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Loli心的怪蜀黎

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糖尿病足对糖尿病患者的 健康 危害很大,糖尿病足患者的年死亡率为,而截肢(包括大截肢和小截肢)后的5年死亡率高达40%。

作为一名医生,有责任通过科普文章,告诉广大糖尿病患者朋友,防治糖尿病足的正确策略:

为什么会发生糖尿病足,如何预防不发生糖尿病足,发生糖尿病足如何正确治疗?

为什么会发生糖尿病足

发生糖尿病足的主要原因是血糖升高,同时合并神经病变、血管病变,一旦发生糖尿病足,进展非常快。

如果糖尿病足的治疗不规范,病情会急剧恶化。

前段时间,科室接诊了一名糖尿病患者——李某某,因发现血糖升高20年,左足溃烂、坏疽2个月入院。

李某某为2型糖尿病患者,平常予胰岛素控制血糖,血糖控制欠佳,1月前曾经住外院,诊断为:“2型糖尿病:糖尿病足(Wagner4分级)糖尿病周围神经病变、糖尿病周围血管病变、败血症”,经过积极治疗,患者病情无明显好转,足部坏疽加重,感染不能控制,有截肢的指征,但患者及家属拒绝截肢而要求出院。

为进一步治疗又住我科,入院检查:体温39 ,左足前端发黑、红肿,伴有脓性渗出及恶臭,查血常规白细胞明显升高,血培养阳性,提示存在血液感染,血管造影检查下肢远端血管闭塞,很明显患者糖尿病足有截肢指征。

患者及家属再次拒绝截肢手术,认为“身体发肤,受之父母”,不敢毁伤,拒绝截肢,亦或者是其他原因拒绝截肢,反复劝说无效而再次要求出院,出院一周后随访,患者病情进一步加重,出现左足完全坏疽,感到非常可惜。

如何预防糖尿病足

1.定期做糖尿病足检查: 糖尿病足病强调“预防重于治疗”,糖尿病足病治疗困难,但预防则比较有效。应对所有糖尿病患者每年进行全面的足部检查,评估目前神经病变的症状(疼痛、烧灼、麻木感、感觉异常)和下肢血管疾病(下肢疲劳、跛行),以确定溃疡和截肢的危险因素。

2.学习糖尿病足预防相关知识: 系统的 健康 教育可以减少糖尿病足溃疡的发生,降低糖尿病足的复发率与截肢率,降低医疗费用和提高患者的生活质量。

3.识别糖尿病足的危险因素: 定期检查患者是否存在糖尿病足病的危险因素,足是否有畸形、胼胝、溃疡、皮肤颜色变化;足背动脉和胫后动脉搏动、皮肤温度以及有否感觉异常等。

4.注重日常生活护理: 洗脚时的水温要合适,低于37 ;不宜用热水袋、电热器等物品直接保暖足部;避免自行修剪胼胝或用化学制剂来处理胼胝或趾甲;穿鞋前先检查鞋内是否有异物或异常;不穿过紧的或毛边的袜子或鞋;水平地剪趾甲;由专业人员修除胼胝或过度角化的组织。

一旦发生糖尿病足,如何治疗

首先, 控制好血糖、糖化血红蛋白、血压、血脂等指标;

其次, 一旦发生足部溃疡,应及时就医,由专业医生评估足部溃疡性质,彻底的糖尿病足溃疡的清创,有利于溃疡愈合;

第三, 正规治疗,早发现、早诊断、早治疗,切莫病急乱投医,延误治疗。

第四, 出现截肢不要犹豫。 截肢是一项严重的致残性手术,在肢体完全失去生理功能的条件下,为了挽救或延长患者生命的一种不得已的措施,截肢术后,患者余生将失去一部分肢体,丧失一定的功能和造成某些缺陷。

截肢指征:

文章开始提到的患者李某某,诊断为糖尿病足合并足部坏疽,同时合并足部脓肿、败血症、下肢远端血管闭塞,经过内科保守治疗无好转,有截肢的指征,患者及家属因为各种原因拒绝截肢,反复劝说无效而出院,最终愈后差,感到非常遗憾。

在此提醒广大糖尿病患者,一定要注意预防糖尿病足,定期检查患者是否存在糖尿病足病的危险因素,注重日常生活护理,发现糖尿病足,要及时就医,切莫延误诊治。

参考文献: 《中国2型糖尿病防治指南(2020年版)》

作者: 梅高财 主任医师

单位: 怀化市第二人民医院(怀化市肿瘤医院)肾病内分泌科

怀化市糖尿病学专业委员会

怀化市内分泌学专业委员会

怀化市糖尿病康复协会

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阿哥丶WLy

糖尿病作为一种代谢性疾病,其患病率随经济的发展呈逐年增加趋势。糖尿病对人体的危害主要是造成各种器官功能障碍和衰竭。下面是我带来的关于糖尿病的英文 文章 ,欢迎阅读!

关于糖尿病的英文文章1

糖尿病英文简介-What is diabetes

Diabetes is a chronic condition that affects over 150 million people in the world today.

The precentage of people suffering from diabetes is increasing rapidly, to the point where many medical authorities are referring to it as an epidemic.

So what is diabetes?

Diabetes prevents your body from turning your food into energy. Instead glucose stays in your bloodstream, and left untreated can result in a range of complications.

If you have recently been diagnosed as diabetic, don't worry. With proper treatment and care, you will lead a normal and happy life. You may need to make a few changes in your lifestyle - but then, if you are like me, you probably had plans to do that anyway and just never got round to it.

Now is the time to kick yourself into action. You cannot leave this up to your doctor alone - it needs you to take responsibility for your own treatment, and that starts with understanding what you are dealing with.

There are three types of Diabetes:

Type 1 Diabetes, (sometimes called Juvenile Diabetes) is usually found in young children and teenagers, but can also occur later in life.

In Type 1 Diabetes, your body is not producing insulin, a hormone needed to convert blood sugar into energy. Normally this hormone is produced by cells in your pancreas, but for some reason this is not happening as it should.

As the glucose in your blood can't be converted into energy and absorbed by your cells, it builds up causing high blood sugar.

Left untreated, high blood sugar can cause serious long-term health problems.

The normal treatment for people with type 1 diabetes is daily injections of insulin which keeps the blood sugar level within normal ranges.

Finding out you have diabetes can be upsetting, but it should not prevent you from living a long and happy life.

If you think this condition will prevent you leading an active life, consider Sir Steve Redgrave, one of the World's greatest Olympic athletes.

Sir Steve battled type 1 diabetes to win his record-breaking fifth Olympic Gold medal at the Sydney games in the coxless fours rowing event!

Type 2 diabetes (sometimes called mature onset diabetes) is the most common form of diabetes.

As with Type 1 Diabetes, the problem is related to insulin, a hormone needed to convert sugar into energy.

With Type 2 diabetes your body might be producing too little insulin, or it might not be reacting to the insulin correctly. Either way, the end result is that glucose builds up in the bloodstream instead of going into the cells. Left untreated, high blood sugar can cause serious long-term health problems.

Type 2 diabetes usually appears later in life, often between the ages of 35-45 years. As it often develops slowly, many people may not recognise the symptoms, and may have diabetes without knowing it.

If you have recently been diagnosed with type 2 diabetes, you are one of the lucky ones. Many people have diabetes without knowing it, and are at much greater risk of long term medical complications.

Finding out you have diabetes can be upsetting, but it should not prevent you from living a long and happy life. You may need to make a few changes in your lifestyle, but these changes are also good advice for non-diabetics, so probably a good idea anyway.

Gestational diabetes is a type of diabetes, that is only suffered by pregnant women.

In Gestational diabetes, a woman’s blood sugar is higher than normal because of the other hormones pridcued during preganancy interfere with the insulin that is produced naturally.

Gestational diabetes usually becomes apparent during the 24th to 28th weeks of pregnancy, and, in most cases, disappears of its own accord once the baby is born.

Women with gestational diabetes usually do NOT have an increased risk of having a baby with birth defects.

Generally, sufferers of gestational diabetes have normal blood sugar levels during the critical first stages of the preganancy.

Whilst there can be complications caused by gestational diabetes, these can usually be managed by careful attention to nutrition and blood sugar levels.

Approximately 3 to 5 percent of all pregnant women in the developed world suffer from gestational diabetes.

关于糖尿病的英文文章2

医学英语 糖尿病专业词汇

A1C –Hemoglobin A1c 醣化血色素

A-II receptor antagonist/blockers-ARA [ARB]血管张力素II 接受体拮抗剂/阻断剂

A chain,insulin, 胰岛素α链

Acanthosis nigrans, 皮肤棘状黑色素瘤

Acarbose,一种α-葡萄苷酶抑制剂 ,Acarbose [Glucobay-Bayer]

Accountability measures 质量改善度评量

ACCU-Check Compact-Roche Diabetes Monitoring Kit 一种携带型血糖机

Accupril --Quinapril [Acupril-Parke Davis]之商品名

ACEI=ACE inhibitor 血管张力素转化酶抑制剂 [ACEI 非正式名词]

ACE inhibitors 血管张力素转化酶抑制剂

ACE-K煮甜甜--Acesulfame Potassium [煮甜甜—益富]一种Sweatener 甜味矫味剂

Aceon--Perindopril [Aceon-Solvay] [Acertil-Servier]一种血管张力素转换酶抑制剂

Acertil--Perindopril [Aceon-Solvay] [Acertil-Servier]一种血管张力素转换酶抑制剂

Acesulfame Potassium =ACE-K [煮甜甜—益富]- 一种Sweatener 甜味矫味剂,

Adalat--Nifedipine [Adalat-Bayer] [Adalat OROS-Bayer] 一种钙离子径路阻断剂

Adalat OROS--Nifedipine[Adalat OROS-Bayer]一种钙离子径路阻断剂 长效型

Adhesion molecule 黏着分子 与动脉硬化形成有关,可被HDL抑制

Acertil --Perinodopril [Acertil-Servier]商品名,属于ACE inhibitor用于糖尿肾病变

Acetoacetate 乙酰乙酸盐 乙酰醋酸

Acetohexamide 口服降糖药物 Acetohexamide [Dymelor-Lilly]

Acetone 丙酮

Acetylsalicylic acid: [Aspirin-Bayer],乙酰水杨酸,阿司匹林

Acidosis 酸血症

Acipimox [Olbetam-Pharmacia] 烟碱酸类降脂剂

Acromegaly肢端肥大症

Action--Insulin 胰岛素之作用

Actos –Pioglitazone,Insulin sensitizer胰岛素敏感度反应性增强剂 新降血糖药物

Actrapid Human Insulin-Novo Regular, Human insulin快速作用型 人体胰岛素

Acute myocardial infarction急性心肌梗塞

ADA=American Diabetes Association 美国糖尿病学会

Additive--Insulin胰岛素制剂之添加剂

ADDQOL=Adult of Diabetes Dependent QOL成人糖尿病相应生活质量

Adhesion--Insulin 胰岛素沾粘性

Adrenergic blockers交感神经阻断剂

Aducut--Delapril [Adecut-武田] 一种血管张力素转换酶抑制剂

Adult of Diabetes Dependent QOL=ADDQOL成人糖尿病相应生活质量

Adult Treatment Panel III , National Cholesterol education Program =NCEP ATP III

AER Albumin excretion rate尿液白蛋白排出率

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