{"id":19466,"date":"2023-04-15T16:00:39","date_gmt":"2023-04-15T09:00:39","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=19466"},"modified":"2023-04-18T12:32:28","modified_gmt":"2023-04-18T05:32:28","slug":"cac-xet-nghiem-truoc-phau-thuat-tim-mach-co-gi-dac-biet","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/cac-xet-nghiem-truoc-phau-thuat-tim-mach-co-gi-dac-biet\/","title":{"rendered":"Ph\u1eabu thu\u1eadt tim m\u1ea1ch c\u00f3 g\u00ec \u0111\u1eb7c bi\u1ec7t v\u1ec1 x\u00e9t nghi\u1ec7m?"},"content":{"rendered":"

Ph\u1eabu thu\u1eadt tim m\u1ea1ch l\u00e0 ph\u1eabu thu\u1eadt l\u1edbn, c\u1ea7n \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb c\u1ea9n th\u1eadn v\u00e0 \u0111i\u1ec1u ch\u1ec9nh x\u00e9t nghi\u1ec7m tr\u01b0\u1edbc ph\u1eabu thu\u1eadt tim m\u1ea1ch l\u00e0 m\u1ed9t quy tr\u00ecnh\u00a0 quan tr\u1ecdng, gi\u00fap \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u1ea3m b\u1ea3o an to\u00e0n trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.\u00a0<\/strong><\/p>\n

1. C\u00e1c x\u00e9t nghi\u1ec7m th\u1ef1c hi\u1ec7n:\u00a0<\/strong><\/h2>\n
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  • T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi(CBC), th\u1eddi gian \u0111\u00f4ng m\u00e1u Prothrombin (PT), th\u1eddi gian \u0111\u00f4ng m\u00e1u to\u00e0n ph\u1ea7n (aPTT) v\u00e0 \u0111\u1ebfm ti\u1ec3u c\u1ea7u.<\/li>\n
  • Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 thi\u1ebfu m\u00e1u trung b\u00ecnh (l\u01b0\u1ee3ng hemoglobin <10g\/dL) c\u00f3 nguy c\u01a1 m\u1eafc c\u00e1c bi\u1ebfn ch\u1ee9ng sau ph\u1eabu thu\u1eadt cao h\u01a1n \u0111\u00e1ng k\u1ec3 v\u00e0 t\u1ec9 l\u1ec7 t\u1eed vong trong ph\u1eabu thu\u1eadt c\u0169ng cao h\u01a1n.<\/li>\n
  • C\u00f3 kh\u1ea3 n\u0103ng r\u1eb1ng m\u1ed1i li\u00ean h\u1ec7 gi\u1eefa thi\u1ebfu m\u00e1u v\u00e0 c\u00e1c b\u1ec7nh l\u00fd \u0111i k\u00e8m nh\u01b0 suy tim n\u1eb7ng v\u00e0 b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh l\u00e0m cho c\u00e1c c\u01a1 quan \u00edt ch\u1ecbu \u0111\u01b0\u1ee3c vi\u1ec7c cung c\u1ea5p oxy gi\u1ea3m, g\u00f3p ph\u1ea7n t\u0103ng nguy c\u01a1 c\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00f4ng tim m\u1ea1ch, nh\u01b0 \u0111\u1ed9t qu\u1ef5, suy th\u1eadn v\u00e0 th\u1eadm ch\u00ed l\u00e0 nhi\u1ec5m tr\u00f9ng v\u1ebft th\u01b0\u01a1ng x\u01b0\u01a1ng \u1ee9c.<\/li>\n
  • M\u1eb7c d\u00f9 ng\u01b0\u1ee1ng truy\u1ec1n m\u00e1u v\u1edbi l\u01b0\u1ee3ng hemoglobin <8 g\/dL \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, c\u1ea7n nh\u1edb r\u1eb1ng h\u1ed3ng c\u1ea7u r\u1ea5t th\u1ea5p tr\u00ean tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3 (CPB). H\u01a1n n\u1eefa, b\u1ec7nh nh\u00e2n nh\u1eadn nhi\u1ec1u \u0111\u01a1n v\u1ecb m\u00e1u trong ph\u1eabu thu\u1eadt th\u01b0\u1eddng c\u00f3 r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u c\u1ea7n s\u1eed d\u1ee5ng th\u00eam th\u00e0nh ph\u1ea7n m\u00e1u kh\u00e1c. N\u1ebfu t\u1ef7 l\u1ec7 Hct tr\u00ean tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3 l\u00e0 nh\u1ecf h\u01a1n 20%, kh\u00f4ng n\u00ean ng\u1ea7n ng\u1ea1i truy\u1ec1n m\u00e1u.Kh\u00f4ng truy\u1ec1n m\u00e1u cho b\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n c\u00f3 t\u1ef7 l\u1ec7 Hct <26% tr\u01b0\u1edbc ph\u1eabu thu\u1eadt. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i trong vi\u1ec7c gi\u1ea3m thi\u1ec3u nguy c\u01a1 suy tim tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, nh\u01b0ng quan tr\u1ecdng h\u01a1n, n\u00f3 c\u00f3 th\u1ec3 gi\u1ea3m thi\u1ec3u m\u1ee9c \u0111\u1ed9 pha lo\u00e3ng m\u00e1u trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt v\u00e0 l\u01b0\u1ee3ng m\u00e1u v\u00e0 th\u00e0nh ph\u1ea7n m\u00e1u c\u1ea7n truy\u1ec1n trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.<\/li>\n
  • Vi\u1ec7c t\u0103ng WBC c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh nhi\u1ec5m tr\u00f9ng c\u1ea7n \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh tr\u01b0\u1edbc ph\u1eabu thu\u1eadt. Tuy nhi\u00ean, n\u00f3 c\u0169ng c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t ch\u1ec9 s\u1ed1 v\u1ec1 vi\u00eam nhi\u1ec5m ho\u1eb7c c\u00f3 th\u1ec3 ph\u1ea3n \u00e1nh vi\u1ec7c s\u1eed d\u1ee5ng steroid. C\u00e1c nghi\u00ean c\u1ee9u cho th\u1ea5y, s\u1ef1 t\u0103ng s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u tr\u01b0\u1edbc ph\u1eabu thu\u1eadt s\u1ebd t\u0103ng nguy c\u01a1 t\u0103ng t\u1ed5n th\u01b0\u01a1ng c\u01a1 tim, \u0111\u1ed9t qu\u1ef5, t\u1eed vong trong ph\u1eabu thu\u1eadt v\u00e0 gi\u1ea3m t\u1ec9 l\u1ec7 s\u1ed1ng m\u1ed9t n\u0103m.<\/li>\n
  • R\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ki\u1ec3m tra s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u h\u00e0ng ng\u00e0y \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c duy tr\u00ec b\u1eb1ng heparin \u0111\u1ec3 cho ph\u00e9p nh\u1eadn bi\u1ebft k\u1ecbp th\u1eddi c\u00e1c tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd gi\u1ea3m ti\u1ec3u c\u1ea7u do Heparin (HIT). N\u1ebfu nghi ng\u1edd d\u1ef1a tr\u00ean s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u gi\u1ea3m, c\u1ea7n th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m ti\u1ebfp theo \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh HIT nh\u01b0 ki\u1ec3m tra t\u1eadp trung ti\u1ec3u c\u1ea7u do heparin g\u00e2y ra ho\u1eb7c c\u00e1c x\u00e9t nghi\u1ec7m mi\u1ec5n d\u1ecbch \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh HIT.<\/li>\n<\/ul>\n

    2.Ch\u1ea9n \u0111o\u00e1n sinh h\u00f3a c\u01a1 b\u1ea3n (\u0111i\u1ec7n gi\u1ea3i, Ure, creatinine, glucose m\u00e1u) v\u00e0 HbA1c.<\/strong><\/p>\n

      \n
    • R\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1eadn c\u1ea5p sau ph\u1eabu thu\u1eadt th\u01b0\u1eddng x\u1ea3y ra nhi\u1ec1u h\u01a1n \u1edf b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh th\u1eadn m\u00e3n t\u00ednh giai \u0111o\u1ea1n III-IV, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, v\u00e0 \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1ef7 l\u1ec7 t\u1eed vong trong ph\u1eabu thu\u1eadt cao h\u01a1n v\u00e0 t\u1ef7 l\u1ec7 s\u1ed1ng l\u00e2u h\u01a1n th\u1ea5p h\u01a1n.
      \nN\u1ebfu creatinine t\u0103ng, ph\u1eabu thu\u1eadt tim m\u1ea1ch n\u00ean \u0111\u01b0\u1ee3c ho\u00e3n l\u1ea1i, n\u1ebfu c\u00f3 th\u1ec3 cho \u0111\u1ebfn khi n\u00f3 tr\u1edf l\u1ea1i m\u1ee9c b\u00ecnh th\u01b0\u1eddng. Tuy nhi\u00ean, kh\u00f4ng n\u00ean tr\u00ec ho\u00e3n ph\u1eabu thu\u1eadt \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nguy k\u1ecbch v\u1edbi suy tim v\u00e0 ch\u1ee9c n\u0103ng th\u1eadn k\u00e9m ng\u00e0y c\u00e0ng tr\u1ea7m tr\u1ecdng, v\u00ec vi\u1ec7c tr\u00ec ho\u00e3n th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn suy th\u1eadn kh\u00f4ng th\u1ec3 h\u1ed3i ph\u1ee5c v\u00e0 suy \u0111a t\u1ea1ng<\/li>\n
    • \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p g\u1eafn li\u1ec1n v\u1edbi c\u00e1c k\u1ebft qu\u1ea3 b\u1ea5t l\u1ee3i, bao g\u1ed3m \u0111\u1ed9t qu\u1ef5, nhi\u1ec5m tr\u00f9ng v\u1ebft th\u01b0\u01a1ng, suy th\u1eadn v\u00e0 t\u1eed vong.Do \u0111\u00f3, ki\u1ec3m so\u00e1t t\u1ed1t \u0111\u01b0\u1eddng huy\u1ebft trong ph\u1eabu thu\u1eadt l\u00e0 r\u1ea5t quan tr\u1ecdng. M\u1ee9c \u0111\u1ed9 t\u0103ng HbA1c ph\u1ea3n \u00e1nh vi\u1ec7c ki\u1ec3m so\u00e1t b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng k\u00e9m trong 3 th\u00e1ng tr\u01b0\u1edbc \u0111\u00f3 v\u00e0 t\u01b0\u01a1ng quan v\u1edbi nguy c\u01a1 nhi\u1ec5m tr\u00f9ng v\u00e0 t\u1ef7 l\u1ec7 s\u1ed1ng ng\u1eafn v\u00e0 d\u00e0i h\u1ea1n b\u1ecb suy gi\u1ea3m.<\/li>\n
    • H\u1ea1 natri h\u1ea7u nh\u01b0 lu\u00f4n c\u00f3 m\u1eb7t \u1edf b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u v\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 ch\u1ee9c n\u0103ng t\u00e2m thu k\u00e9m v\u00e0 suy tim m\u00e3n t\u00ednh. N\u00f3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 cao c\u1ee7a c\u00e1c bi\u1ebfn c\u1ed1 tim m\u1ea1ch, nhi\u1ec5m tr\u00f9ng v\u1ebft th\u01b0\u01a1ng, vi\u00eam ph\u1ed5i, n\u1eb1m vi\u1ec7n k\u00e9o d\u00e0i v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong trong ph\u1eabu thu\u1eadt t\u0103ng cao.
      \n\u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 natri trong n\u01b0\u1edbc ti\u1ec3u s\u1ebd gi\u00fap quy\u1ebft \u0111\u1ecbnh li\u1ec7u li\u1ec7u tr\u00ecnh \u0111i\u1ec1u tr\u1ecb c\u00f3 n\u00ean h\u1ea1n ch\u1ebf n\u01b0\u1edbc, thay \u0111\u1ed5i thu\u1ed1c l\u1ee3i ti\u1ec3u ho\u1eb7c th\u1eadm ch\u00ed s\u1eed d\u1ee5ng dung d\u1ecbch mu\u1ed1i \u01b0u tr\u01b0\u01a1ng<\/li>\n
    • T\u00ecnh tr\u1ea1ng t\u0103ng kali m\u00e1u th\u01b0\u1eddng ph\u1ea3n \u00e1nh ch\u1ee9c n\u0103ng th\u1eadn k\u00e9m v\u00e0 n\u00ean \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>\n

      3. C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t:<\/strong><\/h2>\n
        \n
      • M\u1ee9c \u0111\u1ed9 hormone k\u00edch th\u00edch tuy\u1ebfn gi\u00e1p (TSH) n\u00ean \u0111\u01b0\u1ee3c \u0111o tr\u01b0\u1edbc ph\u1eabu thu\u1eadt n\u1ebfu Amiodarone \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00f2ng ng\u1eeba ho\u1eb7c \u0111i\u1ec1u tr\u1ecb sau ph\u1eabu thu\u1eadt cho nh\u1eefng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129.
        \nAmiodarone l\u00e0 h\u1ee3p ch\u1ea5t gi\u00e0u Iodin c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p, g\u00e2y ra suy gi\u00e1p.<\/li>\n
      • M\u1ee9c \u0111\u1ed9 BNP v\u00e0 pro-BNP c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111o \u0111\u1ec3 ph\u00e2n bi\u1ec7t gi\u1eefa c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y kh\u00f3 th\u1edf. \u1ede b\u1ec7nh nh\u00e2n b\u1ecb suy tim,suy tim do ch\u1ee9c n\u0103ng van b\u1ecb r\u1ed1i lo\u1ea1n, m\u1ee9c \u0111\u1ed9 BNP lu\u00f4n t\u0103ng. C\u00e1c m\u1ee9c \u0111\u1ed9 BNP t\u0103ng cao li\u00ean quan \u0111\u1ebfn r\u1ed1i lo\u1ea1n th\u1ea5t sau ph\u1eabu thu\u1eadt, nhu c\u1ea7u \u0111\u00f2i h\u1ecfi h\u1ed7 tr\u1ee3 c\u1ee7a thu\u1ed1c t\u0103ng co b\u00f3p v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong cao h\u01a1n sau ph\u1eabu thu\u1eadt CABG v\u00e0 ph\u1eabu thu\u1eadt thay van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/li>\n
      • X\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u. L\u1ea5y n\u01b0\u1edbc ti\u1ec3u gi\u1eefa d\u00f2ng v\u00e0o s\u00e1ng s\u1edbm. N\u1ebfu c\u00f3 nghi ng\u1edd v\u1ec1 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u, c\u1ea7n c\u1ea5y n\u01b0\u1edbc ti\u1ec3u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh vi khu\u1ea9n g\u00e2y b\u1ec7nh. Kh\u00e1ng sinh ph\u00f9 h\u1ee3p n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong v\u00e0i ng\u00e0y tr\u01b0\u1edbc khi ph\u1eabu thu\u1eadt ch\u01b0\u01a1ng tr\u00ecnh. N\u1ebfu b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1eabu thu\u1eadt c\u1ea5p c\u1ee9u, m\u1ed9t ho\u1eb7c hai li\u1ec1u kh\u00e1ng sinh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb vi khu\u1ea9n gram \u00e2m c\u00f3 th\u1ec3 \u0111\u1ee7, tuy nhi\u00ean n\u00ean xem x\u00e9t \u0111i\u1ec1u tr\u1ecb trong v\u00e0i ng\u00e0y tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt van tim.<\/li>\n
      • X-quang ng\u1ef1c th\u1eb3ng. X-quang l\u00e0 r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 lo\u1ea1i tr\u1eeb b\u1ea5t k\u1ef3 b\u1ec7nh ph\u1ed5i n\u00e0o c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc ph\u1eabu thu\u1eadt,c\u00e1c kh\u1ed1i u ph\u1ed5i c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 th\u00eam b\u1eb1ng c\u00e1ch th\u1ef1c hi\u1ec7n ch\u1ee5p CT ng\u1ef1c tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, v\u00ec vi\u1ec7c gi\u1ea3i th\u00edch h\u00ecnh \u1ea3nh c\u00f3 th\u1ec3 kh\u00f3 kh\u0103n sau ph\u1eabu thu\u1eadt.<\/li>\n
      • \u0110i\u1ec7n tim \u0111\u1ed3 (ECG). 1. N\u1ebfu b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129, n\u00ean ki\u1ec3m so\u00e1t t\u1ea7n s\u1ed1 v\u00e0 x\u00e1c \u0111\u1ecbnh th\u1eddi gian di\u1ec5n ra r\u1ed1i lo\u1ea1n nh\u1ecbp. Kh\u1ea3 n\u0103ng chuy\u1ec3n nh\u1ecbp xoang sau ph\u1eabu thu\u1eadt g\u1ea7n nh\u01b0 80% \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh r\u1ed1i lo\u1ea1n nh\u1ecbp nh\u0129 trong v\u00f2ng s\u00e1u th\u00e1ng, nh\u01b0ng r\u1ea5t \u00edt khi x\u1ea3y ra n\u1ebfu r\u1ed1i lo\u1ea1n nh\u1ecbp \u0111\u00e3 k\u00e9o d\u00e0i h\u01a1n. Do \u0111\u00f3, th\u1eddi gian di\u1ec5n ra r\u1ed1i lo\u1ea1n nh\u1ecbp s\u1ebd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn t\u00ednh quy\u1ebft li\u1ec7t c\u1ee7a \u0111i\u1ec1u tr\u1ecb sau ph\u1eabu thu\u1eadt v\u00e0 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn quy\u1ebft \u0111\u1ecbnh th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt CoX-Maze b\u00ean c\u1ea1nh ph\u1eabu thu\u1eadt \u0111\u00e3 d\u1ef1 \u0111\u1ecbnh.<\/li>\n<\/ul>\n

        4. C\u00e1c v\u1ea5n \u0111\u1ec1 kh\u00e1c c\u1ea7n quan t\u00e2m:<\/strong><\/h2>\n
          \n
        • B\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng nh\u1ecbp ch\u1eadm tr\u01b0\u1edbc ph\u1eabu thu\u1eadt. C\u1ea7n ch\u00fa \u00fd \u0111\u1ec3 tr\u00e1nh s\u1eed d\u1ee5ng \u03b2-blocker v\u00e0 amiodarone ph\u00f2ng ng\u1eeba r\u1ed1i lo\u1ea1n nh\u1ecbp sau ph\u1eabu thu\u1eadt \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y v\u00ec c\u00f3 th\u1ec3 g\u00e2y ra gi\u1ea3m nh\u1ecbp \u0111\u00e1ng k\u1ec3.<\/li>\n
        • H\u1ea7u h\u1ebft k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m \u0111\u1ec1u ch\u1ea5p nh\u1eadn \u0111\u01b0\u1ee3c khi \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong v\u00f2ng m\u1ed9t th\u00e1ng tr\u01b0\u1edbc ph\u1eabu thu\u1eadt tim. Tuy nhi\u00ean, n\u00ean ki\u1ec3m tra t\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u, \u0111i\u1ec7n gi\u1ea3i, Ure v\u00e0 creatinine trong v\u00e0i ng\u00e0y sau ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cho vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb sau ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

          Ph\u1eabu thu\u1eadt tim m\u1ea1ch l\u00e0 ph\u1eabu thu\u1eadt l\u1edbn, c\u1ea7n \u0111\u01b0\u1ee3c chu\u1ea9n b\u1ecb c\u1ea9n th\u1eadn v\u00e0 \u0111i\u1ec1u ch\u1ec9nh x\u00e9t nghi\u1ec7m tr\u01b0\u1edbc ph\u1eabu thu\u1eadt tim m\u1ea1ch l\u00e0 m\u1ed9t quy tr\u00ecnh\u00a0 quan tr\u1ecdng, gi\u00fap \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u1ea3m b\u1ea3o an to\u00e0n trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt.\u00a0 1. C\u00e1c x\u00e9t nghi\u1ec7m th\u1ef1c […]<\/p>\n","protected":false},"author":7,"featured_media":20037,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nPh\u1eabu thu\u1eadt tim m\u1ea1ch c\u00f3 g\u00ec \u0111\u1eb7c bi\u1ec7t v\u1ec1 x\u00e9t nghi\u1ec7m? - Vinmec<\/title>\n<meta name=\"description\" content=\"X\u00e9t nghi\u1ec7m tr\u01b0\u1edbc ph\u1eabu thu\u1eadt tim m\u1ea1ch l\u00e0 v\u1ea5n \u0111\u1ec1 v\u00f4 c\u00f9ng quan tr\u1ecdng, c\u1ea7n \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cu\u1ed9c ph\u1eabu thu\u1eadt di\u1ec5n ra an to\u00e0n.\" \/>\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=\"Ph\u1eabu thu\u1eadt tim m\u1ea1ch c\u00f3 g\u00ec \u0111\u1eb7c bi\u1ec7t v\u1ec1 x\u00e9t nghi\u1ec7m? 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