What is lower limb deep vein thrombosis?
When the blood in the deep vein system clots and forms thrombus for various reasons, the blood in the lower extremities cannot return to the heart smoothly, and a large amount of blood stays in the lower extremities, which increases the venous pressure and causes extravasation of blood components, resulting in swelling and pain in the extremities.
What are the symptoms of lower extremity deep vein thrombosis?
A: The most common symptoms of lower extremity DVT patients are swelling, distension, and superficial varicose veins in the lower extremities. In addition, the skin color is mostly flushed, or even blue-purple in severe cases; the skin temperature is slightly higher; the heaviness of the limb and elevation of the affected limb can partially relieve the pain.
Is there any danger of lower extremity deep vein thrombosis?
A: The most dangerous complication of lower limb DVT is pulmonary embolism, that is, the thrombus growing in the deep vein system is dislodged and reaches the pulmonary artery through the heart in the direction of blood flow, causing pulmonary artery embolism, patients will have chest pain, chest tightness, coughing and coughing blood, and even sudden death in serious cases; severe lower limb DVT will cause severe edema and compression of arteries and nerves due to the large amount of venous blood retained in the lower limbs. If this kind of DVT has not yet seriously compressed the artery, the main manifestation is the lower limb with blue color, numbness and serious swelling, which is called “femoral cyanosis”; if it has seriously compressed the artery, the manifestation is the lower limb with swelling, coldness, pallor and numbness, which is called “femoral white swelling”. “Both of them are very dangerous, and untimely diagnosis or treatment will lead to serious consequences of amputation or death. In addition, if the lower extremity deep vein thrombosis passes through the acute stage into the chronic stage, it will also destroy the deep vein valve, and deep vein valve insufficiency will occur, leading to swelling, skin pigmentation, and hard-to-heal ulcers in the lower extremity.
Why does thrombosis of the deep veins of the lower extremities occur?
A: In 1856, Virchow, a German pathologist, proposed three basic elements for the formation of venous thrombosis: changes in the vessel wall (intimal damage), changes in blood flow (venous stasis), and changes in the nature of blood (hypercoagulable state of blood), which are the recognized elements for the formation of venous thrombosis. The presence of various risk factors does not necessarily have the consequence of thrombosis, but only indicates that the presence of these factors makes the occurrence of deep vein thrombosis more predisposed and warrants your vigilance.
How can early detection of lower extremity DVT be achieved?
A: The early manifestation of lower limb DVT is mainly the swelling and pain of the limb. This is the most common symptom of DVT. In addition, because the thrombus stimulates the inflammatory reaction of the vein wall and stimulates the nerve endings, pain usually appears in the calf stomach, thigh and groin area, which is also a common symptom.
What kind of people are prone to deep vein thrombosis?
A: Deep vein thrombosis mainly occurs in various braking states, such as bed-bound braking after various abdominal or lower limb surgeries, paralysis in bed, patients who are bed-bound for a long time after fracture are prone to occur; people who are immobile for a long time**, such as those who take airplanes and automobiles for a long time; drivers, editors, clerks, typists, machine tool workers and other people who sit/stand still for a long time are prone to occur; elderly people with thick blood are more prone than young people; men, Obese people, kidney disease patients, immune disease patients, tumor patients and other pathological states are also more susceptible than healthy people.
How to prevent the occurrence of deep vein thrombosis?
A: In daily life, pay more attention to exercise the muscles of the lower limbs to play the role of muscle pump to promote venous blood flow, which can play a role in the prevention of deep vein thrombosis, such as sitting or standing for a long time without moving the lower limbs from time to time to promote blood circulation, to avoid crossed legs and mutual compression, to avoid wearing too tight clothing and pants to avoid obstructing blood circulation, in addition, usually pay attention to drinking more water to dilute blood. In addition, we should pay attention to drink more water to thin the blood, and try to smoke less and drink less coffee and alcohol. If you are already in a high-risk group for DVT, please follow the advice of your vascular surgeon to take oral medication to prevent DVT, and do not self-medicate.
What are the consequences of untreated DVT?
A: Early stage DVT is prone to thrombus dislodgement which leads to pulmonary embolism, and chronic stage DVT will lead to post-thrombotic sequelae, i.e., due to the destruction of DVT valve, it cannot effectively stop the venous blood reflux, which mainly manifests as skin pigmentation on the foot and ankle, superficial venous tortuosity, deep venous blood backflow (some patients manifest a feeling of blood rushing downward in the leg when standing up or when the abdominal pressure increases), and even a feeling of blood rushing downward. Some patients may feel a feeling of blood rushing downward when they stand up or when the abdominal pressure is high.
What are the treatment methods of DVT?
A: The main treatment methods in the acute stage are divided into two categories: conservative treatment and surgical treatment. Currently, the most effective conservative treatment in the acute stage is the use of low-molecular heparin anticoagulation, although some experts advocate the use of thrombolytic drugs for thrombolysis within 72 hours, but comprehensive domestic and foreign literature reports, it is believed that the use of anticoagulation can achieve the greatest therapeutic benefit with the least risk. Patients with “bruising” or “white swelling” need to be considered for surgical thrombectomy, and patients who require thrombectomy or thrombolysis, or who are at high risk for thrombus dislodgement, also need to have a permanent or temporary filter implanted in the inferior vena cava If the DVT has passed the acute phase into the chronic phase, the main treatment is oral anticoagulant medication (warfarin), which is considered effective when the coagulation parameters are monitored regularly and the international standard ratio is between 2 and 3. Since the treatment of DVT requires a high degree of expertise and the specific treatment plan should be tailored to the individual patient, once DVT is suspected or diagnosed, the patient should immediately receive specialized care in vascular surgery.
How long does anticoagulation therapy for DVT take? Why do many patients still have different degrees of swelling in the lower extremities after anticoagulation therapy?
A: Generally speaking, deep vein thrombosis evolves into a chronic course characterized by deep vein valve insufficiency after the acute phase. In the acute phase, low-molecular heparin is used for anticoagulation, and after the acute phase, oral warfarin is used for anticoagulation, and the dosage of the drug is adjusted according to the monitoring of the coagulation index “international standard ratio”, generally the value is between 2 and 3, which indicates that the drug is effective. This is because deep vein thrombosis will cause different degrees of damage to the valves of the deep veins after the formation of deep vein thrombosis, and the role of the valves to prevent the backflow of venous blood is destroyed, and the venous blood is stagnated in the legs under the effect of gravity, resulting in higher venous pressure and increased leakage in the legs. The swelling of the lower limbs occurs, and the symptoms are relieved when the blood flow is increased by elevating the affected limbs. This condition can be treated by taking oral medication to reduce swelling and improve circulation, and wearing anti-thrombotic medical compression stockings.