{"id":18777,"date":"2023-04-22T15:53:00","date_gmt":"2023-04-22T08:53:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=18777"},"modified":"2023-04-22T15:53:00","modified_gmt":"2023-04-22T08:53:00","slug":"dau-hieu-lam-sang-can-lam-sang-chan-doan-xuat-huyet-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/dau-hieu-lam-sang-can-lam-sang-chan-doan-xuat-huyet-nao\/","title":{"rendered":"Nh\u1eefng d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft n\u00e3o"},"content":{"rendered":"

Tr\u00ean m\u1ed9t b\u1ec7nh nh\u00e2n nghi ng\u1edd \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o<\/a>, c\u00e1c d\u1eadu hi\u1ec7u l\u00e2m s\u00e0ng l\u00e0 ti\u1ec1n \u0111\u1ec1 v\u00e0 ch\u1ec9 \u0111i\u1ec3m \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng s\u00e2u h\u01a1n. Nh\u1eadn bi\u1ebft c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng n\u00e0y l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0111\u00fang b\u1ec7nh c\u0169ng nh\u01b0 th\u1ef1c hi\u1ec7n nhanh ch\u00f3ng c\u00e1c \u0111i\u1ec1u tr\u1ecb b\u01b0\u1edbc \u0111\u1ea7u cho b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n

\"\u0111\u00f4t<\/p>\n

1. D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng xu\u1ea5t huy\u1ebft n\u00e3o<\/h2>\n

1.1. Khai th\u00e1c ti\u1ec1n s\u1eed v\u00e0 b\u1ec7nh s\u1eed<\/h3>\n

C\u1ea7n khai th\u00e1c \u0111\u01b0\u1ee3c m\u1ed9t b\u1ec7nh s\u1eed \u0111\u1ea7y \u0111\u1ee7 bao g\u1ed3m th\u1eddi gian kh\u1edfi ph\u00e1t v\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng, c\u0169ng nh\u01b0 \u0111\u00e1nh gi\u00e1 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3. Ch\u00fa \u00fd ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh ngay c\u1ea3 khi c\u00f2n nh\u1ecf v\u00e0 c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo.<\/p>\n

1.2. Kh\u00e1m l\u00e2m s\u00e0ng<\/h3>\n

1.2.1. Kh\u00e1m to\u00e0n th\u00e2n<\/h4>\n

Th\u0103m kh\u00e1m b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft n\u00e3o (XHN) ph\u1ea3i ch\u00fa \u00fd \u0111\u00e1nh gi\u00e1 c\u00e1c d\u1ea5u hi\u1ec7u sinh t\u1ed3n. Kh\u00e1m to\u00e0n th\u00e2n v\u00e0 t\u1eadp trung v\u00e0o \u0111\u1ea7u, tim, ph\u1ed5i, b\u1ee5ng, t\u1ee9 chi v\u00e0 kh\u00e1m th\u1ea7n kinh k\u1ef9 l\u01b0\u1ee1ng nh\u01b0ng nhanh ch\u00f3ng.<\/p>\n

T\u0103ng huy\u1ebft \u00e1p (\u0111\u1eb7c bi\u1ec7t HA t\u00e2m thu l\u1edbn > 220 mm Hg) th\u01b0\u1eddng g\u1eb7p \u0111\u1ed9t quy\u0323 xu\u1ea5t huy\u1ebft n\u00e3o. Huy\u1ebft \u00e1p cao nhi\u1ec1u k\u00e8m theo s\u1ed1t th\u01b0\u1eddng l\u00e0 bi\u1ec3u hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh n\u1eb7ng, ti\u00ean l\u01b0\u1ee3ng x\u1ea5u.<\/p>\n

1.2.2. Ph\u00e1t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa<\/h4>\n

D\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa ph\u1ee5 thu\u1ed9c v\u00e0o khu v\u1ef1c n\u00e3o b\u1ecb t\u1ed5n th\u01b0\u01a1ng.<\/p>\n

N\u1ebfu t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u chi\u1ebfm \u01b0u th\u1ebf<\/strong> (th\u01b0\u1eddng l\u00e0 b\u00ean tr\u00e1i), th\u0103m kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 th\u1ea5y nh\u1eefng d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng sau:
\n– Li\u1ec7t n\u1eeda ng\u01b0\u1eddi ph\u1ea3i
\n– M\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi ph\u1ea3i
\n– Nh\u00ecn sang tr\u00e1i
\n– M\u1ea5t th\u1ecb tr\u01b0\u1eddng ph\u1ea3i
\n– Th\u1ea5t ng\u00f4n
\n– Qu\u00ean n\u1eeda th\u00e2n b\u00ean li\u1ec7t (kh\u00f4ng \u0111i\u1ec3n h\u00ecnh)<\/p>\n

N\u1ebfu t\u1ed5n th\u01b0\u01a1ng b\u00e1n c\u1ea7u kh\u00f4ng chi\u1ebfm \u01b0u th\u1ebf<\/strong> (th\u01b0\u1eddng l\u00e0 b\u00ean ph\u1ea3i), ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3:
\n– Li\u1ec7t n\u1eeda ng\u01b0\u1eddi tr\u00e1i
\n– M\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi tr\u00e1i
\n– M\u1eaft nh\u00ecn sang ph\u1ea3i
\n– M\u1ea5t th\u1ecb tr\u01b0\u1eddng b\u00ean tr\u00e1i<\/p>\n

N\u1ebfu ti\u1ec3u n\u00e3o b\u1ecb t\u1ed5n th\u01b0\u01a1ng,<\/strong>\u00a0b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao b\u1ecb tho\u00e1t v\u1ecb v\u00e0 ch\u00e8n \u00e9p n\u00e3o. Tho\u00e1t v\u1ecb c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m nhanh m\u1ee9c \u0111\u1ed9 \u00fd th\u1ee9c v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ng\u1eebng th\u1edf ho\u1eb7c t\u1eed vong.<\/p>\n

C\u00e1c c\u00e1c v\u1ecb tr\u00ed \u0111\u1eb7c hi\u1ec7u li\u00ean quan \u0111\u1ebfn nh\u1eefng d\u1ea5u hi\u1ec7u th\u1ea7n kinh khu tr\u00fa trong xu\u1ea5t huy\u1ebft n\u00e3o bao g\u1ed3m:<\/strong><\/h5>\n

– Nh\u00e2n b\u00e8o: li\u1ec7t n\u1eeda ng\u01b0\u1eddi b\u00ean \u0111\u1ed1i di\u1ec7n, m\u1ea5t c\u1ea3m gi\u00e1c b\u00ean \u0111\u1ed1i di\u1ec7n, li\u1ec7t v\u1eadn \u0111\u1ed9ng nh\u00e3n c\u1ea7u b\u00ean \u0111\u1ed1i di\u1ec7n, b\u00e1n manh c\u00f9ng b\u00ean, th\u1ea5t ng\u00f4n, qu\u00ean n\u1eeda b\u00ean li\u1ec7t, ho\u1eb7c m\u1ea5t v\u1eadn \u0111\u1ed9ng t\u1ef1 ch\u1ee7 b\u00ean li\u1ec7t.
\n– \u0110\u1ed3i th\u1ecb: m\u1ea5t c\u1ea3m gi\u00e1c b\u00ean \u0111\u1ed1i di\u1ec7n, li\u1ec7t n\u1eeda ng\u01b0\u1eddi b\u00ean \u0111\u1ed1i di\u1ec7n, li\u1ec7t v\u1eadn nh\u00e3n, b\u00e1n manh c\u00f9ng b\u00ean, co \u0111\u1ed3ng t\u1eed, th\u1ea5t ng\u00f4n, ho\u1eb7c nh\u1ea7m l\u1eabn.
\n– Xu\u1ea5t huy\u1ebft th\u00f9y n\u00e3o: li\u1ec7t, m\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi b\u00ean \u0111\u1ed1i di\u1ec7n, li\u1ec7t v\u1eadn nh\u00e3n b\u00ean \u0111\u1ed1i di\u1ec7n, b\u00e1n manh c\u00f9ng b\u00ean, th\u1ea5t ng\u00f4n, qu\u00ean n\u1eeda ng\u01b0\u1eddi b\u00ean li\u1ec7t, ho\u1eb7c m\u1ea5t v\u1eadn \u0111\u1ed9ng t\u1ef1 ch\u1ee7 b\u00ean li\u1ec7t.
\n– Nh\u00e2n \u0111u\u00f4i: li\u1ec7t n\u1eeda ng\u01b0\u1eddi b\u00ean \u0111\u1ed1i di\u1ec7n, li\u1ec7t v\u1eadn nh\u00e3n, ho\u1eb7c nh\u1ea7m l\u1eabn.
\n– Cu\u1ed1ng \u0111\u1ea1i n\u00e3o: li\u1ec7t t\u1ee9 chi, li\u1ec7t m\u1eb7t, gi\u1ea3m \u00fd th\u1ee9c, li\u1ec7t v\u00e2n nh\u00e3n, co \u0111\u1ed3ng t\u1eed.
\n– Ti\u1ec3u n\u00e3o: li\u1ec7t m\u1eb7t, m\u1ea5t c\u1ea3m gi\u00e1c; li\u1ec7t v\u00e2n nh\u00e3n, co \u0111\u1ed3ng t\u1eed, ho\u1eb7c gi\u1ea3m m\u1ee9c \u0111\u1ed9 \u00fd th\u1ee9c.<\/p>\n

C\u00e1c d\u1ea5u hi\u1ec7u kh\u00e1c c\u1ee7a c\u1ee7a ti\u1ec3u n\u00e3o ho\u1eb7c th\u00e2n n\u00e3o g\u1ed3m:<\/strong><\/h5>\n

– D\u00e1ng \u0111i ho\u1eb7c v\u1eadn \u0111\u1ed9ng tay ch\u00e2n m\u1ea5t \u0111i\u1ec1u h\u00f2a
\n– Ch\u00f3ng m\u1eb7t ho\u1eb7c \u00f9 tai
\n– Bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n
\n– Li\u1ec7t n\u1eeda ng\u01b0\u1eddi ho\u1eb7c li\u1ec7t t\u1ee9 chi
\n– M\u1ea5t c\u1ea3m gi\u00e1c n\u1eeda ng\u01b0\u1eddi ho\u1eb7c m\u1ea5t c\u1ea3m gi\u00e1c c\u1ee7a c\u1ea3 4 chi
\n– B\u1ea5t th\u01b0\u1eddng v\u1eadn nh\u00e3n d\u1eabn \u0111\u1ebfn nh\u00ecn \u0111\u00f4i ho\u1eb7c ch\u1ee9ng rung gi\u1eadt nh\u00e3n c\u1ea7u
\n– Suy gi\u1ea3m ch\u1ee9c n\u0103ng h\u1ea7u h\u1ecdng ho\u1eb7c kh\u00f3 nu\u1ed1t
\n– D\u1ea5u hi\u1ec7u b\u1eaft ch\u00e9o (m\u1eb7t c\u00f9ng b\u00ean v\u00e0 c\u01a1 th\u1ec3 \u0111\u1ed1i b\u00ean)
\nC\u00e1c tri\u1ec7u ch\u1ee9ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n:
\n– \u0110\u1ed9t ng\u1ed9t \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i
\n– D\u1ea5u hi\u1ec7u m\u00e0ng n\u00e3o v\u1edbi g\u00e1y c\u1ee9ng
\n– Ch\u1ee9ng s\u1ee3 \u00e1nh s\u00e1ng v\u00e0 \u0111au khi c\u1eed \u0111\u1ed9ng m\u1eaft
\n– Bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n
\n– Ng\u1ea5t: k\u00e9o d\u00e0i ho\u1eb7c kh\u00f4ng \u0111i\u1ec3n h\u00ecnh<\/p>\n

Nhi\u1ec1u h\u1ed9i ch\u1ee9ng \u0111\u1ed9t quy\u0323 kh\u00e1c c\u00f3 li\u00ean quan \u0111\u1ebfn xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd, t\u1eeb \u0111au \u0111\u1ea7u nh \u0111\u1ebfn suy gi\u1ea3m n\u1eb7ng n\u1ec1 ch\u1ee9c n\u0103ng th\u1ea7n kinh. \u0110\u00f4i khi, xu\u1ea5t huy\u1ebft n\u00e3o c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n b\u1eb1ng m\u1ed9t c\u01a1n \u0111\u1ed9ng kinh m\u1edbi kh\u1edfi ph\u00e1t.<\/p>\n

2. D\u1ea5u hi\u1ec7u c\u1eadn l\u00e2m s\u00e0ng xu\u1ea5t huy\u1ebft n\u00e3o<\/h2>\n

C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng th\u00ec kh\u00f4ng \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t XHN v\u1edbi nh\u1ed3i m\u00e1u n\u00e3o hay v\u1edbi c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c c\u00f3 bi\u1ec3u hi\u1ec7n gi\u1ed1ng \u0111\u1ed9t quy\u0323 b\u1edfi v\u1eady ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh XHN ph\u1ea3i d\u1ef1a v\u00e0o h\u00ecnh \u1ea3nh h\u1ecdc th\u1ea7n kinh (ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ho\u1eb7c ch\u1ee5p c\u1ed9ng hu\u1edfng t\u1eeb s\u1ecd n\u00e3o).<\/p>\n

2.1. Ch\u1ee5p c\u1eaft l\u1edbp vi ti\u0301nh (CLVT) s\u1ecd n\u00e3o<\/h3>\n

CLVT kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n quang l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt nhanh v\u1edbi \u0111\u1ed9 nh\u1ea1y r\u1ea5t cao \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh XHN c\u1ea5p t\u00ednh, v\u00e0 do t\u00ednh kh\u1ea3 d\u1ee5ng cao c\u1ee7a n\u00f3 m\u00e0 \u0111\u00e2y \u0111\u01b0\u1ee3c coi nh\u01b0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh XHN trong c\u00e1c khoa c\u1ea5p c\u1ee9u.<\/p>\n

CLVT s\u1ecd n\u00e3o ngo\u00e0i vi\u1ec7c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh XHN, c\u00f2n cung c\u1ea5p th\u00eam c\u00e1c th\u00f4ng tin h\u1eefu \u00edch kh\u00e1c bao g\u1ed3m v\u1ecb tr\u00ed, lan r\u1ed9ng v\u00e0o n\u00e3o th\u1ea5t, gi\u00e3n n\u00e3o th\u1ea5t, s\u1ef1 xu\u1ea5t hi\u1ec7n v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u00f9 n\u00e3o, s\u1ef1 \u0111\u00e8 \u0111\u1ea9y \u0111\u01b0\u1eddng gi\u1eefa c\u0169ng nh\u01b0 th\u00e2n n\u00e3o th\u1ee9 ph\u00e1t do hi\u1ec7u \u1ee9ng kh\u1ed1i c\u1ee7a kh\u1ed1i m\u00e1u.<\/p>\n

Th\u1ec3 t\u00edch kh\u1ed1i m\u00e1u n\u1ed9i s\u1ecd l\u00e0 y\u1ebfu t\u1ed1 d\u1ef1 b\u00e1o m\u1ea1nh m\u1ebd \u0111\u1ea7u ra l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nhanh ch\u00f3ng \u1edf khoa c\u1ea5p c\u1ee9u d\u1ef1a v\u00e0o k\u1ef9 thu\u1eadt \u0111o ABC\/2.<\/p>\n

H\u00ecnh \u1ea3nh XHN c\u1ea5p t\u00ednh tr\u00ean CLVT s\u1ecd n\u00e3o th\u00ec d\u1ec5 nh\u1eadn bi\u1ebft do \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u00ecnh \u1ea3nh t\u0103ng t\u1ef7 tr\u1ecdng so v\u1edbi nhu m\u00f4 n\u00e3o (tr\u1eeb khi s\u1ed1 l\u01b0\u1ee3ng m\u00e1u qu\u00e1 \u00edt). S\u1ef1 tho\u00e1i tri\u1ec3n c\u1ee7a kh\u1ed1i m\u00e1u \u0111\u01b0\u1ee3c \u0111\u00e1nh d\u1ea5u b\u1edfi s\u1ef1 gi\u1ea3m t\u1ef7 tr\u1ecdng d\u1ea7n c\u1ee7a kh\u1ed1i m\u00e1u cho t\u1edbi khi b\u1ecb d\u1ecbch h\u00f3a ho\u00e0n to\u00e0n \u1edf giai \u0111o\u1ea1n m\u1ea1n t\u00ednh.<\/p>\n

    \n
  • Ch\u1ecdn l\u00e1t c\u1eaft ngang c\u1ee7a CLVT c\u00f3 v\u00f9ng ch\u1ea3y m\u00e1u l\u1edbn nh\u1ea5t.<\/li>\n
  • \u0110o \u0111\u01b0\u1eddng k\u00ednh l\u1edbn nh\u1ea5t (A) v\u00e0 \u0111\u01b0\u1eddng k\u00ednh vu\u00f4ng g\u00f3c v\u1edbi n\u00f3 (B)<\/li>\n
  • \u0110\u01b0\u1eddng k\u00ednh C \u0111\u1ef1\u1ee3c t\u00ednh b\u1eb1ng \u0111\u1ed9 d\u00e0y l\u00e1t c\u1eaft c\u1ee7a phim ch\u1ee5p nh\u00e2n v\u1edbi s\u1ed1 l\u00e1t c\u1eaft quan s\u00e1t th\u1ea5y kh\u1ed1i m\u00e1u A, B, C \u0111\u01b0\u1ee3c \u0111o theo cm.<\/li>\n
  • Th\u1ec3 t\u00edch kh\u1ed1i m\u00e1u V=ABC\/2 c\u00f3 \u0111\u01a1n v\u1ecb cm3 hay mL.<\/li>\n<\/ul>\n

    2. 2. Ch\u1ee5p m\u1ea1ch n\u00e3o (CT m\u1ea1ch n\u00e3o)<\/h3>\n

    \u0110\u00e2y l\u00e0 k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n kh\u00f4ng x\u00e2m l\u1ea5n h\u1eefu \u00edch trong b\u1ec7nh c\u1ea3nh XHN c\u1ea5p gi\u00fap ph\u00e1t hi\u1ec7n c\u00e1c b\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a xu\u1ea5t huy\u1ebft n\u00e3o. C\u00e1c y\u1ebfu t\u1ed1 n\u00ean \u0111\u1eb7t ra nghi ng\u1edd c\u00f3 b\u1ea5t th\u01b0\u1eddng m\u1ea1ch n\u00e3o bao g\u1ed3m: xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n, xu\u1ea5t huy\u1ebft n\u00e3o \u1edf th\u00f9y n\u00e3o, xu\u1ea5t huy\u1ebft n\u00e3o th\u1ea5t nhi\u1ec1u, tu\u1ed5i tr\u1ebb v\u00e0 kh\u00f4ng c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 b\u1ec7nh l\u00fd m\u1ea1ch n\u00e3o (nh\u01b0 t\u0103ng huy\u1ebft \u00e1p).<\/p>\n

    Ngo\u00e0i ph\u00e1t hi\u1ec7n nguy\u00ean nh\u00e2n b\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u th\u00ec d\u1ea5u hi\u1ec7u tho\u00e1t thu\u1ed1c c\u1ea3n quang b\u00ean trong kh\u1ed1i m\u00e1u tr\u00ean CT m\u1ea1ch n\u00e3o l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u ch\u1ec9 \u0111i\u1ec3m d\u1ef1 b\u00e1o s\u1ef1 lan r\u1ed9ng c\u1ee7a kh\u1ed1i m\u00e1u v\u00e0 \u0111\u1ea7u ra l\u00e2m s\u00e0ng k\u00e9m cho b\u1ec7nh nh\u00e2n.<\/p>\n

    D\u1ea5u hi\u1ec7u tho\u00e1t thu\u1ed1c r\u1ea5t c\u00f3 \u00edch gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng cho ph\u1eabu thu\u1eadt vi\u00ean trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt l\u1ea5y kh\u1ed1i m\u00e1u t\u1ee5. M\u1ed9t s\u1ed1 \u0111i\u1ec3m b\u1ea5t l\u1ee3i c\u1ee7a ph\u01b0\u01a1ng ph\u00e1p n\u00e0y l\u00e0 nguy c\u01a1 nhi\u1ec5m x\u1ea1 t\u0103ng l\u00ean c\u0169ng nh\u01b0 l\u00e0 nguy c\u01a1 c\u1ee7a thu\u1ed1c c\u1ea3n quang g\u00e2y d\u1ecb \u1ee9ng hay suy th\u1eadn t\u0103ng l\u00ean.<\/p>\n

    M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n m\u1ea1ch m\u00e1u g\u00e2y XHN th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng bao g\u1ed3m: ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch n\u00e3o, d\u1ecb d\u1ea1ng th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch n\u00e3o (AVM), d\u1ecb d\u1ea1ng r\u00f2 \u0111\u1ed9ng t\u0129nh m\u1ea1ch m\u00e0ng c\u1ee9ng (dAVF), huy\u1ebft kh\u1ed1i xoang t\u0129nh m\u1ea1ch n\u00e3o…<\/p>\n

    2.3. Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb s\u1ecd n\u00e3o<\/h3>\n

    C\u1ed9ng h\u01b0\u1edfng t\u1eeb (CHT) c\u00f3 \u0111\u1ed9 nh\u1ea1y \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n XHN t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi CT s\u1ecd n\u00e3o kh\u00f4ng ti\u00eam. CHT c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y xu\u1ea5t huy\u1ebft n\u00e3o nh\u01b0 c\u00e1c u n\u00e3o ch\u1ea3y m\u00e1u hay nh\u1ed3i m\u00e1u chuy\u1ec3n d\u1ea1ng ch\u1ea3y m\u00e1u.<\/p>\n

    \u1ede c\u00e1c b\u1ec7nh nh\u00e2n suy th\u1eadn hay d\u1ecb \u1ee9ng thu\u1ed1c c\u1ea3n quang th\u00ec vi\u1ec7c \u0111\u00e1nh gi\u00e1 m\u1ea1ch n\u00e3o c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c th\u00f4ng qua CHT m\u1ea1ch m\u00e1u m\u00e0 kh\u00f4ng c\u1ea7n ti\u00eam ch\u1ea5t t\u01b0\u01a1ng ph\u1ea3n.<\/p>\n

    Tuy nhi\u00ean, do gi\u00e1 th\u00e0nh cao, vi\u1ec7c th\u0103m kh\u00e1m k\u00e9o d\u00e0i v\u00e0 t\u00ednh kh\u1ea3 d\u1ee5ng th\u1ea5p h\u01a1n CT s\u1ecd n\u00e3o n\u00ean CHT \u00edt khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft n\u00e3o trong b\u1ec7nh c\u1ea3nh c\u1ea5p c\u1ee9u. H\u00ecnh \u1ea3nh xu\u1ea5t huy\u1ebft n\u00e3o tr\u00ean CHT c\u00f3 th\u1ec3 \u0111\u1eb7t ra nhi\u1ec1u th\u00e1ch th\u1ee9c do bi\u1ec3u hi\u1ec7n c\u1ee7a m\u00e1u thay \u0111\u1ed5i theo c\u00e1c chu\u1ed7i xung, th\u1eddi gian k\u1ec3 t\u1eeb l\u00fac b\u1eaft \u0111\u1ea7u ch\u1ea3y m\u00e1u, k\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed ch\u1ea3y m\u00e1u.<\/p>\n

    2.4. C\u00e1c x\u00e9t nghi\u1ec7m huy\u1ebft h\u1ecdc v\u00e0 sinh h\u00f3a m\u00e1u<\/h3>\n

    C\u00e1c x\u00e9t nghi\u1ec7m huy\u1ebft h\u1ecdc v\u00e0 sinh h\u00f3a m\u00e1u \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh l\u1ea5y m\u1eabu ngay khi b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u00e0 qua kh\u00e1m l\u00e2m s\u00e0ng, ng\u01b0\u1eddi th\u00e0y thu\u1ed1c nghi ng\u1edd b\u1ec7nh nh\u00e2n b\u1ecb \u0111\u1ed9t quy\u0323 XHN, bao g\u1ed3m:
    \n– C\u00f4ng th\u1ee9c m\u00e1u, sinh h\u00f3a m\u00e1u: \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, ur\u00ea m\u00e1u, creatinine v\u00e0 glucose.
    \n– \u0110\u00f4ng m\u00e1u c\u01a1 b\u1ea3n: th\u1eddi gian prothrombin, INR, APTT cho t\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n.
    \n– Troponin tim.
    \n– S\u00e0ng l\u1ecdc \u0111\u1ed9c t\u00ednh \u0111\u1ec3 ph\u00e1t hi\u1ec7n cocaine v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c k\u00edch th\u00edch giao c\u1ea3m kh\u00e1c.
    \n– T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u v\u00e0 c\u1ea5y n\u1ee9\u1edbc ti\u1ec3u.
    \n– Th\u1eed thai \u1edf ph\u1ee5 n\u1eef trong \u0111\u1ed9 tu\u1ed5i sinh \u0111\u1ebb.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Tr\u00ean m\u1ed9t b\u1ec7nh nh\u00e2n nghi ng\u1edd \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o, c\u00e1c d\u1eadu hi\u1ec7u l\u00e2m s\u00e0ng l\u00e0 ti\u1ec1n \u0111\u1ec1 v\u00e0 ch\u1ec9 \u0111i\u1ec3m \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng s\u00e2u h\u01a1n. Nh\u1eadn bi\u1ebft c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng n\u00e0y l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0111\u00fang b\u1ec7nh […]<\/p>\n","protected":false},"author":24,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nNh\u1eefng d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft n\u00e3o<\/title>\n<meta name=\"description\" content=\"Tr\u00ean b\u1ec7nh nh\u00e2n nghi ng\u1edd \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o, c\u00e1c d\u1eadu hi\u1ec7u l\u00e2m s\u00e0ng l\u00e0 ti\u1ec1n \u0111\u1ec1 v\u00e0 ch\u1ec9 \u0111i\u1ec3m \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng s\u00e2u h\u01a1n\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, 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