Bolgarska S. Differential-diagnostic peculiarities and approach to treatment of trophic ulcers in lower extremities in diabetic patients

Object: Ulcer necrotic processes in diabetes mellitus. The work is amed to the issues of differential diagnostics of trophic ulcers in lower extremities in diabetes patients and of the improvement of their treatment. Methods and apparatus: clinical, epidemiological, laboratory, instrumental; Doppler, scintillation gamma-camera, tuning fork, Tip-term (for temperature sensation identification), TCD (for discriminative sensation identification). Theoretical and practical results: The most important factors in ulceration of the feet in diabetes are duration of the diabetes, a lower limbs ulceration in anamnesis and the age of the patients. A trigger factor is trauma. The expediency of the inclusion of a systemic enzymotherapy drug Vobenzym for the combined therapy of trophic ulcers in lower extremities in diabetes patients was proved. The new: For the first time the applied system of instrumental methods of examination, which included X-ray angiography and ultrasonic dopplerometry allowed to learn in greater detail the peculiarities of hemodynamics damage as a result of different trophic ulcers in lower extremities in diabetes patients and on the basis of the showing of residual index and the time of the complete and time-lagged sanguinary stream to differentiate the neuropathic and neuroischemic lesions, as well as to determine the approach to treatment. The level of approach: results can be used in treating patients with diabetic foot syndrome and traning specialists-endocrinologists. Field of application: endocrinology