{"id":28077,"date":"2023-04-24T22:08:10","date_gmt":"2023-04-24T15:08:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28077"},"modified":"2023-04-24T22:08:10","modified_gmt":"2023-04-24T15:08:10","slug":"sieu-am-tim-qua-thuc-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/sieu-am-tim-qua-thuc-quan\/","title":{"rendered":"Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n"},"content":{"rendered":"

Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n<\/a> (TEE) l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh b\u00e1n x\u00e2m l\u1ea5n c\u00f3 th\u1ec3 \u0111em l\u1ea1i m\u1ed9t s\u1ed1 th\u00f4ng tin ch\u1ea9n \u0111o\u00e1n t\u1ed1t h\u01a1n, b\u1ed5 sung cho si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c (TTE). \u0110\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n g\u1ea7n tim h\u01a1n v\u00e0 c\u00f3 t\u1ea7n s\u1ed1 cao h\u01a1n (5 MHz), do \u0111\u00f3 cho \u0111\u1ed9 ph\u00e2n gi\u1ea3i t\u1ed1t h\u01a1n \u0111\u1ea7u d\u00f2 th\u00e0nh ng\u1ef1c (2,5 MHz).<\/strong><\/p>\n

\"Si\u00eau<\/p>\n

Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n<\/strong><\/p>\n

1.Ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng<\/h2>\n

Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n (TEE) l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh b\u00e1n x\u00e2m l\u1ea5n c\u00f3 th\u1ec3 \u0111em l\u1ea1i m\u1ed9t s\u1ed1 th\u00f4ng tin ch\u1ea9n \u0111o\u00e1n t\u1ed1t h\u01a1n, b\u1ed5 sung cho si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c (TTE). \u0110\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n g\u1ea7n tim h\u01a1n v\u00e0 c\u00f3 t\u1ea7n s\u1ed1 cao h\u01a1n (5 MHz), do \u0111\u00f3 cho \u0111\u1ed9 ph\u00e2n gi\u1ea3i t\u1ed1t h\u01a1n \u0111\u1ea7u d\u00f2 th\u00e0nh ng\u1ef1c (2,5 MHz).<\/p>\n

Trong k\u1ef9 thu\u1eadt si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n, \u0111\u1ea7u d\u00f2 si\u00eau \u00e2m \u0111\u01b0\u1ee3c \u0111\u1eb7t trong th\u1ef1c qu\u1ea3n, \u00e1p s\u00e1t th\u00e0nh sau nh\u0129 tr\u00e1i n\u00ean c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1eeda s\u1ed5 si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c b\u1ecb h\u1ea1n ch\u1ebf v\u00e0 c\u00f3 th\u1ec3 \u1ee9ng d\u1ee5ng trong ph\u0201u thu\u1eadt m\u00e0 kh\u00f4ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u0201u tr\u01b0\u1eddng. T\u1ea5t c\u1ea3 c\u00e1c \u0111\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n \u0111\u1ec1u c\u00f3 t\u00ednh n\u0103ng quay v\u00e0 g\u1eadp g\u00f3c linh ho\u1ea1t \u0111\u1ec3 quan s\u00e1t \u0111\u01b0\u1ee3c nhi\u1ec1u m\u1eb7t c\u1eaft kh\u00e1c nhau<\/p>\n

2.Ch\u1ec9 \u0111\u1ecbnh si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n<\/strong><\/h2>\n

2.1 B\u1ec7nh l\u00fd van tim:<\/strong><\/h3>\n
    \n
  • \u0110\u00e1nh gi\u00e1 van hai l\u00e1: Sa van hai l\u00e1, \u0111\u00e1nh gi\u00e1 tr\u01b0\u1edbc th\u1ee7 thu\u1eadt nong van hai l\u00e1 qua da ( m\u1ee9c \u0111\u1ed9 h\u1eb9p, h\u1edf, t\u00ecnh tr\u1ea1ng van v\u00e0 d\u00e2y ch\u1eb1ng, huy\u1ebft kh\u1ed1i bu\u1ed3ng tim.)<\/li>\n
  • H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1ed7 tr\u1ee3 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 R\u1ed1i lo\u1ea1n ho\u1ea1t \u0111\u1ed9ng van nh\u00e2n t\u1ea1o<\/li>\n
  • Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n<\/li>\n
  • X\u00e1c \u0111\u1ecbnh c\u00e1c ngu\u1ed3n g\u1ed1c thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u1eeb tim, bao g\u1ed3m c\u1ea3 t\u00ecnh tr\u1ea1ng t\u1ed3n t\u1ea1i l\u1ed7 b\u1ea7u d\u1ee5c<\/li>\n<\/ul>\n

    2.2 B\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7:<\/strong><\/h3>\n
      \n
    • T\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 c\u1ea5p, n\u1ee9t v\u1ee1 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, m\u1ea3ng x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, \u00e1p xe g\u1ed1c v\u00e0 th\u00e0nh \u0110M ch\u1ee7… T\u1ea7m so\u00e1t huy\u1ebft kh\u1ed1i tr\u01b0\u1edbc khi chuy\u1ec3n nh\u1ecbp.<\/li>\n
    • C\u00e1c kh\u1ed1i u tim: u nh\u1ea7y nh\u0129 tr\u00e1i…<\/li>\n
    • B\u1ec7nh m\u00e0ng ngo\u00e0i tim v\u00e0 kh\u1ed1i u m\u00e0ng ngo\u00e0i tim.<\/li>\n
    • M\u1ed9t s\u1ed1 d\u1ecb t\u1eadt tim b\u1ea9m sinh. \u1ee8ng d\u1ee5ng trong ph\u0201u thu\u1eadt s\u1eeda van.<\/li>\n
    • Th\u0103m d\u00f2 ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i v\u00e0 th\u1ea5t ph\u1ea3i t\u1ea1i c\u00e1c \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c t\u00edch c\u1ef1c, t\u00ecm nguy\u00ean nh\u00e2n suy s\u1ee5p huy\u1ebft \u0111\u1ed9ng.<\/li>\n
    • H\u01b0\u1edbng d\u0201n trong th\u1ee7 thu\u1eadt tim m\u1ea1ch can thi\u1ec7p: \u0110\u00f3ng th\u00f4ng li\u00ean nh\u0129, s\u1eeda van hai l\u00e1 qua da.<\/li>\n
    • Khi c\u1eeda s\u1ed5 si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c b\u1ecb h\u1ea1n ch\u1ebf.<\/li>\n
    • Quy tr\u00ecnh l\u00e0m si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n<\/li>\n<\/ul>\n

      \"Si\u00eau<\/p>\n

      H\u00ecnh \u1ea3nh c\u00e1c m\u1eb7t c\u1eaft trong si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n<\/strong><\/p>\n

      2.3 Chu\u1ea9n b\u1ecb b\u1ec7nh nh\u00e2n<\/strong><\/h3>\n

      Th\u00f4ng th\u01b0\u1eddng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c g\u00e2y t\u00ea t\u1ea1i ch\u1ed7, khi c\u1ea7n c\u00f3 th\u1ec3 ph\u1ea3i ph\u1ed1i h\u1ee3p s\u1eed d\u1ee5ng ph\u01b0\u01a1ng ph\u00e1p v\u00f4 c\u1ea3m \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch.<\/p>\n

      2.3.1 Tr\u01b0\u1edbc khi l\u00e0m th\u1ee7 thu\u1eadt<\/h4>\n
        \n
      • B\u1ec7nh nh\u00e2n c\u1ea7n nh\u1ecbn \u0103n v\u00e0 nh\u1ecbn u\u1ed1ng 4 gi\u1edd tr\u01b0\u1edbc khi l\u00e0m th\u1ee7 thu\u1eadt.<\/li>\n
      • Lo\u1ea1i b\u1ecf h\u1ebft r\u0103ng gi\u1ea3.<\/li>\n
      • G\u00e2y t\u00ea t\u1ea1i ch\u1ed7 b\u1eb1ng lidocaine d\u1ea1ng x\u1ecbt (Xylocaine\u00ae) \u1edf th\u00e0nh sau h\u1ecdng, ch\u00fa \u00fd kh\u00f4ng v\u01b0\u1ee3t qu\u00e1 li\u1ec1u t\u1ed1i \u0111a v\u00ec s\u1ef1 h\u1ea5p th\u1ee5 c\u1ee7a thu\u1ed1c g\u00e2y t\u00ea c\u1ee5c b\u1ed9 c\u00f3 th\u1ec3 g\u00e2y ra t\u00e1c d\u1ee5ng to\u00e0n th\u00e2n (bu\u1ed3n n\u00f4n, ng\u1ee7 g\u00e0 v\u00e0 m\u1ea5t \u0111i\u1ec1u h\u00f2a tr\u01b0\u01a1ng l\u1ef1c).<\/li>\n
      • Ti\u00eam t\u0129nh m\u1ea1ch midazolam (li\u1ec1u 2 – 6 mg) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 an th\u1ea7n nh\u1eb9, nh\u01b0ng v\u1edbi ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 l\u00e0 \u0111\u1ee7.<\/li>\n
      • Flumazenil c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng \u0111\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c t\u00e1c d\u1ee5ng c\u1ee7a midazolam trong tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft.<\/li>\n<\/ul>\n

        2.3.2 Trong qu\u00e1 tr\u00ecnh l\u00e0m th\u1ee7 thu\u1eadt Thi\u1ebft b\u1ecb h\u1ed7 tr\u1ee3:<\/h4>\n
          \n
        • Oxy v\u00e0 d\u1ee5ng c\u1ee5 h\u00fat \u0111\u1eddm d\u00e3i.<\/li>\n
        • Thi\u1ebft b\u1ecb theo d\u00f5i nh\u1ecbp tim, nh\u1ecbp th\u1edf, b\u00e3o h\u00f2a Oxy.<\/li>\n
        • Y t\u00e1 h\u1ed7 tr\u1ee3 gi\u00e1m s\u00e1t b\u1ec7nh nh\u00e2n trong v\u00e0 sau khi l\u00e0m th\u1ee7 thu\u1eadt. D\u1ee5ng c\u1ee5 c\u1eafn l\u01b0\u1ee1i (d\u00f9ng trong su\u1ed1t qu\u00e1 tr\u00ecnh l\u00e0m th\u1ee7 thu\u1eadt).<\/li>\n
        • T\u01b0 th\u1ebf: B\u1ec7nh nh\u00e2n n\u1eb1m nghi\u00eang tr\u00e1i, c\u1ed5 g\u1eadp xu\u1ed1ng ng\u1ef1c.<\/li>\n
        • Theo d\u00f5i \u0111\u1ed9 b\u00e3o ho\u00e0 oxy m\u00e1u v\u00e0 \u0111i\u1ec7n t\u00e2m \u0111\u1ed3.<\/li>\n<\/ul>\n

          Ti\u1ebfn h\u00e0nh: <\/strong>\u0110\u1ea7u d\u00f2 \u0111\u01b0\u1ee3c b\u00f4i tr\u01a1n b\u1eb1ng gel v\u00e0 \u0111\u01b0\u1ee3c \u0111\u01b0a nh\u1eb9 nh\u00e0ng \u0111\u1ebfn h\u1ea7u h\u1ecdng. \u0110\u1ea9y \u0111\u1ea7u d\u00f2 v\u00e0o trong ph\u1ed1i h\u1ee3p theo m\u1ed7i nh\u1ecbp nu\u1ed1t c\u1ee7a b\u1ec7nh nh\u00e2n. C\u1ea7n gi\u1ea3i th\u00edch cho b\u1ec7nh nh\u00e2n c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu s\u1ebd gi\u1ea3m d\u1ea7n khi \u0111\u1ea7u d\u00f2 \u0111\u00e3 qua \u0111\u01b0\u1ee3c v\u00f9ng h\u1ea7u h\u1ecdng v\u00e0 n\u1eb1m trong th\u1ef1c qu\u1ea3n. Tr\u00e1nh vi\u1ec7c \u0111\u01b0a \u0111\u1ea7u d\u00f2 qu\u00e1 nhanh v\u00e0 th\u00f4 b\u1ea1o.<\/p>\n

          2.3.3 Sau th\u1ee7 thu\u1eadt<\/h4>\n

          B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 u\u1ed1ng t\u1eebng th\u00eca sau 1 gi\u1edd \u0111\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n g\u00e2y t\u00ea t\u1ea1i ch\u1ed7 khi t\u00e1c d\u1ee5ng c\u1ee7a thu\u1ed1c t\u1ea1i v\u00f9ng h\u1ea7u h\u1ecdng \u0111\u00e3 h\u1ebft.<\/p>\n

          M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n nh\u01b0 b\u1ec7nh nhi ho\u1eb7c thanh thi\u1ebfu ni\u00ean m\u1eafc b\u1ec7nh tim b\u1ea9m sinh ph\u1ee9c t\u1ea1p s\u1ebd c\u1ea7n g\u00e2y m\u00ea to\u00e0n th\u00e2n th\u00ec c\u1ea7n theo d\u00f5i l\u00e2u h\u01a1n.<\/p>\n

          3. Bi\u1ebfn ch\u1ee9ng<\/h2>\n

          Th\u1ee7 thu\u1eadt si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n r\u1ea5t an to\u00e0n: T\u1ef7 l\u1ec7 c\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng hi\u1ebfm (0,2%) v\u00e0 t\u1ef7 l\u1ec7 t\u1eed vong r\u1ea5t th\u1ea5p (< 0,01%). C\u00e1c bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng bao g\u1ed3m v\u1ee1 th\u1ef1c qu\u1ea3n, b\u1ecfng th\u1ef1c qu\u1ea3n, co th\u1eaft thanh qu\u1ea3n, r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t v\u00e0 suy h\u00f4 h\u1ea5p.<\/p>\n

          M\u1ed9t s\u1ed1 \u0111i\u1ec3m c\u1ea7n l\u01b0u \u00fd<\/p>\n

            \n
          • \u0110o\u1ea1n \u0111\u1ea7u c\u1ee7a quai \u0110M ch\u1ee7 v\u00e0 ph\u1ea7n cao c\u1ee7a \u0111\u1ed9ng \u0110M ch\u1ee7 l\u00e0 m\u1ed9t \u0111i\u1ec3m m\u00f9 <\/strong>\u0111\u1ed1i v\u1edbi \u0111\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n v\u00ec c\u00f3 kh\u00ed qu\u1ea3n v\u00e0 nh\u00e1nh ph\u1ebf qu\u1ea3n ph\u1ea3i n\u1eb1m gi\u1eefa th\u1ef1c qu\u1ea3n v\u00e0 tim, v\u00ec v\u1eady c\u00e1c t\u1ed5n th\u01b0\u01a1ng t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u1edf \u0111o\u1ea1n n\u00e0y c\u00f3 th\u1ec3 b\u1ecb b\u1ecf s\u00f3t.<\/li>\n
          • Do \u0111\u1ed9 ph\u00e2n gi\u1ea3i cao c\u1ee7a \u0111\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n n\u00ean m\u1ed9t s\u1ed1 c\u1ea5u tr\u00fac b\u00ecnh th\u01b0\u1eddng , v\u00ed d\u1ee5: m\u1ea1ng Chiari, b\u1edd van \u0110M ch\u1ee7, \u0111\u01b0\u1eddng ch\u1ec9 kh\u00e2u tr\u00ean van c\u01a1 h\u1ecdc… c\u00f3 th\u1ec3 b\u1ecb \u0111\u00e1nh gi\u00e1 nh\u1ea7m l\u00e0 b\u1ec7nh l\u00fd.<\/li>\n<\/ul>\n

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

            Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n (TEE) l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh b\u00e1n x\u00e2m l\u1ea5n c\u00f3 th\u1ec3 \u0111em l\u1ea1i m\u1ed9t s\u1ed1 th\u00f4ng tin ch\u1ea9n \u0111o\u00e1n t\u1ed1t h\u01a1n, b\u1ed5 sung cho si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c (TTE). \u0110\u1ea7u d\u00f2 th\u1ef1c qu\u1ea3n g\u1ea7n tim h\u01a1n v\u00e0 c\u00f3 t\u1ea7n s\u1ed1 cao h\u01a1n (5 MHz), […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[88,33],"tags":[],"yoast_head":"\nSi\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n - Vinmec<\/title>\n<meta name=\"description\" content=\"Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n l\u00e0 m\u1ed9t k\u1ef9 thu\u1eadt ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh b\u00e1n x\u00e2m l\u1ea5n c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n t\u1ed1t h\u01a1n, b\u1ed5 sung cho si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c\" \/>\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=\"Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n - 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