heart failure in the stage of decompensation; ■ paresis and paralysis; ■ age over 45 years; ■ premature termination of the course of indirect anticoagulants or violation of its regulations.

The mechanism of thrombus formation in the venous bed is based on an imbalance between thrombogenic factors and protective reactions due to the previously described etiological aspects. Activation of procoagulant factors with insufficient effectiveness of defense mechanisms leads to the development of acute venous thrombosis. These thrombogenic factors include: ■ activation of coagulation factors and stimulation of platelet aggregation (hypercoagulable state); ■ damage to the vessel wall; ■ slowing or obstruction of blood flow. Defense mechanisms include:■ atrombogenic properties of intact endothelium; ■ neutralization of activated coagulation factors with natural inhibitors; ■ washing out and diluting activated coagulation factors or interrupting platelet aggregation by blood flow; ■ inactivation of activated coagulation factors by the liver; ■ function of the fibrinolytic system. Based on the degree of fixation of the proximal part of the thrombus to the venous wall, the following forms are distinguished: ■ embolic (floating thrombus); ■ non-embolic (parietal and occlusive thrombi). Depending on the extent, segmental or widespread thrombotic occlusion of venous lines is distinguished. Localization of the process can be either one- or two-sided. Most often, a blood clot forms in the veins of the leg and is of an ascending nature. In acute thrombophlebitis, a dense, sharply painful cord is detected in the projection of the affected varicose vein, and hyperemia of the skin above it. They also determine a local increase in temperature, hyperesthesia skin. Acute venous thrombosis is characterized by bursting pain in the limb, sudden development and rapidly increasing swelling of the leg or thigh (the entire limb), and cyanotic skin. The presence of pain in the gastrocnemius muscle when palpated in the anteroposterior direction or dorsiflexion of the foot is pathognomonic (Moses and Homans symptoms). It is imperative to examine both lower extremities, since bilateral combined lesions of both superficial and deep venous systems are possible. ■ The patient must observe strict bed rest. ■ It is necessary to raise the affected limbs of the patient above the body.

■ Local hypothermia of the leg or directly at the site of thrombophlebitis should be carried out with ice.

■ The caller should be warned against using compresses. ■ Apply a compression bandage to the injured limb from the base of the toes to the groin using an elastic bandage. ■ The patient needs to take a drug from the group of antiplatelet agents from the home medicine cabinet (check availability and dose). ■ If the patient has signs of pulmonary embolism, give instructions for resuscitation; maintain contact if necessary. ■ When did clinical signs of acute venous thrombosis/thrombophlebitis first appear and what were they? ■ What does the patient associate with their appearance? ■ Dynamics clinical manifestations(for example, the initial localization of edema or the place of occurrence of thrombophlebitis, its severity, spread to other parts of the limb, the nature and intensity of the pain syndrome)? ■ What medications did the patient take (anticoagulants, antiplatelet agents, phlebotonics, NSAIDs) and what was their effectiveness? ■ Have there been thrombotic complications before? ■ Determine the presence of shortness of breath, pain in chest, hemoptysis. ■ Have there been any episodes of loss of consciousness? INSPECTION AND PHYSICAL EXAMINATION■ Visually assess the color of the skin of the symmetrical parts of the lower extremities, examine the venous pattern (the presence of cyanosis) on the lower leg, thigh, groin area, anterior abdominal wall, indicate the localization and prevalence of areas of hyperemia, hyperpigmentation, areas of pain during palpation.

■ Assess the temperature of the skin (warm, cool), the presence of swelling of the extremities, its severity and prevalence (determine the perimeter on the lower leg and thigh).

■ Examine arterial pulsation at all levels, the presence of deep and superficial sensitivity, the volume of active and passive movements in the joints. Determine the symptoms of Homans, Moses. ■ Conduct a general clinical examination to exclude pulmonary embolism. INDICATIONS FOR HOSPITALIZATION If you suspect acute thrombosis in the inferior vena cava system, all patients must be hospitalized.

Patients whose trunk of the great saphenous vein or its tributaries on the legs are affected do not require emergency hospitalization in a hospital.

Hospitalization is carried out if prehospital treatment is ineffective and the level of thrombophlebitis spreads to the thigh. RECOMMENDATIONS FOR PATIENTS LEFT AT HOME

You should go to the clinic to see a surgeon and consult a phlebologist.

Typical scheme of conservative treatment of varicothrombophlebitis

Common errors. Overdiagnosis of thrombophlebitis in patients suffering from varicose veins of the lower extremities. With varicothrombophlebitis, the contours and dimensions of the palpable infiltrate do not change when the patient is transferred from a vertical to a horizontal position, while non-thrombosed varicose nodes are painless, have a soft consistency and, emptied of blood, collapse in the lying position. TREATMENT AT THE PREHOSPITAL STAGE■ Elastic compression of the lower limb.

■ For severe pain, NSAIDs are indicated (diclofenac 3 ml IM).

■ Single administration of prophylactic doses of low molecular weight heparins (enoxaparin sodium 40 mg, nadroparin calcium 0.6 ml, dalteparin sodium 5000 IU).

■ The patient must be transported in a sitting or lying position.

The day when a person stood on all fours, freeing his forelimbs, and began to walk on his feet was a turning point. Not only in the process of improving the species, but also in obtaining a number of diseases. Thrombophlebitis became one of these diseases.

Acute thrombophlebitis is an inflammatory process in the venous network with the formation of a blood clot. This is essentially a complication varicose veins veins and is one of the most common. It is the diagnosis “acute thrombophlebitis of the superficial veins of the lower extremities” that visitors to a phlebologist’s office are most afraid of.

Redness of the limb as a result of thrombophlebitis

Thrombophlebitis is a generalized name for two processes that simultaneously occur in a vein: thrombosis and phlebitis. Thus, the first represents the appearance of thrombotic masses in the lumen varicose vein, which may lead to its overlap. And the second is an inflammatory process already in the vein itself, which manifests itself as swelling and redness.

There are often situations when acute thrombophlebitis of the lower extremities develops very quickly, almost instantly. This means that if you do not notice or do not contact a surgeon in time, the operation may be too late, which may ultimately lead to death.

Classification of thrombophlebitis

Several groups can be distinguished to classify the type of thrombophlebitis. Namely, by flow, by character and by localization.

Thrombophlebitis is divided into:

• acute thrombophlebitis
• surface
• chronic

Bilateral thrombophlebitis

They differ in the duration of the pathological process or clinical manifestations.

By nature, thrombophlebitis can be purulent or non-purulent, and by localization it can be divided into thrombophlebitis of the superficial veins of the lower extremities and deep veins of the lower extremities.

In addition to all this, it is necessary to highlight ascending thrombophlebitis, which is thrombophlebitis of the great saphenous vein moving from the lower parts up to the inguinal fold.

Causes of thrombophlebitis

The causes of thrombophlebitis of the deep veins of the lower extremities and superficial ones can be completely different. It is worth highlighting several main reasons:

• The first cause of thrombophlebitis may be an infectious disease;
• The formation of the disease is also possible due to traumatic injury;
• Neoplasms that are usually malignant;
• Intravenous administration of medications, followed by allergic reaction on them;
• Also common in obesity and pregnancy. Due to increased body weight, veins are compressed. In addition, pregnancy, and especially during childbirth, the body mobilizes all its resources, including coagulation (the ability of blood to clot). After childbirth, when ruptures may occur, the process of hypercoagulation is activated, which, in addition to the positive side, speedy healing of wounds, also has a negative side, expressed by thrombophlebitis.

Symptoms of acute thrombophlebitis

Result of duplex scanning for thrombophlebitis

Typically, acute thrombophlebitis occurs suddenly, accompanied by elevated temperature bodies for a long time. Along the veins, pain begins to occur, which intensifies over time, as well as with movement (walking). In this case, swelling may also occur.

Symptoms of thrombophlebitis are very dependent on the location of the blood clot and its size. Thus, deep vein thrombophlebitis in the lower leg begins with severe pain in the calf muscle.

There is a feeling that the muscle is swelling, and if you lower your leg down, the pain increases. As mentioned above, this will be accompanied by increased temperature and the leg will swell.

After a few days, the entire lower part will be covered with a network of swollen veins. With any touch or movement, the patient will feel severe pain.

If a patient has thrombophlebitis of the femoral vein, his leg will become very swollen and blue, and very severe pain will be felt. The patient himself will be febrile, and a high temperature can be recorded. Superficial veins will swell in the thigh and groin.

First aid for thrombophlebitis

In any manifestations of acute thrombophlebitis, you must immediately seek help from a doctor, and also ensure that you are in a supine position. Typically, the affected limb is placed on pillows or a rolled-up blanket to provide rest.

It is highly not recommended to use ointments, much less massage, the affected surface before the arrival of a specialist. This may cause separation blood clot with its subsequent drift into internal organs along with microbes.

Diagnosis of the disease

Correct diagnosis of acute thrombophlebitis of the lower extremities should begin with a visit to a phlebologist. Only in this case can a correct assessment of the vessels be carried out and additional studies be prescribed, as well as determine effective method treatment.

The main task of diagnosing thrombophlebitis is to identify a blood clot and its size.

Treatment of acute thrombophlebitis

Treatment can be divided into medical and traditional treatment. Medical, in turn, is divided into conservative treatment and surgical.

In acute thrombophlebitis, bed rest is highly recommended to prevent the spread of microflora. In this case, the limb must be kept in an elevated position, which will help reduce swelling and pain. Drinking is recommended, but only if the patient does not have cardiovascular diseases.

In acute thrombophlebitis, the patient may be allowed to temporarily free himself from the splint, as well as sit down and turn around. In addition, warm compresses are usually used, which should help improve blood circulation.

Surgical intervention, including in ileofemoral thrombophlebitis, is possible only when vital signs are indicated, as well as when there is a threat of venous gangrene.

Surgery depends on the location of the thrombosis. Operations are only possible on medium and large veins. However, such a radical solution is possible only in the early stages of thrombophlebitis. Most often, surgery is performed for progressive ascending thrombophlebitis, which can lead to complications such as thromboembolism.

Conservative treatment

If surgery is not possible for some reason, conservative treatment is usually used. This treatment involves elevating the limb and applying cold.

In addition, it is necessary to lubricate the affected limb with heparin (troxevasin). Ointments are also needed to relieve inflammation. These can be ointments with venorut or anavenol.

Tight bandaging of the legs plays a significant role in the conservative treatment of thrombophlebitis elastic bandage, also, with pronounced inflammatory process and prescription with systematic use of antibiotics.

Traditional methods of treating thrombophlebitis

In addition to medical treatment, there are also non-traditional methods for treating acute thrombophlebitis.

So, one of them is as follows. It is necessary to take plantain leaves equal in both parts, flowers of rue officinalis, yarrow, chamomile and raspberry, white willow bark, horse chestnut fruits and marshmallow root.

Mix all this thoroughly and pour 2 tablespoons of the mixture with 600 milliliters of boiling water. After this, bring to a boil and remove from heat, leave overnight. You should drink 0.75 cups in the morning and evening. And make a compress from the rest.

It is also suggested to make foot baths from the infusion of the herb marshweed for 20-30 minutes a day.

Drug treatment

Drug treatment for thrombophlebitis should be prescribed by a doctor. As a rule, it is based on the degree of development of the disease, the age of the patient and the presence of any pathologies.

Such treatment comes as an auxiliary part of conservative treatment. The doctor prescribes:

• Tight elastic bandaging.
• Drugs that can strengthen the walls of blood vessels. These could be: troxevasin, ginkor-fort, etc.
• Medicines that can prevent the growth of a blood clot. As a rule, this is acetylsalicylic acid.
• In case of absence trophic ulcers Anticoagulant drugs may be prescribed. They reduce blood clotting, which can serve as a preventive measure. They are usually used in a course over several months.
• Anti-inflammatory drugs. These include diclofenac.
• Fibrinolytics are substances that act specifically on blood clots. This could be urokinase or trypsin.
• In addition, with purulent thrombophlebitis and high temperature antibiotics (antimicrobial drugs) are prescribed.

Nutrition for thrombophlebitis

Migration thrombophlebitis

When a clinic or hospital is responsible for your recovery, the doctor himself monitors your proper nutrition during the course of the disease. But we should not forget that some patients are treated at home. In this case, the doctor prescribes food for them, which helps to alleviate and speed up the patient’s recovery. But there are no strict diets, only recommendations.

So, the patient needs to eat mainly vegetables and fruits. This could include ginger, pineapples, and melons. But it is necessary to avoid fats of animal origin. In addition, a person with acute thrombophlebitis should avoid heavy carbohydrates and not eat fried foods. Beans, bananas, and peas should be eaten with caution.

Moreover, provided there is no heart disease, it is recommended to drink more than 2 liters of fluid per day. And traditional healers generally recommend drinking apple cider vinegar, which, in their opinion, is excellent in the fight against thrombophlebitis. To use it, you need to dissolve 1 teaspoon in 200 ml of water and add 2-3 teaspoons of honey. This mixture should be consumed in the morning and evening on an empty stomach.

About thrombophlebitis (video)

Thrombosis is a disease that occurs as a result of increased blood clotting. Clots form in the blood, creating obstacles to the free circulation of blood through the small and big circle blood circulation It is considered a serious pathology because if ignored and there is no treatment, it can be fatal. The consequence of the pathology is heart attack and ischemic stroke. There are different types of arterial thrombosis: blockage of the aorta and thrombosis of the extremities.

Arterial thrombosis is a serious disease. Clinical picture Only a doctor can recognize it, since types of thrombosis have different symptoms and consequences. For example, thrombosis of internal carotid artery leads to ischemic stroke. Due to thrombus damage to the somatomotor projection of brain fibers coming from the leg projection area, blockage of this artery by a thrombus leads to paralysis of the legs. Characteristic symptoms- impaired sensitivity of the limbs.

Thrombosis coronary arteries influences the occurrence and development of myocardial infarction - the condition of blood vessels in which the lumen narrows. The result of their slow overgrowth is the development of angina pectoris, but if the blood supply to the artery stops abruptly, myocardial infarction develops. Impaired blood flow in at least one coronary artery (right, left) leads to this heart disease. Coronary thrombosis is concentrated in the heart arteries.

Symptoms characteristic of the disease are pain in the pit of the stomach, behind the sternum, in the region of the heart, often radiating to the left, sometimes right hand, in the area between the shoulder blades, lower jaw, lack of air, pale skin. The pain manifests itself in different ways: pressing, burning, sharp, stabbing, squeezing. The danger lies in the suddenness of the attack. Coronary thrombosis requires a certain treatment, which can only be prescribed by a doctor after studying the severity of the disease and possible complications.

Iliac artery thrombosis

Blockage of the iliac artery is the cause of circulatory pathology in the pelvic organs. This type of disease is observed more often in women. Complications in men include pain in the legs and erectile dysfunction. Lameness and weakness in the legs are a consequence of thrombosis of the iliac artery.

Arterial thrombosis occurs due to their deformation due to trauma, atherosclerosis, embolism. Thrombosis and embolism are associated. If arterial thrombosis occurs due to the accumulation of blood clots (thrombi), sticking to the walls of the great vessels, then embolism is their clinical manifestation.

Thrombosis of the arteries of the lower extremities is a type of disease of the blood arteries associated with the occurrence of atherosclerotic plaques, the aggregation of platelets on the walls of the arteries. The disease is asymptomatic. A person often does not pay attention to a nagging slight pain in the calf muscles and feet. The disease appears unexpectedly and requires urgent medical care, amputation of a limb, treatment is usually long-term.

Acute arterial thrombosis

Acute arterial thrombosis - circulatory disorders in the arteries, the body’s reaction to pathology in the blood: blood suddenly stops flowing to a certain area.

Numbness, pain in the affected area, lack of movement, followed by low-grade edema developing, lead to partial or complete paralysis of the limbs.

Causes of the disease

Causes causing the disease:

• atherosclerosis;
• diabetes;
• hypertension;
• vascular injuries, including those associated with surgery;
• blockage by emboli.

Symptoms, pathogenesis of the disease

Symptoms do not appear immediately. Initially, pain appears. Gradually, the disease manifests itself in the following sequence:

• the second sign is decreased sensitivity in the leg;
• numbness of the limb;
• redness;
• sharp unexpected pain like a “whip blow”;
• it is almost impossible to move your leg;
• the skin on the affected area becomes transparent, “marbled”;
• the leg looks like it's dead.

If the patient does not consult a doctor in time, the disease will worsen, and there is a danger of complications - infection with gangrene. If such a diagnosis is made, urgent amputation of the infected area is necessary.

A set of medical information about the disease (history)

Before prescribing treatment, the doctor will find out and deeply analyze the patient’s symptoms of the disease. For this purpose, blood tests are done to determine the level of blood clotting and cholesterol. A visual inspection of the affected limb is carried out, attention is paid to:

• the degree of blanching of the skin in the affected area;
• is there any coldness of the limb;
• is there numbness, loss of sensation in the affected area;
• can a thickening be felt on the leg (there is always a thickening in the place where a blood clot forms);
• do they lead to increased sweating attacks of pain.

Treatment formula

Thrombosis cannot be cured at home; hospitalization is necessary. Depending on the severity of the medical history, the doctor prescribes therapeutic or surgery. The doctor analyzes the course of the disease based on the results:

1. blood tests (to determine cholesterol levels, blood clotting), incl. biochemical;
2. duplex ultrasound scanning of arteries;
3. angiography results (if a blockage of the artery exists, the contrast agent injected into the vessel will not be able to pass further through it);
4. treatment with painkillers (if the pain is severe, the doctor will prescribe narcotic drugs);
5. the use of anticoagulants (hirudin, heparin), antiplatelet agents (acetylsalicylic acid);
6. operation.

Surgery for thrombophlebitis

First emergency aid for arterial thrombosis

If upon visual examination there is a suspicion of arterial thrombosis, you need to:

1. Call an ambulance.
2. Before the ambulance arrives, place the patient on a flat horizontal surface.
3. Place your leg so that it does not move. You can't lift it.
4. Cover your foot with something cold.
5. Give the patient a blood thinner (aspirin, asaphen), an antispastic drug (no-spa).
6. Wait for the doctor.

Types of vascular diseases of the lower extremities

If the walls of the vessels lose their frame structure, the walls of the artery protrude, and a limited, diffuse expansion of the lumen occurs against their background - the disease is called an aneurysm. Most often, an aneurysm occurs in the popliteal, femoral artery.

Occurs due to reasons:

• presence of hypertension, atherosclerosis.
• smoking for a long period of time.
• if a person constantly eats fatty foods.
• if you have suffered vascular injuries.

Leg vascular injury

The danger of the disease is the possibility of ischemia, the possibility of thrombosis in combination with vascular occlusion, gangrene.

Lesions of the femoral artery have not been fully studied. The danger of this type of thrombosis is that if it breaks off in this vessel, the blood clot can travel to any organ, including the heart. Complication: stroke. If the patient feels a nagging, bursting pain in the groin, an increase in body temperature, swelling along the entire leg up to the groin - these are signs of thrombosis of the femoral artery.

Arterial thrombosis as a consequence of vascular damage caused by firearms, bladed weapons, or road accidents

A type of arterial thrombosis is damage to the great vessels of the lower extremities. Damage causes special complications. To damage the walls of the arterial trunk, you need to make a lot of effort, because they are elastic. More often they are damaged by a gunshot wound (shell fragment, bullet), dislocations, closed fractures. The most dangerous are injuries to the main arteries of the lower extremities, accompanied by severe hemorrhage, as a result of which a person may die from blood loss.

The danger is that an arterial wound cannot always be immediately diagnosed. Typically, ruptures of blood vessels made using edged weapons are without defects, but when using firearms, they are with defects. If the treatment of the great vessels of the lower extremities was carried out through surgical intervention, sensitivity and integrity of the diseased limb do not always return after the operation, and it is not always possible to completely restore motor activity.

Providing first aid

First emergency aid is applied on the spot:

• Using a tourniquet, splint, handy means, or pressing the vessel, apply a pressure bandage to stop the bleeding.
• Immediately transport the wounded person to a professional medical care facility.
• remember: the tourniquet has a negative effect on the tissue, so apply it as close as possible to the area of ​​the damaged vessel. Place a note under the tourniquet indicating the exact time of application. Keep the tourniquet in the summer for no more than 2 hours, in the winter for no more than 1 hour.

Thrombosis of the arteries of the lower extremities is a disease that requires the patient to follow all the doctor’s recommendations, since long-term treatment, in advanced forms, does not always lead to recovery. Coronary thrombosis is a factor influencing the spread of the disease. Blockage of the iliac artery, femoral artery, and other thromboses provoke pain in the lower extremities and require immediate consultation with a vascular surgeon.

Symptoms of the disease often appear in older people, but recently they are becoming more common among young people. To prevent the treatment of thrombosis from becoming the basis of life, preventive measures are important: quitting smoking, eating foods with low cholesterol content, avoiding fatty foods, walking in the fresh air, drinking enough water, controlling blood sugar (people who are sick diabetes mellitus), use of blood thinners.

Unfortunately, medical statistics confirms that over the past few years the frequency of cases of pulmonary embolism has increased; in fact, this pathology does not relate to isolated diseases; accordingly, it does not have separate signs, stages and outcomes of development; PE often occurs as a consequence of complications of other diseases associated with the formation of blood clots. Thromboembolism is an extremely dangerous condition, often leading to the death of patients; most people with a blocked artery in the lungs die within a matter of hours, which is why first aid is so important, because literally minutes count. If a pulmonary embolism is detected, emergency care must be provided promptly; a person’s life is at stake.

The concept of pulmonary embolism

So what pathology does the concept of pulmonary thromboembolism carry? One of the 2 words that make up the concept, “embolism,” means blockage of an artery; accordingly, in this case, the pulmonary arteries are blocked by a blood clot. Experts consider this pathology as a complication of certain types of somatic diseases, as well as when the condition of patients worsens after surgery or complications after childbirth.

Thromboembolism is ranked third in the frequency of deaths, pathological condition It develops extremely rapidly and is difficult to treat. In the absence of correct diagnosis in the first few hours after pulmonary embolism, the mortality rate is up to 50%; with emergency care and appropriate treatment, only 10% of deaths are registered.

Causes of pulmonary embolism

Most often, experts identify three main causes of pulmonary embolism:

• complication of the course of complex pathology;
• a consequence of the surgery;
• post-traumatic state.

As mentioned above, this pathology is associated with the formation of blood clots of different sizes and their accumulation in blood vessels. Over time, the clot can break off and enter the pulmonary artery and cut off blood supply beyond the blocked area.

The most common diseases that threaten such a complication include deep vein thrombosis of the lower extremities. IN modern world this disease is increasingly gaining momentum, thrombosis is largely provoked by a person’s lifestyle: lack of physical activity, poor nutrition, excess weight.

According to statistics, in patients with femoral vein thrombosis, in the absence of proper treatment, 50% develop thromboembolism.

There are several internal and external factors, which directly affect the development of pulmonary embolism:

• age after 50-55 years;
• sedentary lifestyle;
• operations;
• oncology;
• development of heart failure;
• varicose veins;
• difficult childbirth;
• injuries;
• uncontrolled use of hormonal contraceptives;
• excess weight;
• various autoimmune diseases;
• hereditary pathologies;
• smoking;
• uncontrolled use of diuretics.

If we talk in detail about surgical intervention, then PE can often develop in patients who have undergone:

• installation of catheters;
• heart surgery;
• vein prosthetics;
• stenting;
• shunting.

Symptoms of thromboembolism

Depending on what disease caused PE, the signs of pathology development also depend. Experts usually include the following as the main symptoms of pulmonary embolism:

• a sharp decline blood pressure;
• severe shortness of breath;
• against the background of shortness of breath, tachycardia develops;
• arrhythmia;
• blueness of the skin, cyanosis appears due to insufficient oxygen supply;
• localization of pain in the chest area;
• disruptions in the gastrointestinal tract;
• “tense stomach”;
• sudden swelling of the neck veins;
• interruptions in heart function.

To provide emergency care for pulmonary thromboembolism, it is necessary to carefully understand the specific symptoms of the pathology; they are not necessary. The indicated signs of pulmonary embolism include the following symptoms, but they may not appear at all:

• hemoptysis;
• feverish condition;
• accumulation of fluid in the chest area;
• fainting;
• vomit;
• less often comatose states.

With repeated blockage of the pulmonary arteries, the pathology becomes chronic; at this stage of pulmonary embolism, the symptoms are characterized by:

• constant lack of air, severe shortness of breath;
• skin cyanosis;
• obsessive cough;
• pain in the sternum.

Forms of pulmonary embolism

Now in medicine there are three forms of pulmonary thromboembolism; accordingly, the symptoms of pulmonary embolism differ by type:

1. Massive shape. In this case, there is a sharp drop in blood pressure, often below 90 mm Hg, severe shortness of breath, and fainting. In most cases, heart failure develops in a short time, the veins in the neck are swollen. With this form, up to 60% of deaths are observed.
2. Submassive form. Due to the blockage of the vessel, myocardial damage occurs, the heart begins to work intermittently.
3. The most difficult form to diagnose is non-massive. In patients with this thromboembolism, shortness of breath does not go away even at rest. When listening to the heart, murmurs are heard in the lung area.

Complications of pulmonary embolism

Late diagnosis and untimely first aid threaten the development of complications of this pathology, the severity of which determines the further development of thromboembolism and the patient’s life expectancy. The most serious complication is pulmonary infarction; this disease develops within the first two days from the moment the pulmonary vessel is blocked.

PE can also cause a number of other pathologies, such as:

• pneumonia;
• lung abscess;
• pleurisy;
• pneumothorex;
• development of renal and heart failure.

This is why emergency care for pulmonary embolism is so important, because often a person’s life goes by the clock, and the further course of the disease depends on emergency actions.

First steps for thromboembolism

The first thing to do if you suspect thromboembolism is to call an ambulance, and before the medical team arrives, you need to lay the patient on a hard, flat surface. The patient should be provided with complete rest, close people should monitor the condition of the patient with PE.

To start medical workers resuscitation is carried out, which consists of mechanical ventilation and oxygen therapy; usually, before hospitalization, a patient with PE is given intravenous unfractionated Heparin in a dose of 10 thousand units, along with this drug, 20 ml of rheopolyglucin is administered.

Also, first aid consists of administering the following medications:

• 2.4% solution of Euphyllin - 10 ml;
• 2% solution of No-shpa - 1 ml;
• 0.02% solution of Platifilin - 1 ml.

With 1 injection of Eufillin, the patient must be asked whether he suffers from epilepsy, tachycardia, arterial hypotension, and whether he has symptoms of myocardial infarction.

In the first hour, the patient is anesthetized with Promedol, and Analgin is also allowed. In case of severe tachycardia, appropriate therapy is urgently carried out, and if breathing stops, resuscitation is carried out.

With strong pain injections of a narcotic 1% solution of Morphine in a volume of 1 ml are indicated. However, before intravenous administration of the drug, it is necessary to clarify whether the patient has a convulsive syndrome.

After stabilization of the patient's condition ambulance As soon as possible, the patient is taken to cardiac surgery, where the patient is prescribed appropriate treatment in a hospital setting.

Therapy for pulmonary embolism

Hospitalization and treatment are aimed at normalizing the condition in the pulmonary bloodstream. Often, the patient undergoes surgery to remove a blood clot from an artery.

In case of contraindications to surgery, the patient is prescribed conservative treatment, which usually consists of the administration of fibrinolytic drugs; the effect of drug therapy is noticeable within a few hours from the start of therapy.

To prevent further thrombus formation, the patient is given injections of Heparin, which acts as an anticoagulant, has an anti-inflammatory and analgesic effect, and oxygen therapy is also indicated for all patients with PE.

Patients are prescribed indirect anticoagulants, which are used for several months.

It is important to remember that in case of pulmonary embolism, emergency care is the most important aspect for a successful outcome of the pathology. To prevent further blood clots, patients are advised to adhere to preventive measures.

Prevention of pulmonary embolism

There is a group of people who must carry out preventive actions without fail:

• age after 45 years;
• history of heart attack or stroke;
• excess weight, especially severe obesity;
• previous surgery, especially on the pelvic organs, lower extremities and lungs;
• deep vein thrombosis.

Prevention should also include:

• periodically do ultrasound of the veins of the lower extremities;
• bandaging veins with an elastic bandage (this is especially true when preparing for surgery);
• regular injections of Heparin to prevent thrombosis.

Preventive measures cannot be taken superficially, especially if the patient has already suffered thromboembolism. After all, TELA is extremely dangerous disease which often leads to death or disability of the patient. At the first symptoms of pathology, it is necessary to seek medical advice as soon as possible; in case of obvious signs or a sharp deterioration of the condition, you need to call an ambulance, which will carry out emergency measures before hospitalization with the disease. If the patient has suffered a pulmonary embolism, then the state of health cannot be ignored; strict adherence to the doctor’s prescriptions is the key to a long life without recurrence of thromboembolism.

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