{"id":25495,"date":"2023-04-21T16:09:07","date_gmt":"2023-04-21T09:09:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25495"},"modified":"2023-04-21T18:04:37","modified_gmt":"2023-04-21T11:04:37","slug":"tong-quan-ve-chan-doan-va-dieu-tri-benh-phu-phoi-cap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/tong-quan-ve-chan-doan-va-dieu-tri-benh-phu-phoi-cap\/","title":{"rendered":"T\u1ed5ng quan v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u00f9 ph\u1ed5i c\u1ea5p"},"content":{"rendered":"<p><strong>Ph\u00f9 ph\u1ed5i c\u1ea5p l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1, c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng t\u1edbi t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c k\u1ecbp th\u1eddi ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb. Trong b\u00e0i vi\u1ebft d\u1ee9oi \u0111\u00e2y, ch\u00fang ta s\u1ebd c\u00f9ng t\u00ecm hi\u1ec3u t\u1ed5ng quan v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd n\u00e0y.<\/strong><\/p>\n<h2>1. Ph\u00f9 ph\u1ed5i c\u1ea5p l\u00e0 g\u00ec ?<\/h2>\n<p>Ph\u00f9 ph\u1ed5i c\u1ea5p l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u n\u1ed9i khoa, l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a t\u00ecnh tr\u1ea1ng c\u00f3 s\u1ef1 t\u1eadp trung b\u1ea5t th\u01b0\u1eddng c\u1ee7a d\u1ecbch b\u00ean trong ph\u1ebf nang. Qu\u00e1 tr\u00ecnh n\u00e0y g\u00e2y c\u1ea3n tr\u1edf cho vi\u1ec7c trao \u0111\u1ed5i kh\u00ed t\u1ea1i ph\u1ebf nang, ti\u1ebfn tri\u1ec3n nhanh v\u00e0 c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p tr\u00ean l\u00e2m s\u00e0ng.<\/p>\n<h2>2. Sinh b\u1ec7nh h\u1ecdc ph\u00f9 ph\u1ed5i c\u1ea5p.<\/h2>\n<ul>\n<li><em>Ph\u00f9 ph\u1ed5i c\u1ea5p<\/em> c\u00f3 th\u1ec3 th\u1ec3 chia th\u00e0nh 2 lo\u1ea1i: do tim tim (p<em>h\u00f9 ph\u1ed5i c\u1ea5p huy\u1ebft \u0111\u1ed9ng<\/em>) v\u00e0 kh\u00f4ng do tim (p<em>h\u00f9 ph\u1ed5i c\u1ea5p t\u1ed5n th\u01b0\u01a1ng<\/em>).<\/li>\n<li>Ph\u00f9 ph\u1ed5i do tim (<em>ph\u00f9 ph\u1ed5i c\u1ea5p huy\u1ebft \u0111\u1ed9ng<\/em>) hay ph\u00f9 ph\u1ed5i do qu\u00e1 t\u1ea3i d\u1ecbch g\u00e2y ra b\u1edfi s\u1ef1 t\u0103ng l\u00ean nhanh c\u1ee7a \u00e1p l\u1ef1c thu\u1ef7 t\u0129nh trong l\u00f2ng mao m\u1ea1ch ph\u1ed5i. Lo\u1ea1i n\u00e0y \u0111\u1eb7c tr\u01b0ng trong r\u1ed1i lo\u1ea1n li\u00ean quan t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m thu v\u00e0 t\u00e2m tr\u01b0\u01a1ng th\u1ea5t tr\u00e1i, b\u1ea5t th\u01b0\u1eddng van tim (h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\/van hai l\u00e1, h\u1eb9p van \u1edf m\u1ee9c \u0111\u1ed9 v\u1eeba \u0111\u1ebfn n\u1eb7ng) v\u00e0 lo\u1ea1n nh\u1ecbp ( c\u01a1n lo\u1ea1n nh\u1ecbp nhanh ) .<\/li>\n<li>Ph\u00f9 ph\u1ed5i c\u1ea5p kh\u00f4ng do tim (<em>Ph\u00f9 ph\u1ed5i c\u1ea5p t\u1ed5n th\u01b0\u01a1ng<\/em>) l\u00e0 k\u1ebft qu\u1ea3 c\u1ee7a s\u1ef1 t\u0103ng t\u00ednh th\u1ea5m th\u00e0nh m\u1ea1ch ph\u1ed5i d\u1eabn \u0111\u1ebfn s\u1ef1 d\u1ecbch chuy\u1ec3n c\u1ee7a ch\u1ea5t l\u1ecfng gi\u00e0u protein, \u0111\u1ebfn c\u00e1c ph\u1ebf nang v\u00e0 kho\u1ea3ng k\u1ebd. T\u1ed5n th\u01b0\u01a1ng ph\u1ed5i c\u1ea5p t\u00ednh v\u1edbi t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy nghi\u00eam tr\u1ecdng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng suy h\u00f4 h\u1ea5p c\u1ea5p t\u00ednh (ARDS) v\u00e0 g\u00f3p m\u1eb7t trong trong nhi\u1ec1u t\u00ecnh tr\u1ea1ng \u1ea3nh h\u01b0\u1edfng tr\u1ef1c ti\u1ebfp \u0111\u1ebfn ph\u1ed5i, ch\u1eb3ng h\u1ea1n nh\u01b0 vi\u00eam ph\u1ed5i, t\u1ed5n \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p ho\u1eb7c gi\u00e1n ti\u1ebfp, ch\u1eb3ng h\u1ea1n nh\u01b0 nhi\u1ec5m tr\u00f9ng huy\u1ebft, vi\u00eam t\u1ee5y c\u1ea5p, ch\u1ea5n th\u01b0\u01a1ng n\u1eb7ng k\u00e8m theo s\u1ed1c.\n<p><figure id=\"attachment_25576\" aria-describedby=\"caption-attachment-25576\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-25576\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phu-phoi-cap-300x241.jpg\" alt=\"Minh-hoa-phu-phoi-cap\" width=\"300\" height=\"241\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phu-phoi-cap-300x241.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/phu-phoi-cap.jpg 640w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-25576\" class=\"wp-caption-text\">\u1ea2nh minh h\u1ecda<\/figcaption><\/figure><\/li>\n<\/ul>\n<h2>3. Sinh l\u00fd b\u1ec7nh<\/h2>\n<ul>\n<li><span class=\"Y2IQFc\" lang=\"vi\">H\u1eadu qu\u1ea3 c\u1ee7a vi\u1ec7c t\u0103ng h\u00e0m l\u01b0\u1ee3ng d\u1ecbch ngo\u00e0i l\u00f2ng m\u1ea1ch trong ph\u1ed5i l\u00e0 chung \u0111\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 c\u00e1c d\u1ea1ng ph\u00f9 ph\u1ed5i. Tuy nhi\u00ean, c\u01a1 ch\u1ebf c\u01a1 b\u1ea3n d\u1eabn \u0111\u1ebfn ph\u00f9 ph\u1ed5i ph\u00e1t sinh t\u1eeb s\u1ef1 r\u1ed1i lo\u1ea1n c\u1ee7a c\u00e1c qu\u00e1 tr\u00ecnh sinh l\u00fd ph\u1ee9c t\u1ea1p kh\u00e1c nhau, g\u00e2y ra s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng c\u1ee7a qu\u00e1 tr\u00ecnh l\u1ecdc c\u1ee7a d\u1ecbch v\u00e0 c\u00e1c ch\u1ea5t h\u00f2a tan qua m\u00e0ng mao m\u1ea1ch ph\u1ed5i. S\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng n\u00e0y c\u00f3 th\u1ec3 l\u00e0 do m\u1ed9t ho\u1eb7c nhi\u1ec1u y\u1ebfu t\u1ed1 sau g\u00e2y ra:<\/span><\/li>\n<\/ul>\n<p>&#8211; <span class=\"Y2IQFc\" lang=\"vi\">T\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng mao m\u1ea1ch ph\u1ed5i hay t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/span><\/p>\n<p>&#8211; <span class=\"Y2IQFc\" lang=\"vi\">T\u0103ng \u00e1p su\u1ea5t th\u1ee7y t\u0129nh c\u1ee7a kho\u1ea3ng k\u1ebd.<\/span><\/p>\n<p>&#8211; <span class=\"Y2IQFc\" lang=\"vi\">T\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u00f4 v\u00e0 ph\u00e1 v\u1ee1 h\u00e0ng r\u00e0o bi\u1ec3u m\u00f4.<\/span><\/p>\n<p>&#8211; <span class=\"Y2IQFc\" lang=\"vi\">Gi\u1ea3m \u00e1p l\u1ef1c keo huy\u1ebft t\u01b0\u01a1ng do suy gan, suy th\u1eadn, suy dinh d\u01b0\u1ee1ng v\u00e0 c\u00e1c t\u00ecnh tr\u1ea1ng m\u1ea5t protein kh\u00e1c.<\/span><\/p>\n<p>&#8211; <span class=\"Y2IQFc\" lang=\"vi\">T\u0103ng \u00e1p l\u1ef1c \u00e2m c\u1ee7a kho\u1ea3ng k\u1ebd.\u00a0<\/span><\/p>\n<p>&#8211; Suy tu\u1ea7n ho\u00e0n b\u1ea1ch m\u1ea1ch.<\/p>\n<p>&#8211; T\u0103ng g\u00e1nh th\u1ec3 t\u00edch do t\u0103ng \u0111\u1ed9t ng\u1ed9t ti\u1ec1n g\u00e1nh.<\/p>\n<h2>4. Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p><strong>4.1. Ph\u00f9 ph\u1ed5i c\u1ea5p huy\u1ebft \u0111\u1ed9ng:<\/strong><\/p>\n<p>4.1.1. L\u00e2m s\u00e0ng<\/p>\n<ul>\n<li>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:<\/li>\n<\/ul>\n<p>&#8211; Bu\u1ed3n n\u00f4n, ng\u1ed9t ng\u1ea1t, t\u1ee9c ng\u1ef1c, lo \u00e2u<\/p>\n<p>&#8211; Kh\u00f3 th\u1edf nhanh, co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p<\/p>\n<p>&#8211; T\u00edm, \u0111\u1ea7u chi l\u1ea1nh, v\u00e3 m\u1ed3 h\u00f4i, ho kh\u1ea1c b\u1ecdt h\u1ed3ng.<\/p>\n<p>&#8211; T\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf xu\u1ea5t hi\u1ec7n v\u00e0 t\u0103ng l\u00ean r\u1ea5t nhanh.<\/p>\n<ul>\n<li>D\u1ea5u hi\u1ec7u th\u1ef1c th\u1ec3<\/li>\n<\/ul>\n<p>&#8211; M\u1ea1ch nhanh<\/p>\n<p>&#8211; Huy\u1ebft \u00e1p th\u01b0\u1eddng t\u0103ng, khi suy h\u00f4 h\u1ea5p qu\u00e1 n\u1eb7ng b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 t\u1ee5t huy\u1ebft \u00e1p<\/p>\n<p>&#8211; Nghe ph\u1ed5i ran \u1ea9m t\u0103ng nhanh t\u1eeb \u0111\u00e1y ph\u1ed5i d\u00e2ng l\u00ean \u0111\u1ec9nh ph\u1ed5i.<\/p>\n<p>4.1.2. C\u1eadn l\u00e2m s\u00e0ng<\/p>\n<ul>\n<li>\u0110i\u1ec7n tim<\/li>\n<\/ul>\n<p>&#8211; C\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh b\u1ec7nh l\u00fd: Nh\u1ed3i m\u00e1u c\u01a1 tim, lo\u1ea1n nh\u1ecbp nhanh.<\/p>\n<p>&#8211; Th\u01b0\u1eddng g\u1eb7p d\u1ea5u hi\u1ec7u th\u1ee9 ph\u00e1t: Nh\u1ecbp nhanh th\u1ee9 ph\u00e1t do gi\u1ea3m oxy m\u00e1u hay do suy tim, r\u1ed1i lo\u1ea1n t\u00e1i c\u1ef1c th\u1ee9 ph\u00e1t sau t\u0103ng huy\u1ebft \u00e1p, ho\u1eb7c d\u1ea5u hi\u1ec7u ph\u00ec \u0111\u1ea1i nh\u0129 v\u00e0 th\u1ea5t tr\u00e1i \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 t\u0103ng huy\u1ebft \u00e1p c\u0169.<\/p>\n<ul>\n<li>X quang tim ph\u1ed5i:<\/li>\n<\/ul>\n<p>&#8211; H\u00ecnh \u1ea3nh nhi\u1ec1u \u0111\u00e1m m\u1edd \u1edf 2 ph\u1ed5i, nhi\u1ec1u \u1edf hai r\u1ed1n v\u00e0 \u0111\u00e1y ph\u1ed5i.<\/p>\n<p>&#8211; Ph\u1ed5i m\u1edd h\u00ecnh c\u00e1nh b\u01b0\u1edbm.<\/p>\n<p>&#8211; Ph\u1ed5i tr\u1eafng hay g\u1eb7p trong ph\u00f9 ph\u1ed5i.<\/p>\n<ul>\n<li>Kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch: Giai \u0111o\u1ea1n s\u1edbm PaO2 v\u00e0 PaCO2 ch\u1ec9 gi\u1ea3m nh\u1eb9, giai \u0111o\u1ea1n n\u1eb7ng gi\u1ea3m oxy n\u1eb7ng v\u00e0 t\u0103ng CO2, toan h\u00f3a.<\/li>\n<li>Si\u00eau \u00e2m tim: C\u00f3 th\u1ec3 th\u1ea5y h\u00ecnh \u1ea3nh b\u1ec7nh nguy\u00ean nh\u00e2n: Gi\u1ea3m v\u1eadn \u0111\u1ed9ng th\u00e0nh tim trong nh\u1ed3i m\u00e1u c\u01a1 tim, c\u00e1c b\u1ec7nh van tim, b\u1ec7nh c\u01a1 tim gi\u00e3n.<\/li>\n<\/ul>\n<p><strong>4.2. Ph\u00f9 ph\u1ed5i c\u1ea5p t\u1ed5n th\u01b0\u01a1ng\u00a0<\/strong><\/p>\n<p>4.2.1. L\u00e2m s\u00e0ng<\/p>\n<ul>\n<li>Bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a ph\u00f9 ph\u1ed5i c\u1ea5p t\u1ed5n th\u01b0\u01a1ng r\u1ea5t thay \u0111\u1ed5i. Suy h\u00f4 h\u1ea5p ti\u1ebfn tri\u1ec3n t\u1eeb t\u1eeb, th\u01b0\u1eddng n\u1eb7ng v\u00e0o ng\u00e0y th\u1ee9 3 c\u1ee7a b\u1ec7nh, t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p kh\u00f4ng c\u1ea3i thi\u1ec7n v\u1edbi oxy 100%. Kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u suy tim tr\u00e1i.<\/li>\n<\/ul>\n<p>4.2.2. C\u1eadn l\u00e2m s\u00e0ng<\/p>\n<p>&#8211; Xquang tim ph\u1ed5i: H\u00ecnh \u1ea3nh m\u1edd kho\u1ea3ng k\u1ebd lan t\u1ecfa, c\u00f3 th\u1ec3 g\u1eb7p h\u00ecnh \u1ea3nh ph\u1ed5i tr\u1eafng.<\/p>\n<p>&#8211; Kh\u00ed m\u00e1u PaO2 gi\u1ea3m, SaO2 gi\u1ea3m ho\u1eb7c b\u00ecnh th\u01b0\u1eddng, PaO2\/FiO2 &lt; 200<\/p>\n<p>&#8211; Huy\u1ebft \u0111\u1ed9ng: CVP b\u00ecnh th\u01b0\u1eddng, PCWP b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>&#8211; XN kh\u00e1c: Protid m\u00e1u h\u1ea1; Protein d\u1ecbch ph\u00f9\/ Protein huy\u1ebft t\u01b0\u01a1ng &gt; 0,6 ; \u00e1p l\u1ef1c keo huy\u1ebft t\u01b0\u01a1ng h\u1ea1.<\/p>\n<h2>5. \u0110i\u1ec1u tr\u1ecb<\/h2>\n<p><strong>5.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n<ul>\n<li>Nhanh ch\u00f3ng, kh\u1ea9n tr\u01b0\u01a1ng (\u0111\u00e2y l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u n\u1ed9i khoa)<\/li>\n<li>V\u1edbi suy h\u00f4 h\u1ea5p nguy k\u1ecbch \u0111e d\u1ecda t\u00ednh m\u1ea1ng c\u1ea7n can thi\u1ec7p th\u1ee7 thu\u1eadt tr\u01b0\u1edbc, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c sau.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n g\u00e2y ph\u00f9 ph\u1ed5i c\u1ea5p v\u00e0 c\u00e1c \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 kh\u00e1c<\/li>\n<\/ul>\n<p><strong>5.2. Ph\u00e1c \u0111\u1ed3<\/strong><\/p>\n<ul>\n<li>T\u01b0 th\u1ebf BN: N\u1ebfu kh\u00f4ng c\u00f3 t\u1ee5t huy\u1ebft \u00e1p, \u0111\u1eb7t b\u1ec7nh nh\u00e2n \u1edf t\u01b0 th\u1ebf Fowler \u0111\u1ec3 h\u1ea1n ch\u1ebf m\u00e1u t\u1eeb t\u0129nh m\u1ea1ch tr\u1edf v\u1ec1.<\/li>\n<li>\u0110\u1ea3m b\u1ea3o ch\u1ee9c n\u0103ng h\u00f4 h\u1ea5p<\/li>\n<\/ul>\n<p>&#8211; N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f2n t\u1ec9nh, h\u1ee3p t\u00e1c t\u1ed1t: Cho th\u1edf oxy li\u1ec1u cao qua mask l\u01b0u l\u01b0\u1ee3ng 6-10 l\u00edt\/ph\u00fat<\/p>\n<p>&#8211; N\u1ebfu t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy kh\u00f4ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n: Cho b\u1ec7nh nh\u00e2n <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/tho-may-khong-xam-nhap-ncpap-va-bipap\/\">th\u1edf m\u00e1y kh\u00f4ng x\u00e2m nh\u1eadp<\/a> ( v\u1edbi CPAP b\u1eaft \u0111\u1ea7u l\u00e0 4-5 cmH2O, t\u0103ng d\u1ea7n 2 cmH2O\/l\u1ea7n cho t\u1edbi khi t\u00ecm \u0111\u01b0\u1ee3c m\u1ee9c CPAP th\u00edch h\u1ee3p ho\u1eb7c BiPAP ). Ngo\u00e0i t\u00e1c d\u1ee5ng t\u0103ng trao \u0111\u1ed5i oxy t\u1ea1i ph\u1ed5i, th\u1edf m\u00e1y c\u00f2n l\u00e0m gi\u1ea3m ti\u1ec1n g\u00e1nh v\u00e0 h\u1eadu g\u00e1nh c\u1ee7a th\u1ea5t tr\u00e1i.<\/p>\n<p>&#8211; N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c: \u0110\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n th\u1edf m\u00e1y x\u00e2m nh\u1eadp v\u1edbi PEEP.<\/p>\n<p>&#8211; N\u1ebfu c\u00f3 d\u1ea5u hi\u1ec7u co th\u1eaft ph\u1ebf qu\u1ea3n, c\u00f3 th\u1ec3 d\u00f9ng thu\u1ed1c gi\u1eabn ph\u1ebf qu\u1ea3n nh\u01b0 aminophylin ti\u00eam t\u0129nh m\u1ea1ch.<\/p>\n<ul>\n<li>Gi\u1ea3m ti\u1ec1n g\u00e1nh:<\/li>\n<\/ul>\n<p>&#8211; <a href=\"https:\/\/www.vinmec.com\/vi\/tim-mach\/thong-tin-suc-khoe\/tim-hieu-ve-thuoc-tim-mach-nitroglycerin\/\">Nitroglycerin<\/a><\/p>\n<p>&#8211; <a href=\"https:\/\/www.vinmec.com\/vi\/thong-tin-duoc\/su-dung-thuoc-toan\/tim-hieu-ve-thuoc-loi-tieu-quai\/\">L\u1ee3i ti\u1ec3u Lasix<\/a><\/p>\n<p>&#8211; Morphin<\/p>\n<ul>\n<li>Gi\u1ea3m h\u1eadu g\u00e1nh<\/li>\n<\/ul>\n<p>&#8211; N\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 t\u0103ng huy\u1ebft \u00e1p, t\u1ed1t nh\u1ea5t l\u00e0 d\u00f9ng thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p lo\u1ea1i truy\u1ec1n t\u0129nh m\u1ea1ch c\u00f3 t\u00e1c d\u1ee5ng nhanh, ng\u1eafn: Nitroglycerin, Nicardipin, Nitroprussid.<\/p>\n<ul>\n<li>Tr\u1ee3 tim: S\u1eed d\u1ee5ng Dobutamin ho\u1eb7c Digoxin<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb sau c\u1ea5p c\u1ee9u: H\u1ea1n ch\u1ebf d\u1ecbch v\u00e0o c\u01a1 th\u1ec3 b\u1ec7nh nh\u00e2n, \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n g\u00e2y ph\u00f9 ph\u1ed5i c\u1ea5p.<\/li>\n<\/ul>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u:<\/p>\n<ol>\n<li>B\u1ec7nh h\u1ecdc N\u1ed9i khoa \u0110\u1ea1i h\u1ecdc Y H\u00e0 N\u1ed9i 2020<\/li>\n<li>PubMed: <span class=\"title\">Pulmonary Edema<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ph\u00f9 ph\u1ed5i c\u1ea5p l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1, c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng t\u1edbi t\u00ednh m\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c k\u1ecbp th\u1eddi ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb. Trong b\u00e0i vi\u1ebft d\u1ee9oi \u0111\u00e2y, ch\u00fang ta s\u1ebd c\u00f9ng t\u00ecm hi\u1ec3u t\u1ed5ng quan v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd n\u00e0y. 1. Ph\u00f9 [&hellip;]<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>T\u1ed5ng quan v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh ph\u00f9 ph\u1ed5i c\u1ea5p - Vinmec<\/title>\n<meta name=\"description\" content=\"Ph\u00f9 ph\u1ed5i c\u1ea5p l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd n\u1eb7ng n\u1ec1. 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