Thrombophlebitis

Disease name

This entry is made by Compilation and application of scientific encyclopedia entries of "Science Popularization China" authentication.

Thrombotic Phlebitis include Thrombophlebitis And deep Thrombosis 。 Venous to venous thrombosis often occurs after venous thrombosis Inflammatory reaction 。 The main causes are Vascular wall Injury (caused by trauma or intravenous cannulation or irritant fluid infusion) and varicosity Intravenous blood caused by Stagnation 。 Main causes of the disease clinical manifestation There are redness, swelling, pain and obvious tenderness along the vein, and the cord vein can be touched; Systemic reaction Rare. Lower limb veins The pressure of increases. Venography The position and degree of obstruction can be displayed. The treatment principle is to rest the affected limb and raise it above the heart level, and wear it when necessary Elastic socks Or with Elastic bandage Bandaging; Oral aspirin , patients with embolism should use it early heparin 。

Science popularization in China

Committed to authoritative science communication

The certification expert of this term is

Niu Hongxia | Deputy chief physician

Department of Cardiology, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Sciences to examine

catalog

pathogeny

Announce

edit

Thrombophlebitis is Digital vein Inflammation of the lumen, accompanied by Thrombosis , which is more common Peripheral angiopathy 。 Mainly caused by venous wall injury, blood flow retardation and blood High solidification state Three factors are formed.

clinical manifestation

Announce

edit

It can be divided into shallow and deep layers Phlebitis Two types.

1. Shallow layer Phlebitis

Superficial veins of limbs or chest, along Superficial vein There is hard strip like swelling and pain, 2 to 5 cm short, as long as willow, obvious tenderness, and some accompanied along the vein Redness and swelling scorching hot inflammatory reaction , about 2 to 4 weeks later, Acute symptoms Gradually decline, and can stick to the skin in strips, or strip gray brown pigmentation. Generally, the affected limb has no edema, and the whole body has no symptoms.

2. Deep Phlebitis

It mainly occurs in the lower leg, thoracic vein and femoral iliac vein. The former is swelling of the lower leg, and the latter is mainly swelling of the thigh. The affected limb is swollen in a cylindrical shape, accompanied by pain, and the walking is aggravated. There are pressure marks at the distal end, the skin is light gray purple, and the superficial veins are obviously dilated. About 1 to 2 months later, the swelling and pain of the affected limb can gradually ease, but the swelling is often light in the morning and heavy in the evening, which is related to activities. A few become chronic Venous reflux Obstacle, shallow affected limb varicosity , thrombotic superficial phlebitis, even hemostasis Ulcer of lower limbs Infected.

Check diagnosis

Announce

edit

Deep vein thrombosis The diagnosis is generally not difficult, and the following diagnostic method ：

one Venous pressure measurement

The venous pressure of the affected limb increases, indicating that Lateral pressure place Proximal end Venous obstruction;

2. Ultrasonic

Two-dimensional ultrasound imaging Directly visible Great vein Thrombosis in the vein, with Doppler measurement Blood flow velocity And observe whether the normal reaction of breathing and pressing action exists. This inspection is for the near end Deep vein thrombosis The positive rate of diagnosis was 95%; Diagnose the remote person susceptibility Only 50% to 70%, but Specificity Up to 95%.

three Radionuclide inspection

125I fiber Proteogen Scanning is sometimes used for the diagnosis of this disease. And Ultrasonic examination On the contrary, this inspection Gastrocnemius muscle Internal Deep vein thrombosis Of Detection rate It can be up to 90% Deep vein thrombosis The specificity of diagnosis is poor. The main disadvantage of this inspection is injection Radionuclide The effect can only be displayed after 48 to 72 hours.

4. Impedance volume Tracing IPG and PRG

The former uses skin electrode, and the latter uses inflatable cuff to measure the change of vein volume under physiological changes. When the vein is blocked, the amplitude of the volume wave that rises and falls with the respiration and the cuff inflation and deflation is small. This test is applicable to the near end Deep vein The positive rate of diagnosis of snow mountain formation can reach 90%, and the sensitivity of diagnosis for distal patients is significantly reduced.

5. Deep Venography

Injected from superficial vein of foot contrast agent , used at the proximal end Pulse compression zone It is easy to make the contrast agent directly enter into the deep Venous system , if veins appear Filling defect Can be shaped and Location diagnosis 。 shallow Venous thrombosis The diagnosis is easy and the local symptoms and signs are obvious.

treatment

Announce

edit

Deep vein thrombosis Treatment: treatment Deep vein thrombosis The main purpose of is to prevent pulmonary embolism , especially in the early stage of the disease, the thrombus is not tightly adhered to the vascular wall, which is easy to fall off, so active measures should be taken Treatment measures 。

1. Stay in bed and lift the affected limb above the heart level until edema and tenderness Disappear.

2. Use Anticoagulant Prevent thrombus from increasing, and start the endogenous thrombolysis process. Heparin can be used intravenous injection 。

3. If anticoagulation therapy is not suitable due to bleeding quality, prevent pulmonary embolism Mechanical blocking method can be used. Transcutaneous use in recent years Puncture method stay Inferior vena cava Built in filtering measures to replace the past inferior vein folding surgical treatment 。

4. Thrombolysis treatment. urokinase It has certain effect, although it can not prove prevention pulmonary embolism It is better than Ken Coagulation in terms of treatment, but it can be accelerated if applied early Thrombolysis , conducive to protection Venous valve To reduce the residual venous insufficiency.

5. Traditional Chinese medicine treatment. It can be treated according to the nature of the lesion. If it is positive, add or subtract Simiao Yong'an Soup Treatment, negative, Modified Yanghe Soup treatment.

Novice on the road

Growth task Getting Started with Editing Edit Rule Edit by myself

I have questions

Content query Online Service Official post bar Feedback

Complaints and suggestions

Report bad information Failed to appeal through entries Complaint of infringement information Blocking query and unblocking

Jinggong Network Anbei No. 1100000200001