{"id":26541,"date":"2023-04-22T18:33:55","date_gmt":"2023-04-22T11:33:55","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26541"},"modified":"2023-04-22T18:33:55","modified_gmt":"2023-04-22T11:33:55","slug":"mot-so-phuong-phap-tham-do-tim-mach","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/22\/mot-so-phuong-phap-tham-do-tim-mach\/","title":{"rendered":"M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch"},"content":{"rendered":"

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n gi\u00fap ta hi\u1ec3u \u0111\u01b0\u1ee3c c\u1ea5u tr\u00fac v\u00e0 ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng tim. Ngo\u00e0i ra, c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong qu\u00e1 tr\u00ecnh l\u00e0m m\u1ed9t s\u1ed1 th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n c\u1ee5 th\u1ec3 (v\u00ed d\u1ee5, can thi\u1ec7p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh qua da\u00a0trong qu\u00e1 tr\u00ecnh\u00a0th\u00f4ng tim,\u00a0tri\u1ec7t \u0111\u1ed1t b\u1eb1ng n\u0103ng l\u01b0\u1ee3ng s\u00f3ng t\u1ea7n s\u1ed1 radio\u00a0trong qu\u00e1 tr\u00ecnh\u00a0th\u0103m d\u00f2 \u0111i\u1ec7n sinh l\u00fd tim).<\/span><\/strong><\/p>\n\n\n\n\n\n\n
\u00a0Th\u0103m d\u00f2<\/strong><\/td>\nX\u00e9t nghi\u1ec7m th\u0103m d\u00f2<\/strong><\/td>\n<\/tr>\n
Ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i<\/td>\nCh\u1ee5p bu\u1ed3ng th\u1ea5t\u00a0c\u1ea3n quangSi\u00eau \u00e2m tim<\/p>\n

Ch\u1ee5p MRI \u0111i\u1ec1u khi\u1ec3n b\u1edfi \u0111i\u1ec7n t\u00e2m \u0111\u1ed3<\/p>\n

Ch\u1ee5p x\u1ea1 h\u00ecnh v\u1edbi \u0111i\u1ec1u khi\u1ec3n \u0111a ph\u01b0\u01a1ng th\u1ee9c<\/td>\n<\/tr>\n

Ch\u1ea9n \u0111o\u00e1n v\u00e0 ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh<\/td>\nCh\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh<\/p>\n

Nghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c\u00a0v\u1edbi \u0111i\u1ec7n t\u00e2m \u0111\u1ed3, h\u00ecnh \u1ea3nh t\u01b0\u1edbi m\u00e1u c\u01a1 tim ho\u1eb7c si\u00eau \u00e2m tim<\/p>\n

Si\u00eau \u00e2m n\u1ed9i m\u1ea1ch<\/p>\n

ch\u1ee5p MRI m\u1ea1ch m\u00e1u<\/p>\n

Ch\u1ee5p c\u1eaft l\u1edbp \u0111a d\u00e3y \u0111\u1ed9ng m\u1ea1ch v\u00e0nh<\/td>\n<\/tr>\n

Kh\u1ea3 n\u0103ng s\u1ed1ng c\u00f2n c\u1ee7a c\u01a1 tim<\/td>\nCh\u1ee5p MRI \u0111i\u1ec1u khi\u1ec3n b\u1edfi \u0111i\u1ec7n t\u00e2m \u0111\u1ed3<\/p>\n

Ch\u1ee5p c\u1eaft l\u1edbp ph\u00e1t x\u1ea1 positron<\/a>\u00a0(PET)<\/p>\n

Ch\u1ee5p c\u1eaft l\u1edbp ph\u00e1t x\u1ea1 \u0111\u01a1n photon\u00a0(SPECT) khi ngh\u1ec9 \u0111\u00e1nh gi\u00e1 t\u01b0\u1edbi m\u00e1u c\u01a1 tim<\/p>\n

Nghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c\u00a0(s\u1eed d\u1ee5ng dobutamine li\u1ec1u th\u1ea5p) v\u1edbi si\u00eau \u00e2m tim<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

\u00a0<\/strong><\/p>\n

1. Nghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c v\u1edbi \u0111i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong><\/h2>\n

1.1. Kh\u00e1i ni\u1ec7m<\/strong>
\nNghi\u1ec7m ph\u00e1p g\u1eafng s\u1ee9c (NPGS) \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 l\u00e0 m\u1ed9t th\u0103m d\u00f2 tim m\u1ea1ch kh\u00f4ng ch\u1ea3y m\u00e1u d\u1ef1a tr\u00ean nh\u1eefng bi\u1ebfn \u0111\u1ed5i v\u1ec1 l\u00e2m s\u00e0ng (\u0111au ng\u1ef1c, kh\u00f3 th\u1edf), \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 v\u00e0 huy\u1ebft \u00e1p khi b\u1ec7nh nh\u00e2n g\u1eafng s\u1ee9c (b\u1eb1ng xe \u0111\u1ea1p l\u1ef1c k\u1ebf ho\u1eb7c th\u1ea3m ch\u1ea1y) theo m\u1ed9t quy tr\u00ecnh chu\u1ea9n.
\nNPGS \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh song song v\u1edbi c\u00e1c th\u0103m d\u00f2 tim m\u1ea1ch kh\u00e1c:
\n– \u0110\u00e1nh gi\u00e1 nh\u1eefng thay \u0111\u1ed5i th\u00f4ng kh\u00ed khi g\u1eafng s\u1ee9c (VO2<\/sub>, VCO2<\/sub>)
\n– Th\u0103m d\u00f2 ph\u00f3ng x\u1ea1 t\u01b0\u1edbi m\u00e1u c\u01a1 tim
\n– Th\u0103m d\u00f2 si\u00eau \u00e2m tim.<\/p>\n

1.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong>
\n1.2.1. B\u1ec7nh m\u1ea1ch v\u00e0nh
\n– Ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim \u1edf b\u1ec7nh nh\u00e2n c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 cao v\u00e0 trung b\u00ecnh, b\u1ec7nh nh\u00e2n \u0111au ng\u1ef1c ki\u1ec3u co th\u1eaft.
\n– Ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u c\u01a1 tim th\u1ea7m l\u1eb7ng \u1edf b\u1ec7nh nh\u00e2n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng; c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch ho\u1eb7c l\u00e0m ngh\u1ec1 nghi\u1ec7p c\u00f3 nguy c\u01a1 cao.
\n– Ph\u00e2n t\u1ea7ng nguy c\u01a1 v\u1edbi b\u1ec7nh nh\u00e2n b\u1ec7nh m\u1ea1ch v\u00e0nh \u1ed5n \u0111\u1ecbnh, nh\u1eb1m quy\u1ebft \u0111\u1ecbnh nh\u1eadp vi\u1ec7n \u0111i\u1ec1u tr\u1ecb hay \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa.
\n– Sau nh\u1ed3i m\u00e1u c\u01a1 tim: NPGS s\u1edbm, d\u01b0\u1edbi ng\u01b0\u1ee1ng t\u1ed1i \u0111a \u1edf b\u1ec7nh nh\u00e2n sau NMCT 4 \u2013 7 ng\u00e0y, tr\u01b0\u1edbc khi ra vi\u1ec7n, nh\u1eb1m ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb; NPGS mu\u1ed9n, sau khi ra vi\u1ec7n \u1edf b\u1ec7nh nh\u00e2n NMCT t\u1eeb 3 \u2013 6 tu\u1ea7n gi\u00fap ti\u00ean l\u01b0\u1ee3ng, \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb v\u00e0 kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c.
\n1.2.2. R\u1ed1i lo\u1ea1n nh\u1ecbp tim
\n– Ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111\u00e1nh gi\u00e1 b\u1ec7nh l\u00fd r\u1ed1i lo\u1ea1n nh\u1ecbp c\u00f3 li\u00ean quan \u0111\u1ebfn g\u1eafng s\u1ee9c.
\n– \u0110\u00e1nh gi\u00e1 v\u00e0 t\u1ed1i \u01b0u h\u00f3a ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00e1y \u1edf b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u1eb7t m\u00e1y t\u1ea1o nh\u1ecbp tim v\u0129nh vi\u1ec5n.
\n1.2.3. B\u1ec7nh van tim
\n– \u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 b\u1ec7nh v\u00e0 kh\u1ea3 n\u0103ng g\u1eafng s\u1ee9c c\u1ee7a b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh van tim kh\u00f4ng tri\u1ec7u ch\u1ee9ng.<\/p>\n

1.3 Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh\u00a0<\/strong>
\n1.3.1. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh tuy\u1ec7t \u0111\u1ed1i
\n– Nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p (trong v\u00f2ng 3 ng\u00e0y) ho\u1eb7c \u0111au ng\u1ef1c kh\u00f4ng \u1ed5n \u0111\u1ecbnh
\n– Vi\u00eam c\u01a1 tim c\u1ea5p, vi\u00eam m\u00e0ng ngo\u00e0i tim, vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n \u0111ang ho\u1ea1t \u0111\u1ed9ng.
\n– T\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7
\n– H\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1eb7ng
\n– Suy tim m\u1ea5t b\u00f9
\n– T\u0103ng huy\u1ebft \u00e1p ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t
\n– R\u1ed1i lo\u1ea1n nh\u1ecbp nguy hi\u1ec3m: r\u1ed1i lo\u1ea1n nh\u1ecbp ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, c\u00f3 tri\u1ec7u ch\u1ee9ng ho\u1eb7c g\u00e2y r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng.
\n– R\u1ed1i lo\u1ea1n ngo\u00e0i tim m\u1ea1ch c\u00f3 th\u1ec3 n\u1eb7ng th\u00eam do g\u1eafng s\u1ee9c: nhi\u1ec5m tr\u00f9ng ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t, suy th\u1eadn, thi\u1ebfu m\u00e1u n\u1eb7ng\u2026
\n– Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi, nh\u1ed3i m\u00e1u ph\u1ed5i.
\n1.3.2. Ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i
\n– H\u1eb9p van tim m\u1ee9c \u0111\u1ed9 v\u1eeba.
\n– B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i.
\n– R\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i
\n– T\u0103ng huy\u1ebft \u00e1p, t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i n\u1eb7ng.
\n– R\u1ed1i lo\u1ea1n nh\u1ecbp nhanh, r\u1ed1i lo\u1ea1n nh\u1ecbp ch\u1eadm.
\n– B\u1ea5t th\u01b0\u1eddng tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 c\u1ea3n tr\u1edf ph\u00e2n t\u00edch k\u1ebft qu\u1ea3 NPGS: Bloc nh\u00e1nh tr\u00e1i, bi\u1ebfn \u0111\u1ed5i \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 do digoxin.<\/p>\n

\"minh-hoa-tham-do-tim-mach\"<\/p>\n

2. Th\u0103m d\u00f2 tim m\u1ea1ch b\u1eb1ng Holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong><\/h2>\n

2.1. Kh\u00e1i ni\u1ec7m<\/strong>
\nHolter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ghi \u0111i\u1ec7n tim li\u00ean t\u1ee5c, trong m\u1ed9t th\u1eddi gian d\u00e0i trong khi b\u1ec7nh nh\u00e2n v\u1eabn th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t b\u00ecnh th\u01b0\u1eddng, nh\u1eb1m t\u00ecm hi\u1ec3u s\u1ef1 thay \u0111\u1ed5i c\u1ee7a nh\u1ecbp tim trong nh\u1eefng \u0111i\u1ec1u ki\u1ec7n sinh l\u00fd v\u00e0 b\u1ec7nh l\u00fd kh\u00e1c nhau.
\nM\u1ed9t m\u00e1y Holter \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 th\u00f4ng th\u01b0\u1eddng g\u1ed3m m\u1ed9t \u0111\u1ea7u ghi, s\u1eed d\u1ee5ng th\u1ebb nh\u1edb Flash, g\u1eafn v\u1edbi c\u00e1c \u0111i\u1ec7n c\u1ef1c, \u0111\u01b0\u1ee3c d\u00e1n l\u00ean ng\u1ef1c b\u1ec7nh nh\u00e2n. Th\u1eddi gian \u0111eo m\u00e1y th\u01b0\u1eddng l\u00e0 24 gi\u1edd, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1edbi 72 gi\u1edd. B\u1ec7nh nh\u00e2n v\u1eabn sinh ho\u1ea1t b\u00ecnh th\u01b0\u1eddng, th\u1eadm ch\u00ed l\u1eb7p l\u1ea1i nh\u1eefng ho\u1ea1t \u0111\u1ed9ng c\u00f3 th\u1ec3 l\u00e0m xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng, \u0111\u1ed3ng th\u1eddi ghi ch\u00e9p l\u1ea1i c\u00e1c di\u1ec5n bi\u1ebfn b\u1ea5t th\u01b0\u1eddng x\u1ea3y ra trong qu\u00e1 tr\u00ecnh \u0111eo m\u00e1y. Sau \u0111\u00f3, th\u1ebb nh\u1edb s\u1ebd \u0111\u01b0\u1ee3c r\u00fat ra v\u00e0 ph\u00e2n t\u00edch b\u1edfi m\u1ed9t chuy\u00ean gia nh\u1ecbp h\u1ecdc.
\nNgo\u00e0i ra, c\u00f2n m\u1ed9t thi\u1ebft b\u1ecb kh\u00e1c, g\u1ecdi l\u00e0 h\u1ec7 th\u1ed1ng R-test, cho ph\u00e9p b\u1ec7nh nh\u00e2n \u0111eo tr\u00ean c\u1ed5, v\u00e0 k\u00edch ho\u1ea1t n\u00f3 khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng. Hi\u1ebfm h\u01a1n, v\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng (ng\u1ea5t, th\u1ec9u\u2026) xu\u1ea5t hi\u1ec7n r\u1ea5t th\u01b0a, ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng m\u1ed9t thi\u1ebft b\u1ecb ghi \u0111i\u1ec7n tim c\u1ea5y d\u01b0\u1edbi da ng\u1ef1c c\u1ee7a b\u1ec7nh nh\u00e2n, trong th\u1eddi gian t\u1eeb 18 \u2013 24 th\u00e1ng, \u0111\u1ec3 ph\u00e1t hi\u1ec7n nh\u1eefng bi\u1ebfn \u0111\u1ed5i \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 c\u00f3 th\u1ec3 x\u1ea3y ra.<\/p>\n

2.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong>
\n2.2.1. Ch\u1ec9 \u0111\u1ecbnh chung
\n– Ng\u1ea5t kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n
\n– C\u01a1n h\u1ed3i h\u1ed9p tr\u1ed1ng ng\u1ef1c t\u00e1i ph\u00e1t, kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n
\n– \u0110\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n nh\u1ecbp tim
\n– \u0110\u00e1nh gi\u00e1 v\u00e0 theo d\u00f5i ho\u1ea1t \u0111\u1ed9ng c\u1ee7a m\u00e1y t\u1ea1o nh\u1ecbp tim
\n– Ph\u00e1t hi\u1ec7n t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ngh\u00e8o n\u00e0n.
\n2.2.2. Ch\u1ec9 \u0111\u1ecbnh trong tim m\u1ea1ch nhi
\n– Ng\u1ea5t, th\u1ec9u \u1edf b\u1ec7nh nhi c\u00f3 b\u1ec7nh tim tr\u01b0\u1edbc \u0111\u00f3, ti\u1ec1n s\u1eed r\u1ed1i lo\u1ea1n nh\u1ecbp tim, ph\u1ee5 thu\u1ed9c m\u00e1y t\u1ea1o nh\u1ecbp tim.
\n– Ng\u1ea5t, th\u1ec9u khi g\u1eafng s\u1ee9c kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.
\n– \u0110\u00e1nh gi\u00e1 b\u1ec7nh nhi b\u1ecb b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i ho\u1eb7c b\u1ec7nh c\u01a1 tim gi\u00e3n
\n– \u0110\u00e1nh gi\u00e1 b\u1ec7nh nhi nghi b\u1ecb h\u1ed9i ch\u1ee9ng QT k\u00e9o d\u00e0i, bloc nh\u0129 th\u1ea5t p\u1ea9m sinh kh\u00f4ng tri\u1ec7u ch\u1ee9ng.
\n– H\u1ed3i h\u1ed9p, tr\u1ed1ng ng\u1ef1c \u1edf b\u1ec7nh nhi \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt b\u1ec7nh tim b\u1ea9m sinh, c\u00f2n r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng t\u1ed3n d\u01b0.
\n– \u0110\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng lo\u1ea1n nh\u1ecbp tim.<\/p>\n

3.<\/strong>\u00a0Holter huy\u1ebft \u00e1p<\/strong><\/h2>\n

3.1. Kh\u00e1i ni\u1ec7m<\/strong>
\nHolter huy\u1ebft \u00e1p l\u00e0 ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 trong \u0111\u00f3 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111eo m\u1ed9t m\u00e1y \u0111o huy\u1ebft \u00e1p chuy\u00ean bi\u1ec7t, trong 24 gi\u1edd, t\u1ef1 \u0111\u1ed9ng \u0111o huy\u1ebft \u00e1p m\u1ed9t c\u00e1ch c\u00f3 chu k\u1ef3 trong khi b\u1ec7nh nh\u00e2n v\u1eabn th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t b\u00ecnh th\u01b0\u1eddng, nh\u1eb1m m\u1ee5c \u0111\u00edch ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p.
\nNg\u01b0\u1ee1ng ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p c\u1ee7a Holter huy\u1ebft \u00e1p 24 gi\u1edd, th\u1ea5p h\u01a1n so v\u1edbi ng\u01b0\u1ee1ng t\u0103ng huy\u1ebft \u00e1p \u0111o t\u1ea1i ph\u00f2ng kh\u00e1m. M\u1ee9c \u0111\u1ed9 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi huy\u1ebft \u00e1p 140\/90 mmHg t\u1ea1i ph\u00f2ng kh\u00e1m nh\u01b0 sau:
\n– Holter huy\u1ebft \u00e1p khi th\u1ee9c: 135\/85 mmHg.
\n– Holter huy\u1ebft \u00e1p khi ng\u1ee7: 120\/70 mmHg.
\n– Holter huy\u1ebft \u00e1p 24 gi\u1edd: 130\/80 mmHg.<\/p>\n

3.2 Ch\u1ec9 \u0111\u1ecbnh<\/strong>
\n– Ch\u1ea9n \u0111o\u00e1n t\u0103ng huy\u1ebft \u00e1p, \u0111\u1eb7c bi\u1ec7t t\u0103ng huy\u1ebft \u00e1p \u00e1o cho\u00e0ng tr\u1eafng v\u00e0 hi\u1ec7u \u1ee9ng \u00e1o cho\u00e0ng tr\u1eafng, t\u0103ng huy\u1ebft \u00e1p \u1ea9n gi\u1ea5u v\u00e0 t\u0103ng huy\u1ebft \u00e1p kh\u00e1ng v\u1edbi \u0111i\u1ec1u tr\u1ecb.
\n+ THA \u00e1o cho\u00e0ng tr\u1eafng l\u00e0 hi\u1ec7n t\u01b0\u1ee3ng huy\u1ebft \u00e1p \u0111o t\u1ea1i ph\u00f2ng kh\u00e1m t\u0103ng: HA t\u00e2m thu \u2265 140 mmHg, HA t\u00e2m tr\u01b0\u01a1ng \u2265 90 mmHg, nh\u01b0ng huy\u1ebft \u00e1p h\u00e0ng ng\u00e0y ho\u1eb7c \u0111o 24 gi\u1edd lu\u00f4n < 135\/85 mmHg. THA \u00e1o cho\u00e0ng tr\u1eafng kh\u00e1 ph\u1ed5 bi\u1ebfn v\u00e0 t\u0103ng theo tu\u1ed5i, ng\u01b0\u1eddi THA \u00e1o cho\u00e0ng tr\u1eafng c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh THAt th\u1ef1c s\u1ef1, v\u00ec v\u1eady, c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i huy\u1ebft \u00e1p 24 gi\u1edd \u0111\u1ecbnh k\u1ef3.
\n+ THA \u1ea9n gi\u1ea5u l\u00e0 t\u00ecnh tr\u1ea1ng huy\u1ebft \u00e1p \u0111o t\u1ea1i ph\u00f2ng kh\u00e1m lu\u00f4n < 140 mmHg v\u00e0 90 mmHg, nh\u01b0ng tr\u00ean th\u1ef1c t\u1ebf huy\u1ebft \u00e1p t\u0103ng khi theo d\u00f5i 24 gi\u1edd, trong \u0111i\u1ec1u ki\u1ec7n sinh ho\u1ea1t h\u00e0ng ng\u00e0y b\u00ecnh th\u01b0\u1eddng. B\u1ec7nh nh\u00e2n THA \u1ea9n gi\u1ea5u th\u01b0\u1eddng tr\u1ebb, th\u01b0\u1eddng c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch v\u00e0 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 h\u01a1n.
\n– Theo d\u00f5i bi\u1ebfn \u0111\u1ed5i huy\u1ebft \u00e1p trong ng\u00e0y, \u0111\u1eb7c bi\u1ec7t v\u1ec1 ban \u0111\u00eam, \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u01b0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, h\u1ed9i ch\u1ee9ng ng\u1eebng th\u1edf khi ng\u1ee7\u2026<\/p>\n

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

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n gi\u00fap ta hi\u1ec3u \u0111\u01b0\u1ee3c c\u1ea5u tr\u00fac v\u00e0 ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng tim. Ngo\u00e0i ra, c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong qu\u00e1 tr\u00ecnh l\u00e0m m\u1ed9t s\u1ed1 th\u0103m d\u00f2 ch\u1ea9n \u0111o\u00e1n c\u1ee5 th\u1ec3 (v\u00ed d\u1ee5, can […]<\/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":[],"yoast_head":"\nM\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 x\u00e9t nghi\u1ec7m x\u00e2m l\u1ea5n gi\u00fap ta hi\u1ec3u \u0111\u01b0\u1ee3c c\u1ea5u tr\u00fac v\u00e0 ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng tim.\" \/>\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=\"M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 tim m\u1ea1ch - 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