{"id":22228,"date":"2023-04-16T17:58:10","date_gmt":"2023-04-16T10:58:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=22228"},"modified":"2023-04-17T14:10:51","modified_gmt":"2023-04-17T07:10:51","slug":"mot-so-benh-ho-hap-dong-mac-voi-copd","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/16\/mot-so-benh-ho-hap-dong-mac-voi-copd\/","title":{"rendered":"M\u1ed9t s\u1ed1 b\u1ec7nh h\u00f4 h\u1ea5p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD"},"content":{"rendered":"

B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD<\/a>) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5i m\u00e3n t\u00ednh, nh\u01b0ng nhi\u1ec1u b\u1ec7nh h\u00f4 h\u1ea5p kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 \u0111\u1ed3ng m\u1eafc v\u1edbi COPD. Hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec n\u00f3 gi\u00fap b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 nh\u1eadn ra c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba s\u1edbm h\u01a1n. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 m\u1ed9t s\u1ed1 b\u1ec7nh h\u00f4 h\u1ea5p th\u01b0\u1eddng g\u1eb7p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD.<\/strong><\/p>\n

1. Ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7<\/h2>\n

B\u1ec7nh nh\u00e2n COPD c\u00f3 th\u1ec3 c\u00f3 th\u00eam ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7.<\/p>\n

– Ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7 (Obstructive Sleep Apnea – OSA) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd ph\u1ed5 bi\u1ebfn trong \u0111\u00f3 c\u00f3 s\u1ef1 gi\u00e1n \u0111o\u1ea1n c\u1ee7a qu\u00e1 tr\u00ecnh h\u00f4 h\u1ea5p khi ng\u1ee7 do t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf. \u0110\u00e2y l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n COPD, do \u0111\u01b0\u1eddng th\u1edf c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e3 b\u1ecb h\u1ea1n ch\u1ebf do t\u1ed5n th\u01b0\u01a1ng m\u00f4 ph\u1ed5i v\u00e0 m\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 kh\u00e1c.<\/p>\n

– OSA c\u00f3 th\u1ec3 g\u00e2y ra nh\u1eefng t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c \u0111\u1ebfn s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n COPD, bao g\u1ed3m:<\/p>\n

    \n
  • 1. T\u0103ng nguy c\u01a1 suy tim: S\u1ef1 gi\u00e1n \u0111o\u1ea1n c\u1ee7a qu\u00e1 tr\u00ecnh h\u00f4 h\u1ea5p khi ng\u1ee7 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn gi\u1ea3m l\u01b0\u1ee3ng oxy trong m\u00e1u v\u00e0 t\u0103ng l\u01b0\u1ee3ng carbon dioxide, g\u00e2y ra t\u00ecnh tr\u1ea1ng stress cho tim m\u1ea1ch v\u00e0 \u0111\u01b0a \u0111\u1ebfn t\u00ecnh tr\u1ea1ng suy tim.<\/li>\n
  • 2. T\u0103ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5: OSA c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p v\u00e0 b\u1ec7nh nh\u00e2n COPD c\u00f3 nguy c\u01a1 cao h\u01a1n b\u1ecb \u0111\u1ed9t qu\u1ef5.<\/li>\n
  • 3. Gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng gi\u1ea5c ng\u1ee7: T\u00ecnh tr\u1ea1ng OSA c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng gi\u1ea5c ng\u1ee7, g\u00e2y ra m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n.<\/li>\n
  • 4. T\u0103ng nguy c\u01a1 tai bi\u1ebfn: OSA c\u00f3 li\u00ean quan \u0111\u1ebfn t\u0103ng nguy c\u01a1 tai bi\u1ebfn.<\/li>\n<\/ul>\n

    – \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n OSA, b\u00e1c s\u0129 c\u00f3 th\u1ec3 y\u00eau c\u1ea7u b\u1ec7nh nh\u00e2n th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m nh\u01b0 \u0111o l\u01b0u l\u01b0\u1ee3ng kh\u00ed th\u1edf, gi\u00e1m s\u00e1t gi\u1ea5c ng\u1ee7 qua \u0111\u00eam, ho\u1eb7c \u0111o m\u1ee9c \u0111\u1ed9 oxy trong m\u00e1u.<\/p>\n

    – \u0110\u1ec3 \u0111i\u1ec1u tr\u1ecb OSA \u1edf b\u1ec7nh nh\u00e2n COPD, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u01b0a ra c\u00e1c gi\u1ea3i ph\u00e1p nh\u01b0 s\u1eed d\u1ee5ng m\u00e1y h\u1ed7 tr\u1ee3 th\u1edf khi ng\u1ee7 (Continuous Positive Airway Pressure – CPAP) ho\u1eb7c s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3 h\u00f4 h\u1ea5p kh\u00e1c. \u0110\u1ed3ng th\u1eddi, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb COPD m\u1ed9t c\u00e1ch hi\u1ec7u qu\u1ea3 c\u0169ng l\u00e0 m\u1ed9t ph\u1ea7n quan tr\u1ecdng \u0111\u1ec3 gi\u1ea3m thi\u1ec3u t\u00ecnh tr\u1ea1ng ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7 \u1edf b\u1ec7nh nh\u00e2n COPD.<\/p>\n

    – H\u1eadu qu\u1ea3:<\/p>\n

    – Gi\u1ea3m \u0111\u1ed9 b\u00e3o h\u00f2a oxy khi ng\u1ee7, t\u1ed5ng th\u1eddi gian ng\u1ee7 c\u00f3 gi\u1ea3m oxy m\u00e1u v\u00e0 t\u0103ng CO2\u00a0<\/sub>m\u00e1u nhi\u1ec1u h\u01a1n.<\/p>\n

    – Trong l\u00fac ng\u01b0ng th\u1edf khi ng\u1ee7: oxy m\u00e1u gi\u1ea3m nhi\u1ec1u h\u01a1n, lo\u1ea1n nh\u1ecbp tim nhi\u1ec1u h\u01a1n.<\/p>\n

    – T\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

    – Ti\u00ean l\u01b0\u1ee3ng k\u00e9m h\u01a1n.<\/p>\n

    – C\u1ea7n ngh\u0129 \u0111\u1ebfn ng\u01b0ng th\u1edf t\u1eafc ngh\u1ebdn khi ng\u1ee7 khi:<\/p>\n

    – Ng\u1ee7 ng\u00e1y.<\/p>\n

    – Bu\u1ed3n ng\u1ee7 ng\u00e0y qu\u00e1 m\u1ee9c.<\/p>\n

    – Gi\u1ea3m oxy-m\u00e1u kh\u00f4ng t\u01b0\u01a1ng x\u1ee9ng v\u1edbi m\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn.<\/p>\n

    Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong>: \u0111o \u0111a k\u00fd h\u00f4 h\u1ea5p ho\u1eb7c \u0111a k\u00fd gi\u1ea5c ng\u1ee7.<\/p>\n

    \u0110i\u1ec1u tr\u1ecb<\/strong>: xem x\u00e9t th\u1edf m\u00e1y kh\u00f4ng x\u00e2m nh\u1eadp CPAP ho\u1eb7c BiPAP, d\u1ee5ng c\u1ee5 h\u00e0m m\u1eb7t, \u0111i\u1ec1u tr\u1ecb oxy n\u1ebfu c\u1ea7n \u0111\u1ec3 b\u1ea3o \u0111\u1ea3m b\u00e3o h\u00f2a oxy tr\u00ean 90%.<\/p>\n

    2. Ung th\u01b0 ph\u1ed5i<\/h2>\n
    \"Ung
    Ung th\u01b0 ph\u1ed5i l\u00e0 b\u1ec7nh h\u00f4 h\u1ea5p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD<\/figcaption><\/figure>\n

    Nguy c\u01a1: COPD hay ph\u1ed1i h\u1ee3p c\u00f9ng ung th\u01b0 ph\u1ed5i, nh\u1ea5t l\u00e0 \u1edf b\u1ec7nh nh\u00e2n tu\u1ed5i cao, ti\u1ec1n s\u1eed h\u00fat thu\u1ed1c l\u00e1 n\u1eb7ng, c\u00f3 kh\u00ed ph\u1ebf th\u0169ng.<\/p>\n

    C\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n s\u1edbm b\u1eb1ng ch\u1ee5p CLVT ng\u1ef1c li\u1ec1u th\u1ea5p (low dose chest computed tomography, LDCT) c\u00f3 hi\u1ec7u qu\u1ea3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed h\u00fat thu\u1ed1c l\u00e1 \u2265 30 bao n\u0103m, v\u1eabn \u0111ang h\u00fat ho\u1eb7c b\u1ecf ch\u01b0a qu\u00e1 15 n\u0103m. Tuy nhi\u00ean ph\u01b0\u01a1ng ph\u00e1p n\u00e0y ch\u01b0a ph\u1ed5 bi\u1ebfn v\u00ec t\u1ed1n k\u00e9m v\u00e0 c\u00f3 nhi\u1ec1u b\u1ea5t c\u1eadp nh\u01b0 can thi\u1ec7p qu\u00e1 m\u1ee9c, theo d\u00f5i kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7.<\/p>\n

    3. Gi\u00e3n ph\u1ebf qu\u1ea3n<\/h2>\n

    Do 2 b\u1ec7nh c\u00f3 c\u00f9ng tri\u1ec7u ch\u1ee9ng h\u00f4 h\u1ea5p kh\u00f4ng \u0111\u1eb7c hi\u1ec7u v\u00e0 b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng ph\u1ed5i t\u01b0\u01a1ng t\u1ef1, v\u00e0 m\u1eb7t kh\u00e1c CNTK \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn h\u01a1n CLVT n\u00ean ch\u1ea9n \u0111o\u00e1n gi\u00e3n ph\u1ebf qu\u1ea3n d\u1ec5 b\u1ecb b\u1ecf s\u00f3t \u1edf b\u1ec7nh nh\u00e2n h\u00fat thu\u1ed1c l\u00e1, c\u00f3 ho kh\u1ea1c \u0111\u1eddm v\u00e0 h\u1ea1n ch\u1ebf l\u01b0\u1ee3ng kh\u00ed th\u1edf ra.<\/p>\n

    L\u00e2m s\u00e0ng<\/strong>: 2 \u0111\u1eb7c \u0111i\u1ec3m n\u1ed5i b\u1eadt l\u00e0 l\u01b0\u1ee3ng \u0111\u1eddm h\u00e0ng ng\u00e0y nhi\u1ec1u v\u00e0 th\u01b0\u1eddng c\u00f3 nhi\u1ec1u \u0111\u1ee3t k\u1ecbch ph\u00e1t. T\u1ea7n su\u1ea5t c\u00f3\u00a0Pseudomonas aeruginosa\u00a0\u0111\u1ecbnh c\u01b0 trong ph\u1ebf qu\u1ea3n cao, v\u00e0 nguy c\u01a1 t\u1eed vong do m\u1ecdi nguy\u00ean nh\u00e2n cao h\u01a1n. Kh\u00e1m ph\u1ed5i c\u00f3 th\u1ec3 nghe ran \u1ee9 \u0111\u1ecdng. Xquang ng\u1ef1c c\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh t\u1ed5 ong ho\u1eb7c h\u1ed9i ch\u1ee9ng ph\u1ebf qu\u1ea3n.<\/p>\n

    Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh: ch\u1ee5p CLVT ng\u1ef1c l\u1edbp m\u1ecfng 1 mm \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao.<\/p>\n

    \u0110i\u1ec1u tr\u1ecb<\/strong>: \u0111i\u1ec1u tr\u1ecb c\u1ea3 COPD v\u00e0 gi\u00e3n ph\u1ebf qu\u1ea3n trong \u0111\u00f3 ch\u00fa tr\u1ecdng ki\u1ec3m so\u00e1t nhi\u1ec5m tr\u00f9ng c\u1ea5p v\u00e0 m\u1ea1n. L\u01b0u \u00fd trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 gi\u00e3n ph\u1ebf qu\u1ea3n k\u00e8m theo th\u00ec ICS c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb COPD, \u0111\u1eb7c bi\u1ec7t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 vi khu\u1ea9n \u0111\u1ecbnh c\u01b0 trong c\u00e2y ph\u1ebf qu\u1ea3n v\u00e0 nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p d\u01b0\u1edbi t\u00e1i di\u1ec5n, tr\u1eeb khi b\u1ec7nh nh\u00e2n c\u00f3 eosinophil m\u00e1u cao v\u00e0\/ho\u1eb7c d\u1ea5u hi\u1ec7u c\u1ee7a t\u0103ng ph\u1ea3n \u1ee9ng ph\u1ebf qu\u1ea3n. \u0110i\u1ec1u tr\u1ecb thay th\u1ebf trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 macrolides ho\u1eb7c roflumilast l\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00f3 hi\u1ec7u qu\u1ea3 kh\u00e1ng vi\u00eam t\u0103ng b\u1ea1ch c\u1ea7u \u0111a nh\u00e2n trung t\u00ednh v\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 ho kh\u1ea1c m\u1ea1n t\u00ednh.<\/p>\n

    4. Lao ph\u1ed5i<\/h2>\n

    Vi\u1ec7t Nam l\u00e0 n\u01b0\u1edbc c\u00f3 \u0111\u1ed9 l\u01b0u h\u00e0nh b\u1ec7nh lao cao. Lao l\u00e0 b\u1ec7nh th\u01b0\u1eddng g\u1eb7p, c\u00f3 th\u1ec3 c\u00f3 tr\u01b0\u1edbc, ho\u1eb7c sau khi c\u00f3 ch\u1ea9n \u0111o\u00e1n COPD. L\u01b0u \u00fd lao ph\u1ed5i m\u1edbi ho\u1eb7c t\u00e1i ph\u00e1t c\u00f3 th\u1ec3 b\u1ecf s\u00f3t trong qu\u00e1 tr\u00ecnh ch\u0103m s\u00f3c \u0111i\u1ec1u tr\u1ecb COPD.<\/p>\n

    COPD c\u00f3 nguy c\u01a1 cao b\u1ecb lao ph\u1ed5i, v\u00e0 l\u00e0 b\u1ec7nh \u0111\u1ed3ng m\u1eafc \u0111\u1ee9ng h\u00e0ng th\u1ee9 hai sau ti\u1ec3u \u0111\u01b0\u1eddng \u1edf b\u1ec7nh nh\u00e2n lao. Ti\u1ec1n s\u1eed lao c\u00f3 t\u00e1c \u0111\u1ed9ng ti\u00eau c\u1ef1c tr\u00ean di\u1ec5n ti\u1ebfn d\u00e0i h\u1ea1n c\u1ee7a COPD v\u1edbi t\u1eed vong s\u1edbm h\u01a1n v\u00e0 t\u0103ng t\u1ea7n su\u1ea5t c\u00e1c \u0111\u1ee3t k\u1ecbch ph\u00e1t.<\/p>\n

    COPD c\u0169ng thay \u0111\u1ed5i b\u1ec7nh c\u1ea3nh c\u1ee7a lao v\u00e0 l\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1 t\u0103ng b\u1ec7nh t\u1eadt v\u00e0 t\u1eed vong do lao. Khi c\u00f3 lao \u0111\u1ed3ng m\u1eafc COPD, c\u1ea7n \u0111i\u1ec1u tr\u1ecb song h\u00e0nh 2 b\u1ec7nh. Kh\u00f4ng c\u00f3 \u0111i\u1ec1u tr\u1ecb kh\u00e1c bi\u1ec7t cho b\u1ec7nh lao \u0111\u1ed3ng m\u1eafc v\u00e0 ng\u01b0\u1ee3c l\u1ea1i.<\/p>\n

    T\u00f3m l\u1ea1i, b\u1ec7nh nh\u00e2n COPD c\u00f3 th\u1ec3 \u0111\u1ed3ng m\u1eafc v\u1edbi nhi\u1ec1u b\u1ec7nh l\u00fd h\u00f4 h\u1ea5p kh\u00e1c, v\u00ec v\u1eady, vi\u1ec7c \u0111\u01b0a ra ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u00fang b\u1ec7nh l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

    Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

    B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5i m\u00e3n t\u00ednh, nh\u01b0ng nhi\u1ec1u b\u1ec7nh h\u00f4 h\u1ea5p kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 \u0111\u1ed3ng m\u1eafc v\u1edbi COPD. Hi\u1ec3u bi\u1ebft v\u1ec1 c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD l\u00e0 r\u1ea5t quan tr\u1ecdng v\u00ec n\u00f3 gi\u00fap b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 nh\u1eadn ra c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"\nM\u1ed9t s\u1ed1 b\u1ec7nh h\u00f4 h\u1ea5p \u0111\u1ed3ng m\u1eafc v\u1edbi COPD - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh (COPD) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ph\u1ed5i m\u00e3n t\u00ednh, nh\u01b0ng nhi\u1ec1u b\u1ec7nh h\u00f4 h\u1ea5p kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 \u0111\u1ed3ng m\u1eafc v\u1edbi COPD. 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