Deep vein thrombosis

Outlined vein thrombosis occurred in the deep veins of the more common clinical, treatment is not ideal enough. Chang left lower limb deep venous obstruction, or venous insufficiency. Cause pathogenesis one, causes the mid-19th century (1946-1956). Virchow proposed vein thrombosis in the three major factors, namely venous flow has stagnated and vein injury and hypercoagulability. In recent years, a large number of clinical and experimental observations, not only with the specific factors, and detection methods can be used to be confirmed. However, in the above three factors, any one single factor often not pathogenic, must be a combination of factors. particularly slow blood flow and hypercoagulable state that they may cause thrombosis. 2, pathological venous thrombosis of pathological changes were mainly due to high blood coagulation and blood stagnant thrombosis occurred, thrombosis and generally only mildly wall adhesion, easily peeled off, can cause pulmonary embolism. Stimulating inflammatory response, thrombosis and vascular adhesion can be more closely. In accordance with the composition of thrombosis, venous thrombosis in three types : ?٠Red thrombosis most common form uniform, platelets and leukocytes scattered distribution in RBC and cellulose gel block; ?ڠbasic white thrombosis from cellulose, WBC and platelet layered composition, only a very small amount of red blood cells; ?۠mixed thrombosis by white thrombus composition head, Lamellar red and white thrombosis thrombosis constitute the body, red or thrombosis Lamellar thrombosis constitute the tail. Venous thrombosis caused venous return, the extent of vascular involvement depends on the size and location, and thrombosis of the scope and nature. Hypertension vein occlusion distal capillary bleeding, and endothelial cells under hypoxia and increased capillary permeability, obstruction distal limb swelling there. Deep venous hypertension and venous return, the traffic branch phlebectasia open, obstruction distal flow of traffic through the door and support superficial vein, there superficial vein expansion. Venous thrombosis along the direction of blood flow to the proximal end of vines in the past, the leg can be extended thrombosis of the inferior vena cava, or the opposite. When thrombosis completely blocked vein, thrombosis can be extended distal to reverse. Thrombosis can be peeled off, with the blood flow through the right heart, pulmonary embolism, and pulmonary embolism. Thrombosis of the other aircraft can, again and again of endometriosis, so that the lumen venous return to a degree of patency. Lumen due by fibrous tissue contraction, and the valve damage, to venous insufficiency. Clinical manifestations of deep vein thrombosis, can occur in the deep veins of the lower extremities any location. Clinical common of two categories : calf muscle venous thrombosis Cong iliac and femoral vein thrombosis. The former is located in the terminal, known as peripheral; The latter at the center, known as the Central. Whether central or peripheral can propagate through antegrade or retrograde expansion, which involved the entire body, called the mixed type, Clinical most common (Figure 2 -120). (1) Peripheral (2) Central (3) mixed type 2 -120 map deep-vein thrombosis in the small type Leg muscle venous plexus thrombosis (peripheral), after surgery for deep vein thrombosis the lesion. Because of the extent of lesions smaller, excited by the inflammatory response to a lesser extent, the clinical symptoms are not obvious and easily overlooked. Usually feel small bulging leg pain or flu, muscle tenderness, slight swelling of the ankles. If the knee extensor spaces will be adequate dramatic dorsiflexion, the gastrocnemius and soleus muscle elongation, motivate thrombosis caused by inflammatory pain and muscle pain there, as George Homans levy positive. Not affect the blood returning, superficial venous pressure is usually higher. Thrombosis of the proximal continues to reproduce, and clinical performance is increasingly clear that leg swelling, superficial vein expansion popliteal fossa tenderness along the popliteal vein. Iliofemoral vein thrombosis (Central), left disappearing with the right iliac artery across the left common iliac vein, to the left common iliac vein is certainly the oppression. Sudden onset emergency; Local pain, tenderness; Inguinal ligament following limb swelling; Superficial vein expansion Mrs groin and lower abdominal wall obvious; Unit 3 in the area can be palpable femoral vein thrombosis which is full of the formation of blood clot; with a fever, but generally not more than 38.5 ?殠Antegrade expansion, violations of the inferior vena cava. Exfoliated as thrombosis, pulmonary embolism can form, cough, chest pain, breathing difficulties, severe occurred when cyanosis, coma and even sudden death. Whether iliofemoral retrograde venous thrombosis proliferation, or calf muscle venous thrombosis Cong antegrade expansion As long as implicating the entire lower extremity deep venous system, are known as mixed. Clinical manifestations of the performance of the two together. However, the incidence of misprision of the latter, at the beginning of minor symptoms until iliac and femoral vein involvement, appeared curly-performance. Where The risk, iliac and femoral vein thrombosis expansion or retrograde venous plexus calf muscle thrombosis antegrade reproduction, as long as the growth thrombosis, so that the entire limb venous system, almost all in a state of congestion, but caused strong artery spasm, known as the Special Unit was swollen. Severe pain, the whole limb extensive obvious swelling, skin tight, shiny purple color was purple, and others may occur blisters, skin temperature decreased significantly, foot, the posterior tibial artery pulse. Systemic reactions, the temperature often reached more than 39 ° C, there will be shock and venous limb gangrene. Diagnosis calf muscle venous plexus thrombosis, symptoms veiled and not typical, and often difficult to diagnosis. Iliofemoral vein thrombosis, stocks mixed and bruises, with more typical clinical presentation, diagnosis generally no more difficult. However, in order to determine the diagnosis, clearly the extent of lesions, can choose the following examinations : (1) radioisotope examination currently venography isotopes and radioactive fibrinogen test two methods. The former at an experimental stage and not yet in clinical applications; The latter is the application of iodine 125 markers human fibronectin, be thrombosis is the formation of calories per gram thrombosis content than contour high blood more than five times, thus creating the concentration of radioactive rare phenomenon, the next body scan that can detect the thrombosis. The method is simple, noninvasive, high accuracy, can be found smaller vein thrombosis occult. (2) the use of Doppler ultrasound screening effect of the probe placed in the larger surface vein, and can hear or venous blood flow was recorded sound, the sound of no blood, can vein thrombosis. The use of new imaging device, but also directly observed and venous diameter of the cavity, embolization can understand the size and location of the injury. (3) electrical impedance plethysmography inspection application volume depiction apparatus, Determination of balloon occlusion shares with the venous return after leg volume increase, and after the removal of blocking leg volume reduction rate, thus be judged leg vein patency, to determine whether venous thrombosis. (4) intravenous manometry standing foot normal venous pressure is generally 130 cmH2O, ankle 510282 activities, general decline of 60 cmH2O, stop activities, the pressure picked up, picked up for more than 20 seconds. Trunk venous thrombosis, either standing or resting when pressure was significantly increased. Faster recovery time, usually about 10 seconds. (5) venography for the most accurate method of checking, direct imaging vein can be effectively determine whether thrombosis, Thrombosis can determine the size, location, shape and collateral circulation. OK late retrograde pyelography, but also understanding of vein valve.