{"id":26535,"date":"2023-04-25T14:45:04","date_gmt":"2023-04-25T07:45:04","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26535"},"modified":"2023-04-25T14:45:04","modified_gmt":"2023-04-25T07:45:04","slug":"hoi-chung-giam-hoat-giap-lam-sang-can-lam-sang-va-chan-doan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/25\/hoi-chung-giam-hoat-giap-lam-sang-can-lam-sang-va-chan-doan\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p: l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n"},"content":{"rendered":"

H\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn tuy\u1ebfn gi\u00e1p, m\u1ed9t tuy\u1ebfn n\u1ed9i ti\u1ebft s\u1ea3n xu\u1ea5t c\u00e1c hormone gi\u00fap \u0111i\u1ec1u ch\u1ec9nh qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i ch\u1ea5t trong c\u01a1 th\u1ec3. Khi tuy\u1ebfn gi\u00e1p kh\u00f4ng th\u1ec3 s\u1ea3n xu\u1ea5t \u0111\u1ee7 l\u01b0\u1ee3ng hormone gi\u00e1p \u0111\u1ec3 \u0111\u00e1p \u1ee9ng nhu c\u1ea7u c\u1ee7a c\u01a1 th\u1ec3, ng\u01b0\u1eddi b\u1ec7nh s\u1ebd tr\u1ea3i qua m\u1ed9t lo\u1ea1t c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00f3 ch\u1ecbu v\u00e0 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi v\u00e0 \u0111\u00fang c\u00e1ch, h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng. B\u00e0i vi\u1ebft n\u00e0y s\u1ebd l\u00e0m s\u00e1ng t\u1ecf n\u1ed9i dung v\u1ec1 th\u0103m kh\u00e1m, c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 c\u00e1c c\u1eadn l\u00e2m s\u00e0ng d\u00f9ng trong ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p.<\/strong><\/p>\n

\"Minh
Minh h\u1ecda h\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p<\/figcaption><\/figure>\n

1. H\u1ecfi b\u1ec7nh<\/strong><\/h2>\n

1.1. B\u1ec7nh s\u1eed<\/strong><\/h3>\n

– L\u00fd do v\u00e0o vi\u1ec7n th\u01b0\u1eddng l\u00e0 ph\u00f9 ni\u00eam, m\u1ec7t m\u1ecfi ho\u1eb7c l\u00e0 th\u1ea5y c\u1ed5 to b\u1ea5t th\u01b0\u1eddng
\n– H\u1ecfi b\u1ec7nh nh\u00e2n v\u1ec1 kh\u1ea3 n\u0103ng ch\u1ecbu nhi\u1ec7t c\u1ee7a m\u00ecnh
\nNote: Vd nh\u01b0 \u201cAnh th\u00edch tr\u1eddi l\u1ea1nh hay \u1ea5m? Anh c\u00f3 m\u1eb7c \u0111\u1ed3 \u1ea5m h\u01a1n ng\u01b0\u1eddi b\u00ecnh th\u01b0\u1eddng kh\u00f4ng?Anh c\u00f3 c\u1ea3m th\u1ea5y m\u00ecnh d\u1ec5 b\u1ecb l\u1ea1nh kh\u00f4ng hay Anh c\u00f3 th\u01b0\u1eddng c\u1ea3m th\u1ea5y b\u1ecb l\u1ea1nh kh\u00f4ng?\u201d
\n– H\u1ecfi b\u1ec7nh nh\u00e2n c\u00f3 th\u1ea5y da m\u00ecnh b\u1ea5t th\u01b0\u1eddng kh\u00f4ng?
\n– H\u1ecfi b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1ec3 \u00fd nh\u1ecbp tim m\u00ecnh b\u1ea5t th\u01b0\u1eddng kh\u00f4ng? C\u00f3 c\u1ea3m th\u1ea5y m\u00ecnh t\u0103ng c\u00e2n nhanh kh\u00f4ng?<\/p>\n

1.2. Ti\u1ec1n s\u1eed\u00a0<\/strong><\/h3>\n

1.2.1. Ti\u1ec1n s\u1eed b\u1ea3n th\u00e2n<\/strong><\/p>\n

– H\u1ecfi b\u1ec7nh nh\u00e2n \u0111\u00e3 g\u1eb7p t\u00ecnh tr\u1ea1ng nh\u01b0 th\u1ebf n\u00e0y tr\u01b0\u1edbc \u0111\u00e2y ch\u01b0a?
\n– C\u00f3 t\u1eebng b\u1ecb b\u1ec7nh li\u00ean quan \u0111\u1ebfn tuy\u1ebfn gi\u00e1p tr\u01b0\u1edbc \u0111\u00e2y kh\u00f4ng? N\u1ebfu c\u00f3 th\u00ec \u0111i\u1ec1u tr\u1ecb nh\u01b0 th\u1ebf n\u00e0o?
\n– B\u1ec7nh nh\u00e2n c\u00f3 t\u1eebng m\u1eafc c\u00e1c b\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n nh\u01b0 th\u1ea5p kh\u1edbp, lupus ban \u0111\u1ecf ch\u01b0a?
\n– N\u1ebfu l\u00e0 n\u1eef, c\u1ea7n h\u1ecfi v\u1ec1 t\u00ecnh tr\u1ea1ng kinh nguy\u1ec7t, t\u00ecnh tr\u1ea1ng sinh n\u1edf c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n

1.2.2. Ti\u1ec1n s\u1eed gia \u0111\u00ecnh<\/strong><\/p>\n

Ng\u01b0\u1eddi trong gia \u0111\u00ecnh c\u00f3 ai b\u1ecb gi\u1ed1ng b\u1ec7nh nh\u00e2n kh\u00f4ng?<\/p>\n

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

\u0110a d\u1ea1ng do \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u c\u01a1 quan, li\u00ean quan b\u1ec7nh nguy\u00ean, tu\u1ed5i t\u00e1c v\u00e0 nh\u1ea5t l\u00e0 tu\u1ef3 thu\u1ed9c v\u00e0o th\u1eddi gian v\u00e0 m\u1ee9c \u0111\u1ed9 thi\u1ebfu h\u1ee5t hormone gi\u00e1p.<\/p>\n

2.1.T\u0103ng tr\u01b0\u1edfng v\u00e0 ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3<\/strong><\/h3>\n

Bi\u1ec3u hi\u1ec7n r\u00f5 trong giai \u0111o\u1ea1n tr\u1ebb nh\u1ecf v\u00e0 th\u1eddi k\u1ef3 ni\u00ean thi\u1ebfu.<\/p>\n

\u00b7 S\u1ef1 ph\u00e1t tri\u1ec3n v\u00e0 bi\u1ec7t ho\u00e1 c\u1ee7a n\u00e3o x\u1ea3y ra ph\u1ea7n l\u1edbn (2\/3) trong v\u00f2ng 2 n\u0103m \u0111\u1ea7u ti\u00ean \ud83e\udc6a thay th\u1ebf s\u1edbm b\u1eb1ng hormon gi\u00e1p ngay sau sinh<\/a> s\u1ebd l\u00e0m h\u1ea1n ch\u1ebf t\u1ed1i \u0111a th\u01b0\u01a1ng t\u1ed5n n\u00e3o v\u0129nh vi\u1ec5n.
\n\u00b7 Thi\u1ebfu h\u1ee5t hormon gi\u00e1p sau 3 tu\u1ed5i kh\u00f4ng g\u00e2y ch\u1eadm ph\u00e1t tri\u1ec3n tinh th\u1ea7n, nh\u01b0ng g\u00e2y ch\u1eadm ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3, ch\u1eadm ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng d\u00e0i, ch\u1eadm m\u1ecdc r\u0103ng v\u0129nh vi\u1ec5n.<\/p>\n

2.2. Da-ni\u00eam m\u1ea1c<\/strong><\/h3>\n
    \n
  • M\u1eb7t tr\u00f2n nh\u01b0 m\u1eb7t tr\u0103ng, \u00edt bi\u1ec3u l\u1ed9 t\u00ecnh c\u1ea3m, tr\u00e1n nhi\u1ec1u n\u1ebfp nh\u0103n.<\/li>\n
  • M\u00ed m\u1eaft ph\u00f9, nh\u1ea5t l\u00e0 mi d\u01b0\u1edbi.<\/li>\n
  • G\u00f2 m\u00e1 t\u00edm, nhi\u1ec1u mao m\u1ea1ch b\u1ecb gi\u00e3n; m\u00f4i d\u00e0y v\u00e0 t\u00edm.<\/li>\n
  • Da \u1edf v\u00f9ng m\u1eb7t v\u00e0 b\u00e0n tay c\u00f3 m\u00e0u v\u00e0ng b\u1ee7ng (th\u00e2m nhi\u1ec5m caroten ) .<\/li>\n
  • B\u00e0n tay, b\u00e0n ch\u00e2n d\u00e0y, c\u00e1c ng\u00f3n to v\u00e0 d\u00e0y.<\/li>\n
  • Ni\u00eam m\u1ea1c l\u01b0\u1ee1i b\u1ecb x\u00e2m nhi\u1ec5m l\u01b0\u1ee1i to ra.<\/li>\n
  • D\u00e2y thanh \u00e2m b\u1ecb th\u00e2m nhi\u1ec5m gi\u1ecdng kh\u00e0n<\/li>\n
  • V\u00f2i Eustache b\u1ecb th\u00e2m nhi\u1ec5m \u00f9 tai, nghe k\u00e9m.<\/li>\n
  • Da kh\u00f4 bong v\u1ea3y.<\/li>\n
  • T\u00f3c kh\u00f4, d\u1ec5 r\u1ee5ng; ph\u00eda ngo\u00e0i ch\u00e2n m\u00e0y th\u01b0a ho\u1eb7c r\u1ee5ng h\u1ebft (d\u1ea5u hi\u1ec7u \u201c\u0111u\u00f4i ch\u00e2n m\u00e0y\u201d, d\u1ea5u Queen Anne); l\u00f4ng n\u00e1ch, l\u00f4ng mu r\u1ee5ng.<\/li>\n<\/ul>\n

    2.3. Chuy\u1ec3n ho\u00e1<\/strong><\/h3>\n
      \n
    • S\u1ee3 l\u1ea1nh.<\/li>\n
    • Ch\u1eadm h\u1ea5p thu glucose \u1edf ru\u1ed9t, gi\u1ea3m s\u1eed d\u1ee5ng glucose v\u00e0 \u0111\u1ec1 kh\u00e1ng insulin.<\/li>\n
    • T\u0103ng c\u00e2n d\u00f9 \u0103n k\u00e9m. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n t\u0103ng c\u00e2n v\u1eeba ph\u1ea3i do \u1ee9 d\u1ecbch.<\/li>\n<\/ul>\n

      2.4. Th\u1ea7n kinh<\/strong><\/h3>\n

      \u0110au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, r\u1ed1i lo\u1ea1n nh\u1eadn th\u1ee9c, \u0111i\u1ebfc, \u00f9 tai, d\u1ecb c\u1ea3m.<\/p>\n

      2.5. Tim m\u1ea1ch<\/strong><\/h3>\n

      Nh\u1ecbp ch\u1eadm, th\u1ec3 t\u00edch t\u1ed1ng m\u00e1u gi\u1ea3m, l\u01b0u l\u01b0\u1ee3ng tim gi\u1ea3m, tr\u00e0n d\u1ecbch m\u00e0ng tim.<\/p>\n

      2.6. C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/strong><\/h3>\n
        \n
      • M\u1ecfi, y\u1ebfu c\u01a1, co r\u00fat c\u01a1.<\/li>\n
      • C\u00f3 th\u1ec3 \u0111au kh\u1edbp, tr\u00e0n d\u1ecbch kh\u1edbp, gi\u1ea3 b\u1ec7nh g\u00fat.<\/li>\n
      • \u1ede tr\u1ebb em: ch\u1eadm ph\u00e1t tri\u1ec3n x\u01b0\u01a1ng d\u00e0i.<\/li>\n<\/ul>\n

        2.7. D\u1ea1 d\u00e0y-ru\u1ed9t<\/strong><\/h3>\n
          \n
        • T\u00e1o b\u00f3n, ch\u01b0\u1edbng b\u1ee5ng.<\/li>\n
        • Gi\u1ea3m ti\u1ebft d\u1ecbch d\u1ea1 d\u00e0y do vi\u00eam teo th\u00e2n DD, teo trong vi\u00eam tuy\u1ebfn gi\u00e1p.<\/li>\n
        • Kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i t\u1ebf b\u00e0o th\u00e0nh DD v\u00e0 thi\u1ebfu m\u00e1u \u00e1c t\u00ednh th\u01b0\u1eddng g\u1eb7p \u1edf b\u1ec7nh l\u00fd gi\u00e1p t\u1ef1 mi\u1ec5n.<\/li>\n<\/ul>\n

          2.8. Sinh d\u1ee5c<\/strong><\/h3>\n
            \n
          • N\u1eef: RL kinh nguy\u1ec7t, kh\u00f4ng r\u1ee5ng tr\u1ee9ng, v\u00f4 sinh.
            \nGi\u1ea3m ho\u1ea1t gi\u00e1p khi c\u00f3 thai c\u00f3 th\u1ec3 g\u00e2y thai l\u01b0u, sinh non, THA v\u00e0 xu\u1ea5t huy\u1ebft sau sinh.<\/li>\n
          • Nam: b\u1ea5t th\u01b0\u1eddng ch\u1ee9c n\u0103ng sinh d\u1ee5c.<\/li>\n<\/ul>\n

            2.9. N\u1ed9i ti\u1ebft<\/strong><\/h3>\n

            C\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 b\u01b0\u1edbu gi\u00e1p: b\u01b0\u1edbu gi\u00e1p ch\u1ec9 c\u00f3 trong 1 s\u1ed1 nguy\u00ean nh\u00e2n \u0111\u1eb7c bi\u1ec7t (vi\u00eam tuy\u1ebfn gi\u00e1p Hashimoto, do RLCH iode …).<\/p>\n

            3. C\u1eadn l\u00e2m s\u00e0ng<\/strong><\/h2>\n

            3.1. X\u00e9t nghi\u1ec7m \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p<\/strong><\/h3>\n

            3.1.1. Hormon gi\u00e1p<\/strong><\/p>\n

            \u0110\u1ecbnh l\u01b0\u1ee3ng hormone gi\u00e1p \ud83e\udc6a gi\u00fap ch\u1ea9n \u0111o\u00e1n.
            \nFT4 quan tr\u1ecdng h\u01a1n n\u1ed3ng \u0111\u1ed9 T4 TP.
            \nFT4 quan tr\u1ecdng h\u01a1n FT3 (gi\u1ea3m FT3 g\u1eb7p \u1edf ng\u01b0\u1eddi gi\u00e0, s\u1eed d\u1ee5ng amiodarone, nhi\u1ec5m tr\u00f9ng n\u1eb7ng).<\/p>\n

            – Gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng:<\/p>\n

              \n
            • T\u1ea1i khoa YH H\u1ea1t nh\u00e2n:
              \n+ T 3: 0,6 \u2013 1,9 ng\/ml
              \n+ T 4: 45 \u2013 110 ng\/ml
              \n+ TSH: 0,25 \u2013 4 \u03bc UI\/ml<\/li>\n
            • T\u1ea1i khoa Sinh Ho\u00e1:
              \n+ FT 4: 12 \u2013 22 pmol\/l
              \n+ TSH: 0,27 \u2013 4,2 \u03bc UI\/ml
              \n\u0110\u1eb7c \u0111i\u1ec3m TSH, FT4 v\u00e0 T3 qua c\u00e1c m\u1ee9c \u0111\u1ed9 gi\u1ea3m ho\u1ea1t gi\u00e1p<\/p>\n\n\n\n\n\n\n
              M\u1ee9c \u0111\u1ed9<\/td>\nTSH<\/td>\nFT4<\/sub><\/td>\nT3<\/sub><\/td>\n<\/tr>\n
              Gi\u1ea3m ho\u1ea1t gi\u00e1p CLS<\/td>\nT\u0103ng<\/td>\nBT<\/td>\nBT<\/td>\n<\/tr>\n
              Gi\u1ea3m ho\u1ea1t gi\u00e1p nh\u1eb9<\/td>\nT\u0103ng<\/td>\nBT\/Gi\u1ea3m<\/td>\nBT\/Gi\u1ea3m<\/td>\n<\/tr>\n
              Gi\u1ea3m ho\u1ea1t gi\u00e1p r\u00f5<\/td>\nT\u0103ng<\/td>\nGi\u1ea3m<\/td>\nGi\u1ea3m<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

              Gi\u1ea3m ho\u1ea1t gi\u00e1p ti\u00ean ph\u00e1t l\u00e0 nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p nh\u1ea5t c\u1ee7a t\u0103ng TSH.
              \nT4 gi\u1ea3m s\u1edbm, trong khi T3 v\u1eabn c\u00f2n b\u00ecnh th\u01b0\u1eddng cho \u0111\u1ebfn khi ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p b\u1ecb \u1ea3nh h\u01b0\u1edfng n\u1eb7ng.<\/li>\n<\/ul>\n

              3.1.2. \u0110\u1ed9 t\u1eadp trung Iode ph\u00f3ng x\u1ea1<\/strong><\/p>\n

              \u0110\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng thu nh\u1eadn iode c\u1ee7a tuy\u1ebfn gi\u00e1p. Th\u1ea5p h\u01a1n b\u00ecnh th\u01b0\u1eddng trong ph\u1ea7n l\u1edbn tr\u01b0\u1eddng h\u1ee3p, c\u00f3 th\u1ec3 t\u0103ng trong ch\u1ee9ng thi\u1ebfu h\u1ee5t iode.<\/p>\n

              Ch\u1ee5p nh\u1ea5p nh\u00e1y ph\u00f3ng x\u1ea1:<\/p>\n

              I 131<\/sup>\u00a0<\/em><\/strong><\/p>\n

              I 123<\/sup><\/em><\/strong><\/p>\n

              Tc 99m<\/sup><\/em><\/strong><\/p>\n

              3.2. X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n<\/strong><\/p>\n

              3.2.1. Mi\u1ec5n d\u1ecbch: <\/strong><\/p>\n

              Kh\u00e1ng th\u1ec3 thyroglobulin (AbTg) v\u00e0\/ho\u1eb7c thyroperoxidase (AbTPO ), kh\u00e1ng th\u1ec3 th\u1ee5 th\u1ec3 TSH (\u1ee9c ch\u1ebf) ( TSH-R Ab block).<\/p>\n

              3.2.2. TSH<\/strong><\/p>\n

              Gi\u00fap \u0111\u1ecbnh v\u1ecb tr\u00ed th\u01b0\u01a1ng t\u1ed5n ti\u00ean ph\u00e1t hay th\u1ee9 ph\u00e1t.
              \nTSH l\u00e0 x\u00e9t nghi\u1ec7m \u0111\u1ec3 g\u1ee3i \u00fd ch\u1ea9n \u0111o\u00e1n gi\u1ea3m ho\u1ea1t gi\u00e1p.
              \nTSH t\u01b0\u01a1ng quan ngh\u1ecbch v\u1edbi FT4 h\u01a1n FT3.<\/p>\n

              3.2.3. Test TRH<\/strong><\/p>\n

              D\u00f9ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n gi\u1ea3m ho\u1ea1t gi\u00e1p trung \u01b0\u01a1ng (tuy\u1ebfn y\u00ean, d\u01b0\u1edbi \u0111\u1ed3i) \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 FT4 th\u1ea5p v\u00e0 TSH b\u00ecnh th\u01b0\u1eddng; ho\u1eb7c \u0111\u1ec3 ph\u00e2n bi\u1ec7t nguy\u00ean nh\u00e2n do tuy\u1ebfn y\u00ean hay do d\u01b0\u1edbi \u0111\u1ed3i.<\/p>\n

              3.3. X\u00e9t nghi\u1ec7m v\u1ec1 h\u00ecnh \u1ea3nh<\/strong><\/h3>\n

              3.3.1. Si\u00eau \u00e2m gi\u00e1p<\/strong><\/p>\n

              Gi\u00fap ph\u00e1t hi\u1ec7n h\u00ecnh \u1ea3nh \u0111\u1ea1i th\u1ec3 b\u1ec7nh l\u00fd tuy\u1ebfn gi\u00e1p li\u00ean quan.<\/p>\n

              3.3.2. Ch\u1ee5p nh\u1ea5p nh\u00e1y ph\u00f3ng x\u1ea1 b\u1eb1ng I 131, I 123 hay Tc 99m<\/strong><\/p>\n

              3.3.3. H\u00ecnh \u1ea3nh c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI) tuy\u1ebfn y\u00ean<\/strong><\/p>\n

              Ph\u00e1t hi\u1ec7n u tuy\u1ebfn y\u00ean.<\/p>\n

              L\u01b0u \u00fd: gi\u1ea3m ho\u1ea1t gi\u00e1p ti\u00ean ph\u00e1t k\u00e9o d\u00e0i \u1edf ng\u01b0\u1eddi tr\u1ebb \ud83e\udc6a tuy\u1ebfn y\u00ean l\u1edbn ra v\u00e0 th\u1eadm ch\u00ed \u0103n m\u00f2n h\u1ed1 y\u00ean nh\u01b0 1 tr\u01b0\u1eddng h\u1ee3p u tuy\u1ebfn y\u00ean th\u1eadt s\u1ef1.<\/p>\n

              3.4. C\u00e1c x\u00e9t nghi\u1ec7m gi\u00e1n ti\u1ebfp kh\u00e1c<\/strong><\/h3>\n

              – Huy\u1ebft h\u1ecdc: thi\u1ebfu m\u00e1u \u0111\u1eb3ng s\u1eafc, h\u1ed3ng c\u1ea7u nh\u1ecf hay h\u1ed3ng c\u1ea7u to.
              \nT\u0103ng cholesterol, t\u0103ng triglyceride m\u00e1u.
              \n– Gi\u1ea3m natri m\u00e1u do ho\u00e0 lo\u00e3ng.<\/p>\n

              4. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n

              Giai \u0111o\u1ea1n l\u00e2m s\u00e0ng \u0111i\u1ec3n h\u00ecnh th\u01b0\u1eddng l\u00e0 qu\u00e1 mu\u1ed9n.<\/p>\n

              4.1. L\u00e2m s\u00e0ng:<\/strong> Ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o:<\/p>\n

              – H\u1ed9i ch\u1ee9ng da, ni\u00eam m\u1ea1c
              \n– H\u1ed9i ch\u1ee9ng gi\u1ea3m chuy\u1ec3n h\u00f3a: m\u1ec7t m\u1ecfi, ng\u1ee7 li b\u00ec, s\u1ee3 l\u1ea1nh, r\u1ed1i lo\u1ea1n tr\u00ed nh\u1edb, t\u0103ng c\u00e2n, ch\u00e1n \u0103n
              \n– Tuy\u1ebfn gi\u00e1p:
              \n+ Kh\u00f4ng s\u1edd th\u1ea5y: vi\u00eam teo tuy\u1ebfn gi\u00e1p m\u1ea1n t\u00ednh.
              \n+ Lan t\u1ecfa: VTG sau sinh v\u00e0 VTG Hashimoto.
              \n+ Lan t\u1ecfa \u0111\u00e0n h\u1ed3i: gi\u1ea3m ho\u1ea1t tuy\u1ebfn gi\u00e1p do thi\u1ebfu iode v\u00e0 RLTH hormone.<\/p>\n

              4.2. C\u1eadn l\u00e2m s\u00e0ng:<\/strong>
              \nFT4 gi\u1ea3m, FT3 gi\u1ea3m, TSH si\u00eau nh\u1ea1y t\u0103ng (nguy\u00ean ph\u00e1t ) ho\u1eb7c gi\u1ea3m (th\u1ee9 ph\u00e1t).<\/p>\n

              5. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h2>\n

              5.1. H\u1ed9i ch\u1ee9ng Down<\/strong><\/p>\n

              5.2. H\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0<\/strong><\/p>\n

              Ph\u00f9 m\u1ec1m, tr\u1eafng, l\u00f5m; n\u01b0\u1edbc ti\u1ec3u c\u00f3 protein ni\u1ec7u cao >3,5 g\/24 gi\u1edd, protein m\u00e1u gi\u1ea3m.<\/p>\n

              5.3. Suy tu\u1ea7n ho\u00e0n n\u00e3o \u1edf ng\u01b0\u1eddi gi\u00e0<\/strong><\/p>\n

              Gi\u1ea3m tr\u00ed nh\u1edb, \u0111\u00f4i l\u00fac bu\u1ed3n r\u1ea7u, \u00edt n\u00f3i, \u00edt \u01b0a ti\u1ebfp x\u00fac, da b\u1ea1c, d\u1ec5 l\u1ea1nh.
              \nFT3, FT4 b\u00ecnh th\u01b0\u1eddng<\/p>\n

              5.4. Suy th\u1eadn m\u1ea1n<\/strong><\/p>\n

              Thi\u1ebfu m\u00e1u, ure v\u00e0 creatinin m\u00e1u cao, THA.<\/p>\n

              Ngu\u1ed3n tham kh\u1ea3o
              \nSlide b\u00e0i gi\u1ea3ng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c Hu\u1ebf 2021<\/p>\n

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

              H\u1ed9i ch\u1ee9ng gi\u1ea3m ho\u1ea1t gi\u00e1p l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd li\u00ean quan \u0111\u1ebfn tuy\u1ebfn gi\u00e1p, m\u1ed9t tuy\u1ebfn n\u1ed9i ti\u1ebft s\u1ea3n xu\u1ea5t c\u00e1c hormone gi\u00fap \u0111i\u1ec1u ch\u1ec9nh qu\u00e1 tr\u00ecnh trao \u0111\u1ed5i ch\u1ea5t trong c\u01a1 th\u1ec3. 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