{"id":26407,"date":"2023-04-22T13:06:51","date_gmt":"2023-04-22T06:06:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26407"},"modified":"2023-04-22T13:06:51","modified_gmt":"2023-04-22T06:06:51","slug":"tang-ap-mach-mau-phoi-trong-thuc-hanh-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/tang-ap-mach-mau-phoi-trong-thuc-hanh-lam-sang\/","title":{"rendered":"T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng"},"content":{"rendered":"

T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i <\/strong>(Pulmonary Hypertension \u2013 PH): \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0<\/strong> t\u00ecnh tr\u1ea1ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i trung b\u00ecnh (AL\u0110MPTB) > 20 mmHg \u0111\u01b0\u1ee3c \u0111o<\/strong> b\u1eb1ng th\u00f4ng tim ph\u1ea3i. T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i bao g\u1ed3m nhi\u1ec1u nh\u00f3m b\u1ec7nh nguy\u00ean<\/strong> kh\u00e1c nhau c\u00f3 chung bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng<\/strong>.<\/strong><\/p>\n

1. <\/strong>\u0110\u1ecbnh ngh\u0129a \u2013 thu\u1eadt ng\u1eef<\/h2>\n

Theo khuy\u1ebfn c\u00e1o c\u1ee7a ESC 2020, c\u00e1c kh\u00e1i ni\u1ec7m v\u1ec1 t\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a nh\u01b0 sau:
\nT\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i (Pulmonary Hypertension \u2013 PH): \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 t\u00ecnh tr\u1ea1ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i trung b\u00ecnh (AL\u0110MPTB) > 20 mmHg \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng th\u00f4ng tim ph\u1ea3i. T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i bao g\u1ed3m nhi\u1ec1u nh\u00f3m b\u1ec7nh nguy\u00ean kh\u00e1c nhau c\u00f3 chung bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng.
\nT\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (Pulmonary Arterial Hypertension \u2013 PAH) (hay T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i tr\u01b0\u1edbc mao m\u1ea1ch): \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a v\u1ec1 m\u1eb7t huy\u1ebft \u0111\u1ed9ng l\u00e0 t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (\u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i trung b\u00ecnh > 20 mmHg), \u0111\u1ed3ng th\u1eddi c\u00f3 t\u0103ng s\u1ee9c c\u1ea3n m\u1ea1ch m\u00e1u ph\u1ed5i (> 3 \u0111\u01a1n v\u1ecb Wood) v\u00e0 \u00e1p l\u1ef1c mao m\u1ea1ch ph\u1ed5i b\u00edt b\u00ecnh th\u01b0\u1eddng \u2264 15 mmHg). \u0110\u00e2y l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng b\u1edfi t\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i tr\u01b0\u1edbc mao m\u1ea1ch v\u00e0 nh\u1eefng thay \u0111\u1ed5i m\u00f4 b\u1ec7nh h\u1ecdc di\u1ec5n ra \u1edf h\u1ec7 vi tu\u1ea7n ho\u00e0n c\u1ee7a ph\u1ed5i.
\nT\u0103ng \u00e1p t\u0129nh m\u1ea1ch ph\u1ed5i (Pulmonary venous hypertension \u2013 PVH) (hay T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i sau mao m\u1ea1ch \u0111\u01a1n \u0111\u1ed9c): \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i trung b\u00ecnh > 20 mmHg, kh\u00f4ng t\u0103ng s\u1ee9c c\u1ea3n m\u1ea1ch m\u00e1u ph\u1ed5i (< 3 \u0111\u01a1n v\u1ecb Wood) v\u00e0 \u00e1p l\u1ef1c mao m\u1ea1ch ph\u1ed5i b\u00edt t\u0103ng (PCWP > 15 mmHg).
\nT\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i (PH) v\u00e0 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (PAH) l\u00e0 hai thu\u1eadt ng\u1eef kh\u00e1c nhau v\u00e0 kh\u00f4ng th\u1ec3 d\u00f9ng thay th\u1ebf cho nhau. T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i \u0111\u1ec3 ch\u1ec9 t\u00ecnh tr\u1ea1ng huy\u1ebft \u0111\u1ed9ng v\u00e0 sinh l\u00fd b\u1ec7nh h\u1ecdc, trong khi \u0111\u00f3 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/a> l\u00e0 m\u1ed9t tr\u1ea1ng th\u00e1i l\u00e2m s\u00e0ng.<\/p>\n

 <\/p>\n

\"T\u0103ng<\/p>\n

T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i<\/strong><\/p>\n

2. Sinh b\u1ec7nh h\u1ecdc t\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i.<\/h2>\n

2.1 <\/strong>V\u1ec1 m\u1eb7t huy\u1ebft \u0111\u1ed9ng<\/strong><\/h3>\n

\u0110\u1eb7c \u0111i\u1ec3m gi\u01b0\u1eddng m\u1ea1ch m\u00e1u ph\u1ed5i \u00e1p l\u1ef1c th\u1ea5p, s\u1ee9c c\u1ea3n th\u1ea5p, t\u00ednh \u0111\u00e0n h\u1ed3i cao \u0111\u01b0\u1ee3c \u0111i\u1ec1u h\u00f2a b\u1edfi s\u1ef1 c\u00e2n b\u1eb1ng gi\u1eefa hai h\u1ec7 th\u1ed1ng co m\u1ea1ch v\u00e0 gi\u00e3n m\u1ea1ch v\u00e0 gi\u1eefa qu\u00e1 tr\u00ecnh ph\u00e2n tri\u1ec3n t\u1ebf b\u00e0o v\u00e0 qu\u00e1 tr\u00ecnh ch\u1ebft t\u1ebf b\u00e0o. C\u00e1c y\u1ebfu t\u1ed1 di truy\u1ec1n v\u00e0 y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng c\u00f3 th\u1ec3 g\u00e2y m\u1ea5t c\u00e2n b\u1eb1ng c\u1ee7a c\u00e1c qu\u00e1 tr\u00ecnh n\u00e0y d\u1eabn \u0111\u1ebfn co m\u1ea1ch qu\u00e1 m\u1ee9c, t\u00e1i c\u1ea5u tr\u00fac th\u00e0nh m\u1ea1ch v\u00e0 h\u00ecnh th\u00e0nh vi huy\u1ebft kh\u1ed1i g\u00e2y t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, h\u1eadu qu\u1ea3 d\u1eabn \u0111\u1ebfn t\u0103ng s\u1ee9c c\u1ea3n m\u1ea1ch ph\u1ed5i, t\u0103ng h\u1eadu g\u00e1nh th\u1ea5t ph\u1ea3i, gi\u00e3n, ph\u00ec \u0111\u1ea1i v\u00e0 suy ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i.<\/p>\n

2.2 <\/strong>V\u1ec1 m\u1eb7t m\u00f4 b\u1ec7nh h\u1ecdc<\/strong><\/h3>\n

l\u00e0 b\u1ec7nh l\u00fd c\u1ee7a to\u00e0n b\u1ed9 h\u1ec7 m\u1ea1ch m\u00e1u ph\u1ed5i v\u00e0 ch\u1ee7 y\u1ebfu \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c \u0111\u1ed9ng m\u1ea1ch nh\u1ecf \u1edf ph\u1ed5i. T\u1ed5n th\u01b0\u01a1ng ban \u0111\u1ea7u ch\u1ec9 l\u00e0 t\u0103ng s\u1ea3n l\u1edbp n\u1ed9i m\u1ea1c v\u00e0 ph\u00ec \u0111\u1ea1i l\u1edbp \u00e1o gi\u1eefa th\u00e0nh m\u1ea1ch, sau \u0111\u00f3 s\u1ebd d\u1eabn t\u1edbi c\u00e1c t\u1ed5n th\u01b0\u01a1ng kh\u00f4ng h\u1ed3i ph\u1ee5c nh\u01b0 x\u01a1 h\u00f3a l\u1edbp n\u1ed9i m\u1ea1c, huy\u1ebft kh\u1ed1i t\u1ea1i ch\u1ed7, \u0111\u00e1p \u1ee9ng vi\u00eam v\u00e0 b\u1ec7nh l\u00fd ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch d\u1ea1ng l\u01b0\u1edbi. C\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u00e0y c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n v\u1edbi c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau, khu tr\u00fa ho\u1eb7c lan t\u1ecfa t\u00f9y thu\u1ed9c giai \u0111o\u1ea1n b\u1ec7nh c\u1ee7a t\u1eebng b\u1ec7nh nh\u00e2n.<\/p>\n

2.3 <\/strong>B\u1ea5t th\u01b0\u1eddng v\u1ec1 ph\u00e2n t\u1eed v\u00e0 n\u1ed9i m\u1ea1c<\/strong><\/h3>\n

C\u00e1c ph\u00e2n t\u1eed ch\u1ea5t ho\u1ea1t m\u1ea1ch kh\u00e1c nhau \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng, tuy nhi\u00ean nh\u1eefng hi\u1ec3u bi\u1ebft hi\u1ec7n t\u1ea1i v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 n\u00e0y c\u00f2n h\u1ea1n ch\u1ebf, m\u1ed9t s\u1ed1 con \u0111\u01b0\u1eddng \u0111\u00e3 \u0111\u01b0\u1ee3c l\u00fd gi\u1ea3i r\u00f5 r\u00e0ng v\u00e0 c\u00f3 \u1ee9ng d\u1ee5ng quan tr\u1ecdng trong \u0111i\u1ec1u tr\u1ecb.<\/p>\n

C\u00e1c c\u01a1 ch\u1ebf b\u1ec7nh sinh trong t\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i.<\/p>\n

2.3.1 <\/strong>Prostacyclin\/thromboxane A2<\/strong><\/h4>\n

L\u00e0 hai ch\u1ea5t chuy\u1ec3n h\u00f3a c\u1ee7a acid arachidonic trong t\u1ebf b\u00e0o th\u00e0nh m\u1ea1ch m\u00e1u. Prostacyclin l\u00e0 ch\u1ea5t gi\u00e3n m\u1ea1ch m\u1ea1nh, c\u00f3 vai tr\u00f2 \u1ee9c ch\u1ebf h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng th\u00f4ng qua \u1ee9c ch\u1ebf ho\u1ea1t h\u00f3a ti\u1ec3u c\u1ea7u trong khi thromboxane A2 c\u00f3 vai tr\u00f2 ng\u01b0\u1ee3c l\u1ea1i. Trong tr\u01b0\u1eddng h\u1ee3p b\u1ecb t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, c\u00e2n b\u1eb1ng n\u00e0y b\u1ecb \u0111\u1ea9y nghi\u00eang v\u1ec1 ph\u00eda thromboxane A2 \u1edf c\u00e1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i k\u00edch th\u01b0\u1edbc nh\u1ecf v\u00e0 v\u1eeba.<\/p>\n

2.3.2 <\/strong>Endothelin-1 (ET-1)<\/strong><\/h4>\n

\u0110\u01b0\u1ee3c t\u1ea1o ra b\u1edfi t\u1ebf b\u00e0o n\u1ed9i m\u1ea1c v\u00e0 g\u00e2y t\u00e1c d\u1ee5ng l\u00ean c\u00e1c t\u1ebf b\u00e0o c\u01a1 tr\u01a1n th\u00f4ng qua hai th\u1ee5 th\u1ec3: endothelin A (ET A) c\u00f3 m\u1eb7t \u1edf t\u1ebf b\u00e0o c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch v\u00e0 endothelin B (ET B) c\u00f3 \u1edf c\u1ea3 t\u1ebf b\u00e0o n\u1ed9i m\u00f4 th\u00e0nh m\u1ea1ch v\u00e0 t\u1ebf b\u00e0o c\u01a1 tr\u01a1n. K\u00edch th\u00edch c\u00f9ng l\u00fac hai th\u1ee5 th\u1ec3 tr\u00ean t\u1ebf b\u00e0o c\u01a1 tr\u01a1n m\u1ea1ch m\u00e1u g\u00e2y co m\u1ea1ch v\u00e0 c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean ty th\u1ec3, trong khi k\u00edch th\u00edch th\u1ee5 th\u1ec3 ET B tr\u00ean t\u1ebf b\u00e0o n\u1ed9i m\u1ea1c g\u00e2y gi\u00e3n m\u1ea1ch th\u00f4ng qua vi\u1ec7c t\u0103ng s\u1ea3n xu\u1ea5t prostacyclin v\u00e0 nitric oxide. \u1ede b\u1ec7nh nh\u00e2n\u00a0 n\u00e0y n\u1ed3ng \u0111\u1ed9 endothelin -1 t\u0103ng v\u00e0 r\u1ea5t gi\u00e0u th\u1ee5 th\u1ec3 ET A<\/p>\n

2.3.3 <\/strong>Nitric oxide (NO)<\/strong><\/h4>\n

\u0110\u01b0\u1ee3c s\u1ea3n xu\u1ea5t b\u1edfi t\u1ebf b\u00e0o n\u1ed9i m\u00f4 t\u1eeb c\u00e1c ph\u00e2n t\u1eed L-Arginine d\u01b0\u1edbi vai tr\u00f2 x\u00fac t\u00e1c c\u1ee7a NO synthases. \u0110\u00e2y l\u00e0 m\u1ed9t ch\u1ea5t g\u00e2y gi\u00e3n m\u1ea1ch m\u1ea1nh, c\u00f3 vai tr\u00f2 \u1ee9c ch\u1ebf ho\u1ea1t h\u00f3a ti\u1ec3u c\u1ea7u v\u00e0 \u1ee9c ch\u1ebf ph\u00e2n tri\u1ec3n t\u1ebf b\u00e0o c\u01a1 tr\u01a1n th\u00e0nh m\u1ea1ch. Khi \u0111\u01b0\u1ee3c t\u1ea1o ra, NO g\u00e2y t\u00e1c d\u1ee5ng qua trung gian GMP v\u00f2ng v\u00e0 nhanh ch\u00f3ng b\u1ecb b\u1ea5t ho\u1ea1t b\u1edfi enzym phosphodiesterase type 5 (PDE-5). Quan s\u00e1t th\u1ea5y \u1edf b\u1ec7nh nh\u00e2n t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng gi\u1ea3m n\u1ed3ng \u0111\u1ed9 enzym sinh t\u1ed5ng h\u1ee3p nitric oxide.<\/p>\n

3. Ph\u00e2n lo\u1ea1i<\/strong><\/h2>\n

Khuy\u1ebfn c\u00e1o n\u0103m 2015 c\u1ee7a H\u1ed9i Tim m\u1ea1ch v\u00e0 H\u1ed9i H\u00f4 h\u1ea5p ch\u00e2u \u00c2u v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh chia 5 nh\u00f3m.<\/p>\n

4. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/h2>\n

4.1 Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/strong><\/h3>\n

Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng c\u1ee7a b\u1ec7nh nh\u00e2n t\u0103ng \u00e1p l\u1ef1c m\u1ea1ch ph\u1ed5i kh\u00f4ng \u0111\u1eb7c hi\u1ec7u v\u00e0 kh\u1edfi ph\u00e1t t\u1eeb t\u1eeb. V\u00ec v\u1eady \u1edf 90% c\u00e1c b\u1ec7nh nh\u00e2n t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, th\u01b0\u1eddng c\u00f3 giai \u0111o\u1ea1n ch\u1eadm tr\u1ec5 kho\u1ea3ng 2 n\u0103m v\u1ec1 ch\u1ea9n \u0111o\u00e1n (t\u1eeb khi kh\u1edfi ph\u00e1t tri\u1ec7u ch\u1ee9ng t\u1edbi khi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c).<\/p>\n

C\u00e1c tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng bao g\u1ed3m: Kh\u00f3 th\u1edf khi g\u1eafng s\u1ee9c, m\u1ec7t, \u0111au ng\u1ef1c, h\u1ed3i h\u1ed9p tr\u1ed1ng ng\u1ef1c, ng\u1ea5t, b\u1ee5ng ch\u01b0\u1edbng ho\u1eb7c ph\u00f9 m\u1eaft c\u00e1 ch\u00e2n. Tri\u1ec7u ch\u1ee9ng xu\u1ea5t hi\u1ec7n c\u1ea3 khi ngh\u1ec9 ng\u01a1i b\u00e1o hi\u1ec7u b\u1ec7nh \u1edf giai \u0111o\u1ea1n n\u1eb7ng v\u00e0 ti\u00ean l\u01b0\u1ee3ng kh\u00f4ng t\u1ed1t. Tr\u00ean l\u00e2m s\u00e0ng, th\u01b0\u1eddng d\u00f9ng ph\u00e2n lo\u1ea1i c\u1ee7a WHO \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 c\u01a1 n\u0103ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

4.2 Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/strong><\/h3>\n

Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 c\u00f3 th\u1ec3 g\u1ee3i \u00fd nguy\u00ean nh\u00e2n g\u00e2y t\u0103ng \u00e1p m\u1ea1ch ph\u1ed5i. C\u00e1c d\u1ea5u hi\u1ec7u th\u1ef1c th\u1ec3 \u0111\u1eb7c hi\u1ec7u c\u1ee7a b\u1ec7nh x\u01a1 c\u1ee9ng b\u00ec, b\u1ec7nh ph\u1ed5i k\u1ebd, c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh l\u00fd gan c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1ecbnh h\u01b0\u1edbng \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

4.3 Kh\u00e1m l\u00e2m s\u00e0ng tim m\u1ea1ch c\u00f3 th\u1ec3 th\u1ea5y:<\/strong><\/h3>\n

L\u1ed3ng ng\u1ef1c tr\u00e1i nh\u00f4 cao, ti\u1ebfng T2 m\u1ea1nh \u1edf \u0111\u00e1y tim, ti\u1ebfng th\u1ed5i to\u00e0n t\u00e2m thu c\u1ee7a h\u1edf van ba l\u00e1, t\u0103ng l\u00ean khi h\u00edt v\u00e0o, ti\u1ebfng th\u1ed5i t\u00e2m tr\u01b0\u01a1ng c\u1ee7a h\u1edf van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i v\u00e0 ti\u1ebfng T3 ng\u1ef1a phi ph\u1ea3i.<\/p>\n

Nghe ph\u1ed5i th\u01b0\u1eddng kh\u00f4ng ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng ngo\u1ea1i tr\u1eeb c\u00e1c b\u1ec7nh nh\u00e2n t\u0103ng \u00e1p l\u1ef1c m\u1ea1ch ph\u1ed5i nh\u00f3m 3.<\/p>\n

T\u0129nh m\u1ea1ch c\u1ed5 gi\u00e3n, gan to, d\u1ea5u hi\u1ec7u m\u1ea1ch \u0111\u1eadp \u1edf gan, ph\u00f9 ngo\u1ea1i vi, c\u1ed5 ch\u01b0\u1edbng l\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u th\u1ec3 hi\u1ec7n giai \u0111o\u1ea1n mu\u1ed9n c\u1ee7a b\u1ec7nh v\u1edbi c\u00e1c bi\u1ec3u hi\u1ec7n suy tim ph\u1ea3i r\u00f5 r\u1ec7t.<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i (Pulmonary Hypertension \u2013 PH): \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 t\u00ecnh tr\u1ea1ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i trung b\u00ecnh (AL\u0110MPTB) > 20 mmHg \u0111\u01b0\u1ee3c \u0111o b\u1eb1ng th\u00f4ng tim ph\u1ea3i. T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i bao g\u1ed3m nhi\u1ec1u nh\u00f3m b\u1ec7nh nguy\u00ean kh\u00e1c nhau c\u00f3 chung bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng. 1. \u0110\u1ecbnh ngh\u0129a \u2013 […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nT\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u0103ng \u00e1p m\u1ea1ch m\u00e1u ph\u1ed5i trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p. 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