Deep vein thrombosis of the lower extremity
1.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 leads to swelling and pain in the extremities due to increased venous pressure and extravasation of blood components.
2.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 red, or even blue-purple in severe cases; the skin temperature is slightly higher; the heaviness of the limb can be partially relieved by raising the affected limb.
3.What is the danger of lower limb 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, the patient 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 in the tissues due to the large amount of venous blood retained in the lower limbs and compression of arteries and nerves. 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, called “femoral cyanosis”; if it has seriously compressed the artery, the manifestation is the lower limb with swelling, coldness, pallor and numbness, 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 of the lower extremity.
4.Why does thrombosis of the deep veins of the lower limbs 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 (blood hypercoagulation), 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 inclined and worthy of your vigilance.
5.How can early detection of lower extremity deep vein thrombosis 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.
6.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, paralyzed in bed, bed-bound patients after fracture for a long time; people who are sedentary for a long time, such as those who ride on 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.
7.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 and promote venous blood return, which can play a role in preventing the formation 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, avoid cross-legged mutual compression, 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 the high-risk group of DVT, please follow the advice of your vascular surgeon to take oral medication to prevent the occurrence of DVT, and do not take medication on your own.
8.What are the consequences of deep vein thrombosis if left untreated?
A: Generally speaking, some of the lower limb DVT has the tendency of self-healing, but after self-healing, the post DVT syndrome will be more serious, which is mainly manifested as skin pigmentation of foot and ankle, superficial venous tortuosity, deep venous blood backflow (some patients feel a feeling of blood rushing downward in their legs when they stand up or when the abdominal pressure increases). (some patients show a feeling of blood rushing downward when standing up or when the abdominal pressure increases), and even develop to the formation of hard-to-heal ulcers on the calf skin, which seriously affects the quality of life, so once the diagnosis of deep vein thrombosis is confirmed, it should be treated promptly.
9.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. At present, 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 the comprehensive domestic and foreign literature reports, it is believed that the use of anticoagulation can obtain the greatest therapeutic benefits with the least risk.
In general, patients with “bruised femur” or “white femur” should be treated immediately with thrombolysis, and for patients who require thrombolysis or thrombolysis, or who are at high risk of thrombus dislodgement, a permanent or temporary filter should be implanted in the inferior vena cava to If the DVT has passed the acute phase into the chronic phase, the main treatment is oral anticoagulant (warfarin) therapy, with regular monitoring of coagulation parameters and international standard ratios between 2 and 3 before the drug is considered effective. Since the treatment of DVT requires a high degree of professionalism, and the specific treatment plan should be formulated according to the individual patient’s condition, once DVT is suspected or diagnosed, the patient should immediately receive professional treatment in vascular surgery.
10.How long does anticoagulation therapy for DVT need to be carried out? Why do many patients still have different degrees of swelling in the lower limbs after anticoagulation therapy?
A: Generally speaking, deep vein thrombosis becomes a chronic disease 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”, which is generally between 2 and 3, indicating 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 exudation 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.