Cov tawv nqaij nyob rau hauv cov ntshav qab zib mellitus cuam tshuam vim muaj kev cuam tshuam txog cov metabolism hauv kev zom zaws uas tshwm sim thaum tsis muaj cov tshuaj insulin ntau lawm, lossis yog tias qhov rhiab ntawm receptors hauv cov ntaub so ntswg ploj mus rau nws.
Cov kev hloov pauv ntawm daim tawv nqaij epithelium, cov hauv paus plaub hau thiab hauv cov tawv nqaij nws tus kheej tau cuam tshuam nrog kev txuam nrog cov khoom lag luam hauv lub cev, cov roj ntsha tsis txaus, thiab kev tiv thaiv qis. Tag nrho cov xwm txheej no tshwm sim tawm tsam keeb kwm ntawm kev puas tsuaj rau phab ntsa ntawm cov hlab ntsha thiab cov hlab ntsha leeg.
Raws li kev xav txog ntawm kev cuam tshuam ntawm cov metabolism hauv kev ua haujlwm, ntau yam pob, ua pob thiab mob tshwm sim ntawm daim tawv nqaij. Cov tsos mob ntawm cov pob liab liab ntawm ob txhais ceg hauv ntshav qab zib yog ib qho kev ua kom pom tseeb ntawm tus kab mob no.
Cov pob liab liab hauv cov ntshav qab zib ua rau lub cev tawv nqaij
Hloov pauv ntawm daim tawv nqaij hauv ntshav qab zib mellitus yog txuam nrog kev ua kom lub cev qhuav dej thiab tsis muaj teeb meem ntawm lub cev. Yog hais tias theem ntawm cov piam thaj hauv cov ntshav tau nce siab tas li, tom qab ntawd daim tawv nqaij yuav tawv, nws lub suab qis, tev tawm tuaj, tshwj xeeb yog rau saum tawv taub hau. Cov plaub hau ua npub, ntog tawm.
Ntawm daim tawv nqaij ntawm taw, qhov kev ua kom pom ntawm daim tawv nqaij qhuav ua rau kom muaj keratinization ntau ntxiv, qhov pom ntawm corns thiab kab nrib pleb. Cov tawv nqaij xim kuj hloov pauv, nws hloov daj los yog siv rau hauv lub zas xim. Cov pob khaus thiab dryness ntawm daim tawv nqaij tshwm ntawm cov tsos mob thawj zaug thiab, ua ke nrog cov pob khaus thiab candidiasis, tuaj yeem yog cov cim ntawm insulin tsis txaus.
Hauv cov menyuam yaus uas muaj ntshav qab zib labile, qhov ntsej mua nce ntshav yuav tshwm, hu ua mob ntshav qab zib rubeosis. Cov tsos ntawm daim tawv nqaij liab zoo nkauj yog cuam tshuam nrog kev ua kom cov hlab ntuag, uas ua rau pom qhov tsis tseeb tias tus menyuam noj qab nyob zoo.
Cov kab mob ntawm daim tawv nqaij uas nrog ntshav qab zib mellitus lossis yog nws cov txheej txheem ua ntej tuaj yeem faib ua pawg:
- Kev tshwm sim ntawm cov teeb meem metabolic thiab angiopathies: lipoid necrobiosis, mob ntshav qab zib dermatopathy, xanthomatosis, mob ntshav qab zib.
- Dermatoses los ntawm kev siv cov tshuaj insulin lossis cov tshuaj tiv thaiv kab mob: kho mob tom qab txhaj tshuaj lipodystrophy, urticaria, eczema, tshuaj tsis haum.
- Kab mob theem ob lossis kab mob.
Mob ntshav qab zib ua rau kev kho mob ntawm daim tawv nqaij ua mob, lawv tau txais qhov tawv ncauj thiab kawm ntev, feem ntau rov tshwm sim dua.
Cov tsos mob ntawm cov pob liab liab ntawm ob txhais ceg nrog ntshav qab zib yees duab ntawm uas tau muab rau hauv tsab xov xwm yog cov tsos mob tshwm sim ntawm tus mob ntshav qab zib dermatopathy. Feem ntau feem ntau, cov ntsiab lus no tshwm sim nyob rau sab pem hauv ntej ntawm sab ceg qis ib txhij ntawm ob txhais ceg. Thaum pib, liab papules yuav tshwm sim, uas maj mam dhau los ua atrophic me ntsis.
Ntau zaus, dermatopathy mob ntshav qab zib cuam tshuam rau cov txiv neej muaj mob ntshav qab zib ntev ntev thiab yog qhov tshwm sim ntawm microangiopathy. Cov tawv nqaij ntawm daim tawv nqaij tsis ua rau mob, khaus tawv nqaij kuj tseem qhaj. Lawv tuaj yeem nyob ntawm lawv ko taw rau ob xyoos, thiab tom qab ntawd ploj ntawm lawv tus kheej. Dermatopathy kho tsis tas yuav tsum tau.
Ntawm lub cev, cov mob ntshav qab zib tuaj yeem tshwm sim li 2-3 hnub, ploj yam tsis muaj kev kho mob. Cov kab uas muaj xim liab ncig nrog lub qhov muag tau tshwm sim rau ntawm qhov chaw qhib ntawm lub cev, ntau zaus hauv cov txiv neej tom qab 40 nrog lub sijhawm luv luv ntawm tus kabmob. Hnov mob siab thiab hais lus rau tus mob ntshav qab zib ua paug tsis hnov qab lossis tej zaum yuav hnov qhov txawv me ntsis.
Xim av me me hauv qhov quav ntawm caj dab thiab nyob rau hauv lub qhov tso tawm tuaj yeem yog qhov tsos mob ntawm acanthosis dub. Pigmentation intensifies, thiab daim tawv nqaij ua dub - xim av, nws zoo li qias neeg. Cov qauv ntawm cov kab tawv nqaij tau qhia meej meej meej, daim tawv nqaij kuj velvety rau qhov kov.
Tib cov xim tsaus nti tuaj yeem nyob rau thaj chaw tiv thaiv ntawm cov pob qij txha ntawm cov ntiv tes. Tawm tsam cov keeb kwm yav dhau los ntawm kev tsaus ntuj nti, cov papules me me tau tsim nyob rau ntawd. Hauv plawv ntawm tus kab mob yog nce siab synthesis ntawm insulin-zoo li kev loj hlob yam.
Xws li cov yam ntxwv ntawm cov neeg muaj kev rog thiab tuaj yeem tshwm ua ntej kuaj ntshav qab zib.
Cov cim qhia ntawm cov ntshav qab zib lipoid necrobiosis
Tsaus nti rau ntawm ob txhais ceg tuaj yeem tshwm sim ntawm lipoid necrobiosis thiab tshwm sim ntev ua ntej cov ntshav qab zib muaj tshwm sim. Feem ntau, cov ntshav qab zib mellitus ntawm thawj hom tau tshawb pom, hauv ib nrab ntawm cov neeg mob, insulin deficiency ua ntej dermatosis. Cov tsos mob thiab mob heev tsis cuam tshuam dab tsi rau qhov mob ntshav qab zib.
Cov ntaub ntawv sib xws ntawm lipoid necrobiosis yog tus cwj pwm los ntawm foci loj uas txuas mus rau tag nrho saum npoo ntawm qis ceg. Tus mob pib nrog cov tsos ntawm cyanotic chaw, taw tes lossis ib puag ncig nodule.
Tom qab ntawd cov khoom no nce loj rau oval lossis multiform atrophic plaques. Qhov chaw pib yog daj los yog xim av, sunken, thiab tom qab ntawd atrophies, lub nkoj hauv lub qhov dej tshwm. Qee zaum nws tshwm sim uas nws hloov xim dub thiab ua kiav txhab ua rau mob. Qhov ntug ntawm qhov me me yog liab, nce siab tshaj theem ntawm daim tawv nqaij.
Kev kho mob ntawm tus mob necrobiosis yog nqa nrog cov tshuaj no:
- Nquag cov metabolism hauv cov roj: clofibrate lossis lipostabil.
- Txhim kho cov ntshav cov ntshav: Curantil, Trental, Nicotinamide, Aevit.
- Sab nraud: sab hauv qhov chaw me me ntawm kev txhaj tshuaj ntawm heparin thiab insulin, corticosteroids, kev siv dimexide, lubrication nrog Troxevasin, Fluorocort.
Rau kev kho mob hauv lub cev, phonophoresis ntawm kev ncua ntawm hydrocortisone, kev kho laser yog siv. Txhawm rau kho peptic rwj, nws txoj kev ua tau zoo thiab tawv nqaij yas yog qee zaum ua.
Pob khaus khaus nrog ntshav qab zib
Cov pob khaus hauv ntshav qab zib mellitus yog feem ntau hnov nrog cov kab mob latent thiab mob me thiab tuaj yeem tshwm sim txij li ob lub hlis mus rau tsib xyoos ua ntej kuaj mob. Feem ntau ua rau daim tawv nqaij khaus nyob hauv plab, puab tais, lauj tshib. Thawj cov khoom ntawm neurodermatitis tuaj yeem yog cov xim papules tawv nqaij. Cov kws kho mob nco ntsoov tias khaus muaj ntshav qab zib feem ntau tshwm sim rau cov poj niam ntau dua li cov txiv neej.
Thaum papules sib tshuam ua ke, ib cheeb tsam infiltration tsim, qhov chaws hauv cov chaw zoo li no yog qhuav thiab them nrog cov nplai. Cov kab nrib pleb yuav tshwm sim thaj tsam ntawm daim tawv nqaij quav. Ua rau khaus khaus thaum tsaus ntuj. Thaum lub caij sov sov, kev ua kom pom yuav tsawg zuj zus.
Kev mob zais zis tuaj yeem tshwm sim sai rau ntawm daim tawv nqaij ntawm qaum los yog qis dua, ntau zaus hauv cov ntiv tes thiab ntawm ko taw. Cov tawv nqaij tsis rov ua dua, qhov kev xav zoo nkauj tuaj yeem ua rau khaus lossis khaus me ntsis, nws tseem tuaj yeem tsim kho lub zais zis ntxiv yam uas tsis muaj cov tsos mob ntxiv. Qhov ntau thiab tsawg los ntawm cov hauv paus ntsiab lus mus txog ob peb centimeters inch.
Cov kua dej hauv lub hlwv ntshiab lossis ua kom ntshav khov; cov kab mob microbes tsis pom pom nyob hauv inoculation. Feem ntau, blisters nyob ntawm daim tawv nqaij li ob asthiv, tsis tshua muaj ntau txog li ib hlis.
Lawv zoo dua yog tsis muaj cicatricial hloov ntawm txoj kev kho mob.
Cov tawv nqaij muaj kab mob hauv cov ntshav qab zib
Ko taw me ntsis nyob rau hauv cov ntshav qab zib nyob rau hauv cov neeg laus cov neeg mob thiab nrog nce lub cev hnyav tuaj yeem ua kom pom kev mob ntawm candidiasis. Kev ua kom tiav ntawm thaj chaw ntawm candidomycosis yog thaj chaw ntawm perineum, qhov chaw mos, cov qhov nqaij loj, cov nqaij tawv sib kis ntawm ko taw. Cov mob Candidiasis feem ntau pib nrog khaus daim tawv nqaij khaus.
Whitish streaks tshwm sim hauv daim tawv nqaij quav tawm tsam ntawm keeb kwm ntawm liab, xeb thiab tawg daim ntawv. Qhov npoo zoo nkauj zoo nkauj, ci ntsa iab lossis liab nrog lub npoo dawb. Tej zaum yuav muaj pob me me ntawm cov hlwv lossis cov pob pustules ncig thaj tsam. Kev txheeb xyuas tau los ntawm cov kev soj ntsuam thiab cov kab mob kev tshawb fawb.
Txoj kev kho yog nqa nrog kev npaj hauv zos: tshuaj pleev lossis Clotrimazole cov kev daws teeb meem, Lamisil qab zib, Cov tshuaj Exoderil lossis lwm yam tshuaj zoo sib xws. Sab hauv noj Itraconazole lossis Ketoconazole, Fluconazole ntawm kev pom zoo ntawm kws kho mob. Kev siv dag zog rau ntshav qab zib thiab ceg teeb meem kuj zoo.
Cov kab mob hauv cov neeg mob ntshav qab zib yog qhov nyuaj dua thiab kho nyuaj. Feem ntau cov qhov txhab tshwm sim yog:
- Mob plab kiav txhab.
- Pauj Kev Ntsim Siab.
- Mob ntsws hawb pob.
- Erysipelas.
- Panaritius.
Tshuaj tua kab mob yog siv rau kev kho mob, coj mus rau hauv tus account qhov rhiab ntawm microbial muaj. Kev ua kom tiav ntawm kev kis kab mob zuj zus ntxiv rau qhov hom mob ntshav qab zib mellitus, ua rau muaj kev phom sij hnyav, lub sijhawm ua kom ntev dua.
Yog li, cov neeg mob zoo li no tau nce qhov koob tshuaj thiab lub zog ntawm cov tshuaj insulin hauv ib qho kev kawm ntawm cov ntshav qab zib, lossis cov neeg mob tau hloov los ntawm cov ntsiav tshuaj mus rau kev kho tshuaj insulin. Nyob rau tib lub sijhawm, kev tiv thaiv kab mob ntawm kev hloov kho thiab, yog tias tsim nyog, kev kho mob phais tawm yog nqa tawm.
Daim vis dis aus hauv tsab xov xwm no hais txog khaus khaus tawv nqaij mob ntshav qab zib.
