{"id":25676,"date":"2023-04-21T11:28:24","date_gmt":"2023-04-21T04:28:24","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25676"},"modified":"2023-04-21T11:37:52","modified_gmt":"2023-04-21T04:37:52","slug":"dot-quy-xuat-huyet-nao-sinh-ly-benh-va-nguyen-nhan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/dot-quy-xuat-huyet-nao-sinh-ly-benh-va-nguyen-nhan\/","title":{"rendered":"\u0110\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o: Sinh l\u00fd b\u1ec7nh v\u00e0 nguy\u00ean nh\u00e2n"},"content":{"rendered":"

\u0110\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd r\u1ea5t nghi\u00eam tr\u1ecdng, c\u00f3 th\u1ec3 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng n\u1ec1 v\u00e0 suy gi\u1ea3m ch\u1ee9c n\u0103ng v\u0129nh vi\u1ec5n. \u0110\u00e2y l\u00e0 m\u1ed9t lo\u1ea1i \u0111\u1ed9t qu\u1ef5 x\u1ea3y ra khi m\u1ed9t \u0111\u1ed9ng m\u1ea1ch trong n\u00e3o b\u1ecb v\u1ee1, d\u1eabn \u0111\u1ebfn m\u00e1u tr\u00e0n v\u00e0o m\u00f4 n\u00e3o v\u00e0 g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng. Vi\u1ec7c hi\u1ec3u v\u1ec1 sinh l\u00fd b\u1ec7nh v\u00e0 nguy\u00ean nh\u00e2n \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh.\u00a0<\/strong><\/p>\n

\"\"
Hemorrhagic stroke. Human brain with Hematoma. tissue injury that caused compression of tissue from an expanding hematoma. Close-up of blood vessel with Ruptured aneurysm and Intracerebral hemorrhage. intracranial aneurysm of brain artery. vector poster<\/figcaption><\/figure>\n

1.T\u1ed5ng quan v\u1ec1 \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o<\/h2>\n

Trong \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o, m\u00e1u ch\u1ea3y tr\u1ef1c ti\u1ebfp v\u00e0o nhu m\u00f4 n\u00e3o. C\u01a1 ch\u1ebf th\u01b0\u1eddng l\u00e0 r\u00f2 r\u1ec9 t\u1eeb c\u00e1c \u0111\u1ed9ng m\u1ea1ch n\u1ed9i s\u1ecd nh\u1ecf b\u1ecb t\u1ed5n th\u01b0\u01a1ng do t\u0103ng huy\u1ebft \u00e1p m\u00e3n t\u00ednh. C\u00e1c thu\u1eadt ng\u1eef xu\u1ea5t huy\u1ebft n\u1ed9i s\u1ecd v\u00e0 \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thay th\u1ebf cho nhau trong nh\u1eefng ph\u1ea7n tr\u00ecnh b\u00e0y d\u01b0\u1edbi \u0111\u00e2y v\u00e0 t\u00e1ch bi\u1ec7t v\u1edbi xu\u1ea5t huy\u1ebft chuy\u1ec3n d\u1ea1ng trong \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9.<\/span><\/p>\n

\u0110\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o \u00edt ph\u1ed5 bi\u1ebfn h\u01a1n \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u n\u00e3o. C\u00e1c th\u1ed1ng k\u00ea d\u1ecbch t\u1ec5 h\u1ecdc cho bi\u1ebft ch\u1ec9 c\u00f3 8-18% \u0111\u1ed9t qu\u1ef5 l\u00e0 xu\u1ea5t huy\u1ebft. Tuy nhi\u00ean, \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong cao h\u01a1n \u0111\u1ed9t qu\u1ef5 do thi\u1ebfu m\u00e1u n\u00e3o.<\/span><\/p>\n

2. Sinh l\u00fd b\u1ec7nh h\u1ecdc<\/h2>\n

Xu\u1ea5t huy\u1ebft n\u00e3o \u0111\u01b0\u1ee3c chia l\u00e0m hai lo\u1ea1i l\u00e0 xu\u1ea5t huy\u1ebft n\u00e3o nguy\u00ean ph\u00e1t v\u00e0 xu\u1ea5t huy\u1ebft n\u00e3o th\u1ee9 ph\u00e1t.<\/span><\/p>\n

Xu\u1ea5t huy\u1ebft n\u00e3o nguy\u00ean ph\u00e1t \u0111i\u1ec3n h\u00ecnh l\u00e0 do c\u0103n nguy\u00ean c\u1ee7a b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u nh\u1ecf. Th\u1ee9 nh\u1ea5t, qu\u00e1 tr\u00ecnh t\u0103ng huy\u1ebft \u00e1p k\u00e9o d\u00e0i d\u1eabn t\u1edbi c\u00e1c b\u1ec7nh l\u00fd m\u1ea1ch m\u00e1u do t\u0103ng \u00e1p l\u1ef1c g\u00e2y ra c\u00e1c tho\u00e1i h\u00f3a vi th\u1ec3 c\u1ee7a th\u00e0nh m\u1ea1ch m\u00e1u nh\u1ecf t\u1edbi m\u1ea1ch m\u00e1u xi\u00ean \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn nh\u01b0 l\u00e0 s\u1ef1 tho\u00e1i h\u00f3a m\u1ee1 k\u00ednh (lipohyalinosis). Th\u1ee9 hai, s\u1ef1 l\u1eafng \u0111\u1ecdng vi tinh b\u1ed9t (amyloid) v\u00e0o th\u00e0nh m\u1ea1ch m\u00e1u nh\u1ecf m\u00e0ng m\u1ec1m hay m\u1ea1ch m\u00e1u v\u1ecf n\u00e3o g\u00e2y ra m\u1ea5t c\u00e1c t\u1ebf b\u00e0o c\u01a1 tr\u01a1n, g\u00e2y d\u00e0y th\u00e0nh m\u1ea1ch l\u00e0m h\u1eb9p l\u00f2ng d\u1eabn t\u1edbi h\u00ecnh th\u00e0nh c\u00e1c vi ph\u00ecnh m\u1ea1ch nh\u1ecf v\u00e0 ch\u1ea3y m\u00e1u nh\u1ecf. Theo sau s\u1ef1 v\u1ee1 c\u1ee7a th\u00e0nh m\u1ea1ch, m\u00e1u ch\u1ea3y ra g\u00e2y c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng tr\u1ef1c ti\u1ebfp cho nhu m\u00f4 n\u00e3o li\u1ec1n k\u1ec1. S\u1ef1 ph\u00f9 xung quanh kh\u1ed1i m\u00e1u ph\u00e1t tri\u1ec3n trong v\u00f2ng 3 gi\u1edd \u0111\u1ea7u k\u1ec3 t\u1eeb khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111\u1ea1t \u0111\u1ec9nh trong kho\u1ea3ng gi\u1eefa 10 t\u1edbi 20 ng\u00e0y. Ti\u1ebfp \u0111\u00f3, m\u00e1u v\u00e0 huy\u1ebft t\u01b0\u01a1ng th\u00fac \u0111\u1ea9y c\u00e1c ti\u1ebfn tr\u00ecnh g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ee9 ph\u00e1t bao g\u1ed3m ph\u1ea3n \u1ee9ng vi\u00eam, s\u1ef1 ho\u1ea1t h\u00f3a chu tr\u00ecnh \u0111\u00f4ng m\u00e1u, v\u00e0 l\u1eafng \u0111\u1ecdng s\u1eaft t\u1eeb s\u1ef1 tho\u00e1i h\u00f3a hemoglobin. Cu\u1ed1i c\u00f9ng, kh\u1ed1i m\u00e1u c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c to ra trong kho\u1ea3ng 38% c\u00e1c b\u1ec7nh nh\u00e2n trong v\u00f2ng 24 gi\u1edd \u0111\u1ea7u. Khi kh\u1ed1i m\u00e1u \u0111\u1ee7 l\u1edbn c\u00f3 th\u1ec3 g\u00e2y ra hi\u1ec7u \u1ee9ng kh\u1ed1i ch\u00e8n \u00e9p g\u00e2y c\u00e1c tho\u00e1t v\u1ecb n\u00e3o, gi\u00e3n h\u1ec7 th\u1ed1ng n\u00e3o th\u1ea5t hay t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd. Khi c\u00f3 ch\u1ea3y m\u00e1u trong khoang d\u01b0\u1edbi nh\u1ec7n, m\u00e1u c\u00f3 th\u1ec3 g\u00e2y ra t\u00ecnh tr\u1ea1ng co m\u1ea1ch c\u1ea5p t\u00ednh, k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u vi m\u1ea1ch d\u1eabn t\u1edbi gi\u1ea3m t\u01b0\u1edbi m\u00e1u v\u00e0 thi\u1ebfu m\u00e1u n\u00e3o.<\/span><\/p>\n

Xu\u1ea5t huy\u1ebft n\u00e3o th\u1ee9 ph\u00e1t l\u00e0 do c\u00e1c c\u0103n nguy\u00ean d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u (ph\u00ecnh m\u1ea1ch, th\u00f4ng \u0111\u1ed9ng-t\u0129nh m\u1ea1ch, r\u00f2 \u0111\u1ed9ng-t\u0129nh m\u1ea1ch m\u00e0ng c\u1ee9ng, d\u1ecb d\u1ea1ng m\u1ea1ch th\u1ec3 hang), chuy\u1ec3n d\u1ea1ng ch\u1ea3y m\u00e1u sau nh\u1ed3i m\u00e1u, b\u1ec7nh l\u00fd \u0111\u00f4ng m\u00e1u, c\u00e1c kh\u1ed1i u\u2026<\/span><\/p>\n

V\u1ec1 m\u1eb7t v\u1ecb tr\u00ed, ch\u1ea3y m\u00e1u trong n\u00e3o kh\u00f4ng do ch\u1ea5n th\u01b0\u01a1ng \u0111\u01b0\u1ee3c chia th\u00e0nh ch\u1ea3y m\u00e1u d\u01b0\u1edbi m\u00e0ng c\u1ee9ng, ch\u1ea3y m\u00e1u \u1edf khoang d\u01b0\u1edbi nh\u1ec7n, ch\u1ea3y m\u00e1u trong nhu m\u00f4 n\u00e3o v\u00e0 ch\u1ea3y m\u00e1u trong n\u00e3o th\u1ea5t. V\u1ecb tr\u00ed c\u1ee7a ch\u1ea3y m\u00e1u trong n\u00e3o g\u1ee3i \u00fd m\u1ed9t ph\u1ea7n n\u00e0o \u0111\u00f3 v\u1ec1 nguy\u00ean nh\u00e2n g\u00e2y ch\u1ea3y m\u00e1u. Ch\u1ea3y m\u00e1u n\u00e3o nguy\u00ean ph\u00e1t th\u01b0\u1eddng hay trong b\u1ec7nh c\u1ea3nh t\u0103ng huy\u1ebft \u00e1p th\u00ec v\u1ecb tr\u00ed ch\u1ea3y m\u00e1u hay g\u1eb7p l\u00e0 \u1edf trong nhu m\u00f4 n\u00e3o s\u00e2u bao g\u1ed3m nh\u00e2n n\u1ec1n, th\u00e2n n\u00e3o v\u00e0 ti\u1ec3u n\u00e3o. Ch\u1ea3y m\u00e1u do c\u0103n nguy\u00ean th\u1ee9 ph\u00e1t \u0111\u01b0\u1ee3c ngh\u0129 \u0111\u1ebfn khi v\u1ecb tr\u00ed ch\u1ea3y m\u00e1u kh\u00f4ng \u0111i\u1ec3n h\u00ecnh \u1edf v\u00f9ng c\u1ee7a ch\u1ea3y m\u00e1u nguy\u00ean ph\u00e1t nh\u01b0 xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n, ch\u1ea3y m\u00e1u trong nhu m\u00f4 th\u00f9y n\u00e3o, ch\u1ea3y m\u00e1u trong n\u00e3o th\u1ea5t v\u00e0 d\u01b0\u1edbi m\u00e0ng c\u1ee9ng. Trong xu\u1ea5t huy\u1ebft d\u01b0\u1edbi nh\u1ec7n, nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p l\u00e0 ph\u00ecnh m\u1ea1ch n\u00e3o v\u1ee1 chi\u1ebfm 85%. Trong xu\u1ea5t huy\u1ebft nhu m\u00f4 th\u00f9y n\u00e3o ho\u1eb7c xu\u1ea5t huy\u1ebft n\u00e3o th\u1ea5t, nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p l\u00e0 d\u1ecb d\u1ea1ng th\u00f4ng \u0111\u1ed9ng-t\u0129nh m\u1ea1ch n\u00e3o (AVM). C\u00f2n trong xu\u1ea5t huy\u1ebft d\u01b0\u1edbi m\u00e0ng c\u1ee9ng, c\u00f3 th\u1ec3 \u0111i k\u00e8m xu\u1ea5t huy\u1ebft nhu m\u00f4 th\u00f9y n\u00e3o, nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 do r\u00f2 \u0111\u1ed9ng-t\u0129nh m\u1ea1ch m\u00e0ng c\u1ee9ng.<\/span><\/p>\n

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

 <\/p>\n

3. Nguy\u00ean nh\u00e2n c\u1ee7a \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o<\/h2>\n

3.1. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/span><\/b><\/h3>\n

Nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft t\u0103ng l\u00ean khi c\u00f3 m\u1ed9t trong c\u00e1c y\u1ebfu t\u1ed1 sau:<\/span><\/p>\n

– Tu\u1ed5i cao<\/span><\/p>\n

– Ti\u1ec1n s\u1eed \u0111\u1ed9t qu\u1ef5: N\u1ebfu \u0111\u00e3 t\u1eebng m\u1eafc \u0111\u1ed9t qu\u1ef5, nguy c\u01a1 m\u1eafc l\u1ea1i ho\u1eb7c m\u1eafc \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft cao h\u01a1n so v\u1edbi ng\u01b0\u1eddi kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed b\u1ec7nh n\u00e0y.<\/span><\/p>\n

– Nghi\u1ec7n r\u01b0\u1ee3u<\/span><\/p>\n

– Nghi\u1ec7n ma t\u00fay (cocaine, heroine)<\/span><\/p>\n

3.2. Nguy\u00ean nh\u00e2n<\/span><\/b><\/h3>\n

– T\u0103ng huy\u1ebft \u00e1p.<\/span><\/p>\n

– B\u1ec7nh amyloidosis n\u00e3o.<\/span><\/p>\n

– C\u00e1c b\u1ec7nh r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/span><\/p>\n

– \u0110i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u.<\/span><\/p>\n

– Li\u1ec7u ph\u00e1p ti\u00eau s\u1ee3i huy\u1ebft trong \u0111i\u1ec1u tr\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p ho\u1eb7c \u0111\u1ed9t qu\u1ef5 thi\u1ebfu m\u00e1u n\u00e3o c\u1ea5p t\u00ednh (c\u00f3 th\u1ec3 g\u00e2y xu\u1ea5t huy\u1ebft n\u00e3o).<\/span><\/p>\n

– D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch, ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch v\u00e0 c\u00e1c d\u1ecb t\u1eadt m\u1ea1ch m\u00e1u kh\u00e1c (u t\u0129nh m\u1ea1ch v\u00e0 xoang hang).<\/span><\/p>\n

– Vi\u00eam m\u1ea1ch.<\/span><\/p>\n

– Kh\u1ed1i t\u00e2n sinh trong s\u1ecd.<\/span><\/p>\n

T\u00f3m l\u1ea1i, vi\u1ec7c hi\u1ec3u v\u1ec1 sinh l\u00fd b\u1ec7nh v\u00e0 nguy\u00ean nh\u00e2n \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh. Vi\u1ec7c ki\u1ec3m so\u00e1t c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 v\u00e0 duy tr\u00ec m\u1ed9t l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh c\u00f3 th\u1ec3 gi\u00fap gi\u1ea3m nguy c\u01a1 \u0111\u1ed9t qu\u1ef5 xu\u1ea5t huy\u1ebft n\u00e3o.<\/p>\n

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

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