Zhongguo linchuang yanjiu (Feb 2025)
Clinical analysis and treatment of superficial vein thrombophlebitis of lower extremities
Abstract
Objective： To investigate the etiologies, clinical features, and treatment outcomes of patients with superficial vein thrombophlebitis (SVT) respectively. Methods： The clinical data of 67 patients with acute SVT of lower extremities in the Affiliated Hospital of Nanjing University of Chinese Medicine from March 2022 to December 2023 were collected. The etiological factors and the clinical features of SVT were analyzed. All patients were diagnosed by color Doppler ultrasound and the extent of thrombosis was determined. The patients were divided into two groups based on their clinical features: the mild group with 42 patients and the severe group with 25 patients. All patients received basic treatment with Aescuven forte, Chinese herbal fumigation and mucopolysaccharide polysulfate. The mild group received aspirin to alleviate swelling and pain, while the severe group received 10 mg of rivaroxaban every day for anticoagulation treatment. After 28-day, objective response rate, incidence of venous thromboembolism (VTE), and complications such as bleeding were monitored, and the incidences of VTE and SVT recurrence were followed up for 30 days after treatment. Results： The pathogenesis of SVT of the lower extremities involved various factors, but patients with varicose veins of lower extremities were the the majority. The clinical symptoms mainly included local redness, swelling and pain, indurated subcutaneous nodules and pigmentation. The D-dimer levels in all patients in the acute stage were significantly increased, and the levels of D-dimer level in the both groups were significantly decreased after receiving treatment(t=15.667，29.314，P<0.01).The curative effect of the mild group was better than that of the severe group (Z=2.281，P=0.023). In the mild group, 1 patient with the thrombosis extending to the proximal sapheno-femoral junction was treated with rivaroxaban and the symptoms were relieved without developing deep vein thrombosis or pulmonary embolism. Two patients in the severe group developed deep vein thrombosis, and the thrombosis subsided after anticoagulant treatment. There was no severe bleeding event in the mild group, and 1 case of nasal bleeding recovered after discontinuation of medication in the severe group. There was no VTE events or SVT recurrences in either group after 30 days of follow-up. Conclusion：： SVT of lower extremities has a diverse etiology, and the thrombus location, scope and clinical symptoms vary from case to case. Risk assessment according to the clinical features of SVT and individualized comprehensive treatment can alleviate symptoms, prevent VTE formation and SVT recurrence with good curative effects.
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