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The causes of deep vein thrombosis
Deep vein thrombosis of the lower limbs occurs in a person under the influence of a combination of several factors. First of all, it is the presence of damage to the inner lining of the vein wall, which arose as a consequence of chemical, mechanical, allergic or infectious action. Also, the development of deep vein thrombosis depends on the violation of the blood coagulation system and slowing blood flow.
Under the influence of certain circumstances may be an increase in blood viscosity. If you have certain obstacles to the walls of the vein blood flow deteriorates, resulting in the possibility of blood clots increases dramatically. Once on the wall there is a small vein thrombus, inflammation develops, the vein wall be damaged and will continue, and eventually appear background to other types of thrombi.
Direct prerequisite to the appearance of deep vein thrombosis is the presence of stagnation in the veins of the legs. This stagnation is due to low mobility and immobility all human for a long period of time.
Thus, factors that are able to "run" the development of the disease, is an infectious disease, the presence of injuries and operations, too much physical exertion. Deep vein thrombosis often occurs in patients who have been immobile for a long time after the operation, with some neurological diseases and therapeutic, the young mothers in the postpartum period. Aggravating factors are also often become malignant diseases, the use of oral hormonal contraceptives, resulting in manifest increased blood clotting, called hypercoagulable .
If a person is too long holding period legs lowered down in a fixed position, the probability of developing the disease increases dramatically. Today, in Western countries even define the terms " TV thrombophlebitis "(A consequence of long sitting in front of the TV) and" economy class syndrome "(A consequence of the frequent and long flights). In both cases, the main factor of the disease is becoming a prolonged stay in the pose of a man with legs bent.
In some cases the blood flow in the deep veins broken due to the appearance Buerger's disease .
In most cases, it affects thrombosis lower limbs. However, it happens that thrombosis develops in the deep veins of the hand. In this case, the reasons for such a state is to find venous catheter in a long period, the presence of an implanted pacemaker or kardiofibrillyatora, the appearance of a malignant tumor in the veins, too heavy load on the hands (seen mostly in athletes).
There are other important risk factors that predispose to deep vein thrombosis. Among these should be noted anesthesia . There are studies showing that the use of general anesthesia with muscle relaxants more often provokes deep vein thrombosis of the lower limbs than regional anesthesia techniques.
Another important factor - obesity . People who have the excess weight It is much more likely to suffer from the symptoms of postoperative thrombosis.
The age factor in this case, also plays a determining role. After the older person becomes, the more reduced its overall mobility and, therefore, blood flow is disturbed, become less elastic blood vessels.
If the patient already has a history of thrombotic events, the possibility of re-displays increases several times.
The symptoms of deep vein thrombosis
Regardless of where it is localized thrombosis patient may experience cyanosis and edema the affected limb, display bursting with pain , Increase temperature skin, which manifests itself locally. The person may feel that subcutaneous veins are overcrowded, and pain may occur in the course of the vascular bundle.
For the symptoms of deep vein thrombosis is not characteristic of stiffness in joints and changes in sensitivity. The majority of patients present signs of thrombosis periflebita and aseptic phlebitis .
With deep veins of the lower leg defeat to establish a diagnosis, usually the most difficult, as the clinical manifestations of this disease is particularly scarce. In general, the disease may not cause concern in the patient, and sometimes a doctor. The most common symptom of deep vein thrombosis shin occur only not strong pain in the calf muscles, which can become more intense in the process of walking or moving the legs to the vertical position. In the presence of edema of distal extremities diagnosis of the disease is facilitated. Generally, swelling occurs in the ankles. When deep vein thrombosis of the lower leg is a strong violation of the venous outflow, hence, the symptoms become more pronounced.
Symptoms, which occur when thrombosis of the femoral vein It depends on how narrow the lumen of the vessel and distributed thrombi. In general, in this form of the disease symptoms appear brighter. The patient increases the volume of the femur and tibia, there is cyanosis of the skin, on the tibia and distal femur occurs extension of saphenous veins. May increase the inguinal The lymph nodes It develops hyperthermia to 38 degrees.
Acute DVT different prevalence and duration of the pathological process. In this state the localization of thrombi observed not only where the damaged vessel wall and in the lumen of the vessel. This flow of blood is blocked.
Quite often, about 50% of cases, the development of deep vein thrombosis blood flowing through the perforating veins in the subcutaneous veins, hence, there is asymptomatic thrombosis. The fact that the man suffered a thrombosis, sometimes indicates the presence of significant venous collaterals in the abdomen, in the shin, thigh, in the hip joints.
Complications of deep vein thrombosis
As a complication of deep vein thrombosis in a patient may eventually emerge chronic venous insufficiency Due to which the development of leg edema, impaired trophic. In turn, this leads to eczema . Lipodermatosclerosis , Appearance trophic ulcers .
The most dangerous complication for a person of deep vein thrombosis is considered pulmonary embolism . With the development of this disease is detached pieces of a blood clot, which move through the bloodstream to the lungs, and getting into the pulmonary artery embolism provoke it. As a result of impaired blood flow in the pulmonary artery is the development of acute respiratory and heart failure. It is fraught with fatal consequences. If there is a blockage of small branches of the pulmonary artery, the patient manifests pulmonary infarction .
Diagnosis of deep vein thrombosis
Diagnosis of deep vein thrombosis holds specialist phlebologist. Initially, after the consultation and examination of the patient are special BCF sample using an elastic bandage. In order to adequately assess the characteristics of blood flow in the deep veins, the method of venography, duplex scanning and an ultrasound diagnosis of leg veins. For information about the state of microcirculation applied rheovasography lower extremities.
Treatment of deep vein thrombosis
The goal of therapy is thrombosis few defining moments. First, an important task in this case is the need to halt the further spread of thrombosis. It is important for this diagnosis to prevent development pulmonary thromboembolism To stop the development of edema, thereby preventing probable gangrene and further - the loss of the limb. No less important point to be considered restoration of patency of the veins in order to avoid the appearance of postthrombophlebitic disease. It is also important to prevent the manifestation of recurrence of thrombosis, adversely affect the prognosis of the disease.
For conservative treatment of deep vein thrombosis of the patient, it is desirable to place in a specialized department of the hospital. Prior to conducting a full examination it has to strictly adhere to bed rest. Subject to bed rest the affected limb thrombosis should always be kept in a raised position. If there is no possibility of full and complete examination of the patient, it is prescribed anticoagulants, as well as using local hypothermia during the projection of the vascular bundle.
In some cases it is advisable to use elastic bandages, however, to take a decision on their application should only doctor.
Treatment of deep vein thrombosis medication means implies the appointment of three main groups of drugs. Firstly, it anticoagulants , Secondly, fibrinolytics and thrombolytics , third, disaggregants .
To prevent new clots symptoms the patient is usually appointed heparin And then prescribe him receiving "soft" anticoagulants ( warfarin ) For a period of about six months. In order to track the status of blood clotting patient must regularly coagulation.
In the treatment of deep vein thrombosis with the use of warfarin may affect the treatment of various other drugs associated diseases. It should not be without a doctor's approval to use anti-inflammatory and pain medications that may affect blood clotting. It is also important to check with your doctor welcome antibiotics , Oral antidiabetic agents.
It is important to take into account the fact that the reception of thrombolytic agents has the desired effect only in the early stages of thrombosis. At later stages of the application of this type of drugs is dangerous because of the likely fragmentation of thrombus and subsequent pulmonary embolism.
If violations of the affected limb Thou very pronounced, the patient is assigned to conduct thrombectomy . This method involves the surgical removal of a blood clot from a vein. This operation is performed only when there are life-threatening patient complications of deep vein thrombosis.
Prevention of deep vein thrombosis
Eating deep vein thrombosis patient comprising administering to the diet of a large amount of raw fruits and vegetables containing fiber. It is because of fibrotic tissue synthesized fiber, strengthen vein walls. Do not eat very spicy and salty foods that can contribute to fluid retention, which in turn increases blood volume. It is also not recommended uporteblyat those products where there is a high level of Vitamin K Because they oppose the treatment. In this case it is the liver, coffee, green tea, green lettuce, spinach, cabbage.
Wrong is the view that patients with deep vein thrombosis have to constantly spend time in bed. In fact require bed rest only at high risk for pulmonary embolism. In other cases, dosed walking, on the contrary, reduces the likelihood of further development of thrombosis and its recurrence.
At the same time, patients thrombosis should not use the sauna, steam room, do any thermal treatments, massages. All these actions provoke the activation of the blood flow, thus filling the venous system of the blood increases. Taking a bath is also not encouraged: patients thrombosis is better to take a shower. In acute condition should also not be exposed to direct sunlight, apply hot wax hair removal.
In order to prevent the manifestation of deep vein thrombosis, healthy people should try to eliminate all possible risk factors: unhealthy diet, a low level of activity. Equally important is the fight against obesity, smoking. This is especially true of people who have a tendency to manifest thrombophlebitis. Sometimes such people it is advisable to wear special elastic underwear. The patients in the postoperative period should pay special attention to ensuring early motor activity. Sometimes, after a major surgical interventions the appointment of small doses Aspirin and heparin, which may reduce blood clotting.
A very important issue in the prevention of thrombosis is regular exercise and sports. This point is extremely important to take into account the people who are mostly inactive. However, people who are prone to thrombosis veins do not need to dwell on sports related to the load on the foot.
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