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Чем отличается тромбоз от тромбофлебита

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17 августа 2019

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Чем отличается тромбоз от тромбофлебита? Специалист легко ответит на этот вопрос, а обыватель может запутаться. Почему? Эти болезни очень похожи и имеют сходные симптомы. Даже течение этих патологий может быть однотипным. Поэтому не обойтись без помощи врача, который проведет необходимое в подобных случаях обследование. В зависимости от установленного диагноза будет назначено максимально эффективное лечение.

Основные отличия

Основным отличием двух схожих болезней является месторасположение их развития. Тромбофлебит будет поражать сосуды, которые располагаются сразу под кожей. Тромбоз проникнет в самые глубокие вены.

Характеристики тромбофлебита:

  • развивается на венах, которые повреждены, имеются признаки деформации;
  • является осложнением варикозного расширения вен, если развивается патология стенок сосуда. В этом случае нарушается кровообращение и происходит задержка крови в сосудах, из-за чего может и появиться тромб.

Характеристики тромбоза:

  • поражает здоровые сосуды;
  • расположенный глубоко сосуд не имеет никаких патологий;
  • тромб будет довольно рыхлый, может свободно перемещаться по всем сосудам. В этом случае есть возможность появления большого количества тромбов и попадание их в область сердца. Это грозит полной закупоркой движения крови через сердце.

Оба заболевания могут протекать вместе. В таком случае происходит выявление варикозного расширения вен. Тромбофлебит будет иметь ярко выраженные характерные симптомы, а тромбоз будет развиваться незаметно.

Что провоцирует развитие этих болезней:

  1. Варикозное расширение вен.
  2. Травмирование сосудов.
  3. Наличие инфекции в организме.
  4. Развитие воспаления в сосудах.

Из-за этого происходит нарушение кровообращения, могут появляться сгустки, которые имеют свойства становиться твердыми. Такие процессы способствуют развитию застойных явлений и — как следствие — ведут к воспалению тканей в конечностях.

Развитие болезней

В чем данных патологий отличия и как развиваются схожие недуги — тромбоз и тромбофлебит? Оба заболевания характеризуются образованием тромбов в кровеносной системе. Различить болезни может только врач по характерным признакам.

Сосуд может получить травму при установке катетера, особенно если он находится там длительное время. В группу риска попадают и люди, перенесшие оперативные вмешательства в области таза. Спровоцировать появление тромбов могут абсцессы и воспаления.

Болезни сосудов возникают при неправильном обмене веществ в организме. На этот процесс влияет питание пациента. Осложняется все употреблением алкоголя, никотина, нарушениями гормонального фона. У женщин большое влияние на этот процесс оказывает беременность, искусственное прерывание вынашивания ребенка.

Закупорку вен провоцируют большие физические нагрузки. Особенно они влияют на суставную область, которая находится в районе таза. Это может быть длительное стояние на ногах или перенос тяжестей. Нарушается кровообращение в организме и при сидячем образе жизни. Поэтому пациентам нужно получать допустимую нагрузку и заниматься физкультурой.

Симптомы болезней

Развитие тромбоза или тромбофлебита характеризуется определенными симптомами. Они будут отличаться. В чем разница между проявлениями патологий?

Симптомы тромбоза таковы:

  1. Заболевание будет развиваться в одном месте на ногах.
  2. Усиление боли происходит в момент передвижения.
  3. Пациент будет ощущать большой дискомфорт при поднятии тяжелых предметов.
  4. Станет заметной отечность на мягких тканях. Появится ощущение тяжести в ногах.
  5. Кожный покров приобретает синий оттенок. Кожа будет сухой и сильно натянутой, ее поверхность будет блестеть.
  6. Проявление вен будет заметным через несколько дней, как появился тромб.

В месте поражения сосуда будет повышенная температура кожи. На этом фоне может произойти общее повышение температуры всего тела. Если страдают вены, расположенные в области икры, симптомы будут выражены неярко. Отечным станет голеностоп, и будет ощущаться боль при любой нагрузке.

При развитии тромбофлебита появятся свои симптомы:

  • боль будет ощущаться с тянущим эффектом;
  • самые сильные болевые ощущения будут в месте расположения тромба;
  • вена будет выступать над поверхностью кожи;
  • пульс будет прощупываться;
  • проявится отечность больной ноги, затрудниться движение;
  • опухнут все ткани по ходу расположения поврежденной вены;
  • в сосуд могут попасть различные частицы и вещества;
  • к месту образования тромба будет приливать кровь;
  • появится синюшный оттенок кожи;
  • вена будет сильно расширена и напряжена;
  • болевые ощущения будут довольно сильными.
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Пациент будет ощущать резкое ухудшение самочувствия. Появится головная боль и общая слабость. Температура тела может повыситься до 40 градусов. Отек будет заметным на всех частях ноги ниже колена. Боль будет характеризоваться тупыми ощущениями. При прикосновении ощущения будут усиливаться. У пациента возникнут проблемы с передвижением, а при длительной ходьбе боль станет нестерпимой.

Чтобы узнать, чем отличается тромбоз от тромбофлебита, необходимо провести сравнительный анализ. Оба патологических состояния приводят к закупорке сосуда кровяным сгустком, но провоцирующие факторы могут быть разными.

Что такое тромбоз

Тромбоз не является самостоятельным заболеванием. Это патологическое состояние, при котором происходит образование кровяного сгустка. Чаще всего такая проблема затрагивает нижние конечности, при этом нарушается кровообращение, возникают воспалительные процессы в венах. Данное патологическое состояние развивается под воздействием ряда факторов, в т.ч. при наличии заболеваний сосудов.

Склеивание стенок тромбоцитов происходит при медленном кровотоке. Способствовать данному процессу могут такие факторы:

  • заболевания сердца;
  • патологии крови;
  • гормональные нарушения;
  • прием оральных контрацептивов;
  • злокачественные опухоли;
  • неправильное питание;
  • наследственные болезни;
  • курение;
  • малоподвижный образ жизни.

Еще одной причиной образования тромбов является ожирение, при котором происходит увеличение в крови количества липопротеидов низкой плотности (вредного холестерина). Это способствует формированию холестериновых отложений на стенках сосудов. При развитии данной патологии возникают болевые ощущения в месте, где образовался сгусток. Дополнительно могут присутствовать отеки, набухание вены, изменения цвета кожи в проблемной зоне.

Что такое тромбофлебит

Заболевание характеризуется воспалением венозной стенки, которое провоцируется формированием кровяного сгустка. Симптомы тромбофлебита:

  • расширение пораженного сосуда;
  • покраснение кожи в проблемной области;
  • болевые ощущения в ногах;
  • повышение температуры тела;
  • ощущение распирания в конечностях;
  • озноб;
  • головная боль;
  • тошнота;
  • общее неудовлетворительное самочувствие.

Заболевание может спровоцировать опасные последствия, в т.ч. тромбоэмболию легочной артерии, что приведет к летальному исходу. Патология может быть острой и хронической. Выделяют также 2 вида: гнойный и негнойный. Первая форма заболевания опасна тем, что может вызвать сепсис.

Чаще всего воспалительный процесс возникает при наличии варикоза. Спровоцировать патологию могут:

  • хронические болезни сердца и сосудов;
  • повышенная вязкость крови;
  • хронические инфекционные очаги;
  • хирургические вмешательства в области вен;
  • злокачественные опухоли;
  • механические повреждения сосудов;
  • прием гормональных лекарств.

Острая форма болезни часто переходит в хроническую даже при комплексном подходе к терапии.

Сходства и отличия

Врач-флеболог уже на снимке видит отличия: при воспалении стенка сосуда утолщена. Тромбоз и тромбофлебит, разница между которыми существенна, возникают чаще у пожилых. Одна патология нередко сопровождает другую: на фоне воспалительного процесса может появляться тромбоз. Сходства двух патологий:

  • Похожие предрасполагающие факторы: болезни сердца, гиподинамия и ожирение. Оба заболевания возникают при нарушениях кровотока.
  • Некоторые совпадения в клинической картине. Часто указанные патологические процессы поражают глубокие вены нижних конечностей. При этом возникают болевые ощущения, изменения цвета кожных покровов.
  • Похожий подход в лечении. Для устранения патологий применяют препараты, снижающие скорость агрегации тромбоцитов, а также медикаменты, укрепляющие венозную стенку и стимулирующие кровоток.
  • Могут спровоцировать летальный исход. Высока вероятность закупорки тромбом артерий, питающих легкие и сердце.

Отличаются такие патологические состояния этиологией. Воспалительный процесс происходит при поражении венозной стенки, а формирование тромба сопряжено в первую очередь с изменением состава крови. Отличия есть и в клинической картине. При воспалении вены повышается температура, а при закупорке сосуда тромбом лихорадка не возникает.

Важную роль в появлении воспалительного процесса играет инфекционный очаг. Однако на формирование кровяных сгустков бактерии и вирусы влияют слабо.

В лечении заболеваний также есть отличия. При тромбозе в первую очередь назначают гепарин, который разжижает кровь. Дополнительно применяют мягкие антикоагулянты. При наличии воспалительного процесса в венозной стенке терапия направлена на устранение застойных явлений. Назначают лекарства, укрепляющие стенки сосудов, и антибактериальные медикаменты. Дополнительно применяют флеботоники.

Кабардино-Балкарский государственный университет им. Х.М. Бербекова, медицинский факультет (КБГУ)

Уровень образования – Специалист

ГОУ «Институт усовершенствования врачей» Минздравсоцразвития Чувашии

Нарушения в работе и состоянии кровеносных сосудов влекут за собой высокую вероятность возникновения патологий в системе кровообращений, работе сердца и некоторых других внутренних органов. Некоторые проявления заболеваний вен имеют ряд схожих черт, потому многие зачастую путают такие болезни, как тромбофлебит и тромбоз. Оба они обладают схожей этиологией, однако определенные различия в симптоматике, специфике течения и риска для здоровья больного требуют понимания различий в этих поражениях. Отвечая на вопрос, тромбоз и тромбофлебит — в чем разница, врач-флеболог (специалист по состоянию вен и артерий) объясняет такие их различия, как место локализации патологического процесса, наличием воспалительного процесса в пораженной вене, а также различная сила проявлений заболеваний.

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Чтобы разобраться, чем отличается тромбоз от тромбофлебита, следует в первую очередь разобраться с характерными проявлениями болезней, причинами их проявления и опасностью для здоровья и жизни больного. Оба поражения затрагивают вены, нарушая процесс кровообращения в определенны частях тела. Однако методика лечебного воздействия при выявлении этих патологий требует несколько различного подхода для нейтрализации внешних проявлений.

Особенности проявлений

Наиболее важным отличием тромбоза от тромбофлебита является место локализации патологического процесса вен. При тромбофлебите особенно часто поражаются вены и капилляры в верхней части тканей, при тромбозе же разрушение стенок вен, изменения в процессе кровообращения отмечается в более глубоко расположенных венах. При этом при обоих заболеваниях этиология его проявлений схожа, степень усугубления процесса зависит как от индивидуальных особенностей организма и восприимчивости вен к ухудшения состояния их стенок, так и от проводимого лечебного воздействия: на более ранних стадиях процесса болезни восстановление их происходит более быстро, негативные последствия минимальны. Более запущенные стадии обоих заболеваний требуют более серьезного лечения с использованием большего количества медикаментозных препаратов и при определенных показаниях — хирургического вмешательства.

Тромбофлебит имеет особенность возникать исключительно в измененных и деформированных венах и кровеносных сосудах, в то время как тромбоз способен поражать даже здоровые и не измененные вены. Это различие двух рассматриваемых заболеваний дает возможность поставить предварительный диагноз при относительно схожих внешних проявлениях. Однако и тромбоз и тромбофлебит требуют более уточненной диагностики: методики лечебного воздействия будут различаться, что необходимо учитывать для определения лечебной схемы для получения наиболее выраженного и быстрого результата.

Общей характеристикой обоих рассматриваемых заболеваний вен следует считать поражения, возникающие в венах вследствие развития в них тромбов, или кровяных сгустков, что в значительной степени мешает нормальному функционированию кровеносной системы: нарушается нормальное кровообращение, ухудшается процесс питания тканей и самих вен необходимыми веществами, поставляемыми кровью, а также кислородом. При этом начинается кислородное голодание тканей, что опасно для пораженной части тела: при отсутствии достаточного количества кислорода в поступающей крови отмечается начало процессов некроза, что чревато развитием гангрены.

Однако при развитии тромбофлебита, в отличие от тромбоза, вероятность развития патологического процесса высока только в поврежденных венах: это могут быть механические повреждения, проникновение и развитие в полости вены или ее стенке инфекции, вирусные поражения. Кровоток в поврежденной вене замедляется. При этом отмечается возникновение воспалительного процесса в тканях стенок вены, что, в свою очередь, усугубляет замедление скорости прохождения через поврежденную вену крови. Тромбоз же способен возникнуть даже в здоровой, неповрежденной вене.

При проведении диагностики лечащим врачом-флебологом изучается как общее состояние вен пораженной области, так и анализируется здоровье больного. При начальных стадиях обычно отмечаются более общие проявления болезни, однако при прогрессировании становятся заметны характерные изменения, что позволяет дифференцировать каждое поражение по отдельности.

Особенности выявления патологий вен

Чтобы отличить тромбофлебит от тромбоза, врачом при подозрении на эти поражения вен назначается более глубокая диагностика. Начальные же стадии обоих процессов имеют незначительные различия, потому изучая тромбоз и тромбофлебит, следует знать, в чем разница проявлений начальной стадии обоих патологических процессов вен.

Тромбофлебит: специфические проявления

При тромбофлебите наиболее характерным симптомом, который может обратить на себя внимание даже на начальной стадии процесса, является воспалительный процесс, возникающий вследствие повреждения вены: именно в поврежденных и деформированных венах начинает развиваться тромбофлебит. Даже начальные этапы этой болезни заметны:

  • возникает покраснение кожи в области поражения;
  • проявляется отечность тканей;
  • кожа начинает приобретать синюшный оттенок, что связано с нарушениями в процессе кровообращения и оттоком венозной крови;
  • появлением болезненности, которая возникает при сдавливании прилежащих тканей увеличившейся в объемах отечной ткани пораженного органа.
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Перечисленные изменения сопровождаются постепенным усугублением всех симптомов — болезненность увеличивается, кожа всё в большей степени изменяет свой цвет.

Характерные проявления тромбоза

При тромбозе, который также поражает вены и их стенки, замедляя процесс кровообращения и ухудшая питание тканей кровью и кислородом, отмечается высокая вероятность поражения даже здоровых вен и кровеносных сосудов — это затрудняет процесс диагностирования и выявления начальной стадии патологии.

К характерным проявлениям начальной стадии тромбоза следует причислить изменения в составе и качествах крови: она приобретает большую вязкость. Однако сложность обнаружения данного изменения затрудняет процесс диагностирования заболевания — поражения вен происходят при тромбофлебите более глубоко расположенных вен.

Особенностью тромбофлебита и тромбоза является их возникновение вследствие при изменениях в составе крови либо поражения вен конечностей, преимущественно вен ног. Однако существуют также разновидности тромбофлебит лицевых вен и тромбоз кавернозного синуса, которые поражает вены лица, ухудшая процессы кровообращения в данной области и вызывая патологические состояния тканей: пещеристая ткань поражается при отсутствии необходимого питания ее кислородом при нарушениях процесса кровообращения. Понимание причин, которые вызывают любые негативные изменения в венах ног, рук или лица, позволит более внимательно отнестись даже к начальным проявлением рассматриваемых поражений и своевременно провести необходимые диагностические мероприятия.

Причины поражений вен

Поскольку тромбофлебит имеет свойство возникать в поврежденных венах и кровеносных сосудах, его возникновение может быть спровоцировано чрезмерной физической активностью, поднятием тяжестей, частым пребыванием на ногах. Это значит, что поражения вен, характерные для тромбофлебита, наиболее часто отмечаются у активных и подвижных людей.

Однако и малая доза физической активности вредна для здоровья человека: уменьшение скорости кровообращения, застой крови и недостаточное питание тканей кислородом и питательными веществами способны привести к значительному ухудшению состояния пораженных органов и частей тела.

Также к причинам тромбоза и тромбофлебита следует отнести:

  • варикозное расширение вен;
  • изменения в составе крови;
  • механические травмы сосудов и вен, их деформация;
  • общее замедление скорости кровотока.

Причинами перечисленных состояний могут стать онкологические болезни, поражения желудочно-кишечного тракта, изменения в составе крови и нарушения в процессе ее образования, беременность с последующими родами.

Симптоматика: различия во внешних проявлениях

При венозных поражениях имеется ряд характерных отличий, которые позволяют также выявить текущую болезнь по ее внешним проявлениям. Симптоматика тромбофлебита и тромбоза различна, и хотя наиболее отчетливые проявления отмечаются при запущенных стадиях патологического процесса, знание проявлений позволяет поставить предварительный диагноз на основании субъективных проявлений.

Проявления тромбоза

Для тромбоза наиболее характерными проявлениями, которые можно отнести к симптомам болезни, можно назвать:

  • появление болезненности даже без наличия внешних патологических изменений в тканях;
  • увеличение степени болезненности при нагрузке, особенно во время ходьбы;
  • изменение в состоянии пораженных тканей — конечность приобретает блестящую поверхность, кожа натянута;
  • при дальнейшем усугублении начинает проявляться и становиться более заметной пораженная вена, которая приобретает синюшный оттенок, свидетельствующий о нарушении движения крови.

Пульсация артерий в пораженной тромбозом части отсутствует или незаметна.

При тромбозе внешние проявления практически всех стадий болезни не слишком заметны, что затрудняет процесс диагностирования болезни. Общей характерной чертой данного поражения следует назвать некоторую отечность тканей.

Симптоматика тромбофлебита

Первое проявления данного заболевания — болезненность в области тромбированной вены. Характерная особенность боли — ее тянущий характер, увеличение степени проявления в активном состоянии. В данной области возникает хорошо заметный отек тканей, которые приобретают нехарактерный оттенок.

Поскольку тромбофлебит сопровождается воспалительным процессом, могут наблюдаться и проявления, характерные для воспаления:

  • ухудшение общего самочувствия;
  • озноб;
  • слабость в мышцах;
  • вероятен подъем температуры тела.

При прогрессировании болезни отмечается усиление характерной симптоматики, больному сложно наступить на пораженную ногу вследствие увеличения ее болезненности.

Перечисленные проявления тромбоза и тромбофлебита, их различия и сходство во внешней симптоматике помогут при предварительной диагностике. Однако даже при незначительных изменениях в самочувствии и состоянии тканей организма требуется обратиться к врачу, который уточнит предварительный диагноз и назначит адекватное лечение.

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