Typhoon “Lichma” is coming. Patients with sugar -footed must be careful!
Guide: Recently, everyone is paying attention to the weather prevention. Typhoon No. 9 this year landed in Wenling City, Zhejiang, Zhejiang, my country. This typhoon has been upgraded to a super typhoon, bringing a strong storm, such as On August 10th, the wind and rain in the entire Yangtze River Delta in just a few hours shocked the colleagues in Shanghai in Shanghai. Last night, Typhoon “Lichma” landed in Qingdao City, Shandong. Today, it will bring storms and heavy precipitation to Shandong and other areas. Everyone should pay attention to travel safety.
Diabetes can cause neuropathy and vascular lesions. When neuropathy, vascular lesions and infection are common, diabetic foot disease can cause diabetic foot disease. Diabetes is one of the most serious chronic complications of diabetes and the highest treatment costs. In severe cases, it can lead to amputation. The neuropathy of some diabetic patients is manifested in sensing or lack of sensation. Therefore, diabetic patients have lost their self -protection and are easily damaged. Foot ulcers can occur in peripheral arteries in patients with diabetes and lack of sensation. When the foot is damaged, the ischemic disease will increase the lesion. As the typhoon strikes, the heavy rainfall brings will cause the road to flood. For patients with diabetes, it is necessary to pay special attention to rainy travel. A little carelessness may cause the condition to worsen.
Diabetes patients with rainy days travel guide
For diabetic patients, the weather should be closely concerned in the near future while taking rainfall measures.
1. Prepare rain fi: Diabetes patients should prepare rainy gear, such as umbrellas, raincoats and raincoles.
2. Protecting feet: Both feet protection should be done on rainy days. Waterproof shoes should be worn. Try not to travel water, especially if your feet do not step on dirty water, let alone walk barefoot. If you need to go out in the case of heavy rain, it is best to put on rain boots, while preventing rainwater from pouring, avoiding both feet pollution, and increasing the probability of diabetic foot infection.
3. Clean in time: After entering the door on rainy days, you should clean your feet in time. After carefully washing your feet, you should also check your feet carefully. If the skin is damaged, it should be treated in time.
4. Prepare cotton socks: People in summer or hot weather are generally not accustomed to wearing socks. Two pairs of cotton socks can be prepared on rainy days. At the same time, wearing socks can make feet and the outside world a block and avoid direct contact with skin and sewage. In addition, if the socks are wet by rain, you can replace the socks in time and keep your feet dry.
Diabetes foot infection signs
Corresponding clinical manifestations of diabetic patients with foot infections will occur: such as typical systemic inflammation such as fever, chills, cold wars may occur; Symptoms and signs of infection. It should be noted that because many diabetic patients have severe peripheral vascular lesions, peripheral neuropathy, and long -term hyperglycemia, about 50%of DFI patients are not typical in clinical manifestations. Essence
Diabetic foot infection diagnosis
The latest (2019) Chinese Diabetes Foot Prevention Guide mentioned that the diagnosis of foot infection (DFI) of diabetic patients should be based on the clinical manifestations of systemic and local inflammation, rather than the diagnosis of whether the genius of the primary bacteria is cultivated. Because the existence of microorganisms on the surface of the skin cannot be considered infection, usually only a large number of bacteria (generally defined as a bacteria per gram of tissue> 10^5 Copies) are the basis of diagnosis of infection, but for DFI, this concept is still There is no enough evidence support.
All DFI patients need to be determined by serum inflammatory signs, including blood leukocyte counts and classifications, superfrigence CRP, ESR, and calcium calcium. It should not be recommended for routine calcium calculin test. It should be noted that in this part of the patient, the elevation of white blood cell count is often not obvious, and even some patients’ neutral granulocyte counting is normal. Therefore, for elderly patients or IDF patients with severe ischemia, if checking Obtaining white blood cell counts significantly increased, which often indicates severe infection.
For ulcer wounds, microorganisms should be performed. The main include cotton swab dipped in wound secretions and scrapes, probes, sterile needles and other deep tissue materials, pus drawing method, etc., but these methods have their own advantages and disadvantages. It is recommended to obtain the specimen of pathogenic bacteria from deep tissue as much as possible. If necessary, collect a small number of tissues in the transition section of wound and health parts for cultivation. For patients who have used antibacterial drugs for several weeks and poor infection treatment effects, the sensitivity of deep tissue materials take material materials. It is more reliability, but hospitals with mild infection wounds, especially conditions, can also be collected in cotton swabs. If necessary, deep tissue is used to obtain materials and send them to higher -level hospitals in a timely manner.
In addition, for patients with diabetic foot, it is recommended to perform routine foot X -ray flat -line examinations.
How to scientifically treat diabetes foot
The treatment of DFI includes systemic treatment and local treatment. Internal medicine treatment should be combined with surgery. It must be emphasized that the use of antibacterial drugs cannot replace debridement, and completely debridement is the basis for successful treatment of DFI.
Principles of antibacterial drugs: fully effective debridement before using antibiotics. Before using antibacterial drugs, it should be carried out in primary education and drug sensitivity tests; the selection of antibacterial drugs should be recommended.
Types of antibacterial drugs: In our country, the proportion of the proportion of Copyciniococcus bacteria in ESBL, ESBL bacteria, carbon -resistant copper green monolithic bacteria, and carbon moldy are rising. There are even “super bacteria” with pan -resistant drugs, so it must be regulated. Studies have shown that in patients with severe infection, the effect of 哌laxin/Hispatanototherapy is better than Espenan (clinical relief rate: 97.2%to 91.5%), Erbonana’s efficacy is better than alfalin (absolute differences difference (absolutely different differences : -5.5); In a moderate infection with patients, the efficacy of 哌 Lasin/Hispatan is similar to Erbinan, and is better than that of alfalin; Based on the use of local antibacterial drugs, it can better improve patient prognosis. Compared with oral/venous infusion of Levofloxacin scheme, the recurrence rate and ulcer recurrence rate of patients treated with amino penicillin schemes are significantly reduced; compared with the pyrite/hezolinan scheme, the use of amine potinon/Sistein The incidence of complications in patients with schemes decreases.
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Powerment and treatment: The application of antibacterial drugs is mainly used in oral and intravenous injection. There are few local antibacterial drugs (mainly dressing with antibacterial drugs). At present, it is recommended to treat antibacterial drugs for mild foot infections for 1-2 weeks, and medium and severe infections are generally 2-3 weeks, which can be extended to 4 weeks.
Generally speaking, the symptoms of clinical infection and purulent secretions disappear, and the negatives of tranquility can be used as a indication of discontinued antibacterial drugs. However, due to the lack of clinical manifestations of DFI patients It is not reliable. It is necessary to combine comprehensive consideration of other clinical indicators, but generally do not advocate the application of antibacterial drugs throughout the process of wound healing.
