{"id":28088,"date":"2023-04-24T22:09:07","date_gmt":"2023-04-24T15:09:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28088"},"modified":"2023-04-24T22:09:07","modified_gmt":"2023-04-24T15:09:07","slug":"sieu-am-tim-trong-tach-thanh-dong-mach-chu","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/sieu-am-tim-trong-tach-thanh-dong-mach-chu\/","title":{"rendered":"Si\u00eau \u00e2m tim trong t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7"},"content":{"rendered":"

T\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/a> l\u00e0 t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u, do r\u00e1ch l\u1edbp n\u1ed9i m\u1ea1c t\u1ea1o th\u00f4ng n\u1ed1i hay kh\u1ed1i m\u00e1u t\u1ee5 gi\u1eefa l\u1edbp n\u1ed9i m\u1ea1c v\u00e0 l\u1edbp gi\u1eefa c\u1ee7a th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c bao g\u1ed3m: tr\u00e0n m\u00e1u, ch\u00e8n \u00e9p tim, h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1ed9i ch\u1ee9ng gi\u1ea3m t\u01b0\u1edbi m\u00e1u ph\u1ea7n g\u1ea7n v\u00e0 xa.<\/strong><\/p>\n

1.\u0110\u1ecbnh ngh\u0129a<\/h2>\n

L\u00e0 t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u, do r\u00e1ch l\u1edbp n\u1ed9i m\u1ea1c t\u1ea1o th\u00f4ng n\u1ed1i hay kh\u1ed1i m\u00e1u t\u1ee5 gi\u1eefa l\u1edbp n\u1ed9i m\u1ea1c v\u00e0 l\u1edbp gi\u1eefa c\u1ee7a th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u00ecnh th\u00e0nh l\u00f2ng th\u1eadt v\u00e0 l\u00f2ng gi\u1ea3.G\u1ecdi l\u00e0 c\u1ea5p t\u00ednh n\u1ebfu xu\u1ea5t hi\u1ec7n <14 ng\u00e0y; b\u00e1n c\u1ea5p n\u1ebfu 15-90 ng\u00e0y v\u00e0 m\u1ea1n t\u00ednh n\u1ebfu >90 ng\u00e0y.<\/p>\n

Ph\u1ea7n l\u1edbn tr\u01b0\u1eddng h\u1ee3p l\u00f3c t\u00e1ch kh\u1edfi ph\u00e1t t\u1eeb s\u1ef1 r\u00e1ch l\u1edbp \u00e1o trong (n\u1ed9i m\u1ea1c) d\u1eabn \u0111\u01b0\u1eddng cho m\u00e1u \u0111i v\u00e0o l\u1edbp \u00e1o gi\u1eefa g\u00e2y l\u00f3c t\u00e1ch, l\u00f3c t\u00e1ch c\u00f3 th\u1ec3 \u0111i ng\u01b0\u1ee3c chi\u1ec1u ho\u1eb7c xu\u00f4i chi\u1ec1u, c\u00f3 th\u1ec3 l\u00e0m v\u1ee1 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 n\u1ebfu ph\u00e1 v\u1ee1 l\u1edbp \u00e1o ngo\u00e0i ho\u1eb7c l\u00f3c t\u00e1ch v\u00e0o l\u1ea1i l\u00f2ng m\u1ea1ch th\u00f4ng qua m\u1ed9t ch\u1ed7 r\u00e1ch n\u1ed9i m\u1ea1c th\u1ee9 2. C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c bao g\u1ed3m: tr\u00e0n m\u00e1u, ch\u00e8n \u00e9p tim, h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1ed9i ch\u1ee9ng gi\u1ea3m t\u01b0\u1edbi m\u00e1u ph\u1ea7n g\u1ea7n v\u00e0 xa.<\/p>\n

2. Ph\u00e2n lo\u1ea1i<\/h2>\n

2.1 Ph\u00e2n lo\u1ea1i DeBakey:<\/strong><\/h3>\n
    \n
  • Lo\u1ea1i I (50% l\u00f3c t\u00e1ch): T\u1ed3n th\u01b0\u01a1ng l\u00f3c t\u00e1ch n\u00e0y b\u1eaft \u0111\u1ea7u t\u1eeb \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean v\u00e0 k\u00e9o d\u00e0i \u00edt nh\u1ea5t \u0111\u1ebfn quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 \u0111\u00f4i khi v\u01b0\u1ee3t qu\u00e1 quai \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/li>\n
  • Lo\u1ea1i II (35%): T\u1ed5n th\u01b0\u01a1ng l\u00f3c t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1eaft \u0111\u1ea7u v\u00e0 n\u1eb1m trong \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00ean (g\u1ea7n v\u1edbi th\u00e2n \u0111\u1ed9ng m\u1ea1ch c\u00e1ch tay \u0111\u1ea7u ho\u1eb7c \u0111\u1ed9ng m\u1ea1ch v\u00f4 danh).<\/li>\n
  • Lo\u1ea1i III (15%): L\u00f3c t\u00e1ch b\u1eaft \u0111\u1ea7u t\u1eeb \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 xu\u1ed1ng ngay d\u01b0\u1edbi ch\u1ed7 xu\u1ea5t ph\u00e1t c\u1ee7a \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n tr\u00e1i v\u00e0 c\u00f3 th\u1ec3 k\u00e9o d\u00e0i xu\u1ed1ng ph\u00eda d\u01b0\u1edbi, m\u1ed9t s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p ti\u1ebfn tri\u1ec3n lan v\u1ec1 ph\u00eda \u0111\u1ea7u g\u1ea7n. L\u00f3c t\u00e1ch lo\u1ea1i IIIa b\u1eaft \u0111\u1ea7u t\u1eeb d\u01b0\u1edbi ch\u1ed7 chia nh\u00e1nh \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n v\u00e0 t\u1ed5n th\u01b0\u01a1ng ch\u1ec9 \u1edf \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c. T\u00e1ch \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 lo\u1ea1i IIIb b\u1eaft \u0111\u1ea7u t\u1eeb d\u01b0\u1edbi ch\u1ed7 chia ra \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n tr\u00e1i v\u00e0 k\u00e9o d\u00e0i xu\u1ed1ng d\u01b0\u1edbi c\u01a1 ho\u00e0nh.<\/li>\n<\/ul>\n

    2.2 Ph\u00e2n lo\u1ea1i Stanford<\/strong><\/h3>\n
      \n
    • Stanford Type A: T\u1ed5n th\u01b0\u01a1ng c\u00f3 li\u00ean quan \u0111\u1ebfn \u0110MC l\u00ean v\u00e0 cung \u0110MC v\u00e0 c\u00f3 th\u1ec3 \/ kh\u00f4ng li\u00ean quan \u0110MC xu\u1ed1ng.<\/li>\n
    • Stanford Type B: T\u1ed5n th\u01b0\u01a1ng li\u00ean quan \u0111\u1ebfn \u0110MC xu\u1ed1ng ph\u00eda xa c\u1ee7a \u0111\u1ed9ng m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n tr\u00e1i.<\/li>\n<\/ul>\n

      Ph\u00e2n lo\u1ea1i Stanford \u0111\u00e3 thay th\u1ebf ph\u00e2n lo\u1ea1i DeBakey.<\/p>\n

      Ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb c\u1ee7a 2 nh\u00f3m r\u1ea5t kh\u00e1c nhau:<\/p>\n

        \n
      • Stanford Type A: \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i khoa ho\u1eb7c can thi\u1ec7p n\u1ed9i m\u1ea1ch .<\/li>\n
      • Stanford Type B : \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa ( n\u1ebfu kh\u00f4ng ph\u1ee9c t\u1ea1p).<\/li>\n<\/ul>\n

        3.Nguy\u00ean nh\u00e2n<\/h2>\n
          \n
        • L\u00f3c t\u00e1ch th\u01b0\u1eddng \u1edf v\u1ecb tr\u00ed ph\u00ecnh v\u00e0 do \u0111\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 g\u00e2y ph\u00ecnh v\u00e0 l\u00f3c t\u00e1ch t\u01b0\u01a1ng t\u1ef1 nhau, v\u00ed d\u1ee5: cao tu\u1ed5i, t\u0103ng huy\u1ebft \u00e1p, b\u1ec7nh van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 2 m\u1ea3nh, h\u1ed9i ch\u1ee9ng Marfan, ti\u1ec1n s\u1eed gia \u0111\u00ecnh ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 ng\u1ef1c hay l\u00f3c t\u00e1ch. Tuy nhi\u00ean, l\u00f3c t\u00e1ch c\u00f3 th\u1ec3 x\u1ea3y ra nh\u1eefng \u0111o\u1ea1n \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 kh\u00f4ng ph\u00ecnh.<\/li>\n
        • Nh\u1eefng th\u1ee7 thu\u1eadt li\u00ean quan \u0111\u1ebfn \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 nh\u01b0 th\u00f4ng tim, b\u00f3ng \u0111\u1ed1i xung trong \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, ph\u1eabu thu\u1eadt tim.<\/li>\n
        • Cocain c\u00f3 th\u1ec3 kh\u1edfi ph\u00e1t l\u00f3c t\u00e1ch.<\/li>\n
        • T\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 do ch\u1ea5n th\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ee9t ngang d\u1eabn \u0111\u1ebfn l\u00f3c t\u00e1ch.<\/li>\n<\/ul>\n

          4. Si\u00eau \u00e2m tim trong t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/h2>\n

          Si\u00eau \u00e2m qua th\u1ef1c qu\u1ea3n cho ph\u00e9p ph\u00e1t hi\u1ec7n v\u1ebft r\u00e1ch n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u1edbi \u0111\u1ed9 ch\u00ednh x\u00e1c r\u1ea5t cao (\u0111\u1ed9 nh\u1ea1y 99%, \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u 98%). Si\u00eau \u00e2m qua th\u1ef1c qu\u1ea3n \u0111\u1ec3 ph\u00e1t hi\u1ec7n nh\u1eefng d\u1ea5u hi\u1ec7u sau:<\/p>\n

          4.1 C\u00e1c d\u1ea5u hi\u1ec7u ch\u00ednh<\/h3>\n
            \n
          • C\u00f3 v\u1ebft r\u00e1ch n\u1ed9i m\u1ea1c \u1edf c\u00e1c v\u1ecb tr\u00ed sau:<\/li>\n
          • \u0110M ch\u1ee7 l\u00ean (tr\u1ee5c d\u1ecdc qua van \u0110M ch\u1ee7 \u1edf v\u1ecb tr\u00ed 120\u00b0 m\u1ee9c gi\u1eefa th\u1ef1c qu\u1ea3n gi\u1eefa, tr\u1ee5c ng\u1eafn qua \u0110M ch\u1ee7 l\u00ean \u1edf 0\u00b0 m\u1ee9c gi\u1eefa th\u1ef1c qu\u1ea3n).<\/li>\n
          • \u0110M ch\u1ee7 xu\u1ed1ng (tr\u1ee5c ng\u1eafn qua \u0110M ch\u1ee7 xu\u1ed1ng \u1edf v\u1ecb tr\u00ed 0\u00b0, tr\u1ee5c d\u1ecdc qua \u0110M ch\u1ee7 xu\u1ed1ng \u1edf 90\u00b0).<\/li>\n
          • Quai \u0110M ch\u1ee7 (tr\u1ee5c d\u1ecdc qua quai \u0110M ch\u1ee7 \u1edf v\u1ecb tr\u00ed 0 o , tr\u1ee5c ng\u1eafn qua quai \u0110M ch\u1ee7 \u1edf v\u1ecb tr\u00ed 90 o tr\u00ean th\u1ef1c qu\u1ea3n).<\/li>\n
          • C\u00f3 t\u00e1ch\/\u00e9p v\u00e0o c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0nh hay kh\u00f4ng (tr\u1ee5c ng\u1eafn qua \u0110M ch\u1ee7 l\u00ean \u1edf v\u1ecb tr\u00ed 0\u00b0 m\u1ee9c gi\u1eefa th\u1ef1c qu\u1ea3n).<\/li>\n
          • M\u1ee9c \u0111\u1ed9 h\u1edf van \u0110M ch\u1ee7, \u0111\u01b0\u1eddng k\u00ednh v\u00f2ng van, c\u00e1c l\u00e1 van (tr\u1ee5c d\u1ecdc qua van \u0110M ch\u1ee7 \u1edf v\u1ecb tr\u00ed 120\u00b0 m\u1ee9c gi\u1eefa th\u1ef1c qu\u1ea3n).<\/li>\n
          • V\u1ecb tr\u00ed c\u1ee7a v\u1ebft r\u00e1ch, t\u00ednh ch\u1ea5t d\u00f2ng m\u00e0u \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh l\u00f2ng th\u1eadt v\u00e0 l\u00f2ng gi\u1ea3. T\u00e1ch th\u00e0nh \u0110M ch\u1ee7 v\u00e0 li\u00ean quan v\u1edbi c\u00e1c c\u01a1 quan xung quanh .<\/li>\n
          • Huy\u1ebft kh\u1ed1i ho\u1eb7c \u00e2m cu\u1ed9n t\u1ef1 nhi\u00ean trong l\u00f2ng gi\u1ea3.<\/li>\n
          • L\u01b0u \u00fd:<\/u><\/strong> C\u1ea7n ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p t\u1ed1t tr\u01b0\u1edbc khi ti\u1ebfn h\u00e0nh si\u00eau \u00e2m qua th\u1ef1c qu\u1ea3n, v\u00e0 n\u00ean d\u00f9ng thu\u1ed1c g\u00e2y m\u00ea \u0111\u1ec3 tr\u00e1nh t\u00ecnh tr\u1ea1ng k\u00edch th\u00edch l\u00e0m huy\u1ebft \u00e1p t\u0103ng th\u00eam.<\/li>\n<\/ul>\n

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

            Si\u00eau \u00e2m t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7<\/strong><\/p>\n

            4.2 Nh\u1eefng \u0111i\u1ec3m c\u1ea7n ch\u00fa \u00fd<\/h3>\n
              \n
            • \u0110i\u1ec3m m\u00f9 (v\u00f9ng kh\u00f4ng quan s\u00e1t \u0111\u01b0\u1ee3c) \u1edf \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a quai \u0110M ch\u1ee7 .<\/li>\n
            • Nhi\u1ec5u trong l\u00f2ng \u0110M ch\u1ee7 , \u0111\u1eb7c bi\u1ec7t trong tr\u01b0\u1eddng h\u1ee3p \u0110M ch\u1ee7 gi\u00e3n l\u1edbn – c\u00e1c h\u00ecnh \u1ea3nh nhi\u1ec5u n\u00e0y \u0111\u1eb7c tr\u01b0ng b\u1edfi h\u00ecnh \u1ea3nh c \u00e1c v\u1ec7t n\u1eb1m song song v\u1edbi th\u00e0nh \u0110M ch\u1ee7 , v\u1eadn t\u1ed1c d\u00f2ng m\u00e1u \u1edf hai b\u00ean v\u1ec7t n\u00e0y t\u01b0\u01a1ng t\u1ef1 nhau, v\u00e0 d\u00f2ng m\u00e0u tr\u00f9m l\u00ean v\u1ec7t nhi\u1ec5u.<\/li>\n
            • N\u1ebfu k\u1ebft qu\u1ea3 si\u00eau \u00e2m th\u1ef1c qu\u1ea3n kh\u00f4ng r\u00f5 r\u00e0ng, c\u1ea7n s\u1eed d\u1ee5ng m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh kh\u00e1c nh\u01b0 ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh ho\u1eb7c c\u1ed9ng h\u01b0\u1edfng t\u1eeb.<\/li>\n<\/ul>\n

              4.3 Huy\u1ebft kh\u1ed1i trong th\u00e0nh \u0110M ch\u1ee7<\/h3>\n

              Huy\u1ebft kh\u1ed1i trong th\u00e0nh \u0110M ch\u1ee7: Khi th\u00e0nh \u0110M ch\u1ee7 d\u00e0y >7 mm <\/strong>c\u00f3 k\u00e8m ho\u1eb7c kh\u00f4ng k\u00e8m m\u1ed9t kho\u1ea3ng kh\u00e1c bi\u1ec7t \u00e2m trong th\u00e0nh \u0110M ch\u1ee7 n\u00ean kh\u1ea3o s\u00e1t k\u1ef9 \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng huy\u1ebft kh\u1ed1i. Vi\u1ec7c ph\u00e2n bi\u1ec7t huy\u1ebft kh\u1ed1i trong th\u00e0nh \u0110M ch\u1ee7 v\u1edbi m\u1ea3ng x\u01a1 v\u1eefa ho\u1eb7c lo\u00e9t xuy\u00ean th\u00e0nh \u0110M ch\u1ee7 \u0111\u00f4i khi t\u01b0\u01a1ng \u0111\u1ed1i kh\u00f3 kh\u0103n, v\u00e0 khi \u0111\u00f3 c\u1ea7n ch\u1ec9 \u0111\u1ecbnh th\u00eam c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh kh\u00e1c.<\/p>\n

              Ch\u1ea9n \u0111o\u00e1n huy\u1ebft kh\u1ed1i trong th\u00e0nh \u0110M ch\u1ee7:<\/p>\n

                \n
              • Th\u00e0nh \u0110M ch\u1ee7 d\u00e0y khu tr\u00fa th\u00e0nh kh\u1ed1i ho\u1eb7c bao quanh th\u00e0nh m\u1ea1ch t\u1eeb 7 mm tr\u1edf l\u00ean.<\/li>\n
              • V\u00f9ng d\u00e0y k\u00e9o d\u00e0i t\u1eeb 1 – 20 cm .<\/li>\n
              • Kh\u00f4ng c\u00f3 v\u1ebft r\u00e1ch n\u1ed9i m\u1ea1c ho\u1eb7c d\u00f2ng m\u00e0u Doppler b\u00ean trong v\u00f9ng d\u00e0y th\u00e0nh \u0110M ch\u1ee7<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                T\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 t\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee9u, do r\u00e1ch l\u1edbp n\u1ed9i m\u1ea1c t\u1ea1o th\u00f4ng n\u1ed1i hay kh\u1ed1i m\u00e1u t\u1ee5 gi\u1eefa l\u1edbp n\u1ed9i m\u1ea1c v\u00e0 l\u1edbp gi\u1eefa c\u1ee7a th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7. C\u00e1c bi\u1ebfn ch\u1ee9ng kh\u00e1c bao g\u1ed3m: tr\u00e0n m\u00e1u, ch\u00e8n \u00e9p tim, h\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, h\u1ed9i ch\u1ee9ng gi\u1ea3m t\u01b0\u1edbi m\u00e1u […]<\/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":"\nT\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 tr\u00ean si\u00eau \u00e2m tim<\/title>\n<meta name=\"description\" content=\"Si\u00eau \u00e2m tim trong t\u00e1ch th\u00e0nh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 l\u00e0 v\u1ea5n \u0111\u1ec1 quan tr\u1ecdng. 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