bubble_chart Overview

Thrombophlebitis refers to the acute non-suppurative inflammation within the venous lumen accompanied by thrombus formation. It is a common vascular thrombotic disease, primarily affecting the superficial and deep veins of the limbs. Thrombosis can cause inflammation, and inflammation can also lead to thrombosis, with the two being mutually causative.

bubble_chart Etiology

disease cause

This disease is associated with factors such as infection, limb trauma, indwelling venous catheters for more than 24 hours, intravenous injection of hypertonic solutions and sclerosing agents, long-term bedridden patients, postoperative patients in the convalescence stage, and increased blood coagulability. Additionally, it is also related to conditions such as cancer and lymphoma.

Pathological changes

Venous wall injury: At the venous entry and confluence points, the vascular wall structure is the weakest. If minor tears occur, platelets are prone to adhere, leading to fibrin deposition.

Slow venous blood flow: Conditions such as surgery, prolonged bed rest, heart failure, increased intra-abdominal pressure, and varicose veins in the lower limbs can all cause slow blood flow, leading to deep vein thrombosis.

Abnormal hypercoagulable state: Blood concentration due to major surgery, trauma, burns, childbirth, or severe dehydration; splenectomy, cancer, long-term use of female oral contraceptives, pregnancy, and infections can all increase blood coagulation.

bubble_chart Clinical Manifestations

Patients with superficial phlebitis experience localized redness, swelling, and pain in the affected limb, which worsens during walking. A painful cord-like induration or beaded nodules may be palpable.

Patients with deep vein phlebitis have a sudden onset, with pitting edema in the affected limb and dark red skin. Extensive venous distension or varicosities and capillary dilation are present. In the late stage [third stage], trophic changes occur, accompanied by stasis dermatitis, pigmentation, or superficial ulcers. The circumference of the thigh or calf is more than 1 cm larger than that of the healthy limb. Swelling and pain worsen during walking and improve with rest. Venography reveals stenosis or occlusion of the deep veins in the affected limb.

bubble_chart Diagnosis

1. History of repeated venipuncture, intravenous drug administration, hypertonic solution infusion, or varicose veins in the lower limbs.

2. The affected vein area presents as a red, swollen, cord-like induration with significant pain and tenderness, accompanied by localized skin warmth. After acute inflammation subsides, the cord-like induration becomes firmer, leaving skin pigmentation, usually without systemic symptoms.

3. Recurrent cases are called migratory thrombophlebitis, often an early manifestation of thromboangiitis obliterans or underlying visceral tumors.

It is mainly divided into two types: superficial thrombophlebitis and deep vein thrombophlebitis. The former includes limb superficial thrombophlebitis, superficial thrombophlebitis of the thoracoabdominal wall veins, and migratory superficial thrombophlebitis. The latter includes thrombophlebitis of the calf muscle venous plexus and thrombophlebitis of the iliac-femoral and popliteal veins. Clinical diagnosis should be carefully made based on different characteristics.

bubble_chart Treatment Measures

Treatment Measures

1.Non-surgical Therapy

Elevate the affected limb, apply local physical therapy or hot compress, and use antibiotics as appropriate.

2.Surgical Therapy

If the affected vein continues to extend proximally with a tendency to invade the deep vein, high ligation or excision of the involved vein should be performed.