{"id":2317,"date":"2023-04-10T18:58:57","date_gmt":"2023-04-10T11:58:57","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2317"},"modified":"2023-04-17T16:39:58","modified_gmt":"2023-04-17T09:39:58","slug":"gay-me-chan-thuong-chinh-hinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/gay-me-chan-thuong-chinh-hinh\/","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p g\u00e2y m\u00ea trong ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh"},"content":{"rendered":"<p><strong>C\u00e1c ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 c\u00f3 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng t\u1eeb v\u1ebft th\u01b0\u01a1ng b\u1ecb c\u00f4 l\u1eadp \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p li\u00ean quan \u0111\u1ebfn nhi\u1ec1u h\u1ec7 th\u1ed1ng c\u01a1 quan. B\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh c\u00f3 th\u1ec3 c\u1ea7n g\u00e2y m\u00ea \u0111\u1ec3 s\u1eeda ch\u1eefa kh\u1ea9n c\u1ea5p ho\u1eb7c ph\u1eabu thu\u1eadt ki\u1ec3m so\u00e1t t\u1ed5n th\u01b0\u01a1ng, ho\u1eb7c cho c\u00e1c th\u1ee7 t\u1ee5c b\u00e1n t\u1ef1 ch\u1ecdn sau khi \u0111\u00e1nh gi\u00e1 v\u00e0 \u1ed5n \u0111\u1ecbnh.<\/strong><\/p>\n<h2>1. \u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc ph\u1eabu thu\u1eadt<\/h2>\n<p>C\u1ea7n xem x\u00e9t to\u00e0n b\u1ed9 m\u1ee9c \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng c\u1ee7a b\u1ec7nh nh\u00e2n, qu\u00e1 tr\u00ecnh k\u1ec3 t\u1eeb khi b\u1ecb th\u01b0\u01a1ng, ti\u1ec1n s\u1eed b\u1ec7nh, d\u1ecb \u1ee9ng, thu\u1ed1c men v\u00e0 l\u1ea7n u\u1ed1ng cu\u1ed1i c\u00f9ng. C\u1ea7n th\u1ef1c hi\u1ec7n \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1eddng th\u1edf v\u00e0 kh\u00e1m l\u00e2m s\u00e0ng theo \u0111\u1ecbnh h\u01b0\u1edbng. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 kh\u00f4ng th\u1ec3 cung c\u1ea5p ti\u1ec1n s\u1eed b\u1ec7nh ch\u00ednh x\u00e1c do ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ea7u, r\u01b0\u1ee3u ho\u1eb7c s\u1eed d\u1ee5ng ma t\u00fay, sa s\u00fat tr\u00ed tu\u1ec7 ho\u1eb7c \u0111au d\u1eef d\u1ed9i.<\/p>\n<p>C\u1ea7n xem x\u00e9t k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m trong ph\u00f2ng th\u00ed nghi\u1ec7m, bao g\u1ed3m ch\u1ea5t \u0111i\u1ec7n gi\u1ea3i, glucose, hemoglobin, s\u1ed1 l\u01b0\u1ee3ng ti\u1ec3u c\u1ea7u, th\u00f4ng s\u1ed1 \u0111\u00f4ng m\u00e1u v\u00e0 lactate. Hemoglobin c\u00f3 th\u1ec3 b\u00ecnh th\u01b0\u1eddng \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n gi\u1ea3m th\u1ec3 t\u00edch, v\u00e0 c\u00f3 th\u1ec3 gi\u1ea3m khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c.<\/p>\n<p>C\u00e1c nghi\u00ean c\u1ee9u ch\u1ea9n \u0111o\u00e1n kh\u00e1c, \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi c\u00e1c ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c c\u1ee7a b\u1ec7nh nh\u00e2n, c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c xem x\u00e9t. \u0110\u00e1nh gi\u00e1 tim tr\u01b0\u1edbc ph\u1eabu thu\u1eadt c\u1ea7n \u0111\u01b0\u1ee3c h\u01b0\u1edbng d\u1eabn d\u1ef1a tr\u00ean t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 tim. X\u00e9t nghi\u1ec7m tim tr\u01b0\u1edbc ph\u1eabu thu\u1eadt ngo\u00e0i \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 (ECG) ch\u1ec9 n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n n\u1ebfu n\u00f3 s\u1ebd thay \u0111\u1ed5i g\u00e2y m\u00ea ho\u1eb7c qu\u1ea3n l\u00fd y t\u1ebf.<\/p>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u v\u00e0 tri\u1ec7u ch\u1ee9ng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng li\u00ean quan nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 b\u1ecb tr\u00ec ho\u00e3n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb \u0111a ch\u1ea5n th\u01b0\u01a1ng k\u00e9o d\u00e0i. C\u00e1c nh\u00f3m g\u00e2y m\u00ea v\u00e0 ph\u1eabu thu\u1eadt n\u00ean duy tr\u00ec ch\u1ec9 s\u1ed1 nghi ng\u1edd cao \u0111\u1ed1i v\u1edbi tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i, ch\u1ea3y m\u00e1u trong, ch\u1ea5n th\u01b0\u01a1ng n\u00e3o v\u00e0 nhi\u1ec5m tr\u00f9ng ph\u1ed5i ho\u1eb7c tim trong su\u1ed1t th\u1eddi gian ph\u1eabu thu\u1eadt.<\/p>\n<h2>2. Th\u1eddi gian ph\u1eabu thu\u1eadt<\/h2>\n<p id=\"H1523129593\" class=\"headingAnchor\">B\u1ec7nh nh\u00e2n b\u1ecb <a href=\"https:\/\/vinmec.com\/vi\/co-xuong-khop\/\">ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh<\/a> n\u00ean \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd theo c\u00e1c quy tr\u00ecnh ti\u1ebfp c\u1eadn b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng, bao g\u1ed3m \u0111\u00e1nh gi\u00e1 ban \u0111\u1ea7u, \u1ed5n \u0111\u1ecbnh, h\u1ed3i s\u1ee9c v\u00e0 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 ch\u1ea5n th\u01b0\u01a1ng v\u00e0 c\u1ea7n \u0111i\u1ec1u tr\u1ecb th\u00eam.<\/p>\n<ul>\n<li class=\"bulletIndent1\"><strong>\u0110a ch\u1ea5n th\u01b0\u01a1ng:<\/strong> B\u1ec7nh nh\u00e2n kh\u00f4ng \u1ed5n \u0111\u1ecbnh v\u1edbi ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nhi\u1ec1u c\u01a1 quan c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb theo c\u00e1c ph\u00e1c \u0111\u1ed3 ki\u1ec3m so\u00e1t t\u1ed5n th\u01b0\u01a1ng. Nhanh ch\u00f3ng c\u1ed1 \u0111\u1ecbnh ngo\u00e0i v\u1edbi ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li class=\"bulletIndent1\"><strong>C\u1ea5p c\u1ee9u ch\u1ec9nh h\u00ecnh: <\/strong>G\u00e3y x\u01b0\u01a1ng d\u1eabn \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u th\u1ea7n kinh l\u00e0 tr\u01b0\u1eddng h\u1ee3p kh\u1ea9n c\u1ea5p th\u1ef1c s\u1ef1. T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 \u0111e d\u1ecda chi v\u00e0, trong c\u00e1c m\u1ea1ch g\u1ea7n, \u0111e d\u1ecda t\u00ednh m\u1ea1ng. Ph\u1eabu thu\u1eadt gi\u1ea3i ch\u00e8n \u00e9p khoang l\u00e0 c\u1ea5p c\u1ee9u. C\u1eaft l\u1ecdc g\u00e3y x\u01b0\u01a1ng h\u1edf n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt c\u1ea5p c\u1ee9u.<\/li>\n<li class=\"bulletIndent1\"><strong>Ch\u1ea5n th\u01b0\u01a1ng kh\u00f4ng kh\u1ea9n c\u1ea5p: <\/strong>\u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 th\u1ec3 tr\u00ec ho\u00e3n ph\u1eabu thu\u1eadt ban \u0111\u1ea7u ho\u1eb7c d\u1ee9t kho\u00e1t, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh sinh l\u00fd v\u00e0 \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc khi \u0111\u1ebfn ph\u00f2ng m\u1ed5.<\/li>\n<\/ul>\n<p>Ph\u1eabu thu\u1eadt kh\u00f4ng n\u00ean tr\u00ec ho\u00e3n ch\u1edd d\u1ea1 d\u00e0y tr\u1ed1ng. Thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 opioid l\u00e0m ch\u1eadm ho\u1eb7c ng\u1eebng l\u00e0m tr\u1ed1ng d\u1ea1 d\u00e0y; Kho\u1ea3ng th\u1eddi gian nh\u1ecbn \u0103n n\u00ean l\u00e0 kho\u1ea3ng th\u1eddi gian gi\u1eefa l\u1ea7n u\u1ed1ng cu\u1ed1i c\u00f9ng v\u00e0 ch\u1ea5n th\u01b0\u01a1ng. Do \u0111\u00f3, h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh \u0111\u1ec1u c\u00f3 nguy c\u01a1 h\u00edt s\u1eb7c trong khi g\u00e2y m\u00ea v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n.<\/p>\n<h3 id=\"H3267713854\" class=\"headingAnchor\">Kh\u00e1m ti\u1ec1n ph\u1eabu<\/h3>\n<p class=\"headingAnchor\">Ph\u1ea3i to\u00e0n di\u1ec7n v\u00e0 bao g\u1ed3m nh\u1eefng \u0111i\u1ec1u sau \u0111\u00e2y:<\/p>\n<ul>\n<li class=\"bulletIndent1\">Th\u1ee7 t\u1ee5c ho\u1eb7c th\u1ee7 t\u1ee5c theo k\u1ebf ho\u1ea1ch v\u00e0 tr\u00ecnh t\u1ef1 c\u00e1c th\u1ee7 t\u1ee5c<\/li>\n<li class=\"bulletIndent1\">T\u00ednh kh\u1ea9n c\u1ea5p c\u1ee7a ph\u1eabu thu\u1eadt<\/li>\n<li class=\"bulletIndent1\">V\u1ecb tr\u00ed\u00a0 ph\u1eabu thu\u1eadt<\/li>\n<li class=\"bulletIndent1\">M\u1ea5t m\u00e1u d\u1ef1 ki\u1ebfn<\/li>\n<li class=\"bulletIndent1\">Th\u1eddi gian ph\u1eabu thu\u1eadt d\u1ef1 ki\u1ebfn<\/li>\n<li class=\"bulletIndent1\">S\u1eed d\u1ee5ng garo trong ph\u1eabu thu\u1eadt<\/li>\n<\/ul>\n<h2>3. L\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt g\u00e2y m\u00ea<\/h2>\n<p id=\"H432171082\" class=\"headingAnchor\">Vi\u1ec7c l\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt g\u00e2y m\u00ea (t\u1ee9c l\u00e0 g\u00e2y m\u00ea to\u00e0n th\u00e2n, g\u00e2y m\u00ea th\u1ea7n kinh ho\u1eb7c kh\u1ed1i th\u1ea7n kinh ngo\u1ea1i bi\u00ean) ph\u1ee5 thu\u1ed9c v\u00e0o c\u00e1c th\u1ee7 t\u1ee5c theo k\u1ebf ho\u1ea1ch v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh nh\u00e2n, bao g\u1ed3m c\u1ea3 b\u1ec7nh \u0111i k\u00e8m.<\/p>\n<p>G\u00e2y t\u00ea v\u00f9ng c\u00f3 th\u1ec3 c\u00f3 l\u1ee3i, ngay c\u1ea3 khi n\u00f3 kh\u00f4ng ph\u1ea3i l\u00e0 thu\u1ed1c g\u00e2y m\u00ea ph\u1eabu thu\u1eadt l\u1edbn, nh\u01b0 m\u1ed9t ph\u1ea7n c\u1ee7a thu\u1ed1c g\u00e2y m\u00ea c\u00e2n b\u1eb1ng c\u00f9ng v\u1edbi g\u00e2y m\u00ea to\u00e0n th\u00e2n \u0111\u1ec3 gi\u1ea3m nhu c\u1ea7u opioid trong ph\u1eabu thu\u1eadt v\u00e0 sau ph\u1eabu thu\u1eadt.<\/p>\n<p>M\u1ed1i quan t\u00e2m chung li\u00ean quan \u0111\u1ebfn vi\u1ec7c l\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt g\u00e2y m\u00ea cho ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh bao g\u1ed3m:<\/p>\n<ul>\n<li class=\"bulletIndent1\"><strong>\u0110a ch\u1ea5n th\u01b0\u01a1ng:<\/strong> G\u00e2y m\u00ea to\u00e0n th\u00e2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111a\u00a0ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng kh\u1ea9n c\u1ea5p v\u00e0 ph\u1eabu thu\u1eadt tr\u00ean nhi\u1ec1u h\u01a1n m\u1ed9t khu v\u1ef1c c\u1ee7a c\u01a1 th\u1ec3.<\/li>\n<li class=\"bulletIndent1\"><strong>H\u1ee3p t\u00e1c v\u1edbi b\u1ec7nh nh\u00e2n:<\/strong> B\u1ec7nh nh\u00e2n say, h\u00f4n m\u00ea, \u0111ang\u00a0 \u1ea3nh h\u01b0\u1edfng c\u1ee7a thu\u1ed1c ho\u1eb7c \u0111au d\u1eef d\u1ed9i c\u00f3 th\u1ec3 kh\u00f4ng th\u1ec3 h\u1ee3p t\u00e1c v\u1edbi vi\u1ec7c \u0111\u1eb7t kim g\u00e2y t\u00ea th\u1ea7n kinh ho\u1eb7c v\u00f9ng. N\u1ebfu c\u1ea7n an th\u1ea7n s\u00e2u \u0111\u1ec3 th\u1ef1c hi\u1ec7n g\u00e2y t\u00ea v\u00f9ng ho\u1eb7c trong khi ph\u1eabu thu\u1eadt, nguy c\u01a1 h\u00edt s\u1eb7c c\u00f3 th\u1ec3 cao; G\u00e2y m\u00ea n\u1ed9i kh\u00ed qu\u1ea3n to\u00e0n th\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u01b0u ti\u00ean cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/li>\n<li class=\"bulletIndent1\"><strong>\u0110\u1ecbnh<\/strong>\u00a0<strong>v\u1ecb:<\/strong>\u00a0 \u0110au ho\u1eb7c kh\u1ea3 n\u0103ng l\u00e0m n\u1eb7ng th\u00eam ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 l\u00e0m cho vi\u1ec7c \u0111\u1ecbnh v\u1ecb v\u1ecb tr\u00ed v\u00f9ng l\u00e0 kh\u00f4ng th\u1ec3 ho\u1eb7c kh\u00f4ng n\u00ean. Tuy nhi\u00ean, g\u00e2y t\u00ea \u0111\u00e1m r\u1ed1i th\u1ea7n kinh ngo\u1ea1i bi\u00ean c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u1ea3m \u0111au \u0111\u1ec3 cho ph\u00e9p \u0111\u1ecbnh v\u1ecb g\u00e2y m\u00ea th\u1ea7n kinh<\/li>\n<li class=\"bulletIndent1\">Ngo\u00e0i ra, v\u1ecb tr\u00ed ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 kh\u00f4ng tho\u1ea3i m\u00e1i v\u00e0 c\u00f3 th\u1ec3 c\u1ea7n d\u00f9ng thu\u1ed1c an th\u1ea7n s\u00e2u ho\u1eb7c g\u00e2y m\u00ea to\u00e0n th\u00e2n.<\/li>\n<li class=\"bulletIndent1\"><strong>H\u1ea1 th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n:<\/strong> Gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n<strong>\u00a0<\/strong>m\u00e1u tr\u01b0\u1edbc ph\u1eabu thu\u1eadt ho\u1eb7c k\u1ef3 v\u1ecdng m\u1ea5t m\u00e1u \u0111\u00e1ng k\u1ec3 trong ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 ng\u0103n c\u1ea3n vi\u1ec7c s\u1eed d\u1ee5ng g\u00e2y m\u00ea th\u1ea7n kinh. K\u1ef9 thu\u1eadt th\u1ea7n kinh g\u00e2y ra ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf giao c\u1ea3m c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ea1 huy\u1ebft \u00e1p n\u1eb7ng, \u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n gi\u1ea3m th\u1ec3 t\u00edch.<\/li>\n<li class=\"bulletIndent1\"><strong>B\u1ec7nh l\u00fd \u0111\u00f4ng c\u1ea7m m\u00e1u:<\/strong><strong>\u00a0<\/strong>G\u00e2y m\u00ea th\u1ea7n kinh v\u00e0 m\u1ed9t s\u1ed1 k\u1ef9 thu\u1eadt g\u00e2y t\u00ea v\u00f9ng t\u01b0\u01a1ng \u0111\u1ed1i ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh cho b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u, c\u00f3 th\u1ec3 l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u ho\u1eb7c thu\u1ed1c ch\u1ed1ng ti\u1ec3u c\u1ea7u, r\u1ed1i lo\u1ea1n y t\u1ebf ho\u1eb7c b\u1ea5t th\u01b0\u1eddng \u0111\u00f4ng m\u00e1u li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng c\u1ee7a h\u1ecd. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 b\u1ecb r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u do h\u1ea1 th\u00e2n nhi\u1ec7t ho\u1eb7c pha lo\u00e3ng m\u00e1u t\u1eeb c\u00e1c bi\u1ec7n ph\u00e1p h\u1ed3i s\u1ee9c ch\u1ea5n th\u01b0\u01a1ng ban \u0111\u1ea7u, ho\u1eb7c do \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u (DVT) t\u00edch c\u1ef1c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao n\u00e0y. K\u1ebf ho\u1ea1ch ch\u1ed1ng \u0111\u00f4ng sau ph\u1eabu thu\u1eadt n\u00ean \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p v\u1edbi b\u00e1c s\u0129 ph\u1eabu thu\u1eadt khi xem x\u00e9t g\u00e2y t\u00ea v\u00f9ng.<\/li>\n<li class=\"bulletIndent1\"><span class=\"glyph\">K<\/span>i\u1ec3m so\u00e1t \u0111au sau ph\u1eabu thu\u1eadt \u2013 RA c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1eb7t \u0111\u1ec3 ki\u1ec3m\u00a0<strong>so\u00e1t \u0111au sau ph\u1eabu<\/strong> thu\u1eadt, ngay c\u1ea3 khi g\u00e2y m\u00ea to\u00e0n th\u00e2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho ph\u1eabu thu\u1eadt ch\u00ednh. Kh\u1ed1i th\u1ea7n kinh ti\u00eam \u0111\u01a1n c\u00f3 th\u1ec3 gi\u00fap ki\u1ec3m so\u00e1t c\u01a1n \u0111au cho v\u1ecb tr\u00ed ho\u1eb7c trong giai \u0111o\u1ea1n h\u1eadu ph\u1eabu ngay l\u1eadp t\u1ee9c, nh\u01b0ng n\u00f3i chung, c\u00e1c k\u1ef9 thu\u1eadt li\u00ean t\u1ee5c v\u1edbi \u1ed1ng th\u00f4ng kh\u1ed1i th\u1ea7n kinh ngo\u00e0i m\u00e0ng c\u1ee9ng ho\u1eb7c ngo\u1ea1i bi\u00ean \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh. B\u1ec7nh nh\u00e2n c\u00f3 m\u1ed9t v\u1ecb tr\u00ed \u0111au d\u1eef d\u1ed9i c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb c\u00e1c k\u1ef9 thu\u1eadt RA li\u00ean t\u1ee5c trong khi ch\u1edd ph\u1eabu thu\u1eadt, \u0111\u1ec3 c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng v\u1eadn \u0111\u1ed9ng v\u00e0 gi\u1ea3m ph\u1ea3n \u1ee9ng giao c\u1ea3m v\u1edbi c\u01a1n \u0111au.<\/li>\n<li class=\"bulletIndent1\"><strong>Ch\u1ea5n th\u01b0\u01a1ng th\u1ea7n kinh:<\/strong> Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh, c\u1ea7n \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u01b0\u1edbc ph\u1eabu thu\u1eadt. N\u1ebfu xem x\u00e9t g\u00e2y t\u00ea v\u00f9ng, kh\u1ea3 n\u0103ng che gi\u1ea5u t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh trong ph\u1eabu thu\u1eadt do ph\u1eabu thu\u1eadt n\u00ean \u0111\u01b0\u1ee3c th\u1ea3o lu\u1eadn v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt.<\/li>\n<li class=\"bulletIndent1\"><strong>\u0110au garo:<\/strong> l\u00e0 m\u1ed9t k\u00edch th\u00edch m\u1ea1nh t\u0103ng theo th\u1eddi gian v\u00e0 c\u00f3 th\u1ec3 v\u01b0\u1ee3t qua th\u1ea7n kinh ngo\u1ea1i bi\u00ean c\u1ea3m gi\u00e1c \u0111\u1ea7y \u0111\u1ee7 ho\u1eb7c g\u00e2y m\u00ea th\u1ea7n kinh. Ngo\u00e0i 90 ph\u00fat th\u1eddi gian garo, c\u00f3 th\u1ec3 c\u1ea7n b\u1ed5 sung opioid to\u00e0n th\u00e2n ho\u1eb7c g\u00e2y m\u00ea to\u00e0n th\u00e2n.<\/li>\n<li class=\"bulletIndent1\"><strong>Theo d\u00f5i trong ph\u1eabu thu\u1eadt: <\/strong>Vi\u1ec7c s\u1eed d\u1ee5ng si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n (TEE) c\u00f3 th\u1ec3 gi\u00fap h\u01b0\u1edbng d\u1eabn li\u1ec7u ph\u00e1p ch\u1ea5t l\u1ecfng v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 theo d\u00f5i c\u00e1c hi\u1ec7n t\u01b0\u1ee3ng t\u1eafc m\u1ea1ch li\u00ean quan \u0111\u1ebfn g\u00e3y x\u01b0\u01a1ng, c\u00e1c m\u1ea3nh v\u1ee5n t\u1eeb v\u1ecb tr\u00ed c\u1ee7a ch\u00e2n gi\u1ea3 ho\u1eb7c thanh n\u1ed9i t\u1ee7y, v\u00e0 thuy\u00ean t\u1eafc kh\u00f4ng kh\u00ed t\u1eeb xoang t\u0129nh m\u1ea1ch m\u1edf. G\u00e2y m\u00ea to\u00e0n th\u00e2n l\u00e0 c\u1ea7n thi\u1ebft cho vi\u1ec7c s\u1eed d\u1ee5ng TEE.<\/li>\n<\/ul>\n<p>Vi\u1ec7c \u0111i s\u00e2u v\u00e0o chi ti\u1ebft g\u00e2y m\u00ea cho t\u1eebng v\u00f9ng: g\u00e2y m\u00ea cho ch\u1ea5n th\u01b0\u01a1ng chi tr\u00ean, g\u00e2y m\u00ea cho ch\u1ea5n th\u01b0\u01a1ng chi d\u01b0\u1edbi, g\u00e2y m\u00ea g\u00e3y x\u01b0\u01a1ng \u0111\u1ea7u g\u1ed1i v\u00e0 c\u1eb3ng ch\u00e2n, g\u00e2y m\u00ea g\u00e3y x\u01b0\u01a1ng ch\u1eadu \u0111\u01b0\u1ee3c n\u00eau chi ti\u1ebft \u1edf m\u1ed9t b\u00e0i li\u00ean quan.<\/p>\n<p><strong>T\u00f3m t\u1eaft v\u00e0 khuy\u1ebfn ngh\u1ecb: <\/strong>G\u00e2y m\u00ea c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u cho c\u00e1c ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh kh\u00e1c nhau, t\u1eeb t\u1ed5n th\u01b0\u01a1ng ri\u00eang bi\u1ec7t, t\u01b0\u01a1ng \u0111\u1ed1i nh\u1ecf \u0111\u1ebfn \u0111a ch\u1ea5n th\u01b0\u01a1ng v\u1edbi xu\u1ea5t huy\u1ebft \u0111e d\u1ecda t\u00ednh m\u1ea1ng ho\u1eb7c ch\u1ea5n th\u01b0\u01a1ng li\u00ean quan.<\/p>\n<ul>\n<li class=\"bulletIndent1\">Vi\u1ec7c l\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt g\u00e2y m\u00ea n\u00ean d\u1ef1a tr\u00ean c\u00e1c th\u1ee7 t\u1ee5c theo k\u1ebf ho\u1ea1ch v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh nh\u00e2n.<\/li>\n<li class=\"bulletIndent2\">G\u00e2y m\u00ea to\u00e0n th\u00e2n th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean cho nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng h\u1ee3p t\u00e1c, nh\u1eefng ng\u01b0\u1eddi b\u1ecb \u0111a ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng c\u1ea5p c\u1ee9u, nh\u1eefng ng\u01b0\u1eddi c\u1ea7n th\u1ee7 thu\u1eadt tr\u00ean nhi\u1ec1u v\u00f9ng c\u01a1 th\u1ec3 v\u00e0 khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi g\u00e2y t\u00ea v\u00f9ng ho\u1eb7c ngo\u1ea1i bi\u00ean (v\u00ed d\u1ee5:, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u).<\/li>\n<li class=\"bulletIndent2\">H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh kh\u00f4ng nh\u1ecbn \u0103n v\u00e0 do \u0111\u00f3 c\u00f3 nguy c\u01a1 h\u00edt ph\u1ea3i trong khi g\u00e2y m\u00ea to\u00e0n th\u00e2n; nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n.<\/li>\n<li class=\"bulletIndent2\">G\u00e2y t\u00ea th\u1ea7n kinh ngo\u1ea1i bi\u00ean c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 g\u00e2y m\u00ea v\u00e0 ki\u1ec3m so\u00e1t c\u01a1n \u0111au sau ph\u1eabu thu\u1eadt, v\u00e0 nh\u01b0 l\u00e0 m\u1ed9t b\u1ed5 sung cho g\u00e2y m\u00ea to\u00e0n th\u00e2n, cho ph\u1eabu thu\u1eadt chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi.<\/li>\n<li class=\"bulletIndent2\">G\u00e2y t\u00ea tu\u1ef7 s\u1ed1ng, ngo\u00e0i m\u00e0ng c\u1ee9ng ho\u1eb7c k\u1ebft h\u1ee3p c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho ph\u1eabu thu\u1eadt h\u00f4ng v\u00e0 chi d\u01b0\u1edbi kh\u00e1c.<\/li>\n<li class=\"bulletIndent1\">M\u1ed9t s\u1ed1 ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh c\u00f3 li\u00ean quan \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee5 th\u1ec3 trong giai \u0111o\u1ea1n ph\u1eabu thu\u1eadt, nh\u01b0 sau:\n<ul>\n<li class=\"bulletIndent2\">Thuy\u00ean t\u1eafc m\u1ee1 x\u1ea3y ra v\u1edbi nhi\u1ec1u g\u00e3y x\u01b0\u01a1ng v\u00e0 x\u01b0\u01a1ng ch\u1eadu d\u00e0i. H\u1ea7u h\u1ebft l\u00e0 c\u1eadn l\u00e2m s\u00e0ng, nh\u01b0ng h\u1ed9i ch\u1ee9ng thuy\u00ean t\u1eafc m\u1ee1 c\u00f3 th\u1ec3 x\u1ea3y ra v\u00e0 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t v\u1edbi g\u00e3y x\u01b0\u01a1ng \u0111\u00f9i hai b\u00ean, trong qu\u00e1 tr\u00ecnh doa, l\u1ea5y trong t\u1ee7y, v\u00e0 ph\u1eabu thu\u1eadt ch\u1eadm. C\u1ea7n nghi ng\u1edd thuy\u00ean t\u1eafc m\u1ee1 khi kh\u1edfi ph\u00e1t \u0111\u1ed9t ng\u1ed9t t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy trong ph\u1eabu thu\u1eadt v\u00e0 nh\u1ecbp tim nhanh v\u00e0 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ea7n kinh \u1edf b\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o.<\/li>\n<li class=\"bulletIndent2\">H\u1ed9i ch\u1ee9ng khoang c\u00f3 th\u1ec3 x\u1ea3y ra v\u1edbi g\u00e3y x\u01b0\u01a1ng ch\u00e0y v\u00e0 x\u01b0\u01a1ng m\u00e1c v\u00e0, hi\u1ebfm g\u1eb7p h\u01a1n, v\u1edbi b\u00e1n k\u00ednh xa v\u00e0 g\u00e3y m\u1eaft c\u00e1 ch\u00e2n. Khi kh\u1ed1i th\u1ea7n kinh li\u00ean t\u1ee5c \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n cho \u0111au sau ph\u1eabu thu\u1eadt, n\u00ean d\u00f9ng dung d\u1ecbch g\u00e2y t\u00ea c\u1ee5c b\u1ed9 lo\u00e3ng cho b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n \u0111\u00e1nh gi\u00e1 h\u1ed9i ch\u1ee9ng khoang.<\/li>\n<li class=\"bulletIndent2\">G\u00e3y x\u01b0\u01a1ng c\u00f3 li\u00ean quan \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 ph\u1eabu thu\u1eadt c\u1ee7a c\u00e1c d\u00e2y th\u1ea7n kinh g\u1ea7n v\u1ecb tr\u00ed g\u00e3y x\u01b0\u01a1ng. Suy gi\u1ea3m th\u1ea7n kinh c\u1ea7n \u0111\u01b0\u1ee3c ghi nh\u1eadn tr\u01b0\u1edbc ph\u1eabu thu\u1eadt v\u00e0 th\u1ea3o lu\u1eadn khi l\u00ean k\u1ebf ho\u1ea1ch ch\u1eb7n d\u00e2y th\u1ea7n kinh ngo\u1ea1i bi\u00ean.<\/li>\n<li class=\"bulletIndent1\">B\u1ec7nh nh\u00e2n b\u1ecb g\u00e3y x\u01b0\u01a1ng h\u00f4ng th\u01b0\u1eddng l\u1edbn tu\u1ed5i, c\u00f3 b\u1ec7nh \u0111i k\u00e8m. Vi\u1ec7c l\u1ef1a ch\u1ecdn k\u1ef9 thu\u1eadt g\u00e2y m\u00ea cho nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y n\u00ean d\u1ef1a tr\u00ean quy tr\u00ecnh theo k\u1ebf ho\u1ea1ch v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 b\u1ec7nh nh\u00e2n. L\u1ee3i \u00edch c\u1ee7a g\u00e2y t\u00ea v\u00f9ng so v\u1edbi g\u00e2y m\u00ea to\u00e0n th\u00e2n \u0111ang g\u00e2y tranh c\u00e3i.<\/li>\n<li class=\"bulletIndent1\">\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n g\u00e2y m\u00ea to\u00e0n th\u00e2n ho\u1eb7c g\u00e2y m\u00ea th\u1ea7n kinh s\u1ebd th\u00edch h\u1ee3p cho ph\u1eabu thu\u1eadt g\u00e3y x\u01b0\u01a1ng h\u00f4ng, ch\u00fang t\u00f4i \u0111\u1ec1 ngh\u1ecb g\u00e2y m\u00ea th\u1ea7n kinh (Khuy\u1ebfn c\u00e1o IIC). Ch\u00fang t\u00f4i th\u01b0\u1eddng th\u00edch g\u00e2y t\u00ea t\u1ee7y s\u1ed1ng li\u00ean t\u1ee5c v\u00e0 th\u1ef1c hi\u1ec7n g\u00e2y t\u00ea ngo\u00e0i m\u00e0ng c\u1ee9ng n\u1ebfu ch\u00fang t\u00f4i d\u1ef1 \u0111\u1ecbnh s\u1eed d\u1ee5ng \u1ed1ng th\u00f4ng ngo\u00e0i m\u00e0ng c\u1ee9ng \u0111\u1ec3 gi\u1ea3m \u0111au sau ph\u1eabu thu\u1eadt.<\/li>\n<li class=\"bulletIndent1\">G\u00e3y x\u01b0\u01a1ng ch\u1eadu th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c ch\u1ea5n th\u01b0\u01a1ng ch\u1ea5n th\u01b0\u01a1ng kh\u00e1c v\u00e0 c\u00f3 th\u1ec3 g\u00e2y xu\u1ea5t huy\u1ebft \u0111e d\u1ecda t\u00ednh m\u1ea1ng. G\u00e2y m\u00ea to\u00e0n th\u00e2n th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean cho ph\u1eabu thu\u1eadt ki\u1ec3m so\u00e1t t\u1ed5n th\u01b0\u01a1ng. C\u00f3 th\u1ec3 c\u1ea7n truy\u1ec1n m\u00e1u l\u01b0\u1ee3ng l\u1edbn.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><b>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/b> l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh vi\u1ec7n \u00e1p d\u1ee5ng nghi\u00eam ng\u1eb7t c\u00e1c ti\u00eau chu\u1ea9n th\u1ef1c h\u00e0nh g\u00e2y m\u00ea ph\u1eabu thu\u1eadt an to\u00e0n theo c\u00e1c h\u01b0\u1edbng d\u1eabn qu\u1ed1c t\u1ebf. V\u1edbi m\u1ed9t \u0111\u1ed9i ng\u0169 b\u00e1c s\u0129 v\u00e0 \u0111i\u1ec1u d\u01b0\u1ee1ng g\u00e2y m\u00ea gi\u00e0u kinh nghi\u1ec7m, c\u00f9ng v\u1edbi c\u00e1c trang thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>C\u00e1c ch\u1ea5n th\u01b0\u01a1ng c\u00f3 th\u1ec3 c\u00f3 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng t\u1eeb v\u1ebft th\u01b0\u01a1ng b\u1ecb c\u00f4 l\u1eadp \u0111\u1ebfn ch\u1ea5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p li\u00ean quan \u0111\u1ebfn nhi\u1ec1u h\u1ec7 th\u1ed1ng c\u01a1 quan. B\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh c\u00f3 th\u1ec3 c\u1ea7n g\u00e2y m\u00ea \u0111\u1ec3 s\u1eeda ch\u1eefa kh\u1ea9n c\u1ea5p ho\u1eb7c ph\u1eabu thu\u1eadt ki\u1ec3m so\u00e1t t\u1ed5n th\u01b0\u01a1ng, ho\u1eb7c cho [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":2355,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[75,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p g\u00e2y m\u00ea trong ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh - Vinmec<\/title>\n<meta name=\"description\" content=\"G\u00e2y m\u00ea ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh l\u00e0 ph\u01b0\u01a1ng ph\u00e1p chuy\u00ean s\u00e2u c\u1ea7n th\u1ef1c hi\u1ec7n nhanh ch\u00f3ng, ch\u00ednh x\u00e1c \u0111\u1ec3 ph\u1ed1i h\u1ee3p ph\u1eabu thu\u1eadt vi\u00ean x\u1eed l\u00ed t\u1ed5n th\u01b0\u01a1ng\" \/>\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=\"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p g\u00e2y m\u00ea trong ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh - 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