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Тромбофлебит и тромбоз отличие

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17 августа 2019

Венозные патологии являются результатом серьезного нарушения функционирования работы сердечно-сосудистой системы. Многие считают их единым целым, но это не так. Человеку, имеющему предрасположенность к сосудистым патологиям, необходимо знать, чем тромбофлебит отличается от варикозного расширения вен.

На самом деле эти патологии объединяют процессы, негативно влияющие на организм в целом и значительно снижающие качество жизни человека. Каждое из них имеет свои характерные причины возникновения, симптомы и специфические свойства.

Происхождение варикоза и тромбофлебита разное.

Варикоз возникает вследствие растяжения, истончения и снижения тонуса стенок сосудов. В результате чего кровеносные каналы становятся хрупкими, они начинают растягиваться, воспаляются и появляются под кожей в виде изогнутых вен или узелков. Что внешне выглядит совсем неэстетично.

Воспаленные каналы не могут в полной мере выполнять свои функции, поэтому происходит нарушение циркуляции и застой крови, что повышает внутриартериальное давление.

Избавиться от полностью от варикоза невозможно. Но, если своевременно начать эффективное лечение, недуг можно приостановить.

Тромбофлебит — распространенное осложнение варикоза. При данной патологии вены находятся в воспаленном состоянии, что приводит к образованию кровяных сгустков. Затрагивает в основном поражение варикозом капилляры, при этом нормальный кровоток нарушается. Является одной из наиболее опасных болезней для жизни человека. Как правило, локализуется в областях лодыжек, голени и бедер и носит угрожающий характер.

Этиологию имеют одинаковую, отличаются же местам локализации, симптоматикой и соответственно методами лечения.

Место локализации — глубокие венозные сосуды. Тромбофлебит же поражает вены, находящиеся близко к поверхности.

Причины

Причины возникновения могут быть разные. Способствуют различные факторы, как наследственные, так и приобретенные.

Варикоз

  • роды и беременность;
  • неудобная обувь, высокие каблуки;
  • хронические патологии;
  • алкоголь, табак, вредная пища;
  • рацион включает в себя недостаточно клетчатки;
  • низкая физическая активность;
  • продолжительно нахождение в стоячем положении;
  • дисбаланс на гормональном уровне;
  • избыточный вес, ожирение.

Не редко возникает у людей, имеющих родственников с такой патологией. Каждое из состояний оказывает дополнительное неблагоприятное воздействие на кровеносные каналы.

Тромбофлебит

Первыми признаками является наличие варикоза. Обычно это его последняя стадия. Но это не единственная причина возникновения, их существует немало.

Причины:

  • бактериальное, респираторное или инфекционное заражение — бактерии проникают в венозное русло, что в дальнейшем ведет за собой их размножение, в последствии чего возникает воспаление;
  • ведение лекарств внутривенно при помощи катетера — вокруг места инъекции скапливаются вредные микроорганизмы, которые способствуют образованию сгустков крови;
  • роды и травмы различных степеней — повреждение тканей и сосудов приводит к появлению тромбов;
  • доброкачественные и злокачественные опухоли;
  • гормональные препараты — в результате их применения меняется состав крови, образуется склонность к воспалительным процессам;
  • обезвожимость организма — кровь приобретает густую консистенцию;
  • наследственная предрасположенность;
  • замедление или нарушение циркуляции крови — возникает после длительного лежачего состояния;
  • избыточный вес.

Наиболее распространенной причиной является варикозное расширение вен, которое провоцирует непроходимость крови по венозному руслу. Тем самым влечет за собой воспаление.

Механизмы развития

Развитие этих заболеваний происходит по определенным механизмам. Главное распознать их на первых стадиях появления.

Варикоз

Появление можно определить по припухлости на теле, которая возникает в месте венозного русла. При этом ощущается усталость или судороги мышц нижних конечностей.

Далее кровь начинает скапливаться на нижних участках ног, процесс сопровождается появлением в проблемных участках бурых или темно — коричневых пятен.

В проблемных местах застаивается кровь, что приводит к нарушению процесса правильной циркуляции.

В процессе кровеносные каналы приобретают деформированный вид. Места локализации — задняя поверхность коленных суставов, икроножные мышцы.

Тромбофлебит

В процессе возникновения имеет место инфекционные или бактериологические факторы, провоцирующие воспаление.

Развитие непосредственно зависит от общего состояния организма, предшествующие или сопутствующие заболевания, реже лечебные мероприятия.

Главной причиной развития является прогрессирующий варикоз. Кроме того, ко всем факторам присоединяются спазмы артериальных и венозных сосудов.

Клиническая картина поверхностных и глубоких кровеносных каналов имеет значительные отличия.

Чем опасны

Варикоз

Развивающееся заболевание уже не пройдет, далее оно будет только прогрессировать, если не выявить его на ранних стадиях и не применять методы эффективного лечения.

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В дальнейшем может вызвать серьезные осложнения:

  • экзема, дерматит;
  • трофические язв;
  • острый тромбофлебит.

Осложнением часто может быть телеангиэктазия. Состояние характеризуется появлением венозных звездочек и сеточек. Одновременно сопрягается с усталостью ног, отечностью и онемением.

Тромбофлебит

Опасность определяется 3 основными факторами риска.

  • воспалительные процессы протекают в сосудистой стенке;
  • кровоток значительно замедляется;
  • свертываемость крови повышается.

Появление одного из факторов риска, способствует быстрому прогрессированию болезни.

Симптомы

На разных стадиях симптоматика может отличаться. Этому нужно уделить особое внимание.

Варикозное расширение вен

На стадии появления не имеет ярко выраженных симптомов кроме внешних дефектов. Под кожей становятся заметны кровеносные каналы узловатого вида, имеющие темно — синий оттенок.

Для патологии характерно внезапное появление венозных каналов. Особенно часто их появление может быть спровоцировано жаркой погодой, физическими нагрузками, продолжительным нахождением в стоячем положении.

  • заметное утолщение вен, которое образуется в положении стоя, когда человек ложится, утолщение становится незаметным;
  • голень и стопы отекают днем, опухоль спадает утром;
  • кожа в проблемных местах теряет эластичность, темнеет, приобретает блестящий оттенок.

На поздних стадиях появляется быстрая утомляемость, усталость, судороги, жжение в конечностях.

Тромбофлебит

На первых стадиях состояние пациента считается удовлетворительным. Далее усиливается процесс появления симптомов, по мере распространения воспаления.

  • при ходьбе и продолжительном стоянии появляются боли;
  • на месте образования тромбов кожный покров меняет свой оттенок на темно — коричневый или бурый;
  • температура тела поднимается до 38 градусов;
  • конечности отекают;
  • в конечностях появляется тупая боль при минимальной нагрузке на пораженную конечность.

Развивается стремительней. У пациента замечается озноб и дальнейшее повышение температуры тела, воспаление лимфатических узлов, пораженный участок конечности становится горячим на ощупь.

Диагностика

На ранних стадиях применяется комплексное обследование пациента на основании его жалоб.

В комплекс входит инструментальное и лабораторное исследования, а также визуальный осмотр и пальпация конечности.

Наиболее распространенные методы диагностирования:

  • ангиография — определяет наличие тромбов;
  • допплерография — оценивает состояние клапанов глубоких и поверхностных вен, характер кровотока;
  • ультразвуковое исследование — венозная система просматривается в срезе.

Ультразвуковое дуплексное сканирование применяется в обязательном порядке для сосудистых заболеваний. Она считается одной из эффективных в этом направлении.

Исследование совершенно безвредно для организма. Процедура не требует особой подготовки к проведению, неинвазивна.

Методика имеет один минус — проводится стоя. В некоторых случаях это может быть проблематично для пациента. Продолжительность обследования составляет 30-40 минут.

Терапия

Чаще всего методы лечения выбираются с использованием лекарственной терапии. Во время лечения сосудистых патологий двигательная активность не ограничена.

Своевременные способы лечения способны предотвратить развитие заболеваний.

Ранее эффективно использовались только хирургические методы. Сейчас преобладают малоинвазивные или безоперационные.

Все методы являются безопасными и эффективными при лечении сосудистых патологий.

Основные терапевтические мероприятия:

  • устранение источников возникновения тромбов;
  • восстановление циркуляции крови в конечностях;
  • устранение главных симптомов патологии;
  • полное восстановление функций конечностей.

Терапия применяется системная, направленная на использование нескольких методик.

  • лечебная гимнастика и массаж;
  • физиотерапия и лечение пиявками;
  • диета;
  • медикаментозные препараты;
  • хирургическое вмешательство.

Профилактика

Профилактические мероприятия необходимо проводить не только когда болезнь застала врасплох. С их помощью можно своевременно предотвратить ее появление.

Достаточно будет воспользоваться некоторыми рекомендациями специалистов.

Рекомендации по профилактике:

  • носить только удобную качественную обувь;
  • отказаться от вредных привычек, таких, как: переедание, употребление алкоголя и курения;
  • стараться не стоять долгое время;
  • сидеть нужно в правильном положении и недолго;
  • всегда помнить, что ноги должны регулярно отдыхать;
  • полезно использовать контрастные ванночки и массаж ног.

При появлении первых признаков недугов необходимо обратиться к специалисту флебологу. И ни в коем случае не прибегать к самолечению.

Итоги. Чем отличаются

Ключевые отличия варикоза и тромбофлебита это патологический характер течения заболеваний. Первое возникает в результате деформации и истончения стенок сосудов. Второе протекает с характерными воспалительными процессами, которые провоцируются патогенной микрофлорой извне.

У многих пациентов сложилось мнение, что тромбоз, тромбофлебит и флеботромбоз между собой ничем не отличаются. Но это разные болезни, хоть и со схожей этиологией. Рассмотрим, в чем разница между тромбозом и тромбофлебитом.

Характеристика заболеваний (краткое описание)

Многие пациенты, переписываясь на форумах, путают названия патологий, симптоматика и лечение которых заметно отличаются. Во избежании путаницы, следует знать, чем отличается тромбофлебит от тромбоза нижних конечностей.

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Тромбофлебит

Воспалительный процесс сосудистых стенок, который приводит к формированию внутри сгустков крови, называется тромбофлебитом. Обычно патология возникает в результате недолеченного варикоза. Для болезни характерны частые рецидивы, которые без адекватного лечения могут вызвать перекрытие тромбом легочной артерии. Иногда на фоне тромбофлебита развивается заражение крови. К характеристикам заболевания относится:

  • Поражение исключительно поверхностных сосудов, находящихся под эпителием;
  • Образование тромбов происходит в пораженном, деформированном ранее сосуде;
  • Диагностируется проще, благодаря яркой симптоматике.

Тромбоз

Тромбоз – более опасное заболевание. Обычно патология развивается у больных, которые потеряли возможность самостоятельного передвижения. К его последствиям относится эмболия ветвей легочной артерии. Для тромбоза характерны:

  • Возможность поражения глубокого сосуда;
  • Тромбообразование происходит на здоровой области, не задевая воспаленную ранее;
  • Болезнь возникает в результате нарушений коагуляционных свойств крови. Не важно какое состояние имеется у вен;
  • Не наблюдается воспалений. В начале развития симптоматика отсутствует, что усложняет диагностирование болезни.

Флеботромбоз

Тромбофлебит и флеботромбоз диагностируются на фоне не вылеченного варикоза. Воспаление замедляет скорость кровотока, что провоцирует образование тромба. Флеботромбоз отличается отсутствием симптоматики в начале развития.

Обычно патология возникает после оперативного вмешательства на глубокие вены тазовой области или нижних конечностей. В первые 4 дня формирования тромб отличается слабой фиксацией к стенкам сосудов. Поэтому имеется риск развития эмболии легочной артерии. Флеботромбоз вен имеет некоторые особенности:

  • Наличие поврежденных ранее стенок сосудов без разрывов. В результате чего происходит торможение кровотока, нарастание объема тромбоцитов. Этот процесс приводит к образованию тромбов;
  • Нарушенная свертываемость крови, вызываемая гиперкоагуляцией. Этот процесс запускается из-за сбоев организма;
  • Нарушение силы кровотока.

Чем отличаются патологии

Хотя у патологий похожая этиология, имеется отличие тромбоза от тромбофлебита в симптоматике и особенности терапии.

Симптомы

Патологии отличаются в своем проявлении. Это связано с тем, какие сосуды поражены, глубокие или поверхностные, а также присутствием воспалительного процесса. Из-за того, что тромбоз поражает глубокие вены, проявляются следующие симптомы:

  • Резкие боли в нижних конечностях;
  • Дискомфорт после активных физических нагрузок;
  • По мере развития заболевания отмечается отеки. В вечернее время пациент страдает от ощущения распирания и тяжести;
  • В месте поражения тромбом кожа характеризуется синюшным оттенком, блеском;
  • Температура больной ноги на 2-3 градуса выше температуры тела;
  • Ощущение пульсации пораженной вены.

В результате воспалительного процесса, происходящего в сосудах, тромбофлебит имеет следующие симптомы:

  • В месте расположения тромба отмечаются тянущие боли;
  • Уплотнения на участке пораженной вены;
  • Отеки;
  • Затруднение движений;
  • Покраснение кожи в области вены;
  • Наличие припухлости;
  • Проникновение воспаления в мягкие ткани.

Тромбоз отличается от тромбофлебита пульсацией пораженной вены.

Терапия

Лечение тромбоза и тромбофлебита имеет свои отличия. Терапия тромбофлебита характеризуется:

  • Отсутствием госпитализации. Лечение может проводиться амбулаторно;
  • Необходимостью соблюдать постельный режим в течение 2 дней. Нога должна находиться в приподнятом состоянии для улучшения кровотока;
  • Позволяет облегчить состояние теплый компресс, наложение аппликаций с Димексидом;
  • Прием нестероидных противовоспалительных средств;
  • Использование противовоспалительных мазей.

Нельзя затягивать лечение тромбофлебита. Воспалительный процесс легко переходит на глубокие вены с поверхностных.

К лечению тромбоза необходимо подойти более внимательно. Он имеет следующие особенности:

  • Проводится терапия в условиях стационара;
  • Необходимо проведение инъекций Гепарином. Это позволит не вызвать дальнейшее увеличение образовавшегося тромба, исключает формирование новых сгустков;
  • Важно следить за показателями крови;
  • Возможно проведение оперативного лечения, во время которого происходит устранение сгустков крови, перекрывающих сосуд. Если имеется необходимость, то производится установка фильтра в нижнем полом сосуде.

Тромбофлебит и тромбоз схожи патогенезом. Основное отличие заключается в том, какие вены подверглись поражению, а также наличием воспалительного процесса.

Тромбофлебит и флеботромбоз часто считают синонимами, названиями одного и того же заболевания. На самом деле это не так. Несмотря на отчасти схожую этиологию, это разные патологии. Так в чем разница тромбоза и тромбофлебита? Какие факторы влияют на их развитие? Какими симптомами проявляется поражение вен в первом и во втором случае?

Основным отличием тромбоза от тромбофлебита считается место локализации. Тромбофлебит обычно развивается в поверхностных венозных сосудах, в то время как тромбоз чаще поражает глубокие вены. Кроме того, при тромбофлебите тромбы образуются в деформированных сосудах, в то время как тромбоз может возникнуть в неизмененных, нормальных венах.

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Причиной патологических изменений вен, как правило, становится варикозное расширение, повреждение внутренних стенок кровеносного сосуда из-за травмы, инфекции (местной, общей) и т.д. В результате повреждений ток крови по вене нарушается, замедляется. В итоге это приводит к воспалению сосуда, образованию в нем плотных кровяных сгустков, ещё больше мешающих прохождению крови по венам, воспалению мягких тканей нижних или верхних конечностей.

Тромбоз считается гораздо более опасным заболеванием. Для него, как и для тромбофлебита, характерно образование в венах тромбов, препятствующих нормальному прохождению крови по сосудам. Однако флеботромбоз глубоких вен, в первую очередь, возникает из-за нарушения коагуляционных свойств самой крови, а не повреждения сосудов.

Тромбоз и тромбофлебит в основном различаются тем, что первый может возникнуть в невоспаленной вене. Этим объясняется частое отсутствие или малая выраженость симптомов патологии.

Что касается тромбофлебита, выявить его намного проще. Заболевание протекает на фоне воспалительного процесса в вене, поэтому практически всегда сопровождается специфическими для воспаления местными и общими явлениями.

Существенных различий в этиологии заболеваний нет. Образованию тромбов в обоих случаях способствуют множественные факторы. Вне зависимости от локализации патологии, и тромбоз, и тромбофлебит возникают на фоне:

  • Варикозной болезни.
  • Заболевания сосудов.
  • Повреждения венозных стенок.
  • Патологически измененного состава крови.
  • Повышенной свертываемости крови.
  • Замедленного кровотока.

В свою очередь причинами развития подобных состояний становятся:

  • Эндокринные заболевания.
  • Онкологические заболевания.
  • Хронические болезни сердечно-сосудистой системы.
  • Общие и местные инфекционные заболевания.
  • Болезни крови.
  • Нейротрофические расстройства.
  • Аллергические процессы.
  • Внутривенные инъекции, при которых происходит повреждение кровеносного сосуда.
  • Катетеризация вен в течение длительного времени.
  • Операции, проводившиеся в области тазобедренного сустава, тазового дна, нижней части брюшной полости.
  • Местные воспалительные, гнойные процессы.
  • Неправильное питание.
  • Вредные привычки.
  • Нарушение процессов общего метаболизма.
  • Сбои гормональной регуляции.
  • Аборты.
  • Беременность, роды.

Чаще всего тромбофлебит развивается в деформированных венах. Деформация сосудов происходит из-за избыточных нагрузок на тазобедренные суставы, ноги (поднятие тяжестей, длительное нахождение на ногах и др.). Соответственно, в зоне риска находятся люди активные, подвергающиеся чрезмерным физическим нагрузкам.

Но и отсутствие движения также вредно для здоровья. Малоподвижный образ жизни, сидячая работа приводят к формированию явлений застоя крови в венах нижних конечностей. Следствием таких состояний становится нарушение нормального кровотока, расширение, деформация вен, образование в их просветах сгустков крови, тромбов.

Основным признаком флеботромбоза является внезапно вспыхивающая боль в пораженной конечности. Болевые ощущения не постоянны, а усиливаются нагрузках на ноги (ходьба, поднятие тяжестей, длительное стояние).

Далее возникает отечность тканей. Появляется чувство тяжести, распирания ноги. Кожа вокруг тромбированного участка вены цианотична (синюшный оттенок), сильно натянута, блестит. Расширенные напряженные вены становятся заметными через несколько дней с момента образования тромба.

Температура конечности повышается на 1,5-2 градуса. Возможно повышение общей температуры тела. Пульсация артерий больной конечности может быть не нарушена, но чаще всего чувствуется слабо либо отсутствует полностью.

При тромбозе икроножных или только глубоких вен клиническая картина заболевания стерта. В таких случаях единственным симптомом возникшей патологии служит незначительная отечность в области голеностопного сустава и боль в икроножной мышце, возникающая при физическом напряжении.

При остром тромбофлебите поверхностных вен первыми симптомами становятся болевые ощущения тянущего характера. Боль локализуется в области тромбированного участка кровеносного сосуда. Пораженная вена уплотнена, выступает над поверхностью кожи. В отличие от тромбоза пульсация артерий и температура конечности остается нормальной.

Наблюдается отечность больной ноги, двигательные функции затруднены. По ходу тромбированной вены наблюдается припухлость, инфильтрация, гиперемия мягких тканей. Кожа приобретает синюшный оттенок. Варикозно расширенные вены напряжены, при пальпации пораженных участков возникает сильная боль.

Специфические признаки тромбофлебита нередко сопровождаются воспалительной симптоматикой:

  1. 1. ухудшение самочувствия;
  2. 2. общая слабость;
  3. 3. озноб;
  4. 4. головная боль;
  5. 5. повышение температуры тела (в тяжелых случаях до 39 градусов).

Тромбофлебит глубоких вен проявляется равномерной отечностью стопы и голени. Боль тупая, резко усиливается при нажатии на икроножную мышцу, при сгибании стопы. Ходить больной может с трудом. Иногда боль так сильна, что человек не может ступить на ногу.

При появлении любых вышеописанных симптомов необходимо обязательно получить консультацию флеболога. Пройти медицинское обследование и в случае выявления тромбофлебита или тромбоза немедленно начать адекватное лечение под руководством врача.

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