Benh Parkinson o nguoi cao tuoi

Benh parkinson con goi la benh liet rung, la benh do suy thoai chuc nang cua he thong than kinh. Benh thuong gap o nguoi tren 50 tuoi va da so la dan ong, voi ty le mac benh la 1/500.

Nguoi mac benh Parkinson thuong gap nhieu kho khan trong cuoc song sinh hoat hang ngay va co the dan den tram cam.

Nguyen nhan

Hien nay y hoc van chua biet ro nguyen nhan gay ra benh Parkinson, nhung nhan thay o nguoi mac benh, ham luong dopamin trong co the giam di dang ke!

Benh Parkinson o nguoi cao tuoi

Dopamin la chat dan truyen than kinh thuoc nhom catecholamin (gom co: dopamin, noradrenalin, adrenalin) tap trung nhieu o vung hach day (basal ganglia) cua nao. Dopamin dong vai tro quan trong trong viec cu dong va phoi hop cac dong tac cua co the. Khi cac te bao san sinh ra dopamin bi thoai hoa hay chet di, gay nen su thieu hut dopamin trong co the va day chinh la yeu to nguy co gay ra benh parkinson.

Ngoai ra con co mot so yeu to thuan loi nhu:

- Thuong tiep xuc voi thuoc tru sau, thuoc diet co.

- Co tien su ve chan thuong vung dau, viem nao.

- Co benh xo vua dong mach...

Trieu chung

Cac trieu chung cua benh Parkinson thuong dien tien keo dai:

- Luc dau bi run o mot tay, sau lan ra o chan cung ben roi dan dan run o ca hai ben.

- Nguoi benh thuong co tu the cung do, cham chap, khuon mat vo cam, dang di khom ve phia truoc, hay mat thang bang.

- Nguoi benh gap kho khan khi viet chu, tam trang lo lang thuong dan den tram cam.

Dieu tri

Hien nay y hoc van chua co the tri het benh Parkinson nhung giup ngan chan qua trinh phat trien benh qua cac phuong phap sau:

Phuong phap vat ly tri lieu:

Trong giai doan dau cua benh

Parkinson, viec ap dun g phuong phap vat ly tri lieu giup cai thien dang ke kha nang van dong va nang do ve mat tinh than cho benh nhan.

Phuong phap dung thuoc:

Levodopa: day la thuoc chu yeu dung de dieu tri benh Parkinson va RLS. Viec su dung levodopa se giup cho nguoi benh giam bot nhung trieu chung va cai thien chat luong cuoc song. Levodopa la tien chat cua dopamin. Khi vao co the, levodopa vuot qua duoc hang rao mau nao va chuyen hoa than h dopamin (dopamin khong vuot qua duoc hang rao mau nao nen khong the su dung truc tiep).

Tuy nhien o ngoai bien, levodopa bi cac enzym decarboxylase chuyen hoa thanh dopamin, nen levodopa thuong duoc phoi hop voi cac chat uc che enzym nay nhu carbidopa, benserazid voi cac che pham nhu: sinemet (levodopa + carbidopa), madopar (levodopa + benserazid). De tang hieu qua dieu tri, levodopa thuong duoc phoi hop voi cac thuoc sau day:

- Amantadin la thuoc dieu tri virut cum typ A2 nhung con duoc su dung trong dieu tri benh Parkinson.

Amantadin giup kich thich su phongthich dopamin noi sinh.

- Cac thuoc chu van dopamin (dopamine agonists) gom cobromocriptin, pergolid, pramipexole...kich thich truc tiep len cac thu thedopaminergic.

- Cac thuoc khang tiet cholin: gom co trihexyphenidyl, benzatrophine, procyclidine… Hien nay cac thuoc nay it duoc su dung trong dieu tri benh Parkinson.

Phuong phap ngoai khoa Phuong phap ngoai khoa duoc su dung khi cac phuwong phap tren khong mang lai hieu qua dieu tri nhu mong muon. Viec phau thuat nao se cai thien dang ke cac trieu chung run, cung do... cua nguoi mac benh Parkinson.

DS. MAI XUAN DUNG

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