{"id":25640,"date":"2023-04-20T19:00:02","date_gmt":"2023-04-20T12:00:02","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25640"},"modified":"2023-04-21T14:35:24","modified_gmt":"2023-04-21T07:35:24","slug":"dot-quy-thieu-mau-nao-phan-loai-sinh-ly-va-giai-phau-benh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/20\/dot-quy-thieu-mau-nao-phan-loai-sinh-ly-va-giai-phau-benh\/","title":{"rendered":"\u0110\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o: Ph\u00e2n lo\u1ea1i, sinh l\u00fd v\u00e0 gi\u1ea3i ph\u1eabu b\u1ec7nh"},"content":{"rendered":"

\u0110\u1ed9t qu\u1ef5 n\u00e3o (th\u01b0\u1eddng g\u1ecdi l\u00e0 \u0111\u1ed9t qu\u1ef5 hay tai bi\u1ebfn<\/a> m\u1ea1ch n\u00e3o) c\u00f3 hai th\u1ec3 l\u00e2m s\u00e0ng ch\u00ednh: \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 c\u1ea5p t\u1ec9nh \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi s\u1ef1 m\u1ea5t l\u01b0u th\u00f4ng m\u00e1u \u0111\u1ed9t ng\u1ed9t \u0111\u1ebfn m\u1ed9t khu v\u1ef1c c\u1ee7a n\u00e3o do t\u1eafc ngh\u1ebdn m\u1ea1ch b\u1edfi huy\u1ebft kh\u1ed1i ho\u1eb7c c\u1ee5c t\u1eafc \u1edf \u0111\u1ed9ng m\u1ea1ch n\u00e3o, d\u1eabn \u0111\u1ebfn m\u1ea5t ch\u1ee9c n\u0103ng th\u1ea7n kinh t\u01b0\u01a1ng \u1ee9ng. \u0110\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o hay c\u00f2n g\u1ecdi l\u00e0 nh\u1ed3i m\u00e1u n\u00e3o (NMN) ph\u1ed5 bi\u1ebfn h\u01a1n \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o (XHN) m\u00e0 nguy\u00ean nh\u00e2n l\u00e0 do v\u1ee1 c\u00e1c \u0111\u1ed9ng m\u1ea1ch trong n\u00e3o.<\/strong><\/p>\n

\"\u0110\u1ed9t
\u0110\u1ed9t qu\u1ef5 nh\u1ed3i m\u00e1u n\u00e3o ph\u1ed5 bi\u1ebfn h\u01a1n \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o<\/figcaption><\/figure>\n

1. Ph\u00e2n lo\u1ea1i \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o<\/h2>\n

\u0110\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o c\u1ee5c b\u1ed9 c\u1ea5p t\u00ednh (acute ischemic stroke) hay c\u00f2n g\u1ecdi l\u00e0 nh\u1ed3i m\u00e1u n\u00e3o l\u00e0 t\u00ecnh tr\u1ea1ng d\u00f2ng m\u00e1u \u0111\u1ed9t ng\u1ed9t kh\u00f4ng l\u01b0u th\u00f4ng \u0111\u1ebfn m\u1ed9t khu v\u1ef1c c\u1ee7a n\u00e3o l\u00e0m m\u1ea5t ch\u1ee9c n\u0103ng th\u1ea7n kinh t\u01b0\u01a1ng \u1ee9ng (h\u00ecnh 1).<\/span><\/p>\n

<\/span><\/p>\n

H\u00ecnh 1-\u00a0<\/span><\/b>H\u00ecnh \u1ea3nh ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh cho th\u1ea5y huy\u1ebft kh\u1ed1i g\u00e2y h\u1eb9p t\u1eafc t\u1ea1i \u0111\u1ed9ng m\u1ea1ch n\u00e3o gi\u1eefa \u0111o\u1ea1n M1-2 (v\u00f2ng tr\u00f2n m\u00e0u \u0111\u1ecf)<\/span><\/p>\n

H\u1ec7 th\u1ed1ng ph\u00e2n lo\u1ea1i \u0111\u1ed9t qu\u1ef5 \u0111\u01b0\u1ee3c x\u00e2y d\u1ef1ng d\u1ef1a tr\u00ean Th\u1eed nghi\u1ec7m \u0111a trung t\u00e2m \u0111i\u1ec1u tr\u1ecb \u0111\u1ed9t qu\u1ef5 c\u1ea5p (TOAST), trong \u0111\u00f3 ph\u00e2n chia nh\u1ed3i m\u00e1u n\u00e3o th\u00e0nh 3 th\u1ec3 ch\u00ednh nh\u01b0 sau:<\/span><\/p>\n

– Nh\u1ed3i m\u00e1u n\u00e3o \u0111\u1ed9ng m\u1ea1ch l\u1edbn<\/span><\/p>\n

– Nh\u1ed3i m\u00e1u n\u00e3o \u0111\u1ed9ng m\u1ea1ch nh\u1ecf, ho\u1eb7c nh\u1ed3i m\u00e1u \u1ed5 khuy\u1ebft<\/span><\/p>\n

– Nh\u1ed3i m\u00e1u n\u00e3o do c\u1ee5c t\u1eafc di chuy\u1ec3n t\u1eeb tim<\/span><\/p>\n

Nh\u1ed3i m\u00e1u n\u00e3o \u0111\u1ed9ng m\u1ea1ch l\u1edbn th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn huy\u1ebft kh\u1ed1i h\u00ecnh th\u00e0nh tr\u00ean th\u00e0nh \u0111\u1ed9ng m\u1ea1ch b\u1ecb v\u1eefa x\u01a1, th\u01b0\u1eddng l\u00e0 \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, \u0111\u1ed9ng m\u1ea1ch s\u1ed1ng n\u1ec1n v\u00e0 \u0111\u1ed9ng m\u1ea1ch n\u00e3o; tuy nhi\u00ean, nh\u1ed3i m\u00e1u n\u00e3o \u0111\u1ed9ng m\u1ea1ch l\u1edbn c\u0169ng c\u00f3 th\u1ec3 do huy\u1ebft kh\u1ed1i ho\u1eb7c c\u1ee5c t\u1eafc t\u1eeb tim v\u00e0 \u0111\u00e2y c\u0169ng l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t g\u00e2y t\u00e1i ph\u00e1t nh\u1ed3i m\u00e1u n\u00e3o.<\/span><\/p>\n

Nh\u1ed3i m\u00e1u \u1ed5 khuy\u1ebft do t\u1eafc m\u1ea1ch nh\u1ecf (th\u01b0\u1eddng l\u00e0 nh\u1eefng \u0111\u1ed9ng m\u1ea1ch xuy\u00ean n\u1eb1m s\u00e2u trong n\u00e3o) m\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng do b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u. Nhi\u1ec1u khi kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n g\u00e2y nh\u1ed3i m\u00e1u n\u00e3o v\u00e0 \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o lo\u1ea1i nh\u1ed3i m\u00e1u n\u00e3o kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.<\/span><\/p>\n

2. Gi\u1ea3i ph\u1eabu b\u1ec7nh \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o<\/h2>\n

N\u00e3o l\u00e0 c\u01a1 quan c\u00f3 ho\u1ea1t \u0111\u1ed9ng chuy\u1ec3n h\u00f3a cao nh\u1ea5t trong c\u01a1 th\u1ec3. M\u1eb7c d\u00f9 ch\u1ec9 chi\u1ebfm 2% kh\u1ed1i l\u01b0\u1ee3ng c\u1ee7a c\u01a1 th\u1ec3, nh\u01b0ng n\u00f3 c\u1ea7n 15-20% t\u1ed5ng cung l\u01b0\u1ee3ng tim l\u00fac ngh\u1ec9 \u0111\u1ec3 cung c\u1ea5p glucose v\u00e0 oxy c\u1ea7n thi\u1ebft cho qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i ch\u1ea5t.<\/span><\/p>\n

C\u00e1c b\u00e1n c\u1ea7u n\u00e3o \u0111\u01b0\u1ee3c c\u1ea5p m\u00e1u b\u1edfi s\u1ef1 k\u1ebft n\u1ed1i c\u1ee7a 3 \u0111\u1ed9ng m\u1ea1ch ch\u00ednh, c\u1ea7n \u0111\u1eb7c bi\u1ec7t ghi nh\u1edb l\u00e0 c\u00e1c \u0111\u1ed9ng m\u1ea1ch n\u00e3o tr\u01b0\u1edbc, n\u00e3o gi\u1eefa v\u00e0 n\u00e3o sau.<\/span><\/p>\n

C\u00e1c \u0111\u1ed9ng m\u1ea1ch n\u00e3o tr\u01b0\u1edbc v\u00e0 gi\u1eefa \u0111\u1ea3m b\u1ea3o tu\u1ea7n ho\u00e0n ph\u00eda tr\u01b0\u1edbc, nguy\u00ean \u1ee7y l\u00e0 c\u00e1c \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh trong. \u0110\u1ed9ng m\u1ea1ch n\u00e3o tr\u01b0\u1edbc c\u1ea5p m\u00e1u cho ph\u1ea7n gi\u1eefa c\u1ee7a th\u00f9y tr\u00e1n v\u00e0 th\u00f9y \u0111\u1ec9nh v\u00e0 c\u00e1c ph\u1ea7n tr\u01b0\u1edbc c\u1ee7a h\u1ea1ch n\u1ec1n v\u00e0 bao trong.<\/span><\/p>\n

<\/span><\/p>\n

C\u00e1c \u0111\u1ed9ng m\u1ea1ch \u0111\u1ed1t s\u1ed1ng tham gia t\u1ea1o th\u00e0nh \u0111\u1ed9ng m\u1ea1ch n\u1ec1n. C\u00e1c \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o sau (PICAs) ph\u00e1t sinh t\u1eeb c\u00e1c \u0111\u1ed9ng m\u1ea1ch \u0111\u1ed1t s\u1ed1ng xa. C\u00e1c \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o tr\u01b0\u1edbc d\u01b0\u1edbi (AICAs) ph\u00e1t sinh t\u1eeb \u0111o\u1ea1n g\u1ea7n c\u1ee7a \u0111\u1ed9ng m\u1ea1ch n\u1ec1n. C\u00e1c \u0111\u1ed9ng m\u1ea1ch ti\u1ec3u n\u00e3o tr\u00ean (SCA) ph\u00e1t sinh xa t\u1eeb \u0111o\u1ea1n xa c\u1ee7a \u0111\u1ed9ng m\u1ea1ch n\u1ec1n tr\u01b0\u1edbc khi ph\u00e2n chia th\u00e0nh c\u00e1c \u0111\u1ed9ng m\u1ea1ch n\u00e3o sau (PCAs)<\/span><\/p>\n

B\u1ea3ng 1 – Gi\u1ea3i ph\u1eabu m\u1ea1ch m\u00e1u nu\u00f4i n\u00e3o<\/span><\/b><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
V\u00f9ng m\u1ea1ch m\u00e1u<\/span><\/td>\nC\u1ea5u tr\u00fac \u0111\u01b0\u1ee3c nu\u00f4i d\u01b0\u1ee1ng<\/span><\/td>\n<\/tr>\n
Tu\u1ea7n ho\u00e0n tr\u01b0\u1edbc (h\u1ec7 c\u1ea3nh)<\/span><\/i><\/td>\n<\/tr>\n
\n

\u0110M n\u00e3o tr\u01b0\u1edbc<\/span><\/p>\n<\/td>\n

Nh\u00e1nh v\u1ecf n\u00e3o: tr\u00e1n gi\u1eefa, th\u00f9y \u0111\u1ec9nh<\/span><\/p>\n

Nh\u00e1nh xi\u00ean b\u00e8o v\u00e2n: \u0111\u1ea7u nh\u00e2n \u0111u\u00f4i, nh\u00e2n b\u00e8o, c\u00e1nh tay tr\u01b0\u1edbc bao trong<\/span><\/td>\n<\/tr>\n

\n

\u0110M n\u00e3o gi\u1eefa<\/span><\/p>\n<\/td>\n

Nh\u00e1nh v\u1ecf n\u00e3o: V\u00f9ng tr\u00e1n b\u00ean, v\u00e0 th\u00f9y \u0111\u1ec9nh, v\u00f9ng tr\u01b0\u1edbc va b\u00ean th\u00f9y th\u00e1i d\u01b0\u01a1ng<\/span><\/p>\n

Nh\u00e1nh xi\u00ean b\u00e8o v\u00e2n: Nh\u00e2n b\u00e8o x\u1ea5m v\u00e0 nh\u1ea1t, bao trong<\/span><\/td>\n<\/tr>\n

\n

\u0110M m\u1ea1ch m\u1ea1c tr\u01b0\u1edbc<\/span><\/p>\n<\/td>\n

D\u1ea3i th\u1ecb gi\u00e1c, th\u00e1i d\u01b0\u01a1ng trong, \u0111\u1ed3i th\u1ecb, v\u00e0nh tia, c\u00e1nh tay sau bao trong,<\/span><\/td>\n<\/tr>\n
Tu\u1ea7n ho\u00e0n sau (h\u1ec7 s\u1ed1ng n\u1ec1n)<\/span><\/i><\/td>\n<\/tr>\n
\n

\u0110M n\u00e3o sau<\/span><\/p>\n<\/td>\n

Nh\u00e1nh v\u1ecf n\u00e3o: T\u00f9y ch\u1ea9m, ph\u1ea7n sau, trong th\u00f9y th\u00e1i d\u01b0\u01a1ng, th\u00f9y \u0111\u1ec9nh<\/span><\/p>\n

Nh\u00e1nh xi\u00ean: T\u00e2n n\u00e3o, \u0111\u1ed3i th\u1ecb ph\u1ea7n sau, v\u00e0 gi\u1eefa<\/span><\/td>\n<\/tr>\n

\n

\u0110M ti\u1ec3u n\u00e3o sau d\u01b0\u1edbi<\/span><\/p>\n<\/td>\n

Th\u00f9y nh\u1ed9ng d\u01b0\u1edbi, ph\u1ea7n sau d\u01b0\u1edbi b\u00e1n c\u1ea7u ti\u1ec3u n\u00e3o<\/span><\/td>\n<\/tr>\n
\n

\u0110M ti\u1ec3u n\u00e3o tr\u01b0\u1edbc d\u01b0\u1edbi<\/span><\/p>\n<\/td>\n

Ph\u1ea7n tr\u01b0\u1edbc d\u01b0\u1edbi b\u00e1n c\u1ea7u ti\u1ec3u n\u00e3o<\/span><\/td>\n<\/tr>\n
\n

\u0110M ti\u1ec3u n\u00e3o tr\u00ean<\/span><\/p>\n<\/td>\n

Ph\u1ea7n th\u00f9y nh\u1ed9ng tr\u00ean, ti\u1ec3u n\u00e3o tr\u00ean<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

3. Sinh l\u00fd b\u1ec7nh<\/h2>\n

Nh\u1ed3i m\u00e1u n\u00e3o c\u1ea5p t\u00ednh do huy\u1ebft kh\u1ed1i ho\u1eb7c c\u1ee5c t\u1eafc l\u00e0m thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, d\u1eabn \u0111\u1ebfn thi\u1ebfu oxy v\u00e0 gi\u1ea3m ATP t\u1ebf b\u00e0o, \u1ea3nh h\u01b0\u1edfng t\u1edbi s\u1ef1 ch\u00eanh l\u1ec7ch n\u1ed3ng \u0111\u1ed9 ion qua m\u00e0ng t\u1ebf b\u00e0o, g\u00e2y ph\u00f9 t\u1ebf b\u00e0o n\u00e3o.<\/span><\/p>\n

3.1. V\u00f9ng trung t\u00e2m v\u00e0 v\u00f9ng r\u00eca \u1ed5 nh\u1ed3i m\u00e1u<\/span><\/b><\/h3>\n

T\u1eafc m\u1ea1ch n\u00e3o c\u1ea5p t\u00ednh g\u00e2y ra c\u00e1c v\u00f9ng thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t. C\u00e1c v\u00f9ng c\u00f3 l\u01b0u l\u01b0\u1ee3ng m\u00e1u n\u00e3o d\u01b0\u1edbi 10 ml\/100g m\u00f4\/ph\u00fat \u0111\u01b0\u1ee3c g\u1ecdi v\u00f9ng l\u00f5i hay trung t\u00e2m \u1ed5 nh\u1ed3i m\u00e1u v\u00e0 \u1edf v\u00f9ng n\u00e0y, t\u1ebf b\u00e0o n\u00e3o s\u1ebd ho\u1ea1i t\u1eed sau v\u00e0i ph\u00fat nh\u1ed3i m\u00e1u n\u00e3o.<\/span><\/p>\n

Khu v\u1ef1c ngo\u1ea1i bi\u00ean c\u1ee7a \u1ed5 nh\u1ed3i m\u00e1u (l\u01b0u l\u01b0\u1ee3ng m\u00e1u n\u00e3o <25 mL\/100g m\u00f4\/ph\u00fat) hay c\u00f2n g\u1ecdi l\u00e0 v\u00f9ng r\u00eca \u1ed5 nh\u1ed3i m\u00e1u m\u00e0 \u1edf \u0111\u00e2y, t\u1ebf b\u00e0o n\u00e3o c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i trong v\u00e0i gi\u1edd v\u00ec v\u1eabn c\u00f2n \u0111\u01b0\u1ee3c t\u01b0\u1edbi m\u00e1u.<\/span><\/p>\n

3.2. D\u00f2ng th\u00e1c thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9<\/span><\/b><\/h3>\n

T\u1ebf b\u00e0o th\u1ea7n kinh kh\u1eed c\u1ef1c trong t\u00ecnh tr\u1ea1ng thi\u1ebfu oxy v\u00e0 kh\u00f4ng \u0111\u1ee7 ATP khi nh\u1ed3i m\u00e1u n\u00e3o g\u00e2y \u0111\u00ecnh tr\u1ec7 h\u1ec7 th\u1ed1ng v\u1eadn chuy\u1ec3n ion qua m\u00e0ng t\u1ebf b\u00e0o, t\u1eeb \u0111\u00f3 l\u00e0m r\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng c\u1ee7a b\u01a1m natri-kali, t\u0103ng natri n\u1ed9i b\u00e0o, t\u0103ng th\u1ec3 t\u00edch n\u01b0\u1edbc n\u1ed9i b\u00e0o. H\u1eadu qu\u1ea3 l\u00e0 ph\u00f9 n\u00e3o x\u1ea3y ra r\u1ea5t s\u1edbm khi thi\u1ebfu m\u00e1u n\u00e3o.<\/span><\/p>\n

B\u00ean c\u1ea1nh \u0111\u00f3, ho\u1ea1t \u0111\u1ed9ng trao \u0111\u1ed5i natri-canxi qua m\u00e0ng t\u1ebf b\u00e0o c\u0169ng b\u1ecb r\u1ed1i lo\u1ea1n. C\u00e1c ion can xi \u0111i v\u00e0o trong t\u1ebf b\u00e0o, gi\u1ea3i ph\u00f3ng gi\u1ea3i ph\u00f3ng m\u1ed9t s\u1ed1 ch\u1ea5t d\u1eabn truy\u1ec1n th\u1ea7n kinh nh\u01b0 glutamate, ho\u1ea1t h\u00f3a N-methyl-D-aspartate (NMDA) v\u00e0 c\u00e1c th\u1ee5 th\u1ec3 k\u00edch th\u00edch kh\u00e1c tr\u00ean c\u00e1c t\u1ebf b\u00e0o th\u1ea7n kinh, t\u1eeb \u0111\u00e2y t\u1ea1o ra m\u1ed9t v\u00f2ng xo\u1eafn b\u1ec7nh l\u00fd t\u1ea1o ra m\u1ed9t d\u00f2ng canxi kh\u1ed5ng l\u1ed3 \u0111i v\u00e0o t\u1ebf b\u00e0o v\u00e0 k\u00edch ho\u1ea1t c\u00e1c enzyme tho\u00e1i h\u00f3a kh\u00e1c nhau, d\u1eabn \u0111\u1ebfn s\u1ef1 ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o th\u1ea7n kinh. C\u00e1c g\u1ed1c t\u1ef1 do, axit arachidonic v\u00e0 oxit nitric t\u1ea1o ra l\u00e0m t\u1ebf b\u00e0o th\u1ea7n kinh t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng n\u1ec1 h\u01a1n.<\/span><\/p>\n

Thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tr\u1ef1c ti\u1ebfp ph\u00e1 h\u1ee7y h\u00e0ng r\u00e0o m\u00e1u n\u00e3o (th\u01b0\u1eddng x\u1ea3y ra trong 4 – 6 gi\u1edd sau \u0111\u1ed9t qu\u1ef5) l\u00e0m protein v\u00e0 n\u01b0\u1edbc tr\u00e0n v\u00e0o kho\u1ea3ng gian b\u00e0o g\u00e2y ph\u00f9 m\u1ea1ch, ph\u00f9 n\u00e3o, n\u1eb7ng nh\u1ea5t th\u01b0\u1eddng sau 3 – 5 ng\u00e0y v\u00e0 k\u00e9o d\u00e0i nhi\u1ec1u tu\u1ea7n n\u1ebfu n\u01b0\u1edbc v\u00e0 protein \u0111\u01b0\u1ee3c t\u00e1i h\u1ea5p thu.<\/span><\/p>\n

Trong v\u00f2ng v\u00e0i gi\u1edd \u0111\u1ebfn v\u00e0i ng\u00e0y sau \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o, c\u00e1c cytokin \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh, th\u00fac \u0111\u1ea9y qu\u00e1 tr\u00ecnh vi\u00eam v\u00e0 c\u1ea3n tr\u1edf vi tu\u1ea7n ho\u00e0n. V\u00f9ng ngo\u1ea1i vi \u1ed5 nh\u1ed3i m\u00e1u d\u1ea7n d\u1ea7n b\u1ecb thu h\u1eb9p, v\u00f9ng trung t\u00e2m \u1ed5 nh\u1ed3i m\u00e1u lan r\u1ed9ng. C\u00e1c t\u1ebf b\u00e0o h\u00ecnh sao, t\u1ebf b\u00e0o \u0111u\u00f4i gai l\u1edbn v\u00e0 vi t\u1ebf b\u00e0o th\u1ea7n kinh \u0111\u1ec7m d\u1ea7n b\u1ecb ho\u1ea1i t\u1eed. Nhu m\u00f4 n\u00e3o b\u1ecb nh\u1ed3i m\u00e1u s\u1ebd d\u1ecbch h\u00f3a v\u00e0 b\u1ecb c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o ti\u00eau h\u1ee7y. V\u00f9ng m\u00f4 ho\u1ea1i t\u1eed n\u00e0y d\u1ea7n m\u1ea5t \u0111i, thay th\u1ebf b\u1eb1ng c\u00e1c nang n\u01b0\u1edbc trong n\u00e3o.<\/span><\/p>\n

3.3. Nh\u1ed3i m\u00e1u chuy\u1ec3n d\u1ea1ng xu\u1ea5t huy\u1ebft<\/span><\/b><\/h3>\n

– Kho\u1ea3ng 5% b\u1ec7nh nh\u00e2n nh\u1ed3i m\u00e1u n\u00e3o kh\u00f4ng bi\u1ebfn ch\u1ee9ng, kh\u00f4ng \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c ti\u00eau huy\u1ebft kh\u1ed1i c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng ch\u1ea3y m\u00e1u trong \u1ed5 nh\u1ed3i m\u00e1u.<\/span><\/p>\n

– H\u00ecnh th\u00e1i c\u00f3 th\u1ec3 l\u00e0 nh\u1eefng ch\u1ea5m xu\u1ea5t huy\u1ebft trong \u1ed5 nh\u1ed3i m\u00e1u ho\u1eb7c m\u1ed9t ho\u1eb7c nhi\u1ec1u kh\u1ed1i m\u00e1u t\u1ee5, l\u00e0m suy gi\u1ea3m th\u1ea7n kinh v\u00e0 c\u00f3 th\u1ec3 ph\u1ea3i can thi\u1ec7p ph\u1eabu thu\u1eadt ho\u1eb7c d\u1eabn l\u01b0u.<\/span><\/p>\n

– Nguy\u00ean nh\u00e2n chuy\u1ec3n d\u1ea1ng xu\u1ea5t huy\u1ebft c\u00f3 th\u1ec3 do t\u00e1i t\u01b0\u1edbi m\u00e1u, t\u00e1i th\u00f4ng m\u1ea1ch b\u1ecb t\u1eafc, do tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 ho\u1eb7c do v\u1ee1 h\u00e0ng r\u00e0o m\u00e1u n\u00e3o l\u00e0m h\u1ed3ng c\u1ea7u tho\u00e1t qu\u1ea3n.<\/span><\/p>\n

– Th\u01b0\u1eddng x\u1ea3y ra t\u1eeb 2 – 14 ng\u00e0y sau \u0111\u1ed9t qu\u1ef5.<\/span><\/p>\n

– Th\u01b0\u1eddng g\u1eb7p \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n:<\/span><\/p>\n

\u25cb C\u00f3 b\u1ec7nh l\u00fd tim m\u1ea1ch g\u00e2y huy\u1ebft kh\u1ed1i trong bu\u1ed3ng tim<\/span><\/p>\n

\u25cb Sau khi d\u00f9ng thu\u1ed1c ti\u00eau s\u1ee3i huy\u1ebft rt-PA v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 nh\u1eefng \u1ed5 gi\u1ea3m t\u1ef7 tr\u1ecdng ngay khi ch\u1ee5p c\u1eaft l\u1edbp kh\u00f4ng c\u1ea3n quang nh\u1eefng gi\u1edd \u0111\u1ea7u.<\/span><\/p>\n

3.4. Ph\u00f9 n\u00e3o v\u00e0 co gi\u1eadt sau \u0111\u1ed9t qu\u1ef5<\/span><\/b><\/h3>\n

M\u1eb7c d\u00f9 ph\u00f9 n\u00e3o n\u1eb7ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u h\u1ec7 c\u1ea3nh (tu\u1ea7n ho\u00e0n tr\u01b0\u1edbc) nh\u01b0ng c\u0169ng \u00edt g\u1eb7p (10-20%). Ph\u00f9 v\u00e0 tho\u00e1t v\u1ecb l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t g\u00e2y t\u1eed vong s\u1edbm \u1edf b\u1ec7nh nh\u00e2n nh\u1ed3i m\u00e1u n\u00e3o.<\/span><\/p>\n

Co gi\u1eadt x\u1ea3y ra \u1edf 2-23% b\u1ec7nh nh\u00e2n trong nh\u1eefng ng\u00e0y \u0111\u1ea7u ti\u00ean sau nh\u1ed3i m\u00e1u. M\u1ed9t ph\u1ea7n nh\u1ecf b\u1ec7nh nh\u00e2n sau nh\u1ed3i m\u00e1u n\u00e3o b\u1ecb co gi\u1eadt m\u1ea1n t\u00ednh.<\/span><\/p>\n

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

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