Vascular thrombosis: what causes it and how to treat it. Acute thrombosis What is venous thrombosis

Date of publication of the article: 07/14/2017

Date of updating the article: 21.12.2018

From the article you will learn what thrombosis is. What is it dangerous, what consequences it can lead to. Causes of the disease, its main clinical manifestations, depending on the localization of the process. Methods for detecting pathology and methods of its treatment.

Thrombosis is a process of formation on the inner wall of a vessel of a conglomerate of blood elements (platelets, erythrocytes, leukocytes) and fibrin filaments, which narrows or completely blocks the vascular lumen.

Such a conglomerate is called a thrombus. If it is completely or partially separated from the vessel wall, then an embolus is formed - a mobile pathological particle that moves with the blood flow and can settle in other vessels.

The process of thrombus formation is a normal defense mechanism of the body in case of damage to vascular structures, aimed at stopping bleeding. But if it loses its locally restrictive nature and (or) becomes excessive, then this condition is a pathology.

With such a disease, the formation of a clot inside the vessel leads to a violation of the inflow (in the artery) or outflow (in the vein) of blood. Depending on the degree of blood flow block, pathology develops:

• reduced oxygen supply and nutrients to tissues with arterial variant,
• violation of the excretion of fluid and metabolic products from organs in the venous form.

Both options are dangerous because in the area with impaired blood flow, the processes of cell decay are activated and areas of tissue necrosis (necrosis) are formed.

With an arterial block, this process proceeds faster than with a venous one. Therefore, impaired blood flow in the artery is more dangerous pathology, which can quickly cause death if a blood clot is located in large cardiac, pulmonary or cerebral vessels.

The possibility of a cure for a disease is determined by:

• type of vessel - arterial or venous;
• lumen diameter - the larger the vessel, the higher the risk severe consequences including death;
• time of initiation of treatment - especially important for arterial disorders and wide venous trunks;
• the technical capabilities of the medical institution - the larger the center, the more modern techniques treatment and elimination of blockage of the vessel;
• age, the presence of concomitant pathology in the patient - the older the sick person, the lower the restorative and protective forces of the body, and severe cardiovascular diseases significantly impair the possibilities of correction.

Vascular and general surgeons deal with the problem of detecting and treating thrombus formation. When the process is localized in the brain, neurologists are involved, and if the cardiac vessels are blocked, cardiologists.

Types of blood clots

Group	Private options
Classic	White - consists of platelets, leukocytes and fibrin. Formed first Red - the second stage of clot formation, when erythrocytes settle on the conglomerate Mixed - consists of several layers of white and red bundles
Specific	Septic - formed during infectious and inflammatory changes in the vascular wall Tumor - formed in the area of ​​vessel germination by a neoplasm Spherical - a detached fragment of a mixed clot with mitral stenosis Vegetation - thrombotic layers with infectious and inflammatory lesions of the inner lining of the heart Maranth - a red clot that forms during stagnation venous blood against the background of a decrease in the volume of circulating blood

Classification of thrombosis

Causes

Pathological thrombus formation in the venous system occurs under the action of several factors that can affect both individually and all at once:

Group of factors	Specific reasons
Decrease in the rate of movement of blood in the lumen of the vessel	Prolonged immobilization (surgery and postoperative period, working conditions with a forced position, "lying" patients in serious condition) External vascular compression (bearing a child, cancer) Violation normal development vessels during the period of organ laying (pathological tortuosity, disruption of the course, wall defects)
Increased blood viscosity	Systemic disorders of the coagulation system (thrombophilia) Severe general somatic diseases (oncological processes, dehydration due to infections and poisoning) Adverse drug effects (contraceptives, tamoxifen, etc.)
Injury to the vessel	Direct damage to all wall elements during trauma or surgery Complication of invasive diagnostic procedures Inflammatory changes in blood vessels (vasculitis, thromboangiitis) Germination of the wall by a tumor

The arterial variant of thrombus formation is associated with other reasons:

• atherosclerotic lesion of the vascular system;
• all variants of tachyarrhythmias, especially atrial fibrillation;
• an infectious process on the inner lining of the heart;
• congenital and acquired disorders of the structure of the heart valves;
• aneurysms of the heart cavities and aorta.

Manifestations of the venous form

The symptoms of venous thrombosis and the severity of the condition depend on the localization of the process. Patients with thrombophlebitis and jugular vein block feel relatively well and can perform their usual activities. The rest of the forms quickly lead to disability.

Sinuses of the brain

1. Growing, diffuse headache with a gradual decrease in the effect of pain medications.
2. Increased pain when lying down and during physical exertion.
3. An increase in body temperature above 38 degrees.
4. Nausea.
5. Convulsive seizures.
6. Weakness.
7. Change of consciousness.
8. Stroke-like symptoms.

Portal vein

• Enlargement of the spleen and liver.
• Accumulation of fluid in the abdomen.
• Decreased liver function.
• Icteric discoloration of the skin and whites of the eyes.
• Enlargement of esophageal veins with bleeding from them.
• Pain syndrome throughout the abdomen.
• Bloating and abnormal stool.

Renal vein

• Pain syndrome in the lower third of the back on both sides.
• Progressive decrease in the amount of urine excreted.
• Blood when urinating.
• An increase in the general intoxication of the body.

Jugular vein

1. Redness of the skin over the vessel.
2. Pain in the affected area.
3. Thickening and expansion of the vein.

Budd-Chiari Syndrome (hepatic veins)

• Severe pain in the projection of the liver.
• Accumulation of fluid in the abdomen, chest.
• Agonizing nausea.
• Profuse vomiting, for more later stages- with blood.
• A network of enlarged, convoluted veins under the skin on the abdomen and chest.
• Slight icteric staining of the skin and mucous membranes.
• An increase in the size of the liver, spleen.
• Increasing swelling of the legs.
• Weakness.
• Depression of consciousness.

Paget-Schroetter syndrome (brachial and subclavian vein)

• Swelling of the hand suddenly developed.
• Increasing, throbbing pain.
• Blue staining of the skin.
• Increased sweating.
• Impaired arm mobility.

Mesenteric veins

Click on the photo to enlarge

1. Increasing diffuse abdominal pain.
2. Bloating.
3. Violation of passing gas and stool.
4. Severe weakness, drowsiness.
5. Increased heart rate.
6. A gradual decrease in pressure.

Deep veins of the lower limb

• Swelling of the legs.
• Changes in skin color from pale to cyanotic.
• Increasing fatigue in the lower limbs.

For high forms at the level of the upper third of the thigh and iliac segments:

• Rapidly increasing increase in leg size.
• Violet-black skin color.
• Significant pain syndrome.
• General serious condition with impaired consciousness.

Superficial veins of the leg

1. Increase in size and appearance of tortuosity of veins.
2. The skin over them is red, painful, with seals.
3. Pain syndrome along the pathologically altered vessel.
4. Heaviness in the lower leg and foot when standing and under load.

Pulmonary artery

• Sharp chest pain.
• Difficulty breathing.
• Cough with bloody expectoration.
• Frequent, small pulse.
• Significant reduction in blood pressure.
• Great weakness.

Arterial manifestations

Signs of arterial thrombosis depend on the area of ​​blood flow disturbance. The pathology is more heavy course than with venous forms of vessel lumen occlusion. Patients for a short time lose the ability to perform any actions and in most cases require bed rest.

Brain (stroke)

The combination of clinical symptoms depends on the area where the blood flow is impaired. The severity of the course is due to the number of bypass arteries and the initial state of their walls.

• Loss of all range of motion and sensation in a part or half of the body.
• Sagging facial muscles.
• Inability to speak and swallow.
• Visual and hearing impairment of varying degrees to complete loss.
• Trembling of the body or individual limbs (tremors).
• Unstable gait.
• Memory impairment, including complete loss of memory (amnesia).
• Problems with urination and defecation (retention, incontinence).
• Mental disorders (aggression, denial of illness, depression).

Heart (heart attack)

Manifestations depend on the size of the affected vessel - the larger, the faster the symptoms develop and their severity.

1. Severe pain in the left side chest and / or behind the breastbone.
2. Reflection of pain in the arm, neck, jaw, or abdomen.
3. Frequent palpitations at the beginning, with worsening - slowing of the pulse.
4. High pressure, and later gives way to low.
5. Coldness of the skin.
6. Sweating.
7. Feeling of fear.
8. Feeling of lack of air.

Mesenteric vessels (mesenteric)

• Sharp pain syndrome throughout the abdomen.
• Rapidly increasing intestinal distension.
• No stool and no gas.
• Agonizing nausea.
• Profuse vomiting with fecal odor.
• Pallor.
• Dry skin.
• High heart rate digits.
• Significant pressure drop.
• General deterioration in health.
• A growing sense of powerlessness.

Limb arteries

The defeat of the vessels of the hand is rare.

Disruption of blood flow to the leg can be impaired by different levels, and the severity of the condition depends on it	In the absence of timely assistance
Sharp pain in the area with impaired blood flow	Swelling of the affected area
Marbled pallor of the skin	Darkening of the skin
Violation of all kinds of sensations in this part of the limb	Intravital tissue necrosis (necrosis)
Numbness	Sinus tachyarrhythmia
Fast heartbeat	General poisoning of the body
Pressure rise
Increasing loss of volume of active and then passive movements

Diagnostics

Method	What allows you to evaluate
Collection of information on complaints and examination	Clinical manifestations of the disease in most cases allow already at this stage to establish a presumptive diagnosis During the study of systems, the doctor conducts certain tests to determine the localization of the process (flexion of the limbs, checking reflexes and sensitivity, palpation)
X-ray examinations	Used for research lung tissue and abdominal organs Evaluate the nature of the vascular pattern in the lungs, their airiness In the abdomen, the presence of a large amount of liquid and gas in a swollen intestine is determined, a violation of the movement of contents
Laboratory blood samples	Informative in case of damage to the vessels of the heart and lungs (specific enzymes of heart attack and thromboembolism) In other cases, there are no specific changes
Vascular sonography in different modes (ultrasound)	Highly informative method for detecting blockage of the vessel lumen, determining the extent of the lesion and the possibility of treatment Not used for vascular lesions in the brain and intestines
Magnetic and computed tomography with vascular program	The most reliable and accurate diagnostic method Reveals any types of blood clots, clearly localizing the affected area and the degree of blood flow disturbance Not always available in general practice
Angiography	With arterial forms of thrombosis, it has a therapeutic and diagnostic purpose It is indicated for venous forms with lesions of large vascular trunks Not performed in case of pathology of superficial vessels Invasive procedure using high doses of contrast agent

Treatment

The possibility of a complete cure for a disease depends on:

• from the diameter of the affected vessel;
• time since the violation of blood flow;
• the adequacy of treatment;
• the general condition of the patient;
• stages of the course of concomitant pathology.

In each case, there is a risk of fatal outcome or disability, especially with arterial forms of impaired blood flow. Thrombosis of superficial vessels or small internal branches proceeds more favorably.

Thrombosis treatment includes two directions: medicinal and surgical. In most cases, a combination of them is used.

With pathology of the sinuses of the brain, lesions of superficial veins, blockage of small venous branches, only conservative therapy is performed.

Medicinal methods

Operational methods

Use various techniques, depending on the localization of the clot:

1. Intravascular or endovascular removal (brain, lungs, heart).
2. open operations with dissection of the vessel wall in the projection of the clot with subsequent suturing of the defect ( abdomen, limbs).
3. Removal of tissue, part of an organ or limb in cases of irreversible stages of necrosis (intestines, limbs).
4. Installation of clot-catching devices in the lumen of the inferior vena cava (small pelvis, abdominal cavity, limbs).

Forecast

With any form, there is a risk of death and subsequent disability.

Risk factors are:

• the age of the patient;
• concomitant cardiovascular pathology;
• time of asking for help;
• the amount of treatment performed.

Acute thrombosis- a common disease, 10-20% of people suffer. Becomes a complication varicose veins veins. This is a deep vein disease. The danger is unpredictability. There is a risk of death.

Don't ignore the symptoms. You should immediately consult a doctor. Timely treatment is a guarantee of health.

Acute thrombosis is a common disease. It consists in the formation of blood clots in the veins.

Thrombosis is accompanied by inflammation of the vessel walls - thrombophlebitis. It develops due to a local or general infection. It spreads to superficial veins.

In the next. The formed thrombus can come off - floating (occurs in 10% of cases of acute deep vein thrombosis). It is impossible to predict the direction of its movement. If it gets into the lungs, it will cause pulmonary embolism leading to death. Thrombophlebitis leads to others unpleasant consequences- heart attack, shock, systemic hypotension, heart failure. If left untreated, the blood clot may not come off but grow. This situation leads to a blockage of blood vessels. Corollary - venous insufficiency chronic in nature.

Thrombophlebitis in neglected form leads to sepsis - blood poisoning. A common result of such negligence is death. The disease also proceeds in a purulent form, if venous thrombosis becomes a neglected pathology. The presence of ulcers is not excluded. The neglect of the disease leads to disability.

Classification of thrombosis by the nature of the course of the disease:

• acute (pronounced manifestations of the disease);
• subacute (restrained painful sensations, manifestations);
• chronic.

Thrombosis brings discomfort and requires treatment.

Depending on the connection of the clot with the venous wall, there are:

• parietal thrombosis (the clot is localized on the vessel wall);
• occlusive view (closed lumen of deep veins);
• floating (the clot breaks off, moves);
• mixed look.

Depending on the localization of the disease:

• thrombophlebitis developing in the superficial veins lower limbs;
• deep vein thrombosis.

Causes of the disease:

• heredity,
• obesity,
• problems with the circulatory system,
• immobilization,
• malignant diseases,
• congenital anomalies
• hormonal disruptions
• pregnancy.

Symptoms

Symptoms are not pronounced in the initial stages. The person does not pay attention to them, since they are insignificant. It is not possible to diagnose the disease at an early stage. Already acute venous thrombosis is often detected.

Acute symptoms:

1. Pain in the lower extremities;
2. Stiffness of movement, heaviness;
3. Distension in the legs;
4. Edema;
5. An increase in temperature (accompanies thrombophlebitis);
6. Increase in volume;
7. Density;
8. Purple, blackish coloration of the limb due to deep vein involvement;
9. Venous gangrene of the limb (with an advanced form of the disease).

Acute thrombosis is characterized by bright, sharp manifestations. Symptoms are severe.

The acute form is characterized by suddenness. A person can move calmly, and the next day they can suddenly lose this ability due to edema. At the slightest manifestation, adequate treatment is required.

It is not always possible to establish a diagnosis based on external signs. Clinics provide diagnostic tests to confirm the disease, its type. Such studies include:

• magnetic resonance phlebography;
• radiopaque phlebography;
• ultrasonic duplex scanning.

What to do

At the first manifestations of pathology, consult a doctor. After the diagnosis, treatment will be prescribed.

If the disease is not started, apply conservative treatment... With the wrong therapy, embolism threatens half of the patients.

Doctors resort to medication. This applies to anticoagulants, which reduce the risk of clot spreading, resulting in embolism. The clinic uses drugs that are injected or taken orally.

Such methods are combined with the activation of the patient. With deep vein thrombosis, bed rest used in the initial stages, subject to severe swelling, pain. When the manifestations pass, active classes are prescribed, gymnastic exercises that improve blood flow.

In the supine position, the legs are determined at a height, at an angle of 15-20 degrees. Wearing special compression underwear is not excluded. These methods, when performed comprehensively, will remove thrombophlebitis.

If conservative methods are not enough, other methods are used, up to surgical intervention. The clinics offer a range of treatments.

Thrombolysis helps in the resorption of blood clots. Catheter insertion is required. The advantage is the dissolution of large blood clots in the deep veins. The procedure is fraught with bleeding.

In complicated forms, thrombosis, thrombophlebitis are treated with surgical intervention - application, installation of a special shunt. This removes the clots from the deep veins.

To avoid open surgery, the method of installing a cava filter that traps blood clots is used.

The patient needs to follow a diet. It consists in giving up fatty, high-calorie foods, foods containing vitamins C, K. Reduced fluid intake. In the diet, increase blood thinning foods - garlic, pepper, artichoke.

For prevention, the use of special drugs that thin the blood in the deep veins is not excluded.

Resort to folk remedies... Considered in addition to the medication prescribed by the clinic.

• Honey and red beets. The juice from 50 g of the vegetable is combined with honey. It is taken on an empty stomach in the morning. The course is two weeks. It is considered a prophylactic agent.
• Clay. Treatment consists in applying to sore spots. The use of curd is similar to the use of clay.
• Apple vinegar. Lubricate the lower limbs for a month. Drink vinegar by diluting two tablespoons in a glass of water. Take before meals.
• Kalanchoe. Treatment involves the preparation of a tincture. The cut leaves of the plant are placed in a half-liter jar up to half, filled with alcohol (40%). The infusion is kept in the dark for seven days. Shake occasionally. After seven days, strain. Infusion is rubbed on the legs before going to bed for 4 months. Massaging movements, from bottom to top.
• Greenfinch mushrooms. The substances contained in them will not allow the blood to thicken.

Venous thrombosis is a common disease, in some cases life threatening... You should see a doctor in time. Thrombophlebitis is considered no less threatening. The acute form brings discomfort and complicates treatment. Timely help, prevention is a guarantee of health.

Many people are interested in the question of what is thrombosis. This vascular disease, which in one way or another is associated with normal blood flow. A thrombus is, by and large, a blood clot that blocks the lumen of the vessel. Naturally, such a pathology can lead to a huge number complications, up to the death of the patient. So what are the causes of the development of the disease? What symptoms should you look out for?

What is thrombosis?

It is worth noting that many people are faced with a diagnosis such as thrombosis. Thrombus is the formation of which is natural process... This is an adaptation of the body that helps to stop bleeding in case of damage to blood vessels.

However, sometimes blood clots are not associated with damage to the vascular walls. In such cases, we are talking about pathological process... After all, the clots do not eliminate the "leak" in the veins and arteries, but simply circulate through the vessels. Over time, blood clots can grow in size, reducing the lumen of the vessels. Accordingly, the blood flow is disturbed, which affects the work of the whole organism. Tissues do not receive a sufficient amount of nutrients and oxygen, as a result of which their trophic changes are observed.

Pathology in the absence timely treatment leads to dangerous complications. Thromboembolism is an acute condition, which is accompanied by the separation of a blood clot and a complete blockage of vital vessels (in particular, such a pathology often develops so quickly that the patient dies long before being admitted to the department medical care... That is why it is important to know what thrombosis is and what symptoms it is accompanied by.

The main causes of the development of the disease

According to the information that the researchers managed to obtain, there are three main reasons, the simultaneous presence of which in almost 100% of cases leads to the development of thrombosis:

• violation of the integrity of the vessel wall (can be caused as a direct mechanical damage and exposure to tissue of infectious toxins);
• a sharp decrease in the speed of blood flow (such a violation may be the result of compression of the vascular wall, or, for example, insufficiency of the venous valves);
• (to the reasons in in this case include congenital anomalies in the development and structure of platelets, exposure to chemicals, including some drugs).

The main etiological causes of the development of the disease are described above. But certain factors lead to their appearance, which are also worth considering:

• more often suffer from thrombosis in old age;
• the likelihood of developing the disease is not excluded among young people who, for one reason or another, are forced to carry out long time in a sitting position as well as carry on sedentary image life; this is due to impaired blood flow to the heart and a gradual decrease in muscle tone of the lower extremities;
• for the same reason, blood clots form in people who have to stay in bed for a long time;
• risk factors include abdominal surgery;
• thrombosis can develop in a woman after a cesarean section;
• being overweight and obese also increase the likelihood of developing the disease;
• long-term use of drugs that affect blood clotting, can provoke the formation of a clot;
• smoking causes and, accordingly, also increases the risk of developing pathology;
• Risk factors include the placement of implants (eg, pacemakers) and prolonged catheterization;
• long-term use hormonal drugs, including contraceptives, can also affect the state of the vascular system;
• protracted infectious diseases can damage the walls of blood vessels, which provokes the development of thrombosis.

Quite often, thrombosis develops against the background of other diseases, including, for example, endarteritis, diabetes mellitus, etc.

Types of thrombosis

Naturally, there are several classification systems for this pathology. Nevertheless, first of all, the disease is divided depending on which vessels it affects:

• The most common is venous thrombosis. A similar pathology is accompanied by blood clotting and the formation of clots in the lumen of the veins. Most often, the ailment affects the deep veins of the lower extremities, but vascular thrombosis in upper section the body is observed less often. In addition, pathology sometimes develops in the superficial veins. In any case, in the absence of treatment, the number of clots increases, blood clots spread along new venous lines.
• Arterial thrombosis, according to statistics, is diagnosed less often, but it is much more dangerous. The fact is that the pressure and speed of blood flow in large arteries is much higher, and therefore there is always the possibility of a clot detachment with further blockage of the lumen of important arteries. Even a temporary cessation of blood flow leads to organ ischemia. For example, blood clot separation and blockage almost always result in myocardial infarction. If, as a result of thrombosis, the arteries that carry blood to the brain are blocked, it is almost impossible to avoid a stroke.

The defeat of deep veins and its features

Most often, patients are faced with the diagnosis of "venous thrombosis of the lower extremities." Symptoms, treatment, causes of pathology are important questions. This type of disease is considered one of the most common. For a long time it can develop without any complications, but its consequences can be extremely dangerous.

In the early stages, the disease is accompanied by a feeling of fullness in the legs, as well as soreness. The pain first appears during physical activity, but then it is present at rest. Other symptoms include pallor. skin as well as constant swelling. The patient's quality of life is constantly deteriorating - even a short walk becomes a problem. Often, against the background of thrombosis, phlebitis (inflammation of the venous walls), as well as other complications, develops.

Intestinal vascular thrombosis

Of course, all vessels are theoretically susceptible to thrombosis. human body... And in medicine, cases of damage to the superior mesenteric artery are quite often recorded. With a similar disease from circulatory disorders, it suffers small intestine and some sections of the thick.

Diagnosing a disease can be difficult, because clinical picture pretty blurry. At the initial stages, abdominal pain, nausea and vomiting appear, which are practically not associated with food intake, diarrhea, as well as a gradual decrease in body weight. Detachment of a blood clot and blockage of the vessel cause rapidly progressive ischemia of the intestinal tissues, which is accompanied by severe, sharp pain in the abdomen. This condition often requires urgent surgical intervention.

Acute thrombosis and its signs

Pathology can develop for many weeks or even months without causing major changes in the patient's condition. Therefore, people, as a rule, go to the doctor when complications appear.

The formation of a large blood clot causes an emergency condition called acute thrombosis, the symptoms of which are hard to miss. Violation of blood circulation in the tissues, expressed are accompanied by the following symptoms:

• acute pain that occurs in the affected limb;
• pallor of the skin;
• the skin over the affected area becomes cool to the touch;
• there is a violation of tactile and pain sensitivity;
• the development of muscle contracture;
• violation motor activity.

The presence of such violations is a good reason to immediately consult a doctor.

Thrombosis and thromboembolism

Do not underestimate the danger of thrombosis. Thromboembolism is extremely dangerous condition... This is not an independent disease, but rather one of the consequences of thrombosis. For one reason or another, a blood clot enters the open bloodstream, after which it completely clogs the vessel. The result of an embolism is oxygen starvation and rapidly developing tissue ischemia.

Detachment of a blood clot and getting it into the heart vessels leads to a heart attack. Blockage of the arteries that carry blood to the brain leads to stroke and other damage to the nervous system. In most cases, the prognosis for patients is unfavorable, since not every patient manages to receive urgent medical care on time.

Diagnosis of the disease

The diagnostic process includes several main stages. Of course, the doctor first conducts an external examination and collects an anamnesis, but other studies are needed to determine the localization of thrombosis. In particular, one of the most informative tests is ultrasound doppler... For example, such a procedure can diagnose venous thrombosis in the veins of the lower extremities. There are other methods of examination, including phlebography, computed angiography, plethysmography, etc.

Coagulological tests are also prescribed, with the help of which it is possible to assess the degree and rate of blood clotting. In the event that there is a suspicion of the presence of autoimmune thrombosis, an additional enzyme immunoassay blood.

Modern methods of treatment

Undoubtedly, important issue for each patient are the methods of treatment that modern medicine can offer. Therapy, of course, depends on the degree of thrombosis and the presence of complications.

More than a dozen years for the prevention of thrombosis and ischemic disease aspirin (acetylsalicylic acid) is used, but long-term use can lead to problems from the gastrointestinal tract, such as heartburn, gastritis, nausea, stomach pain, etc.

To reduce the risk of such undesirable consequences, it is necessary to take funds in a special enteric coating. For example, you can use the drug "Thrombo ACC®" *, each tablet of which is coated with an enteric film coating that is resistant to gastric hydrochloric acid and dissolves only in the intestine. This avoids direct contact with the gastric mucosa and reduces the risk of heartburn, ulcers, gastritis, bleeding, etc.

Moreover, complex treatment includes taking anti-inflammatory drugs, as well as drugs that maintain the tone of the walls of venous vessels. Physical therapy is also helpful. It is important to correct the diet, as well as to maintain physical activity, to do feasible physical work.

In some cases, surgical intervention cannot be avoided. The operation is prescribed in case of large blood clots and serious violations blood flow.

Preventive measures: how to prevent the development of the disease?

Knowing what thrombosis is and under the influence of what factors it develops, several preventive measures to reduce the risk of developing the disease.

Concerning drug treatment, then in the postoperative period, patients are prescribed drugs that thin the blood - this prevents the formation of clots. Patients who are forced to stay in bed need regular massotherapy which eliminates blood stasis.

Nutrition is also an important point - in order to avoid the development of atherosclerosis and thrombosis, it is necessary to reduce the amount of animal fats in the diet. With stagnation of blood in the veins of the lower extremities, wearing special compression underwear will help. And of course, do not forget about physical activity Is the only way to maintain muscle tone and normalize blood circulation.

Is it possible to treat with folk remedies?

Traditional medicine offers many means that can thin the blood and, accordingly, prevent the formation of blood clots and dissolve the existing ones. For example, reception or chestnut is considered quite effective. You can prepare them yourself or buy ready-made medicines at the pharmacy.

You can make a medicine from citrus fruits and garlic. To do this, grind two lemons (using a meat grinder) along with the peel. Add peeled chopped garlic there (one medium-sized head). Stir the ingredients, pour a small amount of boiled chilled water, then cover and leave in the refrigerator for three days. After that, it is recommended to strain the infusion and take it in a tablespoon three times a day.

It should be understood that home remedies can only be used as auxiliary means and only after preliminary consultation with a doctor.

* There are contraindications, before using it is necessary to consult a specialist.

Vein thrombosis is characterized by the appearance of a blood clot (thrombus) in the venous lumen. The thrombus causes impaired blood circulation, changes the structure and size of the veins. Thrombosis can proceed without complaints, in 20% of cases there is pain and restriction of movement in the diseased limb.

Danger of thrombosis

Note: complications of thrombosis can be life-threatening.

Approximately 25% of the population suffers from various thrombosis. Vein pathology is more common in women (5-6 times more often than in men). Uncontrolled reception medical drugs, overweight, environmental factors contribute to the development of the disease.

Most often, thrombosis affects the veins of the legs. The venous network of the lower extremities consists of two sections - superficial and deep. We can see the processes occurring with superficial veins visually. But the pathology of the veins of the lower extremities often remains unrecognized, due to its external inaccessibility.

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Most of the thrombosis of the veins of the lower extremities occurs precisely in the deep section. A thrombus forms in a few days and is not firmly attached to the vein wall. It is at this moment that it can break off and move along the vascular bed of the body, causing blockage in almost any part of the circulatory system.

Causes of venous thrombosis of the lower extremities

Most common reasons thrombosis become:

• hereditary and congenital diseases vessels - Weakness of the vein wall, insufficient functionality of the venous valves, varicose veins (), fistulas (shunts between arteries and veins, leading to the reflux of arterial blood into the veins);
• tumor processes - causing an increase in blood clotting, thickening and thrombus formation;
• hormonal factor - dysfunction of exogenous and endogenous glands, hormonal disbalance during pregnancy, hormone therapy. Female sex hormone (s) promote the formation of blood clots;
• overweight - when in the body in a large number an analogue of female sex hormones is formed - leptin, which causes increased adhesion (stickiness) of platelets, which affects blood clotting and promotes thrombus formation;
• bleeding injuries, fractures and surgery - lead to increased formation of tissue thromboplastin, which causes thickening of the blood and thrombotic alertness;
• paresis and paralysis of the legs - violation of physiological innervation and muscle immobility with atrophy cause a slowdown and impairment of blood flow in the veins, which leads to the formation of blood clots;
• heavy infectious processes - septic conditions (general blood poisoning), volumetric purulent processes, burns of a large surface of the body, severe inflammation of the lungs. Microorganisms secrete toxins that contribute to the formation of thrombotic masses;

Contributing factors join the causes of blood clots:

• elderly age;
• sedentary lifestyle and work (office workers);
• super heavy loads;
• alcohol abuse and.

How a blood clot occurs (developmental mechanism)

The most common theory of thrombus formation is the Virchow triad.

It consists of three main mechanisms for the development of the thrombotic process:

1. Damage (alteration) of the vein wall. Traumatic rupture of the endothelium (inner layer) of the vein, mechanical compression or stretching creates conditions for the formation of a thrombus.
2. Increased blood clotting. The release into the bloodstream of tissue thromboplastin, thrombin and other coagulation factors leads to adhesion of blood cells and further education substances that contribute to this process.
3. Violation dynamic processes passage of blood. Prolonged bed rest, forced immobility, cholesterol formations (plaques) in the vessels contribute to the violation normal flow blood through the vessel. The resulting "vortex" flow also favors conditions for thrombus formation.

Symptoms of deep vein thrombosis of the extremities

When a blood clot forms, patients note:

• heaviness in the legs that grows in the evening,
• bursting, pressing, aching and twitching pains towards the end of the day;
• paresthesia of the lower leg (feeling of numbness and "goose bumps");
• severe swelling and an increase in the volume of the lower extremities;
• pallor and cyanosis of the skin, thinning of the skin;
• with inflammation of the veins (phlebitis), a local and general increase in temperature.

On examination, the doctor determines:

• glossy skin tone;
• swelling and impaired sensitivity of the lower leg;
• enhanced pattern and blood filling of the superficial veins of the leg (due to the outflow of blood through collaterals from the deep veins);
• more low temperature a sore leg compared to a healthy one.

Diagnostics and tests

To confirm the diagnosis of deep vein thrombosis of the extremities, a contrast x-ray examination of the venous vessels is performed - phlebography.

The phlebogram clearly shows the signs of venous thrombosis:

• "Chopped off vein" - a break in the supply of contrast in the affected area;
• pronounced decrease in the lumen of the vein;
• "Rough" inner surface of the vessel as a result of the formation of cholesterol plaques;
• unstained formations fused with the walls of the veins (blood clots).

Doppler ultrasound - allows you to evaluate the properties of blood movement through the veins, due to the reflection of ultrasonic waves from blood cells. Atraumatic diagnostic method with 90% reliability. Doppler ultrasonography measures the blood flow rate, blood flow volume, and the difference between these indicators on symmetrical limbs.

Have informative value specific signs functional tests:

The study is supplemented with sphygmography, skin thermometry, phlebotonometry, and radioisotope techniques.

Treatment of deep vein thrombosis of the extremities

In mild cases, it is allowed ambulatory treatment... But in any case, with bed rest for up to 2 weeks.

Conservative treatment

It is based on several specific groups of drugs:

Drug therapy is complemented by bandaging a sore limb elastic bandage... It is important to follow the correct technique - the bandage is applied in the supine position, with collapsed veins, in rounds from the toes and above.

note : instead of bandages, you can use a special compression underwear(stockings, knee-highs). The size and degree of compression is selected by the doctor. It is necessary to put on linen in bed, before getting up and take it off when it is possible to lie down.

Surgical treatment of thrombosis

The operation is assigned if:

The operation is contraindicated for:

• stock acute phase process;
• in the case of decompensated heart and respiratory diseases;
• acute phases of infections.

Surgical treatment of thrombosis

Modern medicine knows big variety copyright techniques for the treatment of venous thrombosis of the lower extremities. Our task is to get acquainted with the main ones.

Thrombectomy

The most commonly used methods of operations, the task of which is to remove an existing fresh (up to 7 days) thrombus, restore normal blood circulation through the vessel, or through collaterals.

Troyanov-Trendelenburg operation

A large saphenous vein is exposed through an incision in the groin. different ways can be sutured, or secured with special clips that allow blood to pass through, but fix the detached blood clots.

Installing filters

Special umbrella-shaped filters are sewn into the cavity of the inferior vena cava. In this way, an obstacle is created for the spread of blood clots through the bloodstream and their entry into important vessels.

Traditional medicine methods in the treatment of venous thrombosis of the lower extremities

To alleviate the condition and prevent the development and spread of a thrombus, it is recommended for home treatment:

• juice onions with honey (mix the juice with honey in equal proportions, insist for 3 days and keep for 10 days in the refrigerator). Take a tablespoon three times a day. The effect is due to the presence of natural anticoagulants;
• tincture of white acacia - contains glycosides and oils that have the ability to thin the blood. Tincture to rub the skin over the thrombosis and take 5 drops orally 3 times a day. The course of treatment is a month;
• decoction of hop cones. Take half a glass 4 times a day for a month.

Features of nutrition and diet

With the available overweight you need to get rid of it. There should be enough fortified food in the diet. Preference should be given to fruits and vegetables that help strengthen the walls of blood vessels - rose hips, cabbage, dill, garlic, watermelons, sorrel.

Useful foods containing copper - seafood. Copper serves as a source of material for elastin, which is part of the vein wall.

Important : limit - alcohol, excess fat, chocolate and coffee, mayonnaise.

Prevention of venous thrombosis of the lower extremities

As a preventive measure, a motor regimen, recreational jogging, long-term hiking are natural ways to prevent vein disease.

Regular dousing and bathing in cold water lasting several minutes significantly reduce the risk of developing vascular diseases. Quitting smoking and drinking alcohol are also beneficial for vein health.

Is a condition in which blood clots (thrombi) form in the veins that prevent blood from flowing normally. Clinical symptoms deep vein thrombosis includes bursting pain, swelling, cyanosis of the skin, superficial hyperthermia, tenderness on palpation of the affected vein, swelling of superficial veins. The final diagnosis is established according to the ultrasound scan of the veins of the lower extremities and duplex scanning; rheovasography is performed to assess microcirculation. Deep vein thrombosis is treated with heparin under the control of a coagulogram; if necessary, the resulting thrombus is surgically removed.

ICD-10

I80.2 Phlebitis and thrombophlebitis of other deep vessels of the lower extremities

General information

Deep vein thrombosis is a pathology based on a violation of the venous circulation due to blockage of the vessel by a blood clot. In clinical phlebology, deep vein thrombosis of the lower extremities is more common than venous thrombosis other localizations. Blood clots can form not only in deep veins, but also in superficial veins, however, thrombosis of superficial veins (superficial thrombophlebitis) rarely becomes a source serious problems... Unlike thrombophlebitis, deep vein thrombosis is a medical emergency due to the risk of life-threatening complications.

Thrombosis reasons

For the development of the disease, a combination of several factors is necessary:

• damage to the inner lining of the venous wall as a result of exposure to a mechanical, chemical, allergic or infectious agent;
• violation of the blood coagulation system;
• slowing down the blood flow.

Under some circumstances, the viscosity of the blood increases. If the walls of the vein are blocking blood flow, the risk of blood clots increases. A small blood clot that forms on the venous wall causes inflammation and further damage to the vein wall, which causes other blood clots to form.

The occurrence of deep vein thrombosis is promoted by congestion in the veins of the lower extremities. The cause of stagnation is the immobility or inactivity of a person for a long time. Trigger factors for deep vein thrombosis:

• trauma, surgery, excessive physical stress;
• prolonged immobility in conditions after surgery, neurological and therapeutic diseases;
• period after childbirth;
• taking oral hormonal contraceptives;
• malignant tumors (especially cancer of the stomach, lungs and pancreas);

The risk of developing the disease increases with a prolonged motionless position with the legs down. So, in the West there are the terms "economy class syndrome" and "television thrombophlebitis". In the first case, we are talking about people who developed deep vein thrombosis after a long flight. In the second - about elderly patients who developed the disease after sitting in front of the TV for a long time. In both cases, the triggering factor was a prolonged stay in a sitting position with bent legs, in which normal venous outflow is obstructed.

The return of blood through the veins is largely driven by muscle contraction. After operations and with some chronic diseases a patient for a long time remains practically motionless. As a result, congestion develops in the lower extremities, leading to deep vein thrombosis.

When receiving oral contraceptives, blood diseases, malignant tumors, thrombosis is largely due to hypercoagulation ( increased coagulability blood). In some cases, impaired blood flow in deep veins may indicate Buerger's disease (thromboangiitis obliterans of allergic genesis).

Typically, deep vein thrombosis develops in the lower extremities. However, sometimes deep vein thrombosis in the arm area is also observed, which occurs when the following triggering factors are involved:

• vein catheterization upper limbs... A catheter, which is in a vein for a long time, irritates the venous wall and leads to the formation of a blood clot;
• an implanted cardiac fibrillator or pacemaker;
• malignant neoplasm in the vein;
• excessive load on the upper limbs in athletes (baseball players, swimmers, weightlifters). The disease develops due to compression of the deep veins of the upper extremities by the trained muscles of the shoulder girdle.

Thrombosis symptoms

Symptoms depend on the location of the blood clot. In about half of cases, blood flows through the communicating vein system into saphenous veins, blood flow is partially restored, and deep vein thrombosis is asymptomatic. The rest of the patients have one or more of the following symptoms in various combinations:

• bursting pain in the affected limb;
• pain on palpation, aggravated along the course of the vein in which the thrombus has formed;
• swelling;
• local hyperthermia;
• cyanosis of the skin of the affected limb;
• swollen superficial veins.

Developed venous collaterals in the lower abdomen, in the area of hip joints, thighs and shins.

Complications

The outcome of deep vein thrombosis can be chronic venous insufficiency, as a result of which edema of the lower extremities and trophic disorders (lipodermatosclerosis, eczema, trophic ulcers) develop.

The most dangerous complication of deep vein thrombosis is pulmonary embolism. Torn off pieces of blood clots along with the blood flow move into the lungs, enter the pulmonary artery and cause its embolism (blockage). Violation of blood flow in pulmonary artery leads to the development of acute respiratory and heart failure and can cause death of the patient. In the case when a small branch of the pulmonary artery is clogged with a piece of a blood clot, a pulmonary infarction develops.

Diagnostics

Modern phlebology has a good technical base for assessing venous blood flow and diagnosing deep vein thrombosis. As a rule, the diagnosis is made by a phlebologist. He conducts tourniquet tests (elastic bandaging of the legs using a special technique), including a march test, in which an elastic bandage is applied to the patient's leg from toes to groin. Then the patient walks for a while. Bursting pains and saphenous veins that did not collapse after the test indicate thrombosis.

To assess blood flow in deep veins, phlebography, duplex scanning and USDG of the veins of the lower extremities and radionuclide scanning are used. Assessment of the state of microcirculation is carried out according to rheovasography of the lower extremities.

Deep Vein Thrombosis Treatment

Due to the risk of development dangerous complications patients with deep vein thrombosis must be hospitalized. Strict bed rest is prescribed. The affected limb is given an elevated position. The patient is given heparin to prevent new blood clots from forming (usually within a week). Then the patient is transferred to "soft" anticoagulants (warfarin). The course of treatment with warfarin lasts 6 months. To monitor the state of the blood coagulation system, the patient is periodically performed a coagulogram.

Thrombolytic drugs are effective only on early stages thrombus formation. In the later stages, thrombolytic therapy is dangerous due to the possible fragmentation of the thrombus and the development of pulmonary embolism. With severe circulatory disorders in the limb, thrombectomy is indicated.

Prophylaxis

Measures aimed at preventing deep vein thrombosis include the elimination of risk factors, the use of elastic stockings, and early physical activity of patients in postoperative period... In some cases, small doses are prescribed after the operation. acetylsalicylic acid and heparin, which reduce blood clotting.