There are many diseases of the blood vessels. Some of them are combined into the category "phlebitis". This is a general term for several diseases caused by different causes and affecting different parts of the veins. However, without proper treatment, they all lead to the same result - thrombophlebitis or pulmonary embolism, which can cause cardiac arrest. What are the causes of this disease? How to recognize it and start treatment on time so that a sad ending does not happen? What are the preventive measures 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 human blood vessels are divided into two main types - arteries and veins. According to the first, blood under pressure rushes from the heart, according to the second, it enters it more calmly. Precisely because the blood in the veins does not flow under pressure, their walls are thinner than in the arteries, weaker, capable of stretching and causing various unpleasant conditions in people, such asvaricose veins, hemorrhoids and others. They, in turn, provoke phlebitis. These are diseases of the veins, in which their walls become inflamed. The term "phlebitis" is easy to understand. It is derived from the Greek "phleva", which means "vein".
Inflammation of their walls is an unpleasant and rather dangerous thing. It is always accompanied by pain, people's working capacity decreases, motor activity is disturbed, and in advanced cases, thrombophlebitis develops, leading to blockage of veins with blood clots.
Classification of phlebitis by localization
As mentioned above, phlebitis is the common name for several vein diseases. According to the 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, endophlebitis. With inflammation of the outer layer, the disease periphlebitis is diagnosed. It is easy to decipher and remember this term if you remember that in Greek "peri" is used to denote distance from the center, in the free translation "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 vein membrane is inflamed. More oftenthe disease is called panphlebitis, that is, common, multiple, but indicate in which of the three layers of the vein wall predominant lesions are observed.
Classification by disease etiology
According to the nature of the course of the inflammatory process, there are also various phlebitis. These could be:
- necrotic destructive (in some infectious diseases);
- purulent (occurs with allergic inflammation);
- obliterating (proliferative moment prevails);
- pain (observed in the legs of women after childbirth);
- migratory, or wandering (often associated with thrombophlebitis, when blood clots travel through the vessels);
- pylephlebitis (collar vein becomes inflamed).
Phlebitis can be referred to by the name of the primary disease that led to inflammation in the veins:
- tuberculous;
- syphilitic;
- actinomycotic and others.
This classification is very important for determining the right treatment.
Classification according to the nature of the course of the disease
Depending on the location of the problematic blood vessels in the body, superficial phlebitis and deep vein phlebitis are distinguished. If the disease has affected 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 swelling 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 skin discoloration along the problematic vein.
If the disease has become chronic, it can occur with little to no symptoms. At first glance, this is not so serious, but chronic phlebitis is insidious precisely because of its apparent well-being, due to which patients do not go to the doctor and do not undergo treatment. The disease, meanwhile, gradually turns into neglected forms that are difficult to treat with drug therapy.
Reasons
Phlebitis on the upper and lower extremities is caused by different reasons. Most often, this disease on the legs is due to 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, both upper and lower extremities.
These include:
- vascular injury, including burns of any kind;
- infectious diseases;
- high sensitivity of venous walls;
- allergic inflammation;
- certain heart disease;
- prone to blood clots;
- lowered immunity;
- blood clotting problems (acquired or hereditary).
Artificial phlebitis
With varicose veins in recent years, a method of treatment called sclerotherapy has been actively used. It lies in the fact that patients cause artificial (not associated with infection) phlebitis. Inflammation does not occur in this case. The sclerotherapy procedure is almost painless and quite effective. Outpatient patients are injected with a syringe into the problem areas of the veins with special preparations (Trombovar, Ethoxyclerol and others), which cause the walls of blood vessels to stick together. It resolves on its own within 5-6 months.
How true phlebitis occurs
The mechanism of development of this disease can be twofold. In some cases, problems first appear in the vein, and then the inflammation passes to the surrounding tissues. 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 inflammation of the veins of the ankle with varicose veins can look like.
Phlebitis caused by pathogenic microorganisms is obtained as follows: viruses or microbes, having penetrated into a venous blood vessel, move with the blood stream until they attach to its wall in some place. It mostly happens where the veins are abnormal (dilated, with venous congestion, etc.), but can also occur in places where the veins are normal and perfectly he althy.
Phlebitis,symptoms
General symptoms of this disease include:
- soreness of an inflamed vein or entire limb;
- general malaise, weakness;
- change in skin color at the site of inflammation;
- increase in temperature (local and sometimes general);
- densification of the skin in the problem area;
- with phlebitis of the lower extremities, symptoms of varicose veins (heaviness in the legs, swelling, ulcers) can be observed.
However, if there is cerebral phlebitis, the symptoms and treatment are somewhat different. So, patients complain of increased pressure, headache, dizziness, visual impairment, perception of the world.
Pylephlebitis (inflammation of the portal vein in the peritoneum) has slightly different symptoms, in which there are:
- weakness;
- fever;
- vomit;
- ascites;
- severe pain in the liver;
- jaundice of the skin;
- headaches;
- chill;
- enlarged liver, spleen;
- anuria;
- threaded pulse;
- low blood pressure;
- swelling of limbs;
- bloating.
This condition without timely action leads to the death of the patient.
Diagnosis
Regardless of where the phlebitis occurs in the body - on the arm, on the lower extremities or in the collar zone, the diagnosis includes:
- examination by a doctor (phlebologist, vascular surgeon, or at least a general practitioner if there are no specialized doctors in the local medical facility);
- gathering anamnesis;
- general or advanced blood test if an infectious disease is suspected;
- duplex scanning of vessels, which allows you to get all the necessary information about the veins located anywhere in the body;
- doppler ultrasonography of veins.
Treatment of hand phlebitis
If there is no indication for immediate hospitalization (high fever, dizziness, loss of consciousness, acute heart failure, too high blood pressure), 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 rest, it is desirable 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 the cause of inflammation was a viral infection, drugs that fight viruses are prescribed, and antibiotics are prescribed for bacterial phlebitis. In any case, the patient is prescribed:
- anti-inflammatory drugs;
- preparations that strengthen the walls of the veins and improve blood circulation (for example, Trental);
- topical ointments to relieve fever, redness, swelling and pain;
- blood-thinning drugs;
- analgesics.
Treatment of phlebitis of the lower extremities
Inflammation of the vessels in the legs is often the result of varicose veins and is fraught with a transition to thrombophlebitis, leading to thrombosis. A blood clot that has reached the heart can cause it to suddenlystoppage and death of the patient. Therefore, if acute phlebitis (inflammation of deep or superficial veins) and thrombophlebitis are 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 diseased limb, acute pain is stopped, medications are prescribed that regulate blood flow, blood viscosity, improve the elasticity of the walls of the veins, physiotherapy procedures are performed, and in special cases, surgical intervention 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, gallbladder, excision of an abscess). In parallel, medical treatment is carried out (antibiotics, detoxifiers, sorbents, general strengthening).
With cerebral phlebitis, patients are usually hospitalized. Treatment of this disease is aimed at normalizing blood pressure, relieving pain syndromes, normalizing blood flow and strengthening the walls of the veins. Therapy is also available to support normal brain activity.
Treatment of migrating phlebitis is performed by crossectomy (removal of the affected area of the vein). Formed blood clots can be removed surgically, but more often enzymes are used that dissolve the blood clot. They are inserted into a vein with a special catheter. The patient is discharged from the hospital forcontinuation of treatment on an outpatient basis after the removal of inflammation and the achievement of a stable satisfactory condition of the patient.
Prevention
Phlebitis, that is, inflammation of the walls of a vein, can happen to every person. To reduce the risk of developing the disease, you need to follow these recommendations:
- follow the rules for intravenous injections;
- if possible, avoid injury to the veins, and if they happen, treat them correctly;
- in the presence of infectious diseases, follow all the requirements of the doctor and do not self-medicate;
- suffering from varicose veins - strictly follow the recommendations of the treating specialists;
- those with hyperviscosity syndrome - avoid eating spinach, soy, rose hips - foods that increase viscosity even more;
- be sure to lead such a lifestyle that the body receives moderate exercise.
Be he althy!
