Teeb meem ntawm ntshav qab zib feem ntau tau tshwm sim los ntawm cov leeg ntshav thiab cov leeg hlwb uas cuam tshuam rau qis qis. Yog li, nws raug nquahu rau txhua tus neeg mob ntshav qab zib kom kuaj xyuas tus taw thiab txhais ceg qis txhua hnub, kom tsis txhob nco thawj zaug tshwm sim ntawm tus mob ntshav qab zib neuropathy.
Cov tsos mob twg yog xim liab, hnov tsis hnov mob lossis raug mob me tuaj yeem yog lub cim ntawm kev txhim kho ntawm cov mob hnyav xws li mob ntshav qab zib ko taw.
Raws li kev txheeb cais, nws tshwm sim hauv 15% ntawm tus neeg mob ntshav qab zib tom qab 5-6 xyoo mob.
Nrog kev them nyiaj tsis zoo rau cov ntshav qab zib, kab mob purulent koom nrog polyneuropathy, thiab kev mob caj dab kuj tuaj yeem tshwm sim, ua rau muaj kev xav tau txiav tawm.
Hauv lub ntiaj teb, 70% ntawm kev txiav yog ua rau mob neuropathy mob ntshav qab zib.
Ua rau mob ntshav qab zib neuropathy
Kev puas tsuaj rau cov hlab ntawm ob txhais ceg hauv ntshav qab zib yog cuam tshuam nrog ntau dhau ntawm cov piam thaj hauv cov ntshav, uas tsis tuaj yeem nkag mus rau hauv lub hlwb vim yog cov tshuaj insulin. Cov ntshav ntws los ntawm cov hlab ntsha txo qis, kev sib cais ntawm cov hlab ntsha impulses yog inhibited. Nyob rau hauv cov kev mob ntawm qhov tsis muaj zog sab hauv thiab txo qis khoom noj khoom haus, ntaub so ntswg rhiab zuj zus, qhov txhab kho ua kom qis dua.
Cov nqaij mob tawv nqaij me me nyob rau hauv daim ntawv ntawm kev tawg, txiav lossis abrasions tig mus rau hauv qhib ulcerative tsis xws luag, thiab zais mob txhab rau hauv qab txheej ntawm keratinized epithelium. Tag nrho cov no yuav tsis pom los ntawm cov neeg mob, vim nws tsis ua rau tsis xis nyob ntawm tsis raug rhiab siab. Feem ntau, qhov txhab ua rau thaj chaw muaj kev ntxhov siab ntau ntxiv uas tshwm sim thaum taug kev.
Cov kev raug mob zoo li no yuav ua rau hnyav dua los ntawm kev hnav cov khau nruj, nce ntawm daim tawv nqaij qhuav thiab ua rau cov tawv nqaij txhawm rau mob, yog tias raug mob thaum tab tom ko taw lossis taug kev ntawm ko taw.
Qhov kev thaiv ntawm cov hlab ntshav yog txuam nrog kev tso tawm ntawm cov roj cholesterol thiab calcium, ua rau lub plab atherosclerotic plaque. Cov kev hloov pauv hauv cov ntshav qab zib muaj ob peb yam mob:
- Lub qhov txhab tshwm sim tshwm sim hauv qhov chaw ntawm thaj chaw ntawm sab hauv qis - hauv tus taw thiab sab ceg.
- Ob txhais ceg raug kev txom nyem hauv ntau thaj chaw.
- Pib ua ntej hnub nyoog qis dua li cov neeg mob uas tsis muaj ntshav qab zib.
- Ua ke los ntawm kev tuag ntawm cov ntaub so ntswg
- Kev mob qog tuaj yeem tshwm sim yam tsis muaj kev raug mob thiab kev nyuaj siab.
Cov cim ntawm ceg mob hauv ntshav qab zib
Cov tawv nqaij ntawm cov neeg mob ntshav qab zib mellitus qhuav thiab nyias, lawv feem ntau raug mob, tshwj xeeb tshaj yog thaj tsam ntawm cov ntiv tes. Tus tsim cov txheej txheem rau kev txhim kho cov leeg hlwb thiab voos caj dab kuj yuav ua mob fungal, kab mob ko taw los yog phais mob tshem tawm ntawm tus ntsia thawv ingrown.
Txij li thaum qhov tsim tau ntawm tus mob ntshav qab zib muaj qhov tshwm sim hnyav heev nyob rau hauv daim ntawv ntawm txhais ceg txiav lossis tuag los ntawm sepsis, uas tau tsim los ntawm qhov kev ua kom dawb paug, txheeb xyuas thawj cov tsos mob ntawm tus mob ko taw mob ko taw tuaj yeem cawm tus neeg mob lub neej.
Daim phiajcim thawj zaug yog qhov txo qis hauv kev vibration, ces qhov ntsuas kub, qhov mob thiab tactile yog ua txhaum tom qab. Cov tsos mob uas ceeb toom yuav hnov o ntawm txhais ceg hauv qab plab hlaub, hauv thaj chaw ntawm ko taw. Yog tias txhais ceg ua kub lossis txias, ces qhov no txhais tau hais tias cov ntshav ncig yog cuam tshuam lossis tus mob tau tuaj koom.
Cov laj thawj uas yuav hu rau kws phais neeg lossis kws kho mob phais neeg tuaj yeem yog cov kev hloov hauv qab no:
- Qaug zog thaum taug kev nce ntxiv.
- Muaj mob ntawm cov ceg ntawm qhov sib txawv thaum taug kev lossis thaum tsaus ntuj.
- Tingling, qhov kev xav rhiab heev tshwm sim hauv tus taw, thiab chilliness ntau zog.
- Cov xim ntawm daim tawv nqaij ntawm ob txhais ceg yog xim liab lossis cyanotic.
- Cov kab plaub hau ntawm ob txhais ceg txo qis.
- Cov ntsia hlau los ua txoj kev nkhaus, ua rau tawg, daj.
- Bruising sawv nyob rau hauv cov ntsia hlau phaj.
- Tus ntiv tes sai li sai tau tig liab lossis o tuaj.
Cov neeg mob yuav tseem nco ntsoov tias qhov txhab lossis calluses zoo kho kom tsis txhob nyob hauv ib lub lis piam hauv ib hlis lossis ob hlis. Tom qab ua kom nruj ntawm lub qhov txhab, ib lub cim tsaus nti tseem nyob.
Mob rwj yuav tshwm sim ntawm taw, qee zaum kuj tob.
Hom Mob Ntshav Qab Zib
Muaj peb hom mob ntshav qab zib ko taw muaj qhov txawv raws qhov kev cia siab ntawm kev tsis sib haum xeeb sab hauv lossis kev tso ntshav tawm. Nrog cov tsis muaj conductivity hauv cov hlab hlwb, ib daim ntawv neuropathic tsim. Tus yam ntxwv ua cim rau nws yog qhov kev txiav txim siab yooj yim ntawm txoj kev xoo arterial. Tshaj tawm thiab tawm hws zoo li pom ntawm txhais ceg.
Kev taw nyob rau hauv daim ntawv no yog sov, xim tawv nqaij yog qhov ib txwm los yog daj me ntsis, lub rwj nyob rau thaj tsam (xws li hauv daim duab) hauv thaj tsam ntawm qhov nce ntxiv - hauv thaj chaw ntawm cov pob txha metatarsal. Mob taub hau mob sib khuav. Lub qhov txhab ntub, cov npoo yog tuab. Feem ntau cuam tshuam rau cov tub ntxhais hluas uas muaj ntshav qab zib hom 1, kev haus cawv haus cawv tuaj yeem yog qhov xav tau ua ntej.
Daim tawv liab liab ntawm cov ntshav qab zib mellitus hauv daim duab tuaj yeem yog qhov kos npe ntawm ischemic daim ntawv ntawm polyneuropathy, hauv qhov kev mob plawv kom txiav txim siab cov tsos mob ntawm tus mob ko taw.
Nrog rau qhov kev xaiv no, ob txhais ceg tau txias, cov mem tes yog qhov nyuaj rau kev txiav txim siab, ob txhais taw yuav dhau los ua bluish.
Mob rwj nyob hauv qhov chaw ntawm qhov tsis zoo tshaj plaws cov ntshav txaus - luj taws, sab nraud ntawm tus taw, thiab tus ntiv tes xoo. Daim tawv nqaij ncig ntawm lub qhov txhab yog nyias. Tib lub sijhawm, cov neeg mob muaj kev ntxhov siab los ntawm kev hnov mob thaum so, mob heev dua thaum tsaus ntuj, thiab thaum taug kev, lawv feem ntau yuam kom nres vim qhov mob hnyav.
Daim ntawv sib xyaw feem ntau kuaj hauv cov neeg mob ntshav qab zib, nws ua ke cov tsos mob ntawm ischemia thiab lub paj hlwb tsis zoo. Kev phom sij los tsim tus mob ko taw yog:
- Lub sijhawm nws muaj ntshav qab zib ntau dua 10 xyoo.
- Mob ntshav qab zib tsis muaj ntshav lossis ntshav lab.
- Haus Yeeb.
- Cov neeg mob uas tau mob plawv lossis mob stroke.
- Haus dej cawv.
- Nrog txoj kev ua ntshav txhaws.
- Kev rog nyhav.
- Kab mob Varicose.
Kev kuaj mob thiab kho ntshav qab zib neuropathy
Txhawm rau kuaj qhov mob tshwm sim, cov neeg mob soj ntsuam tag nrho: kev kuaj ntshav rau cov piam thaj thiab biochemical tsom, kev txiav txim siab ntawm lub raum muaj nuj nqi, kev xoo hluav taws xob thiab kev tshawb fawb angiographic. Tus kws kho mob hlwb tshawb xyuas qhov kev nyab xeeb ntawm qhov chaw thim rov qab thiab rhiab rau qhov mob, kov, vibration thiab ntsuas kub.
Txhawm rau txiav txim siab ntshav txaus, dopplerometry yog ua tiav, ntsuas siab hauv cov hlab ntsha ntawm ob txhais ceg yog ntsuas. Thaum muaj qhov mob txhab, mob microflora kab lis kev cai thiab rhiab ntawm cov tshuaj tua kab mob.
Kev kho kab mob ntshav qab zib pib los ntawm kev kho cov ntshav qabzib hauv ntshav mus rau qib ntau. Yog hais tias tus neeg mob tau txais cov tshuaj noj kom txo qis qab zib, tom qab ntawd nws yog hloov mus rau cov tshuaj insulin lossis kev qhia ntawm cov tshuaj insulin ntev thiab cov tshuaj tiv thaiv kab mob hauv cov ntsiav tshuaj tau koom ua ke.
Tshem tawm cov kev mob tshwm sim hauv kev mob ntshav qab zib polyneuropathy yog nqa nrog cov tshuaj hauv qab no:
- Cov tshuaj Anticonvulsants (Finlepsin, Gabalept).
- Cov Tshuaj Nplaum (Dexalgin, Nimesulide).
- Cov tshuaj tiv thaiv kab mob (venlafaxine, clofranil).
- Cream nrog lidocaine.
Kev kho nrog thioctic acid npaj (Thiogamma, Berlition), nrog rau kev txhaj tshuaj ntawm cov vitamins B (Milgamma, Neurobion) pab kho cov nqaij mos thiab ua kom zoo sai sai ntawm qhov ua kom ulcerative kho. Dipyridamole, Actovegin, Pentoxifylline yog siv los txhim kho cov ntshav cov ntshav.
Tsis tas li ntawd, mob rwj yog kho, thiab cov caj pas cuam tshuam tsis muaj nrawm. Nrog mob txhab rau sab ceg qis, koj yuav tsum tau sim nyob rau hauv kab rov tav dua feem ntau. Cov cuab yeej orthopedic tshwj xeeb kuj tseem siv tau los daws lub nra ntawm taw. Hauv kev sib ntaus tawm tsam tus kab mob no, kev tawm dag zog rau kev kho ntshav qab zib mellitus hauv txoj kev kho mob muab cov txiaj ntsig zoo.
Thaum muaj kev sib kis kab mob, kev kho mob tua kab mob tau raug kho ntev ntev ua ntej ua kom mob rwj.
Txoj kev kho hnyav yog tseem coj los kho cov kab mob sib kis uas ua rau nws tsis yooj yim kom rov zoo cov neeg mob: mob ntshav tawm, lub raum thiab mob siab.
Kev tiv thaiv polyneuropathy
Rau cov neeg mob ntshav qab zib, kuaj xyuas cov ceg thaum lub sijhawm tu cev txhua hnub yog ib txoj kev tseem ceeb ntawm kev tiv thaiv kev mob ntawm cov leeg hlwb. Txhua qhov mob lossis qhov nqaij ntuag yuav tsum tau kho nrog Miramistin lossis Chlorhexidine, cov tshuaj tov dej ntawm furacilin. Tsis txhob siv cov cawv uas muaj cawv ntau.
Rau kev kho mob ntawm mob txhab, Solcoseryl, Actovegin, Iruksol gel siv. Thaum coj tus ntsia thawv ko taw, koj tsis tuaj yeem siv rab laum, nws yog qhov zoo dua los siv cov txheej txheem kho vajtse. Cov taw yuav tsum tau muab roj nrog roj cream tiv thaiv kom tsis txhob qhuav lossis pleev tshwj xeeb rau cov neeg mob ntshav qab zib: Balzamed, Alpresan.
Thaum muab txoj hlua khau, koj yuav tsum kuaj xyuas nws rau kev ncaj ncees ntawm cov insoles, tsis muaj pob zeb, tawv tawv los yog nti ua rau tuaj yeem ua rau tawv nqaij ntawm ko taw. Cov khau yuav tsum yog sib phim nrog qhov loj me thiab txhawb nqa. Hauv qhov no, koj siv tsis tau cov thom khwm nqaim, nyem cov ntiv tes. Cov khau khiab nrog pob taws kaw thiab ntiv taw yog xaiv rau kev hnav khaub ncaws hauv tsev.
Kuj tseem pom zoo yog cov kev tiv thaiv zoo rau kev txhim kho mob ko taw:
- Ua kom tiav kev txiav luam yeeb thiab haus dej cawv.
- Tsis pub hla dhau ntawm ob txhais ceg yuav tsum raug tso cai.
- Thaum tuav tus da dej taw, lawv qhov kub yuav tsum txog li 36 degrees.
- Nrog kev tsis pom kev zoo, koj tsis tuaj yeem txiav koj cov ntsia hlau.
- Nws tsis pom zoo kom taug kev liab qab, txawm tias nyob hauv tsev.
- Tsis txhob siv lub ntsuas cua kub, lub roj teeb, lossis lub tso cua sov kom sov koj txhais taw.
Kev tseem ceeb rau kev tiv thaiv txhua yam mob ntshav qab zib yog saib xyuas ntshav qab zib. Txhawm rau ua qhov no, koj yuav tsum tau siv cov cuab yeej siv los ntsuas cov ntshav qab zib hauv cov ntshav txhua hnub thiab kuj ib zaug txhua peb lub hlis los txiav txim siab txog qib ntshav glycated hemoglobin thiab mus ntsib tus kws kho qhov mob endocrinologist kom kho cov kev kho mob. Kev sab laj ntawm kws kho menyuam yaus thiab kws kho paj hlwb tau pom zoo yam tsawg ib xyoos ib zaug.
Daim vis dis aus hauv tsab xov xwm no qhia txog cov mob ntshav qab zib.
