{"id":20812,"date":"2023-04-22T00:36:43","date_gmt":"2023-04-21T17:36:43","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=20812"},"modified":"2023-04-24T12:25:55","modified_gmt":"2023-04-24T05:25:55","slug":"chan-doan-va-dieu-tri-xuat-huyet-tieu-hoa-tren","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/chan-doan-va-dieu-tri-xuat-huyet-tieu-hoa-tren\/","title":{"rendered":"Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><strong>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. 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. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c XHTH tr\u00ean l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng v\u00e0 b\u00e0i vi\u1ebft n\u00e0y s\u1ebd cung c\u1ea5p th\u00f4ng tin v\u1ec1 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n l\u01b0u \u00fd khi \u0111\u1ed1i ph\u00f3 v\u1edbi tri\u1ec7u ch\u1ee9ng n\u00e0y.<\/strong><\/p>\n<figure style=\"width: 400px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" src=\"https:\/\/i.imgur.com\/V33BIwb.png\" alt=\"Minh ho\u1ea1 n\u1ed9i soi xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean\" width=\"400\" height=\"305\" \/><figcaption class=\"wp-caption-text\">Minh ho\u1ea1 n\u1ed9i soi xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean<\/figcaption><\/figure>\n<h2><strong>1. Ch\u1ea9n \u0111o\u00e1n xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean<\/strong><\/h2>\n<h3><strong>1.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/strong><\/h3>\n<ul>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/trieu-chung-lam-sang-xuat-huyet-tieu-hoa-tren-va-duoi\/\">L\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng<\/a><\/li>\n<\/ul>\n<h3><strong>1.2. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong><\/h3>\n<ul>\n<li><strong>Ch\u1ea3y m\u00e1u t\u1eeb xoang m\u0169i<\/strong><strong>:<\/strong> G\u1eb7p \u1edf ng\u01b0\u1eddi th\u01b0\u1eddng ch\u1ea3y m\u00e1u cam, cao huy\u1ebft \u00e1p.<\/li>\n<li><strong>Xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a d\u01b0\u1edbi<\/strong><strong>:<\/strong> Ph\u00e2n c\u00f3 m\u00e1u \u0111\u1ecf t\u01b0\u01a1i, k\u1ebft h\u1ee3p v\u1edbi b\u1ec7nh s\u1eed v\u00e0 v\u1ecb tr\u00ed \u0111au \u1edf b\u1ee5ng. N\u1ebfu ch\u1ea9n \u0111o\u00e1n kh\u00f3 c\u1ea7n n\u1ed9i soi d\u1ea1 d\u00e0y ho\u1eb7c n\u1ed9i soi \u0111\u1ea1i tr\u00e0ng.<\/li>\n<li><strong>Ho ra m\u00e1u:<\/strong> M\u00e1u \u0111\u1ecf t\u01b0\u01a1i, kh\u00f4ng c\u00f3 m\u00e1u c\u1ee5c, kh\u00f4ng l\u1eabn v\u1edbi th\u1ee9c \u0103n v\u00e0 b\u1ecdt kh\u00ed. Tuy v\u1eady, v\u1eabn c\u00f3 tr\u01b0\u1eddng h\u1ee3p m\u00e1u n\u00f4n ra l\u00e0 m\u00e1u b\u1ea7m, c\u00f3 m\u00e1u \u0111\u00f4ng v\u00e0 m\u00e1u c\u00f3 l\u1eabn th\u1ee9c \u0103n v\u00e0 b\u1ecdt kh\u00ed l\u00e0 do BN khi ho ra m\u00e1u c\u00f3 nu\u1ed1t 1 \u00edt r\u1ed3i n\u00f4n ra.<\/li>\n<li><strong>Ti\u00eau ph\u00e2n \u0111en<\/strong> do thu\u1ed1c, do th\u1ee9c \u0103n c\u00f3 huy\u1ebft, ho\u1eb7c do t\u00e1o b\u00f3n<\/li>\n<\/ul>\n<h3><strong>1.3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/strong><\/h3>\n<ul>\n<li><strong>Lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng, <\/strong>d\u1ef1a v\u00e0o:<\/li>\n<\/ul>\n<p><strong>+<\/strong> HC lo\u00e9t \u0111i\u1ec3n h\u00ecnh v\u00e0 kh\u00f4ng \u0111i\u1ec3n h\u00ecnh.<\/p>\n<p><strong>+ <\/strong>Ti\u1ec1n s\u1eed lo\u00e9t d\u1ea1 d\u00e0y \u2013 t\u00e1 tr\u00e0ng.<\/p>\n<p><strong>+<\/strong> Ti\u1ec1n s\u1eed s\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1ng vi\u00eam, Corticoid, thu\u1ed1c kh\u00e1ng \u0111\u00f4ng.<\/p>\n<p><strong>+ <\/strong>C\u1eadn l\u00e2m s\u00e0ng nh\u01b0 X quang, n\u1ed9i soi.<\/p>\n<ul>\n<li><strong>Vi\u00eam d\u1ea1 d\u00e0y ch\u1ea3y m\u00e1u:<\/strong><\/li>\n<\/ul>\n<p><strong>Bi\u1ec3u hi\u1ec7n:<\/strong> \u0110au, n\u00f3ng\u00a0 r\u00e1t v\u00f9ng th\u01b0\u1ee3ng v\u1ecb, \u0111ang d\u00f9ng c\u00e1c lo\u1ea1i thu\u1ed1c nh\u01b0 Aspirine, kh\u00e1ng vi\u00eam kh\u00f4ng Steroid v\u00e0 m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1c.<\/p>\n<ul>\n<li><strong>K d\u1ea1 d\u00e0y:<\/strong><\/li>\n<\/ul>\n<p><strong>Bi\u1ec3u hi\u1ec7n: <\/strong>M\u1ec7t m\u1ecfi, g\u1ea7y s\u00fat, ch\u00e1n \u0103n, thi\u1ebfu m\u00e1u, \u0111au v\u00f9ng th\u01b0\u1ee3ng v\u1ecb kh\u00f4ng c\u00f3 chu k\u1ef3, c\u00f3 th\u1ec3 s\u1edd th\u1ea5y kh\u1ed1i u v\u00f9ng th\u01b0\u1ee3ng v\u1ecb hay bi\u1ec3u hi\u1ec7n h\u1eb9p m\u00f4n v\u1ecb. Th\u01b0\u1eddng \u0111i c\u1ea7u ph\u00e2n \u0111en ho\u1eb7c c\u1ea7u m\u00e1u \u1ea9n do ch\u1ea3y m\u00e1u l\u01b0\u1ee3ng \u00edt, r\u1ec9 r\u1ea3.<\/p>\n<ul>\n<li><strong>Polype v\u00e0 c\u00e1c kh\u1ed1i u: <\/strong>Hi\u1ebfm g\u1eb7p, ch\u1ea9n \u0111o\u00e1n nh\u1edd v\u00e0o n\u1ed9i soi.<\/li>\n<\/ul>\n<ul>\n<li><strong>H\u1ed9i ch\u1ee9ng Mallory-weiss:<\/strong><\/li>\n<\/ul>\n<p><strong>Bi\u1ec3u hi\u1ec7n: <\/strong>N\u00f3ng r\u00e1t sau x\u01b0\u01a1ng \u1ee9c. X\u1ea3y ra tr\u00ean b\u1ec7nh nh\u00e2n n\u00f4n m\u1eeda nhi\u1ec1u, b\u1ec7nh nh\u00e2n x\u01a1 gan t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda, b\u1ec7nh u\u1ed1ng r\u01b0\u1ee3u.<br \/>\n<strong>Ch\u1ea9n \u0111o\u00e1n<\/strong>: nh\u1edd v\u00e0o n\u1ed9i soi.<\/p>\n<ul>\n<li><strong>Ch\u1ea3y m\u00e1u t\u1eeb gi\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n:<\/strong><\/li>\n<\/ul>\n<p><strong>Bi\u1ec3u hi\u1ec7n: <\/strong>Ch\u1ea3y m\u00e1u th\u01b0\u1eddng \u0111\u1ed9t ng\u1ed9t kh\u00f4ng c\u00f3 ti\u1ec1n tri\u1ec7u, c\u00f3 khi n\u00f4n ra m\u1ed9t s\u1ed1 l\u01b0\u1ee3ng m\u00e1u r\u1ea5t l\u1edbn b\u1ec7nh nh\u00e2n h\u00f4n m\u00ea v\u00e0 t\u1eed vong. X\u1ea3y ra tr\u00ean b\u1ec7nh nh\u00e2n x\u01a1 gan, t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda c\u00f3 hay ch\u01b0a c\u00f3 c\u1ed5 tr\u01b0\u1edbng.<\/p>\n<ul>\n<li><strong>Ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng m\u1eadt: <\/strong><\/li>\n<\/ul>\n<p><strong>Bi\u1ec3u hi\u1ec7n: <\/strong>V\u1edbi c\u01a1n \u0111au qu\u1eb7n gan, s\u1ed1t, v\u00e0ng da v\u00e0ng m\u1eaft, h\u1ed9i ch\u1ee9ng nhi\u1ec5m tr\u00f9ng, m\u00e1u n\u00f4n ra c\u00f3 th\u1ec3 c\u00f3 h\u00ecnh th\u1ecfi b\u00fat ch\u00ec. Kh\u00e1m th\u1ea5y \u0111au v\u00f9ng gan m\u1ea5t, gan c\u00f3 th\u1ec3 to. G\u1eb7p \u1edf BN c\u00f3 ti\u1ec1n s\u1eed s\u1ecfi ho\u1eb7c giun chui \u0111\u01b0\u1eddng m\u1eadt.<\/p>\n<p><strong>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh:<\/strong> nh\u1edd v\u00e0o si\u00eau \u00e2m nh\u1ea5t l\u00e0 n\u1ed9i soi th\u1ea5y m\u00e1u ch\u1ea3y ra t\u1eeb c\u01a1 v\u00f2ng Oddi.<\/p>\n<ul>\n<li><strong>Ch\u1ea3y m\u00e1u t\u1eeb t\u00fai th\u1eeba t\u00e1 tr\u00e0ng ho\u1eb7c c\u00e1c ph\u00ecnh m\u1ea1ch t\u00e1 tr\u00e0ng: <\/strong>R\u1ea5t kh\u00f3 ch\u1ea9n \u0111o\u00e1n ph\u1ea3i nh\u1edd v\u00e0o n\u1ed9i soi d\u1ea1 d\u00e0y t\u00e1 tr\u00e0ng b\u1eb1ng \u1ed1ng soi m\u1ec1m.<\/li>\n<\/ul>\n<h3><strong>1.4. Ch\u1ea9n \u0111o\u00e1n m\u1ee9c \u0111\u1ed9: <\/strong><\/h3>\n<p>D\u1ef1a v\u00e0o tr\u1ecb s\u1ed1 huy\u1ebft \u00e1p, m\u1ea1ch, s\u1ed1 l\u01b0\u1ee3ng h\u1ed3ng c\u1ea7u, Hematocrite, Hemoglobin, s\u1ed1 l\u01b0\u1ee3ng m\u00e1u n\u00f4n ra v\u00e0 s\u1ed1 l\u01b0\u1ee3ng m\u00e1u \u0111i ra theo ph\u00e2n \u0111\u1ec3 ph\u00e2n ch\u1ea3y m\u00e1u ra <strong>3 m\u1ee9c \u0111\u1ed9:<\/strong> xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 n\u1eb7ng, v\u1eeba v\u00e0 nh\u1eb9.<\/p>\n<table style=\"height: 769px;\" width=\"761\">\n<tbody>\n<tr>\n<td width=\"159\"><strong>D\u1ea5u hi\u1ec7u<\/strong><\/td>\n<td width=\"159\"><strong>Nh\u1eb9 (\u0111\u1ed9 I)<\/strong><\/td>\n<td width=\"159\"><strong>Trung b\u00ecnh ( \u0111\u1ed9 II)<\/strong><\/td>\n<td width=\"159\"><strong>N\u1eb7ng ( \u0111\u1ed9 III)<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>L<\/strong><strong>\u01b0<\/strong><strong>\u1ee3ng m\u00e1u m\u1ea5t<\/strong><\/td>\n<td width=\"159\">\u226410% th\u1ec3 t\u00edch m\u00e1u (500ml)<\/td>\n<td width=\"159\">&lt; 30%(&lt;1500ml)<\/td>\n<td width=\"159\">\u226530%<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>Huy\u1ebft \u00e1p t\u00e2m thu<\/strong><\/td>\n<td width=\"159\">&gt; 90mmHg<\/td>\n<td width=\"159\">80 &#8211; &lt;90<\/td>\n<td width=\"159\">&lt; 80<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>H\u1ea1 \u00e1p t\u01b0 th\u1ebf<\/strong><\/td>\n<td width=\"159\">kh\u00f4ng<\/td>\n<td width=\"159\">C\u00f3 th\u1ec3<\/td>\n<td width=\"159\">Ch\u1eafc ch\u1eafn<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>M\u1ea1ch<\/strong><\/td>\n<td width=\"159\">90 \u2013 100 l\u1ea7n\/ph\u00fat<\/td>\n<td width=\"159\">&gt;100 \u2013 &lt;120 l\u1ea7n\/ph\u00fat<\/td>\n<td width=\"159\">\u2265120 l\u1ea7n\/ph\u00fat<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>Da<\/strong><\/td>\n<td width=\"159\">H\u1ed3ng h\u00e0o<\/td>\n<td width=\"159\">Nh\u1ee3t nh\u1ea1t<\/td>\n<td width=\"159\">Tr\u1eafng b\u1ec7ch<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>Nh\u1ecbp th\u1edf<\/strong><\/td>\n<td width=\"159\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"159\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"159\">B\u1ea5t th\u01b0\u1eddng<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>N\u01b0\u1edbc ti\u1ec3u<\/strong><\/td>\n<td width=\"159\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"159\">Gi\u1ea3m<\/td>\n<td width=\"159\">V\u00f4 ni\u1ec7u<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>Tri gi\u00e1c<\/strong><\/td>\n<td width=\"159\">B\u00ecnh th\u01b0\u1eddng<\/td>\n<td width=\"159\">K\u00edch th\u00edch<\/td>\n<td width=\"159\">L\u01a1 m\u01a1, h\u00f4n m\u00ea<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>Hct<\/strong><\/td>\n<td width=\"159\">\u2265 30%<\/td>\n<td width=\"159\">&lt; 30 &#8211; 20%<\/td>\n<td width=\"159\">\u2264 20<\/td>\n<\/tr>\n<tr>\n<td width=\"159\"><strong>S\u1ed1 l\u01b0\u1ee3ng HC<\/strong><\/td>\n<td width=\"159\">\u2265 3 tri\u1ec7u\/mm<\/td>\n<td width=\"159\">3 &#8211; 2 tri\u1ec7u\/mm3<\/td>\n<td width=\"159\">\u2264 2 tri\u1ec7u\/mm3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Thang \u0111i\u1ec3m Blatchford:\u00a0<\/strong><\/p>\n<table style=\"height: 991px;\" width=\"760\">\n<tbody>\n<tr>\n<td width=\"156\"><strong>Ch\u1ec9 s\u1ed1 \u0111\u00e1nh gi\u00e1<\/strong><\/td>\n<td width=\"156\"><strong>\u0110i\u1ec3m<\/strong><\/td>\n<td width=\"156\"><strong>Ch\u1ec9 s\u1ed1 \u0111\u00e1nh gi\u00e1<\/strong><\/td>\n<td width=\"156\"><strong>\u0110i\u1ec3m<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"156\"><strong>HA t\u00e2m thu (mmHg)<\/strong><\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><strong>Huy\u1ebft s\u1eafc t\u1ed1 BN n\u1eef (g\/dL)<\/strong><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<tr>\n<td width=\"156\">100 &#8211; 109<\/td>\n<td width=\"156\">1<\/td>\n<td width=\"156\">10 \u2013 11,9<\/td>\n<td width=\"156\">1<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">90 &#8211; 99<\/td>\n<td width=\"156\">2<\/td>\n<td width=\"156\">&lt; 10<\/td>\n<td width=\"156\">6<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">&lt; 90<\/td>\n<td width=\"156\">3<\/td>\n<td width=\"156\"><strong>Nh\u1eefng d\u1ea5u hi\u1ec7u kh\u00e1c<\/strong><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<tr>\n<td width=\"156\"><strong>Ur\u00ea m\u00e1u (mmol\/L)<\/strong><\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\">M\u1ea1ch \u2265 100 l\u1ea7n\/ph\u00fat<\/td>\n<td width=\"156\">1<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">6,5 \u2013 7,9<\/td>\n<td width=\"156\">2<\/td>\n<td width=\"156\">\u0110i ti\u00eau ph\u00e2n \u0111en<\/td>\n<td width=\"156\">1<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">8 \u2013 9,9<\/td>\n<td width=\"156\">3<\/td>\n<td width=\"156\">Ng\u1ea5t<\/td>\n<td width=\"156\">2<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">10 \u2013 24,9<\/td>\n<td width=\"156\">4<\/td>\n<td width=\"156\">B\u1ec7nh gan<\/td>\n<td width=\"156\">2<\/td>\n<\/tr>\n<tr>\n<td width=\"156\">\u2265 25<\/td>\n<td width=\"156\">6<\/td>\n<td width=\"156\">Suy tim<\/td>\n<td width=\"156\">2<\/td>\n<\/tr>\n<tr>\n<td width=\"156\"><strong>Huy\u1ebft s\u1eafc t\u1ed1 BN nam (g\/dL)<\/strong><\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<tr>\n<td width=\"156\">12 \u2013 12,9<\/td>\n<td width=\"156\">1<\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<tr>\n<td width=\"156\">10 \u2013 11,9<\/td>\n<td width=\"156\">3<\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<tr>\n<td width=\"156\">&lt; 10<\/td>\n<td width=\"156\">6<\/td>\n<td width=\"156\"><\/td>\n<td width=\"156\"><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Thang \u0111i\u1ec3m Blatchford \u0111\u01b0\u1ee3c t\u00ednh t\u1eeb 0 -23 \u0111i\u1ec3m, \u0111i\u1ec3m s\u1ed1 c\u00e0ng cao th\u00ec nguy c\u01a1 ch\u1ea3y m\u00e1u t\u00e1i ph\u00e1t c\u00e0ng l\u1edbn.<\/p>\n<h2><strong>2. \u0110i\u1ec1u tr\u1ecb xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean<\/strong><\/h2>\n<h3><strong>2.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/h3>\n<p>K\u1ebft h\u1ee3p h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c v\u00e0 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n.<\/p>\n<h3><strong>2.2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/strong><\/h3>\n<ul>\n<li>Ngay khi BN v\u00e0o vi\u1ec7n c\u1ea7n \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng huy\u1ebft \u0111\u1ed9ng.<\/li>\n<li>H\u1ed3i s\u1ee9c t\u00edch c\u1ef1c ngay t\u1eeb \u0111\u1ea7u.<\/li>\n<li>Ti\u1ebfn h\u00e0nh n\u1ed9i soi d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng trong 24 gi\u1edd \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh v\u00e0 \u0111\u00e1nh gi\u00e1 nguy c\u01a1 xu\u1ea5t huy\u1ebft t\u00e1i ph\u00e1t v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ea7m m\u00e1u b\u1eb1ng n\u1ed9i soi.<\/li>\n<\/ul>\n<p>Trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh vi\u1ec7n kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng n\u1ed9i soi m\u00e0 b\u1ec7nh nh\u00e2n \u0111ang trong t\u00ecnh tr\u1ea1ng n\u1eb7ng n\u1ebfu \u0111i\u1ec1u ki\u1ec7n cho ph\u00e9p th\u00ec chuy\u1ec3n ngay t\u1edbi b\u1ec7nh vi\u1ec7n tuy\u1ebfn tr\u00ean \u0111\u1ec3 ti\u1ebfn h\u00e0nh n\u1ed9i soi. N\u1ebfu trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng th\u1ec3 chuy\u1ec3n b\u1ec7nh nh\u00e2n, sau khi h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c m\u00e0 huy\u1ebft \u0111\u1ed9ng v\u1eabn kh\u00f4ng \u1ed5n \u0111\u1ecbnh th\u00ec h\u1ed9i ch\u1ea9n b\u00e1c s\u0129 ngo\u1ea1i khoa \u0111\u1ec3 c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt k\u1ecbp th\u1eddi.<\/p>\n<h3><strong>2.3. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/strong><\/h3>\n<ul>\n<li>C\u1ea7n n\u1ed9i soi s\u1edbm \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n v\u00e0 ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>Lo\u00e9t d\u1ea1 d\u00e0y (xem b\u00e0i xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1\u00a0do lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng).<\/li>\n<li>Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean\u00a0do t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda (Xem b\u00e0i XHTH tr\u00ean do t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1eeda).<\/li>\n<\/ul>\n<p>C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.<\/p>\n<p><strong>&#8211; H\u1ed9i ch\u1ee9ng Mallory- VVeiss:<\/strong><\/p>\n<p>+ N\u1ed9i soi c\u1ea7m m\u00e1u.<\/p>\n<p>+ D\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf b\u00e0i ti\u1ebft acid gi\u1ed1ng nh\u01b0 trong XHTH do lo\u00e9t d\u1ea1 d\u00e0y-t\u00e1 tr\u00e0ng.<\/p>\n<p><strong>&#8211; D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u:<\/strong><\/p>\n<p>+ N\u1ed9i soi c\u1ea7m m\u00e1u: d\u00f9ng clip c\u1ea7m m\u00e1u, \u0111\u1ea7u d\u00f2 nhi\u1ec7t, argonplasma.<\/p>\n<p>+ C\u00f3 th\u1ec3 n\u00fat m\u1ea1ch n\u1ebfu c\u00f3 kh\u1ea3 n\u0103ng can thi\u1ec7p m\u1ea1ch.<\/p>\n<p>+ Trong tr\u01b0\u1eddng h\u1ee3p th\u1ea5t b\u1ea1i ph\u1ea3i ph\u1eabu thu\u1eadt.<\/p>\n<p><strong>&#8211; Polype ch\u1ea3y m\u00e1u:<\/strong> n\u1ed9i soi d\u1ea1 d\u00e0y c\u1eaft polype.<\/p>\n<p><strong>&#8211; Kh\u1ed1i u ch\u1ea3y m\u00e1u:<\/strong>\u00a0n\u1ebfu h\u1ed3i s\u1ef1c t\u00edch c\u1ef1c m\u00e0 kh\u00f4ng d\u1eebng ch\u1ea3y m\u00e1u ph\u1ea3i ph\u1eabu thu\u1eadt.<\/p>\n<p><strong>&#8211; Ch\u1ea3y m\u00e1u \u0111\u01b0\u1eddng m\u1eadt:<\/strong><\/p>\n<p>D\u00f9ng kh\u00e1ng sinh trong tr\u01b0\u1eddng h\u1ee3p do nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng m\u1eadt.<\/p>\n<p>N\u1ebfu h\u1ed3i s\u1ef1c t\u00edch c\u1ef1c m\u00e0 kh\u00f4ng d\u1eebng ch\u1ea3y m\u00e1u c\u00f3 th\u1ec3\u00a0can thi\u1ec7p n\u00fat m\u1ea1ch ho\u1eb7c ph\u1eabu thu\u1eadt.<\/p>\n<h3><strong>3. Theo d\u00f5i b\u1ec7nh nh\u00e2n xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean<\/strong><\/h3>\n<ul>\n<li>D\u1ea5u hi\u1ec7u sinh t\u1ed3n m\u1ed7i 15 \u2013 30 ph\u00fat trong giai \u0111o\u1ea1n h\u1ed3i s\u1ee9c, sau \u0111\u00f3 m\u1ed7i 1-6 gi\u1edd.<\/li>\n<li>T\u00ecnh tr\u1ea1ng xu\u1ea5t huy\u1ebft: l\u01b0\u1ee3ng, t\u00ednh ch\u1ea5t n\u00f4n m\u00e1u, ti\u00eau m\u00e1u<\/li>\n<li>Dung t\u00edch h\u1ed3ng c\u1ea7u.<\/li>\n<li>L\u01b0\u1ee3ng d\u1ecbch xu\u1ea5t nh\u1eadp<\/li>\n<\/ul>\n<p><strong>Di\u1ec5n ti\u1ebfn:\u00a0<\/strong><\/p>\n<p>+ Ti\u00eau ph\u00e2n \u0111en c\u00f3 th\u1ec3 v\u1eabn c\u00f2n \u1edf ng\u00e0y 3-5 sau khi ng\u01b0ng xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a.<\/p>\n<p>+ Ti\u00ean l\u01b0\u1ee3ng: th\u01b0\u1eddng t\u1ef1 h\u1ebft<\/p>\n<p>+ T\u1ec9 l\u1ec7 t\u00e1i ph\u00e1t cao g\u1ea7n 40%<\/p>\n<p>+ Hi\u1ebfm ph\u1eabu thu\u1eadt (5%) t\u1eeb khi \u00e1p d\u1ee5ng n\u1ed9i soi ti\u00eau h\u00f3a c\u1ea7m m\u00e1u.<\/p>\n<p><strong>T\u00f3m l\u1ea1i:<\/strong> Vi\u1ec7c \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c XHTH tr\u00ean l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng trong vi\u1ec7c gi\u00fap b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 v\u00e0 \u0111\u00fang c\u00e1ch, tr\u00e1nh \u0111\u01b0\u1ee3c c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng. Ngo\u00e0i ra, vi\u1ec7c \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c c\u0169ng gi\u00fap ng\u0103n ng\u1eeba \u0111\u01b0\u1ee3c c\u00e1c b\u1ec7nh l\u00fd ti\u00eau h\u00f3a nghi\u00eam tr\u1ecdng kh\u00e1c.<\/p>\n<p>Do \u0111\u00f3, khi g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng xu\u1ea5t huy\u1ebft ti\u00eau h\u00f3a, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch t\u00ecm ki\u1ebfm s\u1ef1 h\u1ed7 tr\u1ee3 y t\u1ebf t\u1eeb c\u00e1c b\u00e1c s\u0129 chuy\u00ean khoa \u0111\u1ec3 \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi. \u0110\u1ed3ng th\u1eddi, vi\u1ec7c th\u1ef1c hi\u1ec7n c\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba nh\u01b0 \u0103n u\u1ed1ng l\u00e0nh m\u1ea1nh, ki\u1ec3m tra s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3 v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u0169ng gi\u00fap gi\u1ea3m thi\u1ec3u nguy c\u01a1 m\u1eafc c\u00e1c b\u1ec7nh l\u00fd ti\u00eau h\u00f3a nghi\u00eam tr\u1ecdng.<\/p>\n<p><strong>Ngu\u1ed3n tham kh\u1ea3o:\u00a0<\/strong><\/p>\n<ol>\n<li>B\u00e0i gi\u1ea3ng Lo\u00e9t d\u1ea1 d\u00e0y &#8211; t\u00e1 tr\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc T\u00e2y Nguy\u00ean 2020<\/li>\n<li>S\u00e1ch l\u00e2m s\u00e0ng n\u1ed9i ti\u00eau ho\u00e1 \u0110H Y khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch<\/li>\n<li>HEALTH Vi\u1ec7t Nam: Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 cao<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>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. 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. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c XHTH tr\u00ean l\u00e0 c\u1ef1c k\u1ef3 quan tr\u1ecdng v\u00e0 b\u00e0i vi\u1ebft n\u00e0y s\u1ebd [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Xu\u1ea5t huy\u1ebft ti\u00eau ho\u00e1 tr\u00ean: Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/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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