Bell D S
University of Alabama, Birmingham 35294.
Postgrad Med. 1991 Jun;89(8):237-40, 243-4. doi: 10.1080/00325481.1991.11700966.
Peripheral neuropathy, infection, and peripheral vascular disease can produce serious problems in diabetic patients, particularly in the lower limbs. Ulceration of the foot may progress to gangrene and ultimately necessitate amputation. Distal symmetric polyneuropathy causes sensory loss. Such loss in patients with peripheral vascular disease creates a high risk for foot ulcers, which are vulnerable to infection. Treatment includes relief of neuropathic pain and antibiotic therapy for infection. Pentoxifylline (Trental) improves microvascular flow and appears to be effective against peripheral vascular disease. Aldose reductase inhibitors are being investigated as therapy for diabetic neuropathy. Prevention is the mainstay of management in these patients. Patient education is essential to help maintain health and prevent the potential adverse effects of diabetes.
周围神经病变、感染和周围血管疾病会给糖尿病患者带来严重问题，尤其是在下肢。足部溃疡可能发展为坏疽，最终需要截肢。远端对称性多发性神经病变会导致感觉丧失。周围血管疾病患者的这种感觉丧失会使足部溃疡的风险很高，而足部溃疡很容易感染。治疗包括缓解神经性疼痛和针对感染的抗生素治疗。己酮可可碱（曲克芦丁）可改善微血管血流，似乎对周围血管疾病有效。醛糖还原酶抑制剂正在作为糖尿病神经病变的治疗方法进行研究。预防是这些患者管理的主要内容。患者教育对于帮助维持健康和预防糖尿病的潜在不良影响至关重要。
