What Is Thrombophlebitis?

Thrombophlebitis includes superficial thrombophlebitis and deep thrombosis. The venous inflammatory response to a thrombus often occurs after intravenous thrombosis first. The main causes are damage to the blood vessel wall (caused by trauma or intravenous intubation or infusion of irritating fluid) and stagnation in the veins caused by varicose veins. The main clinical manifestations of the disease are red, swollen, painful, and tender tenderness along the veins, which can touch cord veins; systemic reactions are rare. Elevated pressure in the lower limb veins. The venography shows the location and extent of the blockage. The principle of treatment is to rest the affected limb and raise it above the level of the heart, wear elastic socks or bandages if necessary; aspirin can be taken orally, and those with embolism should use heparin early.

Basic Information

Causes of thrombophlebitis

Thrombophlebitis refers to inflammation of the venous cavity, accompanied by thrombosis, and is a more common peripheral vascular disease. It is mainly formed by three factors: venous wall injury, blood flow stagnation and blood hypercoagulability.

Clinical manifestations of thrombophlebitis

Can be divided into superficial and deep phlebitis.

Superficial phlebitis

It often occurs in the superficial veins of the extremities or chest, with stiff cord-like swelling and pain along the superficial veins, short 2 to 5 cm, long like wicker, obvious tenderness, and redness and swelling burning inflammation around the veins, about 2 to After 4 weeks, the acute symptoms gradually subsided, and the skin could stick to the skin, or the gray-brown pigmentation was sticky. Generally the affected limb is asymptomatic and asymptomatic throughout the body.

Deep phlebitis

Occurs in the lower legs, thoracic veins and femoral veins. The former is swelling of the lower leg, and the latter is mainly swelling of the thigh. The affected limb was swollen with tube, with pain, intensified walking, pressure marks at the distal end, pale gray-purple skin, and obvious dilation of superficial veins. After about 1 to 2 months, the pain and pain of the affected limb can be gradually relieved, but the swelling tends to be milder and lighter, which is related to the activity. A few have turned into chronic venous reflux disorders, superficial varicose veins in the affected limb, thrombotic superficial venous inflammation, and even congestive lower extremity ulcer infections.

Thrombophlebitis examination diagnosis

The diagnosis of deep vein thrombosis is generally not difficult. The following diagnostic methods can be used:

Venous pressure measurement

Increased venous pressure in the affected limb, suggesting that there is a blockage of the proximal cardiac vein at the lateral pressure;

2. Ultrasound

Two-dimensional ultrasound imaging can directly see the thrombus in the large vein. With Doppler to measure the blood flow velocity in the vein, and observe whether the normal response of breathing and compression action exists. The positive rate of this kind of diagnosis for proximal deep venous thrombosis can reach 95%; the diagnostic sensitivity for distal patients is only 50% to 70%, but the specificity can reach 95%.

3. Radionuclide inspection

125I fibrinogen scan is occasionally used for the diagnosis of this disease. In contrast to the ultrasound examination, the detection rate of deep vein thrombosis in the gastrocnemius muscle can be as high as 90%, but the specificity of the diagnosis of near deep vein thrombosis is poor. The main disadvantage of this test is that after the radionuclide injection, a lag of 48 to 72 hours is required to show the effect.

4. Impedance plethysmography (IPG) and venous angiography (PRG)

The former uses skin electrodes, while the latter uses inflatable cuffs to measure changes in venous volume under physiological changes. When the vein is blocked, the amplitude of the volume wave caused by breathing and sleeve filling and deflation is small. The positive rate of this type of test for the formation of proximal deep vein snow mountains can reach 90%, and the diagnostic sensitivity for distal patients is significantly reduced.

5.Deep venography

Contrast agent is injected from the superficial vein of the foot, and a compression band is used at the proximal end, which makes it easy for the contrast agent to directly enter the deep vein system. If venous filling defects occur, stereotypes and positioning diagnosis can be made. Superficial venous thrombosis is easier to diagnose, and local symptoms and signs are more obvious.

Thrombophlebitis treatment

Deep venous thrombosis treatment: The main purpose of treating deep venous thrombosis is to prevent pulmonary embolism, especially early in the course of the disease, the thrombus is soft and the blood vessel wall is not tightly attached, and it is easy to fall off. Active treatment should be taken.

1. Stay in bed and raise the affected limb above the heart level until the edema and tenderness disappear.

2. Use anticoagulants to prevent thrombus enlargement and start the endogenous thrombolytic process. Heparin can be injected intravenously.

3. If the anticoagulant treatment is not suitable due to the bleeding quality, mechanical blocking can be used to prevent pulmonary embolism. In recent years, percutaneous puncture method has been used to replace the inferior vena cava with surgical treatment.

4. Thrombolytic therapy. Urokinase has certain effects. Although it cannot be proven to be better than Kenning in the prevention of pulmonary embolism, early application can accelerate thrombolysis, help protect venous valves, and reduce venous insufficiency.

5. Chinese medicine treatment. Can be treated according to the nature of the disease, if it is positive, plus or minus Simiao Yongan Decoction, or negative, plus or minus Yanghe decoction.