Cov cim, tsos mob thiab kho tus mob ko taw

Ntshav qab zib mellitus yog ib qho ntawm cov kab mob ntev, nrog ntau yam mob. Qhov phom sij tshaj plaws yog tus mob ko taw mob ntshav qab zib, uas cuam tshuam rau cov hlab ntsha, cov hlab ntsha, pob qij txha, ntxiv rau kev sib xyaw ntawm daim tawv nqaij.

Txoj kev pheej hmoo ntawm nws tshwm sim nce nrog ntev ntev decompensation ntawm ntshav qab zib thiab nrog kev paub ntawm tus kab mob tshaj li 5 xyoo. Kev paub thaum ntxov tuaj yeem nres kev txhim kho ntawm cov teeb meem, thiab tsis tuaj yeem kho cov sijhawm, qhov zoo li ntawm kev phais mob ntau ntxiv.

Ua rau muaj tus kabmob

Tus mob ntshav qab zib mob ko taw muaj ib qho ICD code 10 - E10.5 lossis E11.5, uas tsim qauv ntshav qab zib hom 1 lossis hom 2, feem.

Teeb meem txhais tau tias muaj kev hloov pauv cuam tshuam rau cov leeg ntshav ntawm leeg ntshav thiab leeg ntshav.

Raws li qhov ua txhaum cai, ulcerative necrotic txheej txheem tuaj yeem tsim nyob rau hauv lub cev thiab kev ua haujlwm gangrene.

Qhov:

• trophic mob - tshwm sim hauv 85% ntawm cov neeg mob;
• phlegmon;
• abscesses;
• tenosynovitis;
• osteomyelitis;
• cov kab mob ntshav qab zib;
• purulent mob caj dab.

Lub pathogenesis ntawm kev rov qab yog qhov tsis txaus tsim ntawm cov kua dej yuav tsum tau ua kom tawg ntawm cov piam thaj.

Raws li qhov tshwm sim, qib ntawm glycemia nce siab, cuam tshuam tsis zoo rau cov ntshav khiav thiab tsis hnov ​​qhov muag ntawm cov hlab ntaws. Daim duab no qhia tau hais tias qhov kev tshwm sim zoo li cas nyob rau hauv theem pib.

Cov qauv ntawm pathology:

1. Neuropathic - cov leeg mob hlwb cuam tshuam. Daim foos no yog tsim los ntawm qhov tsim muaj qhov ua kom mob, Charcot txoj kev sib koom lossis qhov ua kom zoo nkauj puffiness.
2. Ischemic - tshwm sim vim yog atherosclerosis, uas cuam tshuam cov hlab ntsha hauv ob txhais ceg thiab cuam tshuam cov ntshav ntws hauv lawv.
3. Sib xyaw - sib txuas ua kev puas tsuaj rau cov hlab ntsha thiab cov hlab ntshav.

Vim li cas rau qhov tsos:

• poob lossis poob qis ntawm qhov rhiab heev nyob rau hauv qhov kawg vim yog neuropathy nrog ntshav qab zib;
• circulatory ntshawv siab cuam tshuam rau cov hlab ntsha thiab cov hlab ntsha (mob ntsws);
• atherosclerosis - ib qho kab mob feem ntau tshwm sim tiv thaiv keeb kwm ntawm cov roj (cholesterol) ntxiv hauv cov ntshav;
• deformation ntawm taw;
• qhuav ntawm daim tawv nqaij nto;
• hnav cov khau kom nruj, nrog rau kev nyuaj siab kho tshuab uas ua rau daim tawv nqaij puas tsuaj;
• fungal qhov txhab;
• kev saib xyuas tsis zoo ntawm tus kws kho mob thaum phais mob tshem tawm ntawm tus ntsia thawv ingrown ntsia hlau.

Kev phom sij ntawm cov teeb meem tau piav qhia los ntawm qhov tseeb hais tias cov neeg mob rau lub sijhawm ntev tsis pom tias muaj qhov xaum, puas, tawg ntawm ob txhais taw ntawm daim tawv nqaij, uas tom qab ntawd tig mus rau hauv qhib lossis kaw qhov mob.

Cov tsos mob thiab cov tsos mob

Cov kev mob tshwm sim thaum tus mob mus txog 5 theem ntawm nws txoj kev loj hlob:

1. Muaj mob rwj rau sab twg tsiag ntawv los ntawm qhov chaw txhab ntawm cov khaubncaws sab nraud ntawm cov tawv nqaij sab sauv.
2. Muaj tus mob loj, tab sis tsis muaj pob txha puas.
3. Mob rwj ntau hauv qhov tob pom, nrog daim tawv nqaij mob, nrog rau cov nqaij mos uas nyob ib ncig ntawm.
4. Ib qho "Charcot tus taw" yog tsim, tus yam ntxwv pom ntawm laib nyob rau qee thaj chaw (piv txwv li tus ntiv tes).
5. Ib qho kev sib deev tsis sib haum yog tsim, uas tuaj yeem ua rau lub txiaj ntsig tuag thiab xav kom txiav tawm sai ntawm tus caj npab cuam tshuam.

Qhov tshwm sim ntawm tus mob tshwm sim yog:

• ib feem lossis ua tiav poob ntawm qhov rhiab siab, uas tau hais tawm thaum tsis muaj qhov tshuaj tiv thaiv rau kev vibration, tom qab ntawd hloov mus rau qhov kub thiab txias, thiab tom qab ntawd ua rau mob thiab kov;
• o tuaj;
• nce qaug zog hauv txhais ceg thaum taug kev;
• kev hnov ​​ntawm qhov mob ntawm sab ceg, uas ua rau nws tus kheej so, mus taus, thaum tsaus ntuj;
• tingling
• kev hnov ​​mob hauv lub taw;
• chilliness;
• kev tshem tawm ntawm daim tawv nqaij (qhov pom ntawm liab lossis cyanotic ntxoov);
• ib qho kev txo qis hauv cheeb tsam ntawm kab plaub hau ntawm ceg;
• kev hloov pauv ntawm cov xim lossis cov duab ntawm cov ntsia hlau;
• lub sijhawm ua kom ntev ntev rau qhov mob, qhov txhab lossis txawm tias khawb me me;
• cov tsos ntawm bruises nyob rau hauv cov rau tes, taw qhia kev txhim kho ntawm fungal tau tus kab mob thiab muaj kev pheej hmoo ntawm necrosis;
• tsim muaj mob rau ntawm taw.

Txhawm rau txhawm rau pom ntau cov tsos mob no, koj yuav tsum ntsuas xyuas ob txhais ceg nrog kev pab ntawm daim iav tsom hauv qab. Thaum lub sijhawm tshuaj xyuas, nws yog ib qho tseem ceeb kom kuaj xyuas qhov chaw sib nrug, ib leeg thiab pob taws thaj chaw.

Charcot tus taw (mob ntshav qab zib osteoarthropathy)

Kev ua rau kev ua kom tsis zoo hauv kev ua kom tiav, dhau los ntawm ntau lub hlis, pab txhawb kom lub cev puas tsuaj ntawm ko taw. Tus mob no yog hu ua Charcot ua ke. Kev hloov pauv pathological cov yam ntxwv ntawm qhov kev cuam tshuam no feem ntau cuam tshuam tsis tsuas yog txhais ceg, tab sis kuj txhais tes.

Raws li qhov tshwm sim, cov neeg mob ntshav qab zib tsis hnov ​​mob hauv pob txha puas hauv thaj chaw puas, uas ntxiv rau nws tus mob. Maj mam, cov leeg mob neuropathic tshwm sim hauv tus taw, nrog ua ke ntawm kev tsim cov mob txhab.

Cov qauv ntawm tus kabmob:

• osteoporosis - yog tus cwj pwm los ntawm thinning ntawm tus pob txha, txo nws lub zog;
• osteolysis - ib qho mob uas cov pob txha tsis nqus kiag li;
• hyperostosis - nrog kev loj hlob ntawm cortical txheej ntawm pob txha.

Qhov tshwm sim "Charcot sib koom ua ke" yuav tsum tau tso dag zog kom ntau li ntau tau los ntawm cov thauj khoom kom cov leeg pob txha tuaj yeem rov zoo dua. Hauv cov xwm txheej zoo li no, cov neeg mob tau qhia kom hnav cov khau orthopedic nkaus xwb.

Mob ntshav qab zib kho ko taw

Kev xa mus rau sijhawm kom sai ntawm tus neeg mob mus rau cov chaw tshwj xeeb koom nrog kev kho mob ntshav qab zib ua rau nws muaj peev xwm tso tseg qhov kev vam meej ntawm kev nthuav qhia cov tsos mob ko taw thiab txhim kho lawv tus mob.

Kev siv cov tshuaj muaj txiaj ntsig tsuas yog nyob rau theem thaum ntxov ntawm kev txhim kho ntawm cov teeb meem. Kev kho mob caj dab yog twb tau ua phais mob.

Yuav kho cov mob kiav txhab li cas?

Txoj kev kho rau cov teeb meem yuav tsum muaj kev nthuav dav. Cov hau kev ntawm kev kho cov mob rwj yog nyob ntawm lub xeev cov ntshav khiav hauv nqua.

Txoj kev kho kom ntshav ntws muaj xws li:

• saib xyuas cov qhov txhab thiab mob txhab;
• txo tus nqi load siv rau ntawm qhov povtseg;
• tshem tawm cov kev sib kis tau los ntawm kev siv cov tshuaj tua kab mob;
• glycemic tswj tau ua nyob hauv tsev;
• kev tshem tawm cov dej cawv, nrog rau kev haus luam yeeb tsis tas.
• kev kho mob ntawm concomitant pathologies uas ua rau muaj kev pheej hmoo ntawm txhais ceg txiav (mob siab, mob ntshav oncology, ntshav liab).

Nrog cov ntshav ntws tsis zoo, ntxiv rau cov khoom saum toj no, ntsuas tau coj los kho nws.

Txoj kev kho cov nqaij mos ua kom tus mob necrosis thiab mob txhab rau:

• kev phais mob;
• txiav tes taw yog tias tsis muaj kev cuam tshuam los ntawm txoj kev kho.

Nws yog ib qho tseem ceeb kom nkag siab tias kev tshem tawm tes taw yog suav tias yog qhov kawg thiab ua rau cov neeg mob hnyav.

Cov Tshuaj Kho Mob

Cov tshuaj hauv qab no tuaj yeem raug kho rau cov neeg mob uas tau hais tawm qhov tshwm sim ntawm pathology:

1. Cov tshuaj muaj alpha-lipoic acid (Thiogamma, Thioctacid, Berlition) Cov tshuaj ua haujlwm tseem ceeb ntawm cov tshuaj no pab tshem tawm cov dawb radicals, rov qab ua kom ntshav khiav, thiab ua kom zoo dua ntawm cov hlab ntsha.
2. Cov vitamins los ntawm pawg B (Milgamma, Neuromultivit). Cov tshuaj daws tau ntxiv rau qhov nyiaj ntawm cov ntsiab no tsis muaj zog tiv thaiv keeb kwm ntawm tus kab mob.
3. Tshuaj siv rau kev kho mob tus yam ntxwv. Kev siv cov pa tshuaj tiv thaiv kev ua kom tsis haum lossis tshuaj tiv thaiv kev ua kom zoo tsuas yog pib thaum ntxov ntawm qhov tsos mob tshwm sim, txij li yav tom ntej, cov neeg mob txo lawv lub siab thiab tsis muaj qhov hnov ​​ntawm qhov mob.
4. Cov tshuaj anticonvulsant, tshuaj tiv thaiv kab mob. Lawv qhov kev siv yog ua tau tsuas yog thaum tsis muaj glaucoma hauv cov neeg mob. Txwv tsis pub, txoj kev kho tuaj yeem cuam tshuam rau txoj kev mob siab.
5. Txhais tau tias txhawb kev tsim cov nqaij ua rau thaj chaw mob txhab (Eberprot-P). Kev txhaj tshuaj ntawm cov tshuaj no ua rau muaj qhov pheej hmoo sai ntawm qhov mob uas tau tshwm sim thiab pab tus neeg mob ua yam tsis tau txiav tu.
6. ACE inhibitors. Lawv pub koj tswj cov ntshav siab.
7. Calcium antagonists. Kev siv tshuaj yog qhov tsim nyog los rov qab cov nyiaj ntawm lub cev no hauv lub cev.
8. Thiazide diuretics kho rau kev kub siab.
9. Cov tshuaj noj muaj roj ua kom tsawg.
10. Antiplatelet tus neeg sawv cev. Kev npaj muaj acetylsalicylic acid txo qhov ntxim nyiam ntawm kev zwm plab menyuam yaus.
11. Cov tshuaj vasoactive. Lawv pab txhim kho kev ntshav nyob hauv thaj chaw ischemic.

Kev kho mob nrog cov teev tau txhais tau qeeb ntawm kev kho mob ntawm pathology, txhawb nqa cov tsos mob.

Kev phais mob

Kev phais mob siv rau hauv cov neeg mob uas mob ko taw muaj xws li cov hauv qab no:

• bypass phais - npaj los tsim ib qho kev txiav rau cov ntshav hauv cov hlab ntsha;
• sympathectomy - kev ua haujlwm tshem tawm ib feem ntawm lumbar ganglia;
• zais pa angioplasty - yuav pab kho vascular lumen;
• txiav tes txiav - tshem tawm cov ntaub so ntswg thiab sib txuas ntawm pob txha caj qaum - pob txha uas tau ploj mus tsis taus.

Txoj kev phais mob tsuas yog siv nyob rau hauv kev mob hnyav, thaum kev siv tshuaj kho mob tsis muab cov nyhuv tsim nyog.

Kev tiv thaiv kab mob

Nws yog ib qho tseem ceeb kom nkag siab tias kev tiv thaiv kev mob nyhav yooj yim dua li sim kho lawv. Cov kev tiv thaiv kev tiv thaiv yog txiav txim siab los ntawm kev saib xyuas txhua hnub kev cai khau thiab kev paub khau.

Kev saib xyuas ko taw yog ua raws li qee cov lus pom zoo.

Cov no suav nrog:

• mus rau tus kws kho mob yog tias pom muaj qhov puas tsuaj ntawm ko taw;
• txhua hnub ntxuav ko taw;
• kev soj ntsuam tsis tu ncua ntawm ob txhais ceg nrog daim iav kom paub meej tias puas muaj kev puas tsuaj;
• ko taw kub tswj;
• txhua hnub hloov cov thom khwm thiab thom khwm;
• zam kev raug mob ceg;
• qhov tseeb ntawm pedicure;
• kev siv cov nplaum ua kom tshem tawm cov ceg qhuav.

Cov khoom siv vis dis aus hais txog yuav tiv thaiv koj ob txhais ceg ntshav qab zib li cas:

Cov tib neeg muaj ntshav qab zib yuav tsum tau ris lawv nkawm khau. Qhov loj tshaj plaws yog tias nws yuav tsum xis nyob, dawb thiab haum rau ntawm nws txhais ceg. Lub xub ntiag ntawm deformity ntawm ko taw yuav tsum tau hnav khau orthopedic.

Nws yog ib qho tseem ceeb kom nkag siab tias qhov kev koom tes tsis tu ncua ntawm tus neeg mob rau kev tshem tawm cov tsos mob ntawm tus mob ko taw yuav ua rau muaj kev pheej hmoo sai.