Diabetic patients with the “pain”!
Posted on December 17, 2009
Filed Under Other complications | Leave a Comment
People are willing to enjoy the carefree life without pain. As everyone knows, the pain itself is a part of life. If a person’s life, never had a painful experience, then, in essence, he would not have felt deeply what is happiness. The same is true in patients with diabetes.
In many complications of diabetes, the incidence is the highest rate of diabetic neuropathy, especially peripheral neuropathy. Over half of diabetic patients with varying degrees of diabetic neuropathy. Clinical manifestations of neuropathy are diverse, the most common manifestation is abnormal pain, including hyperalgesia and pain disappeared. The so-called hyperalgesia, and some patients with distal lower limbs mainly manifested as pain and paresthesia, such as numbness, pins and needles, ants OK flu, severe patients with skin pants, quilts have unbearable pain. Despite the pain in these patients, and even in some patients complicated with depression, but not a foot ulcers. Another outstanding performance is diabetic neuropathy pain disappeared, when these patients inappropriate, such as wearing tight shoes or shoes of a foreign body, such as small nail, the patient can not feel, or even enough of foot ulcers and even necrosis. This painless diabetic peripheral neuropathy in patients with diabetic foot more prone to disease, such as foot ulcers and ankle joint disease, some patients with subluxation of the ankle joint, bone crushing still no feeling. Some patients or even foot ulcers, inflammation and even foot necrosis, and finally was amputated.
Lao Li is a more than 60-year-old has a 20-year history of diabetes, there are times at the end of a walk, he felt that something was amiss right foot, one would have passed, he did not attach importance to. A month later, he was found in the feet found right foot at the end of redness and has a small hole, he squeezed his hand in the hole next to the result out of a nail, he came to our center when the foot clinic with severe ulcer and infection. After nearly 2 months of hospital treatment, local debridement and systemic treatment, cost of 1 million yuan, has finally keep his right foot. Xiao is 10 years of history of diabetes, type 1 diabetes patients with lower extremity feeling particularly cold winter, so will be enough to put on the stove next to the heating, the results of both feet at the end of burn, partial skin necrosis and severe infection, to our center feet at the end of black, festering. After debridement, and systemic support for anti-infective therapy, spent 2 million yuan, to keep the feet. Such a lot of clinical cases, see.
A foreign expert said the well, pain is God’s gift of human gifts. Because of pain, we will adjust our behavior in order to avoid injury, such as when we wear shoes too small narrow shoes, there are foreign bodies or our contact with the object is too hot, too hot to Xijiao Shui, we will instinctively to avoid the sum of correct our behavior, we have adequate protection measures will avoid the occurrence and development of foot ulcers. However, the sensory loss of the foot there is no such warning and acts of corrective measures. Clinically, at home and abroad to reduce the rate of diabetic foot gangrene and amputation experience, timely detection of loss of pain in patients with diabetes and taught how to prevent foot damage is very important.
Clinically, for all diabetic patients should be carried foot sensory testing, such as shallow enough to feel the skin (needle sensation, temperature sensation, etc.) and deep sensation (foot Achilles tendon reflex, knee reflex, etc.). Once a patient has feeling abnormal, which should remind the patient attention to wear the appropriate footwear to avoid foot damage, including the avoidance of foot was scalded and correct nail cutting methods. Through careful screening of active diabetic foot disease risk factors and to correct, diabetic foot and gangrene will be a significant decrease. Overseas experience is that a good risk factors for diabetic foot screening and foot disease preventive measures, so that some Western countries of diabetes amputation rate has dropped by a third to two-thirds. That is why the International Diabetes Federation in 2005 will be diabetes and foot protection as that year’s World Diabetes Day slogan. Prevention is the prevention and treatment of diabetic foot and lower the diabetic lower limb amputation the most fundamental measures.
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