How to treat lower extremity venous thrombosis?

Lower limb venous thrombosis is particularly common in some occupations, such as waiters, security guards, manual laborers, etc., because these people need to stand for a long time, which can cause varicose veins in the veins. If you want to treat lower limb venous thrombosis, you must have targeted methods, such as bed rest, anticoagulant therapy, thrombolytic therapy, etc. If lower limb venous thrombosis is not treated effectively or promptly, it can easily cause vascular ulcers or local ulcers, causing great harm to the patient's health.

1. Bed rest and elevation of the affected limb Leg elevation and initial bed rest can relieve pain in patients with deep vein thrombosis accompanied by acute leg swelling. The traditional method of recommending strict bed rest for 1 to 2 weeks to prevent pulmonary embolism has been questioned. Lung scans show that bed rest does not reduce the incidence of pulmonary embolism. In addition, early ambulation can lead to faster improvement in pain and swelling compared with bed rest. Wearing elastic stockings can improve pain and swelling in patients with deep vein thrombosis. Long-term wear may inhibit clot growth and reduce post-thrombotic syndrome.

2. Anticoagulant therapy This is one of the most important modern treatments for deep vein thrombosis. Correct use of anticoagulants can reduce the incidence of pulmonary embolism and the sequelae of deep vein thrombosis. Its function is to prevent the formed thrombus from continuing to grow and the formation of new thrombus in other parts, and to promote the more rapid revascularization of thrombosed veins. Generally, heparin or low molecular weight heparin is used in the acute phase, followed by a transition to oral anticoagulants, such as warfarin. However, due to the complex drug- or food-related interactions of warfarin, large individual dosage differences, and the risk of bleeding, monitoring is required. In recent years, many new oral anticoagulants have been developed, such as rivaroxaban. Rivaroxaban is rarely affected by drugs or food, generally does not require testing, and is easy to use.

3. Thrombolytic therapy includes systemic thrombolysis and catheter-directed thrombolysis, and the drugs used are mostly urokinase, etc. Systemic thrombolysis: Systemic thrombolysis via intravenous administration: systemic administration of the drug through the superficial veins allows the drug to be evenly distributed in the body with blood circulation to achieve the purpose of thrombolysis. Interventional thrombolysis usually refers to catheter-retaining contact thrombolysis: also known as CDT. The proximal deep vein catheter is retrogradely inserted into the distal deep vein of the limb. The guide wire and catheter are first used to physically open the blood vessel lumen to relieve the outflow tract obstruction. Then, a thrombolytic catheter is inserted to allow the drug to come into direct contact with the thrombus, dissolving the fresh and loose thrombus in the acute phase and restoring the patency of the main vein in a timely manner. Some scholars believe that catheter-directed thrombolysis for iliofemoral vein thrombosis can improve the quality of life compared with anticoagulation alone.

Clinical manifestations

1. Symptoms

The most common clinical manifestation is sudden swelling of one limb. Patients with deep vein thrombosis in the lower extremities experience localized pain that worsens when walking. In mild cases, there is only a feeling of heaviness in some parts of the body, and the symptoms worsen when standing.

2. Physical signs

The physical examination has the following characteristics: ① The degree of swelling of the affected limb must be accurately measured with a tape measure every day and compared with the thickness of the healthy lower limb to be reliable. Simply relying on naked eye observation is unreliable. This sign is of great value in diagnosing deep vein thrombosis. When the calf is severely swollen, it often leads to increased tissue tension. ② Tenderness: There is often tenderness at the site of venous thrombosis. Therefore, the lower extremities should be examined including the calf muscles, popliteal fossa, adductor canal, and femoral vein below the groin;