Volume 03 Issue 10-2023
42
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
42-46
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The results of examination and treatment of 112 patients with acute thrombophlebitis of subcutaneous veins of the
lower extremities were studied. According to the method of treatment, the patients were divided into 2 groups: the
main group consisted of 62 patients receiving lymphotropic therapy, and the control group consisted of 50 patients
to whom medications were administered by the traditional method.
KEYWORDS
Acute thrombophlebitis of the lower extremities. Complex treatment with the use of lymphotropic therapy.
INTRODUCTION
Despite the presence of a huge arsenal of various
methods of conservative and surgical treatment of
patients with venous pathology of the lower
extremities, the percentage of unsatisfactory results of
this category of patients ranges from 10 to 60%. Acute
thrombophlebitis of superficial veins is one of the most
common diseases in all countries of the world. The
number of such patients does not decrease every year,
but there is a clear tendency for their growth. [1 ], [ 3],
[5], [6]. The thrombotic process in the superficial veins
can be a source of deep vein damage. [ 2] ,[4 ] , [7 ].
Research Article
OUR EXPERIENCE IN IMPROVING THE EFFECTIVENESS OF TREATMENT
OF PATIENTS WITH ACUTE THROMBOPHLEBITIS OF SUBCUTANEOUS
VEINS OF THE LOWER EXTREMITIES
Submission Date:
October 08, 2023,
Accepted Date:
October 13, 2023,
Published Date:
October 18, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue10-08
Umetaliev Dilshod Alievich
Andijan State Medical Institute, Uzbekistan
Azizov Gofur Abdurakhimovich
Andijan State Medical Institute, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 10-2023
43
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
42-46
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
The purpose of the work: The analysis of the results of
treatment of patients with acute thrombophlebitis of
subcutaneous veins of the lower extremities in 112
patients, depending on the method of treatment. In 62
patients, lymphotropic therapy was used in complex
treatment and in 50 control groups of patients, the
traditional treatment method was used. The study
groups did not include patients with the spread of
thrombophlebitis along the large saphenous vein to
the upper third of the thigh.
MATERIALS AND METHODS OF THE STUDY
We studied the results of the use of lymphotropic
therapy in 62 patients with acute thrombophlebitis of
the superficial veins of the lower extremities. In 83
patients, the localization of the pathological process
was in the basin of the large saphenous vein and in 29
patients in the basin of the small saphenous vein.
Basically, the pathological process was localized on the
lower leg in the lower and middle third of the thigh. In
76
patients,
acute
thrombophlebitis
was
a
complication of varicose veins of the subcutaneous
veins of the lower extremities.
Studies have revealed that the main group of patients
84 (75%) were admitted 3-5 days after the appearance
of the first clinical signs of the disease. Upon
admission, patients had moderate and sometimes
more pronounced pain at the site of the thrombus
localization, which increased when walking. Along the
affected thrombosed vein, redness was noted due to
the inflammatory process with its gradual transition to
the surrounding tissues, sometimes there was swelling
of the skin along the thrombosed vein, which was
palpated as a painful seal along the subcutaneous veins
that did not disappear with the elevated position of the
limb and was soldered to the skin and surrounding
tissues. Body temperature sometimes rose to
subfebrile, and with a pronounced inflammatory
process, there was an increase in div temperature to
38-38.50 C and an increase in inguinal lymph nodes.
Diagnosis and evaluation of the effectiveness of
treatment was carried out by studying the state of
regional blood flow. The study of the circulatory and
lymphatic system using ultrasound Dopplerography.
Radionuclide lymphoscintigraphy and scanning using
technetium
–
99 Tc labeled technetium were used to
determine the lymph flow.
In order to improve the results in complex treatment,
we applied lymphotropic therapy. Lymphotropic
therapy was performed with lidase 16 units; heparin at
a dose of 70ed./ per 1 kg; with a solution of 1ml lasix-1%.
In the presence of pronounced inflammatory
phenomena, lymphotropic antibiotic therapy was
additionally included. A semi-alcoholic compress was
applied to the injection sites. Depending on the
severity of the pathological process, the course of
treatment ranged from 6 to 8 daily sessions.
Volume 03 Issue 10-2023
44
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
42-46
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Results and their discussions: In patients of the main
group, during the course of lymphotropic therapy, pain
stopped on the 2-3 day of treatment, hyperemia,
edema decreased by 3-4, and the peripheral infiltrate
gradually disappeared. By 7-9 days of treatment,
palpation revealed painless seals along the affected
subcutaneous vein. In the early stages, edema
decreased and the difference in the volume of the
diseased limb decreased compared to the healthy one.
To determine hemocoagulation in patients on the
second day after admission, a coagulogram was
studied, both from the ulnar vein (central blood flow)
and from the femoral vein of the affected limb in order
to study regional blood flow. The examination revealed
in
patients
with
acute
thrombophlebitis
of
subcutaneous veins a shortening of blood clotting time
to 4.1 0.3 min in the central and to 3.8 0.2 min in the
regional, the time of plasma tolerance to heparin was
shortened by 12 and 20%, respectively (P<0.01), and the
prothrombin
index
increased
by
7.3
and
16.6%.Fibrinogen increased in the central and regional
blood flow by 14.2 and 29%, respectively. A positive
reaction to fibrinogen B was detected in 80% of
patients in the central bloodstream and in all patients
in the regional one. The data are statistically reliable
(P<0.01). There was a moderate decrease in
fibrinolytic activity in the central bloodstream (9%) and
pronounced violations of fibrinolytic activity in the
regional bloodstream (30%) (P<0.01).
After
a
course
of
lymphotropic
therapy,
hemocoagulation studies before discharge, mainly on
days 9-11, showed that blood clotting time increased
and reached an average of 5.1 0.3 minutes by the end
of treatment in both central and regional blood flow,
prothrombin activity decreased and amounted to 87-
88% in central blood flow and 89-90% in regional.
Plasma tolerance to heparin decreased and amounted
to 8'1 and 8'2, respectively, by the end of the course of
treatment. Plasma recalcification time decreased in the
central and regional blood flow, and amounted to 115 ±
4.1 and 118±2.6, respectively. The reaction to fibrinogen
B was negative in the central and regional blood flow.
Studies have also shown an increase in the fibrinolytic
activity of the blood and a decrease in fibrinogen
In order to study the lymph flow in patients with acute
thrombophlebitis
of
subcutaneous
veins,
the
resorption function of the lymphatic system was
studied. In the radionuclide study, the intensity of
radionuclide excretion from the tissue depot after 60
minutes was 19%, and the rate of lymph movement in
the limb was 10.7 ± 0.6 mm/min.
The rate of lymph flow and the intensity of RFP
excretion from the tissue depot in patients with acute
thrombophlebitis under the skin veins of the lower
extremities (n-24)
Volume 03 Issue 10-2023
45
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
42-46
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Clinic. forms
Survey.gr.
Lymph flow rate (mm/min)
Inten. output. RFP made of
fabric.depot (%) for 1 hour
The original.
After.treatment
.
The original.
After.treatment
.
an old blood clot.
Subcutaneous veins.
10,7±0,6
13,5±1,2
P<0,1
19
24
Contr.gr.
Zdorov.persons.
(n-20)
14,1
24
In the control group of healthy individuals, the time of
reabsorption of RFP from the tissue depot after 1 hour
was 24%, and the speed of lymph movement in the limb
was 14.1 mm/min. The results of the study after the
treatment showed that the reabsorption of
radionuclide and the rate of lymph flow were
somewhat accelerated in terms of up to 10-12 days
from the onset of the disease. We explained this by the
compensatory function of the lymphatic system aimed
at drainage of edematous fluid. In the future, a
decrease in the reabsorption function was noted to
19%. After the course of treatment with lymphotropic
therapy, radionuclide reabsorption after 60 minutes
was maintained by 24%, and the lymph flow rate was
13.5 ± 1.2 mm/min. Thus, after the treatment in this
group of patients, the indicators of the lymph flow rate
and the intensity of the removal of RFP from the tissue
depot were within the control group of healthy
individuals.
In patients of the control group with acute
thrombophlebitis of subcutaneous veins, pain
decreased on 7-8 days, edema decreased and acute
inflammatory phenomena were stopped by 9 days. On
the 12th
–
13th day, the seals decreased along the
course of the affected veins. The average stay of
patients in the main group in a hospital bed was 7 1 day
in the control group - 11 1 day.
CONCLUSIONS
1. Patients with acute thrombophlebitis of the
superficial veins of the lower extremities have
disorders of microhemo - and lymphocirculation in the
form of veno
–
and lymphostasis.
2. In this category of patients, microcirculation
improved faster against the background of
lymphotropic therapy, edema decreased and
inflammatory phenomena were stopped, the duration
of stationary treatment was reduced compared to the
control group.
REFERENCES
Volume 03 Issue 10-2023
46
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
ISSUE
10
P
AGES
:
42-46
SJIF
I
MPACT
FACTOR
(2021:
5.
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)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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