{"id":25089,"date":"2023-04-19T22:02:53","date_gmt":"2023-04-19T15:02:53","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25089"},"modified":"2023-04-22T13:13:04","modified_gmt":"2023-04-22T06:13:04","slug":"cap-cuu-ngung-tuan-hoan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/","title":{"rendered":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft"},"content":{"rendered":"

Ng\u1eebng tu\u1ea7n ho\u00e0n<\/a> l\u00e0 t\u00ecnh tr\u1ea1ng \u0111\u1ed9t ng\u1ed9t ng\u1eebng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a tim ho\u1eb7c tim ho\u1ea1t \u0111\u1ed9ng<\/strong> kh\u00f4ng hi\u1ec7u qu\u1ea3 k\u00e8m theo suy s\u1ee5p huy\u1ebft \u0111\u1ed9ng nhanh ch\u00f3ng. Trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n<\/strong> h\u00ecnh, t\u00ecnh tr\u1ea1ng n\u00e0y x\u1ea3y ra do nh\u1ecbp nhanh th\u1ea5t ho\u1eb7c rung th\u1ea5t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed<\/strong> m\u1eafc b\u1ec7nh l\u00fd tim c\u1ea5u tr\u00fac \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch v\u00e0nh.<\/strong><\/p>\n

\"C\u1ea5p<\/p>\n

\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n<\/strong><\/p>\n

1. D\u00e2y chuy\u1ec1n c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n<\/h2>\n


\n<\/strong>V\u1edbi m\u1ee5c \u0111\u00edch t\u0103ng c\u01b0\u1eddng kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t cho ng\u01b0\u1eddi b\u1ec7nh, d\u00e2y chuy\u1ec1n c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng trong hai t\u00ecnh hu\u1ed1ng: Ng\u1eebng tu\u1ea7n ho\u00e0n trong b\u1ec7nh vi\u1ec7n v\u00e0 ng\u1eebng tu\u1ea7n ho\u00e0n ngo\u00e0i b\u1ec7nh vi\u1ec7n.
\nD\u00e2y chuy\u1ec1n c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n trong b\u1ec7nh vi\u1ec7n g\u1ed3m n\u0103m b\u01b0\u1edbc:
\n(1) X\u00e2y d\u1ef1ng h\u1ec7 th\u1ed1ng gi\u00e1m s\u00e1t v\u00e0 ph\u00f2ng tr\u00e1nh ng\u1eebng tu\u1ea7n ho\u00e0n.
\n(2) Nh\u1eadn bi\u1ebft t\u00ecnh tr\u1ea1ng ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 k\u00edch ho\u1ea1t h\u1ec7 th\u1ed1ng ph\u1ea3n \u1ee9ng kh\u1ea9n c\u1ea5p.
\n(3) Ti\u1ebfn h\u00e0nh h\u1ed3i sinh tim ph\u1ed5i ngay l\u1eadp t\u1ee9c.
\n(4) Kh\u1eed rung (s\u1ed1c \u0111i\u1ec7n) k\u1ecbp th\u1eddi.
\n(5) Duy tr\u00ec s\u1ef1 s\u1ed1ng v\u00e0 ch\u0103m s\u00f3c sau ng\u1eebng tu\u1ea7n ho\u00e0n.
\nTr\u00ecnh t\u1ef1 c\u1ee7a d\u00e2y chuy\u1ec1n c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n ngo\u00e0i b\u1ec7nh vi\u1ec7n nh\u01b0 sau:
\n(1) Nh\u1eadn bi\u1ebft ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 k\u00edch ho\u1ea1t h\u1ec7 th\u1ed1ng ph\u1ea3n \u1ee9ng kh\u1ea9n c\u1ea5p.
\n(2) Ti\u1ebfn h\u00e0nh h\u1ed3i sinh tim ph\u1ed5i ngay l\u1eadp t\u1ee9c.
\n(3) Kh\u1eed rung k\u1ecbp th\u1eddi.
\n(4) Ti\u1ebfn h\u00e0nh c\u1ea5p c\u1ee9u c\u01a1 b\u1ea3n v\u00e0 n\u00e2ng cao.<\/p>\n

(5) Duy tr\u00ec s\u1ef1 s\u1ed1ng v\u00e0 ch\u0103m s\u00f3c sau ng\u1eebng tu\u1ea7n ho\u00e0n.<\/p>\n

2.S\u1eed d\u1ee5ng thu\u1ed1c trong m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd c\u1ea5p c\u1ee9u tim m\u1ea1ch<\/h2>\n

2.1. Y\u00eau c\u1ea7u c\u1ee7a h\u1ed3i sinh tim ph\u1ed5i: \u0111\u00fang quy tr\u00ecnh v\u00e0 \u0111\u1ea1t ch\u1ea5t l\u01b0\u1ee3ng cao \u0111\u1eb7c bi\u1ec7t ch\u00fa tr\u1ecdng v\u00e0o qu\u00e1 tr\u00ecnh \u00e9p tim<\/strong><\/h3>\n

\u0110\u1ed1i v\u1edbi c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n, c\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n t\u1ea1i \u0111\u1ec1u ch\u00fa tr\u1ecdng v\u00e0o qu\u00e1 tr\u00ecnh h\u1ed3i sinh tim ph\u1ed5i (Cardiopulmonary Resuscitation \u2013 CPR), c\u1ea7n \u0111\u1ea3m b\u1ea3o vi\u1ec7c h\u1ed3i sinh tim ph\u1ed5i ph\u1ea3i \u0111\u00fang quy tr\u00ecnh v\u00e0 \u0111\u1ea1t ch\u1ea5t l\u01b0\u1ee3ng cao. Quy tr\u00ecnh c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n cho m\u1ed9t ng\u01b0\u1eddi c\u1ee9u h\u1ed9 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o nh\u01b0 sau: ng\u01b0\u1eddi c\u1ee9u h\u1ed9 duy nh\u1ea5t s\u1ebd b\u1eaft \u0111\u1ea7u \u00e9p tim tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh h\u00f4 h\u1ea5p nh\u00e2n t\u1ea1o (quy tr\u00ecnh C-A-B).<\/p>\n

H\u1ed3i sinh tim ph\u1ed5i ch\u1ea5t l\u01b0\u1ee3ng cao \u0111\u01b0\u1ee3c c\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n t\u1ea1i nh\u1ea5n m\u1ea1nh \u0111\u1eb7c bi\u1ec7t bao g\u1ed3m:
\n\u00c9p tim v\u1edbi t\u1ed1c \u0111\u1ed9 v\u00e0 bi\u00ean \u0111\u1ed9 v\u1eeba \u0111\u1ee7 cho ph\u00e9p ng\u1ef1c n\u1ea3y l\u00ean ho\u00e0n to\u00e0n sau m\u1ed7i l\u1ea7n \u00e9p, gi\u1ea3m thi\u1ec3u gi\u00e1n \u0111o\u1ea1n trong khi \u00e9p tim v\u00e0 tr\u00e1nh th\u00f4ng kh\u00ed qu\u00e1 m\u1ee9c.T\u1ed1c \u0111\u1ed9 \u00e9p tim \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o l\u00e0 100 \u0111\u1ebfn 120 l\u1ea7n\/ph\u00fat, bi\u00ean \u0111\u1ed9 \u00e9p tim \u1edf ng\u01b0\u1eddi l\u1edbn \u00edt nh\u1ea5t l\u00e0 5cm nh\u01b0ng kh\u00f4ng qu\u00e1 6cm. \u0110\u1ec3 th\u00e0nh ng\u1ef1c n\u1ea3y l\u00ean ho\u00e0n to\u00e0n sau m\u1ed7i l\u1ea7n \u00e9p tim, ng\u01b0\u1eddi c\u1ee9u h\u1ed9 ph\u1ea3i tr\u00e1nh \u0111\u00e8 l\u00ean ng\u1ef1c gi\u1eefa c\u00e1c l\u1ea7n \u00e9p tim. Gi\u1ea3m thi\u1ec3u gi\u00e1n \u0111o\u1ea1n trong khi \u00e9p tim nh\u1ea5n m\u1ea1nh tr\u00e1nh hi\u1ec7n t\u01b0\u1ee3ng \u00e9p tim b\u1ecb gi\u00e1n \u0111o\u1ea1n b\u1edfi c\u00e1c c\u00f4ng vi\u1ec7c kh\u00e1c nh\u01b0 \u0111\u1eb7t \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch, \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n ho\u1eb7c gi\u1ea3m thi\u1ec3u th\u1eddi gian t\u1eeb khi ng\u1eebng \u00e9p tim t\u1edbi khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c s\u1ed1c \u0111i\u1ec7n.
\n\u0110\u1ec3 tr\u00e1nh th\u00f4ng kh\u00ed qu\u00e1 m\u1ee9c, khuy\u1ebfn ngh\u1ecb t\u1ef7 l\u1ec7 th\u00f4ng kh\u00ed \u0111\u01a1n gi\u1ea3n l\u00e0 10 l\u1ea7n th\u00f4ng kh\u00ed\/ph\u00fat (6 gi\u00e2y\/l\u1ea7n th\u00f4ng kh\u00ed).<\/p>\n

2.2. Vai tr\u00f2 c\u1ee7a s\u1ed1c \u0111i\u1ec7n<\/h3>\n


\n<\/strong>C\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n h\u00e0nh nh\u1ea5n m\u1ea1nh vai tr\u00f2 c\u1ee7a s\u1ed1c \u0111i\u1ec7n trong h\u1ed3i sinh tim ph\u1ed5i trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1eebng tu\u1ea7n ho\u00e0n do nh\u1ecbp nhanh th\u1ea5t ho\u1eb7c rung th\u1ea5t. N\u00ean s\u1eed d\u1ee5ng m\u00e1y kh\u1eed rung c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t. Tuy nhi\u00ean, tr\u01b0\u1edbc khi l\u1ea5y \u0111\u01b0\u1ee3c m\u00e1y kh\u1eed rung, ng\u01b0\u1eddi c\u1ee9u h\u1ed9 c\u1ea7n kh\u1ea9n tr\u01b0\u01a1ng h\u1ed3i sinh tim ph\u1ed5i \u0111\u00fang quy tr\u00ecnh v\u00e0 \u0111\u1ea1t ch\u1ea5t l\u01b0\u1ee3ng nh\u01b0 \u0111\u1ec1 c\u1eadp \u1edf ph\u1ea7n tr\u00ean.<\/p>\n

2.3. Vai tr\u00f2 c\u1ee7a c\u00e1c bi\u1ec7n ph\u00e1p kh\u00e1c sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n<\/h3>\n

C\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n nh\u01b0 h\u1ed3i s\u1ee9c tu\u1ea7n ho\u00e0n, h\u00f4 h\u1ea5p, l\u1ecdc m\u00e1u\u2026<\/p>\n

3. S\u1eed d\u1ee5ng thu\u1ed1c trong h\u1ed3i sinh tim ph\u1ed5i:<\/h2>\n

3.1. Adrenalin<\/h3>\n

C\u1eadp nh\u1eadt c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n c\u1ee7a H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 2019 nh\u1ea5n m\u1ea1nh vai tr\u00f2 c\u1ee7a adrenalin trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n. Adrenalin \u0111\u01b0\u1ee3c cho r\u1eb1ng c\u00f3 l\u1ee3i \u00edch trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n do t\u00e1c \u0111\u1ed9ng k\u00edch th\u00edch alpha adrenergic (g\u00e2y co m\u1ea1ch). C\u00e1c t\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng \u00e1p l\u1ef1c trong \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u00e0 \u0111\u1ed9ng m\u1ea1ch n\u00e3o trong qu\u00e1 tr\u00ecnh h\u1ed3i sinh tim ph\u1ed5i. Vai tr\u00f2 v\u00e0 an to\u00e0n c\u1ee7a c\u00e1c t\u00e1c \u0111\u1ed9ng tr\u00ean beta adrenergic hi\u1ec7n t\u1ea1i v\u1eabn \u0111ang tranh c\u00e3i do c\u00e1c t\u00e1c \u0111\u1ed9ng n\u00e0y c\u00f3 th\u1ec3 t\u0103ng ti\u00eau th\u1ee5 oxy c\u01a1 tim, gi\u1ea3m t\u01b0\u1edbi m\u00e1u d\u01b0\u1edbi n\u1ed9i t\u00e2m m\u1ea1c v\u00e0 nguy c\u01a1 d\u1eabn \u0111\u1ebfn c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp tim. M\u1eb7t kh\u00e1c, c\u00e1c t\u00e1c
\n\u0111\u1ed9ng tr\u00ean alpha adrenergic c\u1ee7a thu\u1ed1c c\u0169ng c\u00f3 th\u1ec3 g\u00e2y co m\u1ea1ch \u1edf m\u1ee9c \u0111\u1ed9 vi m\u1ea1ch v\u00e0 g\u00e2y h\u1eadu qu\u1ea3 thi\u1ebfu m\u00e1u m\u00f4 nhi\u1ec1u h\u01a1n.
\nNhi\u1ec1u th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean v\u00e0 kh\u00f4ng ng\u1eabu nhi\u00ean \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 vai tr\u00f2 c\u1ee7a adrenalin trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n. C\u00f3 th\u1ec3 k\u1ebft lu\u1eadn nh\u01b0 sau: adrenalin gi\u00fap t\u0103ng s\u1ed1ng s\u00f3t t\u1ea1i th\u1eddi \u0111i\u1ec3m ra vi\u1ec7n, t\u0103ng kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t t\u1ea1i th\u1eddi \u0111i\u1ec3m 30 ng\u00e0y, tuy nhi\u00ean adrenalin kh\u00f4ng c\u1ea3i thi\u1ec7n bi\u1ebfn c\u1ed1 th\u1ea7n kinh gi\u1eefa c\u00e1c nh\u00f3m so s\u00e1nh.
\n\u0110\u1ed1i v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng adrenalin li\u1ec1u cao (0,1 \u2013 0,2 mg\/kg), gi\u1ea3 thuy\u1ebft cho r\u1eb1ng s\u1eed d\u1ee5ng adrenalin li\u1ec1u cao s\u1ebd l\u00e0m t\u0103ng t\u01b0\u1edbi m\u00e1u \u0111\u1ed9ng m\u1ea1ch v\u00e0nh t\u1eeb \u0111\u00f3 l\u00e0m t\u0103ng t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t sau h\u1ed3i sinh tim ph\u1ed5i. Tuy nhi\u00ean, t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a adrenalin li\u1ec1u cao \u1edf giai \u0111o\u1ea1n sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n c\u00f3 th\u1ec3 l\u00e0m m\u1ea5t l\u1ee3i \u00edch ti\u1ec1m t\u00e0ng c\u1ee7a thu\u1ed1c trong giai \u0111o\u1ea1n \u0111ang ng\u1eebng tim. C\u00e1c th\u1eed nghi\u1ec7m c\u0169ng ch\u1ee9ng minh adrenalin li\u1ec1u cao th\u1ea5t b\u1ea1i trong vi\u1ec7c c\u1ea3i thi\u1ec7n s\u1ed1ng c\u00f2n t\u1ea1i th\u1eddi \u0111i\u1ec3m ra vi\u1ec7n.
\nKhuy\u1ebfn c\u00e1o c\u1ee7a H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 n\u0103m 2019 v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng adrenalin nh\u01b0 sau:
\nAdrenalin \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh s\u1eed d\u1ee5ng cho c\u00e1c b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n (khuy\u1ebfn c\u00e1o I, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng B-R).
\nN\u00ean s\u1eed d\u1ee5ng 1mg adrenalin m\u1ed7i 3 \u2013 5 ph\u00fat ti\u00eam t\u0129nh m\u1ea1ch (khuy\u1ebfn c\u00e1o IIa, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng C-LD).
\nKh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng adrenalin li\u1ec1u cao trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n (khuy\u1ebfn c\u00e1o III: kh\u00f4ng c\u00f3 l\u1ee3i \u00edch, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng B-R).
\nV\u1ec1 th\u1eddi \u0111i\u1ec3m s\u1eed d\u1ee5ng adrenalin trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n. Hi\u1ec7n ch\u01b0a c\u00f3 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng t\u1eadp trung v\u00e0o vi\u1ec7c x\u00e1c \u0111\u1ecbnh th\u1eddi \u0111i\u1ec3m t\u1ed1i \u01b0u s\u1eed d\u1ee5ng adrenalin. C\u00e1c nghi\u00ean c\u1ee9u quan s\u00e1t m\u1eb7c d\u00f9 c\u00f3 nhi\u1ec1u sai s\u1ed1 nh\u01b0ng ph\u1ea7n l\u1edbn ch\u1ee9ng minh vi\u1ec7c s\u1eed d\u1ee5ng adrenalin s\u1edbm gi\u00fap t\u0103ng t\u1ef7 l\u1ec7 t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean. Khuy\u1ebfn c\u00e1o c\u1ee7a H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 n\u0103m 2019 nh\u1ea5n m\u1ea1nh:
\nN\u00ean s\u1eed d\u1ee5ng adrenalin s\u1edbm trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n c\u00f3 nguy\u00ean nh\u00e2n kh\u00f4ng ph\u1ea3i c\u00e1c r\u1ed1i lo\u1ea1n nh\u1ecbp c\u1ea7n s\u1ed1c \u0111i\u1ec7n (khuy\u1ebfn c\u00e1o IIa, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng CLD). N\u00ean s\u1eed d\u1ee5ng adrenalin s\u1edbm sau khi kh\u00f4ng t\u00e1i l\u1eadp \u0111\u01b0\u1ee3c tu\u1ea7n ho\u00e0n do s\u1ed1c \u0111i\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n do r\u1ed1i lo\u1ea1n nh\u1ecbp c\u1ea7n s\u1ed1c \u0111i\u1ec7n.<\/p>\n

3.2. Vasopressin<\/h3>\n

Vasopressin l\u00e0 m\u1ed9t ch\u1ea5t co m\u1ea1ch ngo\u1ea1i vi kh\u00f4ng ph\u1ea3i adrenergic, thu\u1ed1c n\u00e0y c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y co m\u1ea1ch v\u00e0nh v\u00e0 m\u1ea1ch th\u1eadn. C\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng \u0111\u1ebfn th\u1eddi \u0111i\u1ec3m n\u0103m 2020 cho th\u1ea5y vi\u1ec7c s\u1eed d\u1ee5ng vasopressin t\u1eeb \u0111\u1ea7u kh\u00f4ng ch\u1ee9ng minh mang l\u1ea1i b\u1ea5t k\u1ef3 l\u1ee3i \u00edch n\u00e0o so v\u1edbi adrenalin v\u00e0 vi\u1ec7c k\u1ebft h\u1ee3p vasopressin v\u1edbi adrenalin c\u0169ng kh\u00f4ng mang l\u1ea1i l\u1ee3i \u00edch kh\u00e1c bi\u1ec7t so v\u1edbi s\u1eed d\u1ee5ng adrenalin \u0111\u01a1n thu\u1ea7n. Do kh\u00f4ng cung c\u1ea5p \u0111\u01b0\u1ee3c c\u00e1c b\u1eb1ng ch\u1ee9ng c\u00f3 l\u1ee3i c\u1ee7a vasopressin, \u0111\u1ed3ng thu\u1eadn c\u1ee7a H\u1ed9i Tim
\nM\u1ea1ch Hoa K\u1ef3 2020 nh\u1ea5n m\u1ea1nh vi\u1ec7c duy tr\u00ec ch\u1ec9 s\u1eed d\u1ee5ng adrenalin \u0111\u01a1n \u0111\u1ed9c nh\u01b0 m\u1ed9t ch\u1ea5t co m\u1ea1ch trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n.<\/p>\n

3.3. Amiodarone v\u00e0 lidocaine<\/h3>\n

Trong 2 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean m\u00f9 \u0111\u00f4i ti\u1ebfn h\u00e0nh tr\u00ean \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 rung th\u1ea5t\/nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch ph\u1ee5c h\u1ed3i b\u1eb1ng s\u1ed1c \u0111i\u1ec7n ngo\u00e0i b\u1ec7nh vi\u1ec7n, c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u00e3 nh\u1eadn \u0111\u01b0\u1ee3c \u00edt nh\u1ea5t 3 l\u1ea7n s\u1ed1c \u0111i\u1ec7n v\u00e0 ti\u00eam adrenaline.
\nTh\u1ed1ng k\u00ea cho th\u1ea5y nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c truy\u1ec1n amiodarone c\u00f3 kh\u1ea3 n\u0103ng c\u1ea3i thi\u1ec7n s\u1ed1ng c\u00f2n t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1eadp vi\u1ec7n cao h\u01a1n so v\u1edbi nh\u00f3m kh\u00f4ng \u0111\u01b0\u1ee3c truy\u1ec1n amiodarone.T\u01b0\u01a1ng t\u1ef1, nhi\u1ec1u th\u1eed nghi\u1ec7m sau \u0111\u00f3 ch\u1ee9ng minh amiodarone 300mg c\u00f3 kh\u1ea3 n\u0103ng c\u1ea3i thi\u1ec7n s\u1ed1ng c\u00f2n t\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1eadp vi\u1ec7n t\u1ed1t h\u01a1n so v\u1edbi nh\u00f3m \u0111\u1ed1i ch\u1ee9ng. C\u00e1c th\u1eed nghi\u1ec7m n\u00e0y kh\u00f4ng kh\u1ea3o s\u00e1t th\u1eddi \u0111i\u1ec3m ho\u1eb7c c\u00e1ch th\u1ee9c ph\u1ed1i h\u1ee3p gi\u1eefa amiodarone v\u1edbi adrenaline. Kh\u00f4ng c\u00f3 th\u1eed nghi\u1ec7m n\u00e0o \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u0111\u00e1nh gi\u00e1 vai tr\u00f2 c\u1ee7a
\namiodarone \u1edf b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n trong b\u1ec7nh vi\u1ec7n.
\nTruy\u1ec1n t\u0129nh m\u1ea1ch lidocaine \u2013 m\u1ed9t thu\u1ed1c ch\u1ed1ng r\u1ed1i lo\u1ea1n nh\u1ecbp tim ph\u1ed5 bi\u1ebfn \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh trong nhi\u1ec1u th\u1eed nghi\u1ec7m \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n ngo\u00e0i b\u1ec7nh vi\u1ec7n.
\nC\u00e1c th\u1eed nghi\u1ec7m so s\u00e1nh gi\u1eefa nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c truy\u1ec1n amiodarone ho\u1eb7c lidocaine v\u1edbi nh\u00f3m placebo cho th\u1ea5y kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a th\u1ed1ng k\u00ea v\u1ec1 m\u1eb7t s\u1ed1ng c\u00f2n gi\u1eefa nh\u00f3m b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c truy\u1ec1n amiodarone v\u00e0 lidocaine nh\u01b0ng nh\u1eefng b\u1ec7nh nh\u00e2n \u1edf hai nh\u00f3m n\u00e0y c\u00f3 t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n cao h\u01a1n c\u00f3 \u00fd ngh\u0129a so v\u1edbi nh\u00f3m placebo. Hi\u1ec7n kh\u00f4ng c\u00f3 th\u1eed nghi\u1ec7m n\u00e0o \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 c\u1ee7a lidocaine trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ng\u1eebng tu\u1ea7n ho\u00e0n trong b\u1ec7nh vi\u1ec7n.
\nKhuy\u1ebfn c\u00e1o c\u1ee7a H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 n\u0103m 2018 \u0111\u1ed1i v\u1edbi vi\u1ec7c s\u1eed d\u1ee5ng amiodarone v\u00e0 lidocaine nh\u01b0 sau:
\nAmiodarone ho\u1eb7c lidocaine c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p rung th\u1ea5t ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi s\u1ed1c \u0111i\u1ec7n. C\u00e1c thu\u1ed1c n\u00e0y c\u00f3 th\u1ec3 \u0111\u1eb7c bi\u1ec7t hi\u1ec7u qu\u1ea3 \u1edf b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n c\u00f3 ng\u01b0\u1eddi ch\u1ee9ng ki\u1ebfn v\u00e0 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thu\u1ed1c s\u1edbm (khuy\u1ebfn c\u00e1o IIb, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng B-R).
\nTrong l\u01b0\u1ee3c \u0111\u1ed3 c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n n\u0103m 2018, H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 khuy\u1ebfn c\u00e1o ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng amiodarone v\u00e0 lidocaine nh\u01b0 sau:
\nTi\u00eam t\u0129nh m\u1ea1ch amiodarone li\u1ec1u \u0111\u1ea7u ti\u00ean 300 mg, li\u1ec1u th\u1ee9 hai 150 mg ho\u1eb7c Ti\u00eam t\u0129nh m\u1ea1ch lidocaine li\u1ec1u \u0111\u1ea7u ti\u00ean 1\u20131,5 mg\/kg, li\u1ec1u th\u1ee9 hai 0,5\u20130,75 mg\/kg. Sau khi t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean, vai tr\u00f2 c\u1ee7a lidocain v\u1eabn c\u00f2n nhi\u1ec1u tranh c\u00e3i do thi\u1ebfu c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 l\u1ee3i \u00edch. H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 khuy\u1ebfn c\u00e1o v\u1ec1 s\u1eed d\u1ee5ng lidocaine sau khi t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean nh\u01b0 sau:
\nHi\u1ec7n t\u1ea1i thi\u1ebfu c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng lidocain \u1edf giai \u0111o\u1ea1n s\u1edbm (trong v\u00f2ng 1h) sau khi t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean. N\u1ebfu kh\u00f4ng c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh, c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng lidocain \u0111\u1ec3 d\u1ef1 ph\u00f2ng trong m\u1ed9t
\ns\u1ed1 t\u00ecnh hu\u1ed1ng \u0111\u1eb7c bi\u1ec7t khi \u0111i\u1ec1u ki\u1ec7n \u0111i\u1ec1u tr\u1ecb rung th\u1ea5t ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch b\u1ecb h\u1ea1n ch\u1ebf (v\u00ed d\u1ee5 trong qu\u00e1 tr\u00ecnh v\u1eadn chuy\u1ec3n c\u1ea5p c\u1ee9u) (khuy\u1ebfn c\u00e1o IIb, m\u1ee9c \u0111\u1ed9 b\u1eb1ng ch\u1ee9ng C-LD).<\/p>\n

3.3. Magie<\/h3>\n

Magie ho\u1ea1t \u0111\u1ed9ng gi\u1ed1ng nh\u01b0 m\u1ed9t ch\u1ea5t gi\u00e3n m\u1ea1ch v\u00e0 l\u00e0 m\u1ed9t co-factor quan tr\u1ecdng trong \u0111i\u1ec1u ch\u1ec9nh n\u1ed3ng \u0111\u1ed9 natri, kali v\u00e0 canxi qua m\u00e0ng t\u1ebf b\u00e0o. M\u1ed9t s\u1ed1 th\u1eed nghi\u1ec7m \u0111\u00e1nh gi\u00e1 vai tr\u00f2 c\u1ee7a magie cho th\u1ea5y magie kh\u00f4ng c\u1ea3i thi\u1ec7n t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean ho\u1eb7c s\u1ed1ng c\u00f2n khi ra vi\u1ec7n. Magie th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong \u0111i\u1ec1u tr\u1ecb xo\u1eafn \u0111\u1ec9nh nh\u01b0ng vai tr\u00f2 th\u1ef1c s\u1ef1 l\u00e0 d\u1ef1 ph\u00f2ng t\u00e1i ph\u00e1t xo\u1eafn \u0111\u1ec9nh h\u01a1n l\u00e0 t\u00e1c \u0111\u1ed9ng \u0111i\u1ec1u tr\u1ecb. M\u1eb7t kh\u00e1c c\u00e1c th\u1eed nghi\u1ec7m v\u1ec1 vai tr\u00f2 c\u1ee7a magie \u1edf ng\u01b0\u1eddi b\u1ec7nh xo\u1eafn \u0111\u1ec9nh ch\u1ec9 d\u1eebng l\u1ea1i \u1edf m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u quan s\u00e1t v\u1edbi c\u1ee1 m\u1eabu nh\u1ecf m\u00e0 ch\u01b0a c\u00f3 th\u1eed nghi\u1ec7m ng\u1eabu nhi\u00ean c\u00f3 \u0111\u1ed1i ch\u1ee9ng n\u00e0o \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1.
\nH\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 n\u0103m 2018 khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng magie nh\u01b0 sau:
\nKh\u00f4ng khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng th\u01b0\u1eddng quy magie trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n \u1edf ng\u01b0\u1eddi l\u1edbn (khuy\u1ebfn c\u00e1o III: kh\u00f4ng c\u00f3 l\u1ee3i, m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o C-LD). C\u00e2n nh\u1eafc s\u1eed d\u1ee5ng magie \u1edf b\u1ec7nh nh\u00e2n xo\u1eafn \u0111\u1ec9nh (khuy\u1ebfn c\u00e1o IIb, m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o C-LD).<\/p>\n

3.4. Ch\u1eb9n beta giao c\u1ea3m<\/h3>\n

N\u0103m 2015 H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 s\u1eed d\u1ee5ng ch\u1eb9n beta trong c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n: hi\u1ec7n thi\u1ebfu c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng th\u01b0\u1eddng quy thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n. Tuy nhi\u00ean, c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc kh\u1edfi \u0111\u1ea7u ho\u1eb7c ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m
\n\u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch sau khi nh\u1eadp vi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n ng\u1eebng tu\u1ea7n ho\u00e0n do rung th\u1ea5t ho\u1eb7c nh\u1ecbp nhanh th\u1ea5t v\u00f4 m\u1ea1ch (khuy\u1ebfn c\u00e1o IIb, m\u1ee9c \u0111\u1ed9 khuy\u1ebfn c\u00e1o C-LD). N\u0103m 2018, sau khi xem x\u00e9t l\u1ea1i c\u00e1c d\u1eef li\u1ec7u c\u0169ng nh\u01b0 c\u00e1c nghi\u00ean c\u1ee9u, H\u1ed9i Tim M\u1ea1ch Hoa K\u1ef3 n\u0103m 2018 kh\u00f4ng \u0111\u01b0a ra khuy\u1ebfn c\u00e1o v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng ch\u1eb9n beta giao c\u1ea3m sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n do thi\u1ebfu c\u00e1c b\u1eb1ng ch\u1ee9ng v\u1ec1 l\u1ee3i \u00edch trong s\u1eed d\u1ee5ng th\u01b0\u1eddng quy thu\u1ed1c ch\u1eb9n beta giao c\u1ea3m \u1edf giai \u0111o\u1ea1n s\u1edbm (trong v\u00f2ng 1h) sau khi t\u00e1i l\u1eadp tu\u1ea7n ho\u00e0n t\u1ef1 nhi\u00ean.
\nVai tr\u00f2 c\u1ee7a thu\u1ed1c n\u00e0y v\u1eabn l\u00e0 m\u1ed9t d\u1ea5u h\u1ecfi v\u00e0 c\u1ea7n th\u1eddi gian c\u0169ng nh\u01b0 c\u00e1c th\u1eed nghi\u1ec7m \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh vai tr\u00f2 c\u1ee7a thu\u1ed1c \u1edf b\u1ec7nh nh\u00e2n sau c\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n.<\/p>\n

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

Ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 t\u00ecnh tr\u1ea1ng \u0111\u1ed9t ng\u1ed9t ng\u1eebng ho\u1ea1t \u0111\u1ed9ng c\u1ee7a tim ho\u1eb7c tim ho\u1ea1t \u0111\u1ed9ng kh\u00f4ng hi\u1ec7u qu\u1ea3 k\u00e8m theo suy s\u1ee5p huy\u1ebft \u0111\u1ed9ng nhanh ch\u00f3ng. Trong tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n h\u00ecnh, t\u00ecnh tr\u1ea1ng n\u00e0y x\u1ea3y ra do nh\u1ecbp nhanh th\u1ea5t ho\u1eb7c rung th\u1ea5t \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed m\u1eafc b\u1ec7nh l\u00fd tim […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"\nC\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.\" \/>\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\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec\" \/>\n<meta property=\"og:description\" content=\"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-19T15:02:53+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-22T06:13:04+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20211012_030025_693280_cap-cuu-ngung-tuan-.max-1800x1800-2-300x178.png\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"11 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/\",\"name\":\"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-19T15:02:53+00:00\",\"dateModified\":\"2023-04-22T06:13:04+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.\",\"breadcrumb\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft\"}]},{\"@type\":\"WebSite\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/\",\"name\":\"Vinmec\",\"description\":\"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\",\"name\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/\",\"url\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"contentUrl\":\"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g\",\"caption\":\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\"},\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/\"}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec","description":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.","robots":{"index":"noindex","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"og_locale":"en_US","og_type":"article","og_title":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec","og_description":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.","og_url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/","og_site_name":"Vinmec","article_published_time":"2023-04-19T15:02:53+00:00","article_modified_time":"2023-04-22T06:13:04+00:00","og_image":[{"url":"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/20211012_030025_693280_cap-cuu-ngung-tuan-.max-1800x1800-2-300x178.png"}],"author":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","twitter_card":"summary_large_image","twitter_misc":{"Written by":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","Est. reading time":"11 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/","url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/","name":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-19T15:02:53+00:00","dateModified":"2023-04-22T06:13:04+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh. B\u00e0i vi\u1ebft s\u1ebd cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c chuy\u00ean m\u00f4n \u0111\u1ec3 th\u1ef1c h\u00e0nh t\u1ed1t h\u01a1n.","breadcrumb":{"@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/"]}]},{"@type":"BreadcrumbList","@id":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/19\/cap-cuu-ngung-tuan-hoan\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"C\u1ea5p c\u1ee9u ng\u1eebng tu\u1ea7n ho\u00e0n v\u00e0 nh\u1eefng \u0111i\u1ec1u c\u1ea7n bi\u1ebft"}]},{"@type":"WebSite","@id":"http:\/\/noithathoaphat.in\/ctv\/#website","url":"http:\/\/noithathoaphat.in\/ctv\/","name":"Vinmec","description":"H\u1ec7 th\u1ed1ng Y t\u1ebf Vinmec","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"http:\/\/noithathoaphat.in\/ctv\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Person","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629","name":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/image\/","url":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","contentUrl":"http:\/\/2.gravatar.com\/avatar\/50f51f67852bc7e49c0b8b60a1fefe3e?s=96&d=mm&r=g","caption":"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i"},"url":"http:\/\/noithathoaphat.in\/ctv\/index.php\/author\/viettai304-304gmail-com\/"}]}},"_links":{"self":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25089"}],"collection":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/users\/7"}],"replies":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/comments?post=25089"}],"version-history":[{"count":5,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25089\/revisions"}],"predecessor-version":[{"id":26627,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/25089\/revisions\/26627"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=25089"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=25089"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=25089"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}