Тромбофлебит представляет собой сосудистое заболевание, которое проявляется воспалительным процессом на стенках вен и капилляров, которое приводит к образованию сгустков и тромбов. Когда они перекрывают просвет сосуда, нарушается кровообращение, что в свою очередь может привести к множеству негативных последствий. Заболевание может проявлять себя в нескольких формах – острой и хронической.
Почему возникает и чем опасен?
Тромбофлебит может быть гнойным и негнойным
Локализоваться патология может в любой части тела, но чаще всего данное явление поражает нижние конечности. Самое страшное то, что тромб может оторваться и полностью перекрыть кровеносный сосуд, что приводит к инсультам, инфарктам или летальному исходу. Учитывая эти последствия, рекомендуется своевременно реагировать на симптомы и лечить тромбофлебит, чтобы не усугублять ситуацию.
Кроме этого, говоря об опасности сосудистых заболеваний, нельзя не отметить, что это первый шаг к сердечным заболеваниям. Ишемия, аритмия, стенокардия и сердечная недостаточность чаще всего развивается из-за нарушений кровообращения и целостности сосудов.
По статистике тромбофлебитом болеют чаще женщины, чем мужчины.
Это связано с тем, что у представительниц прекрасного пола больше рисков повредить кровеносные сосуды посредством ношения обуви на высоких каблуках, что приводит к нарушению циркуляции крови. Также беременность является предрасположенностью к развитию сосудистых патологий.
Существует множество причин для развития тромбофлебита. Рассмотрим самые распространенные:
- застой в венах и капиллярах – это первый шаг к развитию тромбофлебита. Возникать он может из-за различных факторов. Чаще провокатором к кровяному застою выступают другие заболевания, например, варикозное расширение вен
- образ жизни напрямую влияет на состояние здоровья. При чрезмерной физической активности и поднятии тяжестей кровеносные сосуды могут повреждаться (у спортсменов, грузчиков). Также и наоборот, малоподвижный образ приводит к застоям. Из-за этого возникает налипание тромбоцитов друг на друга и появляется тромб
- гиперкоагуляция – это явление, которое связано с высокой свертываемостью. Оно возникает из-за индивидуальных особенностей организма, при наличии отклонений, которые возникают из-за патологий, влияющих на свертываемость. Также гиперкоагуляция может передаваться на генетическом уровне от родителей
- другие причины – обезвоживание, употребление спиртных напитков, курение, наркотики, наличие хронических заболеваний, неправильное питание, употребление медикаментозных средств (контрацептивов, антидепрессантов или транквилизаторов);
- медицинские факторы: длительная катетеризация, оперативное вмешательство. Именно из-за этого при любой операции пациенту туго перевязывают нижние конечности эластичным бинтом, во избежание деформации сосудов и возникновения тромбофлебита
Причину установить сможет специалист на основе результатов анализов. Это очень важно при лечении. В первую очередь необходимо искоренить саму причину, а потом уже лечить симптоматику.
Основные симптомы патологии
Патология характеризуется болезненностью, отеком и уплотнением по ходу расширенной вены
Точный диагноз должен поставить специалист (обращаться с данным заболеванием нужно к флебологу или сосудистому хирургу). Заболевание на начальной стадии проявляет себя, как усталость конечностей. По этой причине не все люди сразу реагируют на развитие тромбофлебита, так как списывают дискомфорт на усталость.
При поражении вены возникает жжение и боль, которая с каждым днем будет нарастать. При воспалительном процессе возникает температура 37-38 градусов, которая не сбивается обычными жаропонижающими средствами. Точнее говоря, сбивается, но через несколько часов опять повышается, так как воспаление никуда не девается.
Второй и один их самых явных признаков болезни – это появление деформации сосудов, из-за которой они выпирают из-под кожи. При благоприятном течение патологии, они сами исчезают, если врач назначит «правильное» лечение. Курс зависит от состояния здоровья и индивидуальных особенностей организма. Одним пациентам достаточно двух недель, чтобы вернуть конечностям прежний вид, а другим нужно лечиться около трех месяцев.
Если тромбофлебит развивается с осложнениям, то он поражает более крупные сосуды.
Риск глубокого тромбофлебита увеличивается при ослабленной сосудистой системе и наличии варикозного расширения вен. Поражение крупных сосудов называется флеботромбоз. Его симптомы могут быть самыми разнообразными и зависят по большей части от локализации болезни.
Больше информации о тромбофлебите можно узнать из видео:
Например, в стандартном случае, при поражении нижних конечностей возникают следующие симптомы:
- рельефность кожи, вызванная деформацией вены
- отечность конечностей (по вечерам) или лица (по утрам)
- повышение температуры тела
- сильные боли не только в месте локализации, но и по всей ноге
Кроме этого могут возникать симптомы, связанные с нарушением кровообращения и кислородной недостаточностью, которая возникает из-за нарушения циркуляции. У больных часто развивается анемия (недостаток в крови белка гемоглобина). При этом кожа теряет здоровый цвет и становится более бледной, волосы, ногти и зубы начинают ломаться, так как теряют естественную крепость.
Сердечные заболевания – это сопутствующие патологии, возникающие из-за проблем с сосудами, поэтому часто возникают скачка артериального давления, развивается ишемическая болезнь или сердечная недостаточность.
Лекарства и рецепты от недуга
При выраженном местном воспалении назначают антибиотики
Сразу нужно отметить, что способ лечения должен выбирать и назначать специалист на основе анализов и клинической картины. Как правило, флеболог назначает ряд препаратов, действие которых направлено на укрепление стенок сосудов и разжижение крови, что способствует восстановлению кровообращения.
Кроме этого, можно самостоятельно, в домашних условиях использовать средства народной медицины. Главное помнить, что рецепты наших предков не могут стать основной терапией, только лишь вспомогательными методами для усиления эффекта.
В случае начальной стадии заболевания, можно обойтись консервативным лечением тромбофлебита. При этом врач в индивидуальном порядке подбирает комплексное лечение:
- препараты для разжижения крови
- лекарственные средства, снижающие свертываемость
- препараты внутреннего и внешнего действия для укрепления сосудистой системы
- противовоспалительные лекарства
Наряду с таблетками, кремами и различными инъекциями должен быть активный образ жизни и правильное питание. Нельзя при лечении сосудистой системы соблюдать постельный режим. Наоборот – хоть небольшая активность помогает привести вены и капилляры в тонус, что положительно влияет на сосудистую систему.
Методы народной медицины включают в себя средства, приготовленные на натуральных компонентах такого же воздействия.
Незаменимым средством для сосудов во время тромбофлебита, варикоза и прочих сосудистых патология являются следующие:
- листья и плоды конского каштана и грецкого ореха – они способствуют укреплению венозной стенки
- экстракт пиявки является производным гирудина, которые незаменим для очищения и разжижения крови
- листья сирени способствуют снятию воспаления
- отвары трав из череды, календулы, зверобоя и кориандра помогут изнутри воздействовать на воспалительный процесс, возникший из-за поражения сосуда
Эти средства – это лишь малейшая часть всех, помогающих при тромбофлебите. Главное перед выбором рецепта убедиться в отсутствии индивидуальной непереносимости или противопоказаний.
Прогнозы сосудистых заболеваний
Тромбофлебит может стать причиной венозной гангрены
Сосудистые заболевания реально вылечить консервативным методом исключительно на ранней стадии. В запущенном состоянии никакие лекарства не помогут, и, чаще всего, требуется хирургическое вмешательство. При правильном лечении и своевременном обращении прогнозы обычно радостные.
Если же игнорировать симптомы, о которых буквально «кричит» вам организм, то могут развиваться многие патологии сердечно-сосудистой системы, из-за которых нарушается много жизненно важных функций.
Сепсис – это заражение крови, которое может возникнуть из-за тромбофлебита.
Он приводит к летальному исходу. Чтобы избежать его, а также инфаркта, инсульта и других патологий, то нужно своевременно обращаться к специалистам и проводить профилактические меры.
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От состояния сосудов на ногах зависит общее самочувствие человека и его способность вести активную жизнь. Однако некоторые патологии могут угрожать даже жизни человека. Чтобы этого избежать, важно вовремя их диагностировать и начать терапию. Рассмотрим, чем опасен тромбоз, как его выявить и можно ли полностью излечиться.
Клиническая картина
Чтобы понять, чем опасен тромбофлебит нижних конечностей, рассмотрим, как проявляется данное заболевание. Тромбоз вены в большинстве случаев не остается незамеченным. При появлении нескольких признаков важно незамедлительно обратиться к врачу.
Медлить с лечением тромбофлебита нельзя, это может привести к летальному исходу!
Закупорка вен вызывает следующие симптомы:
- Скачок температуры;
- Одышка;
- Боль в груди;
- Боль в области икроножных мышц;
- Сильные отеки, особенно по вечерам;
- Слабость и быстрая утомляемость;
- Воспаление в месте образования сгустка;
- Покраснение или синюшность кожи в зоне тромбоза;
- Уплотнение вен.
Иногда патология протекает в вялой форме. Из-за этого пациент не подозревает, что у него развивается тяжелое заболевание. Далеко не все люди понимают, что тромб в ноге опасен для жизни.
Последствия тромбоза
Осложнения тромбофлебита способны повлиять на функционирование всего организма. При отсутствии лечения последствия могут быть фатальными. А справиться с болезнью в ранних стадиях просто.
Разберем, каковы осложнения и исходы тромбоза. Так как осознание важности своевременного обращения к флебологу позволит сохранить жизнь.
Тромбоэмболия легочной артерии
Эмболия легочной артерии – одно из самых опасных последствия тромба в ноге. По мере роста сгустка он увеличивается. Может наступить момент, когда он оторвется от венозной стенки. Вместе с током крови тромб заносится через легочную артерию в легкие. При закупорке крупной ветви легких наступает мгновенная смерть.
Признаки тромбоэмболии настолько выражены, что не ощутить их невозможно. Возникают следующие симптомы:
- Нарушение дыхания;
- Острая боль в области груди и живота;
- Одышка;
- Страх смерти;
- Тревога;
- Бледность и синюшность кожи лица и тела;
- Увеличение вен на шее;
- Кашель с кровавой мокротой;
- Увеличение частоты пульса;
- Резкое снижение артериального давления;
- Нарушение мочеиспускания;
- Потеря сознания.
В большинстве случаев перекрытие тромбом легочной артерии ведет к смерти. Не существует экстренных методов терапии, которые могли бы оградить человека от таких последствий. Защитить может только своевременное лечение тромбофлебита.
Тромб может перекрывать не только легочную артерию, но и другие жизненно важные сосуды. В таком случае клиническая картина будет не настолько выраженной, однако последствия для здоровья также губительны
Сепсис
Сепсис или заражение крови развивается на фоне тромбофлебита не очень часто. Этот процесс может развиться вследствие инфекционного заражения трофической язвы или в случае занесения инфекции гематогенным путем в область сгустка.
Сепсис происходит только при очень тяжелом течении тромбофлебита. Чтобы оказать помощь, важно вовремя обратиться в медицинское учреждение.
Посттромбофлебитический синдром (ПТФС)
Состояние, которому характерно хроническое течение. Развивается у пациентов, которые уже прошли курс лечения против тромбофлебита.
ПТФС – это венозная недостаточность. Хотя риск образования тромба, как кажется, позади, нужна постоянная профилактическая терапия и обследования у врача.
Трофические язвы
Последствия тромбоза глубоких вен – трофические язвы на ногах. Это неприятное явление, сложно поддающееся даже адекватной терапии. Ранки появляются даже в результате незначительного повреждения. Высок риск нагноения.
Длительное нагноение приводит к тому, что гнойное содержимое может перетекать в соседние ткани. Это ведет к развитию перифлебита. Такое опасное осложнение приводит к сильному воспалению, абсцессу. По мере прогрессирования состояния мышечная ткань отделяется от кости. В тяжелых случаях приходится ампутировать конечность.
Флебосклероз
В процессе этого осложнения тромбофлебита стенки вен становятся толстыми и плотными. В итоге сужается просвет сосуда. Кровь не может свободно течь, и образуются застойные явления.
Разрастание стенки может быть настолько выраженным, что кровоток перекроется полностью. Состояние идентично тому, как если бы крупный тромб перекрыл вену.
Ишемический неврит
На фоне неполноценного кровоснабжения происходит нарушение работы нервной системы. Периферические нервы прекращают функционировать, что ведет к следующим признакам:
- Снижение чувствительности;
- Дистрофия мышц;
- Уменьшение рефлекторных реакций.
Состояние сопровождается выраженными болевыми ощущениями. Клиническая картина обостряется после приема алкоголя.
Лечение патологии
Тромбофлебит поверхностных и глубоких вен ведет к тяжелым последствиям. Некоторые из них вылечить невозможно. Единственная возможность их предотвратить – проводить своевременную терапию тромбоза сосудов.
Легче справиться с тромбофлебитом, если одновременно лечить сопутствующие патологии, варикозное расширение вен или нарушение оттока крови.
Восстановить кровоток при тромбозе можно с помощью консервативного и хирургического лечения. Методика терапии зависит от состояния пациента и от того, с какими осложнениями он уже столкнулся.
Консервативное лечение тромбофлебита препаратами продолжается не менее полугода. Пациент принимает флеботоники, антикоагулянты, нестероидные противовоспалительные средства. При высоком риске образования тромба в вене назначается строгий постельный режим.
Иногда применяются местные инъекции с кроворазжижающими препаратами. Такая терапия относится к экстренным мерам при образовании тромба.
Хирургическое лечение проводится несколькими методами:
- На начальной стадии в полость вены вводится специальный катетер, который удаляет сгусток;
- Может быть установлен кава-фильтр, препятствующий перемещению тромба в область внутренних органов;
- Проводится прошивание вены, благодаря чему внутри тромба образуются ходы, через которые кровоснабжение восстанавливается;
- Проводится тромбэктомия, при которой из полости вены удаляется сформировавшийся сгусток.
Пациент должен понимать, что чем раньше он обратиться за медицинской помощью, тем меньше осложнений будет на фоне образования тромба в вене. Сгустки, которым более 7 дней, невозможно удалить малоинвазивным методом.
Профилактика
Снизить риск осложнений тромбоза можно следующими методами:
- Ношение компрессионных чулок;
- Умеренная физическая активность;
- Правильное питание;
- Отказ от вредных привычек.
Правильный образ жизни и умеренная физическая нагрузка положительно влияют на процессы кровообращения. Это способствует восстановлению кровотока при тромбозе и снижает риск развития осложнений.
Своевременное лечение тромбоза – гарантия полноценной здоровой жизни. Хотя риск формирования тромба в вене все равно остается, вероятность развития тяжелых и опасных для жизни осложнений сокращается.
Тромбофлебит представляет собой воспалительный процесс венозной стенки, приводящий к образованию тромба. В ходе развития патологического процесса нарушается целостность венозной стенки, вследствие чего просвет вены перекрывается сгустком крови.
Тромбофлебит — достаточно опасное заболевание, особенно в острой стадии, когда существует высокая вероятность отрыва тромба и развития таких опасных осложнений, как инфаркт миокарда или легочная эмболия. Ниже расскажем о том, чем опасен тромбофлебит нижних конечностей, более подробно.
Клиническая картина
Тромбофлебит подразделяется на три формы:
- Острый (гнойный и негнойный) — стадия длится 2 недели.
- Подострый — развивается со 2 по 8 недели.
- Хронический — переходит в эту стадию после 2 месяцев с начала болезни.
Для острой стадии тромбофлебита характерно повышение субфебрильной температуры. Одновременно в области вен возникает болевой синдром, особенно усиливающийся при физической активности. На пораженной конечности начинается отек. Кожа по ходу вен становится уплотненной и болезненной, появляются признаки цианоза. Кожные покровы приобретают небольшой блеск. Если вовремя не взяться за лечение острой стадии болезни, тромбофлебит перейдет сначала в подострую, а затем и в хроническую форму.
Острый тромбофлебит может принять и гнойную форму. Такой характер течения тромбофлебита очень опасен, поскольку патологический процесс при этом затрагивает не только вены, но и находящиеся поблизости ткани. В результате возникает септикопиемия.
Тромбофлебит классифицируют по локализации процесса:
- кожные покровы (проявление патологии в виде дерматита, экземы или трофических язв);
- подкожная клетчатка или в виде флегмонов и абсцессов;
- кровеносные сосуды (процесс приводит к поражению не только поверхностных, но и глубоких вен);
- лимфатическая система;
- периферическая система (при такой локализации возможны ишемические невриты).
Причины
К тромбофлебиту приводят следующие факторы:
- Травматическое повреждение венозной стенки.
- Нарушенный или замедленный кровоток. Нарушения могут быть спровоцированы недостаточной двигательной активностью, продолжительным сдавливанием вен нижней конечности (к примеру, вследствие ношения гипса). Неправильное кровообращение возникает как результат сердечной недостаточности, когда сердце не обеспечивает перекачку должного объема крови. При нарушенном и замедленном кровотоке в нижних конечностях возникают застойные явления.
- Высокая свертываемость крови. Причина чаще всего заключается в генетической предрасположенности. Однако возможно влияние и других факторов, в том числе онкологических и инфекционных заболеваний. Сгущать кровь могут некоторые медикаментозные препараты.
Помимо прямых, существуют и косвенные причины, способствующие развитию тромбофлебита:
- возрастной фактор (люди старше 45-летнего возраста чаще подвержены этой патологии);
- заболевания сердечно-сосудистой системы;
- чрезмерная масса тела;
- сахарный диабет;
- беременность (гормональные изменения в совокупности с лишним весом).
Симптомы
Указанные ниже симптомы соответствуют острой и подострой стадиям тромбофлебита:
- стремительное развитие симптоматики без каких бы то ни было явных причин;
- повышенная температура тела;
- болевой синдром (острые распирающие боли);
- выраженная отечность нижней конечности (может доходить до паховой области);
- ощущение тяжести в ногах;
- при пальпировании ноги ощущается повышенная местная температура;
- болевой синдром усиливается при физической активности;
- пальпация вызывает усиление болезненных ощущений;
- кожа становится синюшной, а если тромб охватывает бедренную или подвздошную вену — черноватой;
- цианоз (при продвижении тромба вверх по нижней конечности).
Для тяжело протекающего тромбофлебита характерно появление пузырей с геморрагическим наполнением. Данное осложнение может привести к венозной непроходимости и гангрене.
Обратите внимание! В случае перекрытия тазовой вены отечность и цианоз могут перейти на здоровую ногу.
Для хронического тромбофлебита характерно более спокойное течение. Периоды обострения болезни сменяются ремиссией. Когда обострение возвращается, симптоматика заболевания в хронической фазе становится такой же, как и на острой стадии. В период ремиссии тромбофлебита симптомы могут практически никак не проявлять себя.
Опасность тромбофлебита
В рассказе о том, чем опасен тромбофлебит, следует остановиться на трех факторах, особенно сильно воздействующих на состояние венозной системы:
- Ухудшение кровотока. Замедленное кровообращение особенно неблагоприятно сказывается при беременности, переломах, у людей, страдающих сердечно-сосудистыми заболеваниями.
- Увеличение вязкости крови. Данный фактор приводит к образованию тромбов. Наибольшей опасности подвергаются лежачие пациенты, больные раком.
- Повышенная травматичность вен. У беременных женщин это может привести к кровотечениям при родах и гинекологических манипуляциях.
Ниже речь пойдет об основных осложнениях, которые могут развиться вследствие тромбофлебита.
Кровотечения
Обычно кровотечения при тромбофлебите локализуются в области голени. Интенсивность потери крови может отличаться, однако при вертикальном положении тела кровотечение всегда будет более обильным.
При кровотечении пациента переводят в горизонтальное положение. Проблемную конечность располагают на возвышении, после чего накладывают повязку. После этого нужно вызвать бригаду «Скорой помощи», чтобы доставить пациента в стационарное отделение больницы.
Иногда кровотечение в мелких поверхностных венах в течение долгого времени практически не ощущается больным, однако на повреждение вен указывают подкожные гематомы. Как правило, такие кровоподтеки очень выражены.
Если же кровотечение затрагивает глубокие вены, состояние пациента неизбежно ухудшается, поскольку потери крови более значительны. Больной в этом случае нуждается в экстренной помощи, иначе его жизнь подвергается угрозе.
Тромбоэмболия
Данное осложнение наиболее нежелательно и самое опасное. Тромбоэмболия представляет собой отрыв тромба с дальнейшим перекрытием кровотока в легочной артерии. Результатом эмболии становятся инфаркт миокарда, венозная недостаточность или даже летальный исход для больного.
Решающее влияние оказывает размер отслоившегося сгустка крови. Если речь идет о крупном тромбе, большая часть больных умирает в течение первых 30 минут. Как правило, в этом случае врачи просто не успевают оказать медицинскую помощь. Если же больной находится в момент развития легочной эмболии в стационарном отделении, его шансы выжить значительно возрастают.
Терапевтические мероприятия нацелены на улучшение кровообращения и соблюдение постельного режима. Тромбы необходимо удалить из кровеносной системы. Для этого применяются тромболитическое лечение или хирургическая операция. Инфузионное лечение осуществляется для разжижения крови и предотвращения дальнейшего тромбообразования. На оперативное вмешательство решаются, если консервативные методы не дают результата.
Флебосклероз
Патологический процесс, в ходе которого стенки вен подвергаются изменениям (становятся толще и плотнее), называется флебосклерозом. Основная опасность флебосклероза в том, что в связи с утолщением стенки вены происходит сужение просвета в кровотоке, что влечет за собой застойные явления. В результате развития патологии стенка может настолько разрастись, что кровоток через вену прекратится полностью.
При внешнем наблюдении пораженные флебосклерозом вены выглядят как жгутообразные утолщения. Их цвет — белесый. Однако этот симптом заметен лишь снаружи, а изменения в венах под кожей практически незаметны.
Лимфангит
Лимфатическая система негативно отзывается на развитие тромбофлебита в нижних конечностях. Речь идет о лимфангите, представляющем собой воспалительный процесс в лимфатических сосудах. Лимфангит не самостоятельное заболевание, а лишь следствие инфекционного процесса.
Для лимфангита характерна интоксикация, которая проявляется следующими признаками:
- повышенная температура тела;
- головные боли;
- лихорадка;
- быстрая утомляемость;
- общая слабость.
Лимфангит лечится антибиотиками и противовоспалительными препаратами нестероидного типа. Если лечение проведено вовремя, прогноз обычно благоприятен.
Обратите внимание! При наличии подозрений на лимфангит нельзя массажировать или нагревать вены нижней конечности, так как такие действия осложнят течение заболевания.
Слоновость
Патология представляет собой болезненное утолщение кожи и подкожной клетчатки. Развитие патологического процесса связано с нарушением нормального оттока лимфы. Слоновость сопровождается стойкой отечностью нижних конечностей, болевой синдром зачастую отсутствует.
Больные обращаются к медикам, прежде всего, из-за косметического дефекта, а не по причине физического дискомфорта. С течением времени, помимо отеков, к симптомам заболевания добавляется рожистый воспалительный процесс на коже.
При лечении слоновости (кроме терапии основного заболевания) применяются мочегонные средства и лимфодренаж. Если медикаментозная и другие методы консервативной терапии не приносят результата, назначается хирургическое лечение.
Периферическая система
Под периферической нервной системой подразумевается та часть нервных окончаний, которая находится вне головного и спинного мозга. За счет периферической системы обеспечивается взаимосвязь центральной нервной системы с органами и конечностями человека.
Периферическая нервная система травмируется как в результате механических воздействий, так и под влиянием интоксикации. В итоге развивается воспалительный процесс и другие патологические процессы.
Ишемический неврит
Воспалительный процесс в венах — ишемический неврит — напрямую связан с патологически неправильным кровотоком. Из-за дефицита питания периферические нервы прекращают полноценное функционирование, что выражается в следующих симптомах:
- пониженные рефлексы;
- дистрофические процессы в мускулатуре;
- уменьшение чувствительности кожи в области развития заболевания.
Нередко ишемический неврит сопровождается очень сильными болями.
Обратите внимание! Особенность ишемического неврита — резкое обострение заболевания в результате приема алкоголя.
Общие гнойные осложнения
Если пациент не получил своевременного лечения, возможно развитие общих гнойных осложнений. Процесс провоцируется гнойным расплавлением тромба в вене и наличием сопутствующей патогенной микрофлоры. Название патологии — септикопиемия.
В ходе патологического процесса гной нередко метастазирует, что приводит к интоксикации всего организма. При этом следует понимать, что распространение гноя не является самодостаточным процессом. Первопричина развития осложнения — воспалительная реакция в области, через которую инфекция проникла в организм.
Септикопиемия обычно протекает не очень бурно, но в течение длительного времени. Это объясняется тем, что, как правило, организм способен гасить слишком интенсивные воспалительные процессы.
При септикопиемии поражаются легкие, сердечно-сосудистая система. Возможны и проблемы с мочеполовой системой, из-за чего резко сокращается способность организма к выделению мочи.
Сепсис
Септический процесс сопряжен с инфицированием крови. Инфекция попадает в кровоток из тканей. Обычно сепсис развивается при таких осложнениях тромбофлебита, как перитонит, абсцесс или какая-то другая воспалительная реакция, в ходе которой выделяются гноеродные микроорганизмы. Сепсис — очень опасное состояние, которое при отсутствии медицинской помощи может стать причиной летального исхода.
- повышенная температура тела;
- лихорадка;
- повышенный уровень лейкоцитов в крови;
- тахикардия;
- аритмия;
- замедленное образование мочи.
При подозрении на сепсис больной нуждается в безотлагательной медицинской помощи. Лечение проводится исключительно в стационарных условиях.
Диагностика
Чтобы поставить диагноз, медики используют данные, полученные в ходе осмотра пациента, и результаты лабораторных исследований и инструментальной диагностики.
Наиболее информативными являются инструментальные методики, в том числе:
- Ультразвуковое исследование. УЗИ позволяет выяснить местонахождение тромба, его размеры, степень перекрытия кровотока. С помощью ультразвука можно достоверно изучить состояние венозных клапанов.
- Флебография. Методика позволяет обнаружить тромбы в подкожных венах.
- Радионуклидное исследование. Используется радиоактивное вещество, вводимое в вену. Радионуклидная диагностика дает возможность обнаружить тромб и оценить характер поражения вен.
- Магнитно-резонансная флебография. Методика отличатся дороговизной, но позволяет максимально точно определить степень поражения вен, в том числе глубоких.
- Импедансная плетизмография. С помощью этого типа исследования выясняется характер наполнения вен кровью.
Лечение
Терапия тромбофлебита осуществляется консервативными или хирургическими методами. Выбор конкретного способа лечения зависит от стадии патологического процесса и общего состояния больного.
Консервативное лечение
Тромбофлебит лечится долго — не менее полугода. Больному прописывают медикаментозное лечение (гепариновые инъекции). Курс лечения гепарином — от 10 дней и более. Пациенту назначаются тромболитические и противовоспалительные препараты.
Если тромбофлебит протекает в тяжелой форме, в первую неделю больному предписывается постельный режим. Когда острая стадия тромбофлебита сходит на нет, врач назначает пациенту курс лечебной гимнастики.
Хирургическое лечение
Применяется четыре разновидности оперативного вмешательства при тромбофлебите:
- Катетер Фогарти. Во время операции в вены вводится зонд для удаления тромба. Метод используется на начальной стадии тромбофлебита (до 5 дней с момента обострения заболевания).
- Установка кава-фильтра в нижнюю полую вену. Фильтр устроен таким образом, что не позволяет тромбу продвигаться по венам.
- Пликация. Задача пликации состоит в прошивании вены особыми металлическими скрепками.
- Тромбэктомия. Наиболее распространенный метод оперативного лечения тромбофлебита. В ходе операции тромб удаляется из вены. При этом для назначения операции должно соблюдаться обязательное условие — тромб возник не позднее 7 дней назад. Если тромб старше, на стенках вен и венозных клапанах уже произошли деформации, которые сильно уменьшат эффективность операции.
Профилактика
Профилактические мероприятия при тромбозе включают соблюдение следующих рекомендаций:
- Ношение компрессионного трикотажа. Специальное утягивающее белье позволяет улучшить кровоток в пораженных венах. Степень компрессии определяется лечащим врачом.
- При отсутствии риска отслоения тромба больному назначается лечебная гимнастика или другие виды умеренной двигательной активности (ходьба, плавание).
- Прием препаратов, уменьшающих интенсивность возникновения тромбов в венах.
- Специальная диета (аналогична рациону при варикозном расширении вен). Прием соли нужно ограничить, следует отказаться от жирных продуктов. В рационе должно быть достаточное количество продуктов, богатых салицилатами (изюм, чеснок, имбирь и т. д.).
- Отказ от вредных привычек, в том числе курения и употребления алкоголя.
Осложнения тромбофлебита крайне опасны для здоровья больного. Рекомендуется проводить регулярные обследования состояния вен, а при обнаружении первых признаков осложнения немедленно обратиться за медицинской помощью.
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