Венозные капилляры состоят из трех оболочек. Внутренний слой – эндотелий, с которым соприкасаются форменные элементы и плазма, фрагменты, белки. Эндотелий выстилает просвет сосуда и создает зачатки для формирования клапанной системы. Нижний слой защищен соединительной тканью — это средняя оболочка. Вена покрыта мышечным слоем – наружной оболочкой.
Воспалительные процессы, затронувшие одну из них или несколько слоев вены сразу, называется флебитом. Заболевание представляет опасность, потому как провоцирует образование пристеночных сгустков в просвете венозного сосуда.
Воспаление стенок венозных сосудов может возникнуть в любой части тела. Излюбленным местом флебита являются нижние конечности, порой заболевание «поднимается» вверх, вовлекая верхние конечности пациента.
Флебит вен рук носит острый и хронический характер. Развивается вследствие венозной недостаточности или варикоза. Произошедшие патологические изменение сосудистой стенке внешне проявляются в виде припухлости и гиперемии.
В зависимости от того, какой именно слой поврежден, зависит вид флебита.
Классификация
Патологический процесс может коснуться поверхностных и более глубоких вен, слоев венозной стенки.
Классификация зависит от места воздействия различных факторов патогенной этиологии:
- если патологический процесс затронул наружную оболочку, то развивается перифлебит;
- если повреждение коснулось эндотелиального слоя, то – эндофлебит. По сравнению с перифлебитом встречается несколько чаще;
- если воспаление или инфекция вовлекла в патологический процесс все стенки венозного сосуда, развивается панфлебит.
Отличается характером течения:
- острая форма возникает внезапно, и отличается выраженной симптоматикой;
- хроническая форма – латентный вид патологии, не дающий знать о себе на протяжении нескольких лет.
Флебит рук может быть глубоким и поверхностным. В обоих случаях при отсутствии лечения увеличен риск возникновения неблагоприятных последствий и осложнений.
Причины
Имеется несколько причин данного явления и факторов, увеличивающих риск флебита.
Основная причина развития флебита – внутривенные инъекции, в результате которых повреждается стенка вены.
Частые инъекции, травмы венозной стенки, длительное ношение катетера и не квалифицированные действия медперсонала усугубляют процесс, вызывая риск инфицирования.
К иным, не менее распространенным, причинам относятся:
- варикозное расширение вен рук и венозная недостаточность;
- гормональные изменения — беременность, климакс, эндокринные заболевания;
- химических ожог вен при взятии крови или введении лекарственного средства;
- физическая пассивность или наоборот чрезмерная активность, например силовые занятия;
- системные болезни крови;
- веностаз верхних конечностей.
К факторам, увеличивающий риск развития недуга относят: избыточную массу тела, вредные привычки, воздействие ультрафиолетовых лучей.
Часто развивается у лиц, вкалывающих наркотические препараты в локтевые вены. Кроме того, что эти действия угрожают жизни человека, возникает травматизация венозной стенки:
- сосуды становятся твердыми;
- места инъекций воспаляются;
- присоединяется инфекция;
- нарушается состав крови и изменяется ее густота;
- не исключен ожог наркотическими препаратами.
Следует отметить, что не от каждой инъекции у человека развивается воспаление. В основе недуга лежит иммунологический фактор, который может в определенный момент дать сбой и привести к таким последствиям.
Чем опасно
Опасность заключается в травматизации эндотелиального слоя, где происходит скапливание форменных элементов, фибриновых нитей и микрочастиц.
Образованный сгусток преграждает путь кровотоку, вызывает сгущение крови, и повышает проницаемость кровеносных стенок. Пристеночное образование (тромб) может оторваться, что повлечет за собой опасное состояние больного с возможным фатальным исходом.
Флебит сопровождается деформацией сосудистой стенки, общей слабость и рядом своеобразных симптомов.
Как проявляется
Для воспаления вен верхних конечностей характерны следующие симптомы:
- отечность в месте инъекции;
- гиперемия;
- расплывчатые границы покраснения кожных покровов;
- зуд и боль по ходу локализации сосуда;
- жжение в области вены;
- синюшность кожных покровов рук;
- онемение пальцев рук;
- гиперемия сосуда и твердость наружной оболочки.
Симптоматика, по мере течения патологического процесса, усиливается и приобретает выраженный характер.
При хронической форме патологии клиническое проявление отсутствуют, но при возникновении провоцирующих факторов, недуг приобретает острое течение и соответственную симптоматику.
К какому врачу обратиться
Лечением флебита занимаются флебологи и ангиохирурги. Это отдельный вид медицины, а точнее подвид сосудистой хирургии.
Первоначальное обращение пациента с соответствующими жалобами направлено к терапевту, который отправляет больного к узким специалистам.
Диагностика
Дифференциальная диагностика проводится для установления точного диагноза, и включает в себя несколько методов обследования: лабораторные анализы и аппаратные способы.
К лабораторным тестам относятся:
- клинический анализ крови;
- биохимическое исследование;
- коагулограмма.
Лабораторные тесты – стандартные методы диагностики, применяемые вне зависимости от вида патологического процесса системы кровообращения.
Более точными способами являются:
- ультразвуковая диагностика с допплерометрией – наиболее распространенный метод диагностирования;
- дуплексное сканирование, в процессе которого выявляются поврежденные как внутренние, так и поверхностные вены;
- компьютерная томография и метод МРТ применяются при отсутствии результатов после стандартных методов диагностики.
Не менее важен опрос врачом пациента, сбор анамнеза и внешний осмотр больного глазом узкоспециализированного профессионала.
Методы лечения
Противовоспалительная терапия проводится в зависимости от степени тяжести и клинических проявлений.
Лечение может осуществляться амбулаторно и в условиях стационара.
Допускаются нетрадиционные методы лечения, согласованные с флебологом.
Кроме медикаментозного лечения флебологи рекомендуют нормализовать питание и отказаться от вредных привычек.
Лечение в стационаре
Стационарная терапия показана пациентам с выраженной клинической картиной и склонностью к осложнениям. Лечение в стационаре включает в себя следующие группы аптечных препаратов:
- Антибактериальные препараты широкого спектра действия, в сочетании с пребиотиками (Аципол или Линекс). Антибиотикотерапия особенно показана, если причиной патологии явилась некачественная инъекция.
- Противовоспалительные средства местного действия (мази и гели).
- Обезболивающие и противоотечные лекарственные средства, как общего, так и местного действия.
- Для восстановления структуры крови и предотвращения застойных явлений назначают антикоагулянты и антиагреганты: Варфарин, Гепариновая мазь.
- Для восстановления функции вен, а также с целью максимально ускорить процесс восстановления применяется физиотерапия: УВЧ, лазеротерапия и магнитотерапия.
Амбулаторно
Осуществляя лечение в домашней обстановке предпочтение отдается мазям наружного действия:
- Троксевазин;
- Гепариновая мазь;
- йодовая сетка;
- компрессы из вазелина и спирта.
В качестве нетрадиционных рецептов популярны компрессы из капустных листьев, тертого картофеля и из настоя календулы.
Народные способы следует применять после консультации с врачом, и дополнять лечение лекарственными препаратами и традиционными гелями.
Важно поддерживать терапию приемом аптечных средств для разжижения крови.
Побочные эффекты и методы их устранения
При соблюдении всех рекомендаций, побочные эффекты исключены. Однако зачастую «домашняя» терапия заканчивается осложнениями, и врача вынуждены прибегнуть к иному способу устранения воспаления.
Побочные действия могут быть в виде:
- аллергической местной реакции (при имеющейся гиперчувствительности);
- зуда и жжения;
- усиления болезненных ощущений;
- отечности.
Любе отклонение в самочувствии следует сообщать врачу. При отсутствии терапевтического эффекта показано хирургическое вмешательство:
- перевязка воспаленного сосуда;
- устранение тромба;
- удаление вены с последующей заменой на протез.
Возможные осложнения
Воспаление стенок венозных сосудов может быть осложнено тромбофлебитом и тромбоэмболией.
Тромбофлебит – образование сгустков (тромбов) в просвете сосуда, который прикреплен к стенке, но с током крови может оторваться.
Тромбоэмболия – это оторвавшийся тромб, закупоривший жизненнонеобходимые артерии. Процесс закупорки легочной артерии ведет к летальному исходу.
Закупорка вен рук может привести к гипоксии тканей, а в дальнейшем, к гангрене.
Профилактика
Профилактические мероприятия направлены на снижение развития осложнений при имеющейся патологии, а также для предотвращения недуга.
Для предупреждения необходимо:
- следит за питанием;
- укреплять стенки сосудов, а также принимать венотоники, рекомендованные лечащим врачом;
- не делать самостоятельно внутривенные инъекции;
- ограничить воздействие вредных привычек на свой организм;
- заниматься умеренными физическими нагрузками.
При имеющейся патологии необходимо соблюдать все рекомендации специалиста.
Интересное видео: болезни вен на руках
В медикаментозной терапии врачи предпочитают использовать внутривенное введение различных препаратов. Это обусловлено тем, что благодаря такому методу можно получить быстрый и необходимый результат. Однако довольно часто после катетера, который ставят для удобства введения лекарства, возможен риск возникновения флебита. Флебит на руке после катетера является воспалительным процессом, он локализуется на стенках вен в результате их травматического воздействия при лечении определенного заболевания. Если не лечить данное состояние, то через некоторое время поврежденные сосуды начнут разрушаться. Итак, что такое флебит, почему воспаляются вены и какие используют в таком случае терапевтические мероприятия.
Что такое флебит вены?
Флебит вены на руке возникает не только из-за катетера, но и после любой перфорации вены: внутривенная инъекция, инфузия, то есть проведение капельницы. Среди многих воспалительных процессов, происходящих в сосудах и заболеваний, связанных с ними, постинъекционный флебит считается самой распространенной формой.
Принципы постинъекционного флебита
Когда в вену вводят лекарство, возникает спазм сосудов, что провоцирует благоприятное проникновение внутрь инфекции. Эти действия могут привести к воспалению в сосудистых стенках. Затем немного замедляется кровообращение, ухудшаются химические показатели крови, истончаются стенки сосудов, формируются застойные явления, в плазме обнаруживаются возбудители инфекции. Вероятность возникновения сгустков крови увеличивается в разы, что является серьезным осложнением заболевания — тромбофлебитом.
Флебит, возникающий после капельницы, имеет несколько разновидностей:
- перифлебит (когда вместе с поврежденной веной воспаляются подкожные ткани);
- панфлебит (повреждаются все венозные слои);
- эндофлебит (характеризуется изменениями, происходящими внутри вены).
Симптоматика заболевания и ощущения больного
Обычно флебит заявляет о себе в течение 24 часов после проведения внутривенного введения лекарства. У больного на месте установки катетера или укола появляется покраснение. Оно проходит с извлечением катетером. Однако воспалительный процесс может продолжать обостряться и сопровождаться следующими симптомами:
- из-за скопления крови на месте укола происходит утолщение вен и выпячивание их наружу;
- мягкие ткани утолщаются, что становится заметным при пальпации;
- возникают сильные боли, которые отдают в пальцы руки;
- распухает рука (причем, через несколько часов после инъекции), появляется сильная отечность;
- посинение пораженного места;
- заметно увеличиваются локтевые и подмышечные лимфоузлы.
Состояние пациента продолжает ухудшаться, повышается температура тела, на 3-4 день конечность перестает сгибаться и разгибаться в локтевом суставе. Если не начать лечению, то патология начнет распространятся на соседний сосуд. Возможно также нагноение венозных стенок.
Методики терапии
Лечение флебита после уколов в вену, а также инфузий, проводится консервативными методами. В сложных или запущенных ситуация прибегают к радикальному методу терапии — хирургическому вмешательству.
Вид лечения зависит в первую очередь о того, сколько времени прошло после начала воспалительного процесса. Если больной обратился к врачу на 1-3 стуки, то еще применима медикаментозная терапия. Но в любом случае необходимо безотлагательное лечение постинъекционного флебита, иначе не избежать печальных последствий.
Медикаментозное лечение флебита
Чтобы снизить риск возможных осложнений, постинъекционный флебит необходимо лечить при первых признаках проявления патологии. Консервативные методы лечения состоят из следующих действий:
- употребление нестероидных противовоспалительных препаратов;
- для предотвращения заражения крови используют антибактериальные средства;
- чтобы уменьшить вязкость крови и предотвратить образование тромбов, больному назначают антикоагулянты.
На первых стадиях флебита на руке требуется лишь купировать боль и снять воспаление. Если же процесс длится долго и присоединилась бактериальная инфекция, в таком случае применяется комплексное лечение.
Помимо внутреннего приема препаратов применяется лечение наружными: мазями и гелями, содержащие гепарин и троксерутин. Эти средства уменьшают воспаление и улучшают венозную проходимость.
Народные методы лечения
Ускорить процесс выздоровления при флебите активно помогает нетрадиционная медицина, а именно мази и компрессы.
Известно несколько наиболее эффективных народных средств для лечения воспаления вен:
- Компресс из меда. Возьмите мед, тонким слоем нанесите его на воспаленное место и зафиксируйте тканью.
- Капустный лист. Как известно, капустный лист способен снимать воспаление. Помойте капустный лист, ошпарьте его горячей водой, намажьте медом и нанесите на проблемное место.
- Йодная сетка. На сегодняшний день медикам сложно объяснить тот факт, что банальная йодная сетка способна снимать воспаление и боль.
- Спиртовой компресс. Необходимо кусочек ватки смочить в спирте и нанести сверху вазелин. Приготовленный компресс положить на пораженный участок кожи и зафиксировать его бинтовой повязкой.
Народную терапию можно использовать только в качестве дополнительного лечения, она не заменяет медикаментозное, в частности, если дело касается острой формы заболевания.
В каком случае требуется радикальная терапия?
Если медикаментозная терапия не дает положительных результатов в борьбе с флебитом и болезнь протекает длительное время, то разумным решением будет хирургическое вмешательство. Это происходит тогда, когда пораженная область воспалена, начинается нагноение, формируются кровяные сгустки, возникает постинъекционный тромбофлебит.
Операция проводится в стационарных условиях. Под местным наркозом больному удаляют образовавшееся нагноение. На следующий день после операции рекомендовано руку обмотать эластичным бинтом и стараться не беспокоить конечность.
Если не лечить флебит, особенно его острую форму, то может возникнуть осложнение процесса воспаления (например, заражение крови) и привести к летальному исходу.
Рацион питания при флебите
При флебите поражается венозная стенка, на которой в течение времени накапливаются вредные вещества, поэтому питание должно быть исключительно рациональным. Следует избегать следующих продуктов:
- жирные, консервированные и копченые продукты питания;
- газированные и спиртные напитки;
- фаст-фуды;
- свежая выпечка и кондитерские изделия;
- шоколад;
- чипсы;
- маргарин и сливочное масло.
Круг употребляемых продуктов необходимо увеличить теми, которые разжижают кровь, помогают избежать образования тромботических масс в просветах сосудов: лимон, свёкла, корень имбиря, ягоды клюквы, чеснок
Профилактические меры
Каждому человеку следует серьезно относиться к своему здоровью: рационально питаться, вести здоровый образ жизни, проводить своевременные профилактические мероприятия при имеющихся хронических заболеваниях.
В качестве профилактических мероприятий сосудистых патологий врачи рекомендуют:
- гулять на свежем воздухе при любой погоде;
- отказаться от всех вредных привычек;
- заниматься спортом и жить по режиму;
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- не забывать смазывать венотониками то место, где вводят иглу, если проходите лечение с использованием внутривенных уколов или инфузий.
Легкомысленное отношение к флебиту чревато серьезными последствиями. Любое подозрение на венозное воспаление — это повод обратиться к врачу. Если вовремя принять меры, то гарантия полного выздоровления пациента будет высокой.
Флебит вены на руке – это процесс, в ходе которого повреждается венозная стенка, как результат, возникает состояние, замедляющее поток крови в венах и ее застой.
Что такое флебит?
Флебит (инфекционное воспаление вены) на руках, например, может развиться, как осложнение катетеризации, после применения капельницы или вследствие инъекций (в таком случае имеет место постинъекционный флебит). Воспаление вен на руках и предплечьях может также возникать в связи с травмой (переломы и т. д.).
В таких случаях назначаются противовоспалительные мази, применяются холодные компрессы, стягивающие эластичные повязки. Может помочь при флебите использование ацетилсалициловой кислоты (Аспирин) или антибиотиков. Болезнь, обычно, стихает в течение нескольких дней.
В диагностике венозного заболевания важно различать, имеет место флеботромбоз или тромбофлебит. Каждый тип болезни требует различных методов лечения и лекарственных препаратов. Эти заболевания всегда должны лечиться специалистом.
Терапевтические основы флебита
При обнаружении венозного воспаления немедленно назначается введение антитромботических (антикоагулянтных) препаратов, чтобы защитить пациента от тромбов и, следовательно, их попадания в легочную артерию. Сначала путем инъекции – подкожно или внутривенно – вводится гепарин, затем пациент переводится на несколько дней на антикоагулянтную терапию с применением Варфарина (таблетки).
При флебите вены на руке лечение препаратом Варфарин продолжается в течение различного периода, в зависимости от рисков и наличия тромбофилии, как правило, на протяжении 6-12 месяцев. Но иногда терапия может быть пожизненной, особенно, у больных с тромбозом вен в анамнезе или множественной серьезной врожденной тромбофилией, а также в случае комбинации этих факторов.
При лечении Варфарином необходимо на регулярной основе, по крайней мере, 1 раз в месяц, контролировать свертываемость крови с помощью т. н. метода Квика, в соответствии с результатами которого регулируется суточная доза препарата.
При лечении препаратом Варфарин необходимо тщательно следовать режиму, избегать алкоголя и некоторых пищевых продуктов. Также важно, чтобы каждый пациент, принимающий препарат Варфарин, имел при себе карту, информирующую о приеме этого лекарства, и информировал каждого врача об этом факте.
Это необходимо по той причине, что при некоторых вмешательствах, особенно, хирургических или стоматологических, присутствует необходимость заранее исключить Варфарин, в противном случае существует риск кровотечения.
Иногда локализованный постинъекционный тромбофлебит для быстрого растворения тромба требует использования агрессивных методов, в частности, введения катетером специального вещества, способного растворять сгустки крови непосредственно в тромбе. Эти манипуляции проводят специализированные центры, пациенты к ним направляются на основании строгих критериев и указаний.
В большинстве случаев, постинъекционный тромбофлебит лечится без проблем при помощи традиционного лечения. В последнее время лечение заболевания, особенно, среди молодых пациентов с низким уровнем риска проводится на амбулаторной основе, без необходимости госпитализации. Пациенту вводится подкожно низкомолекулярный гепарин, в ходе терапии лечащий врач постепенно переходит к терапии препаратом Варфарин.
Что такое – поддерживающее лечение флебита?
Это лечение направлено на уменьшение последствий венозного воспаления и повышение венозного кровообращения для быстрой проходимости пораженного участка. Терапевтические меры при флебите включают в себя тренировку мышц, начиная со 2-го дня, ношение компрессионного трикотажа (особенно, II класса) и прием поддерживающих лекарственных препаратов, снижающих отеки (например, Детралекса).
Пациентам, имеющим в анамнезе венозный тромбоз, рекомендуется регулярно заниматься физическими упражнениями и избегать длительной статической нагрузки (актуально при работе за компьютером, когда руки подолгу находятся в одном положении). Подходящим видом спорта является плавание.
Поверхностный постинъекционный флебит, чаще всего, лечится при помощи компрессионного трикотажа, движения и лекарственных препаратов (в частности, применяются такие лекарства, как Гливенол, Детралекс, Анавенол, Цикло 3 форте и т. д.), часто назначаются антибиотики.
Флебит более тяжелой формы предполагает введение антикоагулянтов, действие которых направлено на предотвращение образования тромбов и помощи организму в устранении сгустков (обычно, вводятся низкомолекулярные гепарины путем инъекций, в более низкой дозе).
Действие Гливенола
Гливенол принадлежит к группе лекарств, прописываемых при заболеваниях вен, в т. ч. при флебите. Активным веществом препарата является трибенозид.
- Принцип действия: трибенозид воздействует на вены, укрепляет их стенки, повышает гибкость и снижает проницаемость мелких кровеносных сосудов (капилляров), таким образом, противодействует отекам.
- Использование: в основном, препарат принимается в дозе 1 таблетки 2 раза в день. Продолжительность терапии при флебите зависит от рекомендации лечащего врача.
- Побочные эффекты: у Гливенола побочные эффекты очень редки, иногда наблюдаются пищеварительные расстройства и кожные высыпания.
Важно! Препарат не должен быть использован пациентами с нарушением функции печени и почечной недостаточностью.
Эффективность Детралекса
Детралекс является одним из наиболее часто используемых препаратов для лечения венозных заболевания, в т. ч., флебита. Лекарственное средство содержит активный ингредиент диосмин и флавоноиды.
- Принцип действия: диосмин и флавоноиды воздействуют на венозную стенку, укрепляют их и повышают их гибкость. Таким образом, препарат облегчает отток венозной крови из конечностей из-за положительного воздействия на лимфатические сосуды, а также облегчает дренаж лимфы.
- Использование: в основном, Детралекс используется по 1-й таблетке 2 раза в день. Продолжительность лечения при флебите зависит от назначения лечащего врача.
- Побочные эффекты: у Детралекса побочные эффекты случаются крайне редко, иногда наблюдаются пищеварительные симптомы, такие, как тошнота и диарея.
Особенности применения Цикло 3 форте
Цикло 3 форте относится к группе препаратов, применяющихся при венозных заболеваниях и болезнях мелких кровеносных сосудов. Активные вещества препарата представлены экстрактом из растения иглицы колючей, гесперидином и витамином С.
- Использование: применение зависит от рекомендации врача. При флебите, как правило, рекомендуется принимать 2 капсулы в день.
- Побочные эффекты: нежелательные эффекты встречаются редко, в случае использования натощак могут возникнуть проблемы с пищеварением, поэтому, рекомендуется принимать препарат с пищей.
Препараты для разжижения крови
Лекарства для разжижения крови (антикоагулянты) представляют собой значительный и разнообразный класс препаратов, в современной медицине имеющий широкое применение. При флебите они назначаются для облегчения кровотока.
Низкомолекулярные гепарины
Низкомолекулярные гепарины – это современные препараты, действие которых направлено против свертывания крови.
В отличие от других препаратов этого класса, низкомолекулярные гепарины имеют свои преимущества и недостатки, с которыми должны считаться врачи.
Травы при флебите
В дополнение к медикаментозному лечению (ни в коем случае, не вместо него!) можно использовать целительную силу трав.
Действие трав, используемых при флебите, направлено, в основном, на поддержку иммунной системы; благодаря противовоспалительному и стимулирующему действию на организм, травы помогают уменьшить набухание и облегчить боль.
Наиболее часто используются следующие травы:
- конский каштан – используется экстракт цветов на спиртовой основе;
- донник лекарственный – используется чай из цветущих верхушек;
- эхинацея – используется экстракт на спиртовой основе либо сироп либо чай из целого растения;
- окопник лекарственный – используются гели или мази из корня растения;
- календула – используется мазь из цветов.
Питание при флебите
Подходящей при флебите является вегетарианская диета, исключающая мясо и молочные продукты, также рекомендуется уменьшить количество потребляемой соли. Целесообразно включение в рацион большего количества лука, содержащего кверцетин, флавоноид, уменьшающий ломкость капилляров и предотвращающий образование тромбов. Черника отлично подходит для укрепления стенок капилляров.
Важно включить в рацион повышенные дозы омега-3 жирных кислот (льняное масло, кунжутное масло) в сочетании с луком, чесноком. Эти жирные кислоты в организме создает среду, которая не поддерживает развитие воспалений.
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