Bệnh lậu với phác đồ điều trị mới

Benh lau v6i phac dd

dieu tri md

Benh lau la mpt benh nhiem

khuan do song cau gram

am Neisseria gonorrhoeae

gdy ra. Benh thfldng lay trflc tid'p

qua quan he tinh due khong dflpc

bao v§ nhfl dfldng dm dao, dfldng

hau mdn va mieng - sinh due. Thai

phu mac benh lau neu khong dieu

tri cd the lay nhidm cho tre so sinh

luc sanh gay viem ket mac mdt.

Vdi nam qua, benh lau co chilu

hudng gia tang. Theo To chflc Y

te the gidi, mdi nam toan cau cd

khoang 62 trieu benh nhan lau

tren tong so' 390 trieu benh nhdn

mac cac benh lay qua dfldng tinh

due. Rieng d nfldc ta mdi nam co

khoang 50.000 - 100.000 trfldng

hpp bi lau.

Benh bieu hien nhfl sau:

6n«r

Ty le nfl bi mdc benh sau mpt

lan quan he tinh due vdi nam gidi

bi benh vao khoang 60 - 80%. Thdi

gian u benh vao khoang 10 ngay.

Viem CO tfl cung la bieu hien dau

tien. Nieu dao cung bi nhiem lau.

Cac trieu chdng thfldng thay la ra

khi hfl nhieu, tieu budt, ra mau

gifla ky kinh, rong kinh. Cac trieu

chflng cd the rat nhe hoac ram rp,

26

ed khi chi cd mot trieu chflUg hoac

cd nhilu trieu chflng.

Bdnh lau d phu nfl khdng cd

thai gid'ng d phy nfl co thai. Tuy

nhien, phu nfl co thai it bi viem

tiiu khung hOn va hay gap lau hdu

hpng hon.

Biln chflng thfldng xay ra d phu

nfl cd thai la say thai tfl nhidn, vd

oi sdm, de non, viem mang 6'i rau,

viem ke't mac mdt tre so sinh, viem

hau hgng. Bien chflng hay gap

nha't d phu nfl la viem voi trflng

hay viem tieu khung, hau qua lau

dai la vo sinh, chda ngoai tfl cung,

dau tieu khung man tinh vdi nhflng

bieu hien nhfl dau bung dudi, dau

khi giao hgp, rd'i loan kinh nguydt.

O nam

Sau mpt lan quan he tinh due

vdi ngfldi b§nh qua dfldng dm dao

cd khoang 25% nam gidi bi mdc

b§nh. Thdi gian u benh trung binh

la 2 - 5 ngay. Viem nidu dao trflde

la bieu hien thfldng gap nhat cua

benh ldu d nam. Trieu chflng bao

gom dai budt va ra mu (tren lam

sang thfldng gpi la "gigt sflOng ban

mai buoi sang"). Kem theo la phu

ne va do d 16 dau dflOng vat. Chay

mii nieu dao la mot trieu chflng

dac hieu cua benh lau, mu cd mau

vang va so IflOng nhieu. Benh lau

cap tinh co tneu chflng chiem 85%

trfldng hpp, va khoang 25% benh

nhan cd trieu chdng khong rd vdi

bieu hien ra dich nieu dao nhflng

khdng nhieu va mau trong nen

khdng phan biet vdi viem nieu dao

khong do lau. Mgt so' trfldng hpp

khong cd trieu chflng. Du cd hay

khdng cd tneu chflng ma khdng

dflpc dieu tri thi cd the gay bien

chflng sau vai ngay de'n vai tudn

giam trieu chflng cap tinh. Bien

chflng hay gap nhat la viem mao

tinh hoan. Trflde khi cd khdng

.»BS. NGdVANTUXH

sinh tri lieu cd hidu qua, ty Id big'n

chflng nay la khoang 20% si bdnh

nhan ldu. Bilu Men sflng biu d n ^

bdn, dau va thfldng ed viem ni§u

dao. Cdc bien chfltig hiem gap bao

gdm: viem tui tinh, viem tuylo

tien lidt, chit hep nieu dao, dp-xe

quanh nieu dao,

Nhilm trun g h^ u hong

Ty le nhiem trflng hdu hong

d nhflng bdnh nhdn lau nam giffi

khoang 3 - 7%, nfl 10 - 20% (quan

hd khac gidi) va 10 - 25% nam

tinh due ddng gidi. ChUa din 10%

trfldng hop cd trieu chflng nhif

viem hau hgng, vidm amidan cap

tinh, doi khi cd so't va siftig hach

vung cl.

Nhilm trun g ha u mdn

- trrfc tran g

Hay gap d ngfldi tinh due dong

gidi nam. Bieu hidn ngfla hdu mon,

chay dich mu nhay d hdu m5n

nhung khdng dau, doi khi chiy

mdu trflc trang. Ndng nhU vidnv

trflc trang, bieu hidn dau, mdt T^M

va ed the tieu chay, di ra chat dmm

hoac mu, tao bdn. Kham thdy ! ^

mdn do cd mu nhdy, phii ne, niem

mac dl chay mdu.

Dieu tri:

Thang 7.2013 tai cugc hgi thao

cua Hidp hgi Quo'c t l ve nghidn d^

bdnh lay truyen qua dfldng tinh due

d Vienna (Ao) dfldi sfl gidm sdt oR

Trung tam Kiem sodt va Ph6ng

bdnh My (CDC) va Vien Sflc kh6e

Qudc gia Hoa Ky (NIH) da dttera

2 phac do dieu tri mdi ddy hda hen

dd la: phac do 1 gom gentamyoA

dang tidm va azithromycin d^ffi

vien, phac dd 2 gdm gemifloxa^

dang vien va azithromycin dang

vidn. Hai phac do mdi dieu tri l§u

cau dugc cdc nha khoa hoc MJ tfiyfi

hign trdn hon 400 dan dng vd V^^

THUOC & SOC KHOE sl505 (1.8.201^