Treatment of diabetic foot good blood sugar
control is the foundation should, in addition to specialist treatment for
peripheral vascular disease, main Integrative six one route of administration of
treatment, oral medicine Huoxuetongmai, improve microcirculation, intravenous
infusion of trophic nerve, dilate blood vessels to correct metabolic disorder
with vascular perfusion, foot bath and fumigation treatment of diabetic foot
prevention goal is prevention, early diagnosis, early treatment, not only can
significantly improve the quality of life of diabetic patients, but also greatly
reduce the medical expenses has important social and economic benefits.
1, the general treatment:
Support (1) symptomatic treatment, including activity restriction, weight loss, Taigaohuanzhi in order to facilitate blood return leg, reducing edema.
(2) strict control of blood glucose, insulin limb is better to apply positive corrective ketoacidosis, hypoproteinemia, heart, brain, kidney complications and gangrene healing a variety of adverse factors.
(3) debridement: removal of necrotic tissue, drainage placed, such as routine disinfection, dressing.
(4) patient education, foot care, and to prevent the damage from the outside.
2, anti-infective
Pathogens in diabetic foot infection, Staphylococcus aureus is a common, followed by streptococci, enterococci, Enterobacteriaceae, and anaerobic. Take lesion secretions for bacterial culture as soon as possible after admission, first with the commonly used antibiotic therapy until culture results after the switch to effective antibiotics, in addition also added anti-anaerobic agents.
3, the treatment of ischemic foot ulcers
(1) for vascular disease is not very serious or there is no indication for surgery, conservative treatment can be medical, the use of vasodilators such as prostaglandin E-2 654-2 and traditional Chinese medicine, such as breviscapine Shenmai.
(2) For severe cases of vascular lesions, on the basis of conservative treatment, you should line the blood vessel revascularization. The methods are: vascular bypass grafting, carotid endarterectomy, the pedicled omental graft surgery, angioplasty and other percutaneous vascular lumen.
(3) for gangrene in patients with rest pain and a wide range of vascular lesions revascularization should be bold and amputation, amputation is the best line before angiography to determine the amputation plane.
(4) hyperbaric oxygen therapy (HBD): high-pressure oxygen can improve vascular metaplasia of the new organization, to increase collagen synthesis, improve the bactericidal action of neutrophils, but can also promote the synthesis of platelet-derived factor, the factor to promote wound healing. Pulmonary infection is not to use the hyperbaric oxygen therapy.
(5) UV irradiation and oxygenation of blood transfusion therapy (UBID): has antibacterial anti-inflammatory, improve immunity to increase tissue oxygen supply, and reduce blood viscosity and blood lipids, improve blood circulation and role.
4, neuropathic foot ulcers treatment
(1) 90% of the change of foot abnormal stress neuropathic ulcers can be reasonably conservative treatment and healing. The processing key is to reduce the pressure of the primary disease, foot pressure gauge for pressure distribution, and then use special orthopedic shoes or orthoses to change the pressure of the patient's feet.
(2) available B vitamins to improve nerve function, nerve growth factor can promote nerve cell nucleic acid and protein synthesis, and promote axonal regeneration of myelin formation.
(3) cover the dressing dressing to prevent further damage to the wound, reducing the risk of infection, keep the wound healing, the ideal environment. Selectable antibiotic diluent, vitamin mixture, bFGF deposition temperature.
5, amputation
Still active conservative treatment of gangrene, should be timely amputation amputation site to accurately estimate the local loop should be made to ensure good loop height.
1, the general treatment:
Support (1) symptomatic treatment, including activity restriction, weight loss, Taigaohuanzhi in order to facilitate blood return leg, reducing edema.
(2) strict control of blood glucose, insulin limb is better to apply positive corrective ketoacidosis, hypoproteinemia, heart, brain, kidney complications and gangrene healing a variety of adverse factors.
(3) debridement: removal of necrotic tissue, drainage placed, such as routine disinfection, dressing.
(4) patient education, foot care, and to prevent the damage from the outside.
2, anti-infective
Pathogens in diabetic foot infection, Staphylococcus aureus is a common, followed by streptococci, enterococci, Enterobacteriaceae, and anaerobic. Take lesion secretions for bacterial culture as soon as possible after admission, first with the commonly used antibiotic therapy until culture results after the switch to effective antibiotics, in addition also added anti-anaerobic agents.
3, the treatment of ischemic foot ulcers
(1) for vascular disease is not very serious or there is no indication for surgery, conservative treatment can be medical, the use of vasodilators such as prostaglandin E-2 654-2 and traditional Chinese medicine, such as breviscapine Shenmai.
(2) For severe cases of vascular lesions, on the basis of conservative treatment, you should line the blood vessel revascularization. The methods are: vascular bypass grafting, carotid endarterectomy, the pedicled omental graft surgery, angioplasty and other percutaneous vascular lumen.
(3) for gangrene in patients with rest pain and a wide range of vascular lesions revascularization should be bold and amputation, amputation is the best line before angiography to determine the amputation plane.
(4) hyperbaric oxygen therapy (HBD): high-pressure oxygen can improve vascular metaplasia of the new organization, to increase collagen synthesis, improve the bactericidal action of neutrophils, but can also promote the synthesis of platelet-derived factor, the factor to promote wound healing. Pulmonary infection is not to use the hyperbaric oxygen therapy.
(5) UV irradiation and oxygenation of blood transfusion therapy (UBID): has antibacterial anti-inflammatory, improve immunity to increase tissue oxygen supply, and reduce blood viscosity and blood lipids, improve blood circulation and role.
4, neuropathic foot ulcers treatment
(1) 90% of the change of foot abnormal stress neuropathic ulcers can be reasonably conservative treatment and healing. The processing key is to reduce the pressure of the primary disease, foot pressure gauge for pressure distribution, and then use special orthopedic shoes or orthoses to change the pressure of the patient's feet.
(2) available B vitamins to improve nerve function, nerve growth factor can promote nerve cell nucleic acid and protein synthesis, and promote axonal regeneration of myelin formation.
(3) cover the dressing dressing to prevent further damage to the wound, reducing the risk of infection, keep the wound healing, the ideal environment. Selectable antibiotic diluent, vitamin mixture, bFGF deposition temperature.
5, amputation
Still active conservative treatment of gangrene, should be timely amputation amputation site to accurately estimate the local loop should be made to ensure good loop height.
