{"id":25960,"date":"2023-04-25T01:06:51","date_gmt":"2023-04-24T18:06:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=25960"},"modified":"2023-04-25T01:06:51","modified_gmt":"2023-04-24T18:06:51","slug":"nhoi-mau-gan-nguyen-nhan-chan-doan-va-dieu-tri","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/nhoi-mau-gan-nguyen-nhan-chan-doan-va-dieu-tri\/","title":{"rendered":"Nh\u1ed3i m\u00e1u gan: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"<p><strong>Gan l\u00e0 m\u1ed9t c\u01a1 quan c\u00f3 t\u1ed1c \u0111\u1ed9 chuy\u1ec3n h\u00f3a r\u1ea5t cao, n\u00ean r\u1ea5t nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng thi\u1ebfu m\u00e1u. T\u1ebf b\u00e0o gan c\u00f3 th\u1ec3 b\u1ecb thi\u1ebfu m\u00e1u b\u1edfi nhi\u1ec1u bi\u1ebfn c\u1ed1 kh\u00e1c nhau, c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng l\u00e0m gi\u1ea3m t\u01b0\u1edbi m\u00e1u h\u1ec7 th\u1ed1ng nh\u01b0 cho\u00e1ng hay ng\u1eebng tim; ho\u1eb7c l\u00e0 nh\u1eefng bi\u1ebfn c\u1ed1 g\u00e2y gi\u00e1n \u0111o\u1ea1n c\u1ea5p m\u00e1u c\u1ee5c b\u1ed9 m\u1ed9t hay nhi\u1ec1u nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch gan. T\u1ed5n th\u01b0\u01a1ng gan do c\u00e1c bi\u1ebfn c\u1ed1 l\u00e0m gi\u00e1n \u0111o\u1ea1n c\u1ea5p m\u00e1u c\u1ee5c b\u1ed9 \u0111\u1ed9ng m\u1ea1ch gan nh\u01b0 v\u1eady g\u1ecdi l\u00e0 nh\u1ed3i m\u00e1u gan &#8211; c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m r\u1ea5t ri\u00eang v\u1ec1 b\u1ec7nh h\u1ecdc, c\u0169ng nh\u01b0 l\u00e0 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb.<\/strong><\/p>\n<h2>1. Nguy\u00ean nh\u00e2n c\u1ee7a nh\u1ed3i m\u00e1u gan<\/h2>\n<p>M\u1eb7c d\u00f9 c\u00f3 c\u00f9ng c\u01a1 ch\u1ebf l\u00e0 t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o do gi\u00e1n \u0111o\u1ea1n qu\u00e1 tr\u00ecnh cung c\u1ea5p oxy v\u00e0 d\u01b0\u1ee1ng ch\u1ea5t cho nhu m\u00f4 gan, \u0111\u1ed3ng th\u1eddi g\u00e2y t\u00edch l\u0169y c\u00e1c \u0111\u1ed9c ch\u1ea5t c\u00f3 kh\u1ea3 n\u0103ng t\u1ed5n h\u1ea1i \u0111\u1ebfn t\u1ebf b\u00e0o gan. Khi c\u00f3 m\u1ed9t b\u1ec7nh c\u1ea3nh l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ef1 t\u01b0\u1edbi m\u00e1u c\u1ee7a c\u1ea3 l\u00e1 gan nh\u01b0 c\u00e1c t\u00ecnh tr\u1ea1ng cho\u00e1ng hay huy\u1ebft \u0111\u1ed9ng kh\u00f4ng \u1ed5n \u0111\u1ecbnh s\u1ebd g\u00e2y ra t\u1ed5n th\u01b0\u01a1ng gan do gi\u1ea3m t\u01b0\u1edbi m\u00e1u, g\u1ecdi l\u00e0 vi\u00eam gan do gi\u1ea3m t\u01b0\u1edbi m\u00e1u (ischemic hepatitis). C\u00f2n khi xu\u1ea5t hi\u1ec7n bi\u1ebfn c\u1ed1 g\u00e2y gi\u00e1n \u0111o\u1ea1n c\u1ea5p m\u00e1u c\u1ee5c b\u1ed9 m\u1ed9t hay nhi\u1ec1u nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch gan l\u00e0m t\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 gan &#8211; \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 nh\u1ed3i m\u00e1u gan (hepatic infarction). B\u1ec7nh l\u00fd n\u00e0y c\u00f3 c\u00e1c \u0111i\u1ec3m kh\u00e1c bi\u1ec7t v\u1ec1 nguy\u00ean nh\u00e2n c\u0169ng nh\u01b0 ch\u1ea9n \u0111o\u00e1n v\u1ec1 \u0111i\u1ec1u tr\u1ecb so v\u1edbi vi\u00eam gan do gi\u1ea3m t\u01b0\u1edbi m\u00e1u.<\/p>\n<p>C\u00e1c ch\u1ee7 \u0111\u1ec1 m\u00f4 t\u1ea3 \u0111\u1eb7c \u0111i\u1ec3m v\u1ec1 nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh c\u1ea3nh vi\u00eam gan do gi\u1ea3m t\u01b0\u1edbi m\u00e1u c\u00f3 tr\u00ean chuy\u00ean trang <a href=\"https:\/\/vinmecdr.com\/\">VinmecDr.<\/a><\/p>\n<p>V\u1ec1 nguy\u00ean nh\u00e2n, nh\u1ed3i m\u00e1u gan t\u01b0\u01a1ng \u0111\u1ed1i \u00edt g\u1eb7p h\u01a1n c\u00e1c b\u1ec7nh l\u00fd t\u1ed5n th\u01b0\u01a1ng gan do thi\u1ebfu m\u00e1u kh\u00e1c do nhu m\u00f4 gan c\u00f3 \u0111\u1ebfn 2 ngu\u1ed3n c\u1ea5p m\u00e1u. \u00a0M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng ngu\u1ed3n c\u1ea5p m\u00e1u c\u1ee7a gan nh\u01b0 sau:<\/p>\n<ul>\n<li>C\u00e1c b\u1ec7nh c\u1ea3nh huy\u1ebft kh\u1ed1i \u0111\u1ed9ng m\u1ea1ch gan do x\u01a1 v\u1eefa, c\u00e1c b\u1ec7nh l\u00fd t\u0103ng \u0111\u00f4ng hay g\u1eb7p sau gh\u00e9p gan.<\/li>\n<li>Thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch gan do c\u00e1c b\u1ec7nh l\u00fd \u00e1c t\u00ednh, c\u00e1c h\u00f3a ch\u1ea5t g\u00e2y thuy\u00ean t\u1eafc \u0111\u01b0\u1ee3c d\u00f9ng trong \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh hay sau \u0111\u1ed1t c\u1eaft kh\u1ed1i u gan<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch gan trong qu\u00e1 tr\u00ecnh ph\u1eabu thu\u1eadt \u0111i\u1ec1u tr\u1ecb c\u00e1c c\u01a1 quan l\u00e2n c\u1eadn, th\u01b0\u1eddng nh\u1ea5t l\u00e0 trong c\u1eaft t\u00fai m\u1eadt n\u1ed9i soi<\/li>\n<li>B\u1ec7nh l\u00fd h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m, h\u1ed9i ch\u1ee9ng kh\u00e1ng phospholipid, ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch gan hay b\u00f3c t\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y nh\u1ed3i m\u00e1u nhu m\u00f4 gan.<\/li>\n<\/ul>\n<h2>2. Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n nh\u1ed3i m\u00e1u gan \u0111\u01b0\u1ee3c nghi ng\u1edd trong b\u1ed1i c\u1ea3nh x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c t\u1ed5n th\u01b0\u01a1ng gan m\u1edbi kh\u1edfi ph\u00e1t v\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy\u00ean nh\u00e2n \u1edf tr\u00ean. Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c \u1ee7ng h\u1ed9 b\u1edfi c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n h\u00ecnh \u1ea3nh h\u1ecdc v\u00e0 x\u00e1c \u0111\u1ecbnh ch\u1ec9 khi c\u00f3 b\u1eb1ng ch\u1ee9ng v\u1ec1 m\u00f4 b\u1ec7nh h\u1ecdc.<\/p>\n<p>Tri\u1ec7u ch\u1ee9ng tr\u00ean l\u00e2m s\u00e0ng th\u01b0\u1eddng ch\u1ec9 r\u00f5 r\u00e0ng khi t\u1ed5n th\u01b0\u01a1ng n\u1eb7ng, nhi\u1ec1u v\u00f9ng nhu m\u00f4 gan. B\u1ed1i c\u1ea3nh kh\u1edfi ph\u00e1t g\u1ed3m nh\u1eefng tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd t\u1ed5n th\u01b0\u01a1ng t\u1ebf b\u00e0o gan nh\u01b0 v\u00e0ng da, t\u0103ng c\u00e1c aminotransferase c\u1ee7a nhu m\u00f4 gan. Ngo\u00e0i ra c\u00f2n c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng \u0111\u1eb7c hi\u1ec7u nh\u01b0 s\u1ed1t, \u0111au b\u1ee5ng th\u01b0\u1ee3ng v\u1ecb hay h\u1ea1 s\u01b0\u1eddn ph\u1ea3i, bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n.<\/p>\n<p>C\u00e1c ph\u01b0\u01a1ng ti\u1ec7n h\u00ecnh \u1ea3nh h\u1ecdc c\u00f3 th\u1ec3 cho th\u1ea5y nh\u1eefng d\u1ea5u hi\u1ec7u \u1ee7ng h\u1ed9 ch\u1ea9n \u0111o\u00e1n nh\u1ed3i m\u00e1u gan. Tr\u00ean si\u00eau \u00e2m b\u1ee5ng, c\u00f3 th\u1ec3 quan s\u00e1t th\u1ea5y h\u00ecnh \u1ea3nh khu v\u1ef1c nh\u1ed3i m\u00e1u l\u00e0 nh\u1eefng v\u00f9ng gi\u1ea3m h\u1ed3i \u00e2m, kh\u00f4ng c\u00f3 t\u00edn hi\u1ec7u Doppler v\u00e0 c\u00f3 nh\u1eefng d\u00e3y h\u1ed3i \u00e2m b\u1ec7nh trong. Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh c\u00f3 gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n t\u1ed1t h\u01a1n, nh\u1ea1y h\u01a1n si\u00eau \u00e2m trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh nh\u1eefng v\u00f9ng t\u1ed5n th\u01b0\u01a1ng gan. \u00a0Tuy nhi\u00ean h\u00ecnh ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh c\u00f3 th\u1ec3 kh\u00f3 th\u1ec3 kh\u00f3 ph\u00e2n bi\u1ec7t v\u00f9ng gan nh\u1ed3i m\u00e1u v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng abscess hay kh\u1ed1i u. Th\u01b0\u1eddng c\u1ea7n ph\u1ea3i ph\u1ed1i h\u1ee3p nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p h\u00ecnh \u1ea3nh h\u1ecdc v\u1edbi nhau \u0111\u00ea t\u0103ng kh\u1ea3 n\u0103ng ch\u1ea9n \u0111o\u00e1n. Nh\u1ed3i m\u00e1u gan cho h\u00ecnh \u1ea3nh kh\u00f4ng \u0111\u1eb7c hi\u1ec7u tr\u00ean ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb. \u00a0Si\u00eau \u00e2m c\u00f3 Doppler c\u00f3 th\u1ec3 \u0111\u1ec3 kh\u1ea3o s\u00e1t \u0111\u1ed9ng m\u1ea1ch gan.<\/p>\n<figure style=\"width: 294px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"r48jcc pT0Scc iPVvYb\" src=\"https:\/\/www.researchgate.net\/publication\/23258094\/figure\/fig17\/AS:394393119936523@1471042055842\/Hepatic-infarction-in-a-53-year-old-woman-who-had-undergone-transarterial.png\" alt=\"Minh-hoa-nhoi-mau-gan-tren-CT\" width=\"294\" height=\"247\" aria-hidden=\"false\" \/><figcaption class=\"wp-caption-text\">H\u00ecnh \u1ea3nh nh\u1ed3i m\u00e1u gan tr\u00ean ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh<\/figcaption><\/figure>\n<p>Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ch\u1eafc ch\u1eafn c\u1ea7n b\u1eb1ng ch\u1ee9ng t\u1eeb kh\u1ea3o s\u00e1t \u0111\u01b0\u1ee3c xem nh\u01b0 ti\u00eau chu\u1ea9n v\u00e0ng l\u00e0 sinh thi\u1ebft gan. Gan s\u1ebd \u0111\u01b0\u1ee3c sinh thi\u1ebft d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn c\u1ee7a si\u00eau \u00e2m. H\u00ecnh \u1ea3nh m\u00f4 b\u1ec7nh h\u1ecdc c\u1ee7a t\u1ed5n th\u01b0\u01a1ng d\u1ea1ng nh\u1ed3i m\u00e1u l\u00e0 v\u00f9ng gan ho\u1ea1i t\u1eed trung t\u00e2m ho\u00e0n to\u00e0n v\u1edbi v\u00f9ng ph\u1ea3n \u1ee9ng vi\u00eam v\u00e0 nh\u1ed3i m\u00e1u kh\u00f4ng ho\u00e0n to\u00e0n xung quanh.<\/p>\n<h2>3. \u0110i\u1ec1u tr\u1ecb<\/h2>\n<p>Th\u00f4ng th\u01b0\u1eddng, n\u1ebfu nh\u01b0 kh\u00f4ng ph\u1ea3i do nguy\u00ean nh\u00e2n nhi\u1ec5m tr\u00f9ng th\u00ec nh\u1ed3i m\u00e1u gan kh\u00f4ng \u0111\u00f2i h\u1ecfi \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u. \u0110i\u1ec1u tr\u1ecb c\u1ee7a nh\u1ed3i m\u00e1u gan nh\u1eafm v\u00e0o gi\u1ea3i quy\u1ebft c\u00e1c y\u1ebfu t\u1ed1 nguy\u00ean nh\u00e2n v\u00e0 h\u1ea1n ch\u1ebf c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1. L\u01b0u \u00fd c\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0a \u0111\u1ebfn nh\u1eefng k\u1ebft c\u1ee5c nghi\u00eam tr\u1ecdng nh\u01b0 vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m tr\u00f9ng hay c\u00e1c kh\u1ed1i \u00e1c t\u00ednh c\u1ea7n \u0111\u01b0\u1ee3c l\u01b0u t\u00e2m t\u00ecm ki\u1ebfm v\u00e0 lo\u1ea1i tr\u1eeb.<\/p>\n<p>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n nh\u1ed3i m\u00e1u gan do c\u00e1c b\u1ec7nh l\u00fd t\u0103ng \u0111\u00f4ng c\u00f3 th\u1ec3 c\u00e2n nh\u1eafc s\u1eed d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p ch\u1ed1ng \u0111\u00f4ng. Vi\u1ec7c kh\u1edfi \u0111\u1ed9ng c\u00e1c li\u1ec7u ph\u00e1p ch\u1ed1ng \u0111\u00f4ng c\u1ea7n c\u00e2n nh\u1eafc gi\u1eefa nguy c\u01a1 huy\u1ebft kh\u1ed1i ti\u1ebfp di\u1ec5n v\u00e0 nguy c\u01a1 ch\u1ea3y m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n m\u1ed9t c\u00e1ch k\u1ef9 l\u01b0\u1ee1ng.<\/p>\n<p>Qu\u1ea3n l\u00fd sang th\u01b0\u01a1ng nh\u1ed3i m\u00e1u tr\u00ean gan ch\u1ee7 y\u1ebfu l\u00e0 theo d\u00f5i. \u00a0Ph\u01b0\u01a1ng ti\u1ec7n theo d\u00f5i th\u01b0\u1eddng d\u00f9ng l\u00e0 ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh. Sang th\u01b0\u01a1ng c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i v\u00e0i tu\u1ea7n sau nh\u1ed3i m\u00e1u, c\u00f3 th\u1ec3 \u0111\u1ec3 l\u1ea1i s\u1eb9o, v\u00f4i h\u00f3a hay thi\u1ec3u d\u01b0\u1ee1ng th\u00f9y gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng n\u1ebfu nh\u1ed3i m\u00e1u kh\u00f4ng ti\u1ebfp t\u1ee5c lan r\u1ed9ng.<\/p>\n<p>H\u1eadu qu\u1ea3 n\u1eb7ng n\u1ec1 nh\u1ea5t c\u1ee7a nh\u1ed3i m\u00e1u gan l\u00e0 tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n gh\u00e9p gan. Nh\u1ed3i m\u00e1u gan cho th\u1ea5y nguy c\u01a1 ph\u1ea3i gh\u00e9p gan tr\u1edf l\u1ea1i \u0111\u1ec3 k\u00e9o d\u00e0i s\u1ef1 s\u1ed1ng.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Gan l\u00e0 m\u1ed9t c\u01a1 quan c\u00f3 t\u1ed1c \u0111\u1ed9 chuy\u1ec3n h\u00f3a r\u1ea5t cao, n\u00ean r\u1ea5t nh\u1ea1y c\u1ea3m v\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng thi\u1ebfu m\u00e1u. T\u1ebf b\u00e0o gan c\u00f3 th\u1ec3 b\u1ecb thi\u1ebfu m\u00e1u b\u1edfi nhi\u1ec1u bi\u1ebfn c\u1ed1 kh\u00e1c nhau, c\u00f3 th\u1ec3 l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng l\u00e0m gi\u1ea3m t\u01b0\u1edbi m\u00e1u h\u1ec7 th\u1ed1ng nh\u01b0 cho\u00e1ng hay ng\u1eebng tim; ho\u1eb7c l\u00e0 [&hellip;]<\/p>\n","protected":false},"author":37,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Nh\u1ed3i m\u00e1u gan: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u1ed5n th\u01b0\u01a1ng gan do c\u00e1c bi\u1ebfn c\u1ed1 l\u00e0m gi\u00e1n \u0111o\u1ea1n c\u1ea5p m\u00e1u c\u1ee5c b\u1ed9 \u0111\u1ed9ng m\u1ea1ch gan g\u1ecdi l\u00e0 nh\u1ed3i m\u00e1u gan c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m r\u1ea5t ri\u00eang\" \/>\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=\"Nh\u1ed3i m\u00e1u gan: Nguy\u00ean nh\u00e2n, ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - 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