{"id":21374,"date":"2023-04-15T15:21:24","date_gmt":"2023-04-15T08:21:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21374"},"modified":"2023-04-17T15:07:53","modified_gmt":"2023-04-17T08:07:53","slug":"bien-chung-xuat-huyet-trong-hoi-chung-vanh-cap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/bien-chung-xuat-huyet-trong-hoi-chung-vanh-cap\/","title":{"rendered":"Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p<\/a> (ACS) l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u tim m\u1ea1ch nghi\u00eam tr\u1ecdng nh\u1ea5t hi\u1ec7n nay. ACS bao g\u1ed3m c\u00e1c tr\u1ea1ng th\u00e1i b\u1ec7nh l\u00fd nh\u01b0 \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh, nh\u1ed3i m\u00e1u c\u01a1 tim. Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u1ea5t c\u1ee7a ACS, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra nh\u1ed3i m\u00e1u c\u1ee5c b\u1ed9 ho\u1eb7c to\u00e0n b\u1ed9 c\u1ee7a c\u01a1 tim. Bi\u1ebfn ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng nh\u01b0 suy tim, s\u1ed1c v\u00e0 t\u1eed vong. Do \u0111\u00f3, vi\u1ec7c ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ACS v\u00e0 bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u1ef7 l\u1ec7 t\u1eed vong v\u00e0 t\u0103ng c\u01b0\u1eddng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng cho b\u1ec7nh nh\u00e2n<\/strong>.<\/p>\n

\"H\u1ed9i
H\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p<\/figcaption><\/figure>\n

1.Nguy\u00ean nh\u00e2n<\/h2>\n

Nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS l\u00e0 do c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0nh b\u1ecb t\u1eafc ngh\u1ebdn ho\u1eb7c thu h\u1eb9p, d\u1eabn \u0111\u1ebfn gi\u1ea3m l\u01b0\u1ee3ng oxy v\u00e0 dinh d\u01b0\u1ee1ng c\u1ea7n thi\u1ebft \u0111\u1ec3 duy tr\u00ec ho\u1ea1t \u0111\u1ed9ng c\u1ee7a c\u01a1 tim. N\u1ebfu t\u00ecnh tr\u1ea1ng n\u00e0y k\u00e9o d\u00e0i, c\u00e1c t\u1ebf b\u00e0o trong c\u01a1 tim s\u1ebd b\u1ecb t\u1ed5n th\u01b0\u01a1ng v\u00e0 ch\u1ebft, g\u00e2y ra h\u00ecnh th\u00e0nh c\u00e1c v\u1ebft th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t c\u1ee7a c\u01a1 tim. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u00e1c v\u1ebft th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 l\u00e0m cho c\u00e1c m\u1ea1ch m\u00e1u b\u00ean trong c\u01a1 tim b\u1ecb v\u1ee1, g\u00e2y ra xu\u1ea5t huy\u1ebft v\u00e0 ti\u00eau ch\u1ea3y m\u00e1u. Ngo\u00e0i ra, c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 nh\u01b0 b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng, huy\u1ebft \u00e1p cao, h\u00fat thu\u1ed1c v\u00e0 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd tim m\u1ea1ch c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS.<\/p>\n

2.Tri\u1ec7u ch\u1ee9ng<\/h2>\n

Tri\u1ec7u ch\u1ee9ng c\u1ee7a bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u b\u1eb1ng \u0111au ng\u1ef1c, kh\u00f3 th\u1edf v\u00e0 m\u1ec7t m\u1ecfi. C\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 gia t\u0103ng d\u1ea7n theo th\u1eddi gian v\u00e0 khi xu\u1ea5t huy\u1ebft nghi\u00eam tr\u1ecdng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 nh\u1ed3i m\u00e1u ph\u1ed5i, suy tim, s\u1ed1c v\u00e0 t\u1eed vong. \u0110au ng\u1ef1c c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng \u0111au n\u1eb7ng ho\u1eb7c c\u1ea3m gi\u00e1c n\u1eb7ng n\u1ec1, \u00e1p l\u1ef1c ho\u1eb7c kh\u00f3 ch\u1ecbu \u1edf ng\u1ef1c v\u00e0 c\u00f3 th\u1ec3 lan ra c\u1ea3 v\u00f9ng vai, c\u00e1nh tay tr\u00e1i, c\u1ed5 v\u00e0 h\u00e0m. Kh\u00f3 th\u1edf c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u0111\u1ed9t ng\u1ed9t, k\u00e8m theo c\u1ea3m gi\u00e1c ng\u1eafn th\u1edf ho\u1eb7c kh\u00f2 kh\u00e8. N\u1ebfu g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y, b\u1ec7nh nh\u00e2n c\u1ea7n ph\u1ea3i t\u00ecm ki\u1ebfm s\u1ef1 ch\u0103m s\u00f3c y t\u1ebf k\u1ecbp th\u1eddi \u0111\u1ec3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m thi\u1ec3u nguy c\u01a1 bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng.<\/p>\n

3.C\u00e1c y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p<\/h2>\n

C\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 ti\u00ean l\u01b0\u1ee3ng c\u00f3 th\u1ec3 g\u00f3p ph\u1ea7n v\u00e0o bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft tr\u00ean b\u1ec7nh nh\u00e2n h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p (ACS), bao g\u1ed3m:<\/p>\n

    \n
  • Tu\u1ed5i: Ng\u01b0\u1eddi cao tu\u1ed5i c\u00f3 nguy c\u01a1 cao h\u01a1n b\u1ecb bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS.<\/li>\n
  • Gi\u1edbi t\u00ednh: Nam gi\u1edbi c\u00f3 nguy c\u01a1 cao h\u01a1n so v\u1edbi n\u1eef gi\u1edbi.<\/li>\n
  • Ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd: B\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd nh\u01b0 ti\u1ec3u \u0111\u01b0\u1eddng, huy\u1ebft \u00e1p cao, b\u00e9o ph\u00ec, b\u1ec7nh th\u1eadn, b\u1ec7nh gan, b\u1ec7nh t\u0103ng lipid m\u00e1u, b\u1ec7nh l\u00fd tim m\u1ea1ch tr\u01b0\u1edbc \u0111\u00f3, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh vi\u00eam c\u1ea7u th\u1eadn c\u1ea5p c\u00f3 nguy c\u01a1 cao h\u01a1n b\u1ecb bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS.<\/li>\n
  • T\u00ecnh tr\u1ea1ng huy\u1ebft \u00e1p: Huy\u1ebft \u00e1p cao l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 cho bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS.<\/li>\n
  • M\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch v\u00e0nh: N\u1ebfu t\u1eafc ngh\u1ebdn nghi\u00eam tr\u1ecdng h\u01a1n, nguy c\u01a1 xu\u1ea5t huy\u1ebft c\u0169ng cao h\u01a1n.<\/li>\n
  • \u0110\u1eb7c \u0111i\u1ec3m c\u1ee7a c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng: N\u1ebfu c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng n\u1eb7ng h\u01a1n, nguy c\u01a1 xu\u1ea5t huy\u1ebft c\u0169ng cao h\u01a1n.<\/li>\n
  • C\u00e1c ch\u1ec9 s\u1ed1 sinh h\u00f3a: N\u1ed3ng \u0111\u1ed9 troponin, creatinine kinase-MB, fibrinogen, CRP v\u00e0 D-dimer c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 d\u1ef1 \u0111o\u00e1n nguy c\u01a1 xu\u1ea5t huy\u1ebft trong ACS.<\/li>\n
  • G\u00f3c \u0111\u1ed9 \u0111i\u1ec1u tr\u1ecb: C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u01b0 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng, th\u1ee7 thu\u1eadt n\u1ed9i khoa hay ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nguy c\u01a1 xu\u1ea5t huy\u1ebft trong ACS.<\/li>\n<\/ul>\n

    4. \u0110i\u1ec1u tr\u1ecb<\/h2>\n

    Trong tr\u01b0\u1eddng h\u1ee3p bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft x\u1ea3y ra trong ACS, \u0111i\u1ec1u tr\u1ecb c\u0169ng t\u00f9y thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n g\u00e2y ra xu\u1ea5t huy\u1ebft v\u00e0 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a v\u1ea5n \u0111\u1ec1. C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n

      \n
    • S\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng: C\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng nh\u01b0 heparin, enoxaparin, fondaparinux, bivalirudin ho\u1eb7c tirofiban c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ef1 l\u00e3o h\u00f3a v\u00e0 gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t c\u1ee7a ACS. Tuy nhi\u00ean, c\u00e1c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 xu\u1ea5t huy\u1ebft.<\/li>\n
    • S\u1eed d\u1ee5ng thu\u1ed1c kh\u00e1c \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ef1 l\u00e3o h\u00f3a: Ngo\u00e0i thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng, c\u00e1c thu\u1ed1c kh\u00e1c nh\u01b0 aspirin, clopidogrel, prasugrel, ticagrelor ho\u1eb7c cangrelor c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ef1 l\u00e3o h\u00f3a v\u00e0 gi\u1ea3m nguy c\u01a1 t\u00e1i ph\u00e1t c\u1ee7a ACS. Tuy nhi\u00ean, nh\u1eefng thu\u1ed1c n\u00e0y c\u0169ng c\u00f3 th\u1ec3 t\u0103ng nguy c\u01a1 xu\u1ea5t huy\u1ebft.<\/li>\n
    • Truy\u1ec1n m\u00e1u: N\u1ebfu m\u1ea5t m\u00e1u nghi\u00eam tr\u1ecdng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c truy\u1ec1n m\u00e1u \u0111\u1ec3 nhanh ch\u00f3ng t\u0103ng l\u01b0\u1ee3ng m\u00e1u v\u00e0 \u0111\u1ea7y \u0111\u1ee7 c\u00e1c ch\u1ea5t dinh d\u01b0\u1ee1ng c\u1ea7n thi\u1ebft.<\/li>\n
    • Ph\u1eabu thu\u1eadt: N\u1ebfu xu\u1ea5t huy\u1ebft qu\u00e1 nghi\u00eam tr\u1ecdng v\u00e0 kh\u00f4ng th\u1ec3 ki\u1ec3m so\u00e1t b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p tr\u00ean, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i ph\u1eabu thu\u1eadt \u0111\u1ec3 ng\u0103n ch\u1eb7n xu\u1ea5t huy\u1ebft v\u00e0 gi\u1ea3m nguy c\u01a1 t\u1eed vong.<\/li>\n
    • Qu\u1ea3n l\u00fd t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe: B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe t\u1ed5ng th\u1ec3. Vi\u1ec7c ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p, \u0111\u01b0\u1eddng huy\u1ebft, cholesterol, c\u00e2n n\u1eb7ng v\u00e0 kh\u00f4ng h\u00fat thu\u1ed1c c\u00f3 th\u1ec3 gi\u1ea3m nguy c\u01a1 xu\u1ea5t huy\u1ebft trong t\u01b0\u01a1ng lai.<\/li>\n
    • \u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng: B\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u01b0a ra c\u00e1c thu\u1ed1c nh\u01b0 acid tranexamic, thu\u1ed1c ch\u1ed1ng co gi\u1eadt ho\u1eb7c thu\u1ed1c gi\u1ea3m \u0111au \u0111\u1ec3 gi\u1ea3m c\u00e1c tri\u1ec7u ch\u1ee9ng xu\u1ea5t huy\u1ebft.<\/li>\n
    • Nh\u01b0 v\u1eady, \u0111i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong ACS t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a c\u00e1c bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft kh\u00e1c. Tuy nhi\u00ean, b\u00e1c s\u0129 c\u1ea7n c\u00e2n nh\u1eafc k\u1ef9 l\u01b0\u1ee1ng \u0111\u1ec3 t\u1ed1i \u0111a h\u00f3a l\u1ee3i \u00edch \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m thi\u1ec3u nguy c\u01a1 xu\u1ea5t huy\u1ebft.<\/li>\n<\/ul>\n

      5.K\u1ebft lu\u1eadn<\/h2>\n
        \n
      • Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u1ea5t c\u1ee7a ACS.<\/li>\n
      • \u0110\u1ec3 ng\u0103n ng\u1eeba bi\u1ebfn ch\u1ee9ng n\u00e0y, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi v\u00e0 \u0111\u1ea7y \u0111\u1ee7<\/li>\n<\/ul>\n

         <\/p>\n","protected":false},"excerpt":{"rendered":"

        H\u1ed9i ch\u1ee9ng \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p (ACS) l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u tim m\u1ea1ch nghi\u00eam tr\u1ecdng nh\u1ea5t hi\u1ec7n nay. ACS bao g\u1ed3m c\u00e1c tr\u1ea1ng th\u00e1i b\u1ec7nh l\u00fd nh\u01b0 \u0111au th\u1eaft ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh, nh\u1ed3i m\u00e1u c\u01a1 tim. Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u1ea5t c\u1ee7a […]<\/p>\n","protected":false},"author":25,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nBi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p - Vinmec<\/title>\n<meta name=\"description\" content=\"Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u1ea5t, \u0111\u1eb7c bi\u1ec7t x\u1ea3y ra huy\u1ebft kh\u1ed1i c\u1ee5c b\u1ed9 ho\u1eb7c to\u00e0n b\u1ed9 c\u01a1 tim.\" \/>\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=\"Bi\u1ebfn ch\u1ee9ng xu\u1ea5t huy\u1ebft trong h\u1ed9i ch\u1ee9ng v\u00e0nh c\u1ea5p - 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