{"id":19144,"date":"2023-04-12T19:28:51","date_gmt":"2023-04-12T12:28:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19144"},"modified":"2023-04-17T16:30:24","modified_gmt":"2023-04-17T09:30:24","slug":"thay-doi-chuc-nang-gan-sau-phau-thuat-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/thay-doi-chuc-nang-gan-sau-phau-thuat-tim\/","title":{"rendered":"Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i nh\u01b0 th\u1ebf n\u00e0o sau ph\u1eabu thu\u1eadt tim?"},"content":{"rendered":"<div class=\"x78zum5 x1r8uery xdt5ytf x1iyjqo2 xmz0i5r x6ikm8r x10wlt62 x1n2onr6\">\n<div class=\"x1qjc9v5 x9f619 xdl72j9 x2lwn1j xeuugli x1n2onr6 x1ja2u2z x78zum5 xdt5ytf x1iyjqo2 xs83m0k x6ikm8r x10wlt62\">\n<div class=\"x78zum5 xdt5ytf x1iyjqo2 xs83m0k x6ikm8r x10wlt62\">\n<div class=\"x78zum5 xdt5ytf x1iyjqo2 x6ikm8r x10wlt62 x1n2onr6 x1xzczws\">\n<div class=\"x78zum5 xdt5ytf x1iyjqo2 xs83m0k x1xzczws x6ikm8r x1rife3k x1n2onr6 xh8yej3\">\n<div class=\"\">\n<div class=\"x1n2onr6\">\n<div class=\"x1qjc9v5 x9f619 x78zum5 xdl72j9 xdt5ytf x2lah0s x2lwn1j xeuugli x1n2onr6 xc8icb0 x1ja2u2z\">\n<div id=\":r6e:\">\n<div class=\"x63ui4o x18i3tt1 x6ikm8r x10wlt62\" role=\"grid\" aria-label=\"Tin nh\u1eafn trong cu\u1ed9c tr\u00f2 chuy\u1ec7n v\u1edbi L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\">\n<div class=\"__fb-light-mode x1n2onr6\" role=\"row\">\n<div class=\"\">\n<div class=\"x78zum5 xdt5ytf x1n2onr6\" tabindex=\"0\" role=\"gridcell\" data-release-focus-from=\"CLICK\" data-scope=\"messages_table\">\n<div class=\"x78zum5\" role=\"none\">\n<div class=\"x78zum5 x1iyjqo2 xs83m0k xeuugli x15zctf7\" role=\"none\">\n<div class=\"x1h91t0o xkh2ocl x78zum5 xdt5ytf x13a6bvl x1r145dm\" role=\"none\">\n<div class=\"x78zum5 xh8yej3\" role=\"none\">\n<div class=\"x78zum5 xdt5ytf x193iq5w x1n2onr6 xuk3077\">\n<div class=\"x78zum5 xh8yej3\" role=\"none\">\n<div class=\"x1tlxs6b x1g8br2z x1gn5b1j x230xth x14ctfv x1okitfd x6ikm8r x10wlt62 x1mzt3pk x1y1aw1k xn6708d xwib8y2 x1ye3gou x1n2onr6 x13faqbe x1vjfegm\" role=\"none\">\n<div class=\"x9f619 x1n2onr6 x1ja2u2z __fb-light-mode\" role=\"none\">\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong>Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i sau ph\u1eabu thu\u1eadt tim h\u1edf l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p.Tuy nhi\u00ean, n\u00f3 c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn ch\u1ee9c n\u0103ng gan. G\u1ea7n \u0111\u00e2y, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng gan sau ph\u1eabu thu\u1eadt tim h\u1edf. C\u00e1c k\u1ebft qu\u1ea3 cho th\u1ea5y r\u1eb1ng, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n ch\u1ee9c n\u0103ng gan v\u00e0 c\u00e1c ch\u1ebf \u0111\u1ed9 ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t c\u00f3 th\u1ec3 gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng gan v\u00e0 gi\u1ea3m t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn gan.<\/strong><\/div>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong>1. C\u1eadn l\u00e2m s\u00e0ng thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan:\u00a0<\/strong><\/h2>\n<ul>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Ch\u1ee9c n\u0103ng gan phosphatase ki\u1ec1m l\u00e0 \u0111i\u1ec1u kh\u00f4ng hi\u1ebfm sau khi ph\u1eabu thu\u1eadt tim m\u1edf. Kho\u1ea3ng 25% b\u1ec7nh nh\u00e2n s\u1ebd t\u0103ng bilirubin t\u1ea1m th\u1eddi (Bilirubin to\u00e0n ph\u1ea7n&gt; 3 mg \/ dL), v\u1edbi t\u1ef7 l\u1ec7 cao h\u01a1n \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf b\u1ec7nh nh\u00e2n ph\u1eabu thu\u1eadt s\u1eeda ho\u1eb7c thay van. Tuy nhi\u00ean, \u00edt h\u01a1n 1% b\u1ec7nh nh\u00e2n s\u1ebd c\u00f3 d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o gan \u0111\u00e1ng k\u1ec3 c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh vi\u00eam gan m\u1ea1n t\u00ednh ho\u1eb7c suy gan.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Bilirubin t\u0103ng c\u00f3 th\u1ec3 nhi\u1ec1u nguy\u00ean nh\u00e2n, bilirubin t\u0103ng t\u1eeb h\u1ed3ng c\u1ea7u b\u1ecb ph\u00e1 h\u1ee7y c\u0169ng nh\u01b0 s\u1ef1 suy gi\u1ea3m ch\u1ee9c n\u0103ng gan, g\u00f3p ph\u1ea7n cho c\u1ea3 t\u00ecnh tr\u1ea1ng t\u0103ng bilirubin kh\u00f4ng li\u00ean h\u1ee3p v\u00e0 li\u00ean h\u1ee3p.<\/li>\n<\/ul>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong>2. C\u00e1c \u0111i\u1ec1u ki\u1ec7n thay \u0111\u1ed5i ch\u1ee9c n\u0103ng sau ph\u1eabu thu\u1eadt: <\/strong><\/h2>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">2.1. B\u1ec7nh gan m\u1ea1n t\u00ednh c\u00f3 s\u1eb5n:<\/h3>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng gan t\u0103ng, nh\u01b0ng \u0111\u00f4i khi s\u1ebd \u0111\u01b0\u1ee3c k\u1ebft h\u1ee3p v\u1edbi gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng. Tuy nhi\u00ean, ch\u1ee9c n\u0103ng t\u1ed5ng h\u1ee3p c\u1ee7a gan suy gi\u1ea3m (albumin huy\u1ebft thanh th\u1ea5p, INR cao) l\u00e0 m\u1ed9t g\u1ee3i \u00fd cho b\u1ec7nh gan. T\u0103ng bilirubin \u1edf b\u1ec7nh nh\u00e2n suy tim l\u00e0 m\u1ed9t trong nh\u1eefng d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd cho s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a ch\u1ee9c n\u0103ng gan b\u1ea5t th\u01b0\u1eddng sau ph\u1eabu thu\u1eadt.<\/div>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">2.2. C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim m\u1ea1ch:<\/h3>\n<ul>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Suy tim ph\u1ea3i g\u00e2y \u00e1p su\u1ea5t t\u0129nh m\u1ea1ch c\u1eeda ph\u1ea3i cao g\u00e2y t\u1eafc ngh\u1ebdn gan h\u1ec7 t\u0129nh m\u1ea1ch gan ph\u1ea3i.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">S\u1ed1c tim tr\u01b0\u1edbc ph\u1eabu thu\u1eadt (c\u01a1n \u0111au tim c\u1ea5p t\u00ednh, h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng tr\u00ean van) c\u00f3 th\u1ec3 g\u00e2y t\u0103ng ch\u1ec9 s\u1ed1 ch\u1ee9c n\u0103ng gan li\u00ean quan tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, d\u1eabn \u0111\u1ebfn b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ph\u00e1t tri\u1ec3n suy gan v\u00e0 suy \u0111a t\u1ea1ng sau ph\u1eabu thu\u1eadt tim h\u1edf.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng tr\u00ean van v\u1edbi d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng c\u00f3 th\u1ec3 g\u00e2y ch\u1ee9c n\u0103ng gan b\u1ea5t th\u01b0\u1eddng.<\/li>\n<\/ul>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">2.3. C\u00e1c y\u1ebfu t\u1ed1 ph\u1eabu thu\u1eadt:<\/h3>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Th\u1eddi gian k\u00e9o d\u00e0i c\u1ee7a tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3(CPB), c\u00e1c ph\u1eabu thu\u1eadt ph\u1ee9c t\u1ea1p (k\u1ebft h\u1ee3p\u00a0 b\u1eafc c\u1ea7u m\u1ea1ch v\u00e0nh -CABG &#8211; thay van, nhi\u1ec1u van), s\u1ed1 l\u01b0\u1ee3ng m\u00e1u \u0111\u01b0\u1ee3c truy\u1ec1n nhi\u1ec1u h\u01a1n trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.<\/div>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">2.4. C\u00e1c y\u1ebfu t\u1ed1 sau ph\u1eabu thu\u1eadt:<\/h3>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">H\u1ed9i ch\u1ee9ng \u0111\u00e1p \u1ee9ng vi\u00eam to\u00e0n th\u00e2n ,nhi\u1ec5m tr\u00f9ng, truy\u1ec1n m\u00e1u.<\/div>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">2.5. Thu\u1ed1c:<\/h3>\n<p class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Bao g\u1ed3m c\u00e1c statin, acetaminophen v\u00e0 clopidogrel.<\/p>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong>3.C\u01a1 ch\u1ebfsinh l\u00fd b\u1ec7nh:<\/strong><\/h2>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Ch\u1ee9c n\u0103ng gan b\u1ea5t th\u01b0\u1eddng c\u00f3 th\u1ec3 do gi\u1ea3m tu\u1ea7n ho\u00e0n gan ho\u1eb7c t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u to\u00e0n th\u00e2n.<\/div>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">3.1. T\u1ebf b\u00e0o gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng:<\/h3>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 Suy tim b\u00ean ph\u1ea3i ho\u1eb7c van ba l\u00e1 gi\u00e3n n\u1eb7ng.<\/div>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 Nhi\u1ec5m tr\u00f9ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan do c\u00e1c ch\u1ea5t trung gian \u0111\u00e1p \u1ee9ng vi\u00eam v\u00e0 \u0111\u1ed9c t\u1ed1 kh\u00e1c; ch\u1ee9c n\u0103ng gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng do nhi\u1ec5m tr\u00f9ng l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 nguy c\u01a1 ch\u00ednh cho suy \u0111a t\u1ea1ng v\u00e0 t\u1eed vong.<\/div>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 Vi\u00eam gan sau truy\u1ec1n m\u00e1u: virus vi\u00eam gan C ho\u1eb7c nhi\u1ec5m cytomegalovirus (mu\u1ed9n).<\/div>\n<h3 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">3.2. T\u0103ng bilirubin<\/h3>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 H\u1ed3ng c\u1ea7u ph\u00e1 h\u1ee7y(th\u1eddi gian s\u1eed d\u1ee5ng tu\u1ea7n ho\u00e0n c\u01a1 th\u1ec3 d\u00e0i, nhi\u1ec5m tr\u00f9ng,truy\u1ec1n m\u00e1u s\u1ed1 l\u01b0\u1ee3ng l\u1edbn, thu\u1ed1c)<\/div>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 T\u1eafc ngh\u1ebdn trong gan (vi\u00eam gan, ho\u1ea1i t\u1eed t\u1ebf b\u00e0o gan, t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt sau ph\u1eabu thu\u1eadt, nhi\u1ec5m tr\u00f9ng,thu\u1ed1c\u2026)<\/div>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u2022 T\u1eafc ngh\u1ebdn ngo\u00e0i gan (t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt ngo\u00e0i gan)<\/div>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong> 3. C\u00e1c bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng:<\/strong><\/h2>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">S\u1ef1 xu\u1ea5t hi\u1ec7n v\u00e0ng da l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p c\u1ee7a t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o gan ho\u1eb7c t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt. Suy gan n\u1eb7ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn huy\u1ebft \u00e1p th\u1ea5p, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u,h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, suy th\u1eadn ho\u1eb7c t\u0103ng NH3 v\u00e0 nhi\u1ec5m tr\u00f9ng.<\/div>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong>4. X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n: <\/strong><\/h2>\n<div class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">C\u00e1c b\u1ea5t th\u01b0\u1eddng\u00a0 c\u1ee5 th\u1ec3 th\u01b0\u1eddng cho th\u1ea5y t\u00ednh ch\u1ea5t c\u1ee7a v\u1ea5n \u0111\u1ec1. C\u00e1c x\u00e9t nghi\u1ec7m b\u1ed5 sung c\u00f3 th\u1ec3 bao g\u1ed3m c\u00e1c x\u00e9t nghi\u1ec7m ph\u00e1t hi\u1ec7n h\u1ed3ng c\u1ea7u ph\u00e1 h\u1ee7y (LDH, haptoglobin tr\u00ean m\u00e1u ngo\u1ea1i vi), \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng tim m\u1ea1ch v\u00e0 van tim (si\u00eau \u00e2m tim), x\u00e1c \u0111\u1ecbnh b\u1ec7nh \u0111\u01b0\u1eddng m\u1eadt (si\u00eau \u00e2m \u1ed5 b\u1ee5ng ) ho\u1eb7c ph\u00e1t hi\u1ec7n vi\u00eam gan (kh\u00e1ng nguy\u00ean).<\/div>\n<h2 class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><strong> 5. \u0110i\u1ec1u tr\u1ecb<\/strong><\/h2>\n<ul>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">T\u0103ng bilirubin th\u01b0\u1eddng l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng sau ph\u1eabu thu\u1eadt: M\u1ee9c \u0111\u1ed9 bilirubin s\u1ebd tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng d\u1ea7n khi tu\u1ea7n ho\u00e0n t\u1ed1t l\u00ean tr\u1eeb khi c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 b\u1ec7nh l\u00fd gan nghi\u00eam tr\u1ecdng \u1edf b\u00ean trong. Trong t\u00ecnh hu\u1ed1ng n\u00e0y, ch\u1ee9c n\u0103ng gan suy gi\u1ea3m ti\u1ebfn tri\u1ec3n v\u00e0 kh\u00f4ng th\u1ec3 c\u1ea3i thi\u1ec7n d\u1eabn \u0111\u1ebfn suy t\u1ea1ng v\u00e0 t\u1eed vong.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">R\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u c\u00f3 th\u1ec3 x\u1ea3y ra do gi\u1ea3m s\u1ea3n xu\u1ea5t c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Ph\u00f2ng ng\u1eeba vi\u00eam lo\u00e9t d\u1ea1 d\u00e0y n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng b\u1eb1ng m\u1ed9t trong c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf ti\u1ebft axit d\u1ea1 d\u00e0y (PPI) (pantoprazole 40 mg IV \/ PO ).<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">T\u0103ng NH3 c\u00f3 th\u1ec3 g\u00e2y ra b\u1ec7nh n\u00e3o gan v\u00e0 \u1edf m\u1ee9c \u0111\u1ed9&gt; 150\u2013200\u03bcmol \/ L c\u00f3 th\u1ec3 g\u00e2y ra t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd v\u00e0 ph\u00f9 n\u00e3o.\u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng:<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Ki\u1ec3m so\u00e1t s\u1ed1t.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">\u00a0\u0110\u1ed1i v\u1edbi t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd:<\/li>\n<\/ul>\n<ol>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Dung d\u1ecbch mu\u1ed1i \u01b0u tr\u01b0\u01a1ng (NaCl 3%) gi\u1eef cho natri huy\u1ebft thanh &lt;150 mEq \/ L<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\"><span style=\"vertical-align: inherit;\"><span style=\"vertical-align: inherit;\">Mannitol (2 ml\/kg mannitol 20%)<\/span><\/span><\/li>\n<\/ol>\n<ul>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Thu\u1ed1c nh\u01b0 lactulose 4 l\u1ea7n\/ng\u00e0y v\u1edbi sorbitol v\u00e0 neomycin u\u1ed1ng 6 g m\u1ed7i ng\u00e0y. Ch\u00fang c\u00f3 th\u1ec3 c\u00f3 vai tr\u00f2 trong b\u1ec7nh gan m\u1ea1n t\u00ednh nh\u01b0ng l\u1ee3i \u00edch c\u1ee7a ch\u00fang \u0111\u1ed1i v\u1edbi suy gan c\u1ea5p kh\u00f4ng r\u00f5 r\u00e0ng.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">Thay th\u1ebf th\u1eadn (hi\u1ebfm khi d\u00f9ng)<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">K\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft n\u00ean \u0111\u01b0\u1ee3c gi\u00e1m s\u00e1t c\u1ea9n th\u1eadn \u0111\u1ec3 ng\u0103n ng\u1eeba h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft.<\/li>\n<li class=\"x6prxxf x1fc57z9 x1yc453h x126k92a x14ctfv\" dir=\"auto\" role=\"none\">N\u00ean xem x\u00e9t thi\u1ebfu vitamin B1 g\u00e2y ra nhi\u1ec5m toan acid lactic.<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<div class=\"x1h91t0o xkh2ocl x78zum5 xdt5ytf x13a6bvl x193iq5w x1c4vz4f xcrg951\" role=\"none\"><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 m\u00f3c, 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 c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 h\u1ed3i s\u1ee9c sau ph\u1eabu thu\u1eadt tim<\/div>\n<\/div>\n<div class=\"x1h91t0o xkh2ocl x78zum5 xdt5ytf x13a6bvl x193iq5w x1c4vz4f xcrg951\" role=\"none\">\n<div class=\"x78zum5 xdt5ytf x1iyjqo2 x2lah0s xl56j7k x1n2onr6 x1ll7btr x1n327nk x1mpkggp\" aria-hidden=\"true\">\n<div class=\"x6s0dn4 x78zum5 x1ll7btr x15zctf7\" role=\"none\"><\/div>\n<\/div>\n<\/div>\n<div class=\"x1h91t0o xkh2ocl x78zum5 xdt5ytf x13a6bvl x193iq5w x1iyjqo2 xcrg951\" role=\"none\">\n<div class=\"x1r8uery x1iyjqo2\" role=\"none\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i sau ph\u1eabu thu\u1eadt tim h\u1edf l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p.Tuy nhi\u00ean, n\u00f3 c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn ch\u1ee9c n\u0103ng gan. G\u1ea7n \u0111\u00e2y, nhi\u1ec1u nghi\u00ean c\u1ee9u \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ee9c n\u0103ng gan sau ph\u1eabu thu\u1eadt tim h\u1edf. C\u00e1c k\u1ebft qu\u1ea3 cho th\u1ea5y r\u1eb1ng, vi\u1ec7c s\u1eed [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":19980,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i sau ph\u1eabu thu\u1eadt tim<\/title>\n<meta name=\"description\" content=\"Thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan sau ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y.\" \/>\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=\"Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i sau ph\u1eabu thu\u1eadt tim\" \/>\n<meta property=\"og:description\" content=\"Thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan sau ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Tham kh\u1ea3o b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y v\u1ec1 v\u1ea5n \u0111\u1ec1 n\u00e0y.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/thay-doi-chuc-nang-gan-sau-phau-thuat-tim\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-12T12:28:51+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-17T09:30:24+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/untitled-ghep-than.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"501\" \/>\n\t<meta property=\"og:image:height\" content=\"375\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/thay-doi-chuc-nang-gan-sau-phau-thuat-tim\/\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/12\/thay-doi-chuc-nang-gan-sau-phau-thuat-tim\/\",\"name\":\"Ch\u1ee9c n\u0103ng gan thay \u0111\u1ed5i sau ph\u1eabu thu\u1eadt tim\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-12T12:28:51+00:00\",\"dateModified\":\"2023-04-17T09:30:24+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"Thay \u0111\u1ed5i ch\u1ee9c n\u0103ng gan sau ph\u1eabu thu\u1eadt tim l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. 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