{"id":26036,"date":"2023-04-21T14:13:00","date_gmt":"2023-04-21T07:13:00","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26036"},"modified":"2023-04-21T18:02:59","modified_gmt":"2023-04-21T11:02:59","slug":"hep-van-hai-la-benh-sinh-va-dien-tien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/hep-van-hai-la-benh-sinh-va-dien-tien\/","title":{"rendered":"H\u1eb9p van hai l\u00e1 : B\u1ec7nh sinh v\u00e0 di\u1ec5n ti\u1ebfn"},"content":{"rendered":"

H\u1eb9p van hai l\u00e1 l\u00e0 m\u1ed9t b\u1ec7nh kh\u00e1 ph\u1ed5 bi\u1ebfn \u1edf n\u01b0\u1edbc ta chi\u1ebfm kho\u1ea3ng 40,3% c\u00e1c\u00a0 b\u1ec7nh tim m\u1eafc ph\u1ea3i. B\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e1t sinh \u1edf lo\u00e0i ng\u01b0\u1eddi t\u1eeb khi b\u1eaft \u0111\u1ea7u s\u1ed1ng th\u00e0nh t\u1eebng\u00a0 qu\u1ea7n th\u1ec3 do \u0111i\u1ec1u ki\u1ec7n sinh s\u1ed1ng th\u1ea5p k\u00e9m, ch\u1eadt ch\u1ed9i thi\u1ebfu v\u1ec7 sinh d\u1ec5 g\u00e2y l\u00e2y nhi\u1ec5m\u00a0 b\u1ec7nh.<\/strong><\/p>\n

Van hai l\u00e1 n\u1ed1i li\u1ec1n nh\u0129 tr\u00e1i v\u00e0 th\u1ea5t tr\u00e1i, gi\u00fap m\u00e1u di chuy\u1ec3n theo m\u1ed9t h\u01b0\u1edbng t\u1eeb nh\u0129 xu\u1ed1ng th\u1ea5t, bao g\u1ed3m 2 l\u00e1 van: l\u00e1 van l\u1edbn (hay l\u00e1 van tr\u01b0\u1edbc) v\u00e0 l\u00e1 van nh\u1ecf (hay l\u00e1 van sau). V\u00e0o k\u1ef3 t\u00e2m tr\u01b0\u01a1ng di\u1ec7n t\u00edch m\u1edf van (DTMV) trung b\u00ecnh t\u1eeb 4 – 6cm2. \u0110\u01b0\u1ee3c coi l\u00e0 h\u1eb9p van 2 l\u00e1 khi di\u1ec7n t\u00edch m\u1edf van d\u01b0\u1edbi hay b\u1eb1ng 2cm2 (1,18cm2\/ m2 di\u1ec7n t\u00edch c\u01a1 th\u1ec3 (DTCT) ). H\u1eb9p kh\u00edt n\u1eb7ng khi DTMV < 1cm2 (0,6 cm2\/m DTCT).<\/strong><\/p>\n

\"minh-hoa-hep-van-hai-la\"<\/p>\n

1. D\u1ecbch t\u1ec5 h\u1ecdc<\/h2>\n

T\u1eeb 1920 Duckett Jones (Hoa\u00a0 k\u1ef3) \u0111\u00e3 nghi\u00ean c\u1ee9u b\u1ec7nh n\u00e0y v\u00e0 \u0111\u1ebfn 1944 \u00f4ng m\u1edbi c\u00f4ng b\u1ed1 b\u1ea3y ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n\u00a0 b\u1ec7nh. C\u0169ng nh\u1eefng n\u0103m n\u00e0y Cutter v\u00e0 Levine Phillipe (Hoa k\u1ef3) t\u00ecm c\u00e1ch ph\u1eabu thu\u1eadt\u00a0 h\u1eb9p van hai l\u00e1 \u0111\u1ed3ng th\u1eddi trong n\u0103m \u0111\u00f3 Souttar t\u1ea1i Anh c\u0169ng \u0111\u00e3 m\u1ed5 \u0111\u01b0\u1ee3c h\u1eb9p van hai\u00a0 l\u00e1. Giai \u0111o\u1ea1n n\u00e0y b\u1ec7nh h\u1eb9p van hai l\u00e1 l\u00e0 b\u1ec7nh tim m\u1ea1ch ph\u1ed5 bi\u1ebfn nh\u1ea5t, g\u00e2y t\u00e0n ph\u1ebf\u00a0 v\u00e0 t\u1eed vong nhi\u1ec1u. T\u1eeb n\u0103m 1944 vi\u1ec7c ph\u00e1t minh ra Penixillin di\u1ec7t c\u00e1c lo\u1ea1i li\u00ean c\u1ea7u v\u00e0\u00a0 \u0111\u1eb7c bi\u1ec7t t\u1ea1o ra lo\u1ea1i Penixillin ch\u1eadm (Benzathyl Penixillin) c\u00f3 t\u00e1c d\u1ee5ng ph\u00f2ng ng\u1eeba\u00a0 b\u1ec7nh n\u00e0y do \u0111\u00f3 \u0111\u1ebfn nay \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n nh\u01b0 Th\u1ee5y \u0111i\u1ec3n, H\u00e0 lan v\u00e0 \u0110\u1ee9c b\u1ec7nh\u00a0 th\u1ea5p tim g\u1ea7n nh\u01b0 m\u1ea5t h\u1eb3n.<\/p>\n

Tuy v\u1eady, \u1edf c\u00e1c n\u01b0\u1edbc ch\u1eadm ph\u00e1t tri\u1ec3n b\u1ec7nh n\u00e0y c\u00f2n \u0111ang ph\u1ed5 bi\u1ebfn. B\u1ec7nh hay\u00a0 g\u1eb7p \u1edf tu\u1ed5i lao \u0111\u1ed9ng 20 – 30 tu\u1ed5i t\u1ef7 l\u1ec7 b\u1ec7nh h\u1eb9p hai l\u00e1 r\u1ea5t cao kho\u1ea3ng 60 – 70 %, t\u1ef7 l\u1ec7 t\u1eed vong \u0111\u1ebfn 5%. B\u1ec7nh c\u00f3 nhi\u1ec1u bi\u1ebfn ch\u1ee9ng ph\u1ee9c t\u1ea1p v\u00e0 \u0111\u01b0a \u0111\u1ebfn t\u00e0n ph\u1ebf. B\u1ec7nh g\u1eb7p<\/p>\n

\u1edf n\u1eef nhi\u1ec1u h\u01a1n nam (3\/1) v\u00e0 \u1edf n\u00f4ng th\u00f4n m\u1eafc nhi\u1ec1u h\u01a1n th\u00e0nh th\u1ecb.<\/p>\n

2. B\u1ec7nh nguy\u00ean v\u00e0 b\u1ec7nh sinh h\u1eb9p van hai l\u00e1<\/strong><\/h2>\n

Ch\u1ee7 y\u1ebfu do th\u1ea5p tim 99%, s\u1ed1 c\u00f2n l\u1ea1i do b\u1ea9m sinh, ho\u1eb7c do Carcinoid \u00e1c t\u00ednh,\u00a0 lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p c\u00f3 nghi\u00ean c\u1ee9u c\u00f2n cho l\u00e0 do virus\u00a0 Coxsackie g\u00e2y ra. T\u00e1c nh\u00e2n g\u00e2y b\u1ec7nh ch\u1ee7 y\u1ebfu l\u00e0 do li\u00ean c\u1ea7u khu\u1ea9n tan huy\u1ebft nh\u00f3m\u00a0 A g\u00e2y vi\u00eam h\u1ecdng g\u00e2y t\u1ed5n th\u01b0\u01a1ng th\u1ea5p tim. S\u1edf d\u0129 li\u00ean c\u1ea7u \u1edf h\u1ecdng g\u00e2y b\u1ec7nh th\u1ea5p tim\u00a0 m\u00e0 kh\u00f4ng v\u00e0o c\u00e1c c\u01a1 quan kh\u00e1c l\u00e0 do c\u00f3 c\u00e1c \u0111\u01b0\u1eddng th\u00f4ng b\u1ea1ch m\u1ea1ch gi\u1eefa h\u1ecdng v\u00e0\u00a0 tim. C\u1ea5u tr\u00fac b\u00e0o thai h\u1ecdc cho th\u1ea5y c\u00f3 \u0111\u01b0\u1eddng n\u1ed1i m\u1ea1ch m\u00e1u v\u00e0 th\u1ea7n kinh gi\u1eefa tim v\u00e0\u00a0 c\u1ed5.<\/p>\n

T\u1ed5n th\u01b0\u01a1ng van 2 l\u00e1 do th\u1ea5p tim c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn 4 d\u1ea1ng l\u00e0m h\u1eb9p van :
\n. D\u00ednh m\u00e9p van
\n. D\u00ednh l\u00e1 van
\n. D\u00ednh d\u00e2y ch\u1eb1ng
\n. Ph\u1ed1i h\u1ee3p c\u1ea3 3 lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng tr\u00ean
\nTh\u1ea5p tim th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf tu\u1ed5i t\u1eeb 5 – 15 tu\u1ed5i. \u0110\u00f4i khi c\u00f3 th\u1ec3 \u1edf tu\u1ed5i nh\u1ecf h\u01a1n ho\u1eb7c l\u1edbn h\u01a1n. Th\u00f4ng th\u01b0\u1eddng c\u1ea7n \u00edt nh\u1ea5t 2 n\u0103m t\u1eeb khi b\u1ecb \u0111\u1ee3t th\u1ea5p tim c\u1ea5p \u0111\u1ea7u ti\u00ean \u0111\u1ebfn l\u00fac b\u1ecb h\u1eb9p van hai l\u00e1 n\u1eb7ng. \u1ede x\u1ee9 nhi\u1ec7t \u0111\u1edbi nh\u01b0 Vi\u1ec7t Nam, th\u1ea5p tim c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n nhanh h\u01a1n. Nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y d\u1ef1a tr\u00ean huy\u1ebft \u0111\u1ed9ng v\u00e0 si\u00eau \u00e2m tim 2D v\u00e0 Doppler cho th\u1ea5y m\u1ee9c ti\u1ebfn tri\u1ec3n c\u1ee7a h\u1eb9p 2 l\u00e1 h\u1eb1ng n\u0103m l\u00e0 0.09 \u0111\u1ebfn 0.32 cm
\nKhi van 2 l\u00e1 b\u00ecnh th\u01b0\u1eddng, \u0111\u1ed9 ch\u00eanh \u00e1p l\u1ef1c t\u1ed1i \u0111a gi\u1eefa nh\u0129 v\u00e0 th\u1ea5t tr\u00e1i v\u00e0o k\u1ef3 t\u00e2m tr\u01b0\u01a1ng kho\u1ea3ng t\u1eeb 4 – 5 mmHg. Khi van 2 l\u00e1 h\u1eb9p kh\u00edt (DTMV < 0.6 cm2\/m2 DTCT), \u0111\u1ed9 ch\u00eanh \u00e1p l\u1ef1c t\u1ed1i \u0111a c\u00f3 th\u1ec3 \u0111\u1ebfn 20 – 30mmHg l\u00fac ngh\u1ec9. Ap l\u1ef1c cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng trung b\u00ecnh c\u1ee7a th\u1ea5t tr\u00e1i v\u00e0o kho\u1ea3ng 5mmHg. Do \u0111\u00f3 v\u1edbi \u0111\u1ed9 ch\u00eanh l\u00e0 20mmHg, \u00e1p l\u1ef1c nh\u0129 tr\u00e1i s\u1ebd l\u00e0 25mmHg.
\nS\u1ef1 gia t\u0103ng \u00e1p l\u1ef1c trong bu\u1ed3ng nh\u0129 tr\u00e1i s\u1ebd l\u00e0m t\u0103ng \u00e1p l\u1ef1c t\u0129nh m\u1ea1ch ph\u1ed5i, \u00e1p l\u1ef1c mao m\u1ea1ch ph\u1ed5i. Khi tim \u0111\u1eadp nhanh (do g\u1eafng s\u1ee9c hay m\u1ed9t nguy\u00ean nh\u00e2n n\u00e0o kh\u00e1c), \u0111\u1ed9 ch\u00eanh gia t\u0103ng nhi\u1ec1u h\u01a1n, d\u1eabn \u0111\u1ebfn tri\u1ec7u ch\u1ee9ng \u0111\u1ea7u ti\u00ean th\u01b0\u1eddng l\u00e0 kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c, n\u1eb7ng h\u01a1n c\u00f3 th\u1ec3 l\u00e0 ph\u00f9 ph\u1ed5i c\u1ea5p. L\u01b0\u1ee3ng m\u00e1u t\u1eeb nh\u0129 xu\u1ed1ng th\u1ea5t c\u00f2n ch\u1ecbu t\u00e1c \u0111\u1ed9ng c\u1ee7a co b\u00f3p nh\u0129 tr\u00e1i v\u00e0o cu\u1ed1i k\u1ef3 t\u00e2m tr\u01b0\u01a1ng. Do \u0111\u00f3 khi h\u1eb9p 2 l\u00e1 l\u00e2u, c\u00f3 bi\u1ebfn ch\u1ee9ng rung nh\u0129 (kh\u00f4ng c\u00f2n kh\u1ea3 n\u0103ng co b\u00f3p nh\u0129 tr\u00e1i) cung l\u01b0\u1ee3ng tim s\u1ebd gi\u1ea3m th\u00eam 20%.
\nS\u1ef1 gia t\u0103ng \u00e1p l\u1ef1c mao m\u1ea1ch ph\u1ed5i s\u1ebd l\u00e0m t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (b\u00ecnh th\u01b0\u1eddng AL\u0110MP t\u00e2m thu kho\u1ea3ng 20 – 25 mmHg ) khi AL\u0110MP t\u00e2m thu t\u0103ng nh\u1eb9, th\u1ea5t ph\u1ea3i t\u0103ng co b\u00f3p \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o cung l\u01b0\u1ee3ng tim. Khi AL\u0110MP t\u00e2m thu t\u0103ng tr\u00ean 70mmHg s\u1ebd v\u01b0\u1ee3t qu\u00e1 s\u1ee9c ch\u1ecbu \u0111\u1ef1ng c\u1ee7a th\u1ea5t ph\u1ea3i, d\u1eabn \u0111\u1ebfn suy th\u1ea5t ph\u1ea3i v\u00e0 h\u1edf van 3 l\u00e1.
\nNgo\u00e0i t\u00e1c \u0111\u1ed9ng c\u1ee7a gia t\u0103ng \u00e1p l\u1ef1c trong bu\u1ed3ng nh\u0129 tr\u00e1i, s\u1ef1 gia t\u0103ng AL\u0110MP c\u00f3 th\u1ec3 l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a:
\n– Co th\u1eaft ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i
\n– Bi\u1ebfn \u0111\u1ed5i th\u1ef1c th\u1ec3 h\u1ec7 mao m\u1ea1ch ph\u1ed5i do ch\u1ecbu \u00e1p l\u1ef1c cao l\u00e2u ng\u00e0y.<\/p>\n

3. Di\u1ec5n ti\u1ebfn h\u1eb9p van hai l\u00e1:<\/h2>\n

\u1ede v\u00f9ng kh\u00ed h\u1eadu \u00f4n \u0111\u1edbi, nh\u01b0 Hoa K\u1ef3, T\u00e2y \u00c2u, b\u1ec7nh nh\u00e2n t\u1eeb l\u00fac th\u1ea5p tim c\u1ea5p \u0111\u1ebfn khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1eb9p van 2 l\u00e1 h\u1eadu th\u1ea5p, c\u00f3 giai \u0111o\u1ea1n b\u1ec7nh ti\u1ebfn tri\u1ec3n kh\u00f4ng tri\u1ec7u ch\u1ee9ng k\u00e9o d\u00e0i t\u1eeb 15 \u0111\u1ebfn 20 n\u0103m. B\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng nh\u1eb9 (NYHA II) ti\u1ebfn tri\u1ec3n \u0111\u1ebfn n\u1eb7ng (NYHA III ho\u1eb7c IV) m\u1ea5t kho\u1ea3ng 5- 10 n\u0103m. Ng\u01b0\u1eddi ta th\u1ea5y \u1edf c\u00e1c n\u01b0\u1edbc v\u00f9ng nhi\u1ec7t \u0111\u1edbi, c\u1eadn nhi\u1ec7t \u0111\u1edbi b\u1ec7nh ti\u1ebfn tri\u1ec3n nhanh h\u01a1n. \u1ede \u1ea4n \u0110\u1ed9 b\u1ec7nh h\u1eb9p van 2 l\u00e1 n\u1eb7ng h\u1eadu th\u1ea5p c\u00f3 th\u1ec3 g\u1eb7p \u1edf tr\u1ebb t\u1eeb 6 \u0111\u1ebfn 12 tu\u1ed5i. Nguy\u00ean nh\u00e2n l\u00e0 do t\u1ea7n su\u1ea5t b\u1ec7nh th\u1ea5p tim t\u01b0\u01a1ng \u0111\u1ed1i ph\u1ed5 bi\u1ebfn, thi\u1ebfu s\u1ef1 ph\u00f2ng ng\u1eeba ti\u00ean ph\u00e1t v\u00e0 th\u1ee9 ph\u00e1t l\u00e0m cho nh\u1eefng \u0111\u1ee3t th\u1ea5p t\u00e1i ph\u00e1t ch\u1ed3ng l\u00ean van b\u1ecb t\u1ed5n th\u01b0\u01a1ng l\u00e0m t\u1ed5n th\u01b0\u01a1ng van ti\u1ebfn tri\u1ec3n nhanh h\u01a1n.
\n<\/em><\/strong>Khi theo d\u00f5i ti\u1ebfn tri\u1ec3n tr\u00ean si\u00eau \u00e2m ng\u01b0\u1eddi ta ghi nh\u1eadn m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u1ee7a h\u1eb9p van l\u00e0 0.09 cm2\/ n\u0103m. H\u1eb9p van ti\u1ebfn tri\u1ec3n nhanh khi m\u1ee9c \u0111\u1ed9 h\u1eb9p >0.1 cm2\/ n\u0103m. M\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n n\u00e0y ch\u1ec9 \u00e1p d\u1ee5ng cho b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 l\u1edbn tu\u1ed5i, \u1edf c\u00e1c n\u01b0\u1edbc ph\u00e1t tri\u1ec3n. \u1ede c\u00e1c n\u01b0\u1edbc \u0111ang ph\u00e1t tri\u1ec3n, n\u01a1i b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng \u1edf \u0111\u1ed9 tu\u1ed5i tr\u1ebb h\u01a1n, hi\u1ec7n c\u00f2n \u00edt d\u1eef li\u1ec7u.
\n<\/em><\/strong>B\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f3 tri\u1ec7u ch\u1ee9ng n\u1ebfu kh\u00f4ng ph\u1eabu thu\u1eadt t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n sau 5 n\u0103m l\u00e0 62% \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ph\u00e2n \u0111\u1ed9 NYHA III, v\u00e0 15% n\u1ebfu b\u1ec7nh nh\u00e2n c\u00f3 NYHA IV.
\n<\/em><\/strong>Nh\u00ecn chung b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f3 tri\u1ec7u ch\u1ee9ng n\u1ebfu \u0111\u01b0\u1ee3c nong van hay ph\u1eabu thu\u1eadt, tri\u1ec7u ch\u1ee9ng c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3. Tuy nhi\u00ean, tu\u1ed5i th\u1ecd c\u1ee7a nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y v\u1eabn th\u1ea5p h\u01a1n so v\u1edbi d\u00e2n s\u1ed1 chung do nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh (rung nh\u0129, thuy\u00ean t\u1eafc m\u1ea1ch, t\u0103ng \u00e1p ph\u1ed5i) v\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a \u0111i\u1ec1u tr\u1ecb (van c\u01a1 h\u1ecdc, thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng).
\n<\/em><\/strong>Bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a h\u1eb9p van 2 l\u00e1 l\u00e0 rung nh\u0129. T\u1ea7n su\u1ea5t rung nh\u0129 c\u1ee7a b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 li\u00ean quan \u0111\u1ebfn \u0111\u1ed9 n\u1eb7ng c\u1ee7a h\u1eb9p van v\u00e0 tu\u1ed5i c\u1ee7a b\u1ec7nh nh\u00e2n. T\u1ea7n su\u1ea5t n\u00e0y t\u0103ng d\u1ea7n theo tu\u1ed5i. M\u1ed9t nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y tr\u00ean b\u1ec7nh nh\u00e2n nong van 2 l\u00e1 b\u1eb1ng b\u00f3ng cho th\u1ea5y t\u1ea7n su\u1ea5t rung nh\u0129 l\u00e0 4% trong l\u00f4 600 b\u1ec7nh nh\u00e2n \u1ea4n \u0110\u1ed9 c\u00f3 tu\u1ed5i trung b\u00ecnh l\u00e0 27 tu\u1ed5i, 27% trong l\u00f4 4832 b\u1ec7nh nh\u00e2n Trung Qu\u1ed1c tu\u1ed5i trung b\u00ecnh l\u00e0 37, l\u00ean \u0111\u1ebfn 40% \u1edf l\u00f4 1024 b\u1ec7nh nh\u00e2n Ph\u00e1p c\u00f3 \u0111\u1ed9 tu\u1ed5i trung b\u00ecnh l\u00e0 49. Rung nh\u0129 l\u00e0m n\u1eb7ng th\u00eam tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1eb9p 2 l\u00e1, th\u00fac \u0111\u1ea9y t\u1ea1o huy\u1ebft kh\u1ed1i nh\u0129 tr\u00e1i v\u00e0 thuy\u00ean t\u1eafc m\u1ea1ch h\u1ec7 th\u1ed1ng. Rung nh\u0129 \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f3 ti\u00ean l\u01b0\u1ee3ng x\u1ea5u h\u01a1n trong d\u00e2n s\u1ed1 chung. B\u1ec7nh nh\u00e2n rung nh\u0129 c\u00f3 h\u1eb9p 2 l\u00e1, t\u1ef7 l\u1ec7 s\u1ed1ng c\u00f2n 5 n\u0103m l\u00e0 62%, so v\u1edbi 85% \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 kh\u00f4ng k\u00e8m h\u1eb9p 2 l\u00e1.
\n<\/em><\/strong>T\u1eafc m\u1ea1ch h\u1ec7 th\u1ed1ng \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p van 2 l\u00e1 l\u00e0 do huy\u1ebft kh\u1ed1i trong nh\u0129 tr\u00e1i. Bi\u1ebfn ch\u1ee9ng thuy\u00ean t\u1eafc m\u1ea1ch h\u1ec7 th\u1ed1ng hay x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n c\u00f3 rung nh\u0129, tuy nhi\u00ean 20% b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f3 bi\u1ebfn ch\u1ee9ng thuy\u00ean t\u1eafc c\u00f2n nh\u1ecbp xoang. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 l\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 rung nh\u0129 c\u01a1n ho\u1eb7c ph\u1ea3i t\u00ecm th\u00eam nguy\u00ean nh\u00e2n VNTMNT g\u00e2y thuy\u00ean t\u1eafc. C\u00f3 \u0111\u1ebfn 45% b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f2n nh\u1ecbp xoang, tr\u00ean si\u00eau \u00e2m c\u00f3 h\u00ecnh \u1ea3nh c\u1ea3n \u00e2m t\u1ef1 ph\u00e1t trong nh\u0129 tr\u00e1i (ch\u1ec9 \u0111i\u1ec3m c\u1ee7a nguy c\u01a1 thuy\u00ean t\u1eafc). Huy\u1ebft kh\u1ed1i nh\u0129 tr\u00e1i g\u1eb7p trong m\u1ed9t s\u1ed1 \u00edt b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 c\u00f2n nh\u1ecbp xoang, v\u00e0 g\u1eb7p nhi\u1ec1u \u1edf b\u1ec7nh nh\u00e2n rung nh\u0129 m\u1edbi xu\u1ea5t hi\u1ec7n. Ng\u01b0\u1eddi ta gi\u1ea3i th\u00edch \u0111i\u1ec1u n\u00e0y l\u00e0 do m\u1ea5t ch\u1ee9c n\u0103ng co th\u1eaft c\u1ee7a nh\u0129 tr\u00e1i, d\u1eabn \u0111\u1ebfn \u1ee9 \u0111\u1ecdng m\u00e1u v\u00e0 t\u1ea1o huy\u1ebft kh\u1ed1i.
\n<\/em><\/strong>Kho\u1ea3ng 50% b\u1ec7nh nh\u00e2n h\u1eb9p 2 l\u00e1 bi\u1ebfn ch\u1ee9ng thuy\u00ean t\u1eafc x\u1ea3y ra \u1edf m\u1ea1ch n\u00e3o. Ngo\u00e0i ra, c\u00f3 th\u1ec3 thuy\u00ean t\u1eafc m\u1ea1ch v\u00e0nh g\u00e2y \u0111au th\u1eaft ng\u1ef1c ho\u1eb7c nh\u1ed3i m\u00e1u c\u01a1 tim, t\u1eafc m\u1ea1ch th\u1eadn g\u00e2y t\u0103ng huy\u1ebft \u00e1p. Kho\u1ea3ng 25% b\u1ec7nh nh\u00e2n thuy\u00ean t\u1eafc c\u00f3 thuy\u00ean t\u1eafc nhi\u1ec1u ch\u1ed7 v\u00e0 t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n. Hi\u1ebfm h\u01a1n l\u00e0 c\u1ee5c huy\u1ebft kh\u1ed1i to trong nh\u0129 (c\u00f3 cu\u1ed1ng hay t\u1ef1 do) g\u00e2y ngh\u1ebdn van 2 l\u00e1, c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9t t\u1eed. Khi th\u1ea5y huy\u1ebft kh\u1ed1i d\u1ea1ng n\u00e0y c\u1ea7n ph\u1ea3i ph\u1eabu thu\u1eadt kh\u1ea9n c\u1ea5p.<\/p>\n

T\u00e0i li\u1ec7u tham kh\u1ea3o: B\u00e0i gi\u1ea3ng n\u1ed9i khoa – \u0110\u1ea1i h\u1ecdc Y Khoa Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch<\/p>\n","protected":false},"excerpt":{"rendered":"

H\u1eb9p van hai l\u00e1 l\u00e0 m\u1ed9t b\u1ec7nh kh\u00e1 ph\u1ed5 bi\u1ebfn \u1edf n\u01b0\u1edbc ta chi\u1ebfm kho\u1ea3ng 40,3% c\u00e1c\u00a0 b\u1ec7nh tim m\u1eafc ph\u1ea3i. B\u1ec7nh \u0111\u01b0\u1ee3c ph\u00e1t sinh \u1edf lo\u00e0i ng\u01b0\u1eddi t\u1eeb khi b\u1eaft \u0111\u1ea7u s\u1ed1ng th\u00e0nh t\u1eebng\u00a0 qu\u1ea7n th\u1ec3 do \u0111i\u1ec1u ki\u1ec7n sinh s\u1ed1ng th\u1ea5p k\u00e9m, ch\u1eadt ch\u1ed9i thi\u1ebfu v\u1ec7 sinh d\u1ec5 g\u00e2y l\u00e2y nhi\u1ec5m\u00a0 b\u1ec7nh. Van […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[3],"yoast_head":"\nH\u1eb9p van hai l\u00e1 : B\u1ec7nh sinh v\u00e0 di\u1ec5n ti\u1ebfn - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1eb9p van hai l\u00e1 l\u00e0 m\u1ed9t b\u1ec7nh kh\u00e1 ph\u1ed5 bi\u1ebfn \u1edf n\u01b0\u1edbc ta. \u0110\u01b0\u1ee3c coi l\u00e0 h\u1eb9p van 2 l\u00e1 khi di\u1ec7n t\u00edch m\u1edf van d\u01b0\u1edbi hay b\u1eb1ng 2cm2.\" \/>\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=\"H\u1eb9p van hai l\u00e1 : B\u1ec7nh sinh v\u00e0 di\u1ec5n ti\u1ebfn - Vinmec\" \/>\n<meta property=\"og:description\" content=\"H\u1eb9p van hai l\u00e1 l\u00e0 m\u1ed9t b\u1ec7nh kh\u00e1 ph\u1ed5 bi\u1ebfn \u1edf n\u01b0\u1edbc ta. \u0110\u01b0\u1ee3c coi l\u00e0 h\u1eb9p van 2 l\u00e1 khi di\u1ec7n t\u00edch m\u1edf van d\u01b0\u1edbi hay b\u1eb1ng 2cm2.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/hep-van-hai-la-benh-sinh-va-dien-tien\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-04-21T07:13:00+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2023-04-21T11:02:59+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/2-300x257.jpeg\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"8 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/hep-van-hai-la-benh-sinh-va-dien-tien\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/21\/hep-van-hai-la-benh-sinh-va-dien-tien\/\",\"name\":\"H\u1eb9p van hai l\u00e1 : B\u1ec7nh sinh v\u00e0 di\u1ec5n ti\u1ebfn - 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