Phlebitis of the femoral vein. What is phlebitis and thrombophlebitis. What folk remedies are most effective for treating thrombophlebitis?

Phlebitis is any inflammation of the veins. The cause may be infection, mechanical injury to the venous walls, an allergic reaction, or some diseases. Depending on the cause, inflammation manifests itself various symptoms. In the article we will look at the forms of phlebitis, their signs and methods of treatment.

Forms of phlebitis

There are several classifications of phlebitis. First of all, different forms differ from each other in the location of the affected areas vascular system:

Superficial phlebitis– this is an inflammation of the walls of the veins located directly under the skin (at a depth of no more than 3 cm from the surface of the skin). Inflammation of the superficial veins is usually considered less serious and resolves local treatment. But sometimes it can be a symptom of hidden deep vein phlebitis. This can only be recognized with proper medical examination.
Phlebitis of deep veins– affects the veins, which are located deeper in the tissues of the arms and legs. Sometimes accompanied by the formation of thrombi (blood clots) due to changes in the structure of the inflamed veins. Then ordinary phlebitis turns into.

There are different forms of inflammation of the veins, depending on the degree of their damage:

. In this case, only the outer venous walls are affected. Common reason– transfer of inflammation from surrounding tissues to veins.
Endophlebitis. Occurs when the internal venous walls are damaged. Most often it has infectious cause or develops as a result of inflammation of the veins after injections or insertion of a catheter.
Panphlebitis. In this case, all the membranes of the vein become inflamed.
. Inflammatory process in the abdominal area.

The following forms of phlebitis also occur:

infectious– can occur in the vessels of any area of the body;
postpartum– affects the venous membranes lower limbs, occurring acutely and with severe pain;
peripheral– in this case, the arteries of the legs and arms become inflamed;
allergic– has an allergic nature and is characterized by a long, chronic course;
cerebral– occurs when there is inflammation of the vascular system of the brain, most often of an infectious nature;
post-injection– inflammation of the superficial veins as a result of local trauma (for example, irritation from intravenous catheter);
cubital – special case post-injection, when the vein located in the bend of the elbow becomes inflamed.

Below we will look at the main reasons that contribute to the development different forms phlebitis.

Causes of phlebitis

Various surgical and other medical procedures can damage veins, causing superficial phlebitis. The main risk factor is the insertion of an intravenous catheter. In this case, the venous walls become inflamed at the site of insertion of the needle or cannula. Phlebitis can be of a mechanical, chemical or infectious nature:

mechanical damage to veins– movement of a foreign object (catheter cannula) inside the vein causes friction, leading to inflammation;
chemical– caused by a drug administered intravenously (often a risk factor is antibiotic therapy or the administration of hypertonic solutions);
infectious– occurs when bacteria enter a vein (for example, due to insufficient sterilization of the skin before inserting a needle).

In addition to local venous injuries, there are other risk factors that increase the likelihood of various forms of phlebitis:

sedentary or recumbent lifestyle (slow blood flow, especially in the lower extremities, leads to the formation of blood clots);
obesity;
smoking;
diseases affecting blood clotting;
leg and arm injuries;
taking hormonal medications;
pregnancy;
varicose veins;
frequent intravenous catheterization;
various procedures in the postoperative period;
removed lymph nodes (this disrupts the normal drainage of the venous system);
intravenous drug use;
burns.

Symptoms of phlebitis

In some cases, venous inflammation occurs without any symptoms. But most often they are accompanied the following symptoms, regardless of the form of phlebitis: redness, bulging of the vein, its sensitivity and pain.

Nurses and doctors may suspect the presence of phlebitis by hardening of the vein, pain and discomfort during intravenous drug administration, and difficulty injecting.

Both deep and superficial phlebitis can be accompanied by a slight increase in temperature.

Symptoms of phlebitis of the superficial veins:

Itching, swelling, increased sensitivity, warming of the skin.
Pulsation in the area of the damaged vein.
The appearance of a long, thin red line or “web” along the inflamed superficial vein.
Engorgement and hardening of inflamed veins.
Pain, swelling, redness in the area of the damaged vein in the case of infectious phlebitis.

Symptoms of deep vein phlebitis:

Pain, redness, and swelling in the affected upper or lower limb.
The skin in the area of the affected veins may turn blue or milky white.
Severe swelling of the limb without apparent reason(especially in the case of swelling of only one limb).
Fever (usually with bacterial phlebitis).
The appearance of ulcers and swellings on the skin of the extremities.

In some cases you must seek medical help immediately:

a combination of any of the above symptoms with high fever;
the appearance of “lumps” in the arm or leg;
severe pain and swelling in the limbs;
shortness of breath and chest pain (may be symptoms of thrombophlebitis in the lungs).

The above signs of phlebitis of deep and superficial veins refer to inflammation of the venous walls in both the arms and legs.

Symptoms of cubital phlebitis:

Pain immediately after the injection, especially when bending the elbow.
Induration or local swelling in the injection area.
Hematoma or redness of the skin in the elbow.
Muscle tension and a feeling of tight skin.

Symptoms of post-injection phlebitis:

Acute pain, swelling of the limb into which the intravenous injection was made.
Deterioration general condition, fever.
Thickening and hardening of the affected vein.
Increase possible lymph nodes.

Diagnosis of phlebitis

Phlebitis of the superficial veins can be determined based on a doctor's examination. This diagnosis can be suggested by sensitivity, redness, and swelling along the veins. To confirm it, the doctor may prescribe an ultrasound.

Visual inspection is not always informative. Symptoms indicating phlebitis may also be present with lymphangitis (inflammation and swelling of the lymph nodes), skin infections, insect bites and even cellulite.

Deep vein phlebitis is more difficult to diagnose. Most often, to determine it, it is prescribed ultrasound examination. The following examinations and tests may also be prescribed:

phlebography
analysis for D-dimer (uninformative in the diagnosis of phlebitis, and requires additional examinations)
skin biopsy (in rare cases)

Ultrasound of the veins of the lower extremities (video)

An ultrasound examination is often prescribed to detect phlebitis. In this video, a specialist talks about all the nuances of ultrasound of the veins of the lower extremities.

Treatment of different forms of phlebitis

First self-help at home

To reduce pain syndrome and the inflammatory process in the superficial veins, any of the non-steroidal anti-inflammatory drugs will do. For example, Ibuprofen or Aspirin. Also, as prescribed by a doctor, can be used compression stockings. They are placed on the limb with the affected vein and improve blood circulation in it, reducing swelling and pain.

The simplest and affordable way ease discomfort and increase blood circulation - lungs physical activity, for example, walking. The more you move, the faster the pain and other symptoms will go away.

If the doctor has confirmed superficial phlebitis, then you can use it as prescribed. warm compress on inflamed area.

Treatment

The choice of treatment for venous inflammation depends on several factors. The doctor examines the presence of symptoms, their severity, the location of phlebitis and the diseases that accompany it.

Treatment of superficial vein lesions different localization is most often limited to the use of local remedies. TO effective drugs include anti-inflammatory drugs in the form of tablets or local gels and ointments (based on ibuprofen, diclofenac and their analogues). Warming compresses are also used.

In case of post-injection inflammation of the veins, first remove the catheter. Further treatment depends on the form of phlebitis and the reason that caused it. So, an infection is treated with antibiotics.

If blood clots are suspected For any form of phlebitis, anticoagulant drugs can be prescribed. These include agents based on enoxaparin, fondaparinux, warfarin and unfractionated heparin.

Treatment for phlebitis of the superficial veins usually takes several weeks. Inflammation of the deep veins requires treatment for 2-3 weeks to several months.

Complications and prognosis for phlebitis

Inflammation of the superficial veins usually has a favorable prognosis and can be cured without complications or consequences. But phlebitis of the deep veins is already considered serious illness, the main danger of which is the formation of blood clots and the onset of thrombophlebitis. Progression of the disease can lead to deep vein thrombosis and pulmonary embolism (thrombosis pulmonary artery), which can be fatal in some cases.

Another complication deep phlebitis an abscess may occur and infection of the entire body (in the case of an infectious nature of the inflammation). Severe deep vein phlebitis can seriously damage the venous structure, leading to the development of postphlebitis syndrome. It is characterized chronic edema affected limb, constant pain and the occurrence of ulcers.

Prevention of phlebitis

In some cases, venous inflammation cannot be avoided. But there is simple measures, which significantly reduce the chances of its occurrence. Preventive measures include:

gymnastics during and after a long stay on an airplane or car;
quitting smoking;
rapid onset of physical activity after surgery;
maintaining hygiene and quick removal intravenous catheters;
lack of prolonged sitting and recumbent mode(if necessary, wear compression stockings);
daily physical activity.

There are many diseases of the blood vessels. Some of them are combined into the category “phlebitis”. This is a general term for several diseases caused by different causes and affecting different areas of the veins. However, without proper treatment, they all lead to the same result - thrombophlebitis or capable of causing cardiac arrest. What are the reasons of this disease? How to recognize it and start treatment on time so that a sad ending does not occur? Which ones exist? preventive measures, preventing inflammation of the veins? We will try to answer all these questions in detail and clearly.

What is phlebitis

We all know that humans are divided into two main types - arteries and veins. According to the first, blood rushes out of the heart under pressure, while according to the second, it enters it more calmly. Precisely because the blood in the veins does not flow under pressure, their walls are thinner than those in the arteries, weaker, capable of stretching and causing various unpleasant conditions, such as varicose veins, hemorrhoids and others. They, in turn, provoke phlebitis. These are diseases of the veins in which their walls become inflamed. The term "phlebitis" is easy to understand. It is derived from the Greek "phleva", which means "vein".

Inflammation of their walls is an unpleasant and quite dangerous thing. It is always accompanied by pain, people’s performance decreases, and their motor activity, and in advanced cases thrombophlebitis develops, leading to blockage of the veins with blood clots.

Classification of phlebitis by localization

As mentioned above, phlebitis is the general name for several vein diseases. According to the location of diseased vessels, phlebitis of the upper and lower extremities is distinguished. Human veins are hollow tubular structures, the walls of which are formed in three layers - the strongest outer, very weak middle and inner. It is called endothelium, and its inflammation is called endophlebitis. When the outer layer becomes inflamed, the disease periphlebitis is diagnosed. It is easy to decipher and remember this term if you remember that in Greek “peri” is used to indicate distance from the center, loosely translated “edge”, “periphery”.

If the middle layer is inflamed, the disease is called mesophlebitis. "Meso" in Greek means "in the middle." So here, too, everything is logical and understandable.

In practice, phlebitis is very rarely differentiated according to which vein lining is inflamed. More often the disease is called panphlebitis, that is, general, multiple, but they indicate in which of the three layers of the vein wall the predominant lesions are observed.

Classification according to the etiology of the disease

Depending on the nature of the inflammatory process, there are also various phlebitis. These could be:

necrotic destructive (for some infectious diseases);
purulent (occurs with allergic inflammation);
obliterating (the proliferative moment predominates);
pain (observed in the legs of women after childbirth);
migrating, or wandering (often associated with thrombophlebitis, when blood clots travel through the vessels);
pylephlebitis (inflammation of the collar vein).

Phlebitis can be called by name primary disease leading to inflammatory processes in the veins:

tuberculosis;
syphilitic;
actinomycotic and others.

This classification is very important in determining the correct treatment.

Classification according to the nature of the disease

Depending on the location of the problematic blood vessels in the body, phlebitis of superficial veins and phlebitis of deep veins are distinguished. If the disease has affected vessels located close to the surface of the body, hyperthermia (redness, increased temperature) is observed on the skin at the site of the inflamed vein. Inflammation of deep veins is especially dangerous, as it causes more high demands to diagnosis and treatment.

Patients experience swelling and pallor of the skin in the area of the inflamed vessels, general hyperthermia, weakness, and pain. All these signs are well expressed if the patient is diagnosed with acute phlebitis of the lower extremities. The photo above shows the discoloration of the skin along the problematic vein.

If the disease progresses to chronic form, it can occur with virtually no symptoms. At first glance, this is not so serious, but chronic phlebitis is insidious precisely because of its apparent well-being, thanks to which patients do not go to the doctor and do not undergo treatment. Meanwhile, the disease is gradually developing into advanced forms that are difficult to treat with medication.

Reasons

Phlebitis on the upper and lower extremities is caused by different reasons. Most often, this disease on the legs is caused by complications varicose veins veins, and phlebitis on the arm appears after unsuccessful intravenous injections or insufficient disinfection of the injection site. But there are also a number common reasons, causing inflammation in the venous walls of both the upper and lower extremities.

These include:

vascular injury, including burns of any kind;
infectious diseases;
high sensitivity of venous walls;
allergic inflammation;
some heart diseases;
predisposition to blood clots;
decreased immunity;
problems with blood clotting (acquired or hereditary).

Artificial phlebitis

For varicose veins in recent years A treatment method called sclerotherapy is actively used. It consists in causing artificial (not associated with infection) phlebitis in patients. In this case, inflammation does not occur. The sclerotherapy procedure is almost painless and quite effective. Patients are injected with a syringe into problem areas of the veins on an outpatient basis. special drugs(“Thrombovar”, “Ethoxyclerol” and others), causing gluing of the walls of blood vessels. It resolves on its own within 5-6 months.

How do true phlebitis occur?

The mechanism of development of this disease can be twofold. In some cases, problems first appear in the vein, and then the inflammation spreads to the surrounding tissues. In other cases, on the contrary, a person initially has an abscess of some body tissue, which subsequently affects the walls of the vein, that is, phlebitis develops as a complication of the underlying disease. The photo below represents what inflammation of the venous vessels of the ankle may look like with varicose veins.

Phlebitis caused by pathogenic microorganisms, it turns out like this: viruses or microbes, having penetrated the venous blood vessel, move with the blood flow until they attach to its wall in some place. This mainly happens where the veins have deviations from the norm (dilated, with, etc.), but it can also happen in places where the veins are normal and completely healthy.

Phlebitis, symptoms

General symptoms of this disease include:

soreness of the inflamed vein or the entire limb;
general malaise, weakness;
change in skin color at the site of inflammation;
temperature increase (local and sometimes general);
thickening of the skin in a problem area;
with phlebitis of the lower extremities, symptoms of varicose veins (heaviness in the legs, swelling, ulcers) may be observed.

However, if cerebral phlebitis is observed, the symptoms and treatment are somewhat different. Thus, patients complain of increased blood pressure, headache, dizziness, visual disturbances, and perception of the surrounding world.

Pylephlebitis (inflammation in the peritoneum) also has slightly different symptoms, in which the following are observed:

weakness;
fever;
vomit;
ascites;
severe pain in the liver area;
yellowness of the skin;
headaches;
chills;
enlarged liver, spleen;
anuria;
thready pulse;
low blood pressure;
swelling of the limbs;
bloating.

This condition is not promptly measures taken leads to the death of the patient.

Diagnostics

Regardless of where in the body phlebitis occurs - on the arm, on the lower extremities or in the collar area, diagnosis includes:

examination by a doctor or at least a therapist, if the local medical institution does not have doctors of narrow specialties);
taking anamnesis;
general or extended blood test if there is a suspicion of the presence infectious disease;
allowing you to obtain all the necessary information about veins located anywhere in the body;
Doppler ultrasound of veins.

Treatment of phlebitis of the hands

If there are no indications for immediate hospitalization ( high temperature, dizziness, loss of consciousness, acute heart failure, too high blood pressure), treatment of phlebitis on the arm, due to the fact that it is almost never complicated by thrombosis, is carried out on an outpatient basis. The patient is prescribed rest; it is advisable to fix the problematic arm so that there is no increased blood flow to the inflamed area. Therapy is carried out with medication, taking into account the cause of the disease. So, if the cause of inflammation was viral infection, drugs that fight viruses are prescribed; for bacterial phlebitis, antibiotics are prescribed. In any case, the patient is prescribed:

anti-inflammatory drugs;
drugs that strengthen the walls of veins and improve blood circulation (for example, Trental);
local ointments that relieve heat, redness, swelling and pain;
blood thinners;
analgesics.

Treatment of phlebitis of the lower extremities

Inflammation of blood vessels in the legs is often a consequence of varicose veins and can lead to thrombophlebitis, leading to thrombosis. A blood clot that reaches the heart can cause sudden cardiac arrest and death of the patient. Therefore, if acute phlebitis (inflammation of deep or superficial veins) and thrombophlebitis are diagnosed in the lower extremities, the patient may be offered hospitalization without severe symptoms such as dizziness and loss of consciousness. Apply to the affected limb elastic bandage, docked sharp pain, medications are prescribed to regulate blood flow, improve the elasticity of the walls of veins, physiotherapeutic procedures are carried out, and in special cases surgical intervention is prescribed.

Treatment of other types of phlebitis

The success of treatment of pylephlebitis depends on the speed and accuracy of the diagnosis. Very often the patient is prescribed surgery to remove the source purulent inflammation(appendix, gallbladder, abscess excision). Conducted in parallel drug treatment(antibiotics, detoxifiers, sorbents, restoratives).

With cerebral phlebitis, patients are usually hospitalized. Treatment of this disease is aimed at normalizing blood pressure, relieving pain syndromes, normalizing blood flow and strengthening the walls of veins. Therapy is also provided to support normal brain activity.

Treatment of migratory phlebitis is performed by crossectomy (removal of the affected area of the vein). Formed blood clots can be removed surgically, but more often they use enzymes that dissolve the blood clot. They are inserted into a vein with a special catheter. The patient is discharged home from the hospital to continue treatment on an outpatient basis after inflammation has resolved and stable satisfactory condition sick.

Prevention

Phlebitis, that is, inflammation of the vein walls, can happen to anyone. To reduce the risk of developing the disease, you need to follow these recommendations:

follow the rules for performing intravenous injections;
If possible, avoid injury to the veins, and if they occur, carry out treatment correctly;
in the presence of infectious diseases, comply with all the doctor’s requirements and do not self-medicate;
for those suffering from varicose veins - strictly follow the recommendations of the treating specialists;
having the syndrome increased viscosity blood - avoid eating spinach, soy, rose hips - foods that further increase viscosity;
It is imperative to lead a lifestyle in which the body receives moderate physical activity.

Diseases of the blood vessels are diagnosed in patients no less often than other pathologies of vital organs. With phlebitis, the veins are affected.

If treatment is not started on time, then thrombophlebitis, pulmonary embolism up to cardiac arrest will be guaranteed.

Phlebitis: what is it, how does it manifest itself and how to treat it? Prevention measures.

What is phlebitis and its difference from thrombophlebitis

To understand what phlebitis is, it is worth noting that it is a collective medical term. The development of an inflammatory process in the walls of venous vessels in the legs, arms, and other parts of the body.

More often the lower extremities are affected.

Phlebitis often develops as a secondary disease in existing varicose veins with inflammation of the veins of the lower extremities.

Thrombophlebitis is a complication with the formation of a blood clot due to inflammation of the veins.

The danger is posed by blockage of the pulmonary artery, and the detachment of a blood clot while moving through the vessels can cause thromboembolism and death.
Classification of phlebitis

Depending on the cause of occurrence, the location of the inflammatory process with its location around the circumference of the vessels, inside or outside the membrane of the veins, phlebitis can be divided into several forms:

Periphlebitis with damage to the outer membrane of the vein.
Endophlebitis in the event of inflammation developing on the inner lining of the vein.
Panphlebitis involving both membranes of the vein (internal, external) in the inflammatory process.

Types of phlebitis according to the WHO classifier:

post-injection, caused by injury, chemical (medicinal) drugs leading to irritation of the venous walls;
painful with development more often in women after childbirth, accompanied by severe pain;
allergic as a reaction of the veins to a specific allergen irritant;
cerebral with an inflammatory course in the veins of the brain against the background of an abscess, phlegmon, or other infectious disease;
migrating (more common in young men) with inflammation of the veins of the lower extremities, spreading to the walls of the arteries as it progresses;
Portal vein phlebitis caused by a complication peptic ulcer, hemorrhoids, dysentery, liver abscess, appendicitis, purulent-infectious course of the umbilical vein in newborns;
phlebitis of the penis as a secondary disease with gonorrhea, varicose veins in men, accompanied by swelling, hardening of the surface of the penis on the back side.

Depending on the location of the lesion, phlebitis of the veins is distinguished:

deep;
superficial.

The nature of the disease progresses with:

acute with the onset of symptoms: pain in the affected area, weakness, malaise, fever, fever;
chronic in the form of exacerbation with untimely treatment acute form phlebitis.

Causes and mechanisms of disease development

The reasons for the development of inflammation of the upper and lower extremities can be different. The main provoking factor is varicose veins.

Phlebitis of the hand can be caused by infection of the area in the absence of treatment with antiseptics after the injection or in case of unsuccessful placement intravenous injection.

Other reasons that can cause inflammation and suppuration of the venous walls in the arms and legs:

burns of any etiology;
excessive sensitivity of the venous walls;
diseases cardiovascular system;
hereditary factor;
predisposition to thrombosis;
allergy;
weakness immune system;
acquired, hereditary poor clotting blood.

How does phlebitis manifest?

At acute course Phlebitis on an inflamed vein is observed:

redness, thickening;
tension of the affected area;
hyperemia of the skin with a milky white tint;
temperature rise to subfebrile levels;
the appearance of a red stripe at the site of the inflamed vessel.

Chronic phlebitis is accompanied by mild symptoms. Usually progresses after an exacerbation of acute pathology or during remission.

Patients note the appearance of weakness, increased temperature for no obvious reason.

With phlebitis of the penis, the affected area swells, hardens, and becomes painful. The penis is in a semi-erect state.

Lack of treatment for phlebitis can cause a symptom - scarring of the penis with residual swelling for life. Although if you get treatment in time initial stage, then the symptoms disappear quickly.

Signs of cerebral phlebitis or inflammation of the blood vessels of the brain:

confusion;
fainting;
speech disorders;
pressure surges;
headache throbbing.

With pylephlebitis, the development of inflammation of the collar vein, symptoms of purulent intoxication may be observed:

increasing weakness;
vomit;
diarrhea;
jaundice;
sharp cramping pain in the right hypochondrium;
colic in the liver;
chills;
increased sweating.

Pylephlebitis is the most severe form of phlebitis. Causes vomiting ascites, enlargement of the spleen and liver, anuria, drop in blood pressure, swelling of the limbs, bloating and death. Because it quickly passes into the chronic phase, leading to renal (liver) failure.

How dangerous is the disease?

The insidiousness of phlebitis lies in its complications:

thromboembolism in the event of separation or complete occlusion of the lumen of the pulmonary artery;
vascular insufficiency, in which, according to statistics, in 90% of cases it is not possible to save the lives of patients;
thrombophlebitis with the formation of thrombosis in the inflamed area of the vascular wall;
abscess due to inflammation of adjacent tissues;
vascular insufficiency as a consequence vascular pathology with the cessation of the supply of nutrients to the tissues, due to gas exchange disturbances.

The main enemy of phlebitis is thrombophlebitis, the separation of a blood clot with migration throughout the body.

Can lead to blockage of the main vein on the affected limb, obstruction or venous insufficiency, abscess, sepsis, necrosis, gangrene, stroke, heart attack.

Diagnostic methods

A phlebologist carries out diagnosis and treatment. It is also possible to be redirected for consultation to a therapist or vascular surgeon.

Usually, identifying inflammation of deep or superficial veins is not particularly difficult for doctors, because it is enough to conduct a visual examination of the affected area.

To obtain detailed information about the condition of the veins, duplex scanning of the vessels is performed.

For staging accurate diagnosis– instrumental, laboratory examination options:

general analysis blood;
phlebography;
thromboelastogram;
coagulogram to determine the level of prothrombin index.

Instrumental methods for suspected thrombophlebitis:

computed tomography;
scintigraphy;
phlebomanometry;
Doppler ultrasound of veins.

Treatment of pathology

In most cases, treatment of phlebitis begins with medications.

Patients are given rest, placement in surgical department, bed rest and complete immobility of the affected limb with lying on a hill.

If phlebitis develops against the background varicose veins, then it is possible to raise the question of carrying out the operation.

Surgery is also practiced for deep vein thrombosis, threatening life of patients.

Emergency surgery removal of the affected inflamed vein is carried out in case of migrating phlebitis.

Thrombolytic regional therapy - innovative method effects in the treatment of phlebitis with the introduction of enzymes into a venous vessel in order to dissolve a blood clot and prevent the development of thromboembolism.

Medicines

A conservative approach to therapy is carried out for phlebitis of deep veins.

The goal is to normalize blood circulation in the inflamed limb, to prevent disability in patients, so that in the future they can move and live a full life.

Drug therapy– complex with the prescription of different drugs medicinal groups:

non-steroids (Ibuprofen, Dicloberl, Ketoprofen) to relieve inflammation;
venotonics (Venarus, Troxevasin, Troxerutin, Diosmin, Phlebodia 600, Detralex);
local drugs(Voltaren, Heparin);
means for normalizing blood microcirculation in the veins (Curantil, Solcoseryl, Trental, Actovegin, Pentoxifylline, Vazaprostan);
blood thinning drugs (Cardiomagnyl, Aspirin);
antihistamines (Cetrin, Tavegil, Pipolfen, Suprastin);
antibiotics for infectious phlebitis.

As a rule, medications are administered by injection to thin and reduce blood viscosity, improve the trophism of venous walls, provide a countercurrent and anti-inflammatory effect, and normalize blood microcirculation in the vessels.

As a first aid emergency assistance Thrombolytics may be prescribed (if thrombosis is detected). Good help local ointments(indomethacin, butadionic, heparin)

If conservative therapy does not lead to proper results, then according to indications for phlebitis, surgery can be prescribed in the following ways:

laser intervention;
sclerotherapy;
cripectomy;
crossectomy for a migratory form of pathology.

An innovative solution in the treatment of phlebitis may be an endovascular method of influencing deep veins. For example, in Israel intravascular technique is used the highest level. It makes it possible to carry out similar operations, reduce the likelihood of complications of phlebitis, and prevent disability in patients.

Auxiliary therapy using traditional methods

As auxiliary treatment options for patients with phlebitis, gymnastics or simple therapeutic exercises are recommended to train the affected venous walls.

Physiotherapy, prescribed in combination with medications or in the postoperative period, plays an important role:

acupuncture;
laser intravascular coagulation;
phototherapy using Sollux lamps;
infrared irradiation to reduce pain, improve metabolism and blood circulation in the walls of the veins;
magnetic therapy to accelerate capillary blood flow and normalize the condition of vascular walls;
pharmacopuncture, combining 3 methods at once: mesotherapy, acupuncture, homeopathy;
reflexology with effects on nerve receptors.

From folk remedies (to know how to treat phlebitis) the following are applicable:

iodine mesh applied to the affected area to relieve swelling and pain;
compresses made from buckwheat or wormwood, ground into a paste for application to the affected vein.

If thrombophlebitis is detected, then leeches that suck out congestion help a lot venous blood, reducing coagulability and eliminating vascular spasms.

In addition to the treatment of phlebitis - folk remedies: compresses from the juice of lilac leaves, fern with yogurt or wormwood.

Prevention

If a diagnosis of phlebitis has been made, it is extremely important to wear compression garments to prevent the progression of inflammation.

Also:

move more to avoid the risk of developing thrombophlebitis;
give up bad habits(smoking, alcohol);
strengthen immunity;
keep blood tests under control;
take courses of antiplatelet drugs.

Preventing the development of phlebitis of the lower (upper) extremities means treating infectious diseases in a timely manner, treating wounds and cuts antiseptic compounds, in particular before injections.

Phlebitis is a dangerous provoking disease. If the approach to treatment is untimely or unsuccessful, complications are inevitable.

Useful video: Features of the disease phlebitis

Phlebitis– acute or chronic inflammation venous wall. It can develop as a result of exposure to various factors, however, most often it is a complication of varicose veins of the lower extremities. The disease rarely occurs in isolation. Changes in the venous wall as a result of inflammation, as a rule, lead to the formation of blood clots and the transition of phlebitis to thrombophlebitis. The following help a doctor diagnose phlebitis: modern methods studies such as ultrasound and duplex scanning. Treatment is conservative, including anti-inflammatory therapy and physiotherapy.

ICD-10

I80 Phlebitis and thrombophlebitis

General information

Phlebitis is an inflammatory process in the wall of a venous vessel. It can develop as a result of exposure to various factors, however, most often it is a complication of varicose veins of the lower extremities. The disease rarely occurs in isolation. Changes in the venous wall as a result of inflammation, as a rule, lead to the formation of blood clots and the transition of phlebitis to thrombophlebitis. Phlebitis affects 1% of women and 0.7% of men over the age of 50 years.

Causes of phlebitis

Most often, phlebitis of the lower extremities occurs with varicose veins. The second most common type is phlebitis, which is a complication of an abscess, infected wound or infectious disease. Inflammation of the venous wall can be caused by various pathogens, however, most often streptococcus acts as an infectious agent. Phlebitis may develop after chemical burn veins. In certain situations, phlebitis is caused artificially. Thus, in the treatment of varicose veins, modern phlebology widely uses the method of sclerotherapy, the principle of which is based on the introduction into the vein of a special substance that causes aseptic phlebitis and subsequent gluing of the vein walls.

Classification

According to the localization of inflammation in the venous wall:

Periphlebitis– phlebitis with predominant damage to the outer membrane of the vein. As a rule, it develops when the inflammatory process spreads from surrounding tissues to the walls of the vein.
Endophlebitis– phlebitis with predominant damage to the inner lining of the vein. Occurs as a result of damage to the internal venous lining or injury to the vein. The cause of endophlebitis can be catheterization of a vein or prolonged stay of the needle in the vein during drip administration various drugs. Endophlebitis is one of the side effects at intravenous administration hypertonic solution.
Panphlebitis– phlebitis with damage to all vein membranes.

Etiological classification:

Allergic phlebitis. Arises as a result allergic reaction. Prone to chronic benign course.
Painful phlebitis. Affects the lower extremities. Usually develops after childbirth. It is acute. Accompanied by severe pain.
Migratory phlebitis(migratory thrombophlebitis). Occurs more often in young men. The process involves the superficial veins of the upper and lower extremities. Accompanied by damage to the arteries. Prone to long-term relapsing course.
Cerebral phlebitis. Affects the blood vessels of the brain. Usually develops as a result of infection.
Pylephlebitis. Inflammation of the collar vein (pylephlebitis) is a complication of inflammatory processes in the abdominal cavity.
Phlebitis infectious origin can develop in any area of the human body.

Symptoms of phlebitis

With acute superficial phlebitis, the vein becomes painful and tense. The skin over the affected area turns red and thickens. Local hyperthermia is observed. Red stripes may appear along the inflamed veins. In some cases, there is an increase in body temperature, general weakness. Chronic phlebitis of the superficial veins is characterized by a smoothed clinical picture, a recurrent course with periodic exacerbations.

In acute phlebitis of the deep veins, general hyperthermia, pain and swelling in the area of inflammation are noted. The skin of the affected limb becomes milky white. No thickening or redness of the skin is observed. In the vast majority of cases, acute deep vein phlebitis is complicated by the formation of blood clots and develops into acute thrombophlebitis.

Cerebral phlebitis is manifested by headache, increased blood pressure, neurological symptoms. With phlebitis of the penis appear sharp pains, the penis becomes cyanotic and swells. Pylephlebitis (phlebitis of the collar vein) is characterized by a picture of severe purulent intoxication. The patient's condition deteriorates sharply, weakness, vomiting, headache, cramping cutting pains in the right hypochondrium, increasing jaundice. Developing hectic fever with pouring sweats and tremendous chills. There is danger fatal outcome. In a number of patients, phlebitis of the collar vein acquires chronic course and causes the development of liver and kidney failure.

Diagnosis of phlebitis is carried out using duplex scanning or Doppler ultrasound of the veins of the lower extremities or other area, depending on the localization of the process.

Complications

As a result of phlebitis, thrombophlebitis usually develops. There is a danger of thrombosis of the affected vein. Thrombophlebitis of deep veins in acute period may cause

Phlebitis is a disease characterized by inflammation of the walls of the veins. In case of complications in the form of formation blood clots phlebitis develops into thrombophlebitis, which is diagnosed due to the detection of partial or complete blockage of the lumen of the vessel.

Species

The disease has its own classification, where there are types of thrombophlebitis depending on the location.

So, they distinguish:

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peripheral arteries;
internal organs;
cerebral phlebitis – damage to the blood vessels of the brain;
pylephlebitis – damage to the vessels of the collar vein.

Specialists also identified migratory phlebitis of the lower or upper extremities. The course of the disease depends on the duration of development of the pathology and the affected areas. Phlebitis and thrombophlebitis often recur.

Differences in pathology are characterized according to the degree of localization to the wall blood vessel. If a blood clot is present in the outer lining of the vein, then experts diagnose periphlebitis - the pathology develops due to the spread of inflammation in the area surrounding the vein.

If the inflammation is located inside the vein lining, endophlebitis is diagnosed. Sometimes they meet clinical pictures, when inflammation is diagnosed in the inner and outer part of the lining of the vein, which leads to a diagnosis of panphlebitis.

There is a complicated form of thrombophlebitis - septic, where purulent destruction of the blood clot is determined. At the same time, the infection spreads through all the veins of the body, causing blood poisoning.

Risk factors

Phlebitis develops due to exposure to certain factors, including:

mechanical trauma and other damage to the vein itself;
sedentary lifestyle or prolonged stay in a static position;
installation of an intravenous catheter, carried out in a hospital;
complications in postoperative period, where orthopedic operations are often distinguished;
lack of mobility for a long time, the cause of which was a stroke;
tumors and other formations of an oncological nature - lead to blood clotting disorders;
violations of systemic drainage that arose as a result of removal of lymph nodes;
addiction to intravenous drug addiction;
extensive burns.

Clinical picture of phlebitis and thrombophlebitis

The development of pathology occurs with endophlebitis, after which the patient experiences the formation of thrombosis. If you have already started purulent processes, periphlebitis is formed, gradually transforming into thrombophlebitis. But if venous vessels are involved in the process, there is a high probability of developing purulent inflammation.

Infectious inflammation in the situation under consideration is an allergenic factor that provokes significant changes in the biochemical structure of the patient’s blood. There are disturbances in the system of fibrinolysis, hemocoagulation and the reactivity of the body as a whole.

Infectious thrombophlebitis has developmental features in the form of its temporary onset - against the background of recovery. The presented form in most cases is formed in the presence of varicose veins, heart disease and other diseases that provoke circulatory disorders.

When diagnosing peritrombophlebitis, a specialist can see a loosened and thickened vein wall. It is saturated with exudate, has hemorrhages and small areas of necrosis. The lumens of the veins in this case are expanded. When examined under a microscope, loose fibers can be detected, pushed apart by purulent and serous exudate.

As a result of this expansion, the exudate helps to permeate the middle tunic of the vein. Such a hyperergic reaction in a sharp form often ends in extensive necrosis of the vein. The danger of phlebitis lies in possible development thrombosis in a vein is already initial stage diseases.

Endophlebitis is characterized by changes in the endothelium of the vein, where proliferation, desquamation and degeneration are also observed. If the affected vessel is opened, a dense thrombus with melting in the middle part can be found. In this case, the endothelium becomes dull, acquires a gray-dirty color, and the outer layer of the vein turns red.

When examined using a microscope, the presence of microbes and a group of neutrophilic granulocytes can be detected. The upper shell thickens and has fragments already affected by necrosis, which are largely located between the wall of the vein itself and the formed thrombus.

The external sections contain large quantities granulocytes granulation tissue. The middle shell is affected by the processes of leukocyte infiltration, while the outer shell is affected by the expansion of degenerated small vessels. The resulting blood clots often undergo the formation of vein stones called phleboliths.

Symptoms

Why is ascending thrombophlebitis considered very dangerous and what methods of prevention are relevant for it - read.

If you have a predisposition or already have varicose veins, you must follow all doctor’s instructions to prevent complications and treat existing pathology. In particular, such people are prohibited long time be on your feet or take long walks.

To treat or prevent phlebitis of the legs, it is recommended to rest lying on your back with your legs raised 15-20 cm above the level of your heart.