Ntshav qab zib mellitus yog ib yam kab mob uas cuam tshuam ntau yam hauv tib neeg lub cev. Tus mob mob muaj ntau qhov syndromes thiab tsos mob uas qhia tias pom muaj cov teeb meem no. Ib qho ntawm cov xeeb ceem tshwj xeeb yog Charcot txhais taw.
Ntawm cov ntshav qab zib, lub cev tiv thaiv tsis tawm dag zog rau kev tswj lub cev thiab cov kabmob ua haujlwm tsis zoo. Cov neeg mob feem ntau qhia txog kev txhim kho ceg sai.
Mob taw kev yog txoj kev kho mob uas tuaj yeem ua rau muaj kev phom sij loj. Yog tias kuaj tau ntshav qab zib, nws yog ib qho tsim nyog yuav tau ua tib zoo saib xyuas cov xwm txheej ntawm ob txhais ceg thiab cov kev hloov tshwm sim.
Dab tsi yog Charcot tus taw
Kev noj qab haus huv osteoarthropathy ntawm ko taw yog qhia hauv kev ua txhaum ntawm cov qauv ntawm cov qis qis uas tshwm sim nrog kev nce ntshav qab zib. Nrog kev tswj tsis tau ntshav qab zib kom tsis txaus, kev puas siab puas ntsws txo qis thiab los ntshav hauv cov hlab ntsha ntawm txhais ceg tsawg dua.
Yog li, muaj kev pheej hmoo ntawm kev raug mob rau txoj kev nqua thiab cov tsos ntawm kev kis mob.
Mob ntshav qab zib, lub paj hlwb feem ntau cuam tshuam, thiab ib tus neeg tsis tuaj yeem hnov nws nqua. Cov txheej txheem ntawm sebum kev zais, nrog rau tawm hws, cuam tshuam. Cov xwm txheej no ua rau muaj qhov pib ntawm:
- pob txha
- tawv nqaij
- pob qij txha ntawm txhais taw.
Lub siab tshwm sim thaum lub zog txav ntawm nqua, uas ua rau lub cev tawv nqaij tsis xws luag. Yuav mob rwj thiab mob Charcot's syndrome. Tom kawg tau qhia hauv qhov pom ntawm kev mob ntawm ob txhais ceg, kev puas tsuaj rau cov pob txha thiab pob qij txha.
Tib lub sijhawm, kev kho kom zoo coj mus qeeb, microbes feem ntau sib kis. Nrog cov ntaub ntawv sib tw, cov mob ntshav qab zib ua rog tawm nyob rau hauv cov ntshav qab zib mellitus, uas yog fraught nrog txiav ntawm tes taw. Tus kabmob yog lub neej hem vim nws tuaj yeem nkag mus rau hauv cov hlab ntshav.
Charcot's syndrome yog hu ua qhov kev poob ntawm txhua daim ntaub ntawm qhov qis qis.
Qhov no yog vim muaj ntshav nce siab ntau.
Qhov tseeb ntawm qhov pib ntawm tus kab mob
Cov neeg muaj ntshav qab zib thiab kev tswj tus kab mob tsis txaus yuav kis tau raug mob ntawm txhais ceg. Yog tias cov leeg leeg ntawm ob txhais ceg tau puas ntsoog, tom qab ntawd tus neeg mob yuav tsis hnov zoo li nqua.
Hauv qhov xwm txheej no, ib tus neeg tsis tuaj yeem txiav txim siab qhov twg nws cov ntiv tes thiab taw yog qhov thaum tsiv. Yog tias cov leeg hauv tsev noj qab haus huv yog qhov zoo, tom qab lub sijhawm txav ib tus neeg hnov tias txhais taw tau nyob hauv lub cev nruj.
Hauv cov ntshav qab zib mellitus, tus neeg mob tsis tuaj yeem hnov mob ko taw, piv txwv li, hlwv, txiav thiab kos. Nrog pathological hnav ntawm ko taw, pob kws thiab corns feem ntau tshwm sim.
Kev tswj hwm tsis txaus ntawm tus kabmob ua rau cov leeg mob hnyav thiab mob atherosclerosis.
Raug mob rau ntawm txhais ceg ntxiv qhov kev pheej hmoo ntawm qhov kev hloov tseem ceeb hauv ko taw. Kev mob rwj tsis zoo yog suav tias yog ib qho teeb meem uas nquag muaj. Nws qhov ntsej muag tuaj yeem ua rau:
- pheej tso siab rau ntawm txhais ceg
- kev puas tsuaj thib ob
- raug mob los yog hno
- yam khoom txawv teb chaws uas tau nkag rau hauv nkawm khau,
- cov tsos mob ntawm tus kab mob.
Kev puas tsuaj rau ntawm daim tawv nqaij ntawm cov rau tes los yog txhais taw nrog lub pob fungal tuaj yeem ua rau kis mob tseem ceeb. Koj yuav tsum tam sim ntawd sab laj nrog tus kws kho mob thiab pib kho.
Cov qauv ntawm tus kabmob
Ua raws li qhov ua rau mob ntshav qab zib ko taw mob, yuav muaj ntau yam kabmob ntawm tus kabmob.
Daim ntawv neuropathic yog qhov ntau tshaj plaws. Cov hlab ntsha hauv lub cev yog qhov tsis yooj yim rau ntau yam los ntawm kev puas tsuaj nws. Yog li, nws yog qhov yooj yim rau pathology. Muaj kev ua txhaum ntawm kev zais ntawm sab hauv cov nqaij mos ntawm ob txhais ceg, tom qab ntawd lawv cov qauv thiab kev ua haujlwm tsis zoo.
Feem ntau muaj mob txhab ntawm ob txhais tes thiab lub qab xib taws. Hauv cov chaw no, txhais ko taw yog qhov zawm tshaj plaws. Kuj tseem muaj kev ua txhaum ntawm cov pob txha-ligamentous apparatus.
Mob ntshav qab zib neuropathy tuaj yeem yog:
- kev mob
- tsis mob.
Cov chav kawm ntawm tus kab mob ntawm daim ntawv no tsis tshwm sim los ntawm cov tsos mob mob. Ib tus neeg tsis hnov cov tsos ntawm kev mob rwj, tsis xis nyob thiab puas tsuaj. Feem ntau tus mob ntshav qab zib yws yws ntawm loog hauv ob txhais ceg. Daim ntawv mob yog tus cwj pwm los ntawm cov kev ua kom pom tseeb:
- tingling ntawm qis extremities,
- ua npaws hauv ob txhais ceg
- goosebumps
- mob hauv lub xeev txias
- muaj cov mem tes nyob rau ntawm txhais ceg nrog cov tsos ntawm neuropathy.
Kev loj hlob ntawm hom mob no tshwm sim nrog atherosclerotic txhab ntawm cov hlab ntsha ntawm ob txhais ceg. Cov tsos mob hauv qab no tshwm sim:
- cov tawv nqaij txias ntawm ob txhais ceg, feem ntau daj ntseg thiab cyanotic,
- paj yeeb tawv xim zoo nkauj tshwm nrog cov nthuav txav ntawm cov hlab ntsha,
- cov tsos ntawm tus nplaig ntawm cov ntiv tes,
- pob taws mob
- lub impossibility ntawm kev xav cov mem tes nyob rau hauv ko taw,
- claudication yog tias muaj mob hnyav nyob hauv ceg thaum taug kev.
Cov sib xyaw ua ke muaj cov neuropathic thiab ischemic. Tus kab mob cuam tshuam rau thaj tsam li 15% ntawm cov neeg muaj ntshav qab zib.
Cov cim ntawm tus kab mob
Ntshav osteoarthropathy yog fraught nrog tas mus li qhov cuam tshuam, raug mob thiab cuam tshuam ntawm qhov mob ntawm ob txhais ceg. Charcot tus taw yog tus cwj pwm los ntawm kev ua tiav ntawm nws txoj haujlwm.
Nrog cov kab mob pathology no, tej zaum yuav muaj cov tsos mob li no:
- mob vim ncab thiab txhaws ntawm taw,
- kev kis kab mob
- daim tawv liab, lees tias muaj cov kab mob,
- o ob txhais ceg
- nce tawv nqaij kub vim kis tau tus kab mob,
- lub nra ntawm lub taw, lub cev thaum hnav khau tsis xis,
- purulent txheem uas ntws los ntawm cov qhov txhab,
- lameness, taug kev nyuaj,
- ingrowth ntawm tus ntsia thawv phaj,
- muaj cov fungus
- ntawj txias thiab ua npaws los ua kev kis tus kab mob,
- mob hnyav hauv cov ceg thiab lawv loog.
Raws li txoj cai, ntawm ob txhais ceg tshwm sim:
- hlwv thiab calluses
- ntsia thawv ua daim tawv nqaij,
- outgrowths ntawm tus kheej ntawm ko taw,
- bursitis ntawm tus ntiv tes xoo
- fungal tau mob
- tawg pleb tawv
- txhuav tawv nqaij
- curvature ntawm cov ntiv tes.
Muaj plaub ntu hauv kev txhim kho cov ntshav qab zib:
- hauv thawj theem, cov pob qij txha raug pov tseg. Kev sib koom tes ua ke, pob txha me ntawm pob txha lov thiab cuam tshuam muaj tshwm sim. Cov theem no yog tus cwj pwm los ntawm o ntawm taw, liab ntawm daim tawv nqaij, nce ntxiv ntawm qhov kub. Ib tug neeg tsis hnov mob thaum lub sijhawm no,
- hauv theem ob, cov hneev taw yog nrawm, ko taw yog deformed,
- ntawm theem peb, deformation ua kom pom tseeb. Tej zaum yuav muaj qhov tshwm sim thiab cuam tshuam txog kev tawg. Cov ntiv taw pib khoov thiab lub luag haujlwm ntawm tus taw yog cuam tshuam,
- hauv theem peb, qhov mob tshwm, uas ua rau kis tus kabmob.
Sharko qhov sib koom tes yog qhov ua tau zoo ntawm pob qij txha uas tshwm nrog kev hnov mob tsis zoo vim muaj ntau yam kab mob, feem ntau feem ntau mob ntshav qab zib mellitus. Qhov yuav tau txais yog:
- ob leeg sib koom ua ke
- articular effusion,
- deformation
- tsis khov.
Kev kuaj mob
Yog tias ntshav qab zib osteoarthropathy xav tias muaj, nws yog ib qho tseem ceeb kom sab laj nrog kws kho mob raws sijhawm. Yog tias ua tau, nws zoo dua mus xyuas lub tsev kho mob tshwj xeeb.
Txhawm rau kom paub tseeb, nws yog qhov yuav tsum tau ua tib zoo kawm kev kuaj mob hauv daim duab thiab kev kuaj mob xoo, uas yuav qhia txog qib tshwj xeeb ntawm kev txhim kho tus kab mob. Qhov tsis yooj yim ntawm kev txiav txim ntawm tus mob kho mob rwj rau qhov tseeb tias tus mob tshwm sim tuaj yeem zoo ib yam:
- phlegmon ntawm tus taw,
- thrombophlebitis
- lymphostasis thiab lwm yam kab mob.
Qhov nyuaj tshaj plaws yog kev kuaj xyuas qhov txawv txav thaum qhov tshwm sim ntawm Charcot tus taw yog nyob rau theem mob. Thaum zoo li no lawm, kev kho mob qeeb tuaj yeem ua rau tus neeg tsis muaj caj dab tes.
Koj tuaj yeem kho tus mob ntshav qab zib nrog kev phais mob lossis siv cov qauv qub. Kev txuag txoj kev kho mob suav nrog, ua ntej txhua yam, kev kho mob yooj yim. Nyob rau theem no koj xav tau:
- pab them ntshav qab zib
- tswj lub siab
- normalize ntshav qab zib ntau ntau.
Yog tias tus kws kho mob tau tsim muaj qhov tshwm sim ntawm Charcot tus kab mob ntshav qab zib, tom qab ntawv kho yuav tsum muaj kev kho mob antimicrobial nrog tshuaj tua kab mob. Txhawm rau kom tsis txhob mob qhov mob, cov tshuaj xws li Analgin lossis Ibuprofen kuj tseem siv.
Ib qho ntxiv, tus neeg mob yuav tsum yauv mus rau ntau qhov kev kho mob uas tau tsom mus rau kev kho kom rov zoo siab thiab txhim kho cov ntshav ncig hauv thaj chaw ntawm tus taw. Tsis tas li, tus kws kho mob tuaj yeem sau tshuaj muab tshuaj antiseptic.
Ntxiv rau cov duab hluav taws xob, cov duab hluav taws xob resonance imaging kuj tseem siv. Hauv qee kis, scintigraphy ntawm lub cev pob txha ntawm taw yog qhia.
Tag nrho cov ntsuas kev kuaj mob pab txiav txim siab txog qib kev hloov pauv, muaj cov pob txha me thiab qhov ntshav ntws hauv thaj chaw muaj kev cuam tshuam. Yog tias tsim nyog, cov cim cim cim cim (biochemical) ntawm cov pob txha lwj tau raug ntsuas.
Cov cim rau cov ntaub so ntswg ua kom zoo dua kuj tseem coj mus rau hauv tus account, raws li lawv qhia tias cov kab mob enzyme. Cov ntaub ntawv no yuav pab tau zoo tom qab lub sijhawm postoperative uas ua tom qab txiav tu ib qho kawg.
Txhawm rau txiav txim siab rau qhov ua rau pob txha rhuav tshem, koj yuav tsum tau kuaj ntshav tawm ntawm osteomyelitis.
Kev Kho Mob
Ua ntej tshaj plaws, nws yog qhov tsim nyog kom nkag siab tias kev kho mob yuav muab tau qhov txiaj ntsig siab tshaj plaws yog tias ib tus neeg yuav kho tus kws kho mob raws sijhawm. Cov neeg muaj tus mob ntsuas ntshav qab zib yuav tsum soj ntsuam lawv txhais taw tas li.
Txhua tus tuaj yeem kawm qhov kev ntsuas tseeb yog tias nws thov kev pab ntawm kws kho mob tsim nyog. Raws li qhov tshwm sim, ib tus neeg yuav tsum tau tsim ib txwm los tshuaj xyuas nws nqaj qis dua, tshwj xeeb, nws txhais taw.
Sai li ib qho, txawm tias muaj hnub nyoog me me, kev hloov pauv ntawm tus qauv tau txheeb xyuas, koj yuav tsum sab laj nrog kws kho mob sai. Tsis tas li ntawd, nws yog ib qho tseem ceeb uas yuav tau xav txog qhov twg yog qhov feem ntau nrog rau tus mob Charcot-Marie, uas yog mob mob hauv ko taw vim tias atrophy ntawm cov leeg paj. Nws zoo nkaus li tus neeg hais tias cov kev raug mob no tseem me, txawm li cas los xij, kev raug mob hnyav heev.
Yog tias qhov mob txhab tshwm rau ntawm ko taw, tom qab ntawd lawv yuav tsum tau kuaj nrog kev tsim ntawm qhov tob. Txog qee qhov mob txhab, kev rov qab mob nrog orthopedic insoles yog qhia. Cov insoles no ua rau txo qis ntawm kev ntxhov siab thaum taug kev. Yog tias qhov kev ntsuas no tsis txaus, tom qab ntawd siv cov immobilization, uas tiv thaiv ib qho cuam tshuam rau ntawm daim tawv nqaij.
Kev phais mob tuaj yeem yog kws kho mob yog tias qhov txhab mob tau kis mus rau theem ntawm dermis. Thaum kho qhov tseeb ntawm kev kis mob, tus kws kho mob tau sau ntawv siv tshuaj tua kab mob. Hauv qee kis, mob pob qij txha ntev mus rau kev ua kom yuag. Hauv qhov no, xav tau kev phais mob kom tshem tawm cov mob txhab no.
Ib qho piv txwv yog lub pob txha metatarsal, uas tuaj yeem tshem tawm nrog lub qhov txhab ua haujlwm nyob hauv lub forefoot.
Txum Tim Rov Qhab Zog ko taw
Thaum uas qhov mob ko taw ko taw tshwm sim, kev kho mob tsom mus rau kev tshem tawm mob rau sab hauv thiab kiav txhab. Kev phais mob tuaj yeem kho tau raws li kev kho mob rov qab yog tias yuav tsum tau kho ntawm ko taw deformation.
Kev rov ua dua ntawm arthrodesis thiab pob txha qauv yog nruab nrab, uas ua rau muaj kev nce siab ntawm cov nplais ntoo. Yog li, qhov ua tsis kho qhov txhab tshwm.
Txhawm rau siv cov txuj ci zoo li no, nws yog qhov tsim nyog kom ua tiav qhov nres ntawm cov txheej txheem thiab qhov tsis muaj osteolysis. Yog tias cov xwm txheej no tsis tau pom, nws zoo li kev ua haujlwm yuav ua rau foci tshiab ntawm kev rhuav tshem.
Ua ntej kev phais mob, koj yuav tsum ntxiv dag zog rau cov pob txha siv qee yam kev qhia. Rov kho ko taw yog qhov tsim nyog thaum nws raug mob hnyav, uas ua rau kev siv cov khau orthopedic tsis muaj txiaj ntsig.
Kev Tiv Thaiv
Ua ntej tshaj plaws, koj yuav tsum tau soj ntsuam tas li ntawm tus taw ntawm lawv tus kheej. Ntawm thawj qhov kev tshwm sim ntawm daim tawv nqaij los yog nws cov deformation, koj yuav tsum sab laj nrog tus kws endocrinologist.
Nws yog ib qho tsim nyog yuav tsum tso tseg cov txiab uas txiav cov rau tes. Nws yog qhov zoo tshaj plaws los siv cov ntaub ntawv ntsia thawv. Cov nqaim khau yuav tsum tau muab pov tseg thaum lawv thawm ntawm lawv ko taw thiab daim ntawv hu ua calluses.
Nws yog ib qho tseem ceeb tiv thaiv taw ntawm kev cuam tshuam ntawm ntau yam kub. Yog tias qhov mob pom, nws yuav tsum tau kho nrog 3% hydrogen peroxide tov lossis chlorhexidine nrog daim ntaub qhwv. Hauv qhov xwm txheej no, koj siv tsis tau cov khoom uas muaj cov nyhuv tanning. Cov nyiaj no suav nrog:
- cov ntsuab
- iodine
- poov tshuaj permanganate.
Nws yog ib qho tsim nyog yuav tsum xyuas kom meej tias cov tawv nqaij qhuav. Koj tuaj yeem siv cov cream ua, piv txwv, Balzamed lossis Callusan. Daim vis dis aus hauv tsab xov xwm no tham txog cov ntaub ntawv ntawm tus mob ntshav qab zib ko taw.
