txaus siab nyob rau hauv compensating rau mob ntshav qab zib mellitus,

mob hnyav - nrog decompensation thiab txuas ntawm kev mob tshwm sim los ntawm lub hom phiaj plab hnyuv siab raum,

mob hnyav - nrog ketoacidosis, lactic acidosis thiab hyperosmolar coma.

Nco Ncotxais kev cawmdim. Kev hnov ​​hnov ​​tsis zoo tshwm sim nrog coma.

Nce ntxiv tes taw hnyav lisoj ntsuam nrog tus mob ntshav qab zib hom II, txo qis hauv hom 1 mob ntshav qab zib.

Tawv: qhuav, hyperkeratosis, txo turgor qhia tias lub cev qhuav dej.

Yog pom rubeosis thiab hyperemia ntawm lub puab tsaig, puab tsaig, hauv pliajvim yog txiav hauv cov tawv nqaij capillaries

Xanthomas ntawm ob sab tis ntawm lub qhov ntswg, auricles, rau ntawm qhov chaw ywj pheej ntawm cov ceg, ntawm caj dab, hauv siab, lub ntsej muag,

Tshuaj mob ntsws (atrophic me ntsis) - ua ke xim liab-xim av papules ntawm 5-12 hli, uas tig mus rau hauv cov xim atrophic atrophic nyob rau sab pem hauv ntej ntawm ob txhais ceg, kev txhim kho ntawm mob rau sab hauv thiab mob caj pas.

Lipoid necrobiosis - ntom, tsis hnov ​​mob, puag ncig, liab-violet nodules ntawm daim tawv nqaij ntawm ob txhais ceg, nquag txhawm rau qhov kev loj hlob thiab tsim cov waxy plaques, uas tom qab ntawd atrophy, necrotic thiab hloov los ntawm caws pliav,

Vitiligo - thaj chaw uas tawv nqaij tsis xwm yeem.

Ntawm kev txheeb xyuas lub ntsej muag: blepharitis (mob rau ntawm daim tawv muag sab saud), barley, lub zog cuam tshuam ntawm pob muag vim lub cev qhuav ntawm cov leeg oulomotor.

Tej zaum pom kev pom vim yog kev txhim kho ntawm kev tshem tawm qhov muag lossis tawv nqaij ntawm lub lens.

Kev kuaj pom ntawm lub tshuab muaj zog gait yam ntxhov siab vim kev ua haujlwm tsis zoo ntawm lub ceg vim kev ua txhaum ntawm kev nkag siab tob.

Ntawm kev soj ntsuam zoo li qub: ko taw deformity vim yog qhov tsis txaus ntseeg ntawm lub cev hloov pauv thiab txuas nrog ntau qhov sib npaug ntawm cov leeg nruj extensor leeg, protrusion ntawm lub taub hau ntawm cov pob txha metatarsal, qhov tsim ntawm thaj chaw hauv siab.

Kev tswj lub siab tsis tu ncua ua rau autolysis ntawm cov nqaij mos thiab rwj thiab mob ntshav qab zib taw kev tsim.

Atrophy ntawm plab hlaub nqaij.

Kev ua pa tsis ua haujlwm tshwm sim tsuas yog nrog kev txhim kho ntawm cov kev mob hnyav hnyav ntawm ntshav qab zib mellitus: nrog ketoacidotic tsis meej pem, yam ntxwv rau hom ntshav qab zib hom I thiab ntshav qab zib tsis tsaug zog, yam ntxwv rau tus mob ntshav qab zib hom II.

Feem ntau muaj ntshav qab zib nce ntshav siab: nrog DM-I hauv 20% ntawm cov neeg mob, nrog DM-II hauv 75%.

Hauv nws cov keeb kwm, hyperinsulinemia, sodium kev tuav cia los ntawm insulin, nephropathy, macroangiopathy yog qhov tseem ceeb.

BP txo tshwm sim nrog ketoacidosis thiab hyperosmolar coma vim lub cev qhuav dej.

Ib qho kev txo qis hauv cov ntshav thaum lub sij hawm lactic acidosis yog txuam nrog acidosis, ua rau tsis muaj qhov cuam tshuam thiab cog lus ntawm myocardium, nrog rau ib qho kev txiav hauv cov hlab ntsha.

Lub plab zom mov pathology:

- kev mob plab ntawm dyspepsia - hypoacidism,

- mob plab hnyuv dyspepsia syndrome,

Daim siab ua rau lub siab ua rau tus neeg mob hepatomegaly tus yam ntxwv ntawm rog hepatosis.

4. Hloov cov khoom hauv nruab nrog cev ua ntshav qab zib.

Hauv cov neeg mob uas mob ntshav qab zib feem ntau pom hloov pauv ntawm cov hlab plawvsuav nrog feem ntau atherosclerotic txhab ntawm ntau cov hlab ntsha. Myocardial infarction tshwm sim hauv cov neeg mob ntshav qab zib 2 zaug ntau dua li cov neeg uas muaj hnub nyoog tib yam, tab sis tsis raug kev mob los ntawm tus kab mob no. Mob ntshav qab zib atherosclerosis obliterans ntawm qis qis dua coj ua rau kev tsim ntawm trophic mob rau ntawm txhais ceg thiab taw (tshwj xeeb yog thawj ntiv taw) nrog kev txhim kho tom qab ntawm gangrene.

Kev mob plab zom mov muaj ntshav qab zib muaj qhia nyob rau ntau zaus gingivitis thiab stomatitis, tsawg dua cov ntawv zais thiab lub cev muaj zog ntawm lub plab, daim siab ua rog thiab steatohepatitis.

Hauv cov neeg mob ntshav qab zib, nws feem ntau pom uas mob ntshav qab zib nephropathymanifested los ntawm protsinuria thiab leeg ntshav siab thiab thaum kawg coj mus rau kev loj hlob mob ntshav qab zib glomerulosclerosis (Kimmelstil-Wilson syndrome) thiab tom ntej mob raum tsis ua hauj lwm, uas yog ib qho ua rau kev ploj tuag hauv cov neeg mob ntshav qab zib.

60-80% ntawm cov neeg mob ntshav qab zib tau kuaj pom uas yog kuaj ntshav qab zib, pom los ntawm kev nthuav dav ntawm retinal venules, kev txhim kho ntawm microaneurysms, hemorrhages, exudates hauv nws thiab ua rau zuj zus tsis pom kev.

Nrog ntshav qab zib kev puas tsuaj rau lub paj hlwb hauv niaj hnub zoo li uas mob ntshav qab zib neuropathy, uas yog qhia nyob rau hauv cov tsos ntawm paresthesia, qhov kev ua txhaum ntawm qhov mob thiab qhov kub thiab txias, ib qho kev txo qis ntawm cov leeg rov ua dua. Cov tsos mob ntawm tus kab mob ntshav qab zib tseem muaj nyob hauv cov neeg mob, tshwm sim los ntawm qhov tsis tshua nco qab thiab lwm yam kev puas hlwb.

Yuav ua li cas kev tshawb xyuas ko taw hauv tsev rau ntshav qab zib

Mob ntshav qab zib thiab kev tawm dag zog txhua hnub mus ua ke - koj yuav tsum npaj zaub mov kom zoo thiab noj kom txaus thiab noj mov raws sijhawm, so kom txaus, pw txaus, ua kom lub cev ua hauj lwm thiab xyuas koj cov ntshav qabzib. Tab sis muaj ib qho ntxiv uas yuav tsum tau ua kom tsis tu ncua; yog tias koj muaj ntshav qab zib, kuaj koj ob txhais ceg.

Txoj kev no koj tuaj yeem tiv thaiv lossis tsawg kawg yog txo cov teeb meem ceg uas cuam tshuam nrog ntshav qab zib. Nws tsis yog qhov nyuaj thiab tuaj yeem ua tiav tom tsev, qhov tseem ceeb yog tas li. Yog koj tsis tau mob ceg dua, tso tseg ib zaug ib lub lim tiamCov. Yog tias koj raug mob rau koj ob sab ceg, muaj qhov txhab lossis mob txhab, lossis yog tias koj tsis hnov ​​qhov hauv koj sab ceg, kos txhua hnubb!

Kev hnyav dhau lossis tsis ua haujlwm yooj yim tuaj yeem ua rau tus txheej txheem no nyuaj, tab sis nws yog qhov tseem ceeb uas peb thov kom koj tsis txhob txaj muag thiab thov kev pab ntawm cov neeg koj hlubCov. Hauv qab no yog 9 qhov yooj yim uas koj yuav tsum ua thaum ntsuas koj txhais taw hauv tsev rau cov neeg muaj ntshav qab zib.

Vim li cas thiaj li yog tu mob rau tus mob ntshav qab zib ko taw thiaj li tseem ceeb?

Qhov tseem ceeb ntawm kev tiv thaiv thiab tu kom zoo rau taw nrog ntshav qab zib yog qhov nyuaj rau kev ua siab tuab. Yog tias tsis ua raws li cov cai no, tus kab mob yuav loj hlob sai thiab kev mob qog pib.

Raws li lub koom haum WHO, 95% ntawm kev tshem tawm haujlwm txhais lus yog txuam nrog kev kis mob rau cov nqaij mos.

Mob Qog Lom yog theem kawg ntawm SDS, uas yog ua ntej los ntawm cov tsos mob hauv qab no:

• mob ceg thaum taug kev, nrog rau cov nyob ruaj ruaj
• kev mob siab rau ncig (mob khaub thuas ob txhais ceg, leeg ntshav, pob tw, pob loog, thiab lwm yam),
• kev ua kom tsis meej rau cov leeg nqaij ntawm cov nqua,
• cov tsos ntawm deformity ntawm taw,
• qhuav thiab ntub dej corns, ulcerations,
• sib sib zog nqus ntawm lub cev, fungal tau kis ntawm tus taw.

Nws tsis yog qhov nyuaj kom tsis txhob muaj kev sib kis nrog mob caj dab thiab tom qab txiav, nws yog qhov txaus los saib xyuas tus kab mob ntshav qab zib hauv tsev thiab sab laj nrog tus kws kho mob raws sijhawm nrog kev xeb me ntsis.

2. Kev ntsuam xyuas ob txhais ceg tas li.

Kev tshuaj xyuas yuav tsum tau nqa tawm thaum sawv ntxov los yog thaum yav tsaus ntuj, tom qab ntxuav thiab qhuav ceg. Yog tias thaj tsam keratinized ntawm thaj tsam epidermis, pob txha thiab pob txha pom tias tsis muaj feem cuam tshuam nrog kev hnav cov khau tshiab lossis tsis xis nyob, nrog rau cov qhov txhab, qhov txhab, ua rau thaj tsam ntawm daim tawv nqaij, nws kuj pom zoo kom sab laj nrog kws kho mob thiab siv tshuaj pleev ib ce tshwj xeeb rau cov ntshav qab zib ko taw.

Cov khoom lag luam no muaj cov dej noo, ua kom tsis muaj zog, ua kom tawv muag uas ua rau rov txhim kho qhov qub ntawm daim tawv nqaij, nrog rau kev tiv thaiv ko taw los ntawm kev kis tus kab mob, muaj cov nyhuv los tiv thaiv.

3. Kev ntxuav txhua hnub thiab kev kho mob ntshav qab zib ko taw.

Lub taub hau qhuav ntawm taw yuav tsum tau kho nrog lub pob zeb pumice. Tom qab ntxuav, koj yuav tsum so koj ob txhais taw nrog phuam muag muag, tsis txhob muab tshuaj txhuam, tab sis tsuas yog soaking.

Nco ntsoov thov siv cov hmoov nplaum noj mov, uas muaj cov tshuaj pleev ib ce ntuj. Piv txwv, cov kab DiaDerm muaj kev pleev tshwj xeeb rau kev saib xyuas kab mob ntshav qab zib. Cov kab ntawv suav nrog cov tshuaj "Tiv Thaiv", "Intensive" thiab "Softening", uas yog qhov zoo rau kev siv txhua hnub.

Cov tshuaj pleev "Rov ua dua tshiab" - ib qho kev kho zoo heev rau cov neeg taw ntawm qhov muaj ntxhua, tom qab txhaj tshuaj thiab lwm yam kev raug mob. Ib qhov tshwj xeeb ntawm cov khoom lag luam DiaDerm yog qhov muaj urea thiab cov tshuaj ntsuab ntawm cov tshuaj ntsuab thiab roj muaj nyob rau hauv qhov muaj pes tsawg leeg ntawm 5-15%, uas ua kom dej noo, txhawb nqa thiab txhawb qhov txhab zoo thiab rov ua dua tshiab.

Nyem ntawm daim duab hauv qab no txhawm rau paub ntau ntxiv txog kab mob ntshav qab zib thiab kho lawv kom xa hauv tsev lossis xa ntawv.

4. Ua kom ntsia hlau txiav zoo.

Ntsia cov rau tes nrog ntshav qab zib feem ntau ua rau muaj kab mob thiab ua mob. Nws yog qhov tsim nyog los txiav cov rau tes maj mam ncaj hauv kab ncaj nraim tsis muaj kev sib hloov. Cov pob ntsej muag ntse yog ua nrog daim ntaub mos muag kom zoo zoo.

Thaum ua cov ntsia hlau, txiab nrog cov ntse kawg siv tsis tau. Yog hais tias tus ntiv taw ntawm ko taw raug mob nyob rau hauv tus txheej txheem ntawm kev txiav, tom qab ntawd qhov chaw no yuav tsum tau kho nrog hydrogen peroxide thiab lubricated nrog lub qhov txhab kho cov tshuaj pleev, piv txwv li, furacilin lossis raws li streptocide. Hauv peb cov khw online koj yuav pom cov khoom lag luam zoo thiab pheej yig ntsia thawv khoom lag luam.

5. Kev tiv thaiv cov kab mob fungal.

Nrog tus mob fungal kis, mob rau sab hauv, kiav txhab, kiav txhab tshwm ntawm taw. Qhov pom muaj cov nceb ntau ua rau muaj kev pheej hmoo ntawm laib plab. Kev tiv thaiv kev kis kab mob yog ua raws li kev cai tu cev.

Tsis tas li, cov neeg mob ntshav qab zib yuav tsum tsis txhob taug kev liab qab hauv tej chaw pej xeem, ntawm ntug hiav txwv, nyob hauv hav zoov, thiab lwm yam. Cov thom khwm yuav tsum hloov txhua hnub, txhawm rau tiv thaiv kev hnav khaub ncaws tsis huv, ua pa tsw phem thiab khau ntub.

Nco ntsoov siv cov qab zib "tiv thaiv" los tiv thaiv kev txhim kho ntawm cov kab mob thiab cov kab mob fungal, rov kho dua ntawm qhov kev tiv thaiv.

6. Ua raws li cov qauv tseem ceeb ntawm kev ua neej zoo, ua kom muaj zog tiv thaiv.

Kev siv dej cawv haus, kev haus luam yeeb tsis tu ncua, haus luam yeeb, ua lub neej tsis muaj zog yog yam ua rau muaj kev cuam tshuam tsis zoo ntawm tus ceg ntawm ntshav qab zib. Txhawm kom txo txoj kev pheej hmoo ntawm kev mob tshwm sim, nws yog ib qho tsim nyog yuav tsum tso tseg cov kev coj ua phem, ua raws kev noj haus thiab ntxiv dag zog rau kev tiv thaiv.

Txhua tus neeg mob ntshav qab zib yog qhia txhua hnub taug kev ntev mus ntev li 30 feeb. Cov neeg laus dua thiab rog rog siv tau cov pas nrig tshwj xeeb rau kev taug kev.

7. Hnav cov khau kom zoo.

Cov khau yuav tsum yog ua los ntawm cov khoom siv zoo, tsis muaj tuab, muab tshuaj txhuam kev ntxhib. Nws yog qhov tsim nyog tias nws muaj lub lacing lossis Velcro los tswj kom muaj lub zog tag nrho ntawm ob txhais ceg.

Ib qho yuav tsum yog tuab txaus los tiv thaiv tus taw ntawm kev puas tsuaj. Nws raug tso cai kom muaj lub luj taws qis.

8. Kev siv cov insoles tshwj xeeb.

Kev tu mob ko taw kom ntshav qab zib yeej ua tsis tau yog tias tsis muaj qhov zoo txav tsis tau ntawm ko taw. Rau lub hom phiaj no, tsis siv pob txha orthopedic insoles thiab niaj hnub insoles neeg tau raug tsim los uas tusyees faib lub cev hnyav thiab tiv thaiv deformation ntawm cov ntiv tes thiab koov ntawm ko taw, thiab tseem tiv thaiv qhov tsim ntawm pob txha.

Insoles nrog lub cim xeeb ua cim muaj cov yam ntxwv zoo, uas siv daim foos nyob ntawm cov yam ntxwv ntawm lub cev ntawm lawv tus tswv. Siv cov kab mob ntshav qab zib hauv kev sib xyaw nrog cov khau sab xis tuaj yeem tiv thaiv kev txhim kho ntawm ntau cov tsos mob ntawm tus mob VDS.

Nyem ntawm daim duab hauv qab no kom paub ntau ntxiv txog kab mob ntshav qab zib thiab xaj kom lawv xa khoom hauv tsev lossis xa ntawv tuaj.

Tau cov mob ntshav qab zib ko taw tuaj yeem kho tau?

Nws yuav tsum to taub tias mob ko taw yog ib qho txiaj ntsig ntawm ntshav qab zib. Cov tshuaj niaj hnub tuaj yeem kho tsis tau ntau yam mob ntshav qab zib mellitus, uas txhais tau hais tias kev pheej hmoo ntawm kev tsim SDS tseem nyob tag lub neej.

Txawm li cas los xij, kev saib xyuas txhua txoj cai saum toj no thiab paub yuav ua li cas thiab yuav kho tus mob ko taw li cas, koj tuaj yeem txo qhov kev pheej hmoo ntawm kev mob no.

Peb lub khw online muaj cov kev kho mob zoo tshaj plaws thiab niaj hnub kho mob ntshav qab zib. Peb xa thoob plaws tebchaws Russia los ntawm courier rau koj lub tsev, mus rau cov ntsiab lus ntawm kev xa khoom xaj thiab xa ntawv. Nyem rau ntawm daim duab hauv qab no thiab nrhiav paub ntxiv.

Take1 Coj txoj haujlwm tseeb los kuaj nres

Ua ntej tshaj plaws, ceg yuav tsum huv. Tom qab ua kom paub tseeb txog qhov no, zaum saum lub rooj zaum, txaj lossis chav dej nyob hauv chav ua haujlwm zoo. Qhov yooj yim tso koj ob txhais ceg nyob ntawm koj xub ntiag. Tom qab ntawd tsa ib txhais taw ntawm ib txhais ceg thiab nteg nws sab ntawm lub hauv caug ntawm lwm tus kom nws meej. Txhawb nqa ceg yuav tsum tau so.

Zauv 3 Tshawb xyuas ko taw

Siv koj ob txhais tes, ib nyuag tig pob luj taws kom pom tseeb koj tus kheej. Tsis txhob overdo nws thiab tsis ncab cov leeg pob taws. Yog tias qhov kev hloov no tsis muab rau koj, siv kev pab ntawm lub hnab tshos tsom iav kom kuaj xyuas ko taw hauv kev xav.

Heels - Taug kev nrog lawv cov ntiv tes kom hnov ​​zoo, tawg lossis tawv nqaij tawv. Nco ntsoov tias txawm tias cov pob me me tshaj plaws yooj yim muaj mob. Yog li ntawd, nco ntsoov ya raws koj ob txhais taw nrog kev tshwj xeeb kev pleev thiab pleev uas tsis muaj xim thiab tsw. Tab sis nyob rau hauv tsis muaj cov ntaub ntawv tsis txhob moisturize daim tawv nqaij ntawm cov ntiv tes, txij li noo noo thiab qhov chaw sov yog fond ntawm cov kab mob.

Taw ncoo (qhov chaw uas cov ntiv tes loj tuaj) - ua tib zoo sojntsuam cov ntaub qhwv ko taw nrog koj cov ntiv tes rau ib qho tawv nqaij txawv txawv lossis o tuaj. Qhov no ntawm tus ko taw yog feem ntau ntxhov siab thaum taug kev, yog li calluses tuaj yeem tsim nyob ntawm no. Koj tuaj yeem zam lawv cov ntsej muag los ntawm ua tib zoo xaiv khau xis thiab siv kev tiv thaiv tshwj xeeb.

Cov hluas - Tsis tas li, ua tib zoo tshuaj xyuas cov qog thiab o, uas tuaj yeem ua cov cim qhia kev puas tsuaj rau pob txha lossis cov leeg. Yog tias qhov kuaj pom qhov muag pom cov qhov txhab lossis mob txhab, tsis txhob qeeb, sab laj tus kws phais.

Zauv 5 Ua tib zoo soj ntsuam ntawm ob txhais ceg

Ua tib zoo tshuaj xyuas ob txhais ceg los ntawm txhua sab, saib rau ib qho kev sib txawv ntawm cov xwm txheej ib txwm - mob caj dab, khawb, abrasions, liab, tawv nqaij qhuav.

Sab qaum ntawm taw thiab pob taws - Saib rau ib qho cim ntawm kev hloov pauv hauv ntshav txaus - nruj, qhov ci lossis daim tawv nqaij dhau nyias, cov pob twv daj, qhov sib txawv ntawm qhov kub. Cov ntshav tuaj yeem hloov kho tau los ntawm kev siv dag zog thiab tswj ntshav qab zib zoo dua.

# 6 Saib koj cov ntiv tes

Siv koj cov ntiv tes, maj mam kis koj cov ntiv taw, soj ntsuam cov ntiv tes lawv tus kheej thiab daim tawv nqaij ntawm lawv.

Nyob ib ncig ntawm tus ntsia hlauth - saib rau tes ua kom cov plaub hau uas yooj yim kom pom los ntawm daim tawv liab thiab cov tawv nqaij ncig ncig ntawm cov ntsia hlau. Cov ntsia hlau tsis zoo yuav tsum tau mus ntsib tus kws phais neeg (tsis yog tus kws kho mob caj pas!), Thiab cov neeg mob uas tsis quav ntsej muaj qhov tsis zoo rau kev noj qab haus huv tiag.

Ntiv tes - txhawm rau txhawm rau kuaj ntshav kev ntshav, nyem ntiv tes cov ntiv tes ib pliag, tab sis maj mam muab. Yog tias txhua yam nyob hauv kev txiav txim, cov xim tawv nqaij li qub yuav rov qab los li 5 vib nas this. Lub ntsej muag tawv nqaij ntawm cov ntiv tes txhais tau tias koj muaj teeb meem circulatory.

Rau tes - koj yuav tsum tau kuaj cov ntsia hlau tsis muaj kua roj vanish. Saib rau daj lossis flaky lossis discolored lossis tuab heev rau tes, vim cov kev hloov no tej zaum yuav yog qhov pom ntawm kev kis mob fungal ntawm cov ceg. Yog tias koj pom qee yam zoo li no, nco ntsoov sab laj nrog kws kho mob pojniam, tsis txhob tshuaj nws tus kheej, nws yog qhov txaus ntshai!

No. 7 Ua raws cov kev hloov pauv

Sau cov txiaj ntsig ntawm kev ntsuam xyuas - txhua yam yog qhov tseem ceeb: ntsuas kub tsis sib xws, ntug, qhov txhab, o. Piav qhia qhov tseeb seb lawv saib zoo li cas, hnov ​​ntxhiab li cas thiab kov raug qhov twg yog tias muaj kev hloov. Sib piv cov khoom nkag yog tias koj pom qee yam tsis txawv. Yog tias muaj cov tsos mob tshwm sim lossis cov teeb meem tshiab tshwm sim, nco ntsoov nrog koj tus kws kho mob tham tam sim ntawd.

№8 Tiv thaiv kev mob ko taw nyob ntawm txoj kev

Cov neeg feem ntau nyiam huab cua sov, tab sis nco ntsoov tias nws muaj feem cuam tshuam nrog kev ua haujlwm ntawm lub cev, lub hnub thiab tsis yog qhov khau xis.

• Nco ntsoov hnav khau tshwj xeeb aqua ntawm lub puam lossis hauv dej. Txawm tias cov xuab zeb tshaj plaws yuav yooj yim ua rau khawb thiab tawg kom yooj yim mus raws sijhawm.
• Yuav tsum khau rau hauv txoj kev - ib txwm. Cov xuab zeb kub thiab asphalt tuaj yeem ua rau tawv nqaij ntawm koj ob txhais ceg tam sim ntawd. Nws tseem yog qhov yooj yim tsis pom cov khoom ntse lurking insidiously hauv cov nyom thiab ntawm txoj kev.
• Yuav tsum pleev tshuaj pleev qhov muag rau ntawm koj txhais taw ib txwm. Cov hlawv thiab tshwj xeeb tshaj yog cov hlwv yog kis tau yooj yim heev.
• Zam kev khau khiab thiab khau khiab nrog cov hlua nyias thiab ib npuaj. Vim li cas? Vim tias kev txhuam tau ua rau cov qhov txhab, thiab qhib cov qauv tsis tiv thaiv koj ob txhais ceg ntawm kev puas tsuaj.
• Tom qab rov qab los ntawm txoj kev, xyuas koj txhais taw. Nroj hlawv xyoob ntoo, kab tom thiab kiav txhab yog qhib qhov rooj rau kis tau. Ntxuav thiab kho txhua qhov mob thiab qhov raug mob ib zaug.

Tsis Yog. 9 Txiav cov rau tes tuab nrog lub taub ntswg

Cov ntsia hlau ntsia hlau tau yooj yim los daws txawm tias ib txhais tes, thiab lawv siv yog ntau dua los cawm koj ntawm qhov pom ntawm ingrown tes thiab tawv nqaij puas.

Yog tias koj lub qhov muag tsis pom kev zoo, ib zaug mob rau qhov mob lossis muaj qhov tsis hnov ​​qab nyob hauv cov ceg, yog tias ua tau, koj yuav tsum tso siab rau kev saib xyuas koj ob txhais taw mus rau cov kws kho mob tshaj lij - podologist.

Txoj kev tu ko taw yog qhov tseem ceeb rau cov neeg muaj ntshav qab zib. Nco ntsoov kuaj xyuas lawv tus kheej qhov xwm txheej tsis tu ncua thiab mus ntsib kws kho mob kom daws tau txhua yam teeb meem ua ntej lawv dhau mus ua kev mob hnyav. Txog Cov khoom lag luam twg haum rau kev tu tawv nqaij thiab yuav ua li cas saib xyuas koj cov tawv nqaij kom ntshav qab zibnyeem ntawm no.

Cov tsos mob thiab kho mob ntshav qab zib ko taw, tu ko taw rau ntshav qab zib

Ntshav qab zib mellitus yog ib qho mob loj heev, uas nrog cov mob loj heev. Cov feem ntau formidable ntawm lawv tuaj yeem suav hais tias yog mob ntshav qab zib mob ko taw (SDS). Raws li Lub Koom Haum Ntiaj Teb Kev Noj Qab Haus Huv, cov tsos mob no tshwm sim hauv 15% ntawm cov neeg mob ntshav qab zib 5 xyoo lossis ntau dua.

Kev mob ntshav qab zib ko taw - txoj kev hloov pauv ntawm txoj hlab ntshav, txoj hlab ntshav thiab txoj hlab ntaws, uas tuaj yeem ua rau qhov tsim muaj cov txheej txheem ulcerative necrotic thiab mob caj dab.

Li ntawm 85% ntawm cov mob no yog mob kiav txhab rau ntawm qhov ncauj, qhov seem yog vias, phlegmon, osteomyelitis, tendovaginitis thiab mob txha caj qaum. Qhov no tseem suav nrog cov tsis-purulent ua kev puas tsuaj rau cov pob txha ntawm lub extremities - osteoarthropathy mob ntshav qab zib.

Cov ua rau mob ntshav qab zib mob ko taw

Ntawm cov ntshav qab zib, muaj kev tsim tawm ntawm lub cev tsis txaus - insulin, txoj haujlwm yog los pab cov piam thaj (ntshav qab zib) mus txog lub cev lub cev los ntawm cov hlab ntshav, yog li thaum nws tsis muaj txaus, cov piam thaj hauv cov ntshav, thaum kawg cuam tshuam cov ntshav hauv cov hlab ntsha, cuam tshuam rau cov hlab ntsha. Ischemia (tsis muaj ntshav ncig) ua rau cov qhov txhab ua kom tsis zoo, thiab cov leeg puas tsuaj ua rau txo qis hauv rhiab.

Cov kev tsis haum xeeb no ua rau muaj kev txhim kho ntawm cov mob ncauj plab, uas yog zuj zus ntxiv mus rau kev ua laib. Txhua yam kab nrib pleb, abrasions tig mus rau hauv kev qhib mob, thiab tseem zais cov mob rau hauv qab calluses thiab txheej txheej keratinized.

Qhov laj thawj rau kev pib kho lig thiab txiav tawm ntawm qhov kawg yog tias tus neeg mob rau ib lub sijhawm ntev tsis pom qhov kev hloov pauv uas tshwm sim, vim tias feem ntau nws tsis mloog nws ob txhais taw. Vim tias cov ntshav tsis zoo rau cov ceg thaum raug txo qis rhiab, qhov mob los ntawm kev txiav thiab txiab tsis hnov ​​mob los ntawm tus neeg mob thiab txawm hais tias lub rwj yuav ploj mus tsis muaj hnub ntev.

Feem ntau, txhais ko taw puas nyob rau hauv qhov chaw uas tag nrho cov thauj khoom yog tsim nyog thaum taug kev, tawg daim ntawv nyob hauv qab daim tawv nqaij, nkag mus rau hauv kev kis tus kab mob, tsim cov kab mob zoo rau qhov tshwm sim ntawm lub qhov txhab purulent. Xws li qhov mob yuav cuam tshuam rau ob txhais ceg mus txog cov pob txha, leeg. Yog li ntawd, thaum kawg, qhov kev xav tau tshwm sim rau kev txiav tu.

Hauv lub ntiaj teb, 70% ntawm tag nrho cov lus txiav yog cuam tshuam nrog ntshav qab zib, thiab nrog kev kho mob tsis tu ncua thiab tas mus li, yuav luag 85% tiv thaiv tau. Niaj hnub no, thaum Diabetic Foot cov chaw haujlwm tau ua haujlwm, tus naj npawb ntawm kev txiav tawm tau tsawg dua, cov neeg tuag tsawg dua, thiab cov kev txuag kho yog 65%. Txawm li cas los xij, tus naj npawb tiag ntawm cov neeg mob ntshav qab zib mellitus yog 3-4 zaug siab dua cov ntaub ntawv teev, vim tias ntau tus tsis ntseeg tias lawv muaj mob.

Yog li, cov laj thawj ntawm kev txhim kho mob ntshav qab zib taw yog:

• nqig nqhis tas li (mob neuropathy mob ntshav qab zib)
• circulatory ntshawv siab hauv cov hlab ntsha thiab cov hlab ntsha me (ntshav qab zib micro- thiab macroangiopathy)
• ko taw deformity (vim yog neuropathy lub cev muaj zog)
• daim tawv nqaij qhuav

Tsis Muaj Peev Xwm Tsis Zoo - Ntshav Qab Zib Distal Neuropathy

Lub hauv paus tseem ceeb ntawm cov hlab ntshav yog cov nyhuv tas li ntawm cov piam thaj siab ntawm cov paj hlwb. Xws li lub pathology hauv nws tus kheej tsis ua rau cov nqaij necrosis. Mob ncaw tshwm sim rau lwm yam, vim li cas thiaj li:

Cov nqaij mob ua tom qab mikrossadin, txiav thiab abrasions, kho tsis zoo heev, nrhiav kev ua kom ntev. Hnav tsis khab seeb thiab nruj khau ua rau puas tawv nqaij puas tsuaj. Kev mob ncauj plab, loj tuaj thiab ua rau tob tob, dhau mus rau cov leeg nqaij thiab pob txha. Raws li cov kev tshawb fawb, kev txhim kho ntawm cov leeg mob neuropathic hauv 13% ntawm cov neeg mob ua rau ntau qhov tuab ntawm stratum corneum ntawm tus mob epidermis (hyperkeratosis), hauv 33% - kev siv cov khau tsis zoo, hauv 16% - kev kho mob ntawm ko taw nrog cov khoom ntse.

Ntshav khiav tsis txaus - ntshav qab zib macroangiopathy

Qhov tsis zoo ntawm cov ntshav ntws hauv cov hlab ntsha ntawm ob txhais ceg yog cuam tshuam nrog cov atherosclerotic plaques (saib yuav ua li cas kom txo cov roj cholesterol tsis muaj tshuaj). Atherosclerosis, uas ua rau kev puas tsuaj rau cov hlab ntsha loj, uas muaj ntshav qab zib yog qhov nyuaj thiab muaj ntau tus qauv.

• cuam ​​tshuam qis seem ntawm txhais ceg (sab ceg ntawm cov leeg ntshav)
• kev puas tsuaj rau cov hlab ntsha ntawm ob txhais ceg thiab hauv ntau thaj chaw ib zaug
• pib thaum hnub nyoog ntxov dua li cov neeg mob uas tsis muaj ntshav qab zib

Atherosclerosis nyob rau hauv tus neeg mob ntshav qab zib mellitus tuaj yeem ua rau cov nqaij mos tuag thiab tsim kom muaj cov hlab ntaws ntawm lawv tus kheej, tsis muaj kev nyuaj siab thiab kev raug mob. Cov pa oxygen tsis txaus nkag mus rau hauv daim tawv nqaij thiab lwm qhov chaw ntawm ko taw (vim yog qhov ua txhaum cai ntawm cov ntshav txaus), vim li ntawd, daim tawv nqaij tuag. Yog tias tus neeg mob tsis ua raws li kev tiv thaiv kev nyab xeeb thiab ntxiv rau ua kom tawv nqaij, tom qab ntawd thaj chaw kev puas tsuaj nthuav dav.

Cov tsos mob tshwm sim yog qhov mob ntawm ko taw los yog mob plab, ua rau lub cev qhuav thiab daim tawv nyias, uas yooj yim rau microtrauma, tshwj xeeb tshaj yog ntawm cov ntiv tes. Raws li kev tshawb nrhiav, qhov ua rau cov txheej txheem ntawm cov leeg mob neuroischemic yog nyob rau hauv 39% ntawm cov neeg mob fungal txhab ntawm taw, nyob rau hauv 14% kev kho mob ntawm ob txhais ceg nrog cov khoom ntse, hauv 14% - kev saib xyuas tsis tuaj ntawm ingrown tes los ntawm cov kws phais.

Cov kev mob uas tshwm sim ntau tshaj plaws ntawm SDS yog txiav tawm ntawm qhov nqaj (me - tsis pub dhau ko taw thiab siab - nyob rau theem ntawm txhais ceg qis dua thiab ncej puab), zoo li kev tuag ntawm tus neeg mob los ntawm cov teeb meem ntawm cov txheej txheem purulent-necrotic (piv txwv li, los ntawm sepsis). Yog li, txhua tus neeg mob ntshav qab zib yuav tsum paub thawj cov tsos mob ntawm tus mob ko taw.

• Thawj tus cim ntawm cov teeb meem yog qhov kev txo qis hauv siab:
  • vibrating ua ntej
  • tom qab ntawd kub
  • ces mob
  • thiab tactile
• Tsis tas li, qhov tsos ntawm txhais ceg yuav tsum ceeb toom (ua rau)
• Qhov txo qis lossis nce siab hauv ko taw, piv txwv li, txias lossis kub taw, yog qhov cim ntawm lub qog ntshav lossis mob kis
• Txhawb cov ceg qaug zog thaum taug kev
• Kev mob nkees - thaum so, thaum tsaus ntuj, lossis thaum taug kev ntawm qee qhov deb
• Kev qoj ib ce, ua daus no, hlawv ntawm taw thiab lwm yam kev xav txawv txawv
• Hloov xim tawv nqaij ntawm txhais ceg - daj ntseg, liab pliv lossis cyanotic tones tawv nqaij
• Kev txiav plaub hau plaub hau
• Hloov pauv ntawm cov duab thiab xim ntawm cov ntsia hlau, doog ntshav hauv qab ntsia hlau - cov tsos mob ntawm tus mob fungal lossis ntsia thawv raug mob uas tuaj yeem ua rau necrosis
• Ntev kho ntawm khawb, qhov txhab, mob caj dab - hloov ntawm 1-2 lub lis piam 1-2 lub hlis, tom qab kho ntawm cov qhov txhab muaj kab uas tsis ploj hauv kev tsaus ntuj.
• Cov mob rau ntawm taw - tsis zoo rau lub sijhawm ntev, puag ncig los ntawm daim tawv nyias, qhuav, feem ntau sib sib zog nqus

Txhua lub limtiam, koj yuav tsum kuaj xyuas ob txhais ceg, zaum ntawm ib lub rooj zaum hauv daim iav uas teev txij hauv qab - ntiv tes thiab sab qaum ntawm ko taw tuaj yeem tsuas yog kuaj xyuas, them sai sai rau qhov chaw nruab nrab, xav thiab tshuaj xyuas cov luj taws thiab tib leeg nrog daim iav. Yog tias muaj kev hloov pauv, kab nrib pleb, txiav, uas tsis yog qhov kiav txhab pathologies, koj yuav tsum hu rau tus kws kho pob zeb (kws kho mob taw).

Cov neeg mob ntshav qab zib yuav tsum mus ntsib cov kws kho mob tshwj xeeb tsawg kawg ib xyoos ib zaug thiab kuaj xyuas qhov mob qis qis. Yog tias pom cov kev hloov pauv, tus kws kho mob tshaj lij sau tshuaj rau kev kho mob ntawm ko taw, tus kws kho qhov muag tau ua haujlwm ntawm lub nkoj ntawm ob txhais ceg, yog tias xav tau insoles tshwj xeeb, ces yuav tsum muaj angiosurgeon, thiab cov khau tshwj xeeb - orthopedist.

Ua raws li kev nthuav dav ntawm ib qho laj thawj lossis lwm qhov, tus mob tau muab faib ua cov neuropathic thiab neuroischemic.

TSO CAI RAU HAUV KEV KUB COJ HAUV DIABETES MELLITUS

Cov neeg mob ntshav qab zib yuav tsum tau soj ntsuam lawv tus mob tsis tu ncua thiab nyob hauv tsev nkaus xwb, tab sis kuj yuav tau ntsuas hauv chav kuaj.

Lub hom phiaj tseem ceeb ntawm cov ntawv tshawb fawb ib ntu yog:

• txheeb xyuas cov kab mob sib kis,

• ua kom tus neeg mob ua haujlwm tau,

• txhim kho kev ua kom zoo dua qub thiab nce lub neej muaj sia ntawm cov neeg mob ntshav qab zib.

Leej twg tshwj xeeb tshaj yog yuav tsum tau them sai sai rau kev tshuaj xyuas kev kho mob tsis tu ncua, tsis yog cia siab rau cov kev ntsuas tus kheej saib xyuas? Ua ntej tshaj plaws, rau cov neeg mob uas muaj kev tiv thaiv tsis ua qabzib, uas yog, uas tus kab mob ntshav qab zib tuaj yeem hloov mus rau hauv lub labile (kev tswj tsis tau nrog kev pab ntawm insulin) daim ntawv thaum twg los tau.

Ntxiv rau kev sim ntsuas hauv chaw kuaj (Cov Lus 7), cov neeg mob ntshav qab zib yuav tsum tau kuaj lwm yam kev kuaj mob uas siv cov kev kuaj mob (cov lus 8).

Cov kev tshawb fawb tsis tu ncua yuav pab txhawm rau paub qhov kev tsis txaus siab thaum nyuam qhuav pib thaum tus mob tuaj yeem rov qab. Tab sis cov kev kuaj mob no ib leeg tsis txaus ntseeg kom meej tias tsis muaj kev hloov pauv hauv kev noj qab haus huv. Tsis tas li ntawd, cov neeg mob yuav tsum tau mus cuag cov kws kho mob tshwj xeeb hauv ntau thaj chaw uas yuav tshuaj xyuas daim tawv nqaij, hnoos qeev, qhov ncauj tawm ntawm lub qhov ncauj, cov hniav, mloog lub plawv, ua ib qho electrocardiogram, ntsuas qhov siab thiab qhov hnyav, hauv ib lo lus, coj kev soj ntsuam ntau dua thiab tshawb pom lub hom phiaj ntawm lub xeev ntawm tus neeg mob Cov.

Yog li, nrog cov mob ntshav qab zib mellitus me me, kev kuaj mob tag nrho yog nqa ib zaug txhua rau lub hlis, nrog qhov muaj mob nruab nrab ntawm cov kabmob - ib hlis ib zaug, nrog rau mob ntshav qab zib mellitus, cov kws kho mob yuav tsum tau nkag siab kuaj tus neeg mob txhua lub hlis. Cov neeg muaj mob ntshav qab zib yuav tsum raug kuaj xyuas tas li los ntawm cov kws tshwj xeeb hauv qab no: endocrinologist, oculist, neurologist, kws phais mob, kws kho mob pojniam, kws kho plawv.

Vim qhov tseeb tias cov ntshav qab zib tuaj yeem tsim kho hauv tib neeg, tshwj xeeb tshaj yog kis rau nws, thiab pib ua asymptomatically nyob rau theem pib, cov neeg no yuav tsum tau kuaj mob.

Yog tias tus neeg tsis muaj ib qho, tab sis muaj ntau qhov phom sij los ua tus mob ntshav qab zib, nws yuav tsum mus ntsib tus kws kho qhov muag endocrinologist tsawg kawg ib xyoos ib zaug, thiab nyiam dua 2 zaug hauv ib xyoos. Ib qho ntxiv, hauv koj thawj zaug mus rau chaw kho mob, koj yuav tsum tau mus kuaj lub nruab nrog kws kho paj hlwb thiab tus kws kho qhov muag. Kev mus ntsib cov kws kho mob tshwj xeeb no yog muaj thaum tsim nyog. Tus kws kho hniav yuav tsum tau mus ntsib ib xyoos ib zaug. Hauv qhov no, koj yuav tsum kuaj xyuas cov ntshav qab zib kom tsawg, txhua hnub cov piam thaj hauv cov zis thiab ua kev ntsuam xyuas rau cov ntshav qabzib - tsawg kawg yog 1 zaug hauv ib xyoos.

Cov kab ntawm cov kev kuaj ntsuas ntshav tsis tu ncua rau txhua tus neeg mob ntshav qab zib

Cov lus ntawm kev tshuaj xyuas kab mob tsis tu ncua ntawm cov neeg mob ntshav qab zib

Yog tias muaj teeb meem cov ntshav qab zib tsis haum, tus kws kho mob endocrinologist yuav tsum tau mus ntsib 2-3 zaug hauv ib xyoos, thiab tus kws kho paj hlwb, kws kho qhov muag thiab kws kho hniav - 1-2 zaug hauv ib lub xyoo. Ntau zaus, cov neeg mob no yuav tsum kuaj ntshav qab zib thiab zis (ib hnub) - 4 zaug nyob rau ib xyoo, kuaj ntshav qabzib - 1 zaug hauv ib xyoos, kuaj ntshav thiab tso zis ntau yam - tseem 1 zaug ib xyoos. , kev txiav txim siab ntawm cov lipids hauv cov ntshav - 1 zaug hauv ib xyoos, ua ib qho electrocardiogram - 1 zaug hauv ib xyoos.

Kev saib xyuas kab mob ntshav qab zib: puas yog nws nce siab thiab yuav ua li cas pleev tus taw?

Cov neeg muaj ntshav qab zib paub tias txhais ceg yog cov kabmob uas ua rau muaj cov ntshav qab zib. Tom qab tag nrho, cov teeb meem loj tshaj plaws uas tshwm sim nrog mob ko taw mob ko taw yog trophic mob, mob ntev ntev tsis kho thiab mob caj dab.

Tsis tas li, cov neeg mob muaj lwm cov tsos tsis xis nyob - loog, hlawv thiab tingling hauv ob txhais ceg. Feem ntau muaj qhov tsis tshua muaj txiaj ntsig, tab sis pom qhov tsis zoo, xws li ziab tawm ntawm daim tawv nqaij, muaj kab mob rau ntsia. Thiab vim yog cov kab mob sib koom tes, deformation ntawm lub taw yog txawm ua tau.

Nws ntseeg tias muaj tus mob ntshav qab zib hom 2, ko taw puas yog qhov teeb meem nrog lub vascular system. Txawm li cas los xij, qhov kev xav no tsis muaj tseeb nkaus.

Cov txheej txheem ua rau ua rau kev txhim kho mob ntshav qab zib taw mob yog angiopathy (kev tsis zoo ntawm cov hlab ntsha) thiab cov leeg mob hlwb (puas tsuaj rau cov leeg ntawm cov leeg). Ntxiv mus, kawg pathology kev loj hlob 2 lossis 3 zaug ntau zaus. Yog li, nws yog ib qho tseem ceeb kom paub txog kev saib xyuas koj ob txhais ceg mob ntshav qab zib.

Txhawm rau tiv thaiv kev txhim kho ntawm mob txhab, nws yog ib qho tseem ceeb uas yuav tsum tau saib xyuas kom ntshav qab zib kom zoo. Tab sis ua ntej ua txhua yam kev ntsuas, koj yuav tsum kuaj xyuas cov nqua ntawm qhov kom muaj:

1. corns,
2. khawb
3. tej kab nrib pleb
4. fungus
5. pob
6. liab thiab lwm yam kev puas tsuaj.

Thaum kuaj xyuas, saib xyuas yuav tsum tau them tsis tas rau cov tes taw, tab sis kuj rau ko taw. Tom qab txhua tus, txawm tias muaj tus kab mob tuaj yeem nkag mus rau hauv qhov muaj me ntsis. Ntxiv mus, txhim kho peripheral neuropathy thiab ntshav qab zib yuav tsis coj ntau yam tsis xis nyob, tab sis rau tus neeg noj qab haus huv nws yog qhov mob hnyav heev.

Urea-raws li kev saib xyuas ko taw yuav tsum tau siv ob zaug ib hnub. Qhov tshuaj yeeb tshuaj no pab ua rau cov tawv nqaij ua kom tawv nqaij thiab ua kom nws nqus tau dej. Thiab tom qab thov cov tshuaj pleev, txhawm rau txhim kho nws qhov kev txiav txim, koj yuav tsum hnav thom khwm.

Txawm li cas los xij, nws raug txwv tsis pub thov cov cream ua rau thaj chaw thiab nyias ntawm cov ntiv tes. Tom qab tag nrho, daim tawv nqaij hauv thaj chaw no tsis ua rau exfoliate. Feem ntau, txhais ceg uas muaj ntshav qab zib tau smeared nrog cov neeg sawv cev xws li Uroderm, Mikospor, Fungoterbin Neo, Cleore thiab lwm tus.

Yog tias tsis muaj kev raug mob, tawg, mob rau sab hauv, lossis lwm yam uas tsis zoo ntawm koj txhais ko taw, tom qab ntawd muab lawv so dej kom sov. Hauv cov txheej txheem, nws yog ib qho tseem ceeb tswj xyuas qhov kub ntawm dej, nws yuav tsum yog los ntawm 30 txog 36 degrees.

Txog kev siv tshuaj tua kab mob thiab so kom txaus, nws yog qhov tsim nyog los ntxiv cov roj tseem ceeb (1-3 tee), hiav txwv ntsev los yog tshuaj ntsuab kho kom zoo nkauj rau hauv da dej. Tab sis rau kev tiv thaiv ntawm tus kab mob ko taw mob ntshav qab zib, nws yuav txaus kom yaim qis ceg ib zaug ib hnub nyob rau hauv dej sov.

Lub sijhawm caij ntawm ib qho kev sib kho yog 5-15 feeb. Tom qab cov txheej txheem, daim tawv muag muag muag thiab ua ntau dua ywj. Txhawm rau txhim kho cov nyhuv, maj mam roughened ntawm daim tawv nqaij ntawm ko taw yuav tsum tau ua tib zoo tshem tawm txhua hnub siv kua paug.

Thaum kawg ntawm cov txheej txheem, ob txhais ceg tau muab so kom qhuav, suav nrog thaj chaw nruab nrab ntawm cov ntiv taw, vim tias muaj dej noo ntau dhau los pab txo cov khoom tiv thaiv ntawm cov epidermis. Tom qab ntawd lub qab zib tshwj xeeb yog siv rau sab nraum qab ntawm ko taw thiab tib qho.

Yog tias khawb, qhov txhab thiab abrasions tshwm, daim tawv nqaij ntawm ob txhais ceg yuav tsum tau kho nrog hydrogen peroxide lossis tus kab mob tiv thaiv kab mob xws li Aquazan, Dioxidine lossis Miramistin.Cov dej cawv muaj cov khoom lag luam, suav nrog cov ci ntsa iab ntsuab thiab iodine, tsis tuaj yeem siv, vim tias lawv tau ua rau cov kab mob qhuav thiab ua rau muaj kev tawg.

Rau kev tu txhua hnub, nws tseem yog ib qho tseem ceeb kom xaiv cov xab npum tsis muaj dej cawv, uas sib haum rau qib pH ntawm daim tawv nqaij. Rau kev txhais ko taw qhuav, koj yuav tsum xaiv cov rog rog, kev tu roj ntawm lub cev.

Nws tuaj yeem yog cov khoom lag luam muaj lanolin thiab txiv duaj, txiv ntseej lossis roj hiav txwv buckthorn.

Cov txheej txheem rau kev kuaj mob, kho thiab tiv thaiv tus mob ko taw mob ko taw

Cov mob ntshav qab zib mob ko taw mob ntshav qab zib (SDS) ua ke hloov pauv pathological ntawm cov leeg hlwb, hlab ntsha thiab microvasculature, qhov tshwm sim ntawm osteoarthropathy, uas ua rau muaj kev hem thawj ncaj qha rau kev txhim kho

Cov mob ntshav qab zib mob ko taw (SDS) ua ke ntawm cov kab mob hloov pauv hloov pauv hauv cov leeg hlwb, hlab ntsha thiab microvasculature, qhov tshwm sim ntawm osteoarthropathy, uas ua rau muaj kev hem thawj ncaj qha rau kev txhim kho ulcerative necrotic cov txheej txheem thiab mob caj dab ntawm ko taw. SDS yog ib qho kev mob tshwm sim tshaj plaws ntawm cov ntshav qab zib mellitus (DM), txhim kho hauv ntau dua 70% ntawm cov neeg mob. Txawm hais tias qhov tseeb tias kev puas tsuaj rau cov qis qis tsis tshua muaj kev puas tsuaj rau cov neeg mob, feem ntau nws ua rau muaj kev tsis taus. Qhov ntau zaus ntawm nqaj txiav tawm nyob rau hauv cov neeg mob uas muaj ntshav qab zib yog 15-30 zaug siab dua qhov ntsuas no hauv cov neeg pej xeem thiab suav rau 50-70% ntawm tag nrho cov lej ntawm tag nrho cov tsis mob. Txawm li cas los xij, nws yuav tsum raug sau tseg tshwj xeeb tias nyob rau hauv hom II mob ntshav qab zib mellitus (insulin-ywj siab), twb tau thaum lub sij hawm kuaj mob, los ntawm 30% mus rau 50% ntawm cov neeg mob tau muaj cov cim puas tsuaj rau qis qis kawg ntawm ib qib lossis lwm qhov.

Tus nqi kev lag luam tsim nyog rau kev kho mob txaus los ntawm pawg neeg mob no loj heev, tab sis nws yuav tsum nco ntsoov tias thaum siv txoj kev ua haujlwm, cov nqi no nce ntxiv ntawm 2 txog 4 zaug. Qhov no yog vim ob qho tib si rau tus nqi siab dua rau kev kho mob phais nws tus kheej, thiab rau kev nce nqi ntawm cov nqi kho dua tshiab (ua kom zoo nkauj, ua kom tiav). Kev txiav tawm ntawm ib qho povtseg uas ua rau muaj qhov hnyav nce ntxiv rau lwm tus, thiab, vim yog qhov tsim nyog tau qhov no, txoj kev pheej hmoo ntawm kev txhim kho ulcerative tsis zoo nyob rau hauv qhov txha caj qaum txhawm rau nce.

Hauv kev kho mob thoob ntiaj teb ntawm ob tus kws kho mob thiab kws phais neeg, kev sib koom ua ke ntawm cov mob ntshav qab zib ko taw tau raug saws, raws li uas muaj peb hom tseem ceeb:

• neuropathic
• ischemic
• neuroischemic (sib xyaw).

Qhov kev faib tawm no yog ua raws li cov tswv yim niaj hnub hais txog lub pathogenesis ntawm SDS thiab kev hla dhau ntawm ib qho ntawm nws cov kab txuas tseem ceeb (neuropathy, micro- thiab macroangiopathy) hauv qee kis tshwj xeeb. Txhua daim ntawv kho mob ntawm SDS yuav tsum muaj txoj kev kho kom sib txawv.

Ib qho ntawm cov tsos mob tshwm sim rau mob ntshav qab zib yog mob ntshav qab zib osteoarthropathy. Cov kev hloov tshwj xeeb tshaj plaws hauv cov pob txha qauv thiab cov caj dab ntawm ko taw yog hu ua Charcot sib koom tes lossis taw. Ntxiv nrog rau Charcot sib koom tsim nyog, lwm cov ntaub ntawv ntawm osteoarticular txhab hauv ntshav qab zib yog qhov txawv: txha pob txha, mob ntshav nce ntshav, mob txha taub hau, mob pob txha lov thiab mob lub cev. Hauv kev coj ua, ntau yam kev sib txuas ntawm cov ntawv sau saum toj no tau pom hauv tib tus neeg mob, uas cuam tshuam nrog kev sib thooj ntawm lawv cov kab mob tshwm sim thiab paub tseeb. Muab cov ntsiab lus no, ntau tus kws sau tawm tswv yim los sib txuas ntau yam ntawm cov kab mob hloov pauv hauv pob txha thiab pob qij txha hauv qab lo lus "Charcot tus taw."

Txhawm rau paub ntxov ntawm qhov txhab ntawm qis qis qis hauv cov neeg mob ntshav qab zib, yuav tsum muaj qee yam kev ntsuas kev kuaj mob, suav nrog cov kauj ruam hauv qab no.

1. Ib txhij txhua keeb kwm. Lub sijhawm tiv thaiv tus kabmob, hom ntshav qab zib (hom I lossis hom II), kev kho mob dhau los, thiab muaj cov tsos mob neuropathy hauv tus neeg mob thaum lub sijhawm kuaj lossis ua ntej, xws li txhav lossis hlawv mob hauv ob txhais ceg, cramps hauv plab calf leeg, loog, parasthesia, yog qhov tseem ceeb Cov. Kev tsis txaus siab ntawm cov neeg mob ntawm kev sib quas ntus mus ntxiv yog ib qho cim ntawm macroangiopathy. Lub sijhawm ntawm kev pib mob, qhov kev ncua deb uas tus neeg mob dhau ua ntej pib ntawm kev mob thawj zaug, lub xub ntiag ntawm qhov mob ntawm so yog suav nrog. Tsis zoo li ischemic mob, uas tseem tuaj yeem tshwm sim thaum hmo ntuj, mob neuropathically ua rau mob mob nres thaum taug kev. Ischemic mob me ntsis txo qis thaum dai ob txhais ceg los ntawm ntug txaj. Cov keeb kwm ntawm qhov mob txhab lossis mob txiav yog ib qho tseem ceeb hauv kev ntsuas txhawm rau hais txog kev txhim kho cov qhov txhab tshiab. Nrog rau lwm yam kev mob ntshav qab zib lig, xws li retinopathy thiab nephropathy (tshwj xeeb tshaj yog nws qhov davhlau ya nyob twg), qhov yuav tshwm sim ntawm qhov kev hloov kho qhov txhab muaj ntau. Thaum kawg, thaum sau cov anamnesis, nws yog qhov tsim nyog los txiav txim siab ntawm tus neeg mob kev paub txog qhov ua tau ntawm ko taw puas nyob hauv ntshav qab zib, nws cov laj thawj thiab kev tiv thaiv.

2. Kev soj ntsuam ko taw - Txoj kev yooj yim tshaj plaws thiab siv tau hom kev txhawm rau txhawm rau qhov txhab ntawm ko taw. Nws yog ib qho tseem ceeb uas yuav tsum tau them sai sai rau cov paib xws li qhov teeb meem ntawm cov tawv nqaij thiab cov plaub hau, kev ua kom tsis haum, edema, thaj chaw ntawm hyperkeratosis thiab lawv qhov chaw nyob, qhov mob tsis zoo, mob ntawm cov rau tes, tshwj xeeb tshaj yog nyob rau hauv qhov chaw sib tshuam, uas feem ntau mus tsis paub. Palpation yog txiav txim siab los ntawm pulsation nyob rau hauv cov hlab ntsha ntawm lub ko taw.

3. Kev soj ntsuam ntawm lub paj hlwb neurological muaj xws li:
a) Txoj kev kawm ntawm kev co rhiab uas siv lub kawm tiav lub rawg. Txog kev mob hlwb neuropathic, qhov nce ntawm qhov pib ntawm kev vibrational rhiab yog cov yam ntxwv, rau ischemic kev puas tsuaj, qhov ntsuas yog raws li cov hnub nyoog ib txwm muaj.
b) Kev txiav txim siab ntawm qhov mob, kom nruj thiab kub rhiab raws li cov qauv txheej txheem. Xyoo tsis ntev los no, cov neurological teeb tsa ntawm monofilaments tau dhau los ua neeg nyiam heev, cia txiav txim siab nrog qhov siab ntawm qhov tseeb ntawm qhov kev ua tiav ntawm kev ua txhaum ntawm tactile rhiab heev.
c) c) Cov lus txhais ntawm leeg leeg reflexes.
d) Electromyography yog qhov kev qhia ntau tshaj plaws rau kev ntsuam xyuas qhov xwm txheej ntawm cov hlab ntsha leeg, tab sis nws qhov kev siv tsawg vim kev nyuaj thiab tus nqi kawm siab.

4. Kev ntsuas cov ntshav ntawm cov roj ntsha txaus. Kev siv ntau tshaj plaws uas tsis siv rau kev txheeb xyuas lub xeev ntawm cov ntshav ntws - Doppler, dopplerography. Systolic siab nyob rau hauv cov hlab ntsha ntawm tus ncej, sab ceg thiab taw yog ntsuas - qib occlusion yog txiav txim siab los ntawm lub siab gradient. Qhov taw qhia ntawm pob taws-brachial index (LPI) qhia txog qib uas txo qis rau cov ntshav txaus (LPI = RAG / RPA, qhov twg RAG yog systolic siab hauv cov hlab ntsha ntawm txhais taw lossis txhais ceg, RPA yog systolic siab nyob rau hauv cov leeg ntshav txha caj qaum). Qhov ntsuas ntawm systolic siab thiab LPI txiav txim siab mus ntxiv cov chav kawm ntawm kev kuaj mob. Yog tias tsim nyog, kev txiav txim siab ntawm cov ntaub so ntswg oxygen saturation yog ua tiav, thiab cov duab angiography yog siv los daws cov lus nug txog qhov ua tau ntawm kev kho mob angiosurgical. Qhov qhia txog systolic lub siab tuaj yeem ua raws li qee cov lus qhia hauv qhov tseeb ntawm kev kho mob txhawm rau kho ntxiv, lawv tseem cia koj twv seb yuav ua li cas kho tau cov kab mob ntawm ko taw.

5. Radiography ntawm tus taw thiab pob taws tso cai rau koj txhawm rau txheeb xyuas cov cim qhia ntawm osteoarthropathy mob ntshav qab zib, kuaj xyuas qhov tshwm sim ntawm cov pob txha me ntawm ko taw, xav tias muaj osteomyelitis, tsis suav los yog paub tseeb tias kev loj hlob ntawm cov pa roj ntsha.

6. Cov kab mob kev tshawb fawb muaj qhov tseem ceeb tshaj plaws rau kev xaiv cov tshuaj tua kab mob txaus.

Cov neeg mob hauv qab no yog cov muaj pheej hmoo yuav tsim SDS:

• kev txom nyem los ntawm distal polyneuropathy,
• kev txom nyem los ntawm tus kab mob vascular
• keeb kwm ntawm ko taw mob,
• Kev Sib Koom Siab
• kev txom nyem los ntawm kev kub siab thiab hypercholesterolemia,
• tsis pom kev thiab dig muag
• kev txom nyem los ntawm ntshav qab zib mob nephropathy, tshwj xeeb tshaj yog nyob rau theem ntawm kev mob raum tsis zoo,
• kho siab neeg laus
• cov neeg quav dej quav cawv, haus luam yeeb.

Cov neeg mob uas yuav muaj teeb meem yuav tsum mus kuaj mob li tsawg kawg ib zaug txhua rau lub hlis. Kev soj ntsuam yuav tsum tau ua los ntawm cov kws kho tshwj xeeb endocrinologist lossis ib pawg kws tshaj lij (endocrinologist, kws phais mob, kws tshaj lij, tshwj xeeb hauv kev kuaj mob) hauv polyclinics ntawm qhov chaw nyob. Cov neeg mob uas muaj ntau hom kab mob ntshav qab zib taw yuav tsum raug xa mus rau cov chaw haujlwm tshwj xeeb hauv tsev kho mob lossis mus rau Lub Chaw Mob Ntshav Qab Zib, kho raws cov nroog ntau lub tsev kho mob ntau ntau thiab cov chaw tshwj xeeb. Lub tswv yim ntawm kev kho mob rau txhua tus neeg mob tshwj xeeb yog txiav txim siab nyob ntawm daim ntawv thiab mob hnyav ntshav qab zib, muaj lwm cov teeb meem ntshav qab zib thiab kab mob ntsig txog.

1. 
   Gurvich M. Kho khoom noj muaj txiaj ntsig rau ntshav qab zib. Moscow, 1996. Reprint: Moscow, Sovetsky Sport Publishing House, 2001, 285 nplooj ntawv, ncig 10,000 daim ntawv luam.
2. 
   Kamensky A. A., Maslova M. V., Suav A. V. Hormones kav lub ntiaj teb. Nrov endocrinology, Phau Ntawv AST-xovxwm - M., 2013. - 192 c.
3. 
   Watkins P.J. Mob ntshav qab zib mellitus (txhais lus los ntawm lus Askiv). Moscow - St. Petersburg, Binom Publishing House, Nevsky Dialect, 2000, 96 pp., 5000 daim qauv.

Cia kuv qhia kuv tus kheej. Kuv lub npe yog Elena. Kuv tau ua haujlwm li endocrinologist rau ntau tshaj 10 xyoo. Kuv ntseeg hais tias tam sim no kuv yog tus kws tshaj lij hauv kuv daim teb thiab kuv xav pab txhua tus neeg tuaj xyuas lub vev xaib kom daws qhov nyuaj thiab tsis yog li cov haujlwm. Txhua cov ntaub ntawv rau lub xaib tau sau thiab ua tib zoo ua kom tiav thiaj li xa ntau li ntau tau cov ntaub ntawv tsim nyog. Ua ntej thov cov ntaub ntawv uas tau piav qhia hauv lub vev xaib, yuav tsum tau sab laj nrog tus kws kho mob tshwj xeeb.