伴肌腱坏死糖尿病足--经典案例分享

济南慢创小医

&nbsp; &nbsp; 患者杨某，60岁，因：“左足皮肤破溃10月余，加重5天”入院。查体：T：38.6℃ P：100次/分 R：20次/分 BP：120/80mmHg。老年男性，神志清，精神可，心肺（-）专科所见：左足外侧有两处疮面，创周略红肿，远端疮面约2×2cm肉芽稍红润，向近端可探及腔隙，与近端疮面相通，有脓性分泌物渗出；近端疮面约1×1cm表面覆盖黑色坏死组织，味臭，触痛(+)。（<font color="#ed2308">如图1）&nbsp;&nbsp;</font>辅助检查：1.BS：15.5mol/L 2.心电图示：窦性心动过速 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;图1&nbsp; 治疗前 &nbsp; &nbsp; 患者入院后给监测血糖，皮下注射胰岛素控制血糖，应用抗生素控制感染，静滴活血化淤药物促进局部血液循环，营养支持治疗，多次清创+外用中药提毒拔脓，消炎去腐。治疗98天出院。<font color="#ed2308">如（图2-4）</font> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 图2&nbsp; 清创1 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 图3&nbsp; &nbsp; 清创2 &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; 图4&nbsp; 治疗后 &nbsp; &nbsp; 中医“筋疽”多以患足灼热、穿透性溃疡，肌腱变性、坏死，形成窦道、脓液溢出，周围红肿，治疗上，采用内科支持，外科祛腐清创+中药清热解毒、活血止痛为宜。 <a contenteditable="false" href="https://mp.weixin.qq.com/s/CAza7AYKxCdDRgV-PkjCBw" target="_blank" class="link"><i class="iconfont icon-iconfontlink">&nbsp;</i>糖尿病足，如何防治？</a><div><a contenteditable="false" href="http://www.skin120.com" target="_blank" class="link"><i class="iconfont icon-iconfontlink">&nbsp;</i>济南皮肤疮疡医院官网</a><br></div> &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; （扫码关注，了解更多）