{"id":18005,"date":"2023-04-14T21:00:41","date_gmt":"2023-04-14T14:00:41","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18005"},"modified":"2023-04-17T15:31:16","modified_gmt":"2023-04-17T08:31:16","slug":"cai-may-tho-va-rut-ong-noi-khi-quan-o-benh-nhan-hoi-suc-phau-thuat-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/cai-may-tho-va-rut-ong-noi-khi-quan-o-benh-nhan-hoi-suc-phau-thuat-tim\/","title":{"rendered":"Cai m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u1edf b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim"},"content":{"rendered":"<p><strong>Cai m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n l\u00e0 hai th\u1ee7 thu\u1eadt\u00a0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c sau ph\u1eabu thu\u1eadt tim. Cai m\u00e1y th\u1edf \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 gi\u1ea3m d\u1ea7n s\u1ef1 ph\u1ee5 thu\u1ed9c v\u00e0o m\u00e1y th\u1edf v\u00e0 kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p c\u1ee7a b\u1ec7nh nh\u00e2n. Trong khi \u0111\u00f3, r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 lo\u1ea1i b\u1ecf \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n sau khi b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 th\u1ec3 th\u1edf \u0111\u1ed9c l\u1eadp.\u00a0<\/strong><\/p>\n<h2><strong>1.Ti\u00eau chu\u1ea9n cai m\u00e1y th\u1edf:<\/strong><\/h2>\n<p>Vi\u1ec7c cai m\u00e1y th\u1edf c\u1ee7a b\u1ec7nh nh\u00e2n ph\u1ee5 thu\u1ed9c v\u00e0o kh\u1ea3 n\u0103ng khi n\u00e0o b\u1ec7nh nh\u00e2n \u0111\u00e3 s\u1eb5n s\u00e0ng \u0111\u1ec3 cai m\u00e1y th\u1edf c\u00e1c ti\u00eau chu\u1ea9n cho qu\u00e1 tr\u00ecnh cai m\u00e1y th\u1edf nh\u01b0 sau:<\/p>\n<h3><strong><em>1.1 Giai <\/em><\/strong><strong><em>\u0111<\/em><\/strong><strong><em>o\u1ea1n h\u1eadu ph\u1eabu ban <\/em><\/strong><strong><em>\u0111<\/em><\/strong><strong><em>\u1ea7u<\/em><\/strong><strong><em>:<\/em><\/strong><\/h3>\n<p>T\u1ec9nh t\u00e1o khi \u0111\u01b0\u1ee3c k\u00edch th\u00edch. S\u1ee9c c\u01a1 t\u1ee9 chi m\u1ea1nh, \u0111\u1ec1u.L\u01b0\u1ee3ng d\u1ecbch tho\u00e1t ra t\u1eeb c\u00e1c \u1ed1ng d\u1eabn l\u01b0u &lt;50 mL\/gi\u1edd.Nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3 &gt;35,5 \u00b0C.Huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng \u1ed5n \u0111\u1ecbnh \u1edf m\u1ee9c 100-140 mmHg khi c\u00f3\/ng\u1eebng c\u00e1c thu\u1ed1c v\u1eadn m\u1ea1ch.Nh\u1ecbp tim &lt;120 l\u1ea7n\/ph\u00fat. Kh\u00f4ng c\u00f3 lo\u1ea1n nh\u1ecbp.Gi\u00e1 tr\u1ecb kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch t\u1ed1t tr\u00ean m\u00e1y th\u1edf g\u1ed3m:PaO2\/FiO2 &gt;150 (PO2 &gt;75 mmHg v\u1edbi FiO2 l\u00e0 0,5), PCO2 &lt;50 mmHg v\u00e0 pH 7,30-7,50.<\/p>\n<h3><strong><em>1.2 Giai \u0111o\u1ea1n th\u1edf m\u00e1y th\u1edf k\u00e9o d\u00e0i:<\/em><\/strong><\/h3>\n<ul>\n<li>Qu\u00e1 tr\u00ecnh b\u1ec7nh \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>T\u1ec9nh t\u00e1o \u0111\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u1ed9ng t\u00e1c h\u00edt v\u00e0 duy tr\u00ec \u0111\u01b0\u1eddng th\u1edf.<\/li>\n<li>Kh\u00f4ng thi\u1ebfu m\u00e1u.<\/li>\n<li>Gi\u00e1 tr\u1ecb kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch t\u1ed1t nh\u01b0 tr\u00ean (nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u1ec1 ngh\u1ecb PaO2\/FiO2 &gt;200) v\u1edbi t\u1ea7n s\u1ed1 th\u1edf &lt;35\/ph\u00fat.<\/li>\n<\/ul>\n<h2><strong>2.Ph\u01b0\u01a1ng ph\u00e1p gi\u1ea3m m\u00e1y th\u1edf sau th\u1eddi gian ng\u1eafn <\/strong><strong>\u0111<\/strong><strong>\u01b0\u1ee3c s\u1eed d\u1ee5ng:<\/strong><\/h2>\n<ul>\n<li>Gi\u1ea3m t\u1ed1i \u0111a thu\u1ed1c an th\u1ea7n.<\/li>\n<li>Gi\u1eef FiO2 \u1edf m\u1ee9c 0,5 ho\u1eb7c th\u1ea5p h\u01a1n v\u1edbi PEEP kh\u00f4ng qu\u00e1 5-7,5 cmH2O. N\u1ebfu b\u1ec7nh nh\u00e2n v\u1eabn c\u1ea7n m\u1ee9c PEEP cao h\u01a1n, th\u01b0\u1eddng kh\u00f4ng \u0111\u1ec1 xu\u1ea5t cai m\u00e1y th\u1edf. N\u1ebfu s\u1ef1 oxy h\u00f3a l\u00e0 \u0111\u1ea7y \u0111\u1ee7, gi\u1ea3m PEEP theo kho\u1ea3ng c\u00e1ch 2,5-5 cm H2O \u0111\u1ec3 gi\u1ea3m xu\u1ed1ng 5 cm H2O v\u00e0 kh\u1edfi \u0111\u1ed9ng qu\u00e1 tr\u00ecnh cai m\u00e1y th\u1edf.<\/li>\n<li>Qu\u00e1 tr\u00ecnh cai m\u00e1y th\u1edf n\u00ean \u0111\u01b0\u1ee3c ng\u01b0ng v\u00e0 th\u00f4ng kh\u00ed \u0111\u01b0\u1ee3c kh\u1edfi \u0111\u1ed9ng l\u1ea1i \u1edf m\u1ee9c cao h\u01a1n khi c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng cho th\u1ea5y b\u1ec7nh nh\u00e2n kh\u00f4ng ch\u1ecbu \u0111\u01b0\u1ee3c cai m\u00e1y th\u1edf. C\u00e1c d\u1ea5u hi\u1ec7u n\u00e0y bao g\u1ed3m:<\/li>\n<\/ul>\n<p>+ Bu\u1ed3n ng\u1ee7, lo l\u1eafng ho\u1eb7c ra m\u1ed3 h\u00f4i.<\/p>\n<p>+Huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng t\u0103ng h\u01a1n 20 mm Hg ho\u1eb7c tr\u00ean 160 mm Hg.<\/p>\n<p>+Nh\u1ecbp tim thay \u0111\u1ed5i h\u01a1n 20% theo b\u1ea5t k\u1ef3 h\u01b0\u1edbng n\u00e0o ho\u1eb7c l\u00ean tr\u00ean 120 l\u1ea7n\/ph\u00fat.<\/p>\n<p>+Lo\u1ea1n nh\u1ecbp xu\u1ea5t hi\u1ec7n th\u01b0\u1eddng xuy\u00ean h\u01a1n.<\/p>\n<p>+T\u1ea7n s\u1ed1 th\u1edf t\u0103ng h\u01a1n 10 nh\u1ecbp\/ph\u00fat ho\u1eb7c l\u00ean tr\u00ean 35 nh\u1ecbp\/ph\u00fat trong n\u0103m ph\u00fat.<\/p>\n<p>+Gi\u00e1 tr\u1ecb PaO2 gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi 60 mmHg khi FiO2 l\u00e0 0,5 ho\u1eb7c SpO2 gi\u1ea3m xu\u1ed1ng d\u01b0\u1edbi 90%<\/p>\n<p>+Gi\u00e1 tr\u1ecb PCO2 t\u0103ng h\u01a1n 50 mmHg v\u1edbi t\u00ecnh tr\u1ea1ng toan h\u00f3a h\u00f4 h\u1ea5p (pH &lt;7,30)<\/p>\n<p>L\u01b0u \u00fd: T\u0103ng \u00e1p ph\u1ed5i th\u01b0\u1eddng l\u00e0 b\u1ea5t th\u01b0\u1eddng huy\u1ebft \u0111\u1ed9ng \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng ch\u1ecbu \u0111\u01b0\u1ee3c qu\u00e1 tr\u00ecnh cai m\u00e1y th\u1edf. H\u00f4 h\u1ea5p nhanh l\u00e0 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111\u1ea7u ti\u00ean c\u1ee7a qu\u00e1 tr\u00ecnh cai m\u00e1y th\u1edf kh\u00f4ng hi\u1ec7u qu\u1ea3.<\/p>\n<h2><strong>3.Ti\u00eau chu\u1ea9n r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n<\/strong><\/h2>\n<p>Bao g\u1ed3m c\u00e1c ti\u00eau chu\u1ea9n cai m\u00e1y th\u1edf \u0111\u00e3 li\u1ec7t k\u00ea v\u00e0 trong giai \u0111o\u1ea1n h\u1eadu ph\u1eabu ban \u0111\u1ea7u c\u1ea7n:<\/p>\n<ul>\n<li>T\u1ec9nh t\u00e1o m\u00e0 kh\u00f4ng c\u1ea7n k\u00edch th\u00edch.<\/li>\n<li>C\u01a1 h\u00f4 h\u1ea5p \u0111\u1ea1t ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c.<\/li>\n<li>T\u1ea7n s\u1ed1 th\u1edf t\u1ef1 nhi\u00ean &lt;24\/ph\u00fat.<\/li>\n<li>PaO2 &gt;70 mmHg tr\u00ean FiO2 l\u00e0 0,5 ho\u1eb7c \u00edt h\u01a1n.<\/li>\n<li>PCO2 &lt;48 mmHg.<\/li>\n<li>pH 7,32-7,45.<\/li>\n<\/ul>\n<p>Vi\u1ec7c r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1eeb CPAP ho\u1eb7c\u00a0 th\u1edf qua \u1ed1ng ch\u1eef T. M\u1eb7c d\u00f9 s\u1ef1 oxy h\u00f3a c\u00f3 th\u1ec3 t\u1ed1t h\u01a1n m\u1ed9t ch\u00fat trong qu\u00e1 tr\u00ecnh th\u1eed nghi\u1ec7m CPAP h\u01a1n l\u00e0 \u1ed1ng ch\u1eef T, tuy nhi\u00ean s\u1ef1 oxy h\u00f3a sau khi r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n th\u01b0\u1eddng t\u1ed1t h\u01a1n \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c gi\u1ea3m m\u00e1y th\u1edf v\u1edbi \u1ed1ng ch\u1eef T, v\u00ec PaO2 gi\u1ea3m \u00edt h\u01a1n so v\u1edbi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n t\u1eeb CPAP.<\/p>\n<h2><strong>4.Nh\u1eefng y<\/strong><strong>\u1ebf<\/strong><strong>u t\u1ed1 c\u1ea7n xem x\u00e9t b\u1ed5 sung<\/strong><\/h2>\n<ul>\n<li>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n tr\u1edf n\u00ean lo l\u1eafng khi thu\u1ed1c an th\u1ea7n \u0111\u01b0\u1ee3c gi\u1ea3m. M\u1eb7c d\u00f9 gi\u00e1 tr\u1ecb kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch t\u1ed1t nh\u01b0ng b\u1ec7nh nh\u00e2n lo l\u1eafng th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u00eam th\u00eam thu\u1ed1c an th\u1ea7n qua \u0111\u00eam v\u1edbi m\u1ed9t l\u1ea7n th\u1eed cai m\u00e1y th\u1edf v\u00e0o s\u00e1ng h\u00f4m sau. N\u1ebfu b\u1ec7nh nh\u00e2n th\u1edf kh\u00f4ng \u0111\u1ed3ng b\u1ed9 v\u1edbi m\u00e1y th\u1edf, c\u00e1c bi\u1ec7n ph\u00e1p kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng. Gi\u1ea3m d\u1ea7n thu\u1ed1c an th\u1ea7n, thay th\u1ebf propofol b\u1eb1ng dexmedetomidine, \u0111\u1ea3m b\u1ea3o \u0111\u1ed9ng vi\u00ean b\u1ec7nh nh\u00e2n&#8221;b\u1ea1n \u0111ang l\u00e0m t\u1ed1t&#8221;, sau \u0111\u00f3 gi\u1ea3m m\u00e1y th\u1edf nhanh v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n th\u01b0\u1eddng l\u00e0 l\u1ef1a ch\u1ecdn t\u1ed1t nh\u1ea5t cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/li>\n<li>N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf khi \u0111\u01b0\u1ee3c c\u1eafm \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n trong ph\u00f2ng m\u1ed5, c\u1ea7n \u0111\u1ea3m b\u1ea3o gi\u00e1 tr\u1ecb kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch v\u00e0 c\u01a1 h\u00f4 h\u1ea5p \u0111\u1ee7 ch\u1ea5p nh\u1eadn tr\u01b0\u1edbc khi r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n. Trong tr\u01b0\u1eddng h\u1ee3p r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0o gi\u1eefa \u0111\u00eam, c\u1ea7n th\u1eadn tr\u1ecdng v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y. M\u1ed9t c\u00e1 nh\u00e2n c\u00f3 kinh nghi\u1ec7m trong vi\u1ec7c \u0111\u1eb7t \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n kh\u00f3 n\u00ean c\u00f3 m\u1eb7t. N\u00ean chu\u1ea9n b\u1ecb s\u1eb5n b\u1ed9 \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n.<\/li>\n<li>Nh\u1eefng b\u1ec7nh nh\u00e2n gi\u00e0 v\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh tim m\u1ea1ch n\u1eb7ng ho\u1eb7c ch\u1ee9c n\u0103ng gan b\u1ecb r\u1ed1i lo\u1ea1n th\u01b0\u1eddng m\u1ea5t th\u1eddi gian \u0111\u1ec3 t\u1ec9nh l\u1ea1i sau m\u1ed5, ngay c\u1ea3 khi kh\u00f4ng \u0111\u01b0\u1ee3c ti\u00eam thu\u1ed1c an th\u1ea7n. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh s\u1ef1 ch\u1eadm tr\u1ec5 trong qu\u00e1 tr\u00ecnh chuy\u1ec3n h\u00f3a thu\u1ed1c \u0111\u01b0\u1ee3c ti\u00eam trong qu\u00e1 tr\u00ecnh m\u1ed5 ho\u1eb7c c\u00f3 th\u1ec3 \u0111\u00f4i khi l\u00e0 do gi\u1ea3m ho\u1ea1t \u0111\u1ed9ng c\u1ee7a n\u00e3o t\u1ea1m th\u1eddi do thi\u1ebfu m\u00e1u n\u00e3o trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt ho\u1eb7c do nguy\u00ean nh\u00e2n kh\u00e1c. N\u00ean c\u1ea9n tr\u1ecdng khi s\u1eed d\u1ee5ng Naloxone \u0111\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c g\u00e2y m\u00ea. Thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra \u0111au, lo l\u1eafng, huy\u1ebft \u00e1p cao, ch\u1ee9ng r\u1ed1i lo\u1ea1n nh\u1ecbp tim v\u00e0 ch\u1ea3y m\u00e1u, v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn suy h\u00f4 h\u1ea5p t\u00e1i ph\u00e1t khi t\u00e1c d\u1ee5ng c\u1ee7a n\u00f3 \u0111\u00e3 k\u1ebft th\u00fac.<\/li>\n<li>Tuy nhi\u00ean, n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng t\u1ec9nh t\u00e1o sau 24-36 gi\u1edd v\u00e0 c\u00f3 c\u00e2u h\u1ecfi li\u1ec7u \u0111\u00f3 c\u00f3 ph\u1ea3i l\u00e0 tai bi\u1ebfn, ch\u1ee9ng m\u1ea5t ng\u1ee7, hay ch\u1ec9 l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c g\u00e2y m\u00ea c\u00f2n l\u1ea1i, ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 xem x\u00e9t s\u1eed d\u1ee5ng m\u1ed9t ch\u1ea5t \u0111\u1ed1i kh\u00e1ng m\u1ed9t c\u00e1ch th\u1eadn tr\u1ecdng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh b\u1ea3n ch\u1ea5t c\u1ee7a v\u1ea5n \u0111\u1ec1. Naloxone (Narcan) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1eb1ng c\u00e1ch ti\u00eam 1-2 mL\/ph\u00fat c\u1ee7a m\u1ed9t h\u1ed7n h\u1ee3p g\u1ed3m m\u1ed9t l\u1ecd 1 mL ch\u1ee9a 0,4 mg\/mL trong 9 mL n\u01b0\u1edbc mu\u1ed1i sinh l\u00fd (0,04-0,08 mg\/ph\u00fat) \u0111\u1ebfn li\u1ec1u t\u1ed5ng c\u1ed9ng 0,4 mg. 5. Nhi\u1ec1u b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 d\u00f9ng th\u00eam thu\u1ed1c g\u00e2y m\u00ea, s\u1ebd th\u1ec3 hi\u1ec7n c\u01a1 ch\u1ebf h\u00f4 h\u1ea5p t\u1ed1t khi \u0111\u01b0\u1ee3c k\u00edch th\u00edch, nh\u01b0ng sau \u0111\u00f3 l\u1ea1i ng\u1ee7 m\u00ea v\u00e0 tr\u1edf l\u1ea1i tr\u1ea1ng th\u00e1i kh\u00f4ng th\u1edf. \u0110\u1ed3ng t\u1eed co l\u1ea1i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c nh\u1eadn th\u1ea5y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u00e1c d\u1ee5ng g\u00e2y m\u00ea k\u00e9o d\u00e0i. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y ch\u01b0a s\u1eb5n s\u00e0ng \u0111\u1ec3 gi\u1ea3m m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n. Kh\u00f4ng l\u1eabn l\u1ed9n gi\u1eefa h\u00f4 h\u1ea5p tho\u1ea3i m\u00e1i v\u1edbi t\u00e1c d\u1ee5ng g\u00e2y m\u00ea hay an th\u1ea7n k\u00e9o d\u00e0i. \u0110\u00e2y th\u01b0\u1eddng l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u1eb7t \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n l\u1ea1i.<\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.vinmec.com\/\"><strong>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/strong><\/a> \u0111\u00e3 \u0111\u01b0a h\u1ec7 th\u1ed1ng m\u00e1y th\u1edf, thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i \u0111\u1ea1t chu\u1ea9n v\u00e0o c\u00f4ng t\u00e1c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3\u00a0 v\u1ec1 h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Cai m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n l\u00e0 hai th\u1ee7 thu\u1eadt\u00a0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c sau ph\u1eabu thu\u1eadt tim. Cai m\u00e1y th\u1edf \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 gi\u1ea3m d\u1ea7n s\u1ef1 ph\u1ee5 thu\u1ed9c v\u00e0o m\u00e1y th\u1edf v\u00e0 kh\u00f4i ph\u1ee5c ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p c\u1ee7a b\u1ec7nh nh\u00e2n. Trong [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":20168,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Cai m\u00e1y, r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u1edf b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim<\/title>\n<meta name=\"description\" content=\"Cai m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u1edf b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng. T\u00ecm hi\u1ec3u c\u00e1c ti\u00eau chu\u1ea9n trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cai m\u00e1y, r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u1edf b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim\" \/>\n<meta property=\"og:description\" content=\"Cai m\u00e1y th\u1edf v\u00e0 r\u00fat \u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n \u1edf b\u1ec7nh nh\u00e2n h\u1ed3i s\u1ee9c ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng. 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