{"id":27645,"date":"2023-04-24T16:53:12","date_gmt":"2023-04-24T09:53:12","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=27645"},"modified":"2023-04-24T16:53:12","modified_gmt":"2023-04-24T09:53:12","slug":"hoi-chung-ep-tim-cap-do-tran-dich-mang-ngoai-tim","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/hoi-chung-ep-tim-cap-do-tran-dich-mang-ngoai-tim\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p tim c\u1ea5p do tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim"},"content":{"rendered":"

Ch\u00e8n \u00e9p tim<\/a> x\u1ea3y ra khi tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim g\u00e2y \u1ea3nh h\u01b0\u1edfng t\u1edbi huy\u1ebft \u0111\u1ed9ng. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 d\u1ecbch trong khoang m\u00e0ng ngo\u00e0i tim v\u00e0 m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u1ee7a d\u1ecbch m\u00e0ng tim. \u00c9p tim c\u1ea5p c\u00f3 th\u1ec3 x\u1ea3y ra khi l\u01b0\u1ee3ng d\u1ecbch trong m\u00e0ng ngo\u00e0i tim t\u1eeb 100 – 200 mL. <\/strong><\/p>\n

1.L\u00e2m s\u00e0ng<\/strong><\/h2>\n

Ch\u00e8n \u00e9p tim x\u1ea3y <\/strong>ra khi tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim g\u00e2y \u1ea3nh h\u01b0\u1edfng t\u1edbi huy\u1ebft \u0111\u1ed9ng. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 d\u1ecbch trong khoang m\u00e0ng ngo\u00e0i tim v\u00e0 m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u1ee7a d\u1ecbch m\u00e0ng tim. \u00c9p tim c\u1ea5p c\u00f3 th\u1ec3 x\u1ea3y ra khi l\u01b0\u1ee3ng d\u1ecbch trong m\u00e0ng ngo\u00e0i tim t\u1eeb 100 – 200 mL. Trong khi \u0111\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 l\u00ean t\u1edbi 1000 mL d\u1ecbch m\u00e0 kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n ch\u00e8n \u00e9p tim tr\u00ean l\u00e2m s\u00e0ng.<\/p>\n

\"Ch\u00e8n<\/p>\n

Ch\u00e8n \u00e9p tim c\u1ea5p do tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim<\/strong><\/p>\n

2. Nguy\u00ean nh\u00e2n<\/h2>\n
    \n
  • Tr\u00e0n d\u1ecbch m\u00e0ng tim c\u00f3 \u00e9p tim c\u1ea5p<\/li>\n
  • Ch\u1ea5n th\u01b0\u01a1ng tim.<\/li>\n
  • Sau ph\u0201u thu\u1eadt, can thi\u1ec7p tim m\u1ea1ch: Sau th\u00f4ng tim, sau th\u0103m d\u00f2 \u0111i\u1ec7n sinh l\u00fd…<\/li>\n
  • T\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/li>\n
  • Xu\u1ea5t huy\u1ebft t\u1ef1 ph\u00e1t: Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u, h\u1ed9i ch\u1ee9ng huy\u1ebft t\u00e1n ure m\u00e1u cao, xu\u1ea5t huy\u1ebft gi\u1ea3m ti\u1ec3u c\u1ea7u…<\/li>\n
  • V\u1ee1 tim sau nh\u1ed3i m\u00e1u c\u01a1 tim.<\/li>\n
  • B\u1ec7nh l\u00fd \u00e1c t\u00ednh.<\/li>\n
  • Vi\u00eam m\u00e0ng ngo\u00e0i tim v\u00f4 c\u0103n.<\/li>\n
  • H\u1ed9i ch\u1ee9ng huy\u1ebft t\u00e1n ure m\u00e1u cao. Nhi\u1ec5m khu\u1ea9n.<\/li>\n
  • Nhi\u1ec5m x\u1ea1. Suy gi\u00e1p.<\/li>\n
  • Lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng…<\/li>\n<\/ul>\n

    3.Tri\u1ec7u ch\u1ee9ng<\/h2>\n
      \n
    • H\u1ea7u h\u1ebft c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3 l\u00e0 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u bao g\u1ed3m:<\/li>\n
    • Nh\u1ecbp tim nhanh.<\/li>\n
    • H\u1ea1 huy\u1ebft \u00e1p (c\u00f3 th\u1ec3 c\u00f3 s\u1ed1c ho\u1eb7c kh\u00f4ng) k\u00e8m h\u1ea1 huy\u1ebft \u00e1p t\u01b0 th\u1ebf. Nghe tim c\u00f3 th\u1ec3 th\u1ea5y ti\u1ebfng tim m\u1edd.<\/li>\n
    • C\u00e1c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng nh\u01b0 suy tim ph\u1ea3i: Gan to, t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i…<\/li>\n
    • D\u1ea5u hi\u1ec7u m\u1ea1ch \u0111\u1ea3o \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 huy\u1ebft \u00e1p gi\u1ea3m > 10 mmHg khi b\u1ec7nh nh\u00e2n h\u00edt v\u00e0o s\u00e2u.<\/li>\n
    • C\u00e1c d\u1ea5u hi\u1ec7u th\u1ef1c th\u1ec3 kh\u00e1c bao g\u1ed3m \u0111\u1ea7u chi l\u1ea1nh, th\u1edf nhanh, gan to v\u00e0 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a nguy\u00ean nh\u00e2n g\u00e2y tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim.<\/li>\n
    • Trong m\u1ed9t s\u1ed1 b\u1ec7nh c\u1ea3nh n\u1eb7ng n\u1ec1 (v\u1ee1 th\u00e0nh t\u1ef1 do th\u1ea5t tr\u00e1i trong NMCT c\u1ea5p, v\u1ee1 \u0110M ch\u1ee7 trong b\u1ec7nh l\u00fd t\u00e1ch th\u00e0nh \u0110M ch\u1ee7…) b\u1ec7nh nh\u00e2n th\u01b0\u1eddng \u0111\u1ebfn vi\u1ec7n trong b\u1ec7nh c\u1ea3nh ng\u1eebng tu\u1ea7n ho\u00e0n (th\u00f4ng th\u01b0\u1eddng l\u00e0 ph\u00e2n ly \u0111i\u1ec7n c\u01a1) ho\u1eb7c t\u1ee5t huy\u1ebft \u00e1p, cho\u00e1ng v\u00e1ng, r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c hay s\u1ed1c.<\/li>\n
    • C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nguy\u00ean g\u00e2y tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim.<\/li>\n
    • Ch\u00e8n \u00e9p tim ti\u1ebfn tri\u1ec3n n\u1eb7ng c\u00f3 th\u1ec3 d\u0201n \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng bao g\u1ed3m suy gan, suy th\u1eadn, thi\u1ebfu m\u00e1u m\u1ea1ch m\u1ea1c treo…<\/li>\n<\/ul>\n

      4. C\u00e1c x\u00e9t nghi\u1ec7m trong ch\u1ea9n \u0111o\u00e1n<\/h2>\n

      4.1 Si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c:<\/strong><\/h3>\n

      L\u00e0 ph\u01b0\u01a1ng ph\u00e1p b\u1eaft bu\u1ed9c ph\u1ea3i th\u1ef1c hi\u1ec7n khi nghi ng\u1edd c\u00f3 tr\u00e0n d\u1ecbch m\u00e0ng tim tr\u00ean l\u00e2m s\u00e0ng (c\u00f3 d\u1ecbch \u1edf trong khoang m\u00e0ng ngo\u00e0i tim bi\u1ec3u hi\u1ec7n b\u1eb1ng c\u00e1c kho\u1ea3ng tr\u1ed1ng si\u00eau \u00e2m). C\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a \u00e9p tim bao g\u1ed3m:<\/p>\n

        \n
      • D\u1ea5u hi\u1ec7u \u00e9p nh\u0129 ph\u1ea3i th\u00ec t\u00e2m tr\u01b0\u01a1ng th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u t\u1eeb cu\u1ed1i t\u00e2m tr\u01b0\u01a1ng v\u00e0 th\u1ea5y r\u00f5 nh\u1ea5t \u1edf m\u1eb7t c\u1eaft c\u1ea1nh \u1ee9c tr\u00e1i tr\u1ee5c ngang, d\u01b0\u1edbi s\u01b0\u1eddn v\u00e0 4 bu\u1ed3ng t\u1eeb m\u1ecfm.<\/li>\n
      • D\u1ea5u hi\u1ec7u \u00e9p th\u1ea5t ph\u1ea3i th\u01b0\u1eddng quan s\u00e1t th\u1ea5y t\u1ea1i th\u00e0nh tr\u01b0\u1edbc th\u1ea5t ph\u1ea3i v\u00e0 v\u00f9ng ph\u1ec5u trong t\u01b0 th\u1ebf n\u1eb1m ng\u1eeda. Tr\u1ee5c ngang v\u00e0 tr\u1ee5c d\u1ecdc c\u1ea1nh \u1ee9c tr\u00e1i l\u00e0 hai m\u1eb7t c\u1eaft thu\u1eadn l\u1ee3i nh\u1ea5t \u0111\u1ec3 quan s\u00e1t d\u1ea5u hi\u1ec7u n\u00e0y. C\u1ea7n s\u1eed d\u1ee5ng si\u00eau \u00e2m TM \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh d\u1ea5u hi\u1ec7u n\u00e0y. D\u1ea5u hi\u1ec7u \u00e9p th\u1ea5t ph\u1ea3i \u0111\u01a1n \u0111\u1ed9c tr\u00ean si\u00eau \u00e2m c\u00f3 th\u1ec3 c\u00f3 tr\u01b0\u1edbc bi\u1ec3u hi\u1ec7n \u00e9p tim tr\u00ean l\u00e2m s\u00e0ng.<\/li>\n<\/ul>\n

        4.2 \u0110i\u1ec7n t\u00e2m \u0111\u1ed3:<\/h3>\n
          \n
        • \u0110i\u1ec7n th\u1ebf th\u1ea5p c\u1ee7a ph\u1ee9c b\u1ed9 QRS: \u1ede c\u00e1c chuy\u1ec3n \u0111\u1ea1o ngo\u1ea1i bi\u00ean t\u1ed5ng bi\u00ean \u0111\u1ed9 QRS < 5 mm, \u1edf c\u00e1c chuy\u1ec3n \u0111\u1ea1o tr\u01b0\u1edbc tim t\u1ed5ng bi\u00ean \u0111\u1ed9 < 10 mm.<\/li>\n
        • H\u00ecnh \u1ea3nh lu\u00e2n phi\u00ean \u0111i\u1ec7n h\u1ecdc: Ph\u1ee9c \u0111\u1ed9 QRS bi\u00ean \u0111\u1ed9 th\u1ea5p xen k\u1ebd v\u1edbi ph\u1ee9c b\u1ed9 QRS bi\u00ean \u0111\u1ed9 cao k\u00e8m theo nh\u1ecbp nhanh xoang.<\/li>\n<\/ul>\n

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

          5.1 Khi \u0111\u00e3 c\u00f3 ch\u1ea9n \u0111o\u00e1n \u00e9p tim th\u00ec c\u1ea7n ph\u1ea3i th\u00e1o d\u1ecbch m\u00e0ng ngo\u00e0i tim:<\/strong><\/h3>\n
            \n
          • Ph\u01b0\u01a1ng ph\u00e1p c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n l\u00e0 ch\u1ecdc h\u00fat qua da v\u1edbi g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 d\u01b0\u1edbi h\u01b0\u1edbng d\u0201n c\u1ee7a si\u00eau \u00e2m ho\u1eb7c m\u00e0n t\u0103ng s\u00e1ng, ph\u0201u thu\u1eadt d\u0201n l\u01b0u (m\u1edf khoang m\u00e0ng tim d\u01b0\u1edbi x\u01b0\u01a1ng \u1ee9c, m\u1edf c\u1eeda s\u1ed5 m\u00e0ng tim v\u00e0 c\u1eaft m\u00e0ng tim g\u1ea7n to\u00e0n b\u1ed9).<\/li>\n
          • Trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng ph\u1ea3i th\u00e1o d\u1ecbch m\u00e0ng tim ngay l\u1eadp t\u1ee9c k\u1ec3 c\u1ea3 khi kh\u00f4ng c\u00f3 h\u1ed7 tr\u1ee3 c\u1ee7a m\u00e1y si\u00eau \u00e2m hay m\u00e0n t\u0103ng s\u00e1ng.<\/li>\n
          • Trong khi chu\u1ea9n b\u1ecb d\u0201n l\u01b0u d\u1ecbch m\u00e0ng ngo\u00e0i tim, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ea1m th\u1eddi \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n b\u1eb1ng truy\u1ec1n t\u0129nh m\u1ea1ch d\u1ecbch mu\u1ed1i \u0111\u1eb3ng tr\u01b0\u01a1ng.<\/li>\n
          • B\u1ec7nh nh\u00e2n tr\u00e0n d\u1ecbch m\u00e0ng tim do h\u1ed9i ch\u1ee9ng ure m\u00e1u cao c\u1ea7n \u0111\u01b0\u1ee3c l\u1ecdc m\u00e1u c\u1ea5p sau khi \u0111\u00e3 gi\u1ea3i quy\u1ebft t\u00ecnh tr\u1ea1ng \u00e9p tim c\u1ea5p.<\/li>\n
          • C\u00e1c \u0111i\u1ec1u tr\u1ecb, x\u1eed tr\u00ed kh\u00e1c t\u00f9y theo nguy\u00ean nh\u00e2n g\u00e2y tr\u00e0n d\u1ecbch m\u00e0ng tim.<\/li>\n<\/ul>\n

            5.2 Tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t<\/h3>\n
              \n
            • Tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim t\u00e1i ph\u00e1t: <\/em><\/strong>C\u1ea7n t\u00ecm nguy\u00ean nh\u00e2n, ch\u1ec9 \u0111\u1ecbnh ph\u0201u thu\u1eadt m\u1edf m\u00e0ng ngo\u00e0i tim ho\u1eb7c c\u1eaft b\u1ecf m\u00e0ng ngo\u00e0i tim n\u1ebfu c\u1ea7n.<\/li>\n
            • \u00c9p tim v\u1edbi \u00e1p l\u1ef1c th\u1ea5p: <\/em><\/strong>Th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n trong t\u00ecnh tr\u1ea1ng m\u1ea5t n\u01b0\u1edbc. \u00c1p l\u1ef1c t\u0129nh m\u1ea1ch c\u1ea3nh kh\u00f4ng t\u0103ng, \u00e1p l\u1ef1c nh\u0129 ph\u1ea3i b\u00ecnh th\u01b0\u1eddng v\u00e0 ch\u00e8n \u00e9p tim th\u1eadm ch\u00ed x\u1ea3y ra v\u1edbi l\u01b0\u1ee3ng d\u1ecbch m\u00e0ng ngo\u00e0i tim \u00edt. V\u1edbi tr\u01b0\u1eddng h\u1ee3p n\u00e0y b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u00e1p \u1ee9ng t\u1ed1t v\u1edbi d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch. N\u1ebfu c\u00f3 l\u01b0\u1ee3ng d\u1ecbch m\u00e0ng ngo\u00e0i tim \u0111\u00e1ng k\u1ec3 th\u00ec n\u00ean \u0111\u01b0\u1ee3c d\u0201n l\u01b0u.<\/li>\n<\/ul>\n

              6. K\u1ebft lu\u1eadn<\/h2>\n

              Ch\u00e8n \u00e9p tim c\u1ea5p l\u00e0 t\u00ecnh tr\u1ea1ng kh\u1ea9n c\u1ea5p m\u00e0 tim b\u1ecb ch\u00e8n \u00e9p do m\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n nh\u01b0 ch\u1ea3y m\u00e1u trong l\u00f2ng ng\u1ef1c, ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch v\u00e0 c\u1ea3nh b\u00e1o tr\u01b0\u1edbc c\u1ee7a c\u01a1n \u0111au tim. Tri\u1ec7u ch\u1ee9ng c\u1ee7a ch\u00e8n \u00e9p tim c\u1ea5p bao g\u1ed3m \u0111au ng\u1ef1c, kh\u00f3 th\u1edf, m\u1ec7t m\u1ecfi v\u00e0 hoa m\u1eaft. \u0110\u00e2y l\u00e0 t\u00ecnh tr\u1ea1ng nguy hi\u1ec3m v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ngay l\u1eadp t\u1ee9c \u0111\u1ec3 tr\u00e1nh h\u1eadu qu\u1ea3 nghi\u00eam tr\u1ecdng. Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 bao g\u1ed3m thu\u1ed1c gi\u1ea3m \u0111au, oxy v\u00e0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p kh\u00e1c nh\u01b0 ph\u1eabu thu\u1eadt.<\/p>\n","protected":false},"excerpt":{"rendered":"

              Ch\u00e8n \u00e9p tim x\u1ea3y ra khi tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim g\u00e2y \u1ea3nh h\u01b0\u1edfng t\u1edbi huy\u1ebft \u0111\u1ed9ng. Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 d\u1ecbch trong khoang m\u00e0ng ngo\u00e0i tim v\u00e0 m\u1ee9c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u1ee7a d\u1ecbch m\u00e0ng tim. \u00c9p tim c\u1ea5p c\u00f3 th\u1ec3 x\u1ea3y ra khi l\u01b0\u1ee3ng d\u1ecbch trong m\u00e0ng ngo\u00e0i tim […]<\/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":"\nH\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p tim c\u1ea5p do tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng \u00e9p tim c\u1ea5p do tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. 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