{"id":2543,"date":"2023-04-10T19:12:04","date_gmt":"2023-04-10T12:12:04","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=2543"},"modified":"2023-04-13T16:44:01","modified_gmt":"2023-04-13T09:44:01","slug":"tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/","title":{"rendered":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn"},"content":{"rendered":"<p><strong>B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (CAD) l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn ti\u1ebfn tri\u1ec3n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa.C\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa cung c\u1ea5p oxy v\u00e0 nhu c\u1ea7u oxy d\u1eabn \u0111\u1ebfn s\u1ef1 kh\u00f4ng \u0111\u1ee7 l\u01b0u th\u00f4ng c\u01a1 tim \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u trao \u0111\u1ed5i ch\u1ea5t.<\/strong><\/p>\n<h2><strong>1.Sinh l\u00fd b\u1ec7nh:<\/strong><\/h2>\n<p>B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (CAD) l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn ti\u1ebfn tri\u1ec3n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u00e1ng k\u1ec3 bao g\u1ed3m t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n lipid m\u00e1u (\u0111\u1eb7c bi\u1ec7t l\u00e0 LDL cao, HDL th\u1ea5p, Lp(a) ho\u1eb7c apoB cao, ho\u1eb7c triglycerid), \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u00e9o ph\u00ec (k\u1ebft h\u1ee3p c\u1ee7a c\u00e1c y\u1ebfu t\u1ed1 tr\u00ean \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng chuy\u1ec3n h\u00f3a), h\u00fat thu\u1ed1c l\u00e1 v\u00e0 ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc CAD s\u1edbm. C\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa cung c\u1ea5p oxy v\u00e0 nhu c\u1ea7u oxy d\u1eabn \u0111\u1ebfn s\u1ef1 kh\u00f4ng \u0111\u1ee7 l\u01b0u th\u00f4ng c\u01a1 tim \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u trao \u0111\u1ed5i ch\u1ea5t. S\u1ef1 suy gi\u1ea3m ti\u1ebfn \u0111\u1ed9 c\u1ee7a \u0111\u01b0\u1eddng k\u00ednh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh g\u00e2y ra s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng cung c\u1ea5p\/nhu c\u1ea7u th\u01b0\u1eddng t\u1ea1o ra &#8220;b\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1ed5n \u0111\u1ecbnh (SIHD)&#8221;. Vi\u1ec7c v\u1ee1 c\u00f9ng v\u1edbi h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i l\u00ean tr\u00ean l\u00e0 nguy\u00ean nh\u00e2n c\u1ee7a h\u1ea7u h\u1ebft c\u00e1c h\u1ed9i ch\u1ee9ng tim m\u1ea1ch c\u1ea5p t\u00ednh (ACS), bao g\u1ed3m &#8221; b\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1ed5n \u0111\u1ecbnh &#8221; c\u1ed5 \u0111i\u1ec3n,nh\u1ed3i m\u00e1u c\u01a1 tim c\u00f3 kh\u00f4ng ST ch\u00eanh l\u00ean v\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim kh\u00f4ng ST ch\u00eanh l\u00ean.<\/p>\n<h2><strong>2.Ph\u00f2ng ng\u1eeba ch\u00ednh c\u1ee7a b\u1ec7nh tim m\u1ea1ch:<\/strong><\/h2>\n<p>Bao g\u1ed3m ki\u1ec3m so\u00e1t c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 thay \u0111\u1ed5i. \u0110\u00e1ng ch\u00fa \u00fd, th\u01b0\u1eddng kh\u00f4ng khuy\u1ebfn kh\u00edch s\u1eed d\u1ee5ng thu\u1ed1c statin \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 m\u1ee9c \u0111\u1ed9 cholesterol b\u00ecnh th\u01b0\u1eddng (tr\u1eeb tr\u01b0\u1eddng h\u1ee3p c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc CAD s\u1edbm ho\u1eb7c \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 th\u1ea5p m\u1eafc b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh x\u01a1 v\u1eefa (ASCVD) d\u1ef1a tr\u00ean thang \u0111i\u1ec3m nguy c\u01a1 ASCVD.<\/p>\n<p>Ngo\u00e0i ra, aspirin 81mg\/ng\u00e0y l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong ph\u00f2ng ng\u1eeba ch\u00ednh trong qu\u00e1 kh\u1ee9, hi\u1ec7n ch\u1ec9 \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o \u1edf m\u1ee9c IIb \u0111\u1ed1i v\u1edbi b\u1ec7nh nh\u00e2n trong \u0111\u1ed9 tu\u1ed5i t\u1eeb 40-70 tu\u1ed5i c\u00f3 nguy c\u01a1 ASCVD cao, nh\u01b0ng kh\u00f4ng c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u t\u0103ng cao v\u00e0 \u0111\u01b0\u1ee3c xem l\u00e0 kh\u00f4ng khuy\u1ebfn c\u00e1o \u0111\u1ed1i v\u1edbi b\u1ea5t k\u1ef3 b\u1ec7nh nh\u00e2n n\u00e0o tr\u00ean 70 tu\u1ed5i ho\u1eb7c b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u t\u0103ng cao theo b\u00e1o c\u00e1o c\u1ee7a H\u1ecdc vi\u1ec7n Tim m\u1ea1ch Hoa K\u1ef3 n\u0103m 2019.<\/p>\n<h2><strong>3.C\u00e1c ch\u1ec9 \u0111\u1ecbnh cho ph\u1eabu thu\u1eadt trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh \u1ed5n \u0111\u1ecbnh (SIHD) <\/strong><\/h2>\n<p>M\u1eb7c d\u00f9 gi\u1ea3m tri\u1ec7u ch\u1ee9ng l\u00e0 m\u1ed9t trong c\u00e1c m\u1ee5c ti\u00eau c\u1ee7a \u00a0t\u00e1i th\u00f4ng m\u1ea1ch m\u00e1u. M\u1ed9t l\u1ee3i \u00edch quan tr\u1ecdng kh\u00e1c l\u00e0 c\u1ea3i thi\u1ec7n s\u1ef1 s\u1ed1ng s\u00f3t trong d\u00e0i h\u1ea1n so v\u1edbi c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c. V\u00ed d\u1ee5, ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u m\u1ea1ch v\u00e0nh (CABG) cho b\u1ec7nh LM &gt;50% ho\u1eb7c cho b\u1ec7nh nhi\u1ec1u \u0111\u1ed9ng m\u1ea1ch v\u1edbi thi\u1ebfu m\u00e1u r\u1ed9ng v\u00e0\/ho\u1eb7c ch\u1ee9c n\u0103ng t\u00e2m thu tr\u00e1i suy gi\u1ea3m. C\u0169ng c\u00f3 kh\u1ea3 n\u0103ng CABG c\u00f3 th\u1ec3 k\u00e9o d\u00e0i tu\u1ed5i th\u1ecd b\u1eb1ng c\u00e1ch ng\u0103n ng\u1eeba c\u01a1n \u0111au tim, trong khi \u0111i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u00fang \u0111\u1ed1i v\u1edbi\u00a0 can thi\u1ec7p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh qua da(PCI).<\/p>\n<p><strong>3.1. C\u00e1c ch\u1ec9 \u0111\u1ecbnh Class Ia:<\/strong>\u00a0 T\u1eafc \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng \u0111\u01b0\u1ee3c b\u1ea3o v\u1ec7 &gt;50%. Ba nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u1edbi\/ho\u1eb7c kh\u00f4ng c\u00f3 LAD \u0111o\u1ea1n g\u1ea7n.B\u1ec7nh hai nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u1edbi LAD \u0111o\u1ea1n g\u1ea7n.<\/p>\n<p><strong>3.2.C\u00e1c ch\u1ec9 \u0111\u1ecbnh Class IIa:<\/strong>B\u1ec7nh hai nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh m\u00e0 kh\u00f4ng c\u00f3 b\u1ec7nh LAD \u0111o\u1ea1n g\u1ea7n v\u1edbi m\u1ed9t v\u00f9ng c\u1ee7a c\u01a1 tim b\u1ecb thi\u1ebfu m\u00e1u.B\u1ec7nh m\u1ed9t nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u1edbi LAD \u0111o\u1ea1n. B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch LAD \u0111o\u1ea1n g\u1ea7n ho\u1eb7c nhi\u1ec1u \u0111\u1ed9ng m\u1ea1ch v\u00e0nh v\u1edbi EF 35-50% n\u1ebfu c\u01a1 tim c\u00f2n s\u1ed1ng trong v\u00f9ng \u0111\u01b0\u1ee3c d\u1ef1 \u0111\u1ecbnh t\u00e1i t\u1ea1o m\u1ea1ch m\u00e1u.<\/p>\n<p><strong>3.3.C\u00e1c ch\u1ec9 \u0111\u1ecbnh Class IIb: <\/strong>M\u1ed9t, hai ho\u1eb7c ba \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i tr\u1eeb \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i v\u1edbi EF &lt;35%.<\/p>\n<h2><strong>4.Chi\u1ebfn l\u01b0\u1ee3c t\u1ed1i \u01b0u trong b\u1ec7nh nh\u00e2n suy tim c\u1ea5p t\u00ednh do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9<\/strong><\/h2>\n<p>L\u00e0 m\u1ed9t ch\u1ee7 \u0111\u1ec1 g\u00e2y tranh c\u00e3i. Th\u1eed nghi\u1ec7m \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt cho suy tim c\u1ea5p t\u00ednh do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 (STICH) so s\u00e1nh v\u1edbi CABG v\u1edbi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa t\u1ed1i \u01b0u \u1edf b\u1ec7nh nh\u00e2n suy tim c\u1ea5p t\u00ednh do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim \u0111\u00e3 ph\u00e1t hi\u1ec7n ra t\u1ef7 l\u1ec7 t\u1eed vong 30 ng\u00e0y t\u0103ng l\u00ean nh\u01b0ng s\u1ef1 s\u1ed1ng s\u00f3t sau 10 n\u0103m t\u1ed1t h\u01a1n v\u1edbi CABG, s\u1ef1 chuy\u1ec3n \u0111\u1ed5i x\u1ea3y ra sau hai n\u0103m cho th\u1ea5y:<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f3 m\u1ed1i t\u01b0\u01a1ng quan gi\u1eefa s\u1ef1 s\u1ed1ng s\u00f3t v\u1edbi s\u1ef1 c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 \u0111au th\u1eaft ng\u1ef1c trong ph\u00e2n t\u00edch \u0111i\u1ec1u tr\u1ecb, nh\u01b0ng c\u00f3 l\u1ee3i \u00edch d\u1ef1 b\u00e1o. D\u00f9 sao, c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng \u0111au th\u1eaft ng\u1ef1c l\u00e0 t\u1ed1t h\u01a1n v\u1edbi ph\u1eabu thu\u1eadt.<\/li>\n<li>K\u1ebft qu\u1ea3 x\u1ea5u h\u01a1n v\u1edbi suy tim c\u1ea5p t\u00ednh do thi\u1ebfu m\u00e1u n\u1eb7ng (EF &lt;27%) v\u00e0 th\u1ec3 t\u00edch th\u1ea5t tr\u00e1i l\u1edbn h\u01a1n LV&gt; 79 mL\/m2, nh\u01b0ng c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 n\u00e0y kh\u00f4ng d\u1ef1 b\u00e1o t\u1ef7 l\u1ec7 t\u1eed vong c\u1ee7a CABG, do \u0111\u00f3 c\u00f3 l\u1ee3i \u00edch l\u1edbn h\u01a1n v\u1edbi CABG \u0111\u01b0\u1ee3c ghi nh\u1eadn \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/li>\n<li>M\u1ed9t k\u1ebft qu\u1ea3 th\u1eed nghi\u1ec7m STICH kh\u00e1c l\u00e0 kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t trong k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt n\u1ebfu kh\u1ea3 n\u0103ng t\u1ed3n t\u1ea1i c\u1ee7a c\u01a1 tim c\u00f2n l\u1ea1i \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh hay kh\u00f4ng v\u00e0 th\u1ef1c t\u1ebf, quan s\u00e1t n\u00e0y kh\u00f4ng ph\u1ee5 thu\u1ed9c v\u00e0o chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<p>K\u1ebft lu\u1eadn l\u00e0 kh\u1ea3 n\u0103ng t\u1ed3n t\u1ea1i c\u1ee7a c\u01a1 tim c\u00f2n s\u1ed1ng d\u1ef1 b\u00e1o l\u1ee3i \u00edch v\u1ec1 s\u1ef1 s\u1ed1ng s\u00f3t \u1edf b\u1ec7nh nh\u00e2n suy tim trung b\u00ecnh, nh\u01b0ng m\u1ea5t \u0111i l\u1ee3i \u00edch d\u1ef1 b\u00e1o khi suy tim tr\u1edf n\u00ean n\u1eb7ng.<\/p>\n<h2><strong>5.T\u00f3m t\u1eaft l\u1ea1i v\u1ec1 ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh.<\/strong><\/h2>\n<p>B\u1ec7nh m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd tim m\u1ea1ch ph\u1ed5 bi\u1ebfn, \u0111\u01b0\u1ee3c g\u00e2y ra b\u1edfi s\u1ef1 t\u00edch t\u1ee5 c\u1ee7a c\u00e1c m\u1ea3ng b\u00e1m tr\u00ean b\u1ec1 m\u1eb7t c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, g\u00e2y ra s\u1ef1 suy gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u v\u00e0 l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng cung c\u1ea5p oxy cho c\u01a1 tim. Ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh l\u00e0 m\u1ed9t trong nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 c\u1ea3i thi\u1ec7n l\u01b0u l\u01b0\u1ee3ng m\u00e1u \u0111\u1ebfn c\u01a1 tim. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt bao g\u1ed3m CABG (ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u m\u1ea1ch v\u00e0nh) v\u00e0 PCI (can thi\u1ec7p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh qua da).<\/p>\n<p>CABG \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec1u \u0111\u1ed9ng m\u1ea1ch b\u1ecb t\u1eafc ngh\u1ebdn ho\u1eb7c \u0111\u1ed9 t\u1eafc ngh\u1ebdn nghi\u00eam tr\u1ecdng. Trong qu\u00e1 tr\u00ecnh CABG, m\u1ed9t \u0111\u1ed9ng m\u1ea1ch \u0111\u01b0\u1ee3c l\u1ea5y t\u1eeb m\u1ed9t v\u1ecb tr\u00ed kh\u00e1c tr\u00ean c\u01a1 th\u1ec3 v\u00e0 \u0111\u01b0\u1ee3c \u0111\u1eb7t qua \u0111\u1ed9ng m\u1ea1ch b\u1ecb t\u1eafc ngh\u1ebdn \u0111\u1ec3 cung c\u1ea5p m\u00e1u cho c\u01a1 tim.<\/p>\n<p>PCI \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ed9 t\u1eafc ngh\u1ebdn nh\u1eb9 ho\u1eb7c trung b\u00ecnh. Trong qu\u00e1 tr\u00ecnh PCI, m\u1ed9t stent \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o \u0111\u1ed9ng m\u1ea1ch b\u1ecb t\u1eafc ngh\u1ebdn \u0111\u1ec3 gi\u00fap m\u1edf r\u1ed9ng v\u00e0 duy tr\u00ec l\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u1ed1t h\u01a1n \u0111\u1ebfn c\u01a1 tim.<\/p>\n<p>Ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi c\u00e1c b\u00e1c s\u0129 \u00a0ph\u1eabu thu\u1eadt tim m\u1ea1ch. Tuy nhi\u00ean, nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh tim m\u1ea1ch ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c khuy\u00ean d\u00f9ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u00f2ng ng\u1eeba \u0111\u1ec3 gi\u1ea3m nguy c\u01a1 m\u1eafc b\u1ec7nh m\u1ea1ch v\u00e0nh.<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/\"><strong>B\u1ec7nh vi\u1ec7n \u0110a khoa Qu\u1ed1c t\u1ebf Vinmec<\/strong><\/a> \u0111\u00e3 \u0111\u01b0a h\u1ec7 th\u1ed1ng m\u00e1y m\u00f3c, thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i \u0111\u1ea1t chu\u1ea9n v\u00e0o c\u00f4ng t\u00e1c th\u0103m kh\u00e1m, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 c\u00e1c b\u1ec7nh l\u00fd tim m\u1ea1ch, \u0111\u1eb7c bi\u1ec7t ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (CAD) l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn ti\u1ebfn tri\u1ec3n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa.C\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng gi\u1eefa cung c\u1ea5p oxy v\u00e0 nhu c\u1ea7u oxy d\u1eabn \u0111\u1ebfn s\u1ef1 kh\u00f4ng \u0111\u1ee7 l\u01b0u th\u00f4ng c\u01a1 tim \u0111\u1ec3 \u0111\u00e1p [&hellip;]<\/p>\n","protected":false},"author":7,"featured_media":2553,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.\" \/>\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=\"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-10T12:12:04+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-13T09:44:01+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/en3552214.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"300\" \/>\n\t<meta property=\"og:image:height\" content=\"300\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\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=\"6 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/\",\"url\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/\",\"name\":\"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec\",\"isPartOf\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-04-10T12:12:04+00:00\",\"dateModified\":\"2023-04-13T09:44:01+00:00\",\"author\":{\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629\"},\"description\":\"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.\",\"breadcrumb\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"http:\/\/noithathoaphat.in\/ctv\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn\"}]},{\"@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":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec","description":"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.","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":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec","og_description":"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.","og_url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/","og_site_name":"Vinmec","article_published_time":"2023-04-10T12:12:04+00:00","article_modified_time":"2023-04-13T09:44:01+00:00","og_image":[{"width":300,"height":300,"url":"https:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/en3552214.jpg","type":"image\/jpeg"}],"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":"6 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/","url":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/","name":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn - Vinmec","isPartOf":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#website"},"datePublished":"2023-04-10T12:12:04+00:00","dateModified":"2023-04-13T09:44:01+00:00","author":{"@id":"http:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/dded5c0d4cb1bb77d05cf29ab5f85629"},"description":"B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a qu\u00e1 tr\u00ecnh t\u1eafc ngh\u1ebdn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch v\u00e0nh do \u0111\u1ed9ng m\u1ea1ch x\u01a1 v\u1eefa. Ch\u1ec9 \u0111\u1ecbnh can thi\u1ec7p trong b\u00e0i vi\u1ebft.","breadcrumb":{"@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/10\/tom-tat-ve-phau-thuat-benh-dong-mach-vanh-nguoi-lon\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"http:\/\/noithathoaphat.in\/ctv\/"},{"@type":"ListItem","position":2,"name":"Quy tr\u00ecnh ph\u1eabu thu\u1eadt b\u1ec7nh m\u1ea1ch v\u00e0nh ng\u01b0\u1eddi l\u1edbn"}]},{"@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\/2543"}],"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=2543"}],"version-history":[{"count":7,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2543\/revisions"}],"predecessor-version":[{"id":20076,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/posts\/2543\/revisions\/20076"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media\/2553"}],"wp:attachment":[{"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/media?parent=2543"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/categories?post=2543"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/noithathoaphat.in\/ctv\/index.php\/wp-json\/wp\/v2\/tags?post=2543"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}