{"id":27227,"date":"2023-04-23T22:56:20","date_gmt":"2023-04-23T15:56:20","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27227"},"modified":"2023-04-23T22:56:20","modified_gmt":"2023-04-23T15:56:20","slug":"tang-ap-luc-noi-so-xu-tri-tien-luong-va-cac-bien-chung","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/23\/tang-ap-luc-noi-so-xu-tri-tien-luong-va-cac-bien-chung\/","title":{"rendered":"T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd: X\u1eed tr\u00ed, ti\u00ean l\u01b0\u1ee3ng v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng"},"content":{"rendered":"

T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd (TALNS<\/a>) l\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c trong khoang n\u1ed9i s\u1ecd, g\u00e2y ra \u00e1p l\u1ef1c tr\u00ean n\u00e3o v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u cung c\u1ea5p m\u00e1u cho n\u00e3o. T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/strong>\u00a0c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n, bao g\u1ed3m ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o, vi\u00eam n\u00e3o hay kh\u1ed1i u n\u00e3o. T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd l\u00e0 t\u00ecnh tr\u1ea1ng nguy hi\u1ec3m \u0111e d\u1ecda t\u00ednh m\u1ea1ng v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c x\u1eed tr\u00ed ngay khi ph\u00e1t hi\u1ec7n. N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng nh\u01b0 suy h\u00f4 h\u1ea5p, suy tu\u1ea7n ho\u00e0n, t\u1ed5n th\u01b0\u01a1ng n\u00e3o v\u00e0 th\u1eadm ch\u00ed l\u00e0 t\u1eed vong.<\/strong><\/p>\n

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N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng<\/figcaption><\/figure>\n

1. X\u1eed tr\u00ed<\/h2>\n

1.1. Nguy\u00ean t\u1eafc x\u1eed tr\u00ed<\/span><\/b><\/h3>\n

– C\u1ea7n theo d\u00f5i \u00e1p l\u1ef1c n\u1ed9i s\u1ecd li\u00ean t\u1ee5c \u0111\u1ec3 duy tr\u00ec \u0111\u1ee7 \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u n\u00e3o.<\/span><\/p>\n

– \u00c1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p l\u00e0m gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/p>\n

– Duy tr\u00ec huy\u1ebft \u00e1p c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh cao h\u01a1n m\u1ee9c b\u00ecnh th\u01b0\u1eddng ho\u1eb7c huy\u1ebft \u00e1p n\u1ec1n<\/span><\/p>\n

\u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u n\u00e3o (Cranial Perfusion Pressure<\/i>\u00a0– CPP) t\u1eeb 65-75 mmHg.<\/span><\/p>\n

– Duy tr\u00ec \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u m\u00e1u 295 to 305 mOsm\/L.<\/span><\/p>\n

– H\u1ea1n ch\u1ebf t\u1ed1i \u0111a c\u00e1c bi\u1ebfn ch\u1ee9ng do t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd g\u00e2y ra.<\/span><\/p>\n

– Lo\u1ea1i b\u1ecf nguy\u00ean nh\u00e2n g\u00e2y t\u0103ng \u00e1p l\u1ef1c s\u1ecd n\u00e3o.<\/span><\/p>\n

1.2. X\u1eed tr\u00ed ban \u0111\u1ea7u v\u00e0 v\u1eadn chuy\u1ec3n c\u1ea5p c\u1ee9u<\/span><\/b><\/h3>\n

– Cho ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m y\u00ean t\u0129nh n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh t\u1ec9nh.<\/span><\/p>\n

– \u0110\u1ea7u cao 30o<\/sup>\u00a0– 45o<\/sup>\u00a0n\u1ebfu kh\u00f4ng c\u00f3 h\u1ea1 huy\u1ebft \u00e1p.<\/span><\/p>\n

– Cung c\u1ea5p \u0111\u1ee7 oxy cho ng\u01b0\u1eddi b\u1ec7nh: th\u1edf oxy k\u00ednh.<\/span><\/p>\n

– Duy tr\u00ec huy\u1ebft \u00e1p cao h\u01a1n huy\u1ebft \u00e1p n\u1ec1n c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

+ H\u1ea1 huy\u1ebft \u00e1p: truy\u1ec1n d\u1ecbch NaCl 0,9 %.<\/span><\/p>\n

+ T\u0103ng huy\u1ebft \u00e1p: d\u00f9ng thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p (ch\u1eb9n k\u00eanh canxi, \u1ee9c ch\u1ebf men chuy\u1ec3n).<\/span><\/p>\n

– Ch\u1ed1ng ph\u00f9 n\u00e3o: glucocorticoid khi c\u00f3 u n\u00e3o.<\/span><\/p>\n

+ Methylprednisolon: 40 – 120 mg ti\u00eam t\u0129nh m\u1ea1ch, duy tr\u00ec 40mg\/6gi\u1edd.<\/span><\/p>\n

+ Dexamethasone: 8 mg ti\u00eam b\u1eafp ho\u1eb7c t\u0129nh m\u1ea1ch, duy tr\u00ec 4 mg\/6gi\u1edd.<\/span><\/p>\n

– X\u1eed tr\u00ed t\u0103ng th\u00e2n nhi\u00eat: paracetamol 0,5 gram b\u01a1m qua x\u00f4ng ho\u1eb7c 1 gram truy\u1ec1n t\u0129nh m\u1ea1ch.<\/span><\/p>\n

– V\u1eadn chuy\u1ec3n khi huy\u1ebft \u00e1p v\u00e0 h\u00f4 h\u1ea5p \u0111\u01b0\u1ee3c \u0111\u1ea3m b\u1ea3o.<\/span><\/p>\n

1.3. X\u1eed tr\u00ed t\u1ea1i b\u1ec7nh vi\u1ec7n<\/span><\/b><\/h3>\n

a) N\u1ed9i khoa<\/span><\/p>\n

– Chung<\/span><\/p>\n

+ Cho ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m y\u00ean t\u0129nh n\u1ebfu t\u1ec9nh.<\/span><\/p>\n

+ \u0110\u1ea7u cao 30o<\/sup>\u00a0– 45o<\/sup>.<\/span><\/p>\n

+ \u0110i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n n\u01b0\u1edbc \u0111i\u1ec7n gi\u1ea3i.<\/span><\/p>\n

+ \u0110i\u1ec1u tr\u1ecb t\u0103ng th\u00e2n nhi\u1ec7t: paracetamol 0,5 gram b\u01a1m qua \u1ed1ng th\u00f4ng d\u1ea1 d\u00e0y ho\u1eb7c 1 gram truy\u1ec1n t\u0129nh m\u1ea1ch.<\/span><\/p>\n

+ Kh\u00e1ng sinh: khi c\u00f3 d\u1ea5u hi\u1ec7u nhi\u1ec5m khu\u1ea9n th\u1ea7n kinh c\u1ea7n ph\u1ea3i s\u1eed d\u1ee5ng kh\u00e1ng sinh c\u00e0ng s\u1edbm c\u00e0ng t\u1ed1t, l\u1ef1a ch\u1ecdn kh\u00e1ng sinh d\u1ec5 th\u1ea5m m\u00e0ng n\u00e3o, ph\u1ea3i \u0111\u1ee7 li\u1ec1u l\u01b0\u1ee3ng, vi khu\u1ea9n c\u00f2n nh\u1eady c\u1ea3m v\u1edbi kh\u00e1ng sinh \u0111\u00f3, th\u01b0\u1eddng d\u00f9ng 2 lo\u1ea1i kh\u00e1ng sinh k\u1ebft h\u1ee3p, thu\u1ed1c truy\u1ec1n t\u0129nh m\u1ea1ch, \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u theo m\u1ee9c l\u1ecdc c\u1ea7u th\u1eadn.<\/span><\/p>\n

Cephalosporin th\u1ebf h\u1ec7 3: ceftazidime 2g\/ 8 gi\u1edd, cefotaxime 2g\/ 4-6 gi\u1edd, ceftriaxone 2g\/ 12 gi\u1edd…<\/span><\/p>\n

Cephalosporin th\u1ebf h\u1ec7 4: cefepime 2g\/ 8 gi\u1edd. Nh\u00f3m carbapenem: meropenem 2g\/ 8 gi\u1edd. Chloramphenicol: 4g\/ 6 gi\u1edd.<\/span><\/p>\n

Vancomycin 30-60 mg\/kg\/ng\u00e0y chia 2-3l\u1ea7n. Th\u01b0\u1eddng k\u1ebft h\u1ee3p v\u1edbi 1 trong c\u00e1c kh\u00e1ng sinh tr\u00ean (khi ch\u01b0a c\u00f3 kh\u00e1ng sinh \u0111\u1ed3).<\/span><\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh suy gi\u1ea3m mi\u1ec5n d\u1ecbch ho\u1eb7c tr\u00ean 50 tu\u1ed5i: cephalosporin + vancomycin + ampicillin 2g\/ 4 gi\u1edd.<\/span><\/p>\n

+ Ch\u1ed1ng co gi\u1eadt: (xem b\u00e0i tr\u1ea1ng th\u00e1i \u0111\u1ed9ng kinh)<\/span><\/p>\n

+ Ch\u1ed1ng t\u00e1o b\u00f3n: thu\u1ed1c nhu\u1eadn tr\u00e0ng nh\u01b0 sorbitol, duphalac…<\/span><\/p>\n

+ B\u00ed ti\u1ec3u: \u0111\u1eb7t \u1ed1ng th\u00f4ng ti\u1ec3u.<\/span><\/p>\n

– H\u1ed3i s\u1ee9c b\u1ea3o h\u00f4 h\u1ea5p: cung c\u1ea5p \u0111\u1ee7 oxy cho ng\u01b0\u1eddi b\u1ec7nh<\/span><\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh t\u1ec9nh: th\u1edf oxy k\u00ednh.<\/span><\/p>\n

+ Ng\u01b0\u1eddi b\u1ec7nh h\u00f4n m\u00ea, r\u1ed1i lo\u1ea1n h\u00f4 h\u1ea5p c\u1ea7n ph\u1ea3i \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 th\u1edf m\u00e1y (tr\u00e1nh s\u1eed d\u1ee5ng PEEP ho\u1eb7c d\u00f9ng PEEP th\u1ea5p 5 cm H2O), duy tr\u00ec PaCO2 t\u1eeb 35 – 45 mmHg.<\/span><\/p>\n

– H\u1ed3i s\u1ee9c tu\u1ea7n ho\u00e0n<\/span><\/p>\n

*\u00a0C\u1ea7n ch\u00fa \u00fd<\/i>: duy tr\u00ec huy\u1ebft \u00e1p cao h\u01a1n b\u00ecnh th\u01b0\u1eddng ho\u1eb7c huy\u1ebft \u00e1p n\u1ec1n (HATT 140-180 mmHg, HATTr <120 mmHg) \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o \u00e1p l\u1ef1c t\u01b0\u1edbi m\u00e1u n\u00e3o (CPP: 65-75 mmHg).<\/span><\/p>\n

+ N\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 h\u1ea1 huy\u1ebft \u00e1p: c\u1ea7n \u0111\u1eb7t \u1ed1ng th\u00f4ng t\u0129nh m\u1ea1ch trung t\u00e2m 3 l\u00f2ng.<\/span><\/p>\n

Truy\u1ec1n \u0111\u1ee7 d\u1ecbch: d\u1ef1a v\u00e0o ALTMTT, kh\u00f4ng truy\u1ec1n glucosa 5% v\u00e0 NaCl 0,45% v\u00ec l\u00e0m t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd do ph\u00f9 n\u00e3o t\u0103ng l\u00ean.<\/span><\/p>\n

HA v\u1eabn kh\u00f4ng \u0111\u1ea1t \u0111\u01b0\u1ee3c y\u00eau c\u1ea7u: s\u1eed d\u1ee5ng dopamine truy\u1ec1n t\u0129nh m\u1ea1ch.<\/span><\/p>\n

+\u0110i\u1ec1u tr\u1ecb t\u0103ng huy\u1ebft \u00e1p khi: HATT > 180 mmHg v\u00e0\/ho\u1eb7c HATTr > 120 mmHg k\u00e8m theo suy th\u1eadn.<\/span><\/p>\n

N\u1ebfu HATT > 230 mmHg v\u00e0\/ho\u1eb7c HATTr> 140 mmHg: nitroprussid truy\u1ec1n TM: 0,1 – 0,5 \u00b5g\/kg\/ph, t\u1ed1i \u0111a 10 \u00b5g\/kg\/ph\u00fat. Ho\u1eb7c nicardipine truy\u1ec1n TM: 5 -15mg\/gi\u1edd.<\/span><\/p>\n

N\u1ebfu HATT 180 – 230 mmHg v\u00e0\/ho\u1eb7c HATTr 105 – 140 mmHg: u\u1ed1ng ch\u1eb9n \u03b2 (labetalol) n\u1ebfu nh\u1ecbp tim kh\u00f4ng ch\u1eadm < 60 l\u1ea7n\/ph\u00fat.<\/span><\/p>\n

N\u1ebfu HATT < 180 mmHg v\u00e0\/ho\u1eb7c HATTr< 105 mmHg: u\u1ed1ng ch\u1eb9n \u03b2 (n\u1ebfu nh\u1ecbp tim kh\u00f4ng ch\u1eadm < 60 l\u1ea7n \/ph\u00fat. Ho\u1eb7c \u1ee9c ch\u1ebf men chuy\u1ec3n: enalaprin 10mg\/vi\u00ean; peridopril 5mg\/vi\u00ean. L\u1ee3i ti\u1ec3u furosemid ti\u00eam t\u0129nh m\u1ea1ch n\u1ebfu thu\u1ed1c h\u1ea1 HA kh\u00f4ng k\u1ebft qu\u1ea3.<\/span><\/p>\n

– Ch\u1ed1ng ph\u00f9 n\u00e3o: gi\u1eef \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u m\u00e1u 295 – 305 mOsm\/L.<\/span><\/p>\n

+ Manitol ch\u1ec9 d\u00f9ng khi c\u00f3 ph\u00f9 n\u00e3o: 0,5 – 1g\/kg\/6gi\u1edd truy\u1ec1n t\u0129nh m\u1ea1ch trong 30 ph\u00fat; kh\u00f4ng d\u00f9ng qu\u00e1 3 ng\u00e0y.<\/span><\/p>\n

+ Dung d\u1ecbch mu\u1ed1i \u01b0u tr\u01b0\u01a1ng 7,5 – 10% 100 ml\/l\u1ea7n c\u00f3 t\u00e1c d\u1ee5ng gi\u1ea3m nhanh \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, th\u1eddi gian t\u00e1i ph\u00e1t t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd mu\u1ed9n h\u01a1n so v\u1edbi manitol 20%, cho k\u1ebft qu\u1ea3 t\u1ed1t \u1edf ng\u01b0\u1eddi b\u1ec7nh b\u1ecb ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o. Th\u1eddi gian d\u00f9ng kh\u00f4ng qu\u00e1 3 ng\u00e0y.<\/span><\/p>\n

+ Thu\u1ed1c an th\u1ea7n truy\u1ec1n t\u0129nh m\u1ea1ch<\/span><\/p>\n

Thu\u1ed1c: phenobacbital ho\u1eb7c thiopental (100mg\/gi\u1edd), propofol (5 \u2013 80 \u03bcg\/kg\/ph\u00fat).<\/span><\/p>\n

T\u00e1c d\u1ee5ng v\u1edbi li\u1ec1u g\u00e2y m\u00ea: gi\u1ea3m ph\u00f9 n\u00e3o, gi\u1ea3m nhu c\u1ea7u s\u1eed d\u1ee5ng oxy \u1edf n\u00e3o, ch\u1ed1ng co gi\u1eadt. T\u00e1c d\u1ee5ng ph\u1ee5: h\u00f4n m\u00ea s\u00e2u h\u01a1n, h\u1ea1 huy\u1ebft \u00e1p. C\u1ea7n theo d\u00f5i s\u00e1t \u00fd th\u1ee9c v\u00e0 huy\u1ebft \u00e1p.<\/span><\/p>\n

+ Glucocorticoid: ch\u1ec9 \u0111\u1ecbnh trong u n\u00e3o, \u00e1p xe n\u00e3o.Kh\u00f4ng d\u00f9ng khi c\u00f3 t\u0103ng huy\u1ebft \u00e1p.Thu\u1ed1c: Synacthen 1mg ti\u00eam b\u1eafp\/ng\u00e0y (t\u00e1c d\u1ee5ng t\u1ed1t trong u n\u00e3o).Methylprednisolon: 40 – 120 mg ti\u00eam t\u0129nh m\u1ea1ch, duy tr\u00ec 40mg\/6gi\u1edd.Dexamethasone: 8 mg ti\u00eam b\u1eafp ho\u1eb7c t\u0129nh m\u1ea1ch, duy tr\u00ec 4 mg\/6gi\u1edd.<\/span><\/p>\n

b) Ngo\u1ea1i khoa: khi bi\u1ebft r\u00f5 nguy\u00ean nh\u00e2n, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa kh\u00f4ng k\u1ebft qu\u1ea3.<\/span><\/p>\n

– N\u00e3o \u00fang th\u1ee7y: m\u1ed5 d\u1eabn l\u01b0u n\u00e3o th\u1ea5t.<\/span><\/p>\n

– Kh\u1ed1i m\u00e1u t\u1ee5 l\u1edbn: l\u1ea5y kh\u1ed1i m\u00e1u t\u1ee5, gi\u1ea3i quy\u1ebft ch\u1ea3y m\u00e1u do v\u1ee1 d\u1ecb d\u1ea1ng.<\/span><\/p>\n

– U n\u00e3o:<\/span><\/p>\n

+ Kh\u1ed1i u to: m\u1ed5 l\u00e1y kh\u1ed1i u (th\u01b0\u1eddng kh\u00f3 kh\u0103n).<\/span><\/p>\n

+ Kh\u1ed1i u nh\u1ecf \u2264 2 cm: x\u1ea1 tr\u1ecb v\u1edbi tia Gama<\/span><\/p>\n

– \u00c1p xe n\u00e3o: sau khi \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa \u1ed5n \u0111\u1ecbnh, \u00e1p xe khu tr\u00fa l\u1ea1i.<\/span><\/p>\n

– Ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o c\u00f3 \u0111\u1ee5ng d\u1eadp n\u00e3o nhi\u1ec1u: m\u1ed5 b\u1ecf m\u1ed9t ph\u1ea7n x\u01b0\u01a1ng s\u1ecd v\u00f9ng \u0111\u1eadp d\u1eadp ra ngo\u00e0i \u0111\u1ec3 gi\u1ea3m \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/p>\n

c) Theo d\u00f5i \u00e1p l\u1ef1c n\u1ed9i s\u1ecd<\/span><\/p>\n

– Qua n\u00e3o th\u1ea5t: th\u00f4ng qua h\u1ec7 th\u1ed1ng d\u1eabn l\u01b0u n\u00e3o th\u1ea5t.<\/span><\/p>\n

– Trong nhu m\u00f4 n\u00e3o: \u0111\u1ea7u nh\u1eadn c\u1ea3m \u00e1p l\u1ef1c \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o trong nhu m\u00f4 n\u00e3o qua m\u1ed9t l\u1ed7 khoan nh\u1ecf \u1edf x\u01b0\u01a1ng s\u1ecd v\u00e0 \u0111\u01b0\u1ee3c n\u1ed1i v\u1edbi m\u00e1y theo d\u00f5i li\u00ean t\u1ee5c.<\/span><\/p>\n

– D\u01b0\u1edbi m\u00e0ng nh\u1ec7n: \u0111\u1ea7u nh\u1eadn c\u1ea3m \u00e1p l\u1ef1c \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o khoang d\u01b0\u1edbi nh\u1ec7n qua m\u1ed9t l\u1ed7 khoan nh\u1ecf \u1edf x\u01b0\u01a1ng s\u1ecd v\u00e0 \u0111\u01b0\u1ee3c n\u1ed1i v\u1edbi m\u00e1y theo d\u00f5i li\u00ean t\u1ee5c.<\/span><\/p>\n

– Ngo\u00e0i m\u00e0ng c\u1ee9ng: \u0111\u1ea7u nh\u1eadn c\u1ea3m \u00e1p l\u1ef1c \u0111\u01b0\u1ee3c \u0111\u1eb7t v\u00e0o khoang ngo\u00e0i m\u00e0ng c\u1ee9ng qua m\u1ed9t l\u1ed7 khoan nh\u1ecf \u1edf x\u01b0\u01a1ng s\u1ecd v\u00e0 \u0111\u01b0\u1ee3c n\u1ed1i v\u1edbi m\u00e1y theo d\u00f5i li\u00ean t\u1ee5c.<\/span><\/p>\n

2. Ti\u00ean l\u01b0\u1ee3ng v\u00e0 bi\u1ebfn ch\u1ee9ng<\/span><\/b><\/h2>\n

2.1. Ti\u00ean l\u01b0\u1ee3ng<\/span><\/b><\/h3>\n

T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd k\u00e9o d\u00e0i s\u1ebd c\u00f3 t\u1ed5n th\u01b0\u01a1ng n\u00e3o kh\u00f3 h\u1ed3i ph\u1ee5c, ti\u00ean l\u01b0\u1ee3ng x\u1ea5u.<\/span><\/p>\n

\u1ede ng\u01b0\u1eddi b\u1ec7nh h\u00f4n m\u00ea do ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o cho th\u1ea5y th\u1eddi gian t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd c\u00e0ng k\u00e9o d\u00e0i li\u00ean quan \u0111\u1ebfn ti\u00ean l\u01b0\u1ee3ng c\u00e0ng x\u1ea5u.<\/span><\/p>\n

2.2. Bi\u1ebfn ch\u1ee9ng<\/span><\/b><\/h3>\n

T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed tr\u00ed k\u1ecbp th\u1eddi s\u1ebd t\u1ea1o ra v\u00f2ng xo\u1eafn b\u1ec7nh l\u00fd l\u00e0m cho \u00e1p l\u1ef1c n\u1ed9i s\u1ecd ng\u00e0y c\u00e0ng t\u0103ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn co gi\u1eadt, \u0111\u1ed9t qu\u1ef5\u2026t\u1ed5n th\u01b0\u01a1ng n\u00e3o kh\u00f4ng h\u1ed3i ph\u1ee5c..<\/span><\/p>\n

T\u1ee5t n\u00e3o l\u00e0 bi\u1ebfn ch\u1ee9ng n\u1eb7ng, c\u00f3 th\u1ec3 l\u00e0m cho ng\u01b0\u1eddi b\u1ec7nh t\u1eed vong nhanh ch\u00f3ng.<\/span><\/p>\n

3. Ph\u00f2ng b\u1ec7nh<\/span><\/b><\/h2>\n

Khi c\u00f3 d\u1ea5u hi\u1ec7u c\u1ee7a \u0111au \u0111\u1ea7u, nh\u00ecn m\u1edd kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n c\u1ea7n ph\u1ea3i ch\u1ee5p c\u1eaft l\u1edbp s\u1ecd n\u00e3o \u0111\u1ec3 lo\u1ea1i tr\u1eeb nguy\u00ean nh\u00e2n t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/p>\n

Khi c\u00f3 t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd, ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c theo d\u00f5i s\u00e1t v\u00e0 x\u1eed tr\u00ed nguy\u00ean nh\u00e2n g\u00e2y ra t\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd.<\/span><\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n","protected":false},"excerpt":{"rendered":"

T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd (TALNS) l\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c trong khoang n\u1ed9i s\u1ecd, g\u00e2y ra \u00e1p l\u1ef1c tr\u00ean n\u00e3o v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u cung c\u1ea5p m\u00e1u cho n\u00e3o. T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd\u00a0c\u00f3 th\u1ec3 do nhi\u1ec1u nguy\u00ean nh\u00e2n, bao g\u1ed3m ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o, vi\u00eam n\u00e3o hay kh\u1ed1i u n\u00e3o. T\u0103ng \u00e1p […]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\nT\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd: X\u1eed tr\u00ed, ti\u00ean l\u01b0\u1ee3ng v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng - Vinmec<\/title>\n<meta name=\"description\" content=\"T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd (TALNS) l\u00e0 t\u00ecnh tr\u1ea1ng t\u0103ng \u00e1p l\u1ef1c trong khoang n\u1ed9i s\u1ecd, g\u00e2y ra \u00e1p l\u1ef1c tr\u00ean n\u00e3o v\u00e0 c\u00e1c m\u1ea1ch m\u00e1u cung c\u1ea5p m\u00e1u cho n\u00e3o...\" \/>\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=\"T\u0103ng \u00e1p l\u1ef1c n\u1ed9i s\u1ecd: X\u1eed tr\u00ed, ti\u00ean l\u01b0\u1ee3ng v\u00e0 c\u00e1c bi\u1ebfn ch\u1ee9ng - 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