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各位朋友:
大家好,现在是“每天健康三分钟”时间,我是道简-心血管康复医生集团、河南中汇心血管医院康复治疗师宋梦瑾。今天我给大家讲的是糖尿病足。
首先先简单的了解一下糖尿病足,它就是糖尿病患者因下肢远端神经异常和不同程度的周围血管病变导致的足部感染、溃疡和(或)深层组织破坏。同时也是糖尿病患者致残、致死的主要原因之一。
糖尿病足的患病率在逐渐增加,据估计,全球每20秒钟就有一例糖尿病患者截肢,而且糖尿病足的预后也很差,甚至比大多数癌症的病死率和致残率还高。糖尿病足溃疡患者年死亡率高达11%,而截肢患者死亡率更是高达22%;它的主要不良结局就是截肢和死亡。轻度糖尿病足出现手脚麻木、对温度感觉不敏感等神经症状;重度糖尿病足会出现严重的溃疡、感染、血管疾病、神经病变性骨折,甚至截趾、截肢。
糖尿病足的预防胜于治疗,通过加强对糖尿病患者高危足的管理,可以降低糖尿病足的发生。下面就简单说一下糖尿病足的预防。
1.严格控制血糖
血糖控制达标,可以有助于减少糖尿病患者微血管并发症的发生。
2.戒烟
吸烟是糖尿病血管病变发生的一个独立危险因素,它会使血管收缩,妨碍血液循环。而且吸烟者比不吸烟者更加容易发生糖尿病足,每一位吸烟的糖尿病患者都应该戒烟或停用烟草类制品,并减少被动吸烟。
3.适度规律的运动
规律及适量的运动可增强胰岛素敏感性,有助于控制血糖,减轻体重和改善循环,减少心血管危险因素。最好是在医师的指导下,制定一个个体化的运动方案,一切以安全为前提。
4.预防足部破损
做好足部的保护和检查工作,尤其是已经存在糖尿病末梢神经病变的患者,因为这类患者很可能已出现破损,但自身是毫无感觉的。经常检查脚上是否有损伤,一定不要小看脚上的伤口,哪怕是很小,如果不注意的话,都有可能造成难以挽回的后果;穿宽松、软的布鞋或透气的皮鞋;每日用温水泡脚,禁忌热水烫脚;保持足部透气、干燥,预防脚癣。修剪指甲、胼胝或鸡眼时要严防损伤。
5.预防足部感染
感染是糖尿病足进展的真凶,平时要注意个人脚卫生;避免甲沟炎、脚气继发感染的发生;不建议去没有资质的场所修脚;足部出现损伤,尽早就医。
6.心血管疾病高危因素的控制
注意进行异常血脂和高血压的干预,血脂异常是引起糖尿病血管病变的危险因素;而高血压可通过加重周围动脉病变而增加糖尿病足溃疡的发生风险,同时它也是周围动脉病变出现间歇性跛行的危险因素。
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【英文版】
This article helps you understand diabetic foot
Dear friends, nice to meet you!Now it is time for “Health talk for three minutes every day”,My name is Song Mengjin, a rehabilitation therapist of Daojian Doctor Group of Cardiovascular Rehabilitation and Henan Zhonghui Cardiovascular Hospital.Today, I'd like to talk about diabetic foot.
First of all, let's have a brief understanding of diabetic foot.Diabetic foot refers to the foot infection, ulcer and (or) deep tissue destruction caused by peripheral vascular diseases and abnormal distal limb nerves in diabetic patients. At the same time, diabetic foot is one of the main causes of disability and death in diabetic patients
The prevalence of diabetic foot is increasing gradually. It is estimated that one diabetic patient is amputated every 20 seconds in the world, and the prognosis of diabetic foot is very poor, even higher than the mortality and disability rate of most cancers. The annual mortality rate of diabetic foot ulcer patients is as high as 11%, and the mortality rate of amputation patients is as high as 22%. The main adverse outcomes of diabetic foot are amputation and death. Mild diabetic foot patients will have numbness of hands and feet, insensitivity to temperature and other neurological symptoms, while patients with severe diabetic foot will have severe ulcer, infection, vascular disease, neuropathic fracture, and eventually the patient will undergo toe or extremity amputation.