![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
70岁老人,右脚有跖趾关节骨头增生十年,平时无事,前日因运动过多,肿痛,去医院说是痛风,以前有慢性肾炎。用药后右脚有好转,但是今天左脚开始有点疼了(女,70岁)
图片因隐私问题无法显示
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
你好,去医院做过什么检查如何诊断的铜锭
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
如何诊断的痛风
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
没检查,医生看了下就说是痛风
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
左边这个脚趾变形也是很多年了吗
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
左边这个三年
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
右边发作的十年
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
图片因隐私问题无法显示
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
这是今年体检的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
你这个不好说一定是痛风的,有可能基础还是一个骨质增生,这次发作可能是和运动有关系的。
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
这个尿酸对于这个年龄来说不算很高
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
最好去做个关节彩超看一下是不是痛风
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
肾功能不全可能有一些止疼药是不合适吃的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
除了慢性肾功能不全还有别的慢性病吗
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,两脚对称疼是不是更像痛风?这两天基本休息没动过,左脚今天却开始痛了
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
痛风一般不是对称性的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
你这个还是最好去查一下关节彩超,血常规,c反应蛋白
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
看一下
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
之前右脚疼吃的什么药
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,这边医生开了秋水碱,醋氯芬酸肠溶片,二十五味珊瑚胶囊
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
双氯芬酸肾功能不全要注意一点。有可能会有损伤。需要监测肾功能
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
之前有没有别的慢性病,尤其是胃肠道方面的
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
胃肠还好
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
有高血压
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
那醋酸泼尼松呢?伤肾吗
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
这个不伤肾
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
还有可以吃安必定,这个止疼药也不伤肾
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
安必丁
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
可以短期吃小剂量激素,或者吃安必丁,但是还是建议要先去查一下看看到底是什么原因再治疗
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,c反应蛋白是查什么的?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
查炎症的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
如果是痛风会升高很多的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
骨关节炎一般不高或者高一点点
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
嗯
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
提醒一下如果要吃安必丁这个药物有可能会出现大小便变黄或者发红,这个是正常的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
一般晚饭后吃,有的人会有腹泻,如果腹泻严重就不能吃。别的没什么。这个药肾功能不全的病人比较适合
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,买了醋酸泼尼松,能不能先吃点这个看看效果?安必丁要几周见效,我怕老人疼久了难受
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
激素效果可能快一点。但是短期小剂量吃可以。
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
不能长期大剂量吃
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
服药期间要注意感染。注意胃肠道反应,关注有没有大便发黑这些症状
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
哦,醋酸泼尼松是激素药是吧,每天一次每次四粒,吃三天,可行?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
体重多少
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
160多斤
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
体温正常的的有没有发热
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
比较胖
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
不热
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
短期吃一下可以的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
毕竟年龄比较大,不良反应还是注意一下
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
嗯。😊
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
这两天饮食清淡一些
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,痛风去医院一般挂什么科?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
风湿科
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
没有风湿科呢
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
没有风湿科的医院。内分泌科也可以。首选风湿科
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
那就内分泌
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
😊
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
医生,老人说今天不痛了,药是不是可以不用吃了
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
你是说激素吗
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
如果是痛风的话,不控制好尿酸很容易反复。所以还是要去查一下尿酸到底高不高,如果还高不控制尿酸后面还容易复发
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
是的,那我去查一下。平时生活中怎么控制尿酸?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
低嘌呤饮食,不喝酒,少吃海鲜,不喝荤汤。可以适当吃瘦肉。
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
老人的尿酸多少算正常?她以前又有慢性肾炎
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
首先确定她这次到底是不是痛风。有没有发作过痛风对于控制尿酸的水平是很重要的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
如果这次是痛风,那尿酸需要控制在360以下
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,请问怎么确定?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
去医院查呀
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
昨天和你说的那些项目
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的谢谢
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
现在吃了激素可能炎症指标都不一定高了
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
关节彩超要做
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
现在的尿酸要查
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的,彩超是查什么的?
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
关节彩超
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
看看关节里面是什么病变
![用户头像](https://static.chunyuyisheng.com/@/media/images/2017/04/22/c072/8a13d525d3a4_w48_h48_.png)
患者
好的
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
嗯😊
![](https://resourced.chunyu.mobi/Y_wAAABC4SudbHsX-8e6e04b5-7143-4a9c-b958-4aa22f99891e_w1278_h1285_.jpg?imageMogr2/thumbnail/150x)
平雯雯医生
要是没问题,欢迎您给我一个“满意”评价(评价按钮在页面右上角,问题关闭后页面下面也可评价)。春雨系统会自动赠送您一张复诊优惠券。
提示:疾病因人而异,他人的咨询记录仅供参考,擅自治疗存在风险。
咨询时间: 2023-10-29