{"id":26188,"date":"2023-04-23T10:17:47","date_gmt":"2023-04-23T03:17:47","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26188"},"modified":"2023-04-23T10:17:47","modified_gmt":"2023-04-23T03:17:47","slug":"chan-doan-va-dieu-tri-ho-keo-dai-bo-y-te","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/chan-doan-va-dieu-tri-ho-keo-dai-bo-y-te\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ho k\u00e9o d\u00e0i &#8211; B\u1ed9 Y t\u1ebf"},"content":{"rendered":"<p style=\"text-align: left;\"><strong>Ho k\u00e9o d\u00e0i l\u00e0 bi\u1ec3u hi\u1ec7n r\u1ea5t th\u01b0\u1eddng g\u1eb7p, chi\u1ebfm kho\u1ea3ng 40% c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1m ngo\u1ea1i tr\u00fa t\u1ea1i c\u00e1c ph\u00f2ng kh\u00e1m h\u00f4 h\u1ea5p. Trong b\u00e0i vi\u1ebft d\u1ee9oi \u0111\u00e2y, chung ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u1ed1i v\u1edbi tri\u1ec7u ch\u1ee9ng n\u00e0y.<\/strong><\/p>\n<h2>1. Ho k\u00e9o d\u00e0i l\u00e0 g\u00ec ?<\/h2>\n<p>Ho k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ho &gt; 3 tu\u1ea7n.<\/p>\n<h2>2. Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p><b>2.1. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/b><\/p>\n<p>Ho k\u00e9o d\u00e0i bao g\u1ed3m nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ho &gt; 3 tu\u1ea7n v\u00e0 \u0111\u01b0\u1ee3c chia th\u00e0nh:<\/p>\n<p>&#8211; Ho b\u00e1n c\u1ea5p: ho t\u1eeb 3- 8 tu\u1ea7n<\/p>\n<p>&#8211; Ho m\u1ea1n t\u00ednh: ho k\u00e9o d\u00e0i &gt; 8 tu\u1ea7n<\/p>\n<p><b>2.2. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/b><\/p>\n<ul>\n<li>B\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean: l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t g\u00e2y ho k\u00e9o d\u00e0i, c\u00e1c b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p bao g\u1ed3m: vi\u00eam m\u0169i v\u1eadn m\u1ea1ch, vi\u00eam xoang, polyp m\u0169i.<\/li>\n<li>Hen ph\u1ebf qu\u1ea3n: l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ho k\u00e9o d\u00e0i th\u1ee9 hai sau b\u1ec7nh l\u00fd m\u0169i xoang. Ho th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n v\u00e0o n\u1eeda \u0111\u00eam v\u1ec1 s\u00e1ng, khi thay \u0111\u1ed5i th\u1eddi ti\u1ebft, ti\u1ebfp x\u00fac d\u1ecb nguy\u00ean, c\u00f3 th\u1ec3 th\u1ea5y kh\u00f3 th\u1edf c\u00f2 c\u1eed \u1edf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p \u0111i\u1ec3n h\u00ecnh.<\/li>\n<li>Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y &#8211; th\u1ef1c qu\u1ea3n: l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p. C\u00e1c bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng bao g\u1ed3m: ho k\u00e9o d\u00e0i, ho t\u0103ng khi n\u1eb1m, v\u00e0o l\u00fac \u0111\u00f3i. C\u1ea3m gi\u00e1c n\u00f3ng r\u00e1t sau x\u01b0\u01a1ng \u1ee9c, \u1ee3 h\u01a1i, \u1ee3 chua, \u0111au th\u01b0\u1ee3ng v\u1ecb.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p: m\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p c\u00f2n ho k\u00e9o d\u00e0i (ngay c\u1ea3 sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh hi\u1ec7u qu\u1ea3), th\u1eadm ch\u00ed ho k\u00e9o d\u00e0i qu\u00e1 8 tu\u1ea7n.<\/li>\n<li>D\u00f9ng thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin: ho k\u00e9o d\u00e0i l\u00e0 bi\u1ec3u hi\u1ec7n g\u1eb7p \u1edf kho\u1ea3ng 15% c\u00e1c tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c d\u00f9ng thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin.<\/li>\n<li>Lao ph\u1ed5i<\/li>\n<li>B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/li>\n<li>Gi\u00e3n ph\u1ebf qu\u1ea3n<\/li>\n<li>Ung th\u01b0 ph\u1ed5i<\/li>\n<li>Vi\u00eam ph\u1ed5i t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan<\/li>\n<li>M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n hi\u1ebfm g\u1eb7p kh\u00e1c: d\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch ph\u1ed5i, nhuy\u1ec5n s\u1ee5n kh\u00ed, ph\u1ebf qu\u1ea3n, ph\u00ec \u0111\u1ea1i amidan, t\u0103ng c\u1ea3m thanh qu\u1ea3n&#8230;<\/li>\n<\/ul>\n<p><b>2.3. Ti\u1ebfp c\u1eadn ch\u1ea9n \u0111o\u00e1n ho k\u00e9o d\u00e0i<\/b><\/p>\n<p>B\u1ec7nh nh\u00e2n ho k\u00e9o d\u00e0i c\u1ea7n \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh:<\/p>\n<ul>\n<li>Khai th\u00e1c ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n<\/li>\n<li>Kh\u00e1m ph\u00e1t hi\u1ec7n c\u00e1c b\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean<\/li>\n<li>Ti\u1ebfn h\u00e0nh c\u00e1c th\u0103m d\u00f2 ph\u00e1t hi\u1ec7n<\/li>\n<\/ul>\n<p>+ Hen ph\u1ebf qu\u1ea3n<\/p>\n<p>+ Lao ph\u1ed5i, lao n\u1ed9i ph\u1ebf qu\u1ea3n<\/p>\n<p>+ Gi\u00e3n ph\u1ebf qu\u1ea3n<\/p>\n<p>+ B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/p>\n<p>+ Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n<\/p>\n<p>&#8211; Khi kh\u00f4ng r\u00f5 ch\u1ea9n \u0111o\u00e1n, c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh l\u00e0m th\u00eam m\u1ed9t s\u1ed1 th\u0103m d\u00f2 nh\u01b0: test k\u00edch th\u00edch ph\u1ebf qu\u1ea3n (methacholin test), \u0111o pH th\u1ef1c qu\u1ea3n<\/p>\n<p>&#8211; Trong tr\u01b0\u1eddng h\u1ee3p ch\u01b0a r\u00f5 ch\u1ea9n \u0111o\u00e1n, c\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh \u0111i\u1ec1u tr\u1ecb th\u1eed v\u1edbi h\u1ed7n h\u1ee3p thu\u1ed1c kh\u00e1ng histamin &#8211; co m\u1ea1ch trong 1-2 tu\u1ea7n.<\/p>\n<p>&nbsp;<\/p>\n<figure id=\"attachment_26227\" aria-describedby=\"caption-attachment-26227\" style=\"width: 300px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-26227\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/42FB4640-F924-47DF-8117-96F546F004DD-300x200.jpeg\" alt=\"Minh-hoa-ho\" width=\"300\" height=\"200\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/42FB4640-F924-47DF-8117-96F546F004DD-300x200.jpeg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/42FB4640-F924-47DF-8117-96F546F004DD-768x512.jpeg 768w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/42FB4640-F924-47DF-8117-96F546F004DD.jpeg 1024w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-26227\" class=\"wp-caption-text\">Minh ho\u1ea1 ho k\u00e9o d\u00e0i<\/figcaption><\/figure>\n<h2><b>3. \u0110i\u1ec1u tr\u1ecb<\/b><\/h2>\n<p><b>3.1. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n<\/b><\/p>\n<ul>\n<li>\u00a0B\u1ec7nh l\u00fd \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p tr\u00ean:<\/li>\n<\/ul>\n<p>&#8211; Vi\u00eam m\u0169i, xoang d\u1ecb \u1ee9ng, vi\u00eam m\u0169i v\u1eadn m\u1ea1ch: X\u1ecbt r\u1eeda m\u0169i ng\u00e0y 2-4 l\u1ea7n v\u1edbi dung d\u1ecbch r\u1eeda m\u0169i (natriclorua 0,9%, Vesim ho\u1eb7c sterimar), sau \u0111\u00f3 d\u00f9ng corticoid x\u1ecbt m\u0169i (budesonid ho\u1eb7c flixonase) li\u1ec1u 1-2 x\u1ecbt cho m\u1ed7i b\u00ean m\u0169i x 2 l\u1ea7n\/ng\u00e0y. Ho\u1eb7c c\u00f3 th\u1ec3 d\u00f9ng nang budesonide pha v\u1edbi 5 ml dung d\u1ecbch natriclorua 0,9%, b\u01a1m nh\u1eb9 nh\u00e0ng v\u00e0o m\u0169i, k\u1ebft h\u1ee3p thay \u0111\u1ed5i t\u01b0 th\u1ebf bao g\u1ed3m: n\u1eb1m nghi\u00eang 1 b\u00ean, n\u1eb1m ng\u1eeda.<\/p>\n<p>&#8211; Polyp m\u0169i: ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf polyp<\/p>\n<ul>\n<li>Hen ph\u1ebf qu\u1ea3n: hi\u1ec7n nay th\u01b0\u1eddng hay d\u00f9ng k\u1ebft h\u1ee3p thu\u1ed1c \u0111i\u1ec1u tr\u1ecb duy tr\u00ec (fluticason\/salmeterol; budesonid\/formoterol) v\u1edbi 1 thu\u1ed1c c\u1eaft c\u01a1n (salbutamol, terbutalin). Thay \u0111\u1ed5i li\u1ec1u thu\u1ed1c \u0111i\u1ec1u tr\u1ecb theo di\u1ec5n bi\u1ebfn c\u1ee7a b\u1ec7nh. B\u00ean c\u1ea1nh vi\u1ec7c d\u00f9ng thu\u1ed1c, c\u1ea7n tr\u00e1nh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 nh\u01b0: kh\u00f4ng nu\u00f4i ch\u00f3, m\u00e8o, tr\u00e1nh kh\u00f3i thu\u1ed1c l\u00e1, thu\u1ed1c l\u00e0o, b\u1ebfp than <i>(tham kh\u1ea3o th\u00eam b\u00e0i h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb hen ph\u1ebf qu\u1ea3n)<\/i>.<\/li>\n<li>Tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y &#8211; th\u1ef1c qu\u1ea3n:<\/li>\n<\/ul>\n<p>&#8211; Tr\u00e1nh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1: kh\u00f4ng h\u00fat thu\u1ed1c, tr\u00e1nh \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n, gi\u1ea3m c\u00e2n, tr\u00e1nh \u0111\u1ed3 \u0103n m\u1ee1.<\/p>\n<p>&#8211; D\u00f9ng thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton: omeprazol 20 mg\/ng\u00e0y, esomeprazol 40 mg\/ng\u00e0y; d\u00f9ng li\u00ean t\u1ee5c trong 10 ng\u00e0y.<\/p>\n<p>&#8211; Thu\u1ed1c kh\u00e1c: metoclopramid vi\u00ean 10 mg x 4 vi\u00ean\/ng\u00e0y, chia 4 l\u1ea7n, u\u1ed1ng tr\u01b0\u1edbc \u0103n 30 ph\u00fat. Th\u1eddi gian d\u00f9ng thu\u1ed1c: 2 tu\u1ea7n<\/p>\n<ul>\n<li>Ho do d\u00f9ng thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin: d\u1eebng thu\u1ed1c ch\u1eb9n th\u1ee5 th\u1ec3 angiotensin. Ho th\u01b0\u1eddng h\u1ebft sau d\u1eebng thu\u1ed1c 1-6 tu\u1ea7n.<\/li>\n<\/ul>\n<p align=\"center\">T\u00f3m t\u1eaft \u0111i\u1ec1u tr\u1ecb ho<\/p>\n<table border=\"1\" width=\"0\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\" width=\"44%\">\n<p align=\"center\"><b>Nguy\u00ean nh\u00e2n ho<\/b><\/p>\n<\/td>\n<td valign=\"top\" width=\"55%\">\n<p align=\"center\"><b>\u0110i\u1ec1u tr\u1ecb<\/b><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"top\" width=\"100%\"><i>\u0110i\u1ec1u tr\u1ecb theo nguy\u00ean nh\u00e2n g\u00e2y ho<\/i><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Hen ph\u1ebf qu\u1ea3n<\/td>\n<td valign=\"top\" width=\"55%\">Thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n v\u00e0 corticoid d\u1ea1ng h\u00edt<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Vi\u00eam ph\u1ebf qu\u1ea3n t\u0103ng b\u1ea1ch c\u1ea7u \u00e1i toan<\/td>\n<td valign=\"top\" width=\"55%\">H\u00edt corticosteroid; thu\u1ed1c kh\u00e1ng leukotrien<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Vi\u00eam m\u0169i d\u1ecb \u1ee9ng<\/td>\n<td valign=\"top\" width=\"55%\">Thu\u1ed1c steroid x\u1ecbt m\u0169i, kh\u00e1ng histamin<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">H\u1ed9i ch\u1ee9ng tr\u00e0o ng\u01b0\u1ee3c d\u1ea1 d\u00e0y th\u1ef1c qu\u1ea3n<\/td>\n<td valign=\"top\" width=\"55%\">Thu\u1ed1c \u1ee9c ch\u1ebf b\u01a1m proton ho\u1eb7c kh\u00e1ng histamin H2<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Ho do thu\u1ed1c \u1ee9c ch\u1ebf men chuy\u1ec3n<\/td>\n<td valign=\"top\" width=\"55%\">D\u1eebng thu\u1ed1c v\u00e0 thay sang nh\u00f3m kh\u00e1c<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">B\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh<\/td>\n<td valign=\"top\" width=\"55%\">Ng\u1eebng h\u00fat thu\u1ed1c v\u00e0 ti\u1ebfp x\u00fac kh\u00f3i, b\u1ee5i.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh.<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Gi\u00e3n ph\u1ebf qu\u1ea3n<\/td>\n<td valign=\"top\" width=\"55%\">D\u1eabn l\u01b0u t\u01b0 th\u1ebf<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb c\u00e1c \u0111\u1ee3t nhi\u1ec5m tr\u00f9ng v\u00e0 r\u1ed1i lo\u1ea1n th\u00f4ng kh\u00ed t\u1eafc ngh\u1ebdn (n\u1ebfu c\u00f3)<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Vi\u00eam kh\u00ed ph\u1ebf qu\u1ea3n nhi\u1ec5m khu\u1ea9n<\/td>\n<td valign=\"top\" width=\"55%\">Kh\u00e1ng sinh ph\u00f9 h\u1ee3p<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"top\" width=\"100%\"><i>\u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng (ch\u1ec9 d\u00f9ng sau khi \u0111\u00e3 t\u00ecm v\u00e0 \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n \u0111\u1ea7y \u0111\u1ee7)<\/i><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Ho do vi\u00eam ph\u1ebf qu\u1ea3n c\u1ea5p do virus<\/td>\n<td valign=\"top\" width=\"55%\">D\u00f9ng thu\u1ed1c b\u1ed5 ph\u1ebf d\u1ea1ng si r\u00f4<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Ho k\u00e9o d\u00e0i, \u0111\u1eb7c bi\u1ec7t xu\u1ea5t hi\u1ec7n v\u1ec1 \u0111\u00eam<\/td>\n<td valign=\"top\" width=\"55%\">Opiat v\u00e0 c\u00e1c ch\u1ebf ph\u1ea9m<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\" width=\"44%\">Ho k\u00e9o d\u00e0i, kh\u00f3 \u0111i\u1ec1u tr\u1ecb, do b\u1ec7nh l\u00fd \u00e1c t\u00ednh<\/td>\n<td valign=\"top\" width=\"55%\">C\u00e1c opiat (morphin ho\u1eb7c diamorphin)<\/p>\n<p>Thu\u1ed1c gi\u1ea3m ho d\u1ea1ng kh\u00ed dung t\u1ea1i ch\u1ed7<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><b>3.2. C\u00e1c \u0111i\u1ec1u tr\u1ecb kh\u00f4ng \u0111\u1eb7c hi\u1ec7u<\/b><\/p>\n<ul>\n<li>\u00a0Ch\u1ec9 \u0111\u1ecbnh:<\/li>\n<\/ul>\n<p>&#8211; Ho qu\u00e1 nhi\u1ec1u, kh\u00f4ng c\u1ea7m \u0111\u01b0\u1ee3c, g\u00e2y m\u1ec7t nhi\u1ec1u cho b\u1ec7nh nh\u00e2n \u1edf nh\u1eefng tr\u01b0\u1eddng h\u1ee3p ho ch\u01b0a x\u00e1c \u0111\u1ecbnh r\u00f5 nguy\u00ean nh\u00e2n, ho\u1eb7c m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u00e3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n (ung th\u01b0 ph\u1ed5i, vi\u00eam ph\u1ebf qu\u1ea3n, vi\u00eam ph\u1ed5i k\u1ebd) nh\u01b0ng kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n th\u00f4ng kh\u00ed t\u1eafc ngh\u1ebdn.<\/p>\n<p>&#8211; B\u1ec7nh nh\u00e2n \u0111ang c\u00f3 ho m\u00e1u.<\/p>\n<p>&#8211; Kh\u00f4ng n\u00ean d\u00f9ng thu\u1ed1c gi\u1ea3m ho cho nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang c\u00f3 nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p d\u01b0\u1edbi, nh\u1eefng tr\u01b0\u1eddng h\u1ee3p n\u00e0y, b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c ho \u0111\u1ec3 th\u1ea3i \u0111\u1eddm ra ngo\u00e0i.<\/p>\n<ul>\n<li>Thu\u1ed1c \u0111i\u1ec1u tr\u1ecb:<\/li>\n<\/ul>\n<p>&#8211; Thu\u1ed1c ho t\u00e1c d\u1ee5ng l\u00ean trung \u01b0\u01a1ng:<\/p>\n<p>+ Morphin v\u00e0 c\u00e1c ch\u1ebf ph\u1ea9m ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n k\u00e9o d\u00e0i do ung th\u01b0 ph\u1ed5i: c\u00f3 th\u1ec3 d\u00f9ng morphin 5 mg\/l\u1ea7n x 2 l\u1ea7n\/ng\u00e0y, d\u00f9ng trong 2-3 ng\u00e0y. Ho\u1eb7c terpincodein (5 mg codein) x 4 vi\u00ean\/ng\u00e0y x 5-7 ng\u00e0y.<\/p>\n<p>+ Dextromethorphan: li\u1ec1u d\u00f9ng 30 mg\/l\u1ea7n x 3 l\u1ea7n\/ng\u00e0y x 5-7 ng\u00e0y.<\/p>\n<p>&#8211; Thu\u1ed1c ho t\u00e1c d\u1ee5ng t\u1ea1i ch\u1ed7:<\/p>\n<p>+ Corticoid d\u1ea1ng phun h\u00edt: c\u00f3 th\u1ec3 d\u00f9ng li\u1ec1u nh\u1ecf corticoid d\u1ea1ng h\u00edt: budesonid, fluticason,.. (ho\u1eb7c d\u1ea1ng k\u1ebft h\u1ee3p: salmeterol\/fluticason; budesonid\/formoterol) li\u1ec1u 250-500 mcg\/ng\u00e0y x 10 ng\u00e0y.<\/p>\n<p>+ Lidocain: c\u00f3 th\u1ec3 d\u00f9ng t\u1ea1m th\u1eddi trong tr\u01b0\u1eddng h\u1ee3p ho nhi\u1ec1u, pha 2 ml lidocain v\u1edbi 3 ml dung d\u1ecbch natriclorua 0,9%, kh\u00ed dung.<\/p>\n<p>Xem th\u00eam: <a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/nguyen-nhan-gay-ho-cua-ban\/\">Nguy\u00ean nh\u00e2n g\u00e2y ho<\/a><\/p>\n<p>Ngu\u1ed3n t\u00e0i li\u1ec7u\u00a0H\u01af\u1edaNG \u00a0D\u1eaaN CH\u1ea8N \u0110O\u00c1N V\u00c0 \u0110I\u1ec0U TR\u1eca B\u1ec6NH H\u00d4 H\u1ea4P &#8211; B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ho k\u00e9o d\u00e0i l\u00e0 bi\u1ec3u hi\u1ec7n r\u1ea5t th\u01b0\u1eddng g\u1eb7p, chi\u1ebfm kho\u1ea3ng 40% c\u00e1c tr\u01b0\u1eddng h\u1ee3p kh\u00e1m ngo\u1ea1i tr\u00fa t\u1ea1i c\u00e1c ph\u00f2ng kh\u00e1m h\u00f4 h\u1ea5p. Trong b\u00e0i vi\u1ebft d\u1ee9oi \u0111\u00e2y, chung ta h\u00e3y c\u00f9ng t\u00ecm hi\u1ec3u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb \u0111\u1ed1i v\u1edbi tri\u1ec7u ch\u1ee9ng n\u00e0y. 1. Ho k\u00e9o d\u00e0i l\u00e0 g\u00ec ? Ho k\u00e9o [&hellip;]<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ho k\u00e9o d\u00e0i - B\u1ed9 Y t\u1ebf - Vinmec<\/title>\n<meta name=\"description\" content=\"Ho k\u00e9o d\u00e0i l\u00e0 bi\u1ec3u hi\u1ec7n r\u1ea5t th\u01b0\u1eddng g\u1eb7p. 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