Bệnh thường gặp, Bệnh Gút

Bệnh Gout (Gút): Nguyên nhân, triệu chứng và cách điều trị

Posted on by Thiết Bị Y Tế Giá Rẻ ✩彡

Bệnh Gout (Gút) là một căn bệnh phổ biến trong mọi thời đại, ảnh hưởng rất lớn tới sinh hoạt, cuộc sống và cũng là một nỗi lo của rất nhiều người. Vì thế việc hiểu biết về bệnh gout, nguyên nhân, triệu chứng đóng vai trò quan trọng để giúp người thân chẩn đoán, phát hiện sớm để có biện pháp phòng ngừa, điều trị một cách tốt nhất.

Bệnh Gout (Gút): Nguyên nhân, triệu chứng và cách điều trị

Bệnh Gout (Gút) là gì?

Gout (Gút) là bệnh khớp vi tinh thể, do rối loạn chuyển hoá các nhân purin ở trong thận, có đặc điểm chính là tăng acid uric (AU) máu. Acid uric được tạo ra trong dòng máu do các sản phẩm chứa purin bị phá vỡ. Thông thường, thận lọc các acid uric ra khỏi máu và bài tiết vào nước tiểu. Nếu cơ thể sản xuất quá nhiều acid uric hoặc thận không có khả năng để lọc hết gây nên sự tích tụ acid uric trong máu.

Trong quá trình nhiều năm tăng acid uric máu có thể gây ra lắng đọng kết tinh urat khắp cơ thể. Các khớp, gân, vành tai và thận dễ lắng đọng hơn nơi khác. Khi các tinh thể urat gắn kết một phản ứng viêm bao gồm đau, đỏ, sưng và gây tổn thương cho tế bào khớp.

Bênh Gout là gì?

Nguyên nhân bệnh Gout (Gút)

Nguyên nhân bệnh Gout gồm có hai nguyên nhân chính: Gout nguyên phát và Gout thứ phát

Gout nguyên phát

Đa số các trường hợp là gout nguyên phát, chiếm tỷ lệ > 95% trường hợp tăng acid uric máu. Thường ở người trưởng thành.

Chưa rõ nguyên nhân, có thể do:

  • Yếu di truyền với tính chất gia đình. 1/3 bệnh nhân gout có cha mẹ bị bệnh gout.
  • Yếu tố thức ăn chứa nhiều purin như: rượu, bia, hải sản (tôm, cua, cá,..), thịt.

Gout thứ phát

Chiếm tỷ lệ 2-5% các trường hợp gout. Hai nguyên nhân chính là suy thận mạn tính và sử dụng thuốc lợi tiểu. Các nguyên nhân khác rất hiếm gặp.

  • Suy thận mạn tính: hai bệnh thận thường gặp là thận đa nang và nhiễm độc chì.
  • Thuốc lợi tiểu: thiazid, furosemid.
  • Các nguyên nhân khác:

+ Bệnh máu: leucemia thể tuỷ mạn tính, thiếu máu huyết tán, đa u tuỷ xương, đa hồng cầu…

+ Bệnh vảy nến diện rộng.

+ Suy cận giáp, suy giáp, chấn thương, phẫu thuật, chảy máu, nhiễm khuẩn, carcinoma

Triệu chứng bệnh Gout (Gút)

Triệu chứng bệnh guot thường xuất hiện với người bệnh đã từng mắc Gout cấp tính hoặc mạn tính. Tự phát hoặc sau một bữa ăn nhiều chất đạm hoặc uống nhiều rượu bia; một đợt dùng thuốc: aspirin, lợi tiểu. Khởi phát đột ngột vào nửa đêm.

  • Khớp đau ghê gớm, dữ dội, bỏng rát
  • Đau đến cực độ, đau làm mất ngủ
  • Khớp lớn thường tràn dịch, khớp nhỏ thì phù nề
  • Da vùng khớp tổn thương hồng hoặc đỏ

Đau tăng về đêm trong 5-6 đêm tiếp đó. Ban ngày đau giảm dần, có thể hết đau hoàn toàn vào ban ngày. Thường kèm theo cảm giác mệt mỏi, đôi khi sốt 38-38,5 độ C, có thể kèm rét run.

Nếu người bị bệnh gout không dùng thuốc trị gout thường xuyên, các triệu chứng của bệnh sẽ nghiêm trọng hơn.

  • U hạt tophi: tích tụ dưới da thường các vị trí vành tai, mỏm khuỷu, cạnh các khớp tổn thương, ở bàn chân, bàn tay, cổ tay.
  • Tổn thương khớp: khớp sưng kèm biến dạng do huỷ hoại khớp và do sự có mặt của hạt tophi không đối xứng, kèm theo cứng khớp
  • Tổn thương thận: sỏi urat, bệnh thận do gout, suy thận

Hạt tophi trong bệnh Gout

Cách điều trị bệnh Gout (Gút)

Chế độ ăn uống – sinh hoạt cho người bệnh Gout:

  • Giảm kalo, đạt trọng lượng cơ thể ở mức sinh lý.
  • Ăn chế độ giảm đạm. Thịt ăn không quá 150g/ngày. Tránh thức ăn giàu purin phủ tạng động vật, tôm cua, cá béo, thịt bê, đậu hạt các loại… . Có thể ăn trứng, sữa. Ăn nhiều rau xanh, hoa quả.
  • Bỏ hoàn toàn thức uống có cồn, tránh trà, cà phê.
  • Uống nhiều nước, đặc biệt nƣớc khoáng kiềm khoảng 2 lít/ngày
  • Luyện tập sức khỏe lành mạnh, giảm cân nếu trong tình trạng thừa cân, béo phì

Cách điều trị bệnh Gout

Điều trị nội khoa:

  • Thuốc chống viêm không streroid
  • Thuốc hạ acid uric máu

Điều trị ngoại khoa:

Phẫu thuật cắt bỏ u cục tophi được chỉ định từ các bác sĩ, chuyên khoa để tránh các hậu quả không mong muốn.

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