Thaum tus neeg mob ntshav qab zib mellitus, qee zaum kev noj qab haus huv tsis zoo, qee zaum pom, mob ntshav qab zib ko taw tshwm sim nws tus kheej (ICD code - 10). Deterioration tshwm sim, raws li txoj cai, los ntawm kev ua txhaum ntawm tus neeg mob nws tus kheej. Qhov laj thawj yog vim li cas nws tsis ua raws li kev noj zaub mov tshwj xeeb thiab tsis ua raws li kev teem caij ntawm tus kws kho mob tshwj xeeb. E 10, 5 - ICD code 10 ntawm tus mob ntshav qab zib ko taw yog kab mob txaus ntshai heev uas tuaj yeem ua rau cov nqaij mos necrosis (gangrene).
Vim kev kawm
Qhov mob ntshav qab zib ko taw, ICD code 10 uas yog E 10, 5, tshwm sim vim tsis saib xyuas cov cai tsim los ntawm tus neeg mob nws tus kheej. Thaum tus neeg mob tsuas yog tsis saib xyuas nws txoj kev noj qab haus huv, noj tsis raug, tsis kam kho. Tus cwj pwm ntawm kev noj qab haus huv no tuaj yeem ua rau muaj kev nyuaj siab.
Nkauj tawm tshiabDiabetic foot Syndrome (ICD 10 E10.5) yog cov mob yav dhau los thiab raug mob. Ntxiv rau txhua yam, ntau nyob ntawm cov tshuaj nws tus kheej, ntawm nws qhov zoo thiab qhov tseeb npaum li cas ntawm cov tshuaj. Nws yog vim hais tias ntawm tag nrho cov saum toj no cov kab mob ntawm cov ntshav qab zib ko taw yog tsim - lub pathology ntawm cov hlab ntsha ntawm lub qis extremities. Feem ntau cov kev pheej hmoo yog cov neeg mob ntshav qab zib hom 2.
Mob ntshav qab zib ko taw yog tus cwj pwm los ntawm cov ntaub so ntswg puas ntawm ko taw. Thaum lawv qhov mob tshwm sim, qhov tshwm sim yog suppuration hnyav, uas tuaj yeem loj hlob mus rau hauv gangrene ntawm tus mob ntshav qab zib ko taw, raws li ICD 10, tus lej yog E 10-14 nrog tus nqi thib plaub 5.
Ib yam ntawm cov kab mob tuaj yeem ua rau mob ntshav qab zib neuropathy - kev ua txhaum ntawm cov hlab ntsha ntawm sab qis, uas cuam tshuam los ntawm kab mob.
kab mob daim ntawv
Nyob rau lub sijhawm no, rov qab rau xyoo 90s, thawj lub rooj sib tham thoob ntiaj teb tau tuav, uas tau mob siab rau kev txiav txim siab txog kev mob ntshav qab zib ko taw. Thaum kawg, qhov kev faib tawm ntawm tus kab mob tau tsim thiab nws cov ntaub ntawv nce qib tau raug txheeb xyuas.
Txhim kho cov kab mob no:
- Neuropathic - ua rau muaj kev cuam tshuam ntawm lub paj hlwb. Nws manifests nws tus kheej li o, ulceration, kev puas tsuaj ntawm articular ntaub so ntswg.
- Ischemic - qhov tshwm sim ntawm atherosclerotic tshwm sim, vim tias cov ntshav ncig hauv qis qis yog cuam tshuam.
- Neuroischemic, paub zoo tias yog sib xyaw. Daim ntawv no suav nrog cov tsos mob ntawm obyam dhau los.
Thaum kuaj pom ib tus kab mob, koj yuav tsum tsis txhob noj tshuaj rau tus kheej thiab siv cov tshuaj ib txwm siv. Raws li kev xyaum qhia, cov txheej txheem zoo li no tsis zoo thiab qee qhov tuaj yeem ua haujlwm nrawm rau kev txhim kho cov kab mob.
Feem ntau hauv ntshav qab zib muaj ib daim ntawv neuropathic, me ntsis tsawg dua - neuroischemic. Hauv qhov tsawg kawg nkaus, daim ntawv ischemic tshwm sim. Yog li ntawd, ua ntej pib kev kho mob, tus kws kho mob tshwj xeeb yuav tsum txiav txim siab txog hom kab mob thiab, raws li qhov no, pib kho.
Vim li cas thiaj muaj teeb meem?
Thaum muaj teeb meem hauv ntshav qab zib mellitus ntawm tus neeg mob ko taw (ICD - 10 E 10, 5), dhia hauv cov ntshav qab zib tshwm sim, nws ua rau muaj kev phom sij, tshwj xeeb tshaj yog tias cov xwm txheej zoo li no tseem tsis hloov mus ntev. Cov piam thaj siab siab ua rau tsis zoo rau cov hlab ntsha thiab cov hlab ntsha. Ua ntej, capillaries raug kev txom nyem, lawv maj mam pib tuag, tom qab tus kab mob cuam tshuam rau cov hlab ntsha loj. Tag nrho cov no cuam tshuam rau cov ntshav ncig. Vim li no, rov qab tshwm sim, uas yog nrog los ntawm cov ntaub so ntswg necrosis.
Qhov xwm txheej yog qhov hnyav dua los ntawm qhov tseeb tias ko taw yog ib feem ntawm lub cev, nws ua haujlwm tas li, nws raug cuam tshuam los ntawm kev thauj khoom. Qhov no ntawm tib neeg lub cev feem ntau raug mob. Roj hmab, nqaim, khau tsis xis nyob, lossis khau ua los ntawm cov hluavtaws fibers yog qhov muaj feem pheej hmoo kis tus kabmob.
Qee zaumtib neeg yuav tsis pom cov kab nrib pleb me me, txiav, khawb, khawb, tawg, nqaij tawv thiab txawm tias muaj cov kab mob fungal, tag nrho cov no muaj txiaj ntsig zoo rau kev nce hauv qhov txhab, vim tias tsis muaj ntshav txaus, kev tiv thaiv kev ua haujlwm hauv qhov chaw puas tsuaj tsis ua haujlwm. Qhov tshwm sim ntawm cov kev cuam tshuam no tshwm sim nyob rau hauv qhov ntev tsis kho ntawm qhov txhab, thiab thaum kis kab mob, cov kab mob loj, uas tuaj yeem nyuaj heev kom tshem tawm yam tsis muaj qhov tshwm sim, tshwj tsis yog kev kho mob thaum pib.
Thaum tus mob ntshav qab zib ko taw tsim, nws tsis tshua muaj peev xwm tshem tawm tus kab mob kom tiav, yog li, raws li txoj cai, nws yuav mob ntev. Vim li no, tus neeg mob yuav tsum ua raws li kev noj haus, nruj me ntsis raws li cov tshuaj thiab txhua yam uas tus kws kho mob qhia. Yog tias koj muaj teeb meem, koj yuav tsum mus rau tom tsev kho mob tam sim.
Neuropathic Neuropathic
Txhua hom kab mob no tshwm sim los ntawm tus kheej cov tsos mob. Piv txwv li, neuropathic yog tus cwj pwm los ntawm kev txo qis ntawm cov ko taw, tsim cov calluses ntawm lawv thiab deformation. Thaum mus rau hauv daim ntawv hnyav, cov kab mob tshwm sim hauv thaj chaw uas muaj pob kws, uas txawv ntawm cov duab sib npaug.
Ischemic
Daim ntawv ischemic yog tus cwj pwm los ntawm lub plawv tsis muaj zog, uas yuav luag tsis hnov tsw hauv thaj tsam ntawm ko taw. Nyob rau tib lub sijhawm, daim tawv nqaij ua daj ntseg thiab txias, thiab mob rwj kuj tshwm sim. Cov kab mob zoo li no tsis yog, lawv cov npoo tsis muaj ciam teb meej.
Neuroischemic
Neuroischemic suav nrog kev tshwm sim ntawm ob daim ntawv dhau los. Hauv tshuaj, rau theem ntawm tus kab mob yog qhov txawvko taw deformities:
- Tsev tsis muaj qhov txhab.
- Primary ulceration.
- Kev kawm qib siab, thaum cov leeg thiab cov leeg nqaij raug cuam tshuam.
- Ib daim ntawv siab, yog tias tam sim no, cov pob txha raug mob.
- pib theem ntawm gangrene.
- Ntau tus kab mob loj, nws cuam tshuam rau thaj chaw loj.
Thawj cov cim qhia txog qhov pib ntawm tus kab mob: loog ntawm ko taw thiab zoo li goosebumps rau lawv. Yog tias koj ntsib cov tsos mob no, koj yuav tsum hu rau tus kws kho mob tam sim ntawd.
Diagnosis
Kev kuaj mob tsuas yog ua tau los ntawm tus kws kho mob tshwj xeeb, tom qab kuaj xyuas tus neeg mob kom ntxaws, nrog rau kev kuaj mob, uas, dhau los, suav nrog: ua tiav cov ntshav suav, ultrasound ntawm cov hlab ntsha, paj hlwb. kuaj, dopplerography, X-ray ntawm cov hlab ntsha thiab ko taw, biopsy ntawm cov ntsiab lus rwj.
Thaum kuaj, ntsuas lub cev kub, mem tes, siab thiab ua pa ntsuas ntsuas. Tom qab ntawd, cov kab mob raug tshuaj xyuas thiab cov qib ntawm kev loj hlob ntawm tus kab mob raug tsim. Rau kev kawm paub ntau ntxiv txog qhov teeb meem, tus kws kho mob tuaj yeem ua qhov kev soj ntsuam thiab kev kho mob ntawm qhov txhab.
Kev kho mob
Thawj kauj ruam hauv kev kho mob yog qhov normalization ntawm cov ntshav qab zib, ntau npaum li nyob ntawm nws, suav nrog tag nrho cov txiaj ntsig tsis zoo. Kev kho mob ntawm ischemic thiab neuropathic degrees yog qhov zoo sib xws, lawv cov haujlwm tseem ceeb yog tsom rau kev txiav txim siab ntawm cov ntshav mus rau cov ceg. Qhov no tuaj yeem ua tiav nrog kev pab los ntawm kev kho mob lossis kev phais txoj haujlwm.
Nrog txoj kev khosau tshuaj tua kab mob thiab tshuaj uas txo qhov o thiab txhim kho cov ntshav. Thaum lub sij hawm phais, nws tuaj yeem rov pib dua hauv cov hlab ntsha yam tsis tau txiav daim tawv nqaij. Cov txheej txheem no yog ua tsaug rau punctures ntawm cov hlab ntsha los yog distal shunting. Rau cov neeg mob, cov txheej txheem tsis mob feem ntau yog tsim, cov kab mob tau ua tib zoo kho nrog tshuaj tua kab mob.
Nrog rau qib neuropathic, cov kws kho mob tshwj xeeb tsom mus rau qhov rov qab los ntawm innervation hauv cov ceg, rau qhov no qee zaum lawv siv cov tshuaj uas nws qhov kev txiav txim yog txhawm rau txhim kho cov txheej txheem metabolic. Nrog rau kev kho mob tsis tu ncua thiab cov kab mob siab heev, qhov tshwm sim tuaj yeem ua rau tu siab, tom qab ntawd cov kws kho mob yuav tsum txiav txim siab txog kev txiav cov ceg.
Ib yam tseem ceeb rau kev kho kom zoo yog qhov tsis lees paub tus cwj pwm phem, tshwj xeeb yog haus luam yeeb. Raws li koj paub, nicotine muaj kev cuam tshuam tsis zoo rau microvessels, nws yog vim qhov no tias kev kho mob tsis zoo lossis pab rau lub sijhawm luv luv.
Rau tus neeg mob ntshav qab zib ko taw, cov tshuaj hauv tebchaws tuaj yeem pom zoo ua kev kho mob ntxiv, vim tias siv sijhawm ntev, cov tshuaj ib txwm muaj tuaj yeem muab cov txiaj ntsig zoo. Lwm qhov zoo dua ntawm kev siv lawv yog lawv cov txiaj ntsig zoo uas tsis ua rau puas tsuaj.
Kho mob ntshav qab zib ko taw nrog cov tshuaj pej xeem, raws li txoj cai, ntau yam tshuaj ntawm lub hauv paus chiv keeb yog siv nyob rau hauv daim ntawv ntawm da dej, lotions thiab compresses. Decoctions thiab infusions ntawm kws tshuaj yog dav siv - chamomile, sage, eucalyptus, celandine. Cov tshuaj kho kom zoo yog tsim los ntawm cov tshuaj ntsuab lossis cov khoom lag luam muv, uas yog siv rau hauv daim ntaub qhwv rau ib lub sijhawm ntawm ob peb feeb mus txog ob peb teev.
tiv thaiv kab mob
Cov neeg mob ntshav qab zib tau qhia kom saib xyuas lawv txoj kev noj qab haus huv tsis tu ncua, ntsuas cov piam thaj hauv cov ntshav, siv cov tshuaj zoo uas tau dhau tag nrho cov kev tshawb fawb thiab kev sim.
Nws yog ib qho tseem ceeb rau hnav khau zoo ua los ntawm cov khoom zoo. Thaum hnav khau, tsis muaj microcracks lossis raug mob yuav tsum tshwm sim.
Tsis tas li ntawd, khau yuav tsum ua pa, ua rau daim tawv nqaij ua pa. Nws yog ib qho tsim nyog kom tsis txhob tsim cov chafing thiab calluses mus rau qhov siab tshaj plaws.
Nws yuav yog ib qho tseem ceeb rau kev saib xyuas kev huv ntawm ko taw, koj tuaj yeem siv cov tshuaj nplaum thiab tshuaj tsuag kom tsis txhob tawm hws ntau dhau.
Txhua txhua hnub, nws yog ib qho tseem ceeb kom ntxuav koj txhais taw kom huv si nrog xab npum ntxhua khaub ncaws, tiv thaiv cov kab mob, abrasions thiab lwm yam kev raug mob.
