糖尿病周围神经病变课件.pptx

糖尿病周围神经病变/item/%E7%B3%96%E5%B0%BF%E7%97%85%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F%E7%97%85%E5%8F%98糖尿病周围神经病变/item/%E7%B3%96%E5%B0%BF%E7%97%85%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F%E7%97%85%E5%8F%98（/item/DPNDPN/item/DPN）是指在/item/%E6%8E%92%E9%99%A4除/item/%E5%85%B6%E4%BB%96/32788其他/item/%E5%8E%9F%E5%9B%A0/32935原因的/item/%E6%83%85%E5%86%B5情况下，/item/%E7%B3%96%E5%B0%BF%E7%97%85糖尿病/item/%E6%82%A3%E8%80%85患者/item/%E5%87%BA%E7%8E%B0/1921361出现与/item/%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F周围神经/item/%E5%8A%9F%E8%83%BD%E9%9A%9C%E7%A2%8D功能障碍/item/%E7%9B%B8%E5%85%B3相关的/item/%E7%97%87%E7%8A%B6症状和（或）/item/%E4%BD%93%E5%BE%81体征。.临床表现麻木/item/%E7%B3%96%E5%B0%BF%E7%97%85%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F%E7%97%85%E5%8F%98糖尿病周围神经病变的症状，/item/%E4%B8%B4%E5%BA%8A临床呈对称性/item/%E7%96%BC%E7%97%9B/73698疼痛和/item/%E6%84%9F%E8%A7%89/2060感觉/item/%E5%BC%82%E5%B8%B8/33341异常，/item/%E4%B8%8B%E8%82%A2下肢/item/%E7%97%87%E7%8A%B6症状较/item/%E4%B8%8A%E8%82%A2上肢多见。/item/%E6%84%9F%E8%A7%89/2060感觉异常有/item/%E9%BA%BB%E6%9C%A8/1311864麻木、蚁走、虫爬、/item/%E5%8F%91%E7%83%AD/35767发热、/item/%E8%A7%A6%E7%94%B5/18639触电样感觉，往往从远端/item/%E8%84%9A%E8%B6%BE脚趾上行可达膝上，/item/%E6%82%A3%E8%80%85/5885407患者有穿袜子与戴手套样/item/%E6%84%9F%E8%A7%89/2882005感觉。感觉障碍严重的病例可出现下肢关节病及/item/%E6%BA%83%E7%96%A1溃疡。痛呈/item/%E5%88%BA%E7%97%9B刺痛、/item/%E7%81%BC%E7%97%9B灼痛、钻凿痛，似乎在/item/%E9%AA%A8%E9%AB%93骨髓深部作痛，有时剧疼如/item/%E6%88%AA%E8%82%A2截肢痛呈昼轻夜重。有时有/item/%E8%A7%A6%E8%A7%89触觉过敏，甚则不忍/item/%E6%A3%89%E8%A2%AB/7613542棉被之压，须把/item/%E8%A2%AB%E5%AD%90被子/item/%E6%94%AF%E6%92%91/9887193支撑起来。当/item/%E8%BF%90%E5%8A%A8%E7%A5%9E%E7%BB%8F运动神经/item/%E7%B4%AF%E5%8F%8A累及时，/item/%E8%82%8C%E5%8A%9B肌力常有/item/%E8%82%8C%E5%8A%9B不同程度的减退/item/%E8%82%8C%E5%8A%9B／/item/%E8%82%8C%E5%8A%9B晚/item/%E8%82%8C%E5%8A%9B期有营养不良性肌萎缩。/item/%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F%E7%97%85%E5%8F%98周围神经病变可双侧，可单侧，可/item/%E5%AF%B9%E7%A7%B0对称，可不对称，但以双侧对称性者多见。/item/%E7%B3%96%E5%B0%BF%E7%97%85%E5%91%A8%E5%9B%B4%E7%A5%9E%E7%BB%8F%E7%97%85%E5%8F%98糖尿病周围神经病变在体征方面有：/item/%E8%B7%9F%E8%85%B1跟腱反射、膝腱/item/%E5%8F%8D%E5%