Тромбофлебит — заболевание, в основе которого лежит воспаление стенки венозного сосуда и формирование в нем тромба. Как правило, тромбофлебит развивается на фоне варикозной дилатации сосудов, в основном затрагивая поверхностные вены ног. Опасность процесса в том, что он может распространяться на глубокие венозные сосуды нижних конечностей. В таких случаях тромбофлебит может осложняться тромбоэмболией легочной артерии, инфарктом легких, сердечной недостаточностью.
Факторы риска возникновения тромбофлебитического поражения вен нижних конечностей:
- возраст более 40 лет;
- малоподвижный образ жизни, работа, связанная в длительным пребыванием стоя или сидя (водители, хирурги, программисты, парикмахеры);
- длительный постельный режим;
- беременность, роды;
- сахарный диабет, болезни сердца;
- варикозная болезнь;
- прием гормонов, химиотерапия;
- операции;
- ожирение, избыток веса более 30%.
Известно, что европейцы и американцы менее подвержены тромбофлебитическому поражению вен, чем жители азиатских стран. Это связано с традицией азиатов сидеть на полу, при этом создаются более благоприятные условия для тока крови в нижних конечностях, чем при сидении на стульях.
Профилактические мероприятия при тромбофлебите
Всем, кто имеет два или более фактора риска, необходимо принимать меры для профилактики тромбофлебитического процесса в нижних конечностях. Своевременная профилактика поможет избежать воспаления и тромбобразования в венах, а также такого осложнения данного заболевания, как тромбоэмболия легочной артерии.
Профилактика тромбофлебита включает в себя следующее:
- физическая активность;
- массаж;
- регулярная смена положения тела;
- ношение правильной обуви и одежды;
- адекватное лечение простудных заболеваний и инфекционных очагов;
- избегайте переохлаждения, травм, переломов, сильных ударов;
- заботьтесь о гигиене нижних конечностей;
- откажитесь от курения;
- наладьте правильное питание.
Борьба с гиподинамией заключается в увеличении двигательной активности. Необходимы регулярные пешие прогулки, благоприятное действие оказывают велосипедный спорт, плаванье, танцы.
Простые упражнения помогут избежать застойных явлений:
- После сна, лежа на кровати, приподнимите ноги до 8 раз.
- Лежа поднимите ноги вверх и вращайте стопами, затем переходите к упражнению «велосипед».
- Упражнение «горизонтальные ножницы» нижними конечностями до 8 раз.
- Стоя слегка приподнимитесь на носки, резко опуститесь вниз. Сделайте 3 подхода по 20 раз.
Для профилактики задержки крови в нижних конечностях рекомендовано делать регулярный массаж. Метод массажа следующий: снизу от ступни до бедра прокатывайте ладонью восковую свечку, немного придавливая ее.
Используйте обувь на невысоком каблуке, не больше 4 см. Ортопедические стельки не только облегчат ходьбу, но и благоприятно будут воздействовать на кровоток в нижних конечностях. Ношение узких джинсов, тугих поясов или корсетов тоже противопоказано.
Полезен отдых с ногами, расположенными выше уровня сердца. Лежа подложите под ноги одеяло, скрученное валиком, или подушку. Если приходится долгое время проводить в одном положении (поездка на автобусе, перелеты на самолетах) необходимо пить больше жидкости, старайтесь при возможности изменять положение тела, разминайте ступни.
Опасно переносить простуду «на ногах». Вирусы и бактерии могут повреждать внутреннюю поверхность венозных стволов и провоцировать тромбообразование в этих местах. А при травмах разрушаются ткани (кожа, мышцы, подкожная клетчатка, сосуды). К поврежденным тканям приклеиваются тромбоциты и эритроциты, формируя тромб. На травму во время операции организм реагирует повышением активности свертывающей системы. Также, при неправильной установке венозного катетера, вокруг него формируется тромб и воспаление.
Проводите гигиенические процедуры нижних конечностей ежедневно. Вечером делайте контрастный душ, полезны десятиминутные ножные ванночки с морской солью, настоями трав. Общие закаливающие процедуры помогут укрепить сосудистые стенки. Обливания прохладной водой, обтирания, посещение бассейна уменьшат симптомы болезни.
При наличии варикозных расширений на венах нижних конечностей, а также во время беременности, показано эластичное бинтование или использование компрессионного трикотажа.
Избыток массы тела увеличивает риск возникновения тромбофлебитического поражения вен нижних конечностей в три раза. Венозные стволы сдавливаются утолщенной подкожно-жировой клетчаткой, травмируются, ток крови замедляется. Это значит, что необходимо менять пищевые привычки. Во-первых, умеренное употребление пищи, главное, не переедать. Во-вторых, уменьшить употребление жиров и углеводов. Основную часть продуктов на столе должны составлять овощи, фрукты, продукты кисломолочного ряда, рыба. Пищу надо варить, тушить или запекать.
Предпочтительные продукты питания, которые уменьшают активность свертывающей системы и укрепляют сосудистые стенки:
- рыба;
- морская капуста;
- чеснок, лук;
- кисломолочные продукты;
- виноград, арбуз, дыня;
- орехи, сухофрукты, имбирь, корица.
Профилактика обострения тромбофлебита
Если диагноз «тромбофлебит» уже стоит и были эпизоды обострения, то для профилактики новых случаев заболевания необходимы следующие мероприятия:
- использование компрессионного белья или эластичного бинтования нижних конечностей;
- постоянный прием антикоагулянтов и витаминов под наблюдением врача;
- употребляйте достаточно жидкости в течение дня;
- избегайте чрезмерной физической нагрузки, длительного стояния на ногах;
- противопоказаны горячие ванны, баня, сауна.
Отказ о проведения профилактических мероприятий пациентами обычно завершается обострением тромбофлебита. Также необходимо соблюдать диету, сохранять умеренную физическую активность и применять массажные методики.
Профилактика тромбофлебитических осложнений в послеоперационный период
Профилактика тромбофлебита у пациентов в послеоперационный период необходима из-за вынужденного длительного постельного режима и усиленной свертываемости. Избежать застоя венозной крови после операции можно с помощью лекарственных и механических средств:
- прием антикоагулянтов, назначенных врачом;
- ношение компрессионного трикотажа или использование специализированного компрессора;
- обеспечение достаточной гидратации организма;
- использование щадящих оперативных техник;
- максимальное сокращение постельного режима.
Степень эффективности профилактических мер в послеоперационный период индивидуальна у разных пациентов, поэтому врачи ориентируются на степень риска.
Народная медицина против тромбофлебита
В домашних условиях просто проводить профилактику тромбофлебита народными средствами. Нетрадиционная медицина имеет множество рецептов, помогающих избежать развития заболевания:
- Настойка из цветков конского каштана. Растительное сырье и водка в соотношении 1:1 настаиваются 20 дней. Растирать ноги в области варикозных расширений.
- Капустный лист обмакнуть в яичной желток и приложить к больному участку.
- Компрессы с содой.
- Сборы трав (череда, зверобой, ромашка, сушеница, донник, льнянка) заливаются кипятком и принимаются два раза в сутки.
Тромбоз (закупорка вен тромбами) или тромбофлебит (тот же процесс, но сопровождающийся воспалением) нижних конечностей — опасные заболевания, способные привести к осложнениям и существенно ухудшить здоровье и самочувствие.
Данные недуги связаны с нарушениями структуры кроветворения, а также с плохой циркуляцией крови и некоторыми другими негативными факторами.
Образование тромбов можно предотвратить, если следовать простым правилам профилактики. Профилактические меры зависят от состояния пациента и могут применяться как при отсутствии каких-либо признаков недуга, так и на его ранних стадиях.
Основные принципы профилактики
Тромбоз глубоких вен – это состояние, когда глубокие вены (расположенные далеко от эпидермиса, в отличие от поверхностных) поражаются тромбами.
Обычно тромбозу предшествует расширение глубоких вен либо их повреждение. Основная задача профилактики тромбоэмболии – предотвратить отрицательные изменения вен и, как следствие, образование тромбов.
В ходе профилактики обеспечивается защита от следующих факторов, способных привести к болезни:
- расширение вен и сосудистых путей;
- застой крови, ухудшение кровотока;
- нарушения гормонального фона, способные привести к застоям в сосудах;
- травмы ног.
Чтобы перечисленные факторы не возникали, необходимо соблюдать простые правила:
- Соблюдать нормы физической активности. Организм не должен испытывать перегрузки, но и постоянное нахождение в сидячем положении также отрицательно сказывается на нем.
- Правильно питаться. Обилие углеводов и сахаров в пище приводит к подавлению функций спинного мозга, ответственного за кроветворение. В таких условиях он может начать неправильно вырабатывать кровяные тельца, что приводит к сгущению крови.
- Избегать ношения тесной обуви, одежды. Перетягивание нижних конечностей ведет к застоям крови. Если отек сохраняется в течение длительного периода, возможно образование тромба.
- Следить за артериальным и венозным давлением. Низкие показатели ведут к застоям крови, особенно в нижних конечностей. Для восстановления АД и поддержания на должном уровне могут понадобиться медикаментозные препараты либо компрессионные элементы одежды.
- Выполнять простую зарядку при наличии сидячего образа жизни. Ее этапы и особенности описаны ниже.
Это основные рекомендации, которые врачи дают людям, подверженным образованию тромбов. Существуют и другие профилактические меры, однако они назначаются уже на ранних стадиях заболевания, чтобы остановить его дальнейшее развитие.
Профилактика при отсутствии признаков тромбофлебита
Здоровый образ жизни – залог нормального состояния вен нижних конечностей. Здоровому человеку достаточно соблюдать всего несколько рекомендаций, чтобы предотвратить появление тромбоза.
Профилактика тромбоза глубоких вен нижних конечностей
Правильное питание
Употребляемая нами пища является источником витаминов и питательных элементов. Если баланс питательных элементов смещен, то организм, а в особенности система кроветворения, начинает работать неправильно. Это приводит к нарушениям кровообращения.
Чтобы избежать негативных последствий, нужно питаться согласно определенным нормам:
- Принимать витаминные комплексы либо употреблять достаточное количество полезных элементов через пищу. Витамины и минералы могут заменить низкокалорийные фрукты, орехи, молочные продукты.
- Остерегаться чрезмерного употребления витамина С, но и не отказываться от него. Аскорбиновая кислота, которая содержится в основном в цитрусах, влияет на формирование тромбоцитов. Именно они при нарушениях кровотока и кроветворения становятся основой тромба. Следует соблюдать среднесуточную норму витамина С исходя из возраста и пола.
- Употреблять минимум 1,5 литра жидкости в день. Суточная норма отличается в зависимости от возраста и веса пациента. Обезвоживание организма влечет за собой сгущение крови, а это повышает риск закупоривания сосудов и вен.
Особое внимание своему питанию следует уделять при наличии нарушений артериального давления или системы кроветворения. При таких заболеваниях обычно назначаются специальные препараты для профилактики тромбоэмболии или диета, которая компенсирует нарушения.
Физическая активность и зарядка
Ноги наиболее подвержены застоям крови, так как расположены далеко на периферии. Чтобы обеспечить правильную циркуляцию крови, необходимо периодически двигаться, не перегружая при этом ноги.
К застоям крови ведет нахождение в одном и том же положении, не важно, стоит человек или сидит. Поэтому тромбозу нижних конечностей подвержены как программисты, офисные работники, бухгалтеры, так и официанты, бармены, продавцы, служащие ресторанов быстрого питания и т.д.
Если вы постоянно находитесь в сидячем положении или проводите рабочий день на ногах в практически неизменном положении, необходимо выполнять зарядку. Специалисты рекомендуют делать ее каждые 2-3 часа.
Весь спектр упражнений займет не более 5 минут:
- Встаньте ровно, можно снять обувь, если она неудобная. В течение половины минуты быстро поднимайтесь на мыски и опускайтесь, раскачиваясь.
- Положение стоя. Пяткой левой ноги достать до правой ягодицы, затем пяткой правой ноги – до левой ягодицы. Каждый раз, подняв пятку, задерживать ее на несколько секунд. Повторять 5 раз для каждой ноги.
- Примите сидячее или лежачее положение, при котором ноги будут приподняты над телом. Можно положить их на стол или приподнять и согнуть в колени. Специалисты рекомендуют упираться пятками в стену при сгибе колен 40 градусов и задерживаться в таком положении на пару минут. Поднятие ног стимулирует отток крови, которая за время сидячей работы скапливается в нижних конечностях в избытке.
Также полезным будет просто походить, делая шаги со средней скоростью. В день необходимо уделять ходьбе как минимум 2 часа. Если весь рабочий день проходит на ногах, то, напротив, необходим отдых, но от зарядки отказываться нельзя.
Соблюдение режима дня
Сон физически необходим как всему организму, так и ногам. Во время сна человек принимает лежачее положение, благодаря чему улучшается кровообращение в ногах. Если сокращать время сна до минимума, вены не будут успевать восстановиться после ежедневной нагрузки на них.
В сутки необходимо спать 6-8 часов, детям – до 10 часов. Чем старше человек, тем меньше необходимый период сна.
Спать нужно в подходящих условиях. Спальное место должно обеспечивать свободу, чтобы ноги можно было полностью вытянуть.
В первые часы сна можно класть нижние конечности на валик или небольшую подушку, если в течение дня человек сталкивается с отеками по причине постоянного нахождения в одном положении. Однако проводить всю ночь с поднятыми ногами не стоит.
Профилактика на время беременности
Беременность – период, когда женщина наиболее подвержена заболеваниям вен нижних конечностей. Во время вынашивания плода часто возникают отеки, ноги постоянно болят, происходит ухудшение кровотока. Нужно уделить особое внимание профилактике тромбоза вен.
Главная рекомендация – отправиться к врачу, чтобы вместе с ним определить точную профилактику тромбоэмболии.
Выполнять вышеприведенную зарядку без разрешения врача опасно, ведь это может привести к повреждению эмбриона. Все физические упражнения, а также ежедневный рацион должны подбираться индивидуально.
При подозрениях на развитие тромбоза чаще всего назначают компрессионное белье. Оно обеспечивает правильный кровоток и поддерживает давление в нижних конечностях. Носить такое белье (чулки, носки) нужно в течение всего дня, а снимать перед сном.
Профилактические меры на ранних стадиях развития заболевания
Если заболевание уже было диагностировано, но еще находится на ранней стадии, можно избежать оперативного вмешательства, приступив к комплексной профилактике тромбоэмболии с использованием медикаментов.
По назначению врача применяются препараты на гепариновой основе. Лучше использовать местные варианты (гели и мази), так как они практически не обладают побочными эффектами и отличаются направленным действием.
Возможно ношение компрессионного белья низкой степени фиксации. Оно также подбирается врачом.
В период профилактики нужно употреблять большое количество воды, стараться не засиживаться на одном месте. Даже если в результате профилактических мер пациенту станет лучше, отказываться от последующего осмотра у врача нельзя.
Тромбофлебит нижних конечностей – это заболевание вен нижних конечностей воспалительного характера, сопровождающееся образованием в их просвете тромбов. В общей структуре заболеваемости тромбофлебитом на долю этой локализации патологии приходится примерно 80-90%, т. е. подавляющее большинство случаев.
Причины и факторы риска
Патогенез тромбофлебита нижних конечностей достаточно сложен. В нем одновременно принимает участие несколько факторов:
- повышение вязкости и свертывания крови;
- замедление венозного кровотока;
- повреждение клапанного аппарата или стенки вены;
- присоединение инфекции.
Наиболее опасен тромбофлебит глубоких вен нижних конечностей. Это связано с особенностями формирующегося здесь тромба. Резкое замедление тока крови в системе пораженной вены в сочетании с повышенной свертываемостью крови становится причиной формирования красного тромба, состоящего из эритроцитов, незначительного числа тромбоцитов и нитей фибрина. Тромб одной стороной прикрепляется к венозной стенке, в то время как его второй конец свободно плавает в просвете сосуда. При прогрессировании патологического процесса тромб может достигать значительной длины (20–25 см). Его головка в большинстве случаев зафиксирована возле венозного клапана, а хвост заполняет практически всю ветвь вены. Такой тромб называется флотирующим, т. е. плавающим.
В первые несколько суток от момента начала образования тромба его головка плохо фиксируется к стенке вены, поэтому существует высокий риск его отрыва, что, в свою очередь, может привести к развитию тромбоэмболии легочной артерии или ее крупных ветвей.
Через 5-6 дней от начала тромбообразования в пораженной вене начинается воспалительный процесс, который способствует лучшей адгезии кровяного сгустка к венозной стенке и снижению риска тромбоэмболических (вызванных отрывом тромба) осложнений.
При отсутствии адекватного лечения в 20% случаев заболевание заканчивается развитием тромбоэмболии легочной артерии, которая становится причиной летального исхода у 15-20% пациентов.
Предрасполагающими факторами к развитию тромбофлебита нижних конечностей являются:
- варикозное расширение вен нижних конечностей;
- венозный стаз, обусловленный длительным постельным режимом, опухолями малого таза, беременностью, излишней массой тела;
- местная или системная бактериальная инфекция;
- послеродовой период;
- прием пероральных контрацептивов (в этом случае особенно повышается риск у курящих женщин);
- злокачественные новообразования (рак поджелудочной железы, желудка, легких);
- синдром диссеминированного внутрисосудистого свертывания (ДВС-синдром);
- посттромбофлебитическая болезнь;
- травмы;
- хронические заболевания сердечно-сосудистой системы;
- состояние после аборта или иного хирургического вмешательства;
- длительная катетеризация вен;
- системные заболевания.
Формы заболевания
Тромбофлебит нижних конечностей в зависимости от активности воспалительного процесса подразделяется на острый, подострый и хронический. Хроническая форма заболевания протекает с периодически сменяющимися стадиями ремиссии и обострения, поэтому ее обычно называют хроническим рецидивирующим тромбофлебитом нижних конечностей.
В зависимости от локализации патологического процесса выделяют тромбофлебит поверхностных и глубоких вен нижних конечностей.
Признаки тромбофлебита нижних конечностей
Клиническая картина тромбофлебита нижних конечностей во многом определяется формой заболевания.
Острый тромбофлебит поверхностных вен нижних конечностей возникает внезапно. У пациента резко повышается температура тела до 38-39 °С, что сопровождается сильным ознобом (сотрясающий озноб). При пальпации пораженная вена прощупывается как болезненный тяж. Кожные покровы над ним нередко гиперемированы. Подкожная клетчатка может быть уплотненной, что объясняется формированием инфильтрата. Паховые лимфатические узлы на стороне поражения увеличиваются.
Симптомы тромбофлебита нижних конечностей в подострой форме менее выражены. Заболевание обычно протекает при нормальной температуре тела (у некоторых пациентов в первые дни может отмечаться незначительная лихорадка до 38 °С). Общее состояние страдает мало. При ходьбе возникают умеренно выраженные болезненные ощущения, но местных признаков активного воспалительного процесса нет.
Рецидивирующая хроническая форма тромбофлебита поверхностных вен нижних конечностей характеризуется обострением ранее возникшего воспалительного процесса или втягиванием в него новых участков венозного русла, т. е. имеет признаки, схожие с острым или подострым течением. В период ремиссии симптоматика отсутствует.
При хроническом рецидивирующем тромбофлебите нижних конечностей необходимо ежеквартально проводить превентивное лечение заболевания, направленное на предотвращение возникновения обострений.
Тромбофлебит глубоких вен нижних конечностей у половины пациентов протекает бессимптомно. Заболевание диагностируется, как правило, ретроспективно уже после развития тромбоэмболических осложнений, чаще всего тромбоэмболии легочной артерии.
У остальных 50% пациентов признаками заболевания являются:
- чувство тяжести в ногах;
- стойкий отек голени или всей пораженной нижней конечности;
- распирающие боли в области икроножной мышцы;
- повышение температуры тела до 39-40 °С (при острой форме тромбофлебита нижних конечностей);
- симптом Пратта (глянцевая кожа над очагом поражения, на которой отчетливо виден рисунок подкожной венозной сети);
- симптом Пайра (боль распространяется по внутренней поверхности бедра, голени и стопы);
- симптом Хоманса (тыльное сгибание стопы сопровождается возникновением боли в икроножной мышце);
- симптом Лювенберга (сдавление голени манжетой от тонометра при создании давления 80–100 мм ртутного столба приводит к возникновению болевых ощущений, хотя в норме они должны появляться при давлении свыше150–180 мм ртутного столба);
- пораженная конечность на ощупь холоднее, чем здоровая.
Диагностика
Диагностика тромбофлебита поверхностных вен нижних конечностей не представляет сложностей и осуществляется на основании данных характерной клинической картины заболевания, объективного осмотра пациента и результатов лабораторных анализов (в крови отмечается увеличение протромбинового индекса, лейкоцитоз со сдвигом лейкоцитарной формулы влево, повышение СОЭ).
Тромбофлебит поверхностных вен нижних конечностей дифференцируют с лимфангитом и рожистым воспалением.
Наиболее точным диагностическим методом тромбофлебита глубоких вен нижних конечностей является дистальная восходящая флебография. Рентгенконтрастное вещество водят инъекционным путем в одну из подкожных вен стопы ниже уровня жгута, сдавливающего лодыжку, что позволяет перенаправить его в систему глубоких вен, после чего проводят рентгенографию.
Также в диагностике этой формы заболевания применяют следующие методы инструментальной диагностики:
- допплеровское ультразвуковое исследование;
- импедансная плетизмография;
- сканирование с использованием фибриногена, меченного изотопом йода 125.
В общей структуре заболеваемости тромбофлебитом на долю нижних конечностей приходится примерно 80-90%, т. е. подавляющее большинство случаев.
Тромбофлебит глубоких вен нижних конечностей необходимо дифференцировать с целым рядом других заболеваний и, прежде всего, с целлюлитом (воспалением подкожной клетчатки), разрывом синовиальной кисты (кисты Бейкера), лимфатическим отеком (лимфедемой), сдавлением вены извне увеличенными лимфатическими узлами или опухолью, разрывом или растяжением мышц.
Лечение тромбофлебита нижних конечностей
Лечение тромбофлебита нижних конечностей может быть хирургическим или консервативным.
Консервативная терапия начинается с обеспечения пациенту постельного режима на 7-10 суток. Пораженную конечность бинтуют эластичными бинтами, что позволяет снизить риск отрыва тромба и развития тромбоэмболических осложнений и придают ей возвышенное положение. Длительное сохранение постельного режима неоправданно. Как только воспаление начнет стихать, двигательный режим пациента следует постепенно расширять. Физическая активность и мышечные сокращения улучшают отток крови по глубоким венам, снижают риск образования новых тромбов.
Местно применяют компрессы с мазью Вишневского, полуспиртовые или масляные компрессы, а также мази и гели с гепарином.
С противовоспалительной целью назначают нестероидные противовоспалительные средства. При высокой температуре тела или развитии гнойного тромбофлебита нижних конечностей применяют антибиотики широкого спектра действия.
Фибринолитические препараты могут использоваться только на самых ранних стадиях заболевания, которые обычно остаются не диагностированными. В дальнейшем попытки тромболиза могут привести к фрагментации тромба и развитию тромбоэмболии легочной артерии. Поэтому проведение тромболитической терапии у пациентов без установленных кава-фильтров противопоказано.
В схеме консервативного лечения тромбофлебита нижних конечностей немалая роль отводится антикоагулянтным препаратам, которые уменьшают время свертывания крови и тем самым снижают риск образования тромбов. Если у пациента имеются противопоказания к назначению антикоагулянтов (открытая форма туберкулеза, язвенная болезнь желудка и двенадцатиперстной кишки, свежие раны, геморрагические диатезы), то в этом случае возможно проведение гирудотерапии (лечения пиявками).
Для улучшения состояния венозной стенки у пациентов с тромбофлебитом нижних конечностей применяют венотонизирующие средства.
При образовании флотирующего тромба, сопровождающегося высоким риском развития тромбоэмболических осложнений, показано проведение хирургического вмешательства, целью которого является установка кава-фильтра в нижнюю полую вену на уровне ниже почечных вен.
При гнойном тромбофлебите поверхностных вен нижних конечностей выполняют операцию Троянова – Тренделенбурга.
После стихания острых воспалительных явлений пациентов с тромбофлебитом нижних конечностей направляют на санаторно-курортное лечение (показана аппаратная физиотерапия, радоновые или сероводородные ванны).
Диета при тромбофлебите нижних конечностей
Правильно организованное питание создает необходимые предпосылки для улучшения состояния пациентов, сокращает сроки реабилитации, снижает риск рецидивов. Диета при тромбофлебите нижних конечностей должна обеспечивать:
- укрепление венозной стенки;
- улучшение реологических свойств крови;
- нормализацию массы тела пациента.
Пациентам необходимо тщательно соблюдать водный режим. В течение суток следует выпивать не менее двух литров жидкости. Особенно важно контролировать объем потребляемой жидкости в жаркую погоду, так как обильное потоотделение может стать причиной сгущения крови.
В рационе пациентов с тромбофлебитом нижних конечностей в достаточном количестве должны быть включены свежие овощи и фрукты, которые обеспечивают организм витаминами и микроэлементами, что необходимо для улучшения тонуса венозной стенки.
Диета при тромбофлебите нижних конечностей включает в себя следующие продукты:
- растительные масла холодного отжима (желательно ежедневно для заправки салатов использовать льняное масло);
- бахчевые культуры (арбуз, дыня, тыква);
- имбирь, корица;
- лук, чеснок, листовые овощи;
- какао, шоколад;
- все виды фруктов, ягоды;
- жирные сорта морской рыбы.
Особенно полезны при тромбофлебите нижних конечностей вишня и малина. Они содержат природное противовоспалительное вещество – салициловую кислоту, которая не только снижает активность воспалительного процесса, но и оказывает некоторое антикоагулянтное действие.
Возможные последствия и осложнения
Осложнениями тромбофлебита нижних конечностей могут стать:
- тромбоэмболия легочной артерии;
- стрептококковый лимфангит;
- белая болевая флегмазия (связана со спазмом идущей рядом с тромбированной веной артерии);
- синяя болевая флегмазия (развивается в пораженной конечности при практически полной блокировке венозного оттока крови);
- гнойное расплавление тромба, что может привести к формированию абсцесса, флегмоны, а в тяжелых случаях стать причиной сепсиса.
Прогноз
Прогноз при тромбофлебите нижних конечностей серьезен. При отсутствии адекватного лечения в 20% случаев заболевание заканчивается развитием тромбоэмболии легочной артерии, которая становится причиной летального исхода у 15-20% пациентов. В тоже время своевременное назначение антикоагулянтной терапии позволяет снизить смертность более чем в 10 раз.
Полезны при тромбофлебите нижних конечностей вишня и малина. Они содержат природное противовоспалительное вещество – салициловую кислоту, которая снижает активность воспалительного процесса и оказывает некоторое антикоагулянтное действие.
Профилактика
Профилактика развития тромбофлебита нижних конечностей должна включать следующие мероприятия:
- своевременное выявление и активное лечение заболеваний вен нижних конечностей;
- санация очагов хронической инфекции в организме пациента;
- ранняя активизация пациентов в послеоперационном периоде;
- активный образ жизни;
- правильное питание;
- соблюдение водного режима;
- обязательное ношение компрессионного трикотажа при варикозной болезни вен нижних конечностей.
При хроническом рецидивирующем тромбофлебите нижних конечностей необходимо ежеквартально проводить превентивное лечение заболевания, направленное на предотвращение возникновения обострений. Оно должно включать в себя назначение флебопротекторов и физиотерапевтические процедуры (лазерную, магнитную терапию).
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