糖尿病手及其现代治疗  

The Diabetic Hand:A Forgotten Complication?

作　　者：潘紫曜 李昌祁[2] 

机构地区：[1]大庆龙南医院药剂科,黑龙江大庆163453 [2]大庆龙南医院内分泌科大庆市糖尿病诊疗中心,黑龙江大庆163453

出　　处：《药品评价》2016年第15期18-22,58,共6页Drug Evaluation

摘　　要：在20世纪70、80年代,关于糖尿病手部表现国外学者有很多讨论,但在国内学术界则鲜见涉猎。本次综述是为了重温糖尿病手并探讨手的病理可能对于糖尿病患者有非常重要的临床意义。在严格意义上来说,糖尿病手主要有三个临床表现,关节活动收限、掌腱膜挛缩症和扳机手。有证据表明,糖尿病患者出现这些症状的几率更高,其发病率可能与糖尿病的病程,血糖控制不佳,以及微血管的并发症有关。在更普遍的意义上,虽然有其他因素影响手部的病变,但是糖尿病会使其发生几率更高。从临床角度来看,对神经性病变导致的手溃疡和糖尿病手感染提高警觉是非常有必要的。最近,手的力量减少也被确认为糖尿病的并发症。因此,手部表现在糖尿病中有可能揭示实质性的病理过程,临床检查不应忽视。The manifestations of diabetes in the hand were much discussed in the 1970 s and 1980 s. The present review aims to revisit the diabetic hand and to discuss the pathology of the hand that may be clinically important in diabetic patients. In the strict sense of the term, the ＂diabetic hand＂ encompasses the three most widely studied conditions which have traditionally been associated with diabetes, namely limited joint mobility, Dupuytren＇s contracture and trigger finger. There is evidence that these entities are significantly more frequent in patients with diabetes and also that they may be associated with diabetes duration, poor metabolic control and presence of microvascular complications. In a more general sense, though, there are other conditions affecting the hands, which also occur more frequently in diabetes. From a practical point of view, increased alertness both for neuropathic hand ulcers in patients with profound neuropathy and for diabetic hand infections is absolutely necessary. Recently, reduced hand strength is beginning to be recognized as a further complication of diabetes. Thus, the hand may reveal substantial pathology in diabetes, and ideally, clinical examination should not ignore it.

关 键 词：并发症 糖尿病手 糖尿病 微血管病 

分 类 号：R587.1[医药卫生—内分泌]