There are many diseases of blood vessels. Some of them are grouped into the phlebitis category. This is a general term for several diseases caused by various causes and affecting different parts of the veins. However, without proper treatment, all of them lead to the same result - thrombophlebitis or pulmonary thromboembolism, which can cause cardiac arrest. What are the causes of this disease? How to recognize him and start treatment in time so that a sad ending does not happen? What preventive measures are available to prevent inflammation of the veins? We will try to answer all these questions in detail and clearly.
What is phlebitis
We all know that a person’s blood vessels are divided into two main types - arteries and veins. By the first, blood rushes out of the heart under pressure from the heart; by the second, it flows more calmly into it. Precisely because the blood in the veins does not flow under pressure, their walls are thinner than in the arteries, weaker, able to stretch and cause various unpleasant conditions in people, such as varicose veins, hemorrhoids and others. They, in turn, provoke phlebitis. These are vein diseases in which their walls become inflamed. The term phlebitis is easy to understand. It is formed from the Greek "flav", which means "vein".
Inflammation of their walls is an unpleasant and rather dangerous thing. It is always accompanied by pain, people have reduced performance, impaired motor activity, and in advanced cases, thrombophlebitis develops, leading to clogging of the veins with blood clots.
Classification of phlebitis by localization
As already mentioned above, phlebitis is the common name for several diseases of the veins. At the place of localization of diseased vessels, phlebitis of the upper and lower extremities is distinguished. Human veins are hollow tubular structures, the walls of which are formed by three layers - the strongest outer, very weak middle and inner. It is called endothelium, and its inflammation, respectively, is endoflebitis. With inflammation of the outer layer, the disease is diagnosed peripheralitis. It is easy to decipher and remember this term if we recall that in Greek “peri” is used to denote the distance from the center, in the free translation of “edge”, “periphery”.
If the middle layer is inflamed, the disease is called mesophlebitis. "Meso" in Greek means "in the middle." So here, too, everything is logical and understandable.
In practice, phlebitis is very rarely differentiated by the fact that the lining of the vein is inflamed. More often the disease is called panflebitis, that is, general, multiple, but indicate in which of the three layers of the vein wall the primary lesions are observed.
Classification by etiology of the disease
By the nature of the course of the inflammatory process, various phlebitis also exist. It can be:
- necrotic destructive (with some infectious diseases);
- purulent (it happens with allergic inflammation);
- obliterating (proliferative moment predominates);
- pain (observed in the legs of women after childbirth);
- migratory, or wandering (often associated with thrombophlebitis when blood clots travel through vessels);
- pylephlebitis (collar vein inflamed).
Phlebitis can be called by the name of the primary disease that led to inflammatory processes in the veins:
- tuberculous
- syphilitic;
- actinomycotic and others.
This classification is very important for determining the correct treatment.
Classification by the nature of the course of the disease
Depending on the location of the problematic blood vessels in the body, phlebitis of superficial and phlebitis of deeply located veins are distinguished. If the disease affects vessels located close to the surface of the body, hyperthermia (redness, fever) is observed on the skin at the site of the inflamed vein. Inflammation of deep veins is especially dangerous, as it places higher demands on diagnosis and treatment.
Patients have edema and pallor of the skin in the area of inflamed vessels, general hyperthermia, weakness, pain. All these signs are well expressed if the patient is diagnosed with acute phlebitis of the lower extremities. The photo above shows a change in skin color along a problem vein.
If the disease has turned into a chronic form, it can occur with little or no symptoms. At first glance, this is not so serious, but chronic phlebitis is insidious precisely because of its apparent well-being, thanks to which patients do not go to the doctor and do not conduct treatment. The disease, meanwhile, gradually turns into neglected, difficult forms of drug therapy.
Causes
Phlebitis on the upper and lower extremities is caused by various reasons. Most often, this disease on the legs is caused by complications of varicose veins, and phlebitis on the arm appears after unsuccessful intravenous injections or insufficient disinfection of the injection site. But there are a number of common causes that cause inflammation in the venous walls of both the upper and lower extremities.
These include:
- injury to blood vessels, including burns of any kind;
- infectious diseases;
- high sensitivity of venous walls;
- allergic inflammation;
- some heart diseases;
- predisposition to blood clots;
- reduced immunity;
- problems with blood coagulation (acquired or hereditary).
Artificial phlebitis
With varicose veins in recent years, a treatment method called sclerotherapy has been actively used. It lies in the fact that patients cause artificial (not related to infection) phlebitis. Inflammation in this case does not occur. The sclerotherapy procedure is almost painless and quite effective. Special drugs (Trombovar, Ethoksiklerol and others) are injected into the patient outpatient areas of the veins on an outpatient basis, causing gluing of the vessel walls. It resolves independently within 5-6 months.
How true phlebitis arise
The mechanism of development of this disease can be twofold. In some cases, problems first appear in the vein, and after inflammation passes to the surrounding tissue. In other cases, on the contrary, a person initially has an abscess of some body tissues, which subsequently affects the walls of the vein, that is, phlebitis develops as a complication of the underlying disease. The photo below shows what the inflammation of the ankle venous vessels might look like with varicose veins.
Phlebitis caused by pathogenic microorganisms are obtained as follows: viruses or microbes, having penetrated into a venous blood vessel, move with a blood stream until they attach to its wall in some place. This mainly happens where the veins have deviations from the norm (dilated, with venous congestion , etc.), but can also occur in places where the veins are normal and completely healthy.
Phlebitis, symptoms
The general symptoms of this disease include:
- soreness of an inflamed vein or entire limb;
- general malaise, weakness;
- discoloration of the skin at the site of inflammation;
- temperature increase (local, and sometimes general);
- skin tightening in a problem place;
- with phlebitis of the lower extremities, symptoms of varicose veins (heaviness in the legs, swelling, ulcers) may be observed.
However, if cerebral phlebitis is observed, the symptoms and treatment are somewhat different. So, patients complain of increased pressure, headache, dizziness, visual disturbances, perceptions of the outside world.
Pylephlebitis (inflammation of the portal vein in the peritoneum) also has slightly different symptoms, in which there are:
- weakness;
- fever;
- vomiting
- ascites;
- severe pain in the liver;
- yellowness of the skin;
- headache;
- chills;
- enlargement of the liver, spleen;
- anuria
- filamentous pulse;
- low blood pressure;
- swelling of the extremities;
- bloating.
This condition without timely measures leads to the death of the patient.
Diagnostics
Regardless of where the phlebitis appeared in the body - on the arm, on the lower extremities or in the collar zone, the diagnosis includes:
- examination of a doctor (phlebologist, vascular surgeon, or at least a general practitioner, if there are no doctors of narrow specialties at the local medical institution);
- history taking;
- general or extended blood count, if there is a suspicion of the presence of an infectious disease;
- duplex scanning of blood vessels, allowing you to get all the necessary information about veins located anywhere in the body;
- dopplerographic ultrasound of veins.
Hand phlebitis treatment
If there is no indication for immediate hospitalization (high fever, dizziness, loss of consciousness, acute heart failure, too high blood pressure), treatment of phlebitis on the arm, due to the fact that it is almost never complicated by thrombosis, is performed on an outpatient basis. The patient is prescribed peace, it is advisable to fix the problematic arm so that there is no increased blood flow to the inflamed area. Therapy is carried out medically taking into account the cause of the disease. So, if a viral infection was the cause of the inflammation, drugs that fight viruses are prescribed, and antibiotics are prescribed for bacterial phlebitis. In any case, the patient is prescribed:
- anti-inflammatory drugs;
- drugs that strengthen the walls of the veins and improve blood circulation (for example, Trental);
- topical ointments that relieve heat, redness, swelling and pain;
- blood-thinning drugs;
- analgesics.
Treatment of phlebitis of the lower extremities
Vascular inflammation on the legs is often the result of varicose veins and is fraught with a transition to thrombophlebitis, leading to thrombosis. A blood clot that reaches the heart can cause it to suddenly stop and the patient die. Therefore, if acute phlebitis (inflammation of the deep or superficial veins) and thrombophlebitis is diagnosed on the lower extremities, the patient may be offered hospitalization without severe symptoms such as dizziness and loss of consciousness. An elastic bandage is applied to the sore limb, acute pain is stopped, medications that regulate blood flow, blood viscosity, improve the elasticity of the walls of the veins are prescribed, physiotherapeutic procedures are performed, and in special cases, surgery is prescribed.
Treatment of other types of phlebitis
The success of the treatment of pylephlebitis depends on the speed and accuracy of the diagnosis. Very often, the patient is prescribed a surgical operation to remove the source of purulent inflammation (appendix, gall bladder, excision of the abscess). In parallel, drug treatment is carried out (antibiotics, detoxifiers, sorbents, restorative).
With cerebral phlebitis, patients are usually hospitalized. The treatment of this disease is aimed at normalizing blood pressure, relieving pain syndromes, normalizing blood flow and strengthening the walls of veins. There is also therapy that supports the normal functioning of the brain.
Treatment of migratory phlebitis is performed by crossectomy (removal of the affected vein). Blood clots can be removed surgically, but enzymes that dissolve a blood clot are more often used. They are injected into a vein with a special catheter. From the hospital, the patient is discharged home to continue treatment on an outpatient basis after removing the inflammation and achieving a stable satisfactory condition of the patient.
Prevention
Phlebitis, that is, inflammation of the walls of a vein, can happen in every person. To reduce the risk of a disease, you need to follow these recommendations:
- comply with the rules for intravenous injection;
- if possible, avoid trauma to the veins, and if they happen, treat correctly;
- in the presence of infectious diseases, comply with all the requirements of the doctor and not self-medicate;
- suffering from varicose veins - strictly follow the recommendations of the treating specialists;
- those with a syndrome of increased blood viscosity - avoid eating spinach, soybeans, rose hips - foods that increase viscosity even more;
- it is imperative to lead a lifestyle so that the body receives moderate exercise.
Be healthy!