{"id":21683,"date":"2023-04-15T21:22:25","date_gmt":"2023-04-15T14:22:25","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=21683"},"modified":"2023-04-18T15:26:29","modified_gmt":"2023-04-18T08:26:29","slug":"manitol-va-nhung-dieu-can-biet","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/15\/manitol-va-nhung-dieu-can-biet\/","title":{"rendered":"Manitol v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft"},"content":{"rendered":"

Manitol d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng th\u00ec \u0111\u01b0\u1ee3c h\u1ea5p thu r\u1ea5t k\u00e9m \u1edf \u1ed1ng ti\u00eau ho\u00e1, khi \u0111\u00f3 thu\u1ed1c s\u1ebd g\u00e2y ti\u00eau ch\u1ea3y ch\u1ee9 kh\u00f4ng g\u00e2y l\u1ee3i ti\u1ec3u. Manitol \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch. Thu\u1ed1c kh\u00f4ng \u0111\u01b0\u1ee3c chuy\u1ec3n ho\u00e1 v\u00e0 th\u1ea3i tr\u1eeb qua th\u1eadn trong 30-60 ph\u00fat v\u00e0 h\u1ea7u nh\u01b0 kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu c\u0169ng nh\u01b0 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i th\u00eam t\u1ea1i \u1ed1ng th\u1eadn.<\/strong><\/p>\n

1.C\u01a1 ch\u1ebf t\u00e1c d\u1ee5ng<\/strong><\/h2>\n

\u1ed0ng l\u01b0\u1ee3n g\u1ea7n v\u00e0 \u0111o\u1ea1n l\u00ean c\u1ee7a quai Henle c\u00f3 th\u1ec3 cho n\u01b0\u1edbc th\u1ea5m t\u1ef1 do. Do \u0111\u00f3, nh\u1eefng ch\u1ea5t c\u00f3 t\u00ednh th\u1ea9m th\u1ea5u \u0111\u01b0\u1ee3c l\u1ecdc \u1edf c\u1ea7u th\u1eadn nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu c\u00f3 th\u1ec3 k\u00e9o n\u01b0\u1edbc v\u00e0o trong \u1ed1ng th\u1eadn v\u00e0 g\u00e2y ra l\u1ee3i ti\u1ec3u. Nh\u1eefng ch\u1ea5t n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ecd \u0111\u1ed3ng th\u1eddi th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh \u0111\u00e0o th\u1ea3i t\u00ecnh tr\u1ea1ng nhi\u1ec5m \u0111\u1ed9c \u1edf th\u1eadn. M\u1ed9t thu\u1ed1c l\u1ee3i ti\u1ec3u th\u1ea9m th\u1ea5u \u0111i\u1ec3n h\u00ecnh hay \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong l\u00e2m s\u00e0ng l\u00e0 manitol. \u0110\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 g\u00e2y l\u1ee3i ti\u1ec3u, tuy nhi\u00ean \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u01b0\u1eddng huy\u1ebft qu\u00e1 cao c\u00f3 th\u1ec3 g\u00e2y ra t\u00ecnh tr\u1ea1ng l\u1ee3i ti\u1ec3u th\u1ea9m th\u1ea5u do xu\u1ea5t hi\u1ec7n \u0111\u01b0\u1eddng trong n\u01b0\u1edbc ti\u1ec3u.<\/p>\n

2.D\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc v\u00e0 d\u01b0\u1ee3c l\u1ef1c h\u1ecdc<\/strong><\/h2>\n

Manitol d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng th\u00ec \u0111\u01b0\u1ee3c h\u1ea5p thu r\u1ea5t k\u00e9m \u1edf \u1ed1ng ti\u00eau ho\u00e1, khi \u0111\u00f3 thu\u1ed1c s\u1ebd g\u00e2y ti\u00eau ch\u1ea3y ch\u1ee9 kh\u00f4ng g\u00e2y l\u1ee3i ti\u1ec3u. Manitol \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch. Thu\u1ed1c kh\u00f4ng \u0111\u01b0\u1ee3c chuy\u1ec3n ho\u00e1 v\u00e0 th\u1ea3i tr\u1eeb qua th\u1eadn trong 30-60 ph\u00fat v\u00e0 h\u1ea7u nh\u01b0 kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu c\u0169ng nh\u01b0 kh\u00f4ng \u0111\u01b0\u1ee3c \u0111\u00e0o th\u1ea3i th\u00eam t\u1ea1i \u1ed1ng th\u1eadn. Thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng \u1edf c\u00e1c b\u1ec7nh nh\u00e2n suy th\u1eadn, ngay t\u1eeb m\u1ee9c \u0111\u1ed9 nh\u1eb9.<\/p>\n

Manitol t\u00e1c d\u1ee5ng ch\u1ee7 y\u1ebfu l\u00ean \u1ed1ng l\u01b0\u1ee3ng g\u1ea7n v\u00e0 \u0111o\u1ea1n l\u00ean c\u1ee7a quai Henle, g\u00e2y t\u0103ng \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u k\u00e9o n\u01b0\u1edbc ng\u01b0\u1ee3c l\u1ea1i b\u1ecb k\u00e9o v\u00e0o l\u00f2ng \u1ed1ng th\u1eadn v\u00e0 d\u1eabn \u0111\u1ebfn t\u0103ng th\u1ec3 t\u00edch n\u01b0\u1edbc ti\u1ec3u. S\u1ef1 gia t\u0103ng d\u00f2ng ch\u1ea3y n\u01b0\u1edbc ti\u1ec3u l\u00e0m gi\u1ea3m t\u00e1i h\u1ea5p thu Na+ v\u00e0 c\u1ea3 n\u01b0\u1edbc. Tuy nhi\u00ean, s\u1ef1 m\u1ea5t natri th\u01b0\u1eddng \u00edt h\u01a1n so v\u1edbi m\u1ea5t n\u01b0\u1edbc n\u00ean \u0111\u00f4i khi c\u00f3 th\u1ec3 g\u00e2y t\u0103ng natri m\u00e1u.<\/p>\n

3.Ch\u1ec9 \u0111\u1ecbnh v\u00e0 li\u1ec1u d\u00f9ng<\/strong><\/h2>\n
    \n
  • Gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ecd v\u00e0 gi\u1ea3m nh\u00e3n \u00e1p<\/li>\n
  • Thu\u1ed1c l\u1ee3i ti\u1ec3u th\u1ea9m th\u1ea5u l\u00e0m n\u01b0\u1edbc \u0111i ra kh\u1ecfi t\u1ebf b\u00e0o v\u00e0 gi\u1ea3m th\u1ec3 t\u00edch n\u01b0\u1edbc trong t\u1ebf b\u00e0o. Do v\u1eady, thu\u1ed1c c\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0m gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ecd trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o ho\u1eb7c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m nh\u00e3n \u00e1p tr\u01b0\u1edbc c\u00e1c th\u1ee7 thu\u1eadt v\u1ec1 m\u1eaft.<\/li>\n
  • Li\u1ec1u d\u00f9ng 1-2 g\/kg manitol ti\u00eam t\u0129nh m\u1ea1ch. \u00c1p l\u1ef1c n\u1ed9i s\u1ecd th\u01b0\u1eddng gi\u1ea3m sau 60-90 ph\u00fat v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd.<\/li>\n
  • Thu\u1ed1c c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong l\u1ecdc m\u00e1u. T\u1ea1i th\u1eddi \u0111i\u1ec3m \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u m\u00e1u gi\u1ea3m nhanh khi m\u1edbi l\u1ecdc m\u00e1u c\u00f3 th\u1ec3 g\u00e2y ra tri\u1ec7u ch\u1ee9ng, c\u00e1c b\u00e1c s\u0129 th\u1eadn ti\u1ebft ni\u1ec7u th\u01b0\u1eddng s\u1eed d\u1ee5ng manitol \u0111\u1ec3 ph\u00f2ng c\u00e1c tri\u1ec7u ch\u1ee9ng n\u00e0y khi m\u1edbi l\u1ecdc m\u00e1u cho b\u1ec7nh nh\u00e2n. Tuy nhi\u00ean c\u00e1c b\u1eb1ng ch\u1ee9ng nghi\u00ean c\u1ee9u trong v\u1ea5n \u0111\u1ec1 n\u00e0y v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf.<\/li>\n<\/ul>\n

    4.Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u00e0 th\u1eadn tr\u1ecdng<\/strong><\/h2>\n

    4.1 Suy tim<\/strong><\/h3>\n

    Manitol ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p suy tim do l\u00e0m t\u0103ng th\u1ec3 t\u00edch m\u00e1u m\u1ed9t c\u00e1ch \u0111\u1ed9t ng\u1ed9t c\u00f3 th\u1ec3 g\u00e2y suy tim c\u1ea5p, ph\u00f9 ph\u1ed5i c\u1ea5p.<\/p>\n

    C\u01a1 ch\u1ebf ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a Manitol trong suy tim c\u1ea5p li\u00ean quan \u0111\u1ebfn t\u00e1c \u0111\u1ed9ng c\u1ee7a n\u00f3 \u0111\u1ebfn h\u1ec7 th\u1ed1ng th\u1eadn v\u00e0 tim m\u1ea1ch. Khi Manitol \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, n\u00f3 s\u1ebd l\u00e0m t\u0103ng l\u01b0\u1ee3ng n\u01b0\u1edbc trong ni\u1ec7u \u0111\u1ea1o v\u00e0 \u0111\u01b0\u1eddng ti\u1ec3u, d\u1eabn \u0111\u1ebfn gi\u1ea3m \u00e1p l\u1ef1c trong h\u1ec7 th\u1ed1ng m\u1ea1ch m\u00e1u v\u00e0 suy gi\u1ea3m \u00e1p l\u1ef1c trong tim. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra t\u0103ng \u00e1p l\u1ef1c trong tim v\u00e0 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng suy tim n\u1eb7ng.<\/p>\n

    Do \u0111\u00f3, vi\u1ec7c s\u1eed d\u1ee5ng Manitol trong suy tim c\u1ea5p c\u1ea7n \u0111\u01b0\u1ee3c h\u1ea1n ch\u1ebf. B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i th\u01b0\u1eddng xuy\u00ean \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c v\u00e0 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng n\u1ebfu c\u1ea7n thi\u1ebft.<\/p>\n

    4.2 \u1ee8 d\u1ecbch ngo\u00e0i kho\u1ea3ng k\u1ebd<\/strong><\/h3>\n

    Manitol r\u1ea5t nhanh ch\u00f3ng k\u00e9o d\u1ecbch t\u1eeb trong t\u1ebf b\u00e0o ra ngo\u00e0i kho\u1ea3ng k\u1ebd , do \u0111\u00f3, tr\u01b0\u1edbc khi c\u00f3 t\u00e1c d\u1ee5ng l\u1ee3i ti\u1ec3u th\u00ec thu\u1ed1c g\u00e2y ra t\u00ecnh tr\u1ea1ng \u1ee9 d\u1ecbch ngo\u00e0i t\u1ebf b\u00e0o v\u00e0 t\u0103ng natri m\u00e1u. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng suy tim v\u00e0 ph\u00f9 ph\u1ed5i c\u1ea5p. Ngo\u00e0i ra, c\u00e1c t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n kh\u00e1c nh\u01b0 \u0111au \u0111\u1ea7u, bu\u1ed3n n\u00f4n, n\u00f4n th\u01b0\u1eddng hay g\u1eb7p h\u01a1n khi s\u1eed d\u1ee5ng nh\u00f3m thu\u1ed1c n\u00e0y.<\/p>\n

    4.3 M\u1ea5t n\u01b0\u1edbc, t\u0103ng kali m\u00e1u<\/strong><\/h3>\n

    S\u1eed d\u1ee5ng qu\u00e1 li\u1ec1u manitol c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng m\u1ea5t n\u01b0\u1edbc nghi\u00eam tr\u1ecdng, t\u0103ng natri trong t\u1ebf b\u00e0o. Khi n\u01b0\u1edbc b\u1ecb k\u00e9o ra ngo\u00e0i t\u1ebf b\u00e0o, n\u1ed3ng \u0111\u1ed9 K+ trong t\u1ebf b\u00e0o t\u0103ng cao, d\u1eabn \u0111\u1ebfn ph\u00e1 hu\u1ef7 t\u1ebf b\u00e0o v\u00e0 t\u0103ng kali m\u00e1u. C\u00e1c bi\u1ebfn ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 ph\u00f2ng tr\u00e1nh \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1ch theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3 v\u00e0 c\u00e2n b\u1eb1ng d\u1ecbch v\u00e0o ra.<\/p>\n

    4.4 H\u1ea1 natri m\u00e1u<\/strong><\/h3>\n

    C\u01a1 ch\u1ebf ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh c\u1ee7a Manitol trong h\u1ea1 natri m\u00e1u li\u00ean quan \u0111\u1ebfn t\u00e1c \u0111\u1ed9ng c\u1ee7a n\u00f3 \u0111\u1ebfn h\u1ec7 th\u1ed1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i trong c\u01a1 th\u1ec3. Khi Manitol \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, n\u00f3 s\u1ebd l\u00e0m t\u0103ng l\u01b0\u1ee3ng n\u01b0\u1edbc trong ni\u1ec7u \u0111\u1ea1o v\u00e0 \u0111\u01b0\u1eddng ti\u1ec3u. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 g\u00e2y ra m\u1ea5t natri t\u1eeb c\u01a1 th\u1ec3, d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng h\u1ea1 natri m\u00e1u.<\/p>\n

    \u1ede c\u00e1c b\u1ec7nh nh\u00e2n suy th\u1eadn n\u1eb7ng, n\u1ebfu s\u1eed d\u1ee5ng manitol th\u00ec thu\u1ed1c s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ea3i tr\u1eeb qua th\u1eadn v\u00e0 s\u1ebd t\u1ed3n t\u1ea1i trong m\u00e1u. Do \u0111\u00f3, s\u1ebd g\u00e2y ra t\u00ecnh tr\u1ea1ng k\u00e9o n\u01b0\u1edbc ra kh\u1ecfi t\u1ebf b\u00e0o v\u00e0o trong l\u00f2ng m\u1ea1ch m\u00e1u d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng h\u1ea1 natri m\u00e1u nh\u01b0ng l\u1ea1i kh\u00f4ng gi\u1ea3m \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u m\u00e1u.<\/p>\n

    4.5 Suy th\u1eadn c\u1ea5p<\/strong><\/h3>\n

    Ngo\u00e0i ra, Manitol c\u0169ng c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 th\u1eadn, bao g\u1ed3m suy th\u1eadn v\u00e0 t\u0103ng creatinine trong m\u00e1u. Khi th\u1eadn kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng hi\u1ec7u qu\u1ea3, n\u00f3 s\u1ebd kh\u00f4ng th\u1ec3 lo\u1ea1i b\u1ecf \u0111\u1ee7 l\u01b0\u1ee3ng Manitol kh\u1ecfi c\u01a1 th\u1ec3, d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c.<\/p>\n

    C\u00f3 kho\u1ea3ng 6-7% c\u00e1c tr\u01b0\u1eddng h\u1ee3p s\u1eed d\u1ee5ng manitol b\u1ecb suy th\u1eadn c\u1ea5p \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o. Nguy\u00ean nh\u00e2n \u0111\u01b0\u1ee3c cho l\u00e0 do s\u1ef1 gia t\u0103ng qu\u00e1 cao \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u m\u00e1u d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng th\u1eadn.<\/p>\n","protected":false},"excerpt":{"rendered":"

    Manitol d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng th\u00ec \u0111\u01b0\u1ee3c h\u1ea5p thu r\u1ea5t k\u00e9m \u1edf \u1ed1ng ti\u00eau ho\u00e1, khi \u0111\u00f3 thu\u1ed1c s\u1ebd g\u00e2y ti\u00eau ch\u1ea3y ch\u1ee9 kh\u00f4ng g\u00e2y l\u1ee3i ti\u1ec3u. Manitol \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam t\u0129nh m\u1ea1ch. Thu\u1ed1c kh\u00f4ng \u0111\u01b0\u1ee3c chuy\u1ec3n ho\u00e1 v\u00e0 th\u1ea3i tr\u1eeb qua th\u1eadn trong 30-60 ph\u00fat v\u00e0 h\u1ea7u nh\u01b0 kh\u00f4ng \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu c\u0169ng […]<\/p>\n","protected":false},"author":7,"featured_media":21688,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[12,33],"tags":[3],"yoast_head":"\nManitol v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec<\/title>\n<meta name=\"description\" content=\"Manitol l\u00e0 thu\u1ed1c th\u01b0\u1eddng th\u1ea5y trong th\u1ef1c h\u00e0nh. 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