admin 百科大全 2023-02-03 10:47:03

下肢静脉栓塞可怕吗？怎么预防？

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Blood clot in leg vein

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. Deep vein thrombosis can cause leg pain or swelling. Sometimes there are no noticeable symptoms.

You can get DVT if you have certain medical conditions that affect how the blood clots. A blood clot in the legs can also develop if you don't move for a long time. For example, you might not move a lot when traveling a long distance or when you're on bed rest due to surgery, an illness or an accident.

Causes

Anything that prevents the blood from flowing or properly clotting can cause a blood clot.

The main causes of deep vein thrombosis (DVT) are damage to a vein from surgery or inflammation and damage due to infection or injury.

Risk factors

Many things can increase the risk of developing deep vein thrombosis (DVT). The more risk factors you have, the greater your risk of DVT. Risk factors for DVT include:

Age. Being older than 60 increases the risk of DVT. But DVT can occur at any age.Lack of movement. When the legs don't move for a long time, the calf muscles don't squeeze (contract). Muscle contractions help blood flow. Sitting for a long time, such as when driving or flying, increases the risk of DVT. So does long-term bed rest, which may result from a lengthy hospital stay or a medical condition such as paralysis.Injury or surgery. Injury to the veins or surgery can increase the risk of blood clots.Pregnancy. Pregnancy increases the pressure in the veins in the pelvis and legs. The risk of blood clots from pregnancy can continue for up to six weeks after a baby is born. People with an inherited clotting disorder are especially at risk.Birth control pills (oral contraceptives) or hormone replacement therapy. Both can increase the blood's ability to clot.Being overweight or obese. Being overweight increases the pressure in the veins in the pelvis and legs.Smoking. Smoking affects how blood flows and clots, which can increase the risk of DVT.Cancer. Some cancers increase substances in the blood that cause the blood to clot. Some types of cancer treatment also increase the risk of blood clots.Heart failure. Heart failure increases the risk of DVT and pulmonary embolism. Because the heart and lungs don't work well in people with heart failure, the symptoms caused by even a small pulmonary embolism are more noticeable.Inflammatory bowel disease. Crohn's disease or ulcerative colitis increase the risk of DVT.A personal or family history of DVT or PE. If you or someone in your family has had one or both of these conditions, you might be at greater risk of developing DVT.Genetics. Some people have DNA changes that cause the blood to clot more easily. One example is factor V Leiden. This inherited disorder changes one of the clotting factors in the blood. An inherited disorder on its own might not cause blood clots unless combined with other risk factors.

Sometimes, a blood clot in a vein can occur with no identifiable risk factor. This is called an unprovoked VTE.

Complications

Complications of DVT can include:

Pulmonary embolism (PE). PE is a potentially life-threatening complication associated with DVT. It occurs when a blood clot (thrombus) in a leg or other body area breaks free and gets stuck in a blood vessel in a lung.

Get immediate medical help if you have symptoms of PE. They include sudden shortness of breath, chest pain while breathing in or coughing, rapid breathing, rapid pulse, feeling faint or fainting, and coughing up blood.

Postphlebitic syndrome. Damage to the veins from the blood clot reduces blood flow in the affected areas. Symptoms include leg pain, leg swelling, skin color changes and skin sores.Treatment complications. Blood thinners are often used to treat DVT. Bleeding (hemorrhage) is a worrisome side effect of blood thinners. It's important to have regular blood tests while taking blood-thinning drugs.Prevention

Lifestyle changes may help prevent deep vein thrombosis. Try these strategies:

Move your legs. If you've had surgery or have been on bed rest, try to move as soon as possible. Don't cross your legs while sitting. Doing so can block blood flow.

When traveling, take frequent breaks to stretch your legs. When on a plane, stand or walk occasionally. If you're traveling by car, stop every hour or so and walk around. If you can't walk, do lower leg exercises. Raise and lower your heels while keeping your toes on the floor. Then raise your toes while keeping your heels on the floor.

Don't smoke. Smoking increases the risk of DVT.Manage weight. Obesity is a risk factor for DVT. Regular exercise lowers the risk of blood clots. As a general goal, aim for at least 30 minutes of moderate physical activity every day. If you want to lose weight, maintain weight loss or meet specific fitness goals, you may need to exercise more.静脉栓塞常发生在双下肢，还可能发生在髂静脉、脏器血管等。静脉栓塞血栓脱落还可能引起肺栓塞，患者会出现胸闷、胸痛等症状，根据发生部位不同，症状也不同，目前临床上常见的静脉栓塞的症状及治疗主要包括以下几方面：
一、症状1、肢体静脉栓塞：常见的是下肢深静脉血栓栓塞，可发生在一侧下肢，也可发生在双侧下肢，有些患者可无任何症状，或局部皮肤出现蓝丝、红丝，如蚯蚓、蜘蛛网。大部分患者会表现为发病肢体局部的肿胀和疼痛，有些患者会伴有局部肢体皮肤的红肿等症状，在直立和行走时这些症状会加重，在休息、抬高肢体或者卧床时，这些症状会有所好转；
2、肺栓塞：下肢深静脉血栓脱落，随血液游动，流到肺动脉，会造成肺栓塞，患者会出现胸闷、气短、胸痛、咳血等症状，严重时患者还会出现晕厥、休克，甚至危及生命等严重情况。因此有下肢静脉血栓栓塞的患者，一旦出现胸闷、胸痛等症状，考虑发生了肺栓塞，应立即就医，急救治疗；
3、脏器血管静脉栓塞：临床上常见的是肠系膜静脉血栓、门静脉血栓，患者会出现腹痛、腹胀，停止排气、排便，严重的还会导致肠管坏死。
二、治疗静脉栓塞的治疗，住院期间可以用低分子肝素皮下注射或者大分子肝素静脉点滴进行抗凝治疗。出院后要口服抗凝药物，如华法林、利伐沙班等，还要定期复查凝血功能及血管彩超。下肢深静脉血栓一般口服抗凝药物6-12个月，80％的深静脉血栓可以消失，避免按摩或热敷局部肢体，以免造成血栓脱落。如果静脉栓塞发生在髂静脉，会出现整个下肢的肿胀及疼痛，可遵医嘱行介入或手术取栓治疗。肺栓塞患者需做外科血栓清除术、经皮导管介入治疗，同时遵医嘱口服新型抗凝药物，一般预后良好。如果是肠系膜静脉血栓，除了溶栓治疗，必要时给予手术治疗，切除病变肠管。