最新Diabetic Peripheral Neuropathy - Online Diabetes：糖尿病周围神经病变的糖尿病-在线ppt课件.ppt

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1、DiabeticPeripheralNeuropathy-OnlineDiabetes：糖尿病周围神经病变的糖尿病-在线Diabeticfootdisease–thehigh-riskfootPeripheralvasculardiseasePeripheralneuropathyPeripheralneuropathyandperipheralvasculardiseaseSlidescurrentuntil2008SomestatisticsHalfofalllimbamputationsarecausedbydiabetes

2、Riskis40timesincreasedindiabetes70%ofpeoplediefiveyearsfollowinganamputationFootproblemsaccountfor40%ofhealthcareresourcesindevelopingcountries;15%indevelopedcountriesSlidescurrentuntil2008Diabeticperipheralneuropathy–riskfactorsPoorglycaemiccontrolLongdurationAgeHeigh

3、tExcessivealcoholSlidescurrentuntil2008Nervedamage–neuropathySymptoms:burningpinsandneedlespainNosymptomsSlidescurrentuntil2008Slidescurrentuntil2008PainlessnatureofdiabeticfootdiseaseSlidescurrentuntil2008SensorynervedamageSlidescurrentuntil2008MotornervedamageSlidesc

4、urrentuntil2008LocalizedcallusSlidescurrentuntil2008AutonomicnervedamageSlidescurrentuntil2008Takeofftheshoes!Slidescurrentuntil2008DiabeticperipheralneuropathyscreeningtestsTestsensationBiothesiometerTuningfork10gmmonofilamentAnklereflexesSlidescurrentuntil2008Assess

5、mentofhighriskcharacteristicsSlidescurrentuntil2008Charcot’sarthropathyArtery-veinshuntingIncreasedbloodflowBoneresorptionCommonlymisdiagnosedSlidescurrentuntil2008AcutevschronicCharcot’sarthropathyUnilateralWarm,swollenRelativelypainfreeBoundingpedalpulsesDeformitymay

6、bepresentNotemperaturedifferenceRigidfootdeformityGrosslymisshapenfootSlidescurrentuntil2008Charcot’sarthropathySlidescurrentuntil2008Charcot’sarthropathy–treatmentAcutephaseNonweight-bearingTotalcontactcastChronicphaseOrthopaedicsurgerySlidescurrentuntil2008Circulatio

7、nSlidescurrentuntil2008PeripheralvasculardiseaseCause:decreasedperfusionduetomacrovasculardiseaseSites:moredistalTibialandperonealarteries(segmentbetweenthekneeandtheanklebutaortic-illiactokneelessfrequently)Slidescurrentuntil2008Peripheralvasculardiseaseindiabetes15-4

8、0timesmorelikelytohavelowerlimbamputationPeopleover70yearshavea70-foldincreasedriskofamputationSlidescurrentuntil2008