{"id":20795,"date":"2023-04-22T00:28:45","date_gmt":"2023-04-21T17:28:45","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20795"},"modified":"2023-04-22T00:28:45","modified_gmt":"2023-04-21T17:28:45","slug":"xuat-huyet-tieu-hoa-tren-dinh-nghia-nguyen-nhan-trieu-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/xuat-huyet-tieu-hoa-tren-dinh-nghia-nguyen-nhan-trieu-chung\/","title":{"rendered":"Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean: \u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng"},"content":{"rendered":"

Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a (XHTH) l\u00e0 t\u00ecnh tr\u1ea1ng ch\u1ea3y m\u00e1u ra kh\u1ecfi l\u00f2ng m\u1ea1ch v\u00e0o \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. \u0110\u01b0\u1ee3c th\u1ea3i ra kh\u1ecfi \u0111\u01b0\u1eddng ti\u00eau h\u00f3a b\u1eb1ng c\u00e1ch n\u00f4n hay \u0111i ngo\u00e0i ra m\u00e1u ho\u1eb7c ph\u00e2n \u0111en.\u00a0\u00a0Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd ti\u00eau h\u00f3a nghi\u00eam tr\u1ecdng, bao g\u1ed3m lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng, vi\u00eam \u0111\u1ea1i tr\u00e0ng, ung th\u01b0 \u0111\u1ea1i tr\u00e0ng v\u00e0 c\u00e1c b\u1ec7nh l\u00fd v\u1ea1 m\u1ea1c \u0111\u01b0\u1eddng ti\u00eau h\u00f3a kh\u00e1c. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd gi\u00fap b\u1ea1n hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 \u0111\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng, c\u1eadn l\u00e2m s\u00e0ng c\u1ee7a xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean.<\/strong><\/p>\n

\"Xu\u1ea5t
Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a<\/figcaption><\/figure>\n

1. \u0110\u1ecbnh ngh\u0129a:<\/strong><\/h2>\n

Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean <\/strong>l\u00e0 ch\u1ea3y m\u00e1u t\u1eeb g\u00f3c Treitz tr\u1edf l\u00ean. Nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ebfu c\u1ee7a xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean l\u00e0 do lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng v\u00e0 do t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda<\/a>.<\/p>\n

2. Nguy\u00ean nh\u00e2n g\u00e2y xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean:<\/strong><\/h2>\n

2.1. Th\u1ef1c qu\u1ea3n<\/strong><\/h3>\n
    \n
  • V\u1ee1 g<\/strong>i\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n<\/strong><\/li>\n<\/ul>\n

    + X\u01a1 gan t\u0103ng \u00e1p t\u0129nh m\u1ea1ch c\u1eeda
    \n+ Gi\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n b\u1ea9m sinh<\/p>\n

    *C\u01a1 ch\u1ebf<\/strong><\/p>\n

    + Do \u00e1p l\u1ef1c trong h\u1ec7 c\u1eeda t\u0103ng qu\u00e1 m\u1ee9c -> Gi\u00e3n v\u1ee1 t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n -> xu\u1ea5t huy\u1ebft\u00a0\u1ed3 \u1ea1t th\u00e0nh tia.
    \n+ T\u00e1c d\u1ee5ng \u0103n m\u00f2n c\u1ee7a th\u1ee9c \u0103n, c\u1ee7a d\u1ecbch v\u1ecb tr\u00e0o ng\u01b0\u1ee3c.
    \n+ S\u1ef1 thi\u1ebfu nu\u00f4i d\u01b0\u1ee1ng t\u01b0\u1edbi m\u00e1u.<\/p>\n

      \n
    • Ung th\u01b0 th\u1ef1c qu\u1ea3n:<\/strong> g\u00e2y vi\u00eam lo\u00e9t ho\u1ea1i t\u1eed v\u00e0 ch\u1ea3y m\u00e1u t\u1eeb m\u1ea1ch m\u00e1u t\u00e2n sinh c\u1ee7a u<\/li>\n
    • H\u1ed9i ch\u1ee9ng Mallory Weiss:<\/strong> n\u00f4n v\u00e0 tr\u00e0o ng\u01b0\u1ee3c th\u1ef1c qu\u1ea3n \u2013 d\u1ea1 d\u00e0y l\u00e0m acid d\u1ecbch v\u1ecb t\u00e1c d\u1ee5ng l\u00ean \u0111o\u1ea1n <\/strong>1\/3 <\/strong>d\u01b0\u1edbi th\u1ef1c qu\u1ea3n<\/strong> l\u00e0m n\u1ee9t v\u00e0 lo\u00e9t \u0103n m\u00f2n<\/em>.<\/em><\/li>\n
    • Vi\u00eam lo\u00e9t th\u1ef1c qu\u1ea3n c\u1ea5p:<\/strong> u\u1ed1ng nh\u1ea7m acid.<\/li>\n
    • Polype th\u1ef1c qu\u1ea3n<\/strong>.<\/strong><\/li>\n<\/ul>\n

      2.2. Nguy\u00ean nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean t\u1ea1i d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng:<\/strong><\/h3>\n
        \n
      • Lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng:<\/strong> do lo\u00e9t v\u00e0o m\u1ea1ch m\u00e1u
        \n+ \u1ed4 lo\u00e9t n\u00f4ng:<\/strong> ch\u1ea3y m\u00e1u mao m\u1ea1ch, s\u1ed1 l\u01b0\u1ee3ng \u00edt v\u00e0 t\u1ef1 c\u1ea7m.
        \n+ \u1ed4 lo\u00e9t s\u00e2u (lo\u00e9t x\u01a1 chai):<\/strong> lo\u00e9t v\u00e0o c\u00e1c \u0111\u1ed9ng m\u1ea1ch, kh\u1ea3 n\u0103ng co m\u1ea1ch b\u1ecb h\u1ea1n ch\u1ebf, n\u00ean th\u01b0\u1eddng ch\u1ea3y m\u00e1u \u1ed3 \u1ea1t v\u00e0 kh\u00f3 c\u1ea7m.<\/li>\n
      • Ung th\u01b0 d\u1ea1 d\u00e0y
        \n<\/strong>+ G\u00e2y lo\u00e9t v\u00e0 ch\u1ea3y m\u00e1u t\u1eeb c\u00e1c m\u1ea1ch m\u00e1u t\u00e2n sinh.
        \n+ Th\u01b0\u1eddng ch\u1ea3y m\u00e1u dai d\u1eb3ng v\u00e0 \u0111\u1ebfn khi ch\u1ea3y m\u00e1u n\u1eb7ng kh\u00f3 c\u1ea7m.<\/li>\n
      • Vi\u00eam d\u1ea1 d\u00e0y c\u1ea5p:<\/strong>\n
          \n
        • Do thu\u1ed1c:<\/strong> Aspirin, Steroid, NSAIDs.<\/li>\n
        • Do r\u01b0\u1ee3u.<\/li>\n
        • Trong h\u1ed9i ch\u1ee9ng t\u0103ng Ure m\u00e1u cao.<\/li>\n
        • Do stress.<\/li>\n
        • C\u00fam \u00e1c t\u00ednh.<\/li>\n
        • H\u1ed9i ch\u1ee9ng Sholein \u2013 Henoch<\/strong>.<\/strong><\/li>\n<\/ul>\n<\/li>\n
        • V\u1ee1 g<\/strong>i\u00e3n t<\/strong>\u0129n<\/strong>h m\u1ea1ch<\/strong> ph\u00ecnh v\u1ecb<\/strong>:<\/strong> c\u01a1 ch\u1ebf g\u00e2y ch\u1ea3y m\u00e1u nh\u01b0 gi\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n.<\/li>\n
        • Polype d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng<\/strong> ch\u1ea3y m\u00e1u do vi\u00eam<\/li>\n
        • Tho\u00e1t v\u1ecb ho\u00e0nh:<\/strong> do ch\u1ed7 tho\u00e1t v\u1ecb b\u1ecb k\u1eb9t, g\u00e2y thi\u1ebfu m\u00e1u v\u00e0 ho\u1ea1i t\u1eed<\/li>\n<\/ul>\n

          2.3. Ch\u1ea3y m\u00e1u t\u1eeb m\u1eadt t\u1ee5y<\/strong><\/h3>\n
            \n
          • Ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng m\u1eadt:<\/strong> do s\u1ecfi \u0111\u01b0\u1eddng m\u1eadt, giun chui \u1ed1ng m\u1eadt<\/li>\n
          • Ch\u1ea3y m\u00e1u t\u1eeb t\u1ee5y:<\/strong> do s\u1ecfi nh\u01b0 trong s\u1ecfi m\u1eadt. \u0110\u00f4i khi c\u00f3 c\u00e1c nang t\u1ee5y lo\u00e9t v\u00e0o m\u1ea1ch m\u00e1u.<\/li>\n<\/ul>\n

            2.4. Ch\u1ea3y m\u00e1u do b\u1ec7nh v\u1ec1 m\u00e1u<\/strong><\/h3>\n
              \n
            • S<\/strong>\u1ed1<\/strong>t xu\u1ea5t huy\u1ebft:<\/strong> ti\u1ec3u c\u1ea7u gi\u1ea3m, th\u00e0nh m\u1ea1ch t\u1ed5n th\u01b0\u01a1ng.<\/li>\n
            • Xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u<\/strong>.<\/strong><\/li>\n
            • Leucemie:<\/strong> do gi\u1ea3m ti\u1ec3u c\u1ea7u c\u1ea3 v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng.<\/li>\n
            • Suy t\u1ee7y:<\/strong> gi\u1ea3m ti\u1ec3u c\u1ea7u.<\/li>\n
            • Suy gan n\u1eb7ng:<\/strong> gi\u1ea3m prothrombin v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u kh\u00e1c.<\/li>\n
            • Do d\u00f9ng thu\u1ed1c kh\u00e1ng \u0111\u00f4ng:<\/strong> Heparin, kh\u00e1ng vitamin K, gi\u1ea3m c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u.<\/li>\n<\/ul>\n

              3. L\u00e2m s\u00e0ng:<\/strong><\/h2>\n

              3.1. N\u00f4n ra m\u00e1u:<\/strong><\/h3>\n
                \n
              • V\u1ecb tr\u00ed: <\/strong>Ch\u1eafc ch\u1eafn l\u00e0 xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean.<\/li>\n
              • S\u1ed1 l\u01b0\u1ee3ng: <\/strong>\u00edt ho\u1eb7c nhi\u1ec1u, m\u1ed9t ho\u1eb7c nhi\u1ec1u l\u1ea7n trong ng\u00e0y.<\/li>\n
              • T\u00ednh ch\u1ea5t: <\/strong>N\u00f4n ra m\u00e1u \u0111\u1ecf t\u01b0\u01a1i, \u0111\u1ecf b\u1ea7m, n\u00e2u \u0111en, m\u00e1u c\u1ee5c, l\u1ecfng c\u00f3 th\u1ec3 l\u1eabn v\u1edbi th\u1ee9c \u0103n do t\u00e1c \u0111\u1ed9ng c\u1ee7a acid chlohydric, pepsin v\u00e0 m\u00e1u t\u1ea1o th\u00e0nh hematine.<\/li>\n<\/ul>\n

                C\u1ea7n ph\u00e2n bi\u1ec7t:<\/strong><\/p>\n

                  \n
                • Ch\u1ea3y m\u00e1u cam<\/strong><\/li>\n
                • \u0102n ti\u1ebft canh<\/strong><\/li>\n
                • Ho ra m\u00e1u: <\/strong>M\u00e1u \u0111\u1ecf t\u01b0\u01a1i, c\u00f3 b\u1ecdt, kh\u00f4ng c\u00f3 l\u1eabn th\u1ee9c \u0103n.<\/li>\n<\/ul>\n

                  3.2. \u0110i c\u1ea7u ph\u00e2n \u0111en<\/strong><\/h3>\n
                    \n
                  • V\u1ecb tr\u00ed: <\/strong>Th\u01b0\u1eddng do xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean, c\u00f3 th\u1ec3 do xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a d\u01b0\u1edbi.<\/li>\n
                  • T\u00ednh ch\u1ea5t: <\/strong>Ph\u00e2n th\u01b0\u1eddng \u0111en m\u1ec1m, d\u00ednh, m\u00f9i \u0111\u1eb7c tr\u01b0ng: kh\u1eafm. Ch\u1ec9 c\u1ea7n l\u01b0\u1ee3ng m\u00e1u 60ml, th\u1eddi gian m\u00e1u trong \u0111\u01b0\u1eddng ti\u00eau h\u00f3a \u00edt nh\u1ea5t 14 gi\u1edd, s\u1ebd g\u00e2y ti\u00eau ph\u00e2n \u0111en ( do t\u00e1c \u0111\u1ed9ng c\u1ee7a HCl, pepsin, vi khu\u1ea9n \u0111\u01b0\u1eddng ru\u1ed9t).V\u1edbi l\u01b0\u1ee3ng m\u00e1u ch\u1ea3y 200 \u2013 400ml s\u1ebd g\u00e2y ti\u00eau ph\u00e2n \u0111en gi\u1ed1ng nh\u01b0 b\u00e3 c\u00e0 ph\u00ea ho\u1eb7c gi\u1ed1ng nh\u01b0 h\u1eafc \u00edn.<\/li>\n
                  • C\u1ea7n ph\u00e2n bi\u1ec7t:<\/strong> do u\u1ed1ng Bismuth, s\u1eaft, than ho\u1ea1t.<\/li>\n<\/ul>\n

                    3.3. Tri\u1ec7u ch\u1ee9ng m\u1ea5t m\u00e1u c\u1ea5p\u00a0<\/strong><\/h3>\n
                      \n
                    • M\u1ea5t m\u00e1u nhi\u1ec1u<\/strong>: 1500 ml, c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc ho\u1eb7c c\u00f9ng l\u00fac ho\u1eb7c sau khi sau khi n\u00f4n ho\u1eb7c \u1ec9a ra m\u00e1u:
                      \n+ Tri gi\u00e1c: <\/strong>l\u01a1 m\u01a1, h\u1ed1t ho\u1ea3ng, th\u1edf nhanh, ti\u1ec3u \u00edt, c\u00f3 th\u1ec3 co gi\u1eadt do thi\u1ebfu oxy n\u00e3o.
                      \n+ Huy\u1ebft \u00e1p t\u1ed1i \u0111a th\u1ea5p < 80mmHg, ho\u1eb7c k\u1eb9t ho\u1eb7c kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c.
                      \n+ M\u1ea1ch nhanh >120l\u1ea7n\/ ph\u00fat, ho\u1eb7c nhanh nh\u1ecf kh\u00f3 b\u1eaft, to\u00e1t m\u1ed3 h\u00f4i, ch\u00e2n tay l\u1ea1nh.
                      \n+ Da xanh t\u00e1i, ni\u00eam m\u1ea1c tr\u1eafng b\u1ec7ch.<\/li>\n
                    • M\u1ea5t m\u00e1u trung b\u00ecnh: <\/strong>kho\u1ea3ng 500 – 1500ml.\n
                        \n
                      • M\u1ec7t m\u1ecfi, da xanh, ni\u00eam m\u1ea1c nh\u1ee3t, ch\u00f3ng m\u1eb7t, \u0111\u1ed5 m\u1ed3 h\u00f4i, ti\u1ec3u \u00edt<\/li>\n
                      • M\u1ea1ch nhanh t\u1eeb 100 – 120 l\/ ph\u00fat.<\/li>\n
                      • Huy\u1ebft \u00e1p t\u1ed1i \u0111a: 80 – 90mmHg<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n
                          \n
                        • M\u1ea5t m\u00e1u m\u1ee9c \u0111\u1ed9 nh\u1eb9: <\/strong>< 500ml\n
                            \n
                          • C\u00f3 c\u1ea3m gi\u00e1c h\u01a1i m\u1ec7t.<\/li>\n
                          • M\u1ea1ch h\u01a1i nhanh: 90 – 100 l\/ ph\u00fat.<\/li>\n
                          • Huy\u1ebft \u00e1p t\u1ed1i \u0111a: \u00b3 90 mmHg.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                            4. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n

                            4.1. X\u00e9t nghi\u1ec7m m\u00e1u:<\/strong><\/h3>\n
                              \n
                            • Dung t\u00edch h\u1ed3ng c\u1ea7u<\/strong>: <\/strong>\n
                                \n
                              • C\u00f3 th\u1ec3 b\u00ecnh th\u01b0\u1eddng ho\u1eb7c ch\u1ec9 gi\u1ea3m t\u1ea1i th\u1eddi \u0111i\u1ec3m ban \u0111\u1ea7u c\u1ee7a \u0111\u1ee3t kh\u1edfi ph\u00e1t xu\u1ea5t huy\u1ebft n\u1eb7ng.<\/li>\n
                              • X\u00e9t nghi\u1ec7m c\u00f4ng th\u1ee9c m\u00e1u ngo\u1ea1i vi ph\u1ea3i sau \u00edt nh\u1ea5t 6 gi\u1edd m\u1edbi b\u1eaft \u0111\u1ea7u gi\u1ea3m v\u00e0 sau 24- 48 gi\u1edd m\u1edbi ph\u1ea3n \u00e1nh trung th\u1ef1c t\u00ecnh tr\u1ea1ng m\u1ea5t m\u00e1u.<\/li>\n
                              • Trung b\u00ecnh c\u1ee9 m\u1ea5t 500ml m\u00e1u, dung t\u00edch h\u1ed3ng c\u1ea7u gi\u1ea3m 3%. Trung b\u00ecnh c\u1ee9 truy\u1ec1n 500ml m\u00e1u dung t\u00edch h\u1ed3ng c\u1ea7u t\u0103ng 3%.<\/li>\n<\/ul>\n<\/li>\n
                              • S\u1ed1 l\u01b0\u1ee3ng HC<\/strong> gi\u1ea3m.<\/li>\n
                              • H\u1ed3ng c\u1ea7u l\u01b0\u1edbi: <\/strong>T\u0103ng nh\u1eefng ng\u00e0y sau.<\/li>\n
                              • Ti\u1ec3u c\u1ea7u: <\/strong>B\u00ecnh th\u01b0\u1eddng ho\u1eb7c gi\u1ea3m trong xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a do v\u1ee1 d\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n<\/li>\n
                              • B\u1ea1ch c\u1ea7u: <\/strong>T\u0103ng \u2264 15000\/mm3.<\/li>\n
                              • BUN: <\/strong>T\u0103ng trong 75% c\u00e1c tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean do: T\u0103ng c\u00e1c azot m\u00e1u tr\u01b0\u1edbc th\u1eadn ( do gi\u1ea3m th\u1ec3 t\u00edch) v\u00e0 do h\u1ea5p thu c\u00e1c protein m\u00e1u \u1edf ru\u1ed9t non.<\/li>\n<\/ul>\n

                                4.2. Ch\u1ee9c n\u0103ng gan: <\/strong><\/h3>\n

                                N\u1ebfu nghi xu\u1ea5t huy\u1ebft do r\u1ed1i lo\u1ea1n c\u1ea7m m\u00e1u do suy gan c\u00f3 th\u1ec3 x\u00e9t nghi\u1ec7m th\u1eddi gian thrombin, th\u1eddi gian Quick, TCK, th\u1eddi gian m\u00e1u ch\u1ea3y, m\u00e1u \u0111\u00f4ng.<\/p>\n

                                4.3. N\u1ed9i soi th\u1ef1c qu\u1ea3n \u2013 d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng: <\/strong><\/h3>\n

                                C\u1ea7n ch\u1ec9 \u0111\u1ecbnh n\u1ed9i soi c\u1ea5p c\u1ee9u c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t khi t\u00ecnh tr\u1ea1ng t\u1ed5ng qu\u00e1t b\u1ec7nh nh\u00e2n cho ph\u00e9p (\u0111\u1ec3 x\u00e1c \u0111\u1ecbnh s\u1edbm v\u1ecb tr\u00ed xu\u1ea5t huy\u1ebft v\u00e0 c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb c\u1ea7m m\u00e1u qua n\u1ed9i soi).<\/p>\n

                                4.3.1. Ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i xu\u1ea5t huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean<\/strong> do lo\u00e9t d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng. <\/strong><\/h3>\n\n\n\n\n\n\n\n\n
                                Ia<\/td>\nM\u00e1u phun th\u00e0nh tia (\u1ed5 lo\u00e9t \u0103n v\u00e0o \u0111\u1ed9ng m\u1ea1ch)<\/td>\nNguy c\u01a1 t\u00e1i xu\u1ea5t huy\u1ebft cao<\/td>\n<\/tr>\n
                                Ib<\/td>\nM\u00e1u r\u1ec9 quanh \u1ed5 lo\u00e9t do \u1ed5 lo\u00e9t \u0103n v\u00e0o TM<\/td>\n<\/tr>\n
                                IIa<\/td>\nNh\u00ecn th\u1ea5y m\u1ea1ch m\u00e1u nh\u01b0ng kh\u00f4ng ch\u1ea3y m\u00e1u<\/td>\n<\/tr>\n
                                IIb<\/td>\nC\u00f3 c\u1ee5c m\u00e1u \u0111\u00f4ng d\u00ednh v\u00e0o \u1ed5 lo\u00e9t<\/td>\n<\/tr>\n
                                IIc<\/td>\nC\u00f3 c\u1eb7n m\u00e1u \u0111en \u1edf \u1ed5 lo\u00e9t<\/td>\nNguy c\u01a1 t\u00e1i xu\u1ea5t huy\u1ebft th\u1ea5p<\/td>\n<\/tr>\n
                                III<\/td>\n\u0110\u00e1y s\u1ea1ch<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                                B\u1ea3ng 3-1: Ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i xu\u1ea5t huy\u1ebft theo ph\u00e2n \u0111\u1ed9 Forrest<\/p>\n

                                4.3.2. Ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i xu\u1ea5t huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean<\/strong> do<\/strong> gi\u00e3n TM th\u1ef1c qu\u1ea3n.<\/strong><\/h3>\n

                                Ti\u00ean l\u01b0\u1ee3ng kh\u1ea3 n\u0103ng t\u00e1i xu\u1ea5t huy\u1ebft \u1edf b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean do v\u1ee1 gi\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n \u0111\u01b0\u1ee3c ti\u00ean l\u01b0\u1ee3ng theo d\u1ea5u \u0111\u1ecf (Red color sign-RC):<\/p>\n

                                – D\u1ea5u \u0111\u1ecf:<\/strong> \u0110\u01b0\u1ee3c m\u00f4\u00a0 t\u1ea3 nh\u01b0 s\u1ef1 \u0111\u1ed5i m\u00e0u \u0111\u1ecf khu\u00a0 tr\u00fa \u1edf ngay\u00a0 l\u1edbp d\u01b0\u1edbi ni\u00eam m\u1ea1c.<\/p>\n

                                D\u1ea5u \u0111\u1ecf (RC) \u0111\u01b0\u1ee3c ghi nh\u1eadn l\u00e0 (+) hay (-) c\u00f3 th\u1ec3 th\u1ea5y \u1edf c\u00e1c d\u1ea1ng sau:<\/p>\n

                                + L\u1eb1n\u00a0 \u0111\u1ecf\u00a0 (RWM: red wale marking)<\/strong> l\u00e0 nh\u1eefng ti\u1ec3u t\u0129nh m\u1ea1ch gi\u00e3n ch\u1ea1y d\u1ecdc theo c\u1ed9t gi\u00e3n t\u0129nh m\u1ea1ch l\u1edbn gi\u1ed1ng nh\u01b0 m\u1ed9t l\u1eb1n roi.<\/p>\n

                                + B\u1ecdc m\u00e1u (HCS: hematocystic spot)<\/strong> l\u00e0 nh\u1eefng ch\u1ed7 nh\u00f4 cao m\u00e0u \u0111\u1ecf tr\u00f4ng gi\u1ed1ng nh\u01b0 m\u1ed9t b\u1ecdc m\u00e1u. B\u1ecdc m\u00e1u n\u00e0y th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n \u0111\u01a1n \u0111\u1ed9c.<\/p>\n

                                – Lo\u1ea1i d\u1ea5u \u0111\u1ecf s\u1ebd \u0111\u01b0\u1ee3c ghi nh\u1eadn sau k\u00ed hi\u1ec7u RC (+).<\/p>\n

                                – C\u00e1c d\u1ea5u \u0111\u1ecf ch\u1ec9 \u0111i\u1ec3m nguy c\u01a1 xu\u1ea5t huy\u1ebft cao , \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng nh\u1eb9 tu\u1ef3 theo k\u00edch th\u01b0\u1edbc v\u00e0 v\u1ecb tr\u00ed, g\u1ed3m 4 \u0111\u1ed9: (-), (+), (++) v\u00e0 (+++)<\/strong>.<\/p>\n

                                + RC (-):<\/strong> kh\u00f4ng c\u00f3.<\/p>\n

                                + RC (+):<\/strong> s\u1ed1 l\u01b0\u1ee3ng \u00edt v\u00e0 khu tr\u00fa.<\/p>\n

                                + RC (++):<\/strong> s\u1ed1 l\u01b0\u1ee3ng\u00a0 v\u1eeba v\u00e0 r\u1ed9ng h\u01a1n.<\/p>\n

                                + RC (+++):<\/strong> s\u1ed1 l\u01b0\u1ee3ng nhi\u1ec1u v\u00e0 g\u1ea7n nh\u01b0 to\u00e0n b\u1ed9 chu vi.<\/p>\n

                                4.3.3. Si\u00eau \u00e2m: <\/strong><\/h3>\n

                                T\u00ecm nguy\u00ean nh\u00e2n ch\u1ea3y m\u00e1u do nguy\u00ean nh\u00e2n t\u1eeb gan, s\u1ecfi m\u1eadt, vi\u00eam t\u00fai m\u1eadt ho\u1ea1i t\u1eed, x\u01a1 gan c\u1ed5 tr\u01b0\u1edbng, K d\u1ea1 d\u00e0y.<\/p>\n

                                4.3.4. T\u00ecm m\u00e1u \u1ea9n trong ph\u00e2n: <\/strong><\/h3>\n

                                Tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c b\u1ec7nh nh\u00e2n c\u00f3 \u0111i c\u1ea7u ra m\u00e1u hay kh\u00f4ng th\u00ec l\u00e0m x\u00e9t nghi\u1ec7m t\u00ecm h\u1ed3ng c\u1ea7u trong ph\u00e2n \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh.<\/p>\n

                                Ngu\u1ed3n tham kh\u1ea3o:\u00a0<\/strong><\/p>\n

                                  \n
                                1. B\u00e0i gi\u1ea3ng Lo\u00e9t d\u1ea1 d\u00e0y – t\u00e1 tr\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc T\u00e2y Nguy\u00ean 2020<\/li>\n
                                2. S\u00e1ch l\u00e2m s\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 \u0110H Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

                                  Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a (XHTH) l\u00e0 t\u00ecnh tr\u1ea1ng ch\u1ea3y m\u00e1u ra kh\u1ecfi l\u00f2ng m\u1ea1ch v\u00e0o \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. \u0110\u01b0\u1ee3c th\u1ea3i ra kh\u1ecfi \u0111\u01b0\u1eddng ti\u00eau h\u00f3a b\u1eb1ng c\u00e1ch n\u00f4n hay \u0111i ngo\u00e0i ra m\u00e1u ho\u1eb7c ph\u00e2n \u0111en.\u00a0\u00a0Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u c\u1ee7a m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd ti\u00eau h\u00f3a nghi\u00eam tr\u1ecdng, bao g\u1ed3m […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"\nXu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean: \u0110\u1ecbnh ngh\u0129a, nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng<\/title>\n<meta name=\"description\" content=\"Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a tr\u00ean l\u00e0 ch\u1ea3y m\u00e1u t\u1eeb g\u00f3c Treitz tr\u1edf l\u00ean. 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