Thrombosis of the deep veins of the lower extremities. Symptoms, treatment of folk remedies, nutrition, drugs

Deep vein thrombosis, especially in the lower limbs, is an acute medical problem. The symptoms are familiar to millions of people. In many cases, the lack of normal treatment leads to undesirable consequences.

The causes of thrombosis of the lower extremities

Deep vein thrombosis - a condition in which a blood clot falls into one of the deep veins of the lower extremities, hips, pelvis. Thrombus blocks blood flow through the veins, which carry blood from the lower body to the heart. Deep vein thrombosis of the lower limbs (symptoms in men and women alike) occurs in 1-2 people per year in 1000.

Disease and premature death from it is common in low- and middle-income countries than in high-income countries. Primary thrombosis called flebotromboz, the risk of its occurrence is higher in women. Thrombophlebitis or secondary, occurs more often men like recurrent thrombosis.

Three factors can lead to the formation of a blood clot:

• Damage to the inside of the blood vessel as a result of trauma, surgery.
• Changing the normal blood flow, including the unusual turbulence, a partial or complete blockage of blood flow.
• Hypercoagulability, a condition in which the blood is strongly concentrated.

On the development of the disease influenced by genetic, environmental and behavioral reasons. The most frequent causes of disease - surgery, and malignancies.

The causes of venous thrombosis:

medical	The use of drugs	behavioral
Age	oral contraceptives	Obesity
Major surgery	Postmenopausal hormone preparations	Abuse of UV-rays
Neurosurgery	Chemotherapy	Excessive alcohol consumption
Orthopedic surgery	psychotropic drugs	physical inactivity
prostatectomy	The use of thalidomide	Physical stress in the elderly
malignancies	The use of corticosteroids	Excessive consumption of caffeine
Prolonged bed rest	Heavy physical work
Arthroscopy
Lupus

The strongest factor is a cancer in which the possibility of thrombosis is increased 50 times, and certain types of operations. The risk factors of moderate strength are drugs, lifestyle, lack of natural anticoagulants.

Congenital risk factors

Venous thromboembolism is a multifactorial disease that involves hereditary and acquired causes. Most notable genetic thrombosis factors is the lack of natural anticoagulants, protein C, protein S, and antithrombin.

The reasons for increasing the risk of developing the disease include:

• The deficit in the body antithrombin, protein, prevents excessive formation of thrombus.
• Disruption of homeostasis.
• Congenital defects in the circulatory system.

Acquired risk factors

Thrombosis can be developed on the basis of acquired factors that are associated with diseases, medications and surgical interventions. Combined oral preparations containing estrogen, progestin, increase the likelihood of developing the disease by 2-4 times, especially for young women

The prevalence of obesity is increasing worldwide, and this is a factor of thrombosis. With increased weight of the heart begins to work harder to pump blood, and additional load leads to a limitation of cardiac function.

Other causes contributing to the development of thrombosis:

• after 45 years of age;
• chronic lung disease;
• liver disease;
• varicose leg disease;
• early heart attacks;
• diabetes;
• complications during pregnancy;
• fractures of the tibia;
• smoking;

  

• a long period of bed rest.

Mixed risk factors

By cumulative thrombosis reasons include:

• high levels of homocysteine, an amino acid that affects the formation of plaques in blood vessels, blood clots;
• elevated levels of protein produced by the liver, contributing to thrombus formation.

Classification

By location venous blood clot is formed in the ground:

• Femoral, iliac and lower vena cava - the proximal view of thrombosis.
• Vienna shin and thigh part - distal view.

According to the degree of attachment of the thrombus to the venous wall of the disease is determined by:

• emboloopasnym when thrombus can block blood vessels in the lungs;
• neemboloopasnym.

symptoms

Thrombosis of the deep veins of the lower limbs includes symptoms:

• Red or discolored skin on the leg.
• Heat sensation in the affected area.
• Leg pain that starts in the calf, felt in the form of spasms.

Thrombosis can occur and no overt signs.

Diagnostics

Analyzing only the composition of the blood, the doctor can not accurately determine the progression of the disease. But almost all people who have a blood clot in the deep veins, develops in the blood increased levels of D-dimer. Normally, it should be 243 ng / ml, for pregnant women - 644 ng / ml.

If you suspect a thrombosis differential diagnosis of a number of certain diseases:

• Thrombophlebitis, spontaneous or recurrent, superficial veins.
• Injuries, fractures, increased muscle tone.
• Chronic venous insufficiency caused by varicose veins, obesity.
• Swelling of the paralyzed legs that happens in paralysis.
• Cellulite is a reddening of the skin and an elevated temperature in the affected areas.
• Elephantiasis and lymphostasis.

For accurate diagnosis using other techniques.

physical examination

Collecting history, before being sent to the instrumental examination, the doctor needs to hear all complaints, indicating the progression of the disease and to take into account the patient's condition.

For example:

• the presence of a dull or aching pain while walking or at rest;
• heaviness in the calf muscles, leg fatigue;
• development of edema in the lower legs, or feet across the surface;
• combination with puffiness pain;
• primary or secondary thrombosis;
  
• existence of previous violations of blood coagulation;
• acceptance of oral contraceptives;
• pregnancy in the present or recent past.

Physical or clinical examination of the patient is held in the vertical and horizontal positions. Grossly and palpated to detect vascular morbidity in the projection beam in a leg. the disease is often asymptomatic, which is typical for people who observe prolonged bed rest.

functional tests

If necessary, samples are taken functional state determining saphenous vein patency deep venous shunt of the deep veins in the surface.

Homans symptom

The task of the physician to confirm or reject the diagnosis of venous thrombosis. To do this, conducted certain tests. One of the characteristic features is symptom Homansa - pain in the calf muscles of the foot dorsiflexion. Checked at the position of the patient lying on his back on the first day of onset.

sample Moses

Symptom Moses determined by the presence of pain at squeezing tibia in the anteroposterior direction. When you click on the lower leg laterally no pain.

sample Lovenberga

The symptom of the disease is confirmed by the presence of muscle pain tibia at a pressure of up to 150 mm Hg. v., produced cuff sphygmomanometer. The cuff is applied to the middle third of the tibia.

Sample Opitz-Raminesa

Diagnostic assay Opitz-Raminesa is a variation of previous diagnosis of reception. The sphygmomanometer cuff while superimposed on the lower third of the hips, pumping air to 160-150 mm Hg. Art.

Ultrasound diagnostics

Using high-frequency sound waves can be visualized large proximal vein thrombus and to discover if there is one. But in some cases, a blood clot, which appeared in small veins is not always visible.

Doppler ultrasound is assigned as an initial screening stage of deep veins. In the case of normal results is assigned to follow-up study after 6-8 days.

To accurately monitor the patient's condition, a series of studies with an interval of 7 days.

In the event of poor visibility appointed radiopaque venography using MRI.

The treatment of thrombosis of the lower extremities

Deep vein thrombosis of the lower extremities, the symptoms of which are confirmed by a physician determines the treatment goals:

• normalization of blood flow in the lower extremities;
• Prevention of thrombosis in the ascending pelvic region and the inferior vena cava;
• preventing the development of pulmonary embolism;
• preventive measures to prevent recurrence;
• recovery of the patient health;
• reducing the level of disability of patients.

drug therapy

When the development of thrombosis in the acute stages of the drug Heparin is used, and subsequently doctors recommend to switch to Warfarin to prevent a recurrence of thrombosis.

In some cases, to prevent thrombosis in the femoral veins, prescribe thrombolysis. Most patients with thrombosis of the leg and thigh are successfully treated with low molecular weight heparin in outpatient conditions.

When hospitalization, as first line therapy, administered intravenously standard heparin:

• for treatment: 450 IU per day, calculated for 1 kg body weight;
• for the prevention of: 5,000 IU 2-3 times a day.

Instead of heparin can be offered drugs included in the group of heparin:

• Nadroparin.
• Adreparin.
• Enoxaparin.
• Tinzaparin.

Calculation of the preparation administered held by a physician based on the overall indications, degree of diseases. In addition to the non-drug treatment, doctors recommend daily use of compression bandages and stockings, pantyhose.

compression stockings should be selected strictly on the size and need to remember that after 6 months jersey stretch, loses its elasticity. Compression strictly necessary during the first weeks of the disease, but in the future it is necessary to use 1-2 years.

thrombolysis

Thrombolytic therapy is aimed at restoring blood flow in vessels due to lysis of thrombus dissolution or cells under the influence of drugs. To prevent a blood clot in the lungs of the split, thrombolytic therapy, in which a blood clot breaks.

With the catheter in place directly thrombus formation administered drugs such as streptokinase, plasminogen activator muscle. Administration of drugs is carried out under X-ray control.

Installing cava filter

For patients, the body which can not take anticoagulants prescribed cava filter, preventing the risk of recurrent thrombosis. It is installed in the inferior vena cava and allows for thrombolysis.

The filter is made to reach a certain manner on a frame, which is embedded in a vena cava lumen for delaying all particles larger than 4 mm. Thus, venous blood flows freely through the filter, and the large thrombi trapped. Then jammed thrombus is dissolved by means of preparations.

Surgery

Operative methods are needed when the threat of gangrene in the limbs of shock and systemic hypoperfusion. The decision to conduct transactions is taken by doctors immediately when ascending thrombosis and a high risk of thromboembolism in the pulmonary artery.

Types of operations:

• Phlebectomy, eliminating varicose veins.
• Operation, eliminating discharge of blood from the deep veins.
• Flashing of veins.
• Extravasal correction of the venous valves.

Recipes of traditional medicine

Before you begin treatment with home remedies to prevent spontaneous bleeding you should consult with your doctor. This is especially important in patients receiving anticoagulant. Ginger helps in the treatment of thrombosis.

Natural salicylate, which is in its composition, blocking vitamin K and thins the blood:

• It is useful to drink ginger tea 2-3 times a day. To do this, 1 tbsp. l. chopped root is boiled, and then soaked in 2 cups of water. The ginger tea as desired, you can add honey.
  
• Fresh ginger can be added to ready-made culinary specialties, or chew a few bites during the day.

Cayenne pepper helps to better blood circulation, strengthens the arteries and capillaries:

• In a glass of juice add spinach 1/3 hours. l. pepper, salt, and drink 1-2 times a day.
• Pepper can be added to an ointment or gel, for the treatment of pain in the leg muscles.

Turmeric has thinning properties, improves circulation, helps to prevent blood clots:

• Boil ½ hours. l. spices in a glass of milk. Cool, add 1 hour. l. honey. Drink 2 times a day.

Useful vegetable, Garlic prevents the formation of thrombi, improves blood circulation, decreases blood pressure:

• Every day, on an empty stomach, drink 2 cloves of garlic.
• Garlic oil, cooked at home, can be used to massage the affected areas of the feet, in order to reduce swelling, relieve pain.

Recipe of garlic oil:

• Head peeled garlic passed through the press.
• Mass put into sterilized jars and fill with any vegetable oil. Closed cover mixture insist 2 weeks in a warm place.
• Daily mass should be mixed, then strain and the oil is ready for use. It is stored in a dark place at room temperature.

Well it helps the body fish oil containing omega-3 fatty acids. They possess fibrinolytic properties, preventing the formation of arterial blood clots. Useful fat can be obtained by eating salmon, pumpkin seeds, flax, walnuts or special supplements containing Omega-3.

Diet

To prevent the development of thrombosis should follow a healthy diet. This will help to reduce weight, the risk of diabetes, cholesterol, leading to a malfunction of the cardiovascular system, and subsequently to thrombosis.

The criteria to be followed in the diet:

• Limit consumption of products containing harmful fats and sodium.
• Avoid sugary and processed foods.
• Eat more fruits and vegetables.
• Include whole grains in the menu, as well as foods that are low in fat but rich in protein.

To maintain desirable to reduce the weight of food consumed portion.

Scientists propose to compare the food portion consumed at one time, with some items:

products	What should be serving
Fish or chicken	Size eaten piece, no more card deck
Fresh fruits and vegetables	The size of the fruit eaten, no more tennis ball
Potatoes, rice or pasta	Portion should be no more than a ball of ice cream 1
Cheese	Piece should be equal to the size of the thumb

It helps control appetite and the size of the plates on which the dish is served. It should be full size and smaller. Half of its volume must occupy vegetables, ¼ part - the protein, and the rest - the grain or starchy foods. It is necessary to control the drunk alcohol, he not only adds calories, but also adversely affects the cardiovascular system.

Complications and prognosis

Blockage causes severe pain, swelling in the affected leg. blood clot can cause inflammation, which is called thrombophlebitis, but complications occur less often. Severe complications arise when a clot is released (embolization) and passes through the bloodstream, causing a blockage of blood vessels in the lungs.

Pulmonary embolism occurs when a blood vessel is blocked by a blood clot in the lung, usually falling in the lower limbs. It can be life-threatening.

It is important to watch out for symptoms of pulmonary embolism and seek medical attention if they occur:

• sudden shortness of breath;
  
• chest pain or discomfort that is enhanced with a deep breath or cough;
• rapid pulse;
• cough with bloody discharge;
• dizziness, reaching up to fainting.

Deep vein thrombosis of the lower extremities, the symptoms of which can cause a complication in the form of post-thrombotic syndrome develops in 65% of patients within 1.5-2 years, which have primary thrombosis.

Symptoms:

• Persistent edema of the legs.
• Changes in skin color on the legs.
• Pain in the blood.
• Sores on the skin feet.

In 25% of patients who did not go to the doctor, there is a thromboembolism over 5 years. About 10-15% of these are fatal. When active therapy reduced mortality by 10 times.

Other complications:

• Bleeding at break varix.
• Dermatitis, eczema.
• Trophic ulcers.

Rehabilitation

In the postoperative period there legs weakening muscles. Recuperation is an important step on the road to recovery. Significant improvement occurs within 7-10 days after the onset of blood thinners, but during this period the patient is entering a qualitatively new state. To prevent a recurrence should change lifestyle, diet and physical activity.

Tips patients after deep vein thrombosis:

• Do not interrupt anticoagulant therapy, which can be very long. Courses such therapy is not carried out, it must be continuous.
• All patients who underwent disease shows elastic compression. This should teach more in the hospital, how to bandage the leg elastic bandages.
• For the prevention of hyperkeratosis, which may occur in connection with wearing bandages, should be treated for the night legs nourishing creams and gels.
• Avoid micro traumas in the legs, mycotic lesions.
• Conduct hygiene procedures, spraying each leg daily hot and cold water for sosudotoniziruyuschego effect.
• Restrict all kinds of hair removal, which are accompanied by heating feet, laser, mechanical or electrical effects.
• Exclude from the menu foods containing vitamin K: coffee, liver, sorrel.
  
• Try not to sit or stand more than 1 hour, so as not to strain your muscles.
• Regular walking will improve blood circulation, eliminate venous congestion. Should start with a slow walk for 3-5 min., Every 3 min. for relax. The criterion for the possibility of walking will be a feeling of fullness in the leg or pain. After one month, you can increase the duration to 1 hour. This workout should last for 2 years.
• A return to physical activity is possible in a month after undergoing surgery.
• In the first 4 weeks after surgery is not recommended to transfer airline flights. Low pressure in the cabin of the aircraft activates the mechanism of blood clotting and an increased risk of thrombosis.

Lifestyle

Deep vein thrombosis of the lower extremities, the symptoms of which are described earlier in the article brought forward at any age requires a change in lifestyle.

For example:

• Quit smoking and drinking alcohol.
• Lower blood pressure, to use less sugar and salt.
• Reduce weight.
• Avoid prolonged sitting to avoid the stagnation of blood.
• In spending some time exercises for the legs, raising them by pulling the calf during the day.
• Daily deal with walking, swimming once a week, if possible.
• Do not wear tight clothes, especially in the lower body.
• Wear compression stockings or lingerie, especially in the postoperative period.
• Drink plenty of fluids throughout the day.
  
• Consult with your doctor about receiving contraceptives.

Deep vein thrombosis of the lower limbs, is a common disease that affects people of all ages and health affects for many years.

Information about the prognosis, treatment options are always individual, depend on many symptoms. The doctors are doing everything possible to improve the quality of life of patients with postflebiticheskim syndrome, but people need to be more attentive to their health.

Author: Anna Belyaeva

Registration of the article: Lozinski Oleg

Video of thrombosis of deep veins of lower extremities

Deep vein thrombosis leg. Causes, Symptoms and Treatment: