Причины патологии
Тромб в подколенной вене образуется достаточно редко, но все же есть пациенты с таким диагнозом. Установить абсолютно все возможные причины развития патологии на данный момент не удалось, но их список постепенно пополняется. На сегодняшний день выделяют следующие провоцирующие факторы развития тромбоза в подколенной ямке:
- Последствия операций. После любой продолжительной операции может увеличиться степень свертываемости крови, в результате чего будут образовываться сгустки, то есть непосредственно тромбы.
- Последствия переломов. После серьезных травм нижних конечностей пациенту необходимо длительное время носить гипс, а затем и утягивающие повязки. Все это способствует нарушению кровообращения, в частности его замедлению, в результате чего образуются застои, становящиеся впоследствии тромбами.
- Варикозное расширение вен. Если вовремя не начать лечение варикоза, может возникнуть тромбофлебит – воспаление стенки сосуда с последующим образованием тромба.
- Онкологические заболевания. При наличии злокачественных опухолей вероятность развития тромбоза увеличивается, особенно если имела место операция.
- Длительный постельный режим. Если пациенту приходилось долго находиться в лежачем положении, велика вероятность нарушения кровообращения. Опасность выше для пожилых людей.
- Прием гормональных контрацептивов. Применение таких препаратов может нарушить гормональный баланс в организме, что напрямую влияет на все остальные внутренние системы, в том числе и кровеносную.
- Заболевания сердца и кровеносной системы. Наиболее подвержены тромбозу люди, страдающие ишемией, васкулитом и аутоиммунными патологиями.
- Повреждения внутренней поверхности сосудистой стенки. Это может произойти в результате аллергической реакции или механического воздействия, нередко этому способствует инфекционное заболевание.
Однако стоит учитывать, что даже при наличии перечисленных факторов вероятность развития тромбоза неоднозначна. В большинстве случаев патология возникает у людей, которые так или иначе склонны к ней, то есть у пациентов из групп риска. К ним относятся курящие и употребляющие алкоголь люди, женщины старше 40 лет, а также перенесшие трудные беременности или роды. Кроме того, под угрозой находятся люди, ведущие малоподвижный образ жизни, и страдающие от избыточного веса.
Основные симптомы
Опасность тромбоза подколенной вены состоит в том, что во многих случаях он протекает без выраженных симптомов, а первые признаки проявляются только в экстренной ситуации, когда тромб закупоривает сосуд или отрывается. Также следует учитывать, что только у половины пациентов патология протекает классически, у других же наблюдаются те или иные вариации ее развития.
Обычно тромбоз вены под коленом проявляет следующие симптомы:
- Тянущая боль. Неприятные ощущения локализуются в подколенной ямке, поначалу они могут ощущаться, как чувство распирания, но затем переходят в явную боль, усиливающуюся при любом движении ногой.
- Отечность. При тромбозе нарушается кровообращение, и жидкая составляющая крови просачивается сквозь стенки вены, вызывая отеки, обычно локализующиеся под коленом.
- Локальное изменение температуры. В результате тромбообразования область над коленом будет горячей, а под ним – напротив, холодной, поскольку во всей конечности нарушается кровообращение.
- Набухание поверхностных вен. В результате частичной или полной закупорки подколенной вены, кровь ищет обходные пути и начинает течь по другим сосудам, при этом они перегружаются и заметно набухают. Постепенно они становятся видны над поверхность кожи.
- Ухудшение общего состояния. Это происходит редко, симптомы обычно носят локальный характер. Однако в некоторых случаях пациент все же может ощущать головную боль, слабость и усталость, а температура может повышаться до 37-39 градусов.
Симптомы тромбоза подколенной вены схожи с некоторыми другими заболеваниями, в частности, с поражениями суставов – артритами и артрозами. По этой причине не стоит заниматься самодиагностикой и лечением, лучше обратиться к грамотному специалисту, которые подберет подходящую терапию.
Обычно тромбоз поражает подколенную вену только на одной ноге.
Диагностика тромбоза
При обнаружении подобных признаков лучше обратиться к терапевту, он назначит первичные анализы, по результатам которых сможет направить пациента к нужному врачу.
В случае с тромбозом лечащим специалистом становится сосудистый хирург или флеболог.
Он должен провести устный опрос и выяснить не только особенности текущего состояния, но и все возможные предпосылки тромбоза. После этого доктор проводит первичный осмотр, сравнивая больную ногу со здоровой.
В ходе осмотра врач может применить методы специализированных проб, чтобы убедиться в верности диагноза.
Во-первых, применяется проба Хоманса: находясь, в положении лежа, пациент сгибает ногу в колене, а врач производит движения голеностопным суставом, при этом должна ощущаться боль в голени.
Во-вторых, проба Мозеса: если возникает боль при сдавливании голени и по направлению вперед-назад, а при надавливании с боков пациент не чувствует дискомфорта, можно подтвердить диагноз.
В-третьих, проба Ловенберга: на голень пациента надевают манжету тонометра и нагнетают давление, при этом у пациента с тромбозом боль появится при значении 80-100 мм рт. ст.
Самым информативным инструментальным методом диагностики тромбоза считается ультразвуковое исследование с допплером. Это стандартное по технике проведения УЗИ, но в аппарате установлен датчик допплера, ориентированный на рассмотрение именно кровеносных сосудов. Также врач может назначить ультразвуковое ангиосканирование с цветным картированием (УЗДС). Эти два метода дополняют друг друга, позволяя создать более полную клиническую картину.
Классическое лечение
Несмотря на бытующее мнение, что тромб можно удалить только в ходе операции, заболевание поддается и консервативной терапии. Однако следует учитывать, что такое лечение будет эффективно только на ранних стадиях заболевания, а в тяжелых случаях неизбежно хирургическое вмешательство.
Медикаментозное лечение
Если у врача нет опасений по поводу состояния тромба, назначается консервативная терапия, основу которой составляют лекарственные препараты, принимаемые внутрь. При этом наименования средств определяются индивидуально в каждом конкретном случае, поскольку у каждого пациента могут быть свои жалобы и предрасположенности.
В общем виде схема лечения выглядит следующим образом:
- Антикоагулянты. Способствуют разжижению крови и рассасыванию тромбов, предотвращают их повторное появление. Чаще всего назначается Гепарин или варфарин.
- НПВС. Нестероидные противовоспалительные средства способствуют снятию воспаления, отечности и боли. К ним относится Диклофенак, Ибупрофен, Аэртал и т. д.
- Венотоники. Способствует восстановлению венозных стенок и оттоку застойной крови от участка образования тромба. Чаще всего назначаются Троксевазин, Троксерутин или Эсцин.
- Ангиопротекторы. Эти препараты способствуют уменьшению проницаемости сосудистых стенок, нормализации метаболических процессов и улучшению мироциркуляции крови. Среди них можно выделить Рутин, Троксевазин и Эскузан.
- Тромболитики. Эти лекарства направлены непосредственно на расщепление и последующее растворение тромба. К ним относятся Стрептокиназа, Альтеплаза, Тенектеплаза, Ретеплаза и др.
Если тромбоз осложнен инфекцией дополнительно назначают антимикробные средства. Для уменьшения выраженности симптомов можно применять аптечные средства для наружного использования. Ярко выраженным эффектом обладает Гепариновая мазь, также можно применять Венолайф, Лиотон, Эскузан и т. д.
Другие методы
Лечение тромбоза подколенной вены можно дополнять немедикаментозными методами. Чтобы снять симптомы, рекомендуется носить компрессионные чулки, выбранные совместно с лучащим врачом, либо накладывать утягивающую повязку на подколенную область. Это необходимо делать сразу после пробуждения, не вставая с кровати, а снимается компрессионное белье или эластичный бинт перед сном или водными процедурами.
Помимо этого, пациентам обычно назначается лечебная гимнастика, направленная на улучшение кровообращения в подколенной зоне. При этом можно выполнять как классические упражнения, например, «Ножницы», «Березка», «Ножницы» и подобные им, так и некоторые асаны йоги. Согласовывать комплекс упражнений необходимо с лечащим врачом, чтобы не навредить своему состоянию. Чтобы гимнастика возымела эффект, ее нужно выполнять регулярно, желательно, каждый день.
Также следует уделить внимание своему рациону, а страдающим от избыточной массы тела рекомендуется сесть на специализированную диету.
В целом питание при тромбозе подколенной вены должно быть направлено на достижение оптимального веса, что снизит нагрузку на колени, на укрепление сосудистой стенки и уменьшение степени вязкости крови.
Следует употреблять больше фруктов и овощей в разном виде, особенно полезны при тромбозе плоды с высоким содержанием витамина C, витамина E и бета-каротина. Для непосредственного разжижения крови следует употреблять больше имбиря, лука, чеснока, вишни, клювы и черники. При этом следует выпивать до двух литров в день, если это не противоречит индивидуальной норме.
При этом следует частично или полностью ограничить употребление животных жиров, кофе, алкоголя, сливок, сметаны, кондитерских изделий, жирных блюд, копченостей и маринадов. Вместе с этим желательно отказаться от курения и в целом отдать предпочтение здоровому образу жизни – совершать больше пеших прогулок, контролировать потребление калорий, урегулировать время работы и отдыха.
Хирургическое вмешательство
Если консервативное лечение не приносит желаемых результатов, пациенту может быть назначена операция. Она также необходима в тяжелых случаях, когда врач опасается за здоровье пациента. Хирургическое вмешательство может проводиться как в государственных лечебных учреждениях, так и в платных клиниках.
Самым прогрессивным оперативным методом удаления тромбов на сегодняшний день является тромбэктомия. Ее достоинство в том, что она малоинвазивна, то есть не предполагает проведения крупных надрезов. Через небольшой прокол в тромбированную вену вводится катетер, который извлекает сгусток, а если это невозможно, то растворяет его на месте. После такой операции пациенту нужно в течение трех суток носить компрессионное белье, чтобы избежать возникновения рецидива.
Относительно новым методом является установка кава-фильтра, то есть своеобразной ловушки для тромба. В ходе операции в просвете вены закрепляется специальное устройство, по вшенему виду, напоминающее зонтик. Оно свободно пропускает кровь, но задерживает на своей поверхности любые по величине сгустки. Принимая препараты для рассасывания тромбов, пациент быстро избавляется от проблемы, при этом отсутствует опасность того, что сгусток будет перемещаться и закупорит сосуд жизненно-важного органа.
Также могут применяться операции, предусматривающие полное удаление подколенной вены. В любом случае после хирургического вмешательства пациенту потребуется регулярно применять профилактические меры для предотвращения рецидивов и осложнений. Кроме того, ему потребуется в течение нескольких лет постоянно наблюдаться у врача для прослеживания динамики.
Тромбоз подколенной вены – это закупорка подколенного сосуда сгустком крови. Некоторые симптомы указывают на более серьезные осложнения патологического состояния. Прогноз тромбоза подколенной вены во многом зависит от сопутствующих осложнений и состояния здоровья пациента. Меры профилактики направлены на разжижение крови и уменьшение риска дальнейшего тромбоза.
Причины развития тромбоза подколенной вены
Подколенный тромбоз остается незамеченным и часто рассасывается сам по себе. У некоторых пациентов также возникают такие симптомы, как боль и отек. При обнаружении тромбоза необходимо срочное лечение, чтобы избежать серьезных осложнений – тромбоэмболии легочной артерии. Состояние возникает, когда сгусток крови отделяется от места происхождения и попадает в легкие посредством системного кровообращения.
Риск глубокого венозного тромбоза увеличивается после серьезной операции – использование искусственного коленного или тазобедренного сустава. Поэтому после таких процедур обычной практикой является употребление лекарств в течение нескольких месяцев, чтобы предотвратить образование тромбов.
Сгусток крови может развиться, если кровь в вене течет слишком медленно, нарушается свертываемость крови или повреждена стенка сосуда.
Основные причины развития тромбоза подколенной вены:
- длительный постельный режим: если приходится дольше лежать и мало двигаться, нога плохо снабжается кровью;
- расстройства свертываемости крови: некоторые врожденные заболевания стимулируют образование сгустков крови;
- открытая хирургия: более крупные процедуры и серьезные травмы повредят повреждают сосуды и активируют систему свертывания.
Факторы риска, которые увеличивают риск развития тромбоза подколенной вены:
- возраст старше 60 лет;
- семейная предрасположенность;
- определенные виды рака;
- сердечная недостаточность;
- выраженный избыточный вес или ожирение;
- прием противозачаточных таблеток;
- прием гормонов во время менопаузы;
- сильные варикозные вены;
- курение;
- определенные воспалительные заболевания;
- беременность;
- частое путешествие с долгим сидением.
Курение может быть причиной тромбоза подколенной вены
Согласно исследованиям, в среднем у 1 из каждых 1000 человек в год развивается тромбоз подколенных вен. Риск увеличивается с возрастом. Мужчины немного чаще страдают, чем женщины.
Клинические проявления
Типичные симптомы тромбоза подколенной вены – боли, возникающие в одной ноге. Некоторые пациенты характеризуют боль как «очень сильные воспаленные мышцы, чрезвычайно чувствительные к любому давлению». Также возможны лихорадка и тахикардия. В зависимости от прогрессирования тромбоза, боль в основном возникает, когда ноги двигают в разные стороны. Характерно улучшение симптомов при лежании или ходьбе.
По оценкам экспертов, около 2/3 тромбозов, особенно в области голени, не замечаются пострадавшими. У этих людей либо нет никаких симптомов, либо только очень легкие симптомы, которые не предполагают тромбоз. Как только тромбоз развивается и расширяется, появляются явные симптомы. Нога отекает, кожа напрягается и выглядит красной. Также она перегревается и имеет голубоватый оттенок.
Тромбоз подколенной артерии проявляется более остро и вызывает сильные симптомы. Не следует путать с тромбозом вен. В артериях скорость кровоток намного выше, чем в венах. Поэтому тромбоз подколенной артерии более опасен, чем закупорка вены.
Абсолютно в тот же день к врачу должны обратиться больные, чья нога значительно увеличилась в размерах. Рекомендуется немедленно отправляться в больницу, если нога распухла и внезапно появилась одышка. Это может быть признаком легочной эмболии вследствие тромбоза.
Методы диагностики
Тромбоз подколенных вен не может быть достоверно определен одними типичными симптомами. Симптомы – боль, отек и покраснение кожи – также могут быть вызваны множеством других причин: воспаление поверхностных вен, варикозное расширение вен, кутикула или сужение артерий ног.
Анализ крови на D-диметр помогает установить верный диагноз. Этот тест реагирует на продукты деления, которые организм вырабатывает, когда разрушает сгусток крови. Они называются D-димерами.
Анализ крови – метод диагностики тромбоза подколенной вены
Если тест является положительным, для подтверждения диагноза проводится так называемое «дуплексное ультразвуковое исследование». Он предоставляет информацию о состоянии глубоких вен ног и скорости кровотока.
Если подозрение на тромбоз очевидно, ультразвуковое сканирование обычно проводится немедленно. Специальное рентгенологическое исследование сосудов, с помощью которого можно визуализировать сужение сосудов (ангиография), проводится редко. Контрастное вещество вводится в вену через катетер.
Способы лечения
Тромбоз подколенных вен лечится в большинстве случаев консервативно, но иногда может потребоваться хирургическое вмешательство. Схема лечения определяется лечащим врачом на основе показаний и состояния здоровья пациента.
Консервативные методы
Приоритетом всегда является разжижающее кровь лечение, называемое «антикоагуляцией». Схема терапии направлена на растворение сгустка крови и помогает предотвратить легочную эмболию. Антикоагуляция первоначально проводится в острой фазе, в основном с гепаринами, после чего врач назначает производные кумарина.
Хорошо известными активными ингредиентами являются фенпрокумон и аценокумарол в форме таблеток. Доза и длительность терапии должна быть отрегулирована специалистом. Поэтому в начале лечения важны частые анализы крови, чтобы врач мог при необходимости перенастроить медикаментозную схему. Терапия кумарином обычно используется в течение длительного периода времени – от 6 до 12 месяцев. Рецидив тромбоза может быть предотвращен только при последовательной терапии.
В течение некоторого времени в качестве альтернативы кумаринам назначались так называемые прямые «пероральные антикоагулянты». Активными ингредиентами являются апиксабан, ривароксабан или дабигатран.
В острых случаях окклюзии сосудов применяется лизисная терапия. В этом случае лекарства вводятся через венозный доступ. Согласно исследованиям, они способны растворить тромб в течение нескольких часов.
Фермент урокиназа или альтеплаза используется для тромболизиса. Риск внутреннего кровотечения при лизисе высок, поэтому его используют только в особо тяжелых случаях тромбоза. Также высокие дозы гепарина также вводятся путем приема внутрь посредством инфузии или подкожных инъекций.
Компрессия
В дополнение к лекарственной терапии тромбоз обычно лечат компрессионными чулками. Эти очень плотные чулки оказывают давление на вену и предотвращают ее дальнейшее повреждение. Кровь снова может течь лучше и тромбы в окружающей ткани исчезают.
Чтобы компрессионный бандаж или чулок работали хорошо, их необходимо настроить. Как правильно одевать компрессионный чулок покажет врач или фармацевт. Чтобы натянуть компрессионный чулок на ногу, требуется много сил.
Оперативное
В редких случаях сгусток крови иссекается во время операции или удаляется с помощью катетера, вставленного в вену. Хирургические методы используются для терапии выраженного тромбоза, который представляет непосредственную угрозу для жизни пациента и не реагирует на лекарственные средства.
Возможные осложнения патологии
Общим следствием тромбоза подколенных вен является так называемый «посттромботический синдром». Нога может опухать и сильно болеть. Другие возможные последствия включают изменение цвета кожи, зуд и сыпь. Выраженный посттромботический синдром может привести к образованию хронической раны.
Посттромботический синдром возникает, когда тромб повреждает венозные клапаны и кровоток в вене блокируется. Синдром часто возникает только через несколько недель или месяцев после заболевания: иногда даже через 1 или 2 года.
Менее распространенное, но серьезное осложнение тромбоза называется «тромбоэмболией легочной артерии». Заболевание возникает, когда сгусток крови отделяется от места происхождения, попадает в легкие и блокирует там кровеносный сосуд.
- внезапная одышка;
- боль в груди (особенно при вдохе или кашле);
- головокружение, сонливость или обмороки;
- учащенное сердцебиение;
- кровянистая мокрота при кашле (довольно редко).
Боль в груди – возможное осложнение тромбоза подколенной вены
Легочную эмболию нужно лечить быстро, так как заблокированный кровеносный сосуд нарушает работу сердца и легких. Это может привести к перегрузке сердца и в конечном итоге к угрожающей жизни сердечной недостаточности.
Риск смертельного исхода выше для тромбоза в верхней части ноги или в малом тазу, чем для тромбоза в нижней части ноги. То же относится и к тромбозам, которые вызывают сильный дискомфорт.
Меры профилактики
Существует несколько способов предотвратить тромбоз подколенной вены. Людям, которые перенесли операцию или получили травмы и должны провести несколько дней в постели, важно встать и двигаться как можно скорее.
Даже небольшие упражнения, такие как качание ногой, рекомендуются для улучшения кровообращения. В случае повышенного риска могут быть полезны также противотромбозные чулки или лекарства.
Антитромбозные чулки могут снизить риск тромбоза подколенных вен. Их плотная посадка оказывает давление на ноги, позволяя крови быстрее возвращаться к сердцу.
Третий вариант – это лекарство для инъекций или перорального применения, которое снижает способность крови коагулировать. Лекарства, которые вводятся под кожу или в вену, начинают действовать через несколько часов. В эту группу входят так называемые «гепарины».
В случае пероральных препаратов проводится различие между кумаринами и прямыми пероральными антикоагулянтами. Наиболее известным активным веществом из группы кумаринов является фенпрокумон. Антикоагулянты также включают апиксабан, дабигатран, эдоксабан и ривароксабан. Эффект кумаринов начинается через несколько дней, а прямых пероральных антикоагулянтов – через несколько часов.
Тромбоз подколенной вены — патологическое состояние, возникающее вследствие образования кровяного сгустка в просвете крупнейшего магистрального сосуда нижней конечности. Развивающийся недуг характеризуется отсутствием ярко выраженной симптоматики; запущенная форма заболевания может завершиться летальным исходом. В основе сохранения здоровья и жизни пациента — своевременная диагностика и адекватная терапия.
Возможные причины и факторы риска
Патогенез тромбофлебита — болезни, проявляющейся при сбоях в процессе кроветворения и приводящей к появлению тромботических масс — сегодня изучен полностью, но факторы, провоцирующие формирование аномалий, исследованы не до конца.
К основным причинам, вызывающим образование тромбов, врачи относят:
- Патологии сосудов (преимущественно варикоз), сопровождающиеся замедлением оттока биологической жидкости.
- Хирургические вмешательства.
- Длительную иммобилизацию (при переломах, тяжелых травмах ОДА, параличах); постельный режим, назначаемый больным на продолжительное время (при поражениях ЦНС, нарушениях работы сердечно-сосудистой системы).
- Онкологические заболевания. Болезни изменяют состав крови; формирующиеся новообразования деформируют и сдавливают вены.
- Аллергические реакции, инфекционные процессы, повреждающие внутреннюю поверхность сосудистых стенок.
- Генетическую либо приобретенную предрасположенность к повышенному венозному тромбообразованию.
В группе риска — люди старше 40 лет, страдающие гиподинамией, ожирением и вредными привычками.
К появлению тромботической массы под коленкой у женщин приводят особые состояния организма, сопровождающиеся изменением гормонального фона — беременность, менопауза, климакс. Недуг диагностируется и у дам, принимавших оральные контрацептивы.
Сильный пол подвержен заболеванию на рубеже пятидесятилетнего возраста: в это время у большинства мужчин наблюдается снижение уровня тестостерона.
В особую категорию врачи относят пациентов, совершающих длительные переезды, перелеты. По мнению экспертов, регулярное нахождение в сидячей, неудобной позе также приводит к появлению тромбоза.
Среди косвенных факторов, способствующих возникновению недуга — ношение тесной одежды, переедание, переохлаждение, обезвоживание.
По статистике, вероятность формирования тромба под коленом достигает 20%. Такая частота появления кровяных образований в рассматриваемой области связана с условиями гемодинамики венозного русла — низким давлением и медленным кровотоком.
Симптоматика
Основная опасность тромбоза — протекание в отсутствие выраженных признаков. Пораженная патологией подколенная вена может не доставлять больному никакого дискомфорта на протяжении нескольких лет; основные симптомы недуга появляются преимущественно в период критического сужения просвета сосуда либо его полной закупорки.
Прогрессирование аномалии сопровождается:
- острой болью, локализующейся в подколенной ямке (углублении, находящемся сзади коленного сустава) при сгибании;
- значительным дискомфортом в икроножных мышцах после физической нагрузки;
- локальным повышением температуры кожных покровов.
Описывая свое состояние, пациенты жалуются на быстрое наступление усталости и возникающее чувство тяжести в нижних конечностях. При принятии горизонтального положения и помещении ног на возвышение неприятные ощущения стихают. В ряде случаев больные отмечают общее ухудшение состояния, признаки интоксикации.
Визуально симптомы тромбоза подколенной вены проявляются изменением цвета кожи (бледностью, синюшностью, глянцевостью), отечностью голени, набуханием поверхностных сосудов.
При обнаружении перечисленных признаков следует немедленно обращаться в клинику. Отказ от посещения врача приведет к прогрессированию аномалии, развитию осложнений и летальному исходу.
Методы диагностики
Выявить наличие заболевания может только специалист — флеболог, сосудистый хирург. Диагностирование тромбоза вен под коленом осуществляется в 3 этапа.
Первичный включает в себя опрос и осмотр пациента.
На втором доктор задействует функциональные пробы. Их перечень и схема проведения — в таблице ниже.
| Тест | Ход процедур |
| Мозеса | Сдавливание мышц нижних конечностей вначале с боков, затем в направлении вперед-назад. О наличии недуга сигнализирует резкий дискомфорт при проведении последней из перечисленных манипуляций. |
| Хоманса | Последовательное сгибание колен, стоп пациента, лежащего на спине. Возникновение боли в икрах ног свидетельствует о развитии острой стадии болезни. |
| Рамиреза | Тест проводится при помощи тонометра, манжета которого накладывается на голень в срединной части. Неприятные ощущения, появляющиеся при нагнетании давления до 150 мм рт.ст. — признак тромбоза. |
| Ловенберга | Схема проведения аналогична, область фиксации изделия — бедро. Положительной является проба, при которой боль отмечается пациентом в ходе повышения давления воздуха от 50 mm Hg. |
Третий этап диагностики — инструментальные исследования. Уточнить диагноз помогают:
- УЗДС вен. Метод позволяет обнаружить место локализации тромба, размеры сгустка и степень его подвижности.
- Флебография. Дает возможность оценить общее состояние вен.
- Классическое УЗИ, задействуемое в целях определения плотности образования.
Может ли быть назначено экстренное проведение инструментального исследования, является положительным: подозрение на 50% либо полную закупорку сосуда — показание к безотлагательному использованию методики.
Способы лечения
Схемы терапии варьируются в зависимости от вида тромба.
Эксперты выделяют 3 типа сгустков. В их числе:
- пристеночный (не перекрывающий просвет), располагающийся вплотную к тканям эластичных трубчатых образований;
- окклюзивный — более опасный, способный вызвать прекращение тока крови;
- флотирующий, один конец которого прикреплен к стенке вены, второй — свободно перемещается.
При выявлении в сосуде тромботической массы, относящейся к 1 либо 2 категории, назначается консервативная терапия; к третьей — хирургическая операция.
Медикаментозная терапия
Лечение тромбоза проводится в стационаре, при соблюдении пациентом постельного режима от 3 до 10 дней. Для купирования болезни применяется несколько групп медикаментов. В перечне назначаемых лекарственных средств:
- Антиагреганты, антикоагулянты — Курантил, Варфарин, Гепарин. Препараты препятствуют появлению тромбов, прогрессированию патологических процессов.
- НПВС — медицинские товары, снижающие дискомфорт, уменьшающие отечность (Ибупрофен, Диклофенак).
- Ангиопротекторы, используемые для улучшения микроциркуляции вен — Троксевазин, Рутин.
- Антибиотики пенициллиновой, фторхиноловой и цефалоспориновой групп. Назначаются при выявлении гнойных осложнений.
Запрещается применять вышеперечисленные средства без рекомендации врача.
Местная терапия
Методы лечения заболевания, выявленного на ранней стадии, заключаются в нанесении на кожные покровы пораженной области линиментов, гелей. Среди наиболее эффективных препаратов — Индовазин, Лиотон, Гепариновая мазь. Медикаменты снимают отеки, уменьшают дискомфорт.
Местную терапию рекомендуется задействовать в комплексе с ношением компрессионного белья. Класс трикотажа поможет выбрать лечащий врач.
Народные средства
Список наиболее востребованных рецептов нетрадиционной медицины состоит из настоев, ванночек и компрессов.
Для отваров используется вербена и крапива. 1 ст.л. выбранного сырья заваривается в 200 мл кипятка, остужается до комнатной температуры. Полученную жидкость следует употребить в течение дня.
Ванночки можно приготовить из сушеницы болотной (топяной). Стакан высушенной лечебной травы заливается 8 л воды, доводится до кипения и настаивается. Длительность процедур — 20-30 минут.
Регенерацию тканей ускоряют компрессы из полыни, листьев капусты. Облегчению боли способствуют обертывания на основе отвара бадяги.
Оперативное лечение
Хирургическое вмешательство становится единственным способом лечения тромбоза вен под коленями при выявлении риска отслоения сгустка.
Прогрессивным методом является малоинвазивная тромбэктомия — извлечение образования через небольшой разрез.
Среди новейших способов пресечения аномалии — имплантация кава-фильтра. Приспособление может быть временным либо постоянным; оно пропускает кровь и задерживает тромбы.
В сложных случаях назначается перевязка пораженной вены, а также ее разделение при помощи прошивания на каналы, препятствующие движению сгустков.
Возможные осложнения и прогноз
Благоприятный прогноз — результат ранней диагностики и точного выполнения пациентом всех рекомендаций флеболога.
В отсутствии своевременного лечения происходит отрыв образования. Тромб с кровотоком проникает в легочную артерию и закупоривает ее. ТЭЛА, или тромбоэмболия, ведет к гибели отдельной области легкого (пневмонии) либо блокаде движения биологической жидкости из ноги (венозной гангрене), может закончиться инвалидизацией, внезапной смертью.
Методы профилактики
Для предотвращения появления недуга рекомендуется вести здоровый образ жизни, регулярно совершать пешие прогулки, чередовать работу с кратковременными перерывами на отдых, посещать массажиста, соблюдать режим дня.
Особое внимание следует уделять правильному питанию — диета должна содержать большое количество ягод, имбиря, овощей, фруктов. Употребление жирных и сладких блюд, крепкого кофе нужно минимизировать.
Избежать инвалидизации и самого худшего развития событий можно путем своевременного прохождения профилактических медосмотров и посещения врача при малейшей проблеме с венами. Вовремя выявленное заболевание и адекватная терапия — залог сохранения здоровья.
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