Disease

Thrombosis prophylaxis

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Thrombosis and thrombophlebitis are diseases that belong to the category of acute pathologies. Thrombosis - obstruction (clogging) of a vessel with a blood clot due to intravital thrombus formation. Thrombophlebitis - thrombosis of the superficial venous vessel with inflammation of its wall. When deep veins are affected, the terms “deep vein thrombophlebitis” or “phlebothrombosis” are used.

Can the disease be cured completely? Thrombotic lesion is often systemic in nature, that is, several vessels are affected at once, therefore it is impossible to talk about complete cure. But if the damage is local and single in nature, then, provided timely assistance is provided, the pathology can be eliminated and the patient's life prolonged.

In addition to the separation of a thrombus and its entry into the pulmonary arteries (pulmonary embolism), subsequent development of chronic vascular insufficiency of the venous bed and PTFS (post-thrombophlebitic syndrome). The sooner qualified assistance is provided, the lower the risk of developing these conditions.

Which doctor is treating?

He is engaged in the treatment of vascular pathology phlebologist or vascular surgeon. Phlebology is a branch of medicine that studies in detail the structure and functioning of blood vessels. Which doctor should I go to in the absence of highly specialized doctors? In such cases, the general surgeon is involved in the treatment.

Clinical recommendations

There are clinical recommendations for the treatment of thrombosis and thrombophlebitis. The compilers are doctors of the Association of Phlebologists of Russia. They detail the pathomorphology, pathophysiology of the development of the disease, clinical manifestations, diagnostic methods, therapy and prevention.

The developers are V.V. Soroka and K.A. Andreichuk. The protocol was approved on January 23, 2014 by the Russian Society for Emergency Medicine in Kazan.

First Aid Standard

Since thrombosis is an acute condition, emergency treatment is necessary to prevent the development of severe complications. Emergency care is provided by an ambulance team. Prior to her arrival, one must give the limb an elevated position and immobilize it (immobilize).

At the prehospital stage, therapy is carried out with the help of anticoagulants and antiplatelet agents, anti-inflammatory drugs. The standard for ambulance is as follows:

  1. Heparin intravenously up to 10,000 units.
  2. Acetylsalicylic acid 375 mg orally.
  3. Analgin 50% - 2 ml intramuscularly.

Transportation is carried out with a raised position of the affected limb.

The use of anticoagulants

Anticoagulant therapy is aimed at inhibiting the process of further thrombosis and enhancing the action of endogenous thrombolysis enzymes. There are 2 groups of anticoagulants - fast (heparin, enoxaparin) and slow action (warfarin, acenocoumarol and others). For emergency therapy, the first group is used.

Contraindications of blood thinners for thrombophlebitis:

  • hemophilia,
  • increased permeability of the vascular wall,
  • infectious endocarditis in the subacute phase,
  • oncological diseases,
  • leukemia
  • gastrointestinal ulcer,
  • aplastic and hypoplastic anemia,
  • heart aneurysm
  • impaired renal and hepatic function in the stage of decompensation,
  • allergic manifestations.

In addition to vein thrombosis, this group of drugs also has other indications that explain the advisability of prescribing as a preventive measure.. Among them:

  • prevention of thrombosis during surgical interventions,
  • acute myocardial infarction,
  • progressive angina pectoris,
  • DIC
  • during hemodialysis and AIC.

The following drugs are used:

Heparin is prescribed at a dosage of 10,000 units intravenously and 5,000 units intramuscularly every 4 hours during the day. Then, on the second day, 5000 IU every 4 hours, on the third day - 5000 IU every 6 hours. Therapy should be carried out under the supervision of coagulogram indicators. Clinical significance are:

Thrombolytic therapy

What dilutes blood and removes thrombosis? Thrombolytic therapy is the use of thrombolytic drugs. The healing properties of this group are aimed at dissolving an existing blood clot.

Indications:

  • heart attack
  • stroke,
  • Tela
  • thrombosis of arterial and venous vessels,
  • thrombosis of implanted valves, shunts.

The following drugs are referred to thrombolytics:

  1. Streptokinase
  2. Urokinase.
  3. Alteplaza.
  4. Fibrinolysin.
  5. Staphylokinase.
  6. Actilise.
  7. Metalization.

It makes sense to resort to this method at the beginning of the disease. Despite its effectiveness, there are a number of contraindications:

  • the risk of aneurysm stratification,
  • internal or external bleeding,
  • massive uterine bleeding, after which less than 2 weeks have passed,
  • suspected pericarditis, acute pancreatitis,
  • a history of hemorrhagic stroke,
  • thrombocytopenia
  • allergic reactions
  • pregnancy,
  • high blood pressure, not stopped by drugs.

The drug is administered as an injection at a dosage of 250,000 ME, then 100,000 ME / hour (streptokinase), 4400 IU / kg for 20 minutes, then 40000-60000 ME per day (urokinase).

Endovascular surgery to cure thrombosis

Endovascular methods are aimed at intravascular thrombus removal - thrombectomy. Indications for this method are:

  1. Obstruction of large vessels with a thrombus or blood clot.
  2. Floating (mobile) thrombus.

This method has several contraindications:

  • malignant neoplasms,
  • 3 trimester of pregnancy,
  • sepsis,
  • cachexia
  • mental illness.

The technique of the operation is to introduce contrast into the vessel and its incision at the site of the thrombus, followed by extraction with a catheter. This method is quite effective, blood flow through the vessel is quickly restored, takes a small amount of time. (less than 20 minutes). But at the same time there is a risk of complications - bleeding, infection in the surgical wound or the re-emergence of a blood clot.

Other operations: what are and how do they go?

In surgical practice, there is open blood clot removal method. Its essence is to remove the affected area of ​​the vessel, after which the ends of the veins are sutured.

Crossectomy is less common. It consists in the intersection of the affected vessels in the area of ​​safeno-femoral anastomosis with subsequent stitching of the edges. This method, like others, has contraindications:

  • severe somatic pathologies,
  • pregnancy and lactation,
  • atherosclerotic lesion of the lower extremities,
  • the presence of infection in the proposed location for the operation.

Flashing the vessel - another method. In this case, the lumen of the vessel narrows, which makes it impassable for large blood clots. It is used for recurrent phlebothrombosis, when it is impossible to use other methods, and for multiple vascular lesions. Minus - a decrease in blood flow to the limb due to narrowing of the vessel.

Vein dressing it is used when it is impossible to carry out other methods of treating thrombosis, is carried out above the thrombus.

Bypass surgery - creating a workaround for blood flow, is one of the most common way to treat thrombophlebitis.

How to treat vein disease with antiplatelet agents?

In addition to vein thrombosis of the lower extremities, drugs are used for:

  • Ischemic heart disease,
  • hypertension
  • after cardiovascular surgery,
  • thrombosis prevention.

In the following conditions, drugs can not be taken:

  • 3 trimester of pregnancy,
  • gastric ulcer in the acute phase,
  • failure of the functions of the kidneys, heart and liver in the stage of decompensation,
  • hemorrhagic stroke,
  • diseases associated with the risk of bleeding.

Antiplatelet agents include:

  1. Acetylsalicylic acid.
  2. Clopidogrel.
  3. Dipyridamole.
  4. Iloprost.
  5. Ticlopidine et al.

The dosage of Aspirin and its derivatives should be no more than 300 mg / day.

Diet

Diet with pathology consists in observing the diet, the exclusion of provocative products and the correct water regime. The volume of fluid that must be drunk per day is at least 2.5 liters. Recommended Products:

  • olive, linseed or sunflower oil,
  • fruits and vegetables (in particular, containing a large amount of vitamin C - citruses, rose hips, gooseberries, tomatoes),
  • leaves of onion, garlic,
  • chocolate,
  • seasonings
  • seafood, kelp,
  • porridge.

Products containing animal fats are excluded. It is undesirable to use pasta, flour products, fried foods, smoked meats.

Pills used to lower LDL

All patients must be prescribed drugs that lower cholesterol - a group of statins. The mechanism of action is to block the synthesis of cholesterol. These include:

  • Lovastatin,
  • Pravastatin,
  • Simvastatin
  • Atorvastatin
  • Rosuvastatin.

Appointed with:

  • atherosclerosis,
  • diabetes
  • tendency to thrombosis,
  • myocardial infarction
  • ischemia
  • hypercholesterolemia.

Contraindications:

  • severe liver or kidney disease,
  • pregnancy,
  • allergic reactions
  • period of breastfeeding.

The effectiveness of the drug against thrombophlebitis will be noted in patients with atherosclerosis.

The tool is available in tablet form. The minimum dosage is 10 mg / day, the maximum is 80 mg / day. In connection with the rhythm of cholesterol formation, the drug is taken in the evening, during a period of increased synthesis activity.

What drugs can relieve pain with thrombophlebitis?

NSAIDs are used to eliminate pain. - diclofenac, ketonal and others. They are able to eliminate the inflammatory process due to inhibition of the COX-1 and COX-2 enzymes, with the help of which inflammatory mediators are formed. Since pain is a component of inflammation, it, accordingly, is also eliminated.

Indications:

  • inflammatory joint pathologies (rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, Reiter’s syndrome and others),
  • gout,
  • bone metastases with pain,
  • pain syndrome (headache, menstrual, dental, postoperative and other pains),
  • fever,
  • renal colic.

Drugs have the following contraindications:

  • hypersensitivity to components,
  • gastrointestinal ulcerative lesions,
  • leukopenia, thrombocytopenia,
  • pregnancy period
  • impaired renal and hepatic function.

The dosage for all painkillers for thrombophlebitis is individual: diclofenac in the form of injections or tablets up to 150 mg / day, ketonal - no more than 200 mg / day.

Ointment Medicines

For the treatment and prevention of thrombophlebitis, gels and ointments are used:

  • Troxevasin,
  • Heparin ointment,
  • Troxerutin
  • Lyaton et al.

Troxerutin and troxevasin They are aimed at reducing the permeability and fragility of capillaries, reduce swelling and inflammation, have an antiplatelet effect.

Indications for use:

  • varicose vein disease,
  • chronic venous insufficiency,
  • thrombophlebitis
  • peripheralitis,
  • pain and edema of traumatic origin.

  • infected wounds in the area of ​​application,
  • hypersensitivity to the components of the drug,
  • children under the age of 18 years.

The gel is applied twice a day to the affected area.

Heparin Ointment and Lyotonproduced on its basis have antithrombotic, anesthetic and anti-inflammatory effects.

  • thrombophlebitis of the lower extremities,
  • hematomas of traumatic origin,
  • thrombosis of hemorrhoidal vessels,
  • phlebitis
  • peripheralitis,
  • lymphangitis
  • elephantiasis,
  • trophic ulceration on the lower extremities.

  • hypersensitivity
  • damage to the skin,
  • deep vein thrombosis,
  • ulcerative necrotic process.

Apply 1 g to the affected area on 4 cm of the surface, gently rub it with light stroking movements.

Antibiotics for infection

When an infection is attached to an existing thrombophlebitis, broad-spectrum antibiotics are used, they are administered intravenously to quickly achieve a therapeutic effect. These include:

Indications for appointment:

  • severe urinary tract infections,
  • intra-abdominal infections
  • infections of soft tissues, bones and joints,
  • meningitis,
  • salmonella infection in a generalized form,
  • sepsis.

The dosage of ceftriaxone varies from 1 to 2 g / day, the frequency of administration - 2 times a day every 12 hours. Ciprofloxacin is prescribed no more than 0.5 g / day. Only the attending physician can determine the type of drug and dosage after an examination and an accurate diagnosis.

How long is thrombosis and acute thrombophlebitis treated?

The duration of treatment depends on the method chosen: with the surgical method, no more than 1 week, while conservative treatment can drag on for months. During therapy, the patient is recommended to give an elevated position to the limbs and observe bed rest for at least 5 days. Elastic compression for a long time is also shown.

With the development of an emergency, hospitalization in a surgical hospital is indicated. The terms are determined by the doctor, after discharge, rehabilitation in a specialized institution can be prescribed.

Prevention of postoperative complications at risk of thrombosis

Pulmonary embolism and thrombosis can occur as complications in the period after surgery, therefore, patients undergoing surgery in the presence of medium and high risk of developing complications of thrombotic genesis, prevention:

  • wearing compression underwear,
  • the introduction of Heparin daily, conceived 2 days before the operation,
  • oral administration of antiplatelet agents (Xarelto, etc.),
  • infusion therapy 2-3 times a day.

Stomach Injections

For emergency blood thinning in a hospital, thrombolytic injections are prescribed. Heparin is often prescribed, the dosage of which is calculated individually, based on the physiological data of the patient and the degree of development of the pathological process. Such therapy can only be carried out under the supervision of doctors, since there is a high risk of bleeding with subsequent death.

Wearing Special Stockings

Stockings help restore trophism of the skin, innervation, prevent thrombosis. There are several compression classes - 1-4. With thrombophlebitis, grade 2 is assigned.

Indications:

  • chronic venous insufficiency,
  • swelling of the extremities,
  • calf muscle cramps,
  • thrombosis
  • increased blood coagulation.

Contraindications:

  • KHAN
  • atherosclerosis,
  • obliterating endarteritis,
  • tissue necrosis
  • dermatitis,
  • thrombophlebitis in the acute phase,
  • open wound,
  • septic process in the lower extremities,
  • diabetes with lesions of the extremities.

How to prevent using exercise therapy?

Physiotherapy exercises are prescribed by the LFK doctor and the loads are calculated individually. Overload of the lower extremities, especially in the presence of blood clots in the lumen of the vessels, can lead to their separation and the development of an emergency.

The following exercises are shown:

  1. Walking with high legs. It takes 100 steps, accompanied by slow and deep breathing.
  2. Running at a slow pace over short distances.
  3. In the supine position, perform circular movements and flexions for 30 seconds.
  4. Bending the legs in the knee joints, leading to the stomach in turn in the supine position - 10 times.
  5. In a sitting position, lean on the calcaneus with subsequent relaxation - 15 times.

Indications:

  • for the prevention of repeated thrombosis,
  • prevention of the development of pulmonary embolism and PTFS.

Contraindications:

  • severe condition of the patient
  • PTFS,
  • early postoperative period
  • bleeding.

You need to start exercises with small loads, gradually increasing the intensity of training. If pain, redness, and swelling occur in the lower extremities, consult a doctor immediately.

Medications

Drugs that must be taken to prevent thrombosis:

  1. Xarelto is an anticoagulant that does not require INR control.
  2. Troxerutin topically, for a long time.
  3. Statins - to normalize cholesterol and prevent the development of atherosclerotic plaques that block the lumen of blood vessels.
  4. Detralex is a venotonic drug that strengthens the walls of blood vessels.

Acceptance of drugs is prescribed in courses, after thrombosis and thrombophlebitis, it may be constant.

Installation of cava filters in vessels

The cava filter is designed to prevent the movement of a blood clot to the pulmonary artery - the so-called “blood clot trap”. Since the method is invasive, it should be used strictly according to indications. These include:

  • deep vein thrombosis,
  • floating thrombi
  • thrombosis in chronic diseases,
  • History of pulmonary embolism
  • inefficiency or contraindications for anticoagulants,
  • relapse of thrombosis.

Nutrition principles

The diet should be carried out according to the following principles:

  1. Eating 5-6 times a day.
  2. Avoid taking prohibited foods, including fatty meats, certain types of oils.
  3. Cook using stewing, boiling and steaming.
  4. You can’t overeat.
  5. Limit or completely eliminate alcohol consumption.
  6. Observe the water regime.

Thrombophlebitis and thrombosis are acute conditions that must be treated under the supervision of specialists. They can lead to the most serious complications. For prevention, you must adhere to a healthy lifestyle and proper nutrition.

Who needs the prevention of vascular thrombosis?

Caution is recommended:

  • men over the age of 40,
  • women during menopause,
  • obese people
  • patients with diseases of the heart and blood vessels (having suffered a stroke (Insultus), heart attack (Infarctus),
  • patients with varicose veins and thrombophlebitis (Thrombophlebitis).

The risk group also includes people who have undergone surgery, are malnourished or have diseases that cause blood clotting. Fear of the disease should be smokers, people with alcohol addiction, everyone who moves little, experiences constant stress, which is reflected in the hormonal background.

Despite the fact that vascular thrombosis itself is not directly inherited, the tendency to form blood clots may well have a genetically determined predisposition. Therefore, if your close relatives have been diagnosed with thrombosis, you are automatically at risk and should pay special attention to its prevention.

The risks of thrombosis

Blood clots form due to external and internal causes. External include injuries, which violate the integrity of blood vessels. This can happen even with normal blood coagulation or a predisposition to a high level of coagulation.

Internal causes of blood clots include changes in blood proteins that are involved in coagulation. It is about thrombophilia, when the amount of proteins and their structure change. Thrombophilia may be congenital or acquired.

Blood clots can form with varicose veins and atherosclerosis of the arteries, because of which the structure of the vessels is disturbed, and blood clots settle on their walls. If you understand the causes of blood clots, it is easier to prevent the development of the disease.

A special risk group includes pregnant women.During gestation, due to changes in the hormonal background of women, the number of natural anticoagulants decreases and blood viscosity increases. This is especially true of late pregnancy.

Thrombosis Prevention and Treatment

If a person is at risk of developing thrombosis, you must constantly be observed by your doctor. Some drugs may be prescribed to prevent the disease. If we are talking about treatment, then it involves the simultaneous fulfillment of several conditions:

  • It is necessary to thin the blood. For this, patients take drugs that include acetylsalicylic acid (Acidum acetylsalicylicum). You need to choose medicines only with your doctor: acting alone is dangerous for health and life.
  • It is important to strengthen the vessels. For this, drugs with active components are needed, including vitamin C. These include biologically active additives, the Normaven complex of venotonic vitamins and plant extracts. It allows you to maintain the strength and elasticity of blood vessels.
  • Blood purification is required (with the help of special medicines). All these measures prevent the development of the disease.

The manifestation of thrombosis often occurs in the summer months. This is due to high air temperature, loss of fluid by the body along with sweat, inadequate water consumption. Therefore, it is in the hot season that special attention should be paid to the prevention of blood clots.

Thrombosis Prevention and Nutrition

Prevention of lower limb vein thrombosis includes a balanced and healthy diet. It is not difficult to observe it: it is enough to limit the intake of salt, smoked foods, fried and fatty foods, sausages and other unwholesome foods. Replace harmful dishes with vegetables and fruits, meat and fish of low-fat varieties.

Diet suggests the presence of berries in the diet. It is useful to eat oatmeal, a decoction of rice, linseed and olive oils, dishes with ginger and citrus. It is imperative to drink a daily rate of liquid - about 1.5-2 liters of pure drinking water.

Flaxseed oil for the prevention of thrombosis

What is desirable to refuse? It is worth limiting the consumption of broths for meat, white bread, milk cream. Certain varieties of sausages and fruits (especially bananas) can contribute to blood clotting. You need to be careful when taking medicinal herbs: too many herbal decoctions can give a negative result.

You can not abuse alcohol, you must stop smoking. The risk group also includes people who are uncontrollably taking hormones and diuretics, contraceptives.

Prevention of thrombosis after surgery

Prevention of thrombosis after surgery is placed in a separate category. It is performed for all patients who need surgical intervention. The degree of risk of developing the disease here does not matter.

Prevention of deep vein thrombosis after surgery includes:

  • preference for minimally invasive operations performed quickly and with minimal tissue injury,
  • a special compression knit wear, which is particularly elastic
  • early morning awakening and walking,
  • positive mood and attitude to treatment.
Walking for the prevention of thrombosis

Patients who will undergo surgery and who are at risk of developing thrombosis should take medications before and after surgery. Patients are prescribed modern anticoagulant drugs.

The ratio of venous and arterial thrombosis

We should also mention the prevention of deep vein thrombosis after phlebectomy. This is the most common vein surgery and is considered minimally invasive.Patients are discharged home on the fifth day, and in modern clinics hospitalization is not practiced at all. Therefore, the patient must know exactly what the prevention of deep vein thrombosis of the lower extremities should be:

  • It is necessary to constantly monitor the condition of the veins. If alarming symptoms appear, seek medical attention immediately.
  • Weight control. Obesity causes complications.
  • Physical activity. Prolonged lying down provokes a risk of complications.
  • Compression knit wear. The doctor should determine his class so that the prevention of deep vein thrombosis after surgery is effective.
  • Reception of heparins (Heparinum) and application of local preparations, for example, venotonic cream.
  • Physical education classes. Every day you need to perform exercises that improve blood flow and prevent blood stasis in the veins. Patients are advised to swim, walk more and ride a bicycle.

It should be remembered that thrombosis depends on many factors, and the consequences of different operations are different. The most serious are traumatology and orthopedics operations. The greatest risk is surgery on the hip and knee joints.

Since these operations are carried out next to the large main veins, measures to prevent thrombosis after surgery on the joint are especially important. Patients cannot actively move after surgery, therefore, support in the form of drugs and other methods that the doctor will prescribe are needed.

Prevention of thrombosis folk remedies

Traditional medicine offers various remedies for venous thrombosis. Cranberries, for example, help thin the blood. To prepare a ready-to-use product, cranberries are mixed with honey, and then 2 teaspoons a day are consumed.

Mint infusions have a good effect. For their preparation, crushed leaves are used. They need to be poured into a container for brewing, pour boiling water and cover. After the leaves are infused, the infusion must be filtered. Take it half a glass every morning. The duration of the course is 2-3 months, and then a pause should be made.

Regardless of the chosen alternative medicine, it is better to consult a doctor before using it. He will point out ways to prevent deep vein thrombosis and other factors that are right for you.

Prevention of thrombosis during pregnancy

It is especially important to avoid thrombosis in women during pregnancy. This is due to the restructuring of the hormonal background of the female body. The cardiovascular system is under extra load. Body weight increases, other indicators are aggravated.

Prescribe tablets should only be if there is a serious indication for this. But before that, the expectant mother must change her lifestyle and adhere to a healthy diet. It is recommended to wear compression underwear, walk more often and monitor changes in well-being.

Thrombosis Prevention: Exercise

An effective method of protection against thrombosis in the legs is exercise. Physical activity, wellness exercises and regular sports reduce the likelihood of developing this disease.

If a person constantly works while sitting, then once an hour you need to take an active break for five minutes. When you can’t do gymnastic exercises, you can just go for a walk: a light walk is enough to stretch your legs.

To maintain the tone of the veins, it is recommended to dance, ride a bike or swim. Hiking, jogging in the morning, or brisk walking are good for vessel health.

But not all types of physical activity are useful in terms of preventing the formation of blood clots. If there is a load on the arch of the foot, then such a sport will not be useful.People who are more likely to have problems with blood vessels are not advised to jump, play tennis or squash, and do weightlifting and aerobics.

Handyman

We begin the description of the representatives of the group of antiplatelet agents with dipyridamole (Curantil), which has been used for many decades. The drug blocks the enzyme phosphodiesterase, which destroys a compound called cyclic AMP (cAMP), thus providing an elevated level of this substance in the blood. In high concentrations, cAMP prevents platelet adhesion and prevents the formation of a blood clot.

The ability of the drug to reduce the risk of vascular accidents in patients undergoing vascular ischemia is confirmed by the data of Cochrane 1. Among the indications for the appointment of dipyridamole is the prevention of arterial and venous thrombosis, including after the installation of stents and coronary artery bypass grafts.

Nevertheless, dipyridamole is not currently prescribed for the prevention of strokes as part of monotherapy, since it is significantly inferior in activity to modern antiplatelet agents. But he found quite widespread use as a drug that normalizes blood flow in cases of cerebrovascular accident, as well as in placental insufficiency in pregnant women. In addition, it increases the body's resistance to viral infections - influenza and SARS - and is used to prevent and treat these diseases.

Modern and famous

The hope and support for many people who suffer from diseases of the heart and blood vessels or have already suffered a heart attack or stroke are drugs of a potentially new class - P2Y12 receptor inhibitors. These receptors located on the surface of platelets play a central role in the activation of platelets, their subsequent "adhesion" and the formation of a blood clot. Blocking of the P2Y12 site can effectively resist thrombosis and thus reduce the risk of cardiovascular catastrophes.

One of the first drugs of this series of antiplatelet agents was clopidogrel, which appeared on the market in the late 1990s under the trade name Plavix. Its antiplatelet effect is manifested already a few hours after taking the first 75-milligram dose (working dosage of the drug), and the drug has a maximum effect after 3-7 days of regular intake. If you want to get an immediate result, “loading” doses of 300-600 mg are prescribed. In such situations, clopidogrel exerts a powerful antithrombotic effect several hours after administration.

The original clopidogrel, Plavix, is registered in more than 100 countries of the world and is among the drugs with sales reaching several billion dollars a year 2. Until the patent expired, Plavix ranked second in the world among sales leaders. Today, dozens of generic clopidogrel are available in pharmacies, which, of course, greatly increased its availability.

In addition, other drugs of the P2Y12 inhibitor group are already registered in the Russian Federation. Prasugrel (trade name Effiant), ticagrelor (Brilinta), ticlopidine (Tiklid) are quite widely used in clinical practice for the prevention of stroke, myocardial infarction and death from vascular disease in patients who have suffered a stroke or suffer from coronary heart disease or chronic lower limb diseases ( intermittent claudication). The effectiveness of all drugs of this group, without exception, has been confirmed by many clinical studies and is not in doubt.

It should be noted that the original prasugrel, ticagrelor and ticlopidine, like the original clopidogrel, have a fairly high cost. However, the vital testimony for which they are prescribed, and the result that they provide, justify the investment.

One is good and two is better

Antiplatelet agents definitely help reduce the risk of cardiovascular disasters, but sometimes resistance to the action of drugs develops and the likelihood of vascular events increases dramatically. Combination therapy helps to overcome resistance, in which several drugs are prescribed at once.

Most often we are talking about two drugs, this therapy is called double. The increase in the effectiveness of double antiplatelet therapy (DAT) compared with the use of a single drug is achieved due to the influence of drugs with different mechanisms of action on different stages of thrombosis.

One of the essential components of DAT is always acetylsalicylic acid. Almost all people with coronary heart disease are forced to take it constantly throughout their lives. The second component of the scheme, as a rule, becomes a P2Y12 inhibitor - clopidogrel, prasugrel or ticagrelor. Which of the three drugs will be prescribed, the doctor decides, based on the individual risk of thrombosis and bleeding, the probability of which, alas, increases when taking antiplatelet agents.

The duration of double antiplatelet therapy is also established in each case. Patients who have had a myocardial infarction may be prescribed a combination of drugs for at least one year. If the risk of bleeding is low, DAT may extend. Patients after stenting of coronary arteries or those who are highly likely to develop bleeding, DAT is prescribed for at least a month.

Combination drugs that reduce the risk of thrombosis also include combinations of aspirin with dipyridamole (Agrenox) and aspirin with magnesium hydroxide (Cardiomagnyl). They have nothing to do with the standard DAT, which is based on the combination of acetylsalicylic acid + P2Y12 inhibitor.

The first is approved for secondary prevention of stroke, but it is significantly inferior in activity to combinations with P2Y12 inhibitors. And the cardiomagnyl preparation is aimed at reducing the negative effect of acetylsalicylic acid on the gastric mucosa due to the absorption of hydrochloric acid by magnesium hydroxide. This improves aspirin tolerance, which is important with long-term treatment.

1 De Schryver EL, Algra A, van Gijn J (2007). Algra A, ed. Dipyridamole for preventing stroke and other vascular events in patients with vascular disease. Cochrane Database of Systematic Reviews (2): CD001820.

2Top Ten Global Products - 2007 "(PDF). IMS Health. 2008-02-26.

Related products: dipyridamole, clopidogrel, prasugrel, ticagrelor, Agrenox, Cardiomagnyl, Thrombomag, Thrombital, Phasostabil

The mechanism of formation and causes of blood clots

In the process of life, each person has had cases of cuts, bleeding wounds and abrasions.

The hemostatic system, which is divided into two large groups: thrombogenous and thrombolytic systems, saves us from prolonged bleeding and massive loss of blood.

Damage to the vascular wall leads to the release of biologically active substances into the bloodstream, triggering a cascade of reactions aimed at blocking damage and stopping bleeding.

Initially, blood cells that look like white small plates (called platelets) are sent to the site of injury and form a platelet thrombus. It is not stable and is formed only as a result of aggregation (gluing) of blood cells.

Depending on the amount of damage, fibrin fibers are layered on the platelet mass, so-called coagulation occurs, a dense and large fibrin clot forms, which strengthens the primary thrombus.

Gradually, the regeneration of the injured area takes place and a thrombolytic system is connected, aimed at resolving the blockage and restoring the anatomical structure of the vessel.

The formation of blood clots occurs regularly in the body, but, being in equilibrium, thrombosis and thrombolysis systems prevent serious complications in the form of tissue ischemia, prevent the blood clot from coming off and its migration through the vessels begins.

If at least one of these systems malfunctions, then this can lead to disastrous consequences.

External causes of blood clots are:

  • Injuries accompanied by damage to the vascular wall (cuts, hematomas).
  • Surgery.
  • Injection Especially dangerous are post-injection thrombophlebitis that occur at the site of venous catheter placement or as a result of the administration of drugs that irritate the vascular wall.
  • Childbirth.
  • Menstruation and so on.

The causes of internal thrombosis are:

  • Vascular disease.
  • An abnormality of the thrombolytic system. Congenital and acquired pathologies of the anticoagulant system.
  • Endocrine diseases. Hormonal imbalance also provokes thrombosis.

Among vascular diseases, there are:

  • Phlebeurysm. Dilated veins lead to a delay in a large amount of blood, a violation of its movement through the vessels. This causes aggregation of the formed elements and thrombosis.
  • Deep vein thrombosis of the lower extremities. Expansion of the deep veins of the lower extremities is more dangerous than superficial varicose expansion, as it is most often asymptomatic or with minor manifestations in the form of increased fatigue and a feeling of heaviness at the end of the working day, periodic spasms of the calf muscles, and swelling in the evening on the legs. Moreover, with an increase in coagulation factors in the blood (after surgery or massive injury), blood clots can form in the veins, which easily come off and migrate through the vessels.
  • Atherosclerosis of blood vessels. High cholesterol leads to the formation of plaques, the tire of which can be damaged, causing thrombosis.
  • Vasculitis of various etiologies. Inflammation of the vascular wall most often occurs as a result of autoimmune processes and is a manifestation of systemic lupus erythematosus, rheumatoid processes, and so on.
  • Condition after vascular surgery or heart surgery, especially in the presence of foreign objects (pacemakers, artificial valves, stents and so on).

The appearance of a thrombus threatens not only with blockage of the arterial vessel and tissue ischemia, but also with the possible separation of it. Due to the detachment of part or all of the thrombus, it migrates along the bloodstream and completely overlaps vessels of smaller diameter - this condition is called embolism.

The most dangerous thromboembolism of the branches of the pulmonary artery, which causes pulmonary infarction and can lead to death, as part of the lung is completely turned off from the bloodstream. Eye vessels, renal, cerebral and coronary arteries also often suffer.

Risk group

The following categories of patients belong to the risk group for the development of thrombosis:

  • Obese people.
  • Endocrinologist's patients (patients with diabetes mellitus, thyroid gland diseases and so on).
  • Cancer patients who undergo radiation and chemotherapy courses.
  • Women during pregnancy, especially in the later stages.
  • Elderly people.

And also the risk of thrombosis increases due to smoking and drug addicts. The risk group includes people leading a sedentary lifestyle, eating poorly (frequent overeating, the predominance of fatty foods, fast food and so on).

Prevention Products

Prevention of thrombosis is carried out using two main groups of antithrombotic drugs:

The first group is aimed at blocking the first cellular link of hemostasis and helps prevent platelet adhesion, which is necessary in order to avoid the formation of blood clots.

These medicines include:

  • a group of non-steroidal anti-inflammatory drugs (the main drugs are acetylsalicylic acid and branded drugs containing it: Cardiask, Aspirin-cardio, Cardiomagnyl, etc.),
  • thienopyridines or blockers of ADP receptors (clopidogrel, prasugrel and others),
  • phosphodiesterase blockers (these include Curantyl or Dipyridamole, Pentoxifylline).

The most popular tablets are Aspirin, the active substance of which is Acetylsalicylic acid. Its main advantages are efficiency and low cost. It is used in people suffering from chronic diseases and in need of regular medication. The main side effect of the drug is the probability of damage to the gastric mucosa and the development of erosive processes.

Curantyl is also used to prevent blood clots, but unlike aspirin, it does not damage the mucosa. Its intake should be monitored by regular blood coagulation tests. It is also long-lasting, often lifelong. The dose of the drug is selected by the attending physician depending on the data of laboratory tests (coagulogram, IPT).

In patients in the postoperative period, Ketorol is most often used for pain relief. The drug allows you to simultaneously simultaneously perform two important actions: reduces pain and prevents the development of postoperative thrombosis.

The second large group of drugs - anticoagulants, is directed against the formation of fibrin dense blood clots. Both direct-acting anticoagulants (Heparin, Fraxiparin) and indirect-action anticoagulants (Warfarin, Neodicumarin) can be used. Typically, funds are used in courses according to strict indications and in a dosage calculated by the doctor. Long-term use is possible only with local application. Heparin is most often used for varicose veins of the lower extremities in the form of creams or gel based on heparin (heparin ointment, dolobene, thrombus and others).

Folk methods

Traditional medicine has been known to people since ancient times and is based on the use of natural products for the treatment and prevention of various diseases. Before using this or that method, it is necessary to approve its use by a doctor, since herbal and animal preparations may not combine well with the main therapy.

In order to fight the appearance of blood clots, the following folk remedies are most popular:

  • Decoction on willow bark. Before use, dry and grind the bark, then pour 10 tablespoons with one liter of cold water, boil over low heat and let cook for 30 minutes. Cool the broth, and it is ready for use: after filtering three times a day for a tablespoon for a long time.
  • Infusion of raspberry leaves. 2 tablespoons of crushed raspberry leaves must be poured with a glass of boiling water and let it brew for two hours, after straining, the infusion is ready for use. Take half a glass once or twice a day. It is recommended to conduct treatment with courses of 3 months with one month break, this will protect against thrombosis.

Physical exercise

One of the important aspects in the prevention is the elimination of physical inactivity. An active lifestyle helps to prevent pathological blood clots from forming, as it not only strengthens the cardiovascular system, but also helps in the fight against excess weight.

To prevent vascular catastrophes, it is necessary to choose an adequate dose of physical activity.

Here is what physical therapy instructors recommend to prevent blood clots:

  • Take daily walks in the fresh air or ride a bike, do morning jogs.
  • During breaks at work, spend 5-10 minutes breathing exercises.
  • Visit the pool 2-3 times a week.
  • Perform exercise therapy exercises (walking on tiptoe, rolling from heel to toe, doing squats).
  • Useful exercises in stretch gymnastics or yoga, Pilates.

The level of physical activity should be adequate to the physical condition of the person, you should not get involved in sports too much.In the postoperative period for the prevention of deep vein thrombosis of the lower extremities, it is recommended from the first days to try to get up and perform breathing exercises.

Proper nutrition

A proper diet reduces the risk of thrombosis due to the control of blood sugar and cholesterol, helps to maintain normal weight.

List of prohibited products for patients at increased risk of thrombosis:

  • Fat.
  • Margarine and butter.
  • Chocolate.
  • Smoked meats.
  • Hard cheeses.
  • Fatty meat broths.
  • Fast food.
  • Fried foods
  • Coffee.
  • Alcohol.

Plant foods, soups on vegetable broths are introduced into the diet. Potatoes, bananas and mangoes are also beneficial for the cardiovascular system, as they are rich in potassium.

The menu should contain dishes with fatty omega acids (fatty fish). Useful greens: parsley, dill, lettuce and so on.

And also pay attention to the amount of fluid drunk. It is best to drink clean water, but dried fruit compotes and green tea will also be beneficial. An adult needs to drink about 1.5-2 liters of water per day. This improves blood flow, thereby facilitating vascular patency and improving blood circulation.

The diet should be enriched with vitamins necessary for normal life. To strengthen the vascular wall, vitamins C, A, E, P, group B are important. They can increase the strength and elasticity of the vascular wall.

Blood clot prophylaxis: an alternative to aspirin

What antiplatelet agents besides acetylsalicylic acid will the doctor prescribe and why sometimes one drug is not enough

Atherothrombosis is the main cause of myocardial infarction and one of the main factors in the development of stroke. The risk of atherothrombosis can be reduced with antiplatelet therapy. We talked about prophylaxis with acetylsalicylic acid in a previous article, “Blood clots and acetylsalicylic acid.” However, in addition to it, other antiplatelet agents are also used.

The essence of pathology

Thrombosis is the formation of dense blood clots that block the lumen of the vessels and disrupt the blood flow. They can form in any vessel, but the lower extremities most often suffer. From here, blood clots can migrate to the vital arteries of the heart and brain.

The causes of the development of pathology are:

  • Violation of the blood coagulation system,
  • Injuries of the vascular wall,
  • Metabolic disorders
  • Cholesterol plaques in the vessels.

The combination of these factors leads to the subsidence of blood cells on the vascular wall - this is how a blood clot forms. It gradually increases in size and more and more disrupts the blood flow.

There are several risk groups for thrombosis:

  • Overweight people
  • Unhealthy people
  • Having bad habits
  • The profession of which involves low mobility,
  • People with blood diseases,
  • Pregnant women,
  • Women receiving hormonal contraceptives or those in menopause,
  • Patients after extensive surgery.

Patients from these groups must necessarily be given comprehensive prevention of thrombosis.

Preventive measures

Prevention of thrombosis and vascular diseases includes the normalization of lifestyle, rejection of bad habits, maintaining optimal weight. If necessary, medications are prescribed. The goal of prevention is to reduce mortality from heart attacks, strokes, pulmonary embolism.

There is such a thing as postoperative thromboembolism. These are acute thromboses that occur after extensive surgery and are associated with a sharp change in blood coagulation. To prevent such a thrombosis, it is necessary to take aspirin a couple of days before the operation - as prescribed by the doctor. The person goes to the operation itself with compression knitwear - bandages or stockings. They are also used in the early postoperative period.

Medicines

Drug prophylaxis of thrombosis is indicated for people with an increased risk of developing this condition. It includes taking medications inside and out. A doctor will tell you how to avoid blood clots using drugs. Usually assigned:

  • Aspirin. The simplest drug that promotes blood thinning and prevents blood clots. It is best to use a special cardiological aspirin - CardiAsk, AspirinCardio, TromboAss. They are available in the required dosage,
  • Venotonic. Preparations for strengthening blood vessels, improving blood properties, eliminating edema. These include - Phlebodia, Detralex, Venarus, Phlebof. These medicines are taken for 2-4 weeks,

  • Antiplatelet agents - Curantyl, Clopidogrel. They are prescribed by a doctor with severe manifestations of atherosclerosis, a significant increase in cholesterol,
  • Statins - Atorvastatin, Rosuvastatin. Also recommended by a doctor to normalize cholesterol,
  • Heparin ointment, Lyoton, Trombless. All of these topical products contain the anticoagulant heparin. This substance promotes blood thinning. They are used to eliminate the severity and swelling of the legs.

It is recommended to take prophylactic use of blood-thinning drugs in courses, or constantly - this is determined by the doctor, taking into account the condition of the coagulation system.

Blood thinners with thrombosis should be taken with caution, an overdose can lead to bleeding.

Regimen and diet

Proper nutrition is one of the most effective ways to prevent vascular thrombosis. Blood clots form on the basis of cholesterol plaques. And those, in turn, appear due to unhealthy diets.

A preventive diet is aimed at normalizing the amount of fat in the diet, reducing overweight, and strengthening the vascular wall.

Useful products that prevent blood clots are:

  • Low-fat meats and fish,
  • Seafood,
  • Vegetable oil,
  • Low fat dairy products
  • Dairy products,
  • Cereals and pasta,
  • Cereal bread
  • Vegetables, fruits, nuts,
  • Green tea, cocoa, fruit drinks, freshly squeezed juices.

Limiting the use of the following foods will be helpful in preventing thrombosis:

  • Fatty meats and fish,
  • Cheese, dairy products with high fat content,
  • Butter, margarine,
  • Smoked meats, meat and fish delicacies,
  • Fast food,
  • Snacks
  • Baking,
  • Sweets,
  • Black tea, coffee, alcohol.

You should adhere to a fractional diet - take a little food, 5-6 times a day. The diet must be enriched with vitamins that improve the condition of the blood. The intake of vitamins is shown:

  • Vitamin C. Improves metabolism, stimulates the immune system, strengthens the vascular wall. Contained in citrus fruits, gooseberries, black and red currants, herbs,
  • Vitamin E. Improves the metabolism of fats, increases the regenerative abilities of cells. Contained in sea fish, cereals, herbs, legumes, vegetables, nuts,
  • Vitamin A. Normalizes metabolism, prevents the formation of blood clots. It can be obtained from herbs, vegetables, berries and fruits,
  • Vitamin P, or rutin. Strengthens the vascular wall, reduces its permeability. Obtained from herbs, fruits, cereals and nuts.

To maintain normal blood viscosity, so that there are no blood clots, it is necessary to observe a drinking regimen. A person needs to drink at least 1.5 liters of pure water per day. This does not include broths, tea, cocoa. The daily volume of fluid should be divided into 5-6 receptions.

Strengthening blood vessels contributes to an active lifestyle. Regular physical activity trains the muscles of the legs, which ensures a good outflow of blood. The absence of venous stasis is the main prevention of blood clots. Exercise in the fresh air allows you to saturate the body with oxygen. Physical activity allows you to lose weight.

Of great importance is the rejection of bad habits. Nicotine and alcohol cause spasms of blood vessels, which complicates blood flow and is a risk factor for blood clots. A measure of thrombosis prophylaxis is the elimination of alcohol and tobacco use.

The load should be selected in accordance with age, the initial state of the body, the presence of other diseases. It is best to contact a specialist in exercise therapy, who will give the necessary recommendations.

Folk remedies

To prevent the formation of blood clots in the vessels can recipes of alternative medicine. Herbal preparations strengthen blood vessels, improve blood properties:

  • To normalize cholesterol, it is recommended to eat a clove of garlic daily,
  • Cranberries with honey. Wash 100 grams of berries, pour 100 grams of honey. Mix thoroughly, fold in a glass container. Take 2 teaspoons before bedtime.
  • Decoction of rowan bark. Collect bark, rinse and chop. Dry, pour 100 grams of bark with a liter of water, bring to a boil. Let it brew, take 50 ml before meals.

The use of traditional medicine recipes should be agreed with the doctor.

Lifestyle

A person with an existing disease, for the prevention of deep vein thrombosis of the lower extremities, will need some limitations of a familiar lifestyle:

  • Take daily walks of at least 60 minutes,
  • Strengthen the immune system
  • To refuse from bad habits,
  • Women refuse to wear high-heeled shoes,
  • Apply compression knitwear
  • Avoid sudden temperature changes,
  • Take a contrast shower daily
  • Avoid air travel whenever possible.

Compliance with these measures will help to avoid many complications associated with thrombosis.

Venous thrombosis is a dangerous condition. Blood clots can come off and clog vital vessels. Therefore, in the presence of risk factors, great attention should be paid to the prevention of thrombophlebitis of the lower extremities and carried out by all available means.

Who is most prone to thrombosis?

To determine if you are likely to develop thrombosis, you need to know who is at risk:

Do you know?
Which remedy for varicose veins is one of the most effective today? Not? Then read more on the link .

  • patients with diabetes mellitus, varicose veins, overweight, as well as people with high cholesterol,
  • people with a stroke, heart attack, thrombophlebitis,
People with diabetes are at risk
  • Inactive people
  • women taking oral hormonal contraceptives,
  • alcohol addicts and smokers.

If you are even at one of the signs at risk, you need to diagnose thrombosis.

The Importance of Proper Nutrition

It’s difficult to call the usual food for everyone the right one. You need to know how to prevent thrombosis by simply changing your diet a little. For example, you need to eat a little five times a day: single meals should not exceed 200 grams. However, you can’t be hungry, so small snacks are acceptable.

The proper prevention of deep vein thrombosis of the lower extremities should include an adequate supply of water to the body, which helps to thin the blood. Please note that you can drink homemade compotes, natural non-acidic juices and mineral still water, but sweet drinks are not recommended. Prevention of vascular thrombosis allows for the use of berries, vegetables and fruits, juices and teas for snacks. Do not forget that refusing breakfast increases the risk of blood clots. It is enough to adhere to simple rules of food intake to significantly reduce the risks of venous thrombosis of the lower extremities.

Proper nutrition for thrombosis

Do you know how to get tested for blood clots, eat five times a day, and even do jogging? Forced to disappoint you, this is not enough, because you also need to consider what you eat, maybe the menu contains products that provoke the disease!

Even if you are not bothered if there are blood clots, you should slightly review your diet and exclude foods that contribute to the occurrence of clogging of blood vessels:

  • bakery products,
  • sausages
  • fried foods
  • fatty meat broths,
  • fat,
  • smoked meats
  • fatty dairy products,
  • sweet sodas
Sweet carbonated drinks should be excluded from your diet.
  • salted dishes
  • sweets and chocolate
  • pickled vegetables and fruits,
  • products containing preservatives and dyes.

Thrombosis in the veins of the legs can also be caused by alcohol, natural coffee and green tea. The harm of chips, snacks and fast food is known to everyone, they also fall into the list of recommended products.

Watch your health, contact specialists who know how to get tested for blood clots, and you can avoid many unpleasant moments caused by diseases.

Physical education and gymnastics

Prevention of blood clots necessarily includes dosed physical activity, which include moderate exercise on a stationary bike, swimming, recommended exercises and walking. Please note that with exacerbation of the disease, physical activity is not recommended, they can only be started after stabilization and the disappearance of acute symptoms.

Prevention of blood clots necessarily includes dosed physical activity

Treatment classes include both the movements recommended by your doctor and breathing exercises. Perform classes for five to ten minutes several times a day. All movements are performed carefully, trying not to overload the affected limb (s). Be sure to take small walks daily, because movement is the best measure to prevent deep lower vein thrombosis.

Special underwear

As indicated, you need to know not only how to determine thrombosis, but also how to take measures to prevent it. A good effect on the vessels has a special compression underwear, which:

  • stimulates blood flow in the vessels,
  • prevents the deformation of blood vessels,
  • reduces swelling of the limbs,
  • reduces the risk of re-manifestation of thrombosis.

An effective measure to prevent deep vein thrombosis with compression underwear is based on the unique qualities of these products:

  • there is no discomfort when wearing, since the compression underwear is well fixed on the limbs, unlike ordinary elastic bandages,
  • elastic underwear is represented by a wide selection of models, sizes and degrees of compression, so you can wear it not only at home, but also on business and other trips and meetings,
  • prevention of blood clots is based on a uniform distribution of compression along the entire length of the veins,
  • elastic knitwear can be worn for a long time, which completely eliminates its cost.

Prevention of vascular thrombosis with special linen has long been proven effective due to the characteristics of the products and wearing comfort.

Drug Prevention

The traditional answer to the question of how to avoid blood clots is to use medications recommended by specialists. They are effectively used for treatment, in the rehabilitation period after surgery and as a prophylaxis.

Preparations for the prevention of thrombosis

Medicines that prevent the appearance of blood clots are divided into groups:

  • Indirect anticoagulants. Preventive measures against deep vein thrombosis with these drugs allow you to control blood coagulation.
  • Direct anticoagulants.They are based on heparin, therefore, it is necessary to use drugs carefully so that internal bleeding does not occur.
  • Antiplatelet agents. The drugs are used to prevent the formation of platelets, they are also prescribed for angina pectoris and myocardial infarction.

Please note that you can not take several drugs belonging to different groups at the same time!

There are also a number of contraindications for these drugs:

  • first trimester of pregnancy
  • kidney, liver disease,
  • respiratory system diseases
  • gastrointestinal tract diseases
  • oncological diseases,
  • alcoholism.
Warfarin tablets for thrombosis

Most often, so that there are no blood clots, Fenilin, Warfarin, Aspirin are prescribed. These and a number of other drugs against the formation of blood clots are used both for treatment and for prophylactic purposes. The average course of admission is one and a half months.

Gels and ointments that stimulate blood vessels and prevent the formation of blood clots are also used to prevent thrombosis. The gels Lyoton and Troxevasin, Venolife ointment are popular.

Even if blood clots are prevented in vessels, treatment should only be carried out after consulting a specialist, from whom you can find out if you have a tendency to form blood clots and which drugs will be most effective.

Ethnoscience

Traditional healers have long known how to avoid blood clots, and suggest introducing into their daily diet:

  • bow,
  • garlic,
  • feverfew,
  • ginkgo biloba,
  • ginger,
Ginger in the treatment of thrombosis
  • medicinal angelica (helps not only from deep vein thrombosis of the lower extremities, but also has an anti-inflammatory effect and stabilizes blood pressure),
  • Vitamin E
  • fish oil (taking it is not only an excellent prophylaxis of deep vein thrombosis, but also an integral part of rehabilitation procedures after surgical removal of the thrombus).

If you notice any signs of thrombosis, or are at risk, be sure to visit a doctor who can diagnose and determine if there is a blood clot and whether any treatment or preventive measures are needed.

University: NMU named after academician A.A. Bogomolets.

Year of issue: 1999.

Specialization:surgery, proctology.

Experience:

Kiev region, Vyshgorod Central District Hospital.May 2010 - August 2013.

Central Clinical Hospital, Kiev. September 2013 - present. Curation of patients with a cardiovascular profile. Surgical treatment.

About prevention methods

All the events described below are carried out in parallel, there is no point in gradually moving from one to another, there will be much less benefit from such prevention. It makes sense to develop a clear strategy and stick to it.

You also need to keep in mind that this is not a one-time event and is not a matter for a month or two.

If a person is at risk, and these are patients with hormonal problems, diabetes mellitus, burdened by heredity, long smokers, older people and others, you need to follow the recommendations throughout life.

When you depart from the prescribed mode, it is almost guaranteed that a rollback will occur. It is the matter of time.

To give up smoking

Nicotine is not the most harmful substance in cigarette production, no matter what the inhabitants and even some doctors say. It's a delusion.

Despite the obvious toxicity, there are even more dangerous components: cadmium, arsenic, radioactive isotopes, methane, carbon monoxide, dye degradation products.

No need to be mistaken: the filter does not help. Smoking mixtures in vapes have an identical negative effect, they are no less harmful, like hookah. Atherosclerotic processes begin, narrowing of arteries, veins.

The metabolic rate decreases, which is fraught with the deposition of cholesterol on the walls of blood vessels and the formation of atherosclerotic plaques.

Of course, the negative effect is not formed at one time, here the role is played by the individual resistance of the organism. But is it worth the risk?

As surgery statistics show, sooner or later, a sad outcome overtakes all cigarette lovers.

Exclusion of alcohol from life

Alcohol is not beneficial, as are tobacco products. All allegations of a positive effect on blood vessels are a gross myth or an outright lie.

In the first 20 minutes, there is indeed an expansion of the arteries, and then a rapid narrowing with a huge load on the body.

Over time, the system begins to work stereotypically. Arteries are substantially narrowed. This is fraught not only with thrombosis, but also with a heart attack, stroke.

Normal sleep

Night rest is necessary for the full work of the whole organism. The connection here is complex, chain. Lack of rest in the dark leads to a decrease in the concentration of melatonin and an increase in the volume of cortisol in the bloodstream. Adrenaline is also abundantly present.

In the system, such a bias in the specificity of the hormonal background leads to a stable narrowing of blood vessels, their damage, a decrease in blood flow velocity, stagnation and, ultimately, thrombosis.

How fast is an individual question. The process is not rapid, but maintaining a busy schedule at least throughout the year will lead to visible problems. You need to sleep at least 8 hours a night.

Stress avoidance

This is difficult to achieve. Therefore, if it is impossible, it is recommended to master the techniques of relaxation, relaxation.

A simple count to 10, breathing control, turning off active thinking for a while will help. The question can be addressed to a specialist.

A psychotherapist works with stress, insufficient resistance to stress.

Professional Change

If necessary. In the context of modern realities, it is not easy and risky to reconsider the very sphere of activity, the application of skills and knowledge. However, if there is such a chance and work affects the state of health, one must always act.

For example, patients prone to thrombosis are not recommended physical activity, with intense stress. Often pathologies of this type suffer builders, handymen, cooks due to exposure to the legs. Dynamic and static.

Varicose veins, venous insufficiency pose high risks of thrombosis, because this is a key negative factor that needs to be addressed.

Lifestyle changes play one of the main roles, because it eliminates risk factors, relieves the body, creates a "safety margin" and allows you to achieve a greater effect from the following activities.

Diet correction

Avoiding blood clots in the vessels will help change the approach to nutrition. According to the studies of specialists, with prolonged preservation of bad nutritional habits, the absence of a system in food intake, obesity, atherosclerosis develop, and the likelihood of thrombosis increases significantly.

How to organize meals to minimize risks. Three basic principles:

  • Adequate amount of plant foods, fiber. According to calculations, the amount of non-animal food should be about 70%, the rest is dietary meat.

Perhaps the consumption of oil, eggs, etc. As for the coarse fibers, fiber, they are necessary for the rapid excretion of waste products.

Reduce the likelihood of constipation, which in the short term creates a real risk of hemorrhoids. And he, in turn, is dangerous for thrombosis of the nodes formed in the process.

  • Salt restriction. It is allowed to use no more than 6-7 grams of sodium compound per day for cooking.

This will prevent jumps in blood pressure, reduce the likelihood of a sharp stenosis of the vessels, accelerate the outflow of fluid, so you can forget about edema.

But you can’t completely refuse salt.Without sodium, electrolytic balance is impossible, a similar problem is fraught with serious pathologies of the cardiovascular system.

  • Fractional Nutrition. Do not eat in large portions 1-2 times a day. It is better to divide the estimated amount into 6-7 receptions, so as not to overload the digestive tract and not cause stress from the side of the heart, blood vessels.

As for the permitted and prohibited products, the issue is purely individual. It makes no sense to completely refuse certain foods, unreasonable severity will lead to an early breakdown.

You need to understand, this is not a diet. A complete review of the approach to nutrition. So the menu should be made taking into account not only benefits, but also food preferences.

This is best done by specialized nutritionists.

Featured Products

  • Sour-milk products. Low fat. Including possible consumption in moderate amounts of natural sour cream, yogurt, mild cheese. Curd.
  • Cereals. All. The restriction applies to decoy, but this is not a strict prohibition.
  • Wholemeal bread. Also bran, cereal products.
  • Fish. Especially red varieties, rich in unsaturated fatty acids. They effectively fight cholesterol, metabolic disorders in the body. Suitable and river, if desired.
  • Vegetables. Any. In raw and heat treated form. The issue of individual preferences is also important here. Some restrictions apply to potatoes due to their high starch content, which means an increased load on the pancreas. Hence the risks of diabetes, atherosclerosis, and thrombosis. The chain is complicated.
  • Stewed fruits without sugar, natural juices. Sometimes - jelly.
  • Legumes. Without significant restrictions. They are also an effective substitute for animal protein.
  • Black tea, not strong, cocoa in milk.
  • Vegetable oils. Flaxseed, sunflower, olive.
  • Low-fat types of meat. Turkey, chicken. Breast. A little less often - a rabbit, veal.
  • Fruit. Also in any form acceptable to humans. Some restrictions relate to bananas due to the high concentration of starch and grapes due to the high sugar content.

Natural bitter chocolate is not prohibited from confectionery products in the amount of 1-2 “windows” per day (from a whole strip). Dry cookies, home-made jam without sugar.

What is not worth it

  • Fatty dairy products. Cream. At least in unreasonable amounts. Spicy cheeses.
  • Sausage, smoked products.
  • Pickles. Including fish. Pickled vegetables and mushrooms are allowed in small volumes.
  • Butter substitutes, spreads, margarine. These are trans fats, which are very difficult to process by the body.
  • Snacks, chips, crackers, Fast food in any form.
  • Carbonated sweet drinks. Also chocolate (except for the one mentioned earlier), jam, marmalade, ice cream.
  • Potatoes in large quantities.
  • The above fruits. Although the ban is not strict.
  • Fatty meat (pork, lamb).
  • The consumption of offal is possible, but in limited quantities. Not more than once a week. Liver, kidneys, heart.
  • Pastry, pasta. In addition to products from durum wheat.
  • Coffee, strong tea. Especially packaged and granular types of drinks that look little like natural products.
  • You should also limit your intake of fried foods. There can be no talk of canned goods, semi-finished products. They are not useful, and do not provide the body with the necessary substances.

The menu is prepared taking into account daily needs, taste preferences. Possible seasonal adjustment.

Proper drinking regimen

The prevention of blood clots includes simple measures, such as the correction of the drinking regimen. The amount of fluid per day is determined by the body weight of a person.

But the calculations need to be done with an eye on the state of health.So, hypertension, patients with kidney pathologies, drinking more than a certain norm is not recommended, it can be dangerous. Of course, fluid calculations in this case also affect the diet.

A lot of rigorous calculations were carried out, but as it turned out, they all do not take into account a lot of factors. Therefore, it is recommended to adhere to the standard - from 1.5 to 2.5 liters per day, based on their nature of activity, body weight, season, air temperature, the amount will vary.

Only clean water, soups, coffee, drinks and other types where liquid is present are taken into account and cannot be used in the calculation. Since all the useful volume goes to the digestion of what a person ate.

Water provides normal blood flow, reduces the load on the vessels.

As a prevention of thrombosis, it is also possible to consume mineral water in strictly defined quantities, the question of which and how much to drink per day is better addressed to a hematologist. It depends on the specific clinical case.

Adequate level of physical activity

Lack of exercise or lack of exercise, constant sitting in one place leads to stagnation of blood throughout the body. The speed of circulation decreases.

An increase in density, violation of fluidity, damage to the vascular walls, these are just some of the results of this lifestyle.

As part of the prevention of thrombosis, it is recommended to adhere to an allowable and acceptable load: an average person needs only one hour of walks in the fresh air.

In case of serious health problems it is worth resorting to exercise therapy, there are always options.

The intensity is minimal, just to “disperse the blood”, you don’t need to overstrain, this will lead to the release of cortisol, adrenaline, a violation of the regulation of vascular tone and a diametrically opposite effect.

Prevention of deep vein thrombosis of the lower extremities

Thrombosis (blockage of veins by blood clots) or thrombophlebitis (the same process, but accompanied by inflammation) of the lower extremities are dangerous diseases that can lead to complications and significantly impair health and well-being.
These ailments are associated with violations of the structure of blood formation, as well as with poor blood circulation and some other negative factors.

Blood clots can be prevented by following simple prevention rules. Preventive measures depend on the condition of the patient and can be used both in the absence of any signs of the disease and in its early stages.

How does a blood clot (development mechanism)

The most common theory of thrombosis is the Virchow triad.

It consists of three main mechanisms for the development of a thrombotic process:

  1. Damage (alteration) of the vein wall. Traumatic rupture of the endothelium (inner layer) of the vein, mechanical compression or stretching creates the conditions for the formation of a blood clot.
  2. Strengthening blood coagulation. The release of tissue thromboplastin, thrombin and other coagulation factors into the bloodstream leads to cohesion of blood cells and the additional formation of substances that contribute to this process.
  3. Violation of the dynamic processes of the passage of blood. Prolonged bed rest, forced stationary state, cholesterol formations (plaques) in the vessels contribute to the disruption of the normal flow of blood through the vessel. The resulting "vortex" flow also favors conditions for thrombosis.

Basic principles of prevention

Deep vein thrombosis is a condition where deep veins (located far from the epidermis, as opposed to superficial) are affected by blood clots.

Thrombosis is usually preceded by expansion of deep veins or their damage. The main objective of the prevention of thromboembolism is to prevent negative changes in the veins and, as a result, the formation of blood clots.

During prevention, protection is provided against the following factors that can lead to illness:

  • expansion of veins and blood vessels
  • stagnation of blood, impaired blood flow,
  • hormonal disorders that can lead to stagnation in the vessels,
  • leg injuries.

To prevent these factors from arising, you must follow simple rules:

  1. Observe the norms of physical activity. The body should not experience overload, but being in a sitting position also negatively affects it.
  2. Healthy food. The abundance of carbohydrates and sugars in food leads to suppression of the functions of the spinal cord, responsible for blood formation. Under such conditions, he may begin to produce blood cells improperly, which leads to a thickening of the blood.
  3. Avoid wearing tight shoes, clothes. Tugging of the lower extremities leads to stagnation of blood. If the swelling persists for a long period, a blood clot may form.
  4. Monitor blood and venous pressure. Low rates lead to blood stasis, especially in the lower extremities. To restore blood pressure and maintain the proper level, medications or compression clothing items may be needed.
  5. Perform simple exercises with a sedentary lifestyle. Its stages and features are described below.

These are the main recommendations that doctors give people who are prone to blood clots. There are other preventive measures, however, they are prescribed already in the early stages of the disease in order to stop its further development.

Rejection of bad habits

It’s not a secret to anyone that addictions in themselves negatively affect the work of the whole organism. People who often take alcohol and also do not part with a cigarette put their blood vessels at great risk.

If thrombosis has already begun or in preventing the disease, avoid drinking strong tea or coffee.

Fresh Information: Tights and stockings for varicose veins for pregnant women

Constant movement

Leading a sedentary lifestyle is unacceptable if you already have problems with blood clots. Moderate physical activity will also be an excellent prevention of their formation.

If you have a calm office profession, then in your free time you need to lead an active lifestyle. Try to walk more, you can also do swimming or yoga.

Travel Behavior

If you expect a long road in a car or plane that cannot be avoided, do everything possible to prevent vascular diseases.

In order to prevent blood clots from forming after such events, it is necessary to purchase a pack of elastic bandages in advance. Remember to drink enough water along the way.

Heat exposure

If you are serious about preventing heart and vascular diseases, then you should avoid almost all thermal manipulations.

Frequent visits to the bath or sauna. Sudden changes in temperature provoke a spasm of blood vessels, due to which blood clots form. Do not test your body for strength, increasing the risk of thrombosis.

Doctor Examinations

Among patients who have already encountered the problem of thrombosis, it is customary to visit a specialist phlebologist for prevention 2 to 4 times a year.

This is done so that there is no relapse of the disease, and you also need to try to detect small blood clots that appear on time.

It is possible that as a preventative measure, the patient will be advised to take folic acid or similar drugs. Anticoagulants and antiplatelet agents also have a good effect.

Vitamin intake

In order to prevent the formation of blood clots in the vessels, it is necessary to maintain the correct vitamin balance in the body.

What to do if it is not possible to replenish the supply of vitamins through food? Your doctor will recommend special medications that you must take so that blood clots do not bother you. If a person has a suspicion of thrombosis, he will be assigned vitamins E and B.

Folk prevention

To prevent excessive blood density, as well as subsequent thrombosis, you can use herbal decoctions of natural ingredients.

Both eating berries and preparing drinks from them brings human blood to its physiological state. Cranberries, black currants, blackberries, viburnum berries, sea buckthorn are considered useful components.

A lot of trust in alternative medicine has won tea made from raspberries and blueberries.

Great drink from ginger and lemon drunk in the morning will bring. As an alternative, you can use clover tincture.

Another effective prophylactic is a topical cream or tincture for drinking from chestnut fruits.

Significantly improve blood circulation in the vessels using birch buds, raspberry and linden leaves, clover or hawthorn. Dill is also very popular in this regard. Before you start using any product, you must obtain the approval of your doctor.

The specialist will tell you which dosage will be the most appropriate for you, as well as how long it takes to treat. And it also does not hurt to conduct a home test for susceptibility to the components of the product. To do this, a small amount must be applied to the wrist or bend of the elbow.

Today, increased thrombosis is a real problem for patients at risk. If the prevention of blood clots will not be carried out, then the patient faces even death. The prevention of thrombosis needs to be conveyed to the masses of the public.

People definitely need to know how to protect themselves from blood clots and this insidious disease as a whole. Stagnation of blood in the vessels negatively affects the work of the heart, and over time can lead to a heart attack. A detailed explanation of how to prevent the formation of blood clots in your case will be able to specialist. As a rule, with a proper lifestyle, as well as sports activity, the patient does not need medication.

Physical activity and exercise

The legs are most prone to blood stasis, as they are located far on the periphery. To ensure proper blood circulation, it is necessary to periodically move without overloading the legs.

Being in the same position leads to stagnation of blood, it does not matter if a person is standing or sitting. Therefore, thrombosis of the lower extremities affects both programmers, office workers, accountants, and waiters, bartenders, sellers, employees of fast food restaurants, etc.

If you are constantly in a sitting position or spend a working day on your feet in an almost unchanged position, you must charge. Experts recommend doing it every 2-3 hours.

The whole range of exercises will take no more than 5 minutes:

  1. Stand up straight, you can take off your shoes if it’s uncomfortable. Within half a minute, quickly rise to the toes and lower yourself, swaying.
  2. Standing position. Get the heel of the left leg to the right buttock, then the heel of the right leg - to the left buttock. Each time, lifting the heel, hold it for a few seconds. Repeat 5 times for each leg.
  3. Take a sitting or lying position, in which the legs will be raised above the body. You can put them on a table or lift them and bend them to your knees. Experts recommend to rest against the wall with heels when the knees are bent 40 degrees and stay in this position for a couple of minutes. Raising the legs stimulates the outflow of blood, which accumulates in excess in the lower extremities during sedentary work.

It will also be useful to just walk around, taking steps at medium speed. At least 2 hours of walking must be given per day. If the whole working day is on its feet, on the contrary, rest is necessary, but you can not refuse to charge.

Compliance with the daily routine

Sleep is physically necessary for both the whole body and the legs. During sleep, a person takes a lying position, which improves blood circulation in the legs. If you reduce sleep time to a minimum, the veins will not have time to recover after a daily load on them.

It is necessary to sleep 6-8 hours a day, children - up to 10 hours. The older the person, the shorter the required period of sleep.

You need to sleep in suitable conditions. The berth should provide freedom so that the legs can be fully extended.

In the first hours of sleep, you can put the lower limbs on a roller or a small pillow, if during the day a person is faced with edema due to the constant presence in one position. However, you should not spend all night with your legs up.

Diagnostics

Diagnosis of deep vein thrombosis of the lower extremities is carried out by a phlebologist. The disease is not always easy to detect - in some cases, blood flow is restored through perforating veins. The most difficult to establish thrombosis of the leg. Most often, the only symptom of such a lesion is mild pain in the calf muscles, which can be aggravated by walking or moving the leg to an upright position. Therefore, often the examination and assessment of subjective symptoms of thrombosis is not enough. There are several diagnostic methods, the use of which allows to detect the presence of the disease:

  • inspection and functional tests,
  • laboratory research
  • instrumental research.

Inspection and functional tests

First of all, the doctor clarifies the presence and nature of the patient's complaints, examines the affected limb. The presence of pathology is indicated by swelling of the lower leg or the entire leg, a change in the color of the skin: it becomes cyanotic and shiny, the surface vessels are full (due to the flow of blood from deep veins), and the affected limb is colder to the touch than a healthy one.

Samples allow you to establish the presence of thrombosis during the examination of the patient even without the use of special equipment. Functional tests used:

  • Marching test - an elastic bandage is applied to the affected leg, after the patient resembles for several minutes, the bandage is removed. With the appearance of bursting pain and the detection of dilated superficial veins, there is reason to suspect thrombosis in the patient.
  • Test Pratt-1 - the patient lies on his back, he measures the circumference of his lower leg, then the blood from superficial veins is expelled with massaging movements. An elastic bandage is applied to the shin, starting from the fingers - this is necessary for directing blood into the deep vessels. After the patient walks for 10 minutes, the results are evaluated: discomfort, pain, an increase in the volume of the lower leg are signs of thrombosis in the legs.
  • Homans test - the patient lies on his back, legs should be bent at the knees. The occurrence of severe pallor and severe pain in the lower leg with flexion of the foot indicates the presence of pathology.
  • Mayo-Pratt test - the patient lies on his back, a roller is placed under the affected limb, blood is expelled from the saphenous veins with massage movements. Then the doctor puts a tourniquet on the upper thigh. The patient should walk for 30 minutes, the occurrence of bursting in it and the appearance of pain are a sign of deep vein thrombosis.
  • Moses syndrome - the lower leg is compressed from front to back, then in the lateral direction. In the presence of deep vein thrombosis, pain occurs only in the first case.
  • A sign of Lixer is a sensation of pain when tapping on the front surface of the tibia.

Laboratory research

A blood test allows you to detect the presence of inflammation: an increase in the erythrocyte sedimentation rate, the concentration of C-reactive peptide and fibrinogen, and the presence of leukocytosis. To determine the shift in the blood coagulation system allows kaogulogamma. The study of D-dimer also helps to diagnose pathology. Its excess in the blood is a confirmation of the presence of a blood clot. The study of thromboelastogram allows to evaluate the processes of coagulation and fibrinolysis.

Instrumental diagnostics

  • Duplex scanning is an ultrasound technique for diagnosing deep vein thrombosis. The study session is accompanied by a picture of the state of veins with moving blood flow. This study will assess the state of the venous wall and lumen of blood vessels, the presence of blood clots, the nature of the clot and its size, the degree of impaired blood flow and tentatively determine the duration of the process.
  • X-ray contrast phlebography - radiography of the lower extremities, which allows you to explore the veins by introducing a contrast medium. This study is the most informative and is prescribed if the reliability of duplex scanning is in doubt.
  • Magnetic resonance imaging and computed tomography are prescribed if the received data is insufficient.
  • Dopplerography allows you to assess the condition of the femoral vein. It is difficult to diagnose thrombosis of the veins of the leg with this method, with a similar localization of the pathology, dopplerography is not effective enough.

Pregnancy Prevention

Pregnancy is the period when a woman is most susceptible to diseases of the veins of the lower extremities. During gestation, edema often occurs, the legs are constantly sore, and blood flow deteriorates. Particular attention should be paid to the prevention of venous thrombosis.

The main recommendation is to go to the doctor to determine the exact prevention of thromboembolism with him.

Performing the above exercises without the permission of a doctor is dangerous, because this can lead to damage to the embryo. All physical exercises, as well as daily diet should be selected individually.

If you suspect the development of thrombosis, compression underwear is most often prescribed. It provides proper blood flow and maintains pressure in the lower limbs. Wear such underwear (stockings, socks) you need throughout the day, and remove before bedtime.

Traditional medicine recipes

Looking for the answer to the question of how to avoid the formation of blood clots, you can turn to folk recipes. Alternative medicine can be used only if it is approved by the attending physician, since some recipes can harm the body in the presence of concomitant pathologies.

Most often, the following folk remedies are used:

  1. Cranberry berries must be washed and mixed with honey, to use the resulting product must be 2 teaspoons on an empty stomach and before bedtime. Cranberries can be frozen and take the required amount every day.
  2. In spring, you need to collect the mountain ash bark, rinse, dry and grind in any way. Pour 10 tbsp. l raw materials with a liter of cold water, bring to a boil over medium heat, then reduce it to a slow and cook the mixture for 2 hours. Cool the resulting broth, strain and consume 3 tablespoons three times a day.
  3. Grind dried mint, pour 2 tbsp. l a glass of boiling water, cover and let it brew for several hours. Strained broth to use in the morning on an empty stomach for 2-3 months, then take a break and repeat the course.
  4. To lower your blood cholesterol, use a few cloves of garlic every day.

In addition, any herb that improves blood circulation and strengthens the immune system can be added to tea, for example, hawthorn, sage, acacia, cinquefoil, lemon balm, etc. As a sweetener for tea, it is best to use natural liquid honey, since sugar consumption should be minimized.

If we talk about alternative medicine, then for the prevention of thrombosis, hirudotherapy can be used - treatment with medical leeches. However, when choosing this method, it is necessary to choose only a reliable clinic with an existing certificate for such activities.

Preventive measures in the early stages of the disease

If the disease has already been diagnosed, but is still at an early stage, surgical intervention can be avoided by proceeding to the comprehensive prevention of thromboembolism using medications.

As prescribed by the doctor, heparin-based drugs are used. It is better to use local options (gels and ointments), since they practically do not have side effects and differ in directional effect.

It is possible to wear compression garments with a low degree of fixation. It is also selected by a doctor.

During prevention, you need to use a large amount of water, try not to stay too long in one place. Even if as a result of preventive measures the patient becomes better, it is impossible to refuse a subsequent examination by a doctor.

Anticoagulants

About on 6 - 10 days after the start of heparin therapy the treatment regimen provides for the transition to indirect tabletted anticoagulants and antiplatelet agents - agents that prevent platelet adhesion.

Warfarin attributed to long-term anticoagulants that inhibit the synthesis of vitamin K, which is a strong coagulant.

It is taken 1 time per day at a specific time. When using warfarin, an INR indicator is mandatory, for the determination of which a blood test is done every 10 days. Warfarin has a lot of contraindications, therefore It is used only after a doctor selects a specific dose and under strict laboratory control.

Today, there are other drugs with a similar effect: enoxaparin, clexane, dalteparin or phenindione, fraksiparin.

Currently, Western pharmaceutical companies are conducting studies of drugs with even more narrowly targeted anticoagulant effects, which do not require constant testing. This makes it possible apply low molecular weight heparins for outpatient therapy.

Antiplatelet agents


Acetylsalicylic acid, taken at 50 mg per day, helps to keep blood viscosity low enough so that re-formation of pathological blood clots does not occur. For problems with the gastrointestinal tract, depending on the dynamics of the disease, it is advisable to take coated tablets for 4-8 weeks.
Recommended venotonicscontributing to an increase in the tone of veins, strengthening of the walls of blood vessels, improvement of microcirculation and normalization of blood flow: escusan, detralex, phlebodia.

Phlebotonics

The results of compression therapy, which continues on an outpatient basis, are more pronounced if the place of the inflammatory process is lubricated with special phlebotropic ointments and gels: Troxevasin, Venoruton, Venitan, Aescusan, Lyoton-gel, Reparil-gel. These agents have excellent venotonic and anti-inflammatory effects.

Features of the treatment of thrombophlebitis

Deep vein thrombosis is treated in a complex where measures to prevent pulmonary embolism and chronic venous insufficiency are an important area.

Patients are prescribed anticoagulants:

  • Heparin injection
  • Warfarin, in the first two days.

The introduction of drugs should be under appropriate control of the function of the blood coagulation system. Patients with thrombosis are prescribed antithrombotic therapy with heparin, lasting 7-14 days. It is administered intravenously in a jet, or drip, or in fractional doses every 4 hours. Warfarin is prescribed in dosages of 10-20 mg per day, after reaching a certain level of prothrombin time.Upon its achievement, heparin is canceled and maintenance therapy with warfarin is prescribed.

Along with anticoagulants, streptokinase or urokinase are prescribed, which in combination therapy give a good absorbable thrombolytic effect.

The patient is assigned bed rest with an elevated position of the legs. You need compression bandaging of the legs, or special orthopedic stockings. For the ankle joint, special gymnastics is prescribed.

In complex cases, when the conservative treatment is not effective, a thrombectomy is performed, an operation to extract a blood clot from a vein. It is carried out using a special catheter.

Primary and secondary prevention

First of all, as the primary prevention of the occurrence of the disease, you must carefully monitor your health and pay attention to the appearance of any symptom. Symptoms of thrombophlebitis:

  • pain and heaviness in the legs, which increase with increasing load,
  • redness of the skin and the appearance of compaction in the area of ​​inflammation of the veins,
  • an increase in body temperature at the onset of the inflammatory process,
  • swelling of the legs.

First of all, preventive measures should be aimed at identifying the causes, symptoms of the disease and its treatment. In the chronic form of the disease, preventive measures should help to avoid exacerbations and the development of complications.

The main methods of secondary preventive measures:

Strengthening blood vessels, increasing their elasticity and tone. This will help hardening procedures. A contrast shower is very helpful. However, hypothermia should not be allowed. A massage course will also help strengthen blood vessels.

General strengthening of the immune system. Strengthening the immune system is quite simple. You should lead a healthy lifestyle, abandon bad habits, often walk and temper.

Increased physical activity and physical activity. Exercise, moderate exercise and just constant physical activity have a beneficial effect on the state of venous vessels. A sedentary and sedentary lifestyle entails problems with blood vessels.

Proper balanced diet. Proteins, fats and carbohydrates, as well as the necessary vitamins and minerals, must be present in the daily diet in sufficient quantities. Sour-milk products, all kinds of fruits and vegetables are very useful. Meat and fish should also be present in the diet. Be sure to drink as much fluid as possible, 2-2.5 liters per day is mandatory.

Timely treatment of diseases. Many venous diseases lead to the appearance of blood clots, since a full flow of blood through the body is disrupted. In most cases, the appearance of blood clots will be a complication of the disease

Therefore, timely treatment of vein diseases is an important measure as the prevention of thrombophlebitis.

It should be borne in mind that the appearance of blood clots is caused not only by venous diseases. Even simple colds, infectious diseases, gastrointestinal disorders can affect the state of veins and blood vessels

It is recommended to start treatment of any disease in a timely manner and be attentive to the state of veins and blood vessels.

Preventive measures are prescribed by doctors and in conjunction with treatment to reduce the risk of complications and relapses. You need to monitor your health and for any manifestation of the symptoms of the disease, consult a doctor. Preventive measures of thrombophlebitis are primarily aimed at preventing the development of the disease and its consequences. An important measure to prevent the appearance of thrombophlebitis is the timely medical diagnosis of concomitant vein diseases, which will help to detect the disease in time and begin the course of treatment.

It consists of amaranth seeds and juice, and other natural components that effectively fight blood clots, lower cholesterol, normalize veins, cleanse blood and lymph, prevent the deposition of cholesterol plaques, and improve the general condition of the body. In this case, only natural components are used, no chemistry and hormones!

Do you still think that FULLY CURE is impossible?

Prevention of deep vein thrombosis after phlebectomy

Phlebectomy is an operation performed to normalize venous blood flow. Among the possible postoperative complications, there is a risk of developing deep vein thrombosis and pulmonary embolism. Prevention of thrombosis after phlebectomy is as follows:

  • Limit extended horizontal stays. Blood should not stagnate in the veins, so the patient must lead an active lifestyle. In the first days after surgery, the load on the legs should be minimized, but then gradually restored to the optimal level.
  • Wear compression products for the lower extremities for at least 2 weeks. The compression classes for each patient are determined by the attending physician.
  • Take anticoagulants (heparins) and local preparations: ointments, compresses. The scheme of postoperative rehabilitation treatment is signed by the attending physician individually for each patient.
  • Engaged in rehabilitation exercise therapy. Swimming in the pool, walking, cycling are recommended.

In the postoperative period, in order to prevent venous thrombosis of the lower extremities are not recommended:

  • great physical exertion on the legs,
  • a visit to the steam bath and sauna
  • alcohol consumption.

The main prevention of thrombosis, or how to prevent blockage of blood vessels

Thrombophilia is a chronic condition of the body characterized by a violation of the blood coagulation system, which increases the risk of thrombosis. A condition that can be inherited from your parents or acquired during life (occurs due to other health problems). Pathology, in the vast majority of cases, not requiring therapy. Nevertheless, a certain category of people with thrombophilia needs to receive anticoagulants. Prevention of deep vein thrombosis (DVT) requires the participation of not only medical personnel, but also the patients themselves. Understanding what thrombophilia is, a person who does not have a medical education is one of the components of an integrated approach in the prevention of DVT or pulmonary thromboembolism.

Read this article

What is thrombophilia, causes

Thrombophilia is a medical term that implies a tendency to form blood clots inside blood vessels. The appearance of “unwanted” blood clots can lead to serious problems, such as pulmonary embolism or ischemic stroke of the brain.

In the human body, the biological system responsible for maintaining the liquid state of the blood, helping to stop bleeding with vascular damage, is called hemostasis. If he were not there, then the smallest cut would end with a fatal bleeding. If the vessel wall is damaged, when its lumen communicates with the external environment, a cascade of chain reactions is launched, in which the so-called coagulation factors, as well as platelets, take part. These processes cause the blood to “shrink” into a clot that closes the gaping lumen of an artery or vein.

There are natural mechanisms that counteract thrombosis, which are triggered to stop blood coagulation. Thrombophilia occurs as a result of an imbalance between the coagulation and anticoagulation systems of the blood, when there are too many coagulation factors, and few substances counteracting them.

The tendency to thrombosis is divided into hereditary and acquired.The first is passed from parent to child. The second arises as a result of medical problems that “accumulate throughout life.” And there is also a mixed form when genetic and non-genetic factors are involved in the onset of this condition.

Timely diagnosis of thrombophilia allows you to take effective measures to prevent venous and arterial thrombosis in time.

There are no signs of thrombophilia until this condition is realized by the appearance of a blood clot in a vessel that can form in both veins and arteries. Venous thrombosis is more common and, as a rule, is manifested by the following symptoms:

  • The soreness and swelling that forms when a blood clot appears in the deep veins of the limbs, more often in the lower. Therefore, the prevention of thrombosis of the lower extremities is most relevant for people with thrombophilia.
  • A blood clot from the leg can move to the heart, and then to the lungs, thereby causing the so-called pulmonary embolism. This is accompanied by the appearance of pain in the chest, pronounced shortness of breath, and sometimes a collaptoid state.
  • With certain subtypes of thrombophilia, venous thrombosis is possible in unusual places, for example, in the vessels of the intestine or liver (Budd-Chiari syndrome), which is accompanied by the corresponding symptoms.

Arterial thrombosis can result in an ischemic stroke of the brain, myocardial infarction, or placental insufficiency. Therefore, with thrombophilia, the following situations occur:

  • the occurrence of stroke at a relatively young age,
  • miscarriage
  • preeclampsia,
  • stillbirth or fetal death,
  • coronary artery disease.

It is important to remember that the appearance of the above pathological conditions is caused not only by thrombophilia, but can also occur as a result of other reasons. For example, smoking, high blood pressure, diabetes and high cholesterol, which are the main factors in the development of myocardial infarction and stroke. Therefore, getting rid of addiction, ongoing treatment of hypertension and diabetes are effective means of preventing thrombosis.

Five effective methods for the prevention of blood clots in blood vessels

From this article you will learn: what should be the effective prevention of thrombosis, who needs it. The prognosis of the development of complications of thrombosis during prophylaxis.

Thrombosis - the closure of the bloodstream of large or small blood vessels by a blood clot - develops as a response of the body to damage to the vascular wall.

The process of thrombosis is extremely rare (mechanical injury due to shock, bruise) is started in healthy vessels, usually the cause of its appearance is:

  • violation of the integrity of the vascular walls (as a result of atherosclerosis, diabetes, hypertension, inflammation in vasculitis, venous insufficiency),
  • a change in the physicochemical properties of blood (decrease in fluidity, increase in viscosity, coagulability, increase in the number of platelets, their increased aggregation),
  • the nature of the blood flow (speeding up or slowing down).

The risk group includes people over the age of 55, with lipid and carbohydrate metabolism disorders (hyperlipidemia and diabetes mellitus), obesity (the risk of thrombosis increases by 10 times), malicious smokers leading a sedentary and sedentary lifestyle.

Therefore, the most effective measures for the prevention of thrombosis are aimed at:

  1. Formation of a balanced diet with a low content of fats (with hyperlipidemia) and carbohydrates (with diabetes and obesity), a high content of vitamins and bioflavonoids (plant antioxidants, biologically active substances).
  2. Regulation of drinking regimen (improves blood quality and blood flow).
  3. Getting rid of obesity and bad habits (smoking, alcoholism).
  4. Elimination of physical inactivity.

Events are relevant for people at risk, and any other categories (with age, with deviations in diet, drinking disorders, etc.), conditions for changes in the vascular walls, blood viscosity and thrombosis appear.

The prevention of thrombosis is quite effective, in 85% it helps to prevent numerous circulatory disorders (heart attacks, kidneys, intestines, stroke, deep vein thrombosis, soft tissue necrosis, thromboembolism) that result from blockage of the bloodstream.

A pronounced positive result of prevention is fixed for several years (from 2 to 4), a prerequisite is regularity and systematic compliance with the rules. To maintain the result and prevent thrombosis, the recommended prophylaxis regimen must be maintained throughout life.

To consult about the prevention of thrombosis, to recommend additional measures (drug prevention, spa treatment, physiotherapeutic methods) can be a general practitioner, phlebologist, angiosurgeon, cardiologist.

The preventive measures in the article are sorted by their approximate effectiveness: starting with the most effective and then decreasing.

Vitamin Complexes

Used to solve a group of tasks.

  • Vitamin A - provides normal blood flow, prevents blood clots and strengthens the vascular walls.
  • E - acts as a means to combat fatty compounds, partially avoids the development of atherosclerosis.
  • C - it is ascorbic acid. It does not allow the walls of arteries, veins, capillaries to collapse, and therefore prevents their damage.
  • P - participates in regenerative processes.
  • B3 - aka nicotinic acid. It affects the vessels in a complex way. The effect is enhanced with a parallel intake of vitamin C.

The specific names of the funds are determined by a specialist. Ascorutin, Aevit and others. The cost of such medicines is more than affordable.

It is forbidden to abuse vitamins, it can be dangerous. All within the prescribed scheme. As a last resort - it is worth looking at the annotation.

Angioprotectors

As the name implies, they protect vessels of various calibers from the negative influence of factors from the outside and inside.

Pharmaceuticals reduce the rate of oxidation of cell walls and the permeability of capillaries, which helps to protect against thrombosis. Among the specific names is Anavenol, previously named Ascorutin. Many others.

Finally

Prevention of thrombosis is carried out by gentle methods. “Breaking” oneself, forcibly changing a lifestyle, does not make sense, and it is not necessary.

It is enough to revise the vector of everyday efforts to achieve a qualitative result. The main thing is to carefully work out the scheme.

Here the doctor will just help, neglecting the help of a specialist is not recommended. So it will be possible to achieve the effect faster with less effort.

List of literature used in the preparation of the article:

  • Diagnosis, treatment and prevention of venous thromboembolic complications. Version: Clinical recommendations of the Russian Federation (Russia).
  • Scientific and peer-reviewed medical journal "Phlebology". Russian clinical guidelines for the diagnosis, treatment and prevention of venous thromboembolic complications (VTEC).
  • A.K. Lebedev, O.Yu. Kuznetsova. Deep vein thrombosis of the lower extremities. Clinical recommendations. Approved at a meeting of the relevant commission of the Ministry of Health of Russia on AFP 10/13/2015.
  • The clinical protocol for the diagnosis and treatment of embolism and thrombosis of the aorta and arteries. Recommended by the Expert Council of the RSE on PVC “Republican Center for Health Development” of the Ministry of Health and Social Development on September 15, 2015.

Diagnostic tests

The diagnosis is made after certain blood tests. Quite often, they are prescribed by a hematologist who specializes in identifying and treating blood diseases. Here are some of the tests that are used to diagnose thrombophilia:

  • General blood analysis . Assesses the qualitative and quantitative composition of cells: how many and what red blood cells, white blood cells and platelets are in one milliliter of blood.
  • Prothrombin time and partial thromboplastin time. Tests that show how fast thrombosis occurs.
  • Lupus anticoagulant. A specific antibody is detected (autoimmune cause of thrombophilia).
  • Antibodies to cardiolipin.
  • Test for resistance to activated protein, C-positive result suggests thrombophilia by factor V Leiden.

Functions

They differ from arteries by more dense elastic vascular walls. Their main function is the implementation of the outflow of blood from tissues and organs to the heart. They are directly responsible for the outflow of blood from all muscle groups.

In the event of a malfunction, unpleasant symptoms occur, and doctors report venous insufficiency.

Reference! The main function of the deep vein is the transfer of depleted blood from the capillaries towards the heart due to valves. They, in turn, prevent the return of fluid in the opposite direction.

Thrombophilia treatment

Before proceeding with the treatment of thrombophilia, the patient, together with the doctor, needs to consider the possibility of a blood clot in the lumen of the vessel. It depends on what medications for the prevention of thrombosis will need to be taken. The risk of thrombosis in a person with thrombophilia directly depends on a combination of the following factors:

Causes and triggering factors leading to thrombosis

  • lifestyle, weight, age and associated diseases,
  • pregnancy and the postpartum period,
  • were there any "excesses with a thrombus"
  • family history of thrombosis.

This information will help the doctor assess the risks, after which he can discuss with the patient the pros and cons of therapy, and if necessary, what type of treatment to apply in each specific situation.

How to prevent vascular thrombosis with detected thrombophilia, possible treatment options:

Quite often, in order to prevent thrombosis, small doses of aspirin are prescribed, which suppresses platelet activity.

A group of drugs that can prevent deep vein thrombosis. They are also used in the treatment of already appeared vessel thrombosis. With thrombophilia, they are recommended in the following situations:

  • there was a blood clot and we need to prevent the emergence of a new one,
  • there was no blood clot, but there is a high risk to get it,
  • there was a temporary situation when the risk of thrombosis is high, for example, pregnancy, 6 weeks after giving birth, being stationary for a long time.

Anticoagulants are used in the form of injections (for example, heparin), and tablet forms also exist. The latter include warfarin. Currently, low molecular weight heparins have begun to be widely used.

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Saphenous veins

The network of abduction vessels located directly under the skin is represented by small and large saphenous veins. The beginning of the small saphenous vein (abbreviated as MVP) is the lateral marginal located on the foot, as well as the plexus of the vessels of the lateral part of the foot and heel. The localization of this blood tube is limited to two heads of the calf muscle, and in the upper part it passes through the popliteal fossa, where it connects to the popliteal vein.

The main feature of the IPC is the presence of a large number of valves, thanks to which the active upward movement of blood is supported. She has many tributaries in the form of superficial veins of the back of the lower leg.In addition, it is connected to the lower leg with multiple anastomoses. Its diameter does not exceed 4.5 mm.

The beginning of the great saphenous vein (abbreviated BPV) is the medial part of the ankle along which it runs up along the lower leg and rises first behind the epicondyle of the thigh, and then along the premedial surface of the thigh to the ethmoid fascia, where it flows into the femoral vein. Its tributaries are numerous pre-medial veins that encircle the entire surface of the thigh and lower leg, epigastric and superficial, surrounding the ilium, vessels. In addition, shortly before flowing into the femoral vein, venous ducts of the external genitalia join it. The main feature of the BOD is its large diameter (up to 11 mm) and the presence of a developed valve system.

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Watch the video: DVT prophylaxis vs anticoagulation - Dr Jamal USMLE - cardiology lecture (March 2020).