A. What is deep vein thrombosis of the lower extremities? (also known as phlebitis)
1, what is called thrombosis DDD, we all know that the blood in the human circulatory system contains many substances related to coagulation, medically known as factors, some are to prevent coagulation, some are involved in coagulation, when normal anticoagulation and coagulation factors are balanced, so the blood is maintained in the flow state. Once the balance is lost, then the tangible substances in the blood such as platelets, red blood cells and white blood cells will clot together, which is commonly known as the formation of blood clots in the blood vessels.
2, what is the lower extremity deep vein thrombosis DDD, normal organs are supplied by the blood supply arterial system for tissue needs, and metabolism with part of the metabolites of the blood from the venous system back to the heart and lungs in the exchange and then into the circulation, so the cycle is endless. Then, the blood vessels that supply blood are called arteries and the blood vessels that return blood are called veins. The deep veins are invisible in the deep part of the limbs, while the superficial veins are visible under the skin of the body.
Second, what are the symptoms of lower limb deep vein thrombosis?
1.What are the types of lower limb deep vein thrombosis?
First, the central type refers to the thrombosis occurring in the iliofemoral vein.
The second is the peripheral type refers to the thrombosis below the femoral s section.
The third is the mixed type is both of them.
2.There are four kinds of clinical manifestations
(1) Pain, regardless of the type of lower limb deep vein thrombosis has the performance of pain, which is stimulated by the thrombus, mostly distension, while the central type has different degrees of pain in the whole lower limb, and the peripheral type only has pain in the calf, especially when the posterior calf is sagging, and will be better when lying down or the limb is elevated.
(2) Swelling of the limb, because the vein is blocked by thrombus, then the venous return is not good, so no matter what type of lower limb deep vein thrombosis has swelling, only the degree and scope are different, central type and mixed type have swelling of the whole lower limb, while peripheral type is mostly in the calf and foot, the swelling looks obvious and has a hard feeling when touched by hand, and indentation marks can be seen when pressed. If the skin color remains unchanged, it is called white swelling of the femur, and if the bruising is heavy, the skin becomes blue and purple, and it is called blue swelling of the femur.
(3) Superficial varicose vein, because the deep veins of lower limbs are blocked by blood clots, which causes obstruction of return flow, superficial veins will compensate for the varicose, and when examining the lower limbs, we can find that the skin color is blue, and the small veins that usually cannot be seen can be seen.
(4) Systemic reaction, depending on the disease, there are different degrees of temperature increase, pulse rate increase, and white blood cell increase, etc.
What are the incidence and complications of lower extremity deep vein thrombosis?
The incidence of DD is higher in western countries than in China, and the incidence rate of patients after abdominal surgery is reported to be 20%-40%, and the incidence rate in China has been increasing in recent years.
Serious complication DD pulmonary embolism, because the blood flow of lower limbs eventually returns to the heart and lungs, so when the thrombus in the deep vein of lower limbs is dislodged and returns directly to the pulmonary artery DD pulmonary embolism can be formed, and serious cases can die. It is usually most likely to be complicated in the first 10 days. The incidence of pulmonary artery embolism is high, according to the recent statistics of the United States every year in the United States about 260,000 people suffer from lower extremity deep vein thrombosis, of which the number of deaths caused by pulmonary embolism is more than 100,000.
One more complication is the inferior vena cava thrombosis, the two lower extremity veins will merge together in the abdominal cavity and go up to the heart, this section is called vena cava, after the blockage of both lower extremities occur severe swelling.
What factors can lead to venous thrombosis? What groups of people are vulnerable to this disease?
1.Three main factors of thrombosis
(1) Slow blood flow and stagnant blood flow DD arterial thrombosis is less and venous thrombosis is more, which is because of slow venous blood flow, such as fracture patients, hemiplegic patients, postpartum women because of long time bed-ridden slow blood flow and therefore stagnant blood flow, forming thrombosis in the blood vessels.
(2) Damage to the endothelium of the vein – the endothelium of the vein wall is a layer of endothelial cells, which can secrete some anticoagulant substances when it is normal to make the blood flow normal, just like a layer of galvanized layer inside the iron water pipe to prevent water rust, if the endothelium is damaged by trauma, surgery, etc., then thrombus will be formed.
(3) Blood hypercoagulation – blood, such as increased blood lipids, increased other coagulation factors and other factors lead to blood into a hypercoagulable state, which is also known as blood sticky, thick blood. Then, the blood is naturally easy to coagulate and become thrombosis.
2.Predisposed people
(1) People over 40 years old, the aging of the blood vessel wall, the inner lining is not flat, the blood viscosity is increased, the amount of movement is low, and the blood flow is slow.
(2) Patients with malignant tumors, statistics show that the incidence of such patients is 20% higher than that of normal people.
(3) Patients with hemiplegia, patients with hyperlipidemia, patients with fractures and postoperative patients, slow blood flow, high blood viscosity and easy to form thrombosis.
(4) Long-term users of birth control pills. Poor blood anticoagulability.
(5) Patients with severe infection and severe dehydration also form thrombosis due to thick blood and slow blood flow.
V. What are the examination methods for lower limb deep vein thrombosis?
1.Color Doppler vascular ultrasonography is the most commonly used non-invasive examination method, which can directly describe the thrombosis in blood vessels.
2.Venography is an invasive examination method, by injecting the contrast agent into the blood vessel, the thrombus can be seen directly under the X-ray.
3.If available, magnetic resonance imaging (MR), electronic computer scanning (CT), radionuclide examination (ECT) can be performed.
6.What are the diseases that should be distinguished from lower limb deep vein thrombosis?
1.Swelling caused by internal diseases, most commonly caused by kidney disease and cardiac insufficiency.
However, the swelling is characterized by bilateral symmetric swelling and the manifestation of renal insufficiency or cardiac insufficiency, such as the increase of urea nitrogen value in laboratory tests, abnormal cardiac electricity, and previous history of pulmonary heart disease. Therefore, internal diseases should be excluded first.
2. Lymphedema is also easily confused with this disease, which is characterized by swollen skin with thickened sweat pores, mostly in the ankles, and some patients have a history of living in the south, because a filarial infection in the south can lead to this disease.
3, there is also the onset of the disease due to poor liver function and low protein and malnutrition.
Seven, how to treat lower limb deep vein thrombosis?
1.Drug treatment
(1)Thrombolytic therapy: Urokinase, streptokinase, Chinese herbal medicine such as blood sparing and thrombosis.
(2)Anti-platelet coagulation set: aspirin, Chinese herbal medicine such as Chuanxiongzin
(3) anti-coagulation; heparin-like preparations: such as Sulforaphane, Unisu, etc. Chinese herbal medicine has leech preparations such as pulse blood Kang, etc.
2.Surgical treatment
Requires a relatively short history of onset, if the time exceeds 72 hours, then there is no difference between surgery and drug treatment, in fact, the patient’s main story is often more than three days, so clinically suitable for surgical treatment is rare.
3. Body position and elastic stocking application
We all know that water flows to the lower part of the body and veins are the conduit for blood return, so elevation of the lower limbs is good for decreasing the swelling of veins, and wearing elastic stockings when appropriate can also help the return flow.
4.Mechanical treatment.
After ten days, the circulatory drive instrument can be applied for treatment.
Eight, the advantages of combining Chinese and Western medicine to treat this disease?
1. For a long time, the combination of Chinese and Western medicine has been used to treat this disease, especially for patients who have passed the acute stage, the pure Western medicine drug treatment is not very satisfactory, while we have achieved more satisfactory results by applying the combination of Chinese and Western medicine.
2. Chinese medicine classifies this disease into several types such as damp-heat type, blood stasis type, and silt-heat mutual type. According to different tongue and pulse manifestations, we can treat the disease clinically with Dioscorea Z, Blood Stasis, homemade Chinese medicine, intravenous drip Chinese medicine, external fumigation Chinese medicine, etc., which are more satisfactory in terms of efficacy.
3, especially for part of the patients with sequelae, when there is no special treatment method, there is no doubt that the combination of Chinese and Western medicine will bring hope in treating this disease.
Nine, how to prevent deep vein thrombosis?
The classical Chinese medical text “Nei Jing” said: “Do not treat the disease to cure the disease before it happens”. In other words, prevention is more important when you don’t have the disease.
1. Regular exercise can mobilize the pumping action of the leg muscles.
2, people who are engaged in frequent standing work should wear tight-fitting clothes and pants to protect the legs.
3, arteriosclerosis, hyperlipidemia, hypertension, and other people with the tendency of thrombosis, usually can take aspirin and other anti-platelet coagulation drugs.
4, long-term bedridden people such as hemiplegia, fractures and other people should often move the lower extremities, their own activities have difficulties, can be passively moved by others.
5. Pregnant women can often elevate the lower limbs. Wear elastic stockings for protection.
6, long-distance travelers, sleepers, airplanes, etc. should regularly move the lower limbs, flexion and extension of the joint movement.