Post-injection phlebitis
Post-injection thrombophlebitis is the reaction of the human body to a chemical or mechanical aggressive effect of drugs, which is quite pronounced.
Causes of post-injection phlebitis
There are many reasons for post-injection phlebitis. These include alteration of the walls of blood vessels, a change in the main characteristics of blood, a violation of its physical and chemical composition, stagnation of blood, a decrease in blood flow velocity, changes in the circulatory system (coagulation, anti-coagulation), and the presence of pathogens in the blood. Injections cause irritation of the nerve endings located in the walls of blood vessels, which leads to spastic contraction of the veins. Blood clots slow down blood flow. The blood clots themselves, acting on the nerve fibers of the vascular wall, cause a stronger spasm of the main venous trunk and collaterals. Against the background of venous spasm, arterial spasm may develop. There is another reason for arterial spasm - the transition of the inflammatory process from the venous bed to the arterial one. Prolonged spasm of venous vessels and their clogging with a thrombus lead to an increase in venous pressure in the vessels and capillaries, as a result of high pressure, edema occurs, leading to increased permeability of the vascular wall.
Symptoms and diagnosis of post-injection phlebitis
The very first symptom of post-injection phlebitis is acute pain at the site of the affected vessel. The body temperature rises sharply, the general well-being deteriorates noticeably. In the first day after the onset of the disease, severe swelling of the limb develops in the girth, which over time takes up an increasing area. Three days later, there is a soft-paste edema, localized on the hand and forearm. At this stage of the disease, it is important to correctly establish the diagnosis in order to avoid surgical intervention if phlebitis is mistaken for phlegmon of superficial limb veins. The most severe form of post-injection phlebitis is considered to be periphlebitis.
The disease often develops as a consequence of withdrawal symptoms. In this case, the patient's expressed anxiety, complaints of severe pain in the extremities interfere with making an accurate diagnosis. In this case, in addition to the characteristic symptoms of the disease, attention is also paid to certain signs: redness of the skin, a partial increase in the limb twice, localized muscle tension. Four days later, in the lesion focus, the tissues become softer, and fluctuation develops.
Thrombus formation in the central venous trunk can cause reflex spasm of an artery nearby. In this case, the patient runs the risk of receiving an erroneous diagnosis - "acute arterial obstruction".
Treatment of post-injection phlebitis
Post-injection phlebitis in most cases is treated conservatively. As drug therapy, nonsteroidal anti-inflammatory drugs, antibiotics, ointment dressings can be prescribed. At an early stage of the disease, hypothermic procedures are used. It is recommended to refuse physiotherapy in order to avoid purulent inflammation.
In the case of a focus of purulent inflammation, they resort to surgical intervention. During the operation, the purulent focus is opened and the edges of the wound are excised.
Locally, in the treatment of post-injection phlebitis, semi-alcohol dressings are applied to the site of inflammation. The softening of the tissues under the bandage indicates the onset of the inflammatory process and the presence of a purulent focus. In this case, surgical intervention is also required, further treatment is carried out without suturing, which makes it possible to speed up the wound healing process.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".