长沙男子脚趾发掘小伤口，不久后竟发黑坏死！20%的病人接受截肢
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">近期</span>，家住长沙</span><span style="color: black;">34</span><span style="color: black;">岁的邹先生因脚上绿豆<span style="color: black;">体积</span>的溃疡险些截肢</span><span style="color: black;">，这让他<span style="color: black;">非常</span>后怕。其实，这与他<span style="color: black;">身患</span>糖尿病却<span style="color: black;">无</span><span style="color: black;">导致</span><span style="color: black;">注意</span><span style="color: black;">相关</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">邹先生</span><span style="color: black;">患糖尿病</span><span style="color: black;">6</span><span style="color: black;">年</span><span style="color: black;">多了</span><span style="color: black;">，</span><span style="color: black;">自己从未有不适感觉</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">亦</span>不<span style="color: black;">注意</span></span><span style="color: black;">，</span><span style="color: black;">血糖<span style="color: black;">长时间</span></span><span style="color: black;">飙</span><span style="color: black;">高。</span><span style="color: black;">3</span><span style="color: black;">个</span><span style="color: black;">月前，他的脚趾不小心被蹭破，<span style="color: black;">引起</span>绿豆<span style="color: black;">体积</span>的伤口。邹先生</span><span style="color: black;">本想着伤口会慢慢愈合</span><span style="color: black;">，</span><span style="color: black;">没想到创面不仅<span style="color: black;">无</span>愈合</span><span style="color: black;">，</span><span style="color: black;">反而进一步扩大</span><span style="color: black;">、</span><span style="color: black;">加深</span><span style="color: black;">，</span><span style="color: black;">蔓延至足背</span><span style="color: black;">，</span><span style="color: black;">伴有恶臭。</span><span style="color: black;">家人眼看邹先生<span style="color: black;">状况</span>越来越差</span><span style="color: black;">，</span><span style="color: black;">急忙将他送到</span><span style="color: black;">湖南省人民医院手足显微外科就诊</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">入院时</span><span style="color: black;">，</span><span style="color: black;">邹先生的<span style="color: black;">状况</span><span style="color: black;">严重</span></span><span style="color: black;">，</span><span style="color: black;">血糖高达32.7mmol/L。</span><span style="color: black;"><span style="color: black;">大夫</span></span><span style="color: black;">查看</span><span style="color: black;">伤口<span style="color: black;">发掘</span></span><span style="color: black;">其</span><span style="color: black;">右足已有三个脚趾发黑坏死伴流脓</span><span style="color: black;">，</span><span style="color: black;">足底可见约4*4cm<span style="color: black;">体积</span>皮肤溃烂</span><span style="color: black;">，</span><span style="color: black;">并散发一股恶臭味</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">检测</span>结果提示感染指标<span style="color: black;">尤其</span>高</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">脚步</span>影像学提示患足内部<span style="color: black;">海量</span>积气</span><span style="color: black;">、</span><span style="color: black;">积液</span><span style="color: black;">，</span><span style="color: black;">局部肌腱不健康</span><span style="color: black;">，</span><span style="color: black;">骨质有暴露趋势</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">意见</span>截肢手术</span><span style="color: black;">，</span><span style="color: black;">家属<span style="color: black;">剧烈</span><span style="color: black;">需求</span>尽可能保肢</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">思虑</span><span style="color: black;">病人</span><span style="color: black;">青春</span></span><span style="color: black;">，</span><span style="color: black;">又是家里<span style="color: black;">重点</span>劳动力</span><span style="color: black;">，湖南省人民医院手足显微外科</span><span style="color: black;">立即<span style="color: black;">起步</span>糖尿病足MDT多学科</span><span style="color: black;">团队</span><span style="color: black;">，</span><span style="color: black;">在<span style="color: black;">麻木</span>科</span><span style="color: black;">、</span><span style="color: black;">手术室的大力<span style="color: black;">协同</span>下</span><span style="color: black;">，</span><span style="color: black;">彻底清创</span><span style="color: black;">，</span><span style="color: black;">又</span><span style="color: black;">采用抗生素骨水泥填塞+VSD负压吸引术</span><span style="color: black;">，</span><span style="color: black;">有效<span style="color: black;">掌控</span>创面感染</span><span style="color: black;">，</span><span style="color: black;">促进肉芽组织的增生</span><span style="color: black;">，</span><span style="color: black;">顺利的完成急诊手术</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q5.itc.cn/q_70/images03/20240423/b08d8bddbfd040e8bdc0e3c4f1d27ced.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">△</span>陈建民<span style="color: black;">专家</span>查看邹先生的恢复<span style="color: black;">状况</span></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">术后</span><span style="color: black;">每日<span style="color: black;">连续</span>伤口灌洗</span><span style="color: black;">，</span><span style="color: black;">促进创面愈合。</span><span style="color: black;">经</span><span style="color: black;">过医护团队精心的照护</span><span style="color: black;">，</span><span style="color: black;">邹先生<span style="color: black;">保存</span>了拇趾部分</span><span style="color: black;">、环趾、小趾</span><span style="color: black;">，</span><span style="color: black;">避免了截肢</span><span style="color: black;">。</span><span style="color: black;"><span style="color: black;">因为</span>邹先生<span style="color: black;">脚步</span>软组织<span style="color: black;">缺失</span>创面<span style="color: black;">很强</span></span><span style="color: black;">，</span><span style="color: black;">想要最大限度<span style="color: black;">保存</span><span style="color: black;">脚步</span>的完整性</span><span style="color: black;">，</span><span style="color: black;">需<span style="color: black;">经过</span>一段时间的换药</span><span style="color: black;">，</span><span style="color: black;">待创面基底清洁</span><span style="color: black;">，</span><span style="color: black;">肉芽生长良好后</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">按照</span>复查<span style="color: black;">状况</span>实施后续的皮瓣移植术</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">手足显微外科</span><span style="color: black;"><span style="color: black;">专家</span></span><span style="color: black;">陈建民介绍</span><span style="color: black;">，</span><span style="color: black;">临床上类似邹先生<span style="color: black;">这般</span>的案例并不少见</span><span style="color: black;">。</span><span style="color: black;">据国际糖尿病联盟最新<span style="color: black;">颁布</span>数据<span style="color: black;">表示</span></span><span style="color: black;">，</span><span style="color: black;">我国糖尿病<span style="color: black;">病人</span>已超1.1亿</span><span style="color: black;">，</span><span style="color: black;">居<span style="color: black;">全世界</span><span style="color: black;">第1</span></span><span style="color: black;">。</span><span style="color: black;">其中有34%会患上足溃疡</span><span style="color: black;">，</span><span style="color: black;">约20%的糖尿病足溃疡<span style="color: black;">病人</span>将接受截肢</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">亦</span><span style="color: black;">便是</span>说<span style="color: black;">全世界</span>每20秒钟就有一位糖尿病<span style="color: black;">病人</span>截肢</span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">“</span><span style="color: black;"><span style="color: black;">能够</span>说糖尿病足是糖尿病<span style="color: black;">病人</span>致残</span><span style="color: black;">、</span><span style="color: black;">致死的<span style="color: black;">重点</span><span style="color: black;">原由</span>之一</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">亦</span>是<span style="color: black;">导致</span>社会沉重<span style="color: black;">包袱</span>的重大公共卫生问题</span><span style="color: black;">。”</span><span style="color: black;">陈建民说</span><span style="color: black;">，“因</span><span style="color: black;">治疗不<span style="color: black;">即时</span>或不正确</span><span style="color: black;">，</span><span style="color: black;">糖尿病足<span style="color: black;">病人</span>常合并不同程度的下肢动脉闭塞</span><span style="color: black;">，</span><span style="color: black;">严重的还会累及肌肉和骨组织</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">显现</span></span><span style="color: black;">下肢坏疽</span><span style="color: black;">、</span><span style="color: black;">截肢等<span style="color: black;">危害</span></span><span style="color: black;">。</span><span style="color: black;">”</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">陈建民</span><span style="color: black;"><span style="color: black;">专家</span></span><span style="color: black;">提醒</span><span style="color: black;">，</span><span style="color: black;"><span style="color: black;">针对</span>糖尿病<span style="color: black;">病人</span><span style="color: black;">来讲</span></span><span style="color: black;">，</span><span style="color: black;">早筛查</span><span style="color: black;">、</span><span style="color: black;">早诊断</span><span style="color: black;">、</span><span style="color: black;">早治疗<span style="color: black;">针对</span>防治糖尿病足<span style="color: black;">非常</span><span style="color: black;">重要</span></span><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">1.</span><span style="color: black;">有效<span style="color: black;">掌控</span>血糖：正确<span style="color: black;">恰当</span>的<span style="color: black;">膳食</span>，少食多餐，避免过饱、避免低血糖的<span style="color: black;">出现</span>，绝对戒烟、限酒。遵医嘱按时吃药,适当进行体育<span style="color: black;">熬炼</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">2.</span><span style="color: black;">加强<span style="color: black;">脚步</span>护理：<span style="color: black;">保持</span>每日温水泡脚，水温以37℃为宜，泡脚时间在5～10分钟，<span style="color: black;">每日</span>做<span style="color: black;">脚步</span>清洗卫生。<span style="color: black;">检测</span><span style="color: black;">脚步</span>皮肤有<span style="color: black;">没</span>红肿、皲裂、溃疡、创伤、足藓等，应该<span style="color: black;">即时</span>处理。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">3.</span><span style="color: black;">避免外伤：<span style="color: black;">重视</span>生活细节，尽可能避免外源性<span style="color: black;">损伤</span>。每次穿鞋前<span style="color: black;">检测</span>鞋内<span style="color: black;">可否</span>有小颗粒、异物等，鞋子稳定性要好，不穿易绊倒的鞋子。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">4.</span><span style="color: black;"><span style="color: black;">选取</span>适合自己的鞋袜：要避免紧口袜，防止<span style="color: black;">由于</span>不适合而影响<span style="color: black;">脚步</span>血液循环后<span style="color: black;">导致</span><span style="color: black;">脚步</span>摩擦伤。且<span style="color: black;">意见</span><span style="color: black;">病人</span>应穿白色袜子，<span style="color: black;">这般</span><span style="color: black;">能够</span>方便观察<span style="color: black;">脚步</span>局部破损后<span style="color: black;">即时</span><span style="color: black;">发掘</span>，<span style="color: black;">即时</span><span style="color: black;">看病</span>。</span></p>
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