How to treat deep vein thrombosis in lower extremities

Deep vein thrombosis in the lower limbs is relatively common in life and is also quite harmful to patients. It mainly refers to the phenomenon of venous blood flowing into the deep veins of the lower limbs and coagulation. This can cause lower limb edema, phlebitis, skin inflammation, pigmentation, etc. It has a relatively high risk and requires timely treatment. For example, surgical treatment is relatively effective. In addition, attention should be paid to timely medication treatment. For patients with slightly lighter symptoms, elastic stockings should be worn in time, which will help improve the condition. In addition, attention should be paid to diet adjustment and prevention of blood clot formation.

treat

1. Rest in bed and elevate the affected limb

Leg elevation and initial bed rest can relieve pain in patients with deep-vein thrombosis and acute leg swelling. The traditional approach of recommending strict bed rest for 1 to 2 weeks to prevent pulmonary embolism has been questioned, as 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.

2. Anticoagulant therapy

This is one of the mainstays of modern treatment 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.

3. Thrombolytic therapy

It 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.

4. Long-term treatment of deep vein thrombosis

The duration of anticoagulation treatment for deep vein thrombosis remains controversial. Long-term anticoagulation helps reduce the recurrence of deep vein thrombosis and post-thrombotic syndrome. For deep vein thrombosis caused by simple factors such as surgery or inactivity, anticoagulation needs to be continued for 3 months. For idiopathic deep vein thrombosis, it is recommended that anticoagulation be continued for 6 to 12 months. For patients with malignant tumors, low molecular weight heparin is used instead of warfarin for 3 to 6 months. For patients with a first episode of deep vein thrombosis who have anticoagulant antibodies or two or more risk factors for thrombosis, it is recommended that anticoagulation should be continued for at least 12 months. For patients with a history of two deep vein thrombosis, lifelong anticoagulation treatment should be given.