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Комплексный подход к лечению больных с синдромом диабетической стопы

Комплексный подход к лечению больных с синдромом диабетической стопы

Abstract

Целью исследования явилось улучшение результатов лечения больных с синдромом диабетической стопы. Под нашим наблюдением находились 323 пациента за период с 2010 года по 2012 год с различными формами и степенью тяжести инфекционного процесса синдрома диабетической стопы. В выборе лечебно-диагностических мероприятий использовали комплексный мультидисциплинарный подход, который наряду с оперативными вмешательствами включал коррекцию гликемии, антибактериальную и детоксикационную терапию, использование ангиопротекторов, тканевых репарантов, препаратов алипоевой кислоты, эфферентные методы хирургии крови, гипербарическую оксигенацию, физиолечение (УФО, магнитотерапию, КВЧ, биоптрон), иммунокоррекцию, ортопедические приемы. Большие ампутации выполнены у 10 % больных, из них: на уровне голени – 6 %, на уровне бедра – 4 %. При нейроишемической форме диабетической стопы количество больших ампутаций достигает 74,3 % всех наблюдений, а при нейропатической – 25,7 %. Конечность сохранена у 90 % пациентов. Выживаемость в течение 2 лет среди больных с сохранённой конечностью составила 98,5 %. Таким образом, только комплексный мультидисциплинарный и индивидуальный подход, органосохранная тактика при лечении диабетической стопы позволяют существенно улучшить ближайшие результаты лечения, а также значительно увеличить число сохраненных конечностей и повысить качество жизни пациентов.

The aim of the study was to improve treatment outcomes in patients with diabetic foot syndrome. We observed 323 patients during the period from 2010 to 2012 with different forms and degrees of severity of infection of diabetic foot. In the selection of therapeutic and diagnostic measures used integrated multidisciplinary approach, which, along with surgery include correction of glycemia, antibacterial and detoxification, using angioprotectors, fabric reparants, preparations of a-lipoic acid, surgery techniques efferent blood, hyperbaric oxygen therapy, physiotherapy (UV, magnetic, EHF, bioptron), immune, orthopedic devices. Large amputations were performed in 10 % of patients, of which at leg – 6 %, at hip level – 4 %. When neuroischemic form of diabetic foot amputations large number reaches 74.3 % of all observations, and neuropathic – 25.7 %. Finiteness preserved in 90 % of patients. Survival at 2 years in patients with limb salvage was 98.5 %. Thus, only a comprehensive, multidisciplinary and individual approach, organ-saving tactics in the treatment of diabetic foot syndrome can significantly improve the immediate results of treatment, as well as significantly increase the number of saved limbs and improve the quality of life for patients.

Keywords

САХАРНЫЙ ДИАБЕТ, СИНДРОМ ДИАБЕТИЧЕСКОЙ СТОПЫ, НЕЙРОИШЕМИЧЕСКАЯ ФОРМА, НЕЙРОПАТИЧЕСКАЯ ФОРМА, АМПУТАЦИЯ

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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