Healthcare

 Retrieve Password
 join us
search

Diabetic coma

Read in CN

   

[Intro]

Diabetic coma is a clinical syndrome characterized by disturbance of consciousness caused by diabetes. It includes two kinds of clinical types, namely, diabetic keto-acidosis and diabetic non-ketotic coma (hyperosmolar coma), they are the most common diabetes, the most dangerous complications, if timely treatment, often leading to death.


The

disease Overview

diabetic coma caused by diabetes, a clinical syndrome characterized by disturbance of consciousness. It includes two kinds of clinical types, namely, diabetic keto-acidosis and diabetic non-ketotic coma (hyperosmolar coma), they are the most common diabetes, the most dangerous complications, if timely treatment, often leading to death.

signs and symptoms

medical attention dehydration extent, with or without breathing deep and speed, breath ketone flavor and peripheral circulatory failure.
1. history of mostly elderly, mostly occurs in 50 to 70-year-old, male and female prevalence is roughly the same. About half of known diabetes, approximately 30% had a history of heart disease; about 90% of people with kidney disease. Types of diabetes: more than for type 2 diabetes; minority for type 1 diabetes, more than coexist with DKA; can occur even in Cushing's syndrome, acromegaly patients with diabetes.
2. slower onset of the way. Patients before the onset of a few days to several weeks, often diabetes symptoms gradually worsened, clinical manifestations, including polydipsia polydipsia, polyuria, fatigue, dizziness, lack of appetite and vomiting.
3. dehydration and peripheral circulatory failure patients often have severe dehydration signs, visible skin dryness and decreased elasticity, sunken eyes, dry tongue, and may have longitudinal cracks. Patients with peripheral circulatory failure, rapid and weak pulse, incomplete filling of jugular vein in the supine, orthostatic hypotension, standing systolic blood pressure drop compared with the supine low-1.3kPa (10mmHg) above. The number of patient visits in a state of shock, severe dehydration, physical examination can be no sweat found. Although some patients with severe dehydration, but the permeability of plasma state to promote the intracellular fluid out, to add volume, may mask the extent of water loss, so that the blood pressure remained normal.
4. about half of the patients awareness of the signs and symptoms of the nervous system disturbances, 1/3 in a coma, some patients was misdiagnosed as cerebral vascular accident, even mistakenly entered the hypertonic glucose solution or a dehydrating agent, prompting exacerbations. HNDC patients with disturbance of consciousness or not and the extent of major decisions in the extent and speed of the increase in plasma osmolality and blood glucose level of a certain relationship, and has little to do with the degree of acidosis. Abroad, it was found that when the effective osmotic pressure of the plasma of patients with more than 320mmol/L, you can psychiatric symptoms such as apathy, lethargy; more than 350mmol/L when 40% of patients may have vague consciousness or coma. But some patients with effective plasma osmolality is slowly rising, visit Although more than 400 mmol/L, the patient is still in the waking state.
signs of nervous system: such as grand mal epilepsy, hemiplegia, muscle relaxation or involuntary contraction, aphasia, homonymous hemianopsia, visual disturbances, nystagmus, visual hallucination, the bust of sensory loss, Babin The Chomsky sign positive and central heating. These signs suggest that patients may be due to dehydration, hemoconcentration, or blockage of blood vessels caused by the cerebral cortex or subcortical damage. These changes can be reversed by effective treatment after the return to normal a few legacy can still be within a certain nervous and mental disorders in a period of time after HNDC correct the symptoms.
with the incidence of signs and symptoms in patients with high blood pressure, kidney disease, coronary heart disease and other original disease manifestations; pneumonia, urinary tract infections, pancreatitis-induced disease manifestations; and cerebral edema, thrombosis performance of the formation of vascular thrombosis and other complications. The body temperature of patients more than normal or mildly elevated, such as the temperature decreases, the prompt may be associated with acidosis and (or) sepsis, should be paid enough attention.

disease etiology

Note that the previous history of diabetes, recent treatment of the situation, with or without acute infection, diarrhea, eating disorders, sugar too much, not previously discovered diabetes misuse of too much sugar, severe mental stimulation, disable, or a significant reduction in insulin, large doses of biguanide hypoglycemic agents, and so on.
1. stress and infection, such as cerebrovascular accident, acute myocardial infarction, acute pancreatitis, gastrointestinal bleeding, trauma, surgery, heat stroke or cold stress. Infections, particularly upper respiratory tract infection, urinary tract infections, most commonly induced. Insufficient water intake elderly thirst center sensitivity decline in ambulatory patients, mental disorders, or coma suffering from the

diabetic coma


who can not take the initiative to the water intake children.excessive
3. water loss and dehydration such as severe vomiting, diarrhea, severe burn patients, Neurology, Surgery dehydration therapy, dialysis treatment.
4. high intake of sugars and input such as a large intake of sugary drinks and foods high in sugar, the diagnosis is unknown or missed intravenous infusion of a large number of glucose solution, complete intravenous nutrition, and the use of sugar solution hemodialysis or peritoneal dialysis. In particular, in some patients with endocrine diseases with glucose metabolism disorders, such as hyperthyroidism, acromegaly, Cushing's syndrome, pheochromocytoma tumors who more likely to induce.
5. drugs Many drugs can be an incentive, such as extensive use of glucocorticoids, thiophene the triazine furosemide (furosemide), diuretics, propranolol, phenytoin, chlorpromazine , cimetidine, glycerol, azathioprine and other immunosuppressive agents and so on. Can cause or aggravate insulin resistance in the body make blood sugar, dehydration aggravated, some drugs such as thiazide diuretics also inhibit insulin secretion and reduce insulin sensitivity, which can induce HNDC.
6. other areas such as acute and chronic renal failure, diabetes, kidney disease, glomerular filtration rate, clearance of glucose has also decreased. Can also be an incentive.

diagnostic tests

1 admission immediately to check blood glucose, ketone bodies, lactic acid, carbon dioxide combining power, urea nitrogen, blood pH, serum potassium, serum sodium, serum chloride, plasma penetration pressure [calculated using the formula: 2 (Na + + K +) mmol/L + (glucose mg/d1 ÷ 18) + (blood urea nitrogen mg/d1 ÷ 2.8)], urine sugar and ketone bodies, each subsequent 1 ~~ 4h retest 1, until the blood biochemical values ​​returned to normal.
2. renal function tests, ECG. Check urine and ketone.
3. Category
① The blood glucose was significantly higher, and increased blood ketone, blood carbon dioxide combining power and pH decreased, with positive urine ketone as diabetic ketoacidosis and coma.
blood sugar very high (nearly 1000mg/d1 or higher), high sodium, plasma osmolality, no significant ketoacidosis, high permeability nonketotic coma; common in older patients.
③ The due to shock or taking a biguanide hypoglycemic agents, blood lactate increased acidosis generally hyperglycemia, ketosis by diabetes lactic acidosis.

treatment options

1. implemented in accordance with coma care practices, and blood pressure hourly 1
2 diabetic ketoacidosis coma treatment
(1) injection of regular insulin
In order to prevent the course of treatment, blood sugar drop too fast, acidosis corrected too fast, leading to cerebral edema even fatal consequences, can be applied to small doses of insulin treatment plan: initial RI intravenous infusion (in saline middle), the dose at 5 ~ 10U/h, calculate the (0.1U/kg? h,), while intramuscular injection of 10 ~ 20U. close observation of blood glucose until the blood sugar to 13.9mmol/L (250mg/d1), insulin instead of every

symptoms


2h subcutaneous injection once a dose urine + + + +16 U, + + +12 U, + +8 U, +4 U. With insulin and fluid therapy 2 to 3h after the blood sugar is still not decreased, you may have insulin resistance, hourly insulin dose should be doubled. Treatment with excessive insulin, act with undue haste while hypoglycemia, or blood sugar to drop too fast, leading to cerebral edema and hypokalemia should be avoided.
(2) to correct dehydration, electrolyte imbalance, acidosis
① fill saline: the beginning of 2 ~ 4h rehydration 2000ml, the first JCP 4000ml or so. Old age and heart and kidney dysfunction, rehydration should not be too much too fast. To blood glucose decreased to 13.9mmol/L (250mg/d1) following the switch to 5% glucose solution, or 5% glucose solution 4/5 and normal saline 1/5. When the patient can eat, to encourage the liquid food, semi-liquid food.
② timely potassium: If potassium is low or normal, full urine in the treatment of intravenous potassium chloride l ~ 1.5g/500ml, the first day of potassium 6 ~~ 9g. hyperkalemia by pre-treatment, after treatment, 3 ~ 4h Note potassium. The potassium appropriate electrocardiographic monitoring, or 2 ~ 3h measured serum potassium to prevent hyperkalemia. Termination of potassium when the potassium in 5mmol/L or more.
③ to correct acidosis: blood pH> 7.15 when no alkali agent, pH <7.0 with 5% sodium bicarbonate 150ml, pH 7.0 ~ 7.15, with half the amount.
3. hyperosmolar nonketotic coma treatment
(1) to correct the hypertonic dehydration, electrolyte loss: immediate intravenous infusion of normal saline, in the beginning 2h 2 ~ 3L, can also be injected from the tube in a considerable amount of warm water; blood recovery capacity, blood pressure rose to normal, and the osmotic pressure did not fall, especially hypernatremia lose hypotonic solution (0.45% or 0.6% sodium chloride) 500 ~ 1500ml/d; until the blood sugar decreased to 16.7mmol (300mg/d1)

diabetic coma


below in favor of 5% glucose intravenous infusion. Serum potassium <5mmol namely potassium, potassium maintained at 4-5mmol/L.
(2) insulin: The dosage should be lower than ketoacidosis coma for a small (4 ~ 6U/h), the general can refer to the "small dose" program, intravenous regular insulin. But stressed that early diagnosis and treatment. Should not be in the 24 ~ 48h blood glucose less than 13.9mmol/L (250mg/d1).
(3) remove the incentive treatment, and attention to monitoring vital signs, blood, urine, electrolytes, BUN, etc..
4 lactic acid poisoning treatment
(1) active anti-shock, improve microcirculation perfusion, correction of tissue hypoxia.
(2) positive correction of acidosis, which may be intravenous infusion of 1.5% or 5% sodium bicarbonate, a larger amount, usually 5% sodium bicarbonate 200 ~ 1000ml strive to blood ph at 8h to normal, early 24h available 100mmol. Taken to avoid hypokalemia. Old age, heart and kidney dysfunction are required dialysis. Or tromethamine (The THAM), but disable sodium lactate.
(3) high blood sugar treatment; RI high blood sugar to be added glucose.
5. stop the application biguanide drugs
6. general treatment should control incentives
infected persons are speed controlled with antibiotics. shock active anti-shock measures, plasma or whole blood can be lost when the necessary hanged norepinephrine.

Safety Tips

1, if the patient awareness is still awake, and able to swallow, then low blood sugar coma is the most effective way to enable patients to drink sweet water or eat candy, sweet pastry class
2, an effective method of high blood sugar coma drink salt tea or low-salt tomato sauce.
3, in patients with consciousness has been lost, the patient should be flat, unlock the collar to ensure airway patency.

nursing interventions

1 diabetic patients with coma, if not rescued, it may be life-threatening, nursing staff and their families must always observe the patient's condition changes;
2, remember the patient's fluid intake and output, such as water or fluid volume, urine output, etc.;
3, when the patient out of danger, regained consciousness, aggressive treatment of diabetes, diet regulation, rational use of insulin in vivo metabolism of normal, to avoid the recurrence of diabetic coma;
4, diabetes is a chronic and long-term treatment of the disease, patients and their families should eliminate concerns about confidence, and learn knowledge about diabetes, a great benefit to patients;
5, for the prevention of the event, with diabetes should always carry carry marked with diabetes "card and the card can record some of the treatment methods and patient name, address, etc., so that a sudden awareness loss for others and for Physicians.

emergency measures

1. First find out the causes of coma, the difference between high blood sugar coma or low blood sugar coma.
2. Hypoglycemia, the patients first felt the palpitation, dizziness, hunger, tremor, sweating

diagnosis


further development of irritability, convulsions, mental disorders, and finally into a diabetic coma . If the patients are still capable of swallowing, low blood sugar coma, is to enable patients to drink sugar water or eat candy, sweets.
3. High blood sugar coma, let the patient drink some salt in the tea, and at the same time sent to hospital.
4. Difficult to judge the reason of diabetic coma, do not blindly take measures, because of two reasons of hyperglycemia and hypoglycemia can cause coma treatment is exactly the opposite.
5. If the patient awareness has been lost, patients should be flat, unlock the collar to ensure airway patency, and immediately sent to the hospital.

four of the prevention and treatment of diabetic coma

in the course of treatment of diabetes, due to the improper loss rule wrong treatment or conditioning of life of diabetic ketoacidosis coma, hyperosmolar nonketotic diabetic coma, lactic acidosis, coma, diabetic hypoglycemia coma four Intensive, if not rescued, there will be fear for their lives.
diabetic ketoacidosis coma due to severe lack of insulin, the fat accelerate the decomposition of a significant increase in fatty acid oxidation of ketone bodies in the liver, leading to ketone bodies accumulate, and ketoacidosis. On this basis, coma called diabetic ketoacidosis coma. Prevalent in the sudden interruption of the insulin-treated diabetic patients without any treatment of newly diagnosed diabetes. Zheng Jian polydipsia, polyuria, Shenpi, fatigue, poor appetite, Oue, breathing deeply and fast and then slow shallow breath can be a rotten apple, dizziness, headaches, and even shock, lethargy, coma. Treatment to rehydration, the use of insulin, to correct electrolyte imbalance and acid-base balance mainly.
nonketotic hyperosmolar diabetic coma refers to diabetic patients in severe infection, trauma, blood or peritoneal dialysis, the use of diuretics or adrenal corticosteroids, severe high blood sugar, blood hypertonic state, dehydration, coma for the clinical features of disease. Zheng Jian fever polydipsia, polydipsia and polyuria, Shenpi fatigue, the Oue anorexia, dry skin, reduce flexibility, chapped lips and tongue, eyes sunken, blood pressure, dehydration performance and even shock, rapid shallow breathing, rapid heart rate minds dazed, limbs, convulsions, trance, disorientation, irritability or apathy and even coma, epileptic seizures, hemiplegia aphasia, hemianopia, or nystagmus, pathological reflex was positive. Treatment to use insulin, a rapid and massive rehydration, maintenance of water and electrolyte and acid-base balance, prevention of infection was the main patients with errors

drug treatment


diabetes lactic acidosis, coma

diabetic patients with lactic acidosis is common in combined heart, lung, liver, kidney and serious illness The use biguanide phenformin cases. Phenformin, increase the sugar of anaerobic glycolysis, lactate production increases when the number of lactic acid increase more than intake of liver and muscle and kidney excretion limit occurs when lactic acidosis. Zheng Jian, nausea, vomiting, abdominal pain, bloating, fatigue, weakness, breathing deeply and fast, and gradually fell into a coma. Treatment to disable Jiangtangling can cause lactic acidosis, drugs, the use of insulin, 5% sodium bicarbonate injection, infection control, to correct dehydration and shock, diuretic row Acid, to correct water and electrolyte disturbance, oxygen, potassium and, if necessary when blood or peritoneal dialysis-based dialysis solution without lactic acid root.
diabetes low blood sugar coma found in patients with diabetes go on a diet over-injection of insulin overdose, oral hypoglycemic agents improper use of such circumstances. Zheng Jian hunger, fatigue, dizziness, headache, cold sweat dripping, palpitation and shortness of breath, tachycardia, nausea, vomiting, blurred vision, the whole body tremble, and even mental confusion, abnormal behavior, lethargy, coma, limbs, convulsions and even death. hypoglycemia can occur in the daytime, but also occur in the night. Hypoglycaemic episodes cause a patient in a sleep state at night, awakened from a dream, accompanied by cold sweat dripping, irritability, tachycardia. Hypoglycemia, if any, should be timely monitoring of blood glucose, into the syrup, candy, fruit, biscuits, snacks, bread and sugary foods as soon as possible, and promptly to the hospital for infusion of glucose, oxygen, glucose, blood pressure, heart rate, respiration, body temperature monitoring to observe the mind changes, and appropriate treatment, to avoid accidents.the main cause of diabetic coma, and first aid

nonketotic hyperosmolar coma

This coma more common in elderly diabetic patients over the age of 60. Severe dehydration, hyperglycemia, high plasma osmolality and neuropsychiatric symptoms as the main clinical manifestations.

hypoglycemic coma

called hypoglycemia when blood glucose below 3 mmol/l, severe low blood sugar coma. Common reasons are: insulin excessive or oral hypoglycemic medicinal excessive eating less; increased physical activity, but no corresponding increase in food intake.

ketoacidosis, coma

reasons:
1. diabetic patients with insulin-stop or reduce excessive or sicker.
2. a variety of acute and chronic infections.
3. stress, such as trauma, surgery, childbirth, pregnancy, acute myocardial infarction, and hyperthyroidism.
4. eating disorders, eating too much or too little, drinking to excess. the

prognosis and prevention

prognosis

diabetic coma mortality level of a large extent, depends on early diagnosis and treatment of complications, about 28 % of patients within 48h after hospitalization mainly from hypertonic, hyperosmolar state duration is longer the higher mortality rate. A variety of complications, especially infection is the leading cause of death late. However, due to diabetic coma occurred in the elderly, as Arieff, etc., pointed out that even if diagnosed promptly

prevention measures


positive treatment, the mortality rate is still high on HNDC. It is therefore important to try to prevent induced diabetic coma, requires that all subjects clinician age patients, with or without a history of diabetes should be vigilant and to avoid all possible factors that lead to diabetic coma occurs, to prevent the occurrence of this disease .

prevention

1. diabetes knowledge, education and health screening, early detection and early treatment, 50 years old or older should be regular testing of blood glucose. Diagnosed with diabetes patients, regular medication, diet, increase physical activity, and strict control of blood glucose levels.
2. control a variety of predisposing factors, aggressive treatment of various infections, hemodialysis, peritoneal dialysis, mannitol dehydration treatment should pay attention to whether there is dehydration, timely monitoring of blood glucose, urine sugar.
3. attention were not drug application, such as diuretics, sugar, cortisol, propranolol (propranolol).

daily prevention

usually pay attention to all drinking water must not be restrictions on drinking water
2 The law of life, a reasonable living, pay attention to exercise
3. elderly patients had a minor illness to timely treatment of a preventive measure
4. any untimely shall strengthen the monitoring of blood glucose

Care Tips

1, if the patient awareness is still awake and can swallow, then low glycemic coma is the most effective way is to enable patients to drink sweet water or eat candy, sweet pastries and the like
2, an effective method of high blood sugar coma drink salt tea or low

, enhance physical fitness


salt tomato sauce
3, in patients with consciousness has been lost, the patient should be flat, unlock the collar to ensure airway patency;
[care measures]
1, patients with diabetes coma, if not rescued, it may be life-threatening, nursing staff and their families must always observe the patient's condition changes;
2, remember the patient's fluid intake and output, such as water or fluid volume, urine output, etc.;
3, when the patient out of danger, regained consciousness, aggressive treatment of diabetes, diet regulation, rational use of insulin in vivo metabolism of normal, to avoid the recurrence of diabetic coma;
4, diabetes is a chronic and long-term treatment of the disease, patients and their families should eliminate concerns about confidence, and learn knowledge about diabetes, a great benefit to patients;
5, for the prevention of the event, with diabetes should always carry carry marked with diabetes "card and the card can record some of the treatment methods and patient name, address, etc., so that a sudden awareness loss for others and for Physicians.


[Cause]

boil is caused by what the?

infection and skin dirty, scratches, high ambient temperature or lower the body resistance to infection-related. Boils can occur in any follicles of the skin area, often to the head, face, neck, armpits and buttocks so often by the friction of the parts is more common.

(a) causes

boil the pathogenic bacteria Staphylococcus aureus based, Streptococcus, Staphylococcus epidermidis, are also caused by the disease. Local and systemic skin's resistance to infection is reduced mainly due to Benbingfasheng, so infants, malnutrition, diabetes is a good risk of this disease. Dirty skin, skin abrasions, high ambient temperatures often lead to local infection such as the direct cause.

(B) the pathogenesis

bacteria invade the hair follicle and their sebaceous glands and sweat glands, in hair follicles and surrounding tissue multiply rapidly, producing toxins, causing local tissue degeneration, necrosis, and the center of the formation of boils, the performance of local congestion, exudation, induration. Aggregation of neutrophils to the damaged body tissue cells and bacteria to be destroyed, and he gradually necrosis and dissolution, the formation of abscesses in the dermis. Due to Staphylococcus aureus, coagulase contain toxins, so the formation of pus bolt, protruding outward. Swelling and induration clinically visible in the center of a yellow-white pus plug. This is Staphylococcus aureus infected lesion characteristics. Ulceration after discharge pus, abscess gradually by the new fibrous tissue repair and healing.

[Sign]

boil the early symptoms?

1. redness, swelling, heat, pain summary, cylindrical cone.

2. inflammation to the development of nodules increases, the pain intensified.

3. A few days later nodules central necrosis, abscess formation, dissolution, soft induration, pain relief, the central pus head most of the self-rupture, discharge pus, inflammation subsided recovery.

4. furuncle usually no obvious symptoms, but if the blood flow occurred in the rich parts of the body resistance weakened, it can cause discomfort, chills, fever, headache and loss of appetite and other symptoms of toxemia.

5. Facial Boil such as intracranial infection, facial swelling and severe, may be associated with chills, fever, headache, sinus infections and other embolization.

boil because of location, severity of different clinical manifestations may vary.

local swelling and pain sclerosis: no systemic symptoms of early disease and more, only infection redness, swelling, pain, range of not more than 2cm in diameter, small nodules gradually enlarged, as papules bulge. A few days later lesions extended about 3 ~ 5cm, nodules gradually softened, the center was white, a slight touch of the fluctuations; then ulceration pus, and the emergence of yellow-white pus plug. Pus bolt off, pus shed, the inflammation subsides and healing. There is no pus boil bolt (the so-called headless boil), since the collapse a bit late, need to find ways to promote its pus discharge (Figure 2 ).

fever, swollen lymph nodes: furuncle serious infection, the local area of ​​the lymph nodes, tenderness, and may be associated with body heat, and sometimes lymph node abscess formation.

nose, upper lip and around (called "dangerous triangle") of the surface boil, add or pushed in touch, the bacteria via the angular vein, ophthalmic vein into the brain, causing intracranial suppurative infection. At this point may have fever, headache, vomiting, consciousness disorders.

early follicular redness, swelling, heat, pain, induration. After the white purulent center, there is volatility. May be associated with systemic fever, elevated white blood cell count and differential count.

[Aftertreat]

boil ate?

therapeutic side:

1. composed of: a single head of garlic, honey, 9 grams. Usage: pound evenly wrap the affected area.

2. consists of: single head of garlic amount. Usage: Peel and slice into 2 to 3 mm, with the first affected area with warm salt water when dry wash, and then sticking garlic, and gently massage the 10 to 20 minutes, 2 or 3 times a day, 2 3 There is no more. Indications: Boil, folliculitis. Note: In severe cases, such as local irritation may reduce the massage time, a serious condition should be added to serve anti-inflammatory drugs.

3 . composed of: tea 2 grams of dried honeysuckle 1 gram. Usage: boiling water 6 minutes after each meal drink in a cup. Indications: Boil, exogenous heat.

4. composed of: fresh Malan first 100 grams, the amount of liquor. Usage: Add a little salt before blindly smashed wine Ban Cheng paste, coating the surface of the skin furuncle carbuncle. Indications: furuncle, carbuncle.

5. Composition: rosin 10 grams of white wine. Usage: rosin research to fine tune white wine into a paste, resisting heat, wrap the affected area after dissolution, for the degree of responsibility to cover all of the above and then covered with wax paper and tape securely, to enhance efficacy, can drop a few drops of wine, rosin to keep moist. Indications: furuncle, carbuncle, folliculitis.

6. smashed topical papaya leaves, swollen boil carbuncle treatment drug.

7. fresh peach leaf, plug smashed the lesion, treatment of nasal furuncle.

8. rhizome or fresh banana leaves smashed Jiao Zhi, coating the surface of the skin, cure carbuncles, boils, swelling.

9. almond powder with sesame oil paint, heat treatment boil.

10. Purple cane coal deposit of the skin, powder, paint the affected area or sesame oil dressing, boil carbuncle treatment, stomatitis , eczema.

11. raw taro add a little salt, smashed drunk wrap the affected area twice a day replacement, bones can cure pain, swelling of unknown drugs, pediatric head hot boil, finger boil.

12. raw loofah (or leaf), smashed juice, coated surface of the skin, soak sore treatment days, yellow water sores, heat boils, urticaria .

13. mung bean sugar kelp: seaweed 60 grams, shredded, green beans, 150 grams, with the soup, add brown sugar to taste food. There Sedative, diuretic, soft-kin, Phlegm, scattered gall tumor effect. For hypertension, beriberi edema, neck lymphadenopathy, simple goiter, prickly heat boils hot summer day in children poison, phlegm cough embolism.

14. yi melon soup: melon (not peeled) 500-600 g, yi 50-100 grams of soup. Can be flavored with sugar or salt, on behalf of the tea used, heat, hot weather, diuretic, dehumidification effect. Drugs for Rush boils, eczema athlete's foot, yellow urine deficient.

15. Daozhi raw turnip, vinegar and rub the affected area transfer, heat treatment boil.

16. green beans 30 grams of powder, each 10 grams, water delivery service, boils cure breast swelling and pain.

17. failure to adopt the open rose 3 - 5 朵 wash, add water, two pregnant, suffering from a cup of low heat, ice sugar 30 grams, made of rose soup, until the temperature dose, to cure blood stasis amenorrhea, boils Chung pain, traumatic swelling and pain.

18. boils and pus ulceration of the skin sore or eczema, rinse with water, tea, allow the wound clean and promote healing.

19. a white sweet potato, peeled and chopped, smashed, can also be added with the same amount of fresh Houttuynia smashed, spreads in the affected area, apply to the local heating that line replace (about two three hours long), and even apply a few days more, boils cure mastitis.

20. soybeans amount, turn on the water immersed soft, add a little alum were smashed drunk, external surface of the skin, swollen boils boil treatment.

21. adzuki beans with water until soft, mash with water or vinegar, or honey or egg amount, into a paste, external surface of the skin, cure mumps, hot boil.

22. Kapok 30 - 50 grams of sugar amount, fry a bowl with water and drink two bowls and a half. Favorable moisture, heat effect. For enteritis, urethritis, eczema, summer boil embolism.

23. fresh buckwheat leaves 60 grams, Shuijianbi day one; or fried yellow noodles with the vinegar into a paste, applied to the lesion, sooner or later be replaced. Governance sore, swollen boils, erysipelas, mastitis, and swelling of unknown drugs.

appropriate patients to eat what?

1, edible grapes plus zinc salt or zinc, other foods such as soy, sunflower seeds, wheat bran, yeast, brown sugar and so on.

2, Yi Shi taste light, the cold food, such as Malan head, purslane, melon, red and white radish, bitter gourd, sponge gourd, mung bean, red bean, lily, chrysanthemum brain and celery.

patients unfit to eat what?

not eat ginger, pepper and other spicy foods , as well as mustard, yellow croaker, shrimp, crab, chicken head, goose, Zhu Tourou so fat objects.

should avoid fried foods and meat, edible oil cans.

data only refer to the specific, please ask a doctor.

[Prevent]

how to prevent boils?

boil is born of acute suppurative superficial skin disorders, widely available health, children, young people more common. "Surgical management case" that: "boil persons, birth processes, floating red rootless feet, swollen found in the skin, only the width of an inch, there is less pain, a few days later Microsoft, thin peel, the beginning of the blue water, the latter from breaking the pus out of. "The disease occurs in the summer and autumn, protruding roots shallow, swelling potential limitations, lift the red pain, mostly in the range of about 3cm, easily swollen, easy to collapse, Yi Lian. Early can be divided into a head, without the first two kinds of general light and easy to cure the symptoms, so the saying goes, "no boil the size of a pus like." ;;; ;;;;; ;;;;; ;;;;; But also due to the formation of improper treatment or care "mole cricket boils," or repeated seizures, lack of disunion. Multiple furunculosis ", is difficult to cure.

[Treat]

boil precautions before treatment?

attention to the skin clean, timely replacement of underwear and avoid skin injuries, especially in the summer, to bathe, wash your hair, hair, changing clothes, nails, children in particular should pay attention. With honeysuckle and wild chrysanthemum Jiantang tea. Boil the surrounding skin should be kept clean and coated with 70% alcohol to prevent infection spread to nearby hair follicles.

boil Chinese medicine treatment methods

total boil caused by the toxic heat treatment to detoxify the basic principles.

A Differential Treatment:

1. Heat toxin Accumulation card: lesion processes, such as cone, burning pain, or fever, thirst, tongue pink, yellow fur, rapid pulse. Detoxification. Flavors disinfection decoction.

2. Shushi heat Melancholia: seen in summer and autumn, the affected area, such as agglomeration cone, single or multiple, burning pain, chest tightness, anorexia, deficient urination, red tongue, greasy or yellowish, veins slippery. Qingshu dampness, detoxification swelling. Qingshu Decoction.

3. Is virtual evil love cards: distributed in the body, local color dark red, pus scarce, one after another, delayed healing, with fever, irritability, thirst, or fatigue, limb soft, red tongue thin yellow, rapid pulse. Righting detoxification. Liu Wei Di Huang Decoction.

Second, external treatment and other treatment:

1. The beginning of detoxification should be swelling, moderate to henbane, water reconcile, wrap the affected area. Or wishful golden powder for external application. Or green cream Waicha.

2. Pus, the clip bolt out the pus.

3. Unhealed after the collapse, sores can be a little ninety-one Dan to drugs or drug line twist into sores, topical berberine gauze.

4. Oral Meihuadianshe Dan, Niuhuangjiedu, Fang Feng Tong Sheng Wan, Liushen other medicine.

5. Unilateral prescription: Silver Flower 30g, licorice 10g, decoction, on behalf of the tea.

Western boil treatment

1. Local treatment, such as heat, physical therapy, 10% ichthyol coated ointment. Facial Boil should rest in bed should not squeeze or prick Boil, so as not to spread to the brain.

2. Swelling or have a large range of obvious symptoms, should give systemic antibiotics (third-generation cephalosporin antibiotics).

3. The formation of abscess, incision and drainage should be timely but should be avoided Boil the face cut.

(a) treatment

1. The principles of early treatment to promote inflammation subsided, after early drain purulent pus; timely elimination of systemic adverse reactions.

2. Local treatment

(1) Physical therapy: early, ultraviolet micro-irradiation, can promote local anti-inflammatory, to prevent proliferation. Swelling stage, the selection of FM, infrared and other heat, promote Boil liquid. 2 to 3 times / d, 20 ~ 30min / times.

(2) Drug eraser: 0.5% povidone-iodine scrub, the drug not only for skin irritation, and the role of long-lasting, no pigmentation. Can also be used erythromycin, tetracycline ointment.

(3) topical cream: local swelling and a small pustules, use ichthyol, wishful golden powder, Gyokuro powder and so on.

(4) incision and drainage: Boil into pus, nodules soften, a sense of volatility, you can make a small incision drainage or fire needle drainage. Taboo squeeze purulent lesions.

(5) to keep local clean and dry: adhere to local skin cleaning, daily showers are the best conditions. Young children with skin, topical lip after taking a bath in summer, to avoid the formation of multiple Boil.

3. Systemic treatment usually does not require systemic treatment of boils. But facial boils or accompanied by chills, fever, headache, general malaise, etc., should be given antibiotics. Clinical observations and experimental results show that the efficacy of penicillin, cephalothin, cefazolin and amikacin better effect.

(B) the prognosis

generally good prognosis after active treatment, without sequelae.

[Examine]

boil should be how?

1. Peripheral blood

(1) white blood cell count: fever, elevated WBC count may have.

(2) white blood cell count: white blood cell count was elevated often accompanied by increased neutrophils .

2. diabetes check

(1) fasting plasma glucose measurement: two fasting blood glucose were increased, should consider the possibility of diabetes.

(2) glycated serum protein: This clinical trial is not the impact of fluctuations in blood glucose higher than normal to help the diagnosis of diabetes.

(3) glycosylated hemoglobin: glycosylated hemoglobin and blood glucose were positively correlated, and the irreversible reaction. Diabetes is often higher than the normal 2 to 3 times.

3. bacteriologic

(1) bacterial culture: the multiple, repeated infections, abscesses can be extracted directly pus for bacterial culture, positive results will help the diagnosis of pathogens.

(2) drug susceptibility testing: bacterial culture in the pus, while line drug susceptibility testing can provide the scientific basis of clinical drug treatment.

[Diff]

boil diseases easily confused?

1. Multiple sweat gland abscesses are summer disease, more common in infants and young children and frail mother's head, forehead, etc .. Lesions of multiple subcutaneous abscesses. Surface tenderness, inflammation lighter. No pus bolt, left scars. Usually accompanied by a lot of prickly heat. Generally known as prickly heat poison. It was also known as pseudo furunculosis (Pseudofurunculosis).

2. Hidradenitis suppurativa common in young women, lesions of the skin induration. Subcutaneous abscess formation, followed by skin redness, swelling, heat, pain, ulceration scarring. Lesions occur in the armpits, groin, genital and perianal, umbilical, etc.

3. acne acne mild infection, red, swollen, painful, but the disease is small, the top a little bit like creamy.

4. sebaceous cysts sebaceous cyst infection are redness, swelling, pain, but the previous round has been painless mass over an extended period , the epidermis as usual.

5. carbuncle carbuncle with redness, swelling, pain, but there are several hair follicle infection, lesions larger than the boil.

[Disease]

hump-related diseases

juvenile osteochondrosis of vertebral osteoporosis youth sexual hump sore scoliosis ankylosing spondylitis vitamin D deficiency disease

more back symptoms

small blisters appear back back pain back spasms, back pain does not have subtle linen spine back pain sinus pain Road with sensory ataxia spinal nerve root damage spinal cord hemisection syndrome, spinal cord lesions of hemorrhagic infiltration of the spinal cord injury spinal cord infarction, cauda equina involvement across the spinal cord within the spinal cord gliosis in the spinal cord anterior horn of the spinal cord lesion cavity formed spinal thalamic tract compression


小黑屋|Archiver|Healthcare | | 有健康網

GMT+8, 2014-10-2 22:29 , Processed in 0.768387 second(s), 2 queries , Gzip On, Memcache On.

Powered by Discuz! X3.1

© 2001-2013 Comsenz Inc.

Top