{"id":28096,"date":"2023-04-24T22:08:51","date_gmt":"2023-04-24T15:08:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28096"},"modified":"2023-04-24T22:08:51","modified_gmt":"2023-04-24T15:08:51","slug":"viem-noi-tam-mac-nhiem-khuan-tren-sieu-am-qua-thuc-quan","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/24\/viem-noi-tam-mac-nhiem-khuan-tren-sieu-am-qua-thuc-quan\/","title":{"rendered":"Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n tr\u00ean si\u00eau \u00e2m qua th\u1ef1c qu\u1ea3n"},"content":{"rendered":"

Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh tim m\u1ea1ch.<\/strong> Ng\u00e0y nay, m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 r\u1ea5t nhi\u1ec1u ti\u1ebfn b\u1ed9 v\u1ec1 b\u1ec7nh nguy\u00ean, ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec1u<\/strong> tr\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n<\/a> (VNTMNK), nh\u01b0ng hi\u1ec3u bi\u1ebft c\u1ee7a ch\u00fang ta v\u1ec1<\/strong> VNTMNK r\u00f5 r\u00e0ng c\u00f2n nhi\u1ec1u thi\u1ebfu s\u00f3t.<\/strong><\/p>\n

1.D\u1ecbch t\u1ec5 h\u1ecdc<\/h2>\n

Ng\u00e0y nay, m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 r\u1ea5t nhi\u1ec1u ti\u1ebfn b\u1ed9 v\u1ec1 b\u1ec7nh nguy\u00ean, ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n (VNTMNK), nh\u01b0ng hi\u1ec3u bi\u1ebft c\u1ee7a ch\u00fang ta v\u1ec1 VNTMNK r\u00f5 r\u00e0ng c\u00f2n nhi\u1ec1u thi\u1ebfu s\u00f3t. T\u1ef7 l\u1ec7 m\u1eafc h\u1eb1ng n\u0103m g\u1ea7n nh\u01b0 kh\u00f4ng thay \u0111\u1ed5i, dao \u0111\u1ed9ng t\u1eeb 3 \u0111\u1ebfn 9 ca trong 100.000 ng\u01b0\u1eddi \u1edf c\u00e1c n\u01b0\u1edbc c\u00f4ng nghi\u1ec7p ph\u00e1t tri\u1ec3n. T\u1ef7 l\u1ec7 t\u1eed vong trong vi\u1ec7n dao \u0111\u1ed9ng t\u1eeb 15% \u0111\u1ebfn 20%, t\u1ef7 l\u1ec7 t\u1eed vong sau 1 n\u0103m t\u1eeb 30% \u0111\u1ebfn 40% t\u00f9y thu\u1ed9c v\u00e0o ch\u1ee7ng vi sinh, v\u1ecb tr\u00ed van t\u1ed5n th\u01b0\u01a1ng, lo\u1ea1i van, c\u00e1c b\u1ec7nh l\u00fd k\u00e8m theo, ch\u1ec9 thay \u0111\u1ed5i r\u1ea5t \u00edt trong v\u00f2ng 20 n\u0103m qua.
\n\u0110a s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng tim c\u1ea5u tr\u00fac tr\u01b0\u1edbc \u0111\u00f3 (b\u1ec7nh van tim, van tim nh\u00e2n t\u1ea1o, b\u1ec7nh tim b\u1ea9m sinh c\u00f3 t\u00edm\u2026), tr\u1eeb tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n nghi\u1ec7n ch\u00edch ma t\u00fay ho\u1eb7c ch\u1ee7ng vi khu\u1ea9n c\u00f3 \u0111\u1ed9c l\u1ef1c cao, b\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 th\u1ec3 m\u1eafc VNTMNK m\u00e0 kh\u00f4ng c\u00f3 t\u1ed5n th\u01b0\u01a1ng c\u1ea5u tr\u00fac tim r\u00f5 r\u00e0ng tr\u01b0\u1edbc \u0111\u00f3.<\/p>\n

2.Sinh l\u00fd b\u1ec7nh<\/h2>\n
    \n
  • S\u00f9i do vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n th\u01b0\u1eddng \u1edf n\u01a1i d\u00f2ng m\u00e1u c\u00f3 t\u1ed1c \u0111\u1ed9 cao \u0111i qua g\u00e2y t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u1ea1c. C\u1ea7n ch\u00fa \u00fd r\u1eb1ng s\u00f9i n\u1eb1m \u1edf ph\u00eda m\u1eb7t nh\u0129 c\u1ee7a van nh\u0129 \u2013 th\u1ea5t v\u00e0 \u1edf m\u1eb7t th\u1ea5t c\u1ee7a van b\u00e1n nguy\u1ec7t. Ngo\u00e0i ra, d\u00f2ng ph\u1ee5t ng\u01b0\u1ee3c t\u1eeb c\u00e1c van b\u00e1n nguy\u1ec7t (van t\u1ed5 chim) c\u00f3 th\u1ec3 l\u00e0m t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng. D\u1ea5u hoa th\u1ecb \u0111\u00e1nh d\u1ea5u c\u00e1c khu v\u1ef1c t\u1ed5n th\u01b0\u01a1ng do d\u00f2ng m\u00e1u g\u00e2y ra (m\u1ea3ng McCallum) tr\u00ean n\u1ed9i t\u00e2m m\u1ea1c trong th\u00f4ng li\u00ean th\u1ea5t (tr\u00ean l\u00e1 v\u00e1ch van ba l\u00e1) ho\u1eb7c \u1edf nh\u0129 tr\u00e1i do d\u00f2ng ph\u1ee5t ng\u01b0\u1ee3c qua van hai l\u00e1.<\/li>\n<\/ul>\n

    C\u00e1c giai \u0111o\u1ea1n ph\u00e1t tri\u1ec3n t\u1ed5n th\u01b0\u01a1ng c\u1ee7a vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c tr\u00ean van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7.<\/p>\n

      \n
    • L\u00e1 van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u00ecnh th\u01b0\u1eddng c\u00f3 m\u1ed9t ph\u1ea7n d\u00e0y l\u00ean \u1edf d\u01b0\u1edbi \u0111\u01b0\u1eddng m\u00e9p l\u00e0 v\u00f9ng c\u00e1c l\u00e1 van \u00e1p v\u1edbi nhau v\u00e0 l\u00e0 n\u01a1i hay x\u1ea3y ra t\u1ed5n th\u01b0\u01a1ng. L\u1edbp n\u1ed9i m\u1ea1c ph\u1ee7 l\u00ean l\u00e1 van l\u00e0 m\u1ed9t ph\u1ea7n m\u1edf r\u1ed9ng c\u1ee7a n\u1ed9i m\u1ea1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 v\u00e0 t\u00e2m th\u1ea5t. L\u1edbp s\u1ee3i l\u00e0 c\u1ea5u tr\u00fac n\u00e2ng \u0111\u1ee1 ch\u00ednh cho l\u00e1 van. L\u1edbp th\u1ea5t n\u1eb1m d\u01b0\u1edbi b\u1edd t\u1ef1 do c\u1ee7a l\u00e1 van v\u00e0 l\u1edbp x\u1ed1p n\u1eb1m \u1edf ph\u1ea7n trung t\u00e2m, gi\u1eefa l\u1edbp s\u1ee3i v\u00e0 l\u1edbp th\u1ea5t.<\/li>\n
    • C\u00e1c t\u1ed5n th\u01b0\u01a1ng ban \u0111\u1ea7u \u1edf n\u1ed9i m\u1ea1c v\u00e0 l\u00e0m b\u1ed9c l\u1ed9 collagen c\u1ee7a van.<\/li>\n
    • S\u1ef1 l\u1eafng \u0111\u1ecdng ti\u1ec3u c\u1ea7u v\u00e0 t\u01a1 huy\u1ebft v\u1edbi s\u1ef1 h\u00ecnh th\u00e0nh c\u1ee7a t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u1ea1c d\u1ea1ng huy\u1ebft kh\u1ed1i v\u00f4 khu\u1ea9n.<\/li>\n
    • \u00a0C\u00e1c vi sinh v\u1eadt b\u00e1m v\u00e0o v\u00e0 x\u00e2m nh\u1eadp v\u00e0o t\u1ed5n th\u01b0\u01a1ng n\u1ed9i m\u1ea1c, sau \u0111\u00f3 nh\u00e2n l\u00ean. C\u00e1c t\u1ebf b\u00e0o vi\u00eam th\u00e2m nh\u1eadp, ph\u00e1 h\u1ee7y elastin v\u00e0 collagen, g\u00e2y t\u1ed5n h\u1ea1i \u0111\u1ebfn van tim.B\u00ecnh th\u01b0\u1eddng l\u1edbp n\u1ed9i m\u1ea1c \u0111\u00f3ng vai tr\u00f2 nh\u01b0 m\u1ed9t h\u00e0ng r\u00e0o t\u1ef1 nhi\u00ean b\u1ea3o v\u1ec7 ch\u1ed1ng l\u1ea1i c\u00e1c vi khu\u1ea9n g\u00e2y b\u1ec7nh. Khi l\u1edbp n\u1ed9i m\u1ea1c b\u1ecb t\u1ed5n th\u01b0\u01a1ng, theo sau \u0111\u00f3 l\u00e0 s\u1ef1 l\u1eafng \u0111\u1ecdng ti\u1ec3u c\u1ea7u \u2013fibrin, t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho vi khu\u1ea9n c\u00f3 th\u1ec3 b\u00e1m d\u00ednh l\u1ea1i, ph\u00e1t tri\u1ec3n v\u00e0 h\u00ecnh th\u00e0nh t\u1ed5n th\u01b0\u01a1ng s\u00f9i. H\u1ea7u h\u1ebft c\u00e1c v\u1ecb tr\u00ed h\u00ecnh th\u00e0nh s\u00f9i \u0111\u1ec1u t\u01b0\u01a1ng \u1ee9ng v\u1edbi l\u1edbp n\u1ed9i m\u1ea1c b\u1ecb d\u00f2ng m\u00e1u g\u00e2y t\u1ed5n th\u01b0\u01a1ng, v\u00ed d\u1ee5: \u1edf m\u1eb7t th\u1ea5t c\u1ee7a c\u00e1c van t\u1ed5 chim, \u1edf m\u1eb7t nh\u0129 c\u1ee7a c\u00e1c van nh\u0129 th\u1ea5t.
      \nKho\u1ea3ng 30% b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a t\u1ed5n th\u01b0\u01a1ng c\u1ea5u tr\u00fac tim tr\u01b0\u1edbc \u0111\u00f3. M\u1ed9t s\u1ed1 vi khu\u1ea9n c\u00f3 \u0111\u1ed9ng l\u1ef1c cao c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y t\u1ed5n th\u01b0\u01a1ng tr\u00ean c\u1ea3 van b\u00ecnh th\u01b0\u1eddng g\u1ed3m: S. aureus, m\u1ed9t s\u1ed1 Streptococcus, Salmonella, Rickettsia, Borrelia\u2026<\/li>\n<\/ul>\n

      3. Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n trong b\u1ec7nh vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n.<\/h2>\n

      Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n c\u00f3 \u0111\u1ed9 nh\u1ea1y cao h\u01a1n so v\u1edbi si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng s\u00f9i (\u0111\u1ed9 nh\u1ea1y > 90% so v\u1edbi < 60%) trong b\u1ec7nh vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n, \u0111\u1eb7c bi\u1ec7t n\u1ebfu t\u1ed5 ch\u1ee9c s\u00f9i c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf < 5 mm.<\/p>\n

      Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n l\u00e0 ph\u01b0\u01a1ng ph\u00e1p th\u0103m d\u00f2 \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p:<\/em><\/p>\n

        \n
      • B\u1ec7nh nh\u00e2n c\u00f3 h\u00ecnh \u1ea3nh si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c m\u1edd. Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 van nh\u00e2n t\u1ea1o.<\/li>\n
      • Nh\u1eefng tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n nh\u01b0ng si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c.<\/li>\n
      • Ph\u00e1t hi\u1ec7n nh\u1eefng bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n.<\/li>\n<\/ul>\n

        M\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u1ec1 ngh\u1ecb t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n m\u1eafc vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n n\u00ean \u0111\u01b0\u1ee3c l\u00e0m si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 \u00e1p xe \u0110M ch\u1ee7 v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n do t\u1ee5 c\u1ea7u v\u00e0ng v\u00ec nguy c\u01a1 xu\u1ea5t hi\u1ec7n bi\u1ebfn ch\u1ee9ng cao. Ch\u00fa \u00fd r\u1eb1ng n\u1ebfu c\u1ea3 si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c v\u00e0 si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n \u0111\u1ec1u lo\u1ea1i tr\u1eeb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n th\u00ec gi\u00e1 tr\u1ecb ch\u1ea9n \u0111o\u00e1n \u00e2m t\u00ednh l\u00e0 >95%. N\u1ebfu tr\u00ean l\u00e2m s\u00e0ng \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng m\u1eafc vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n v\u0201n cao, n\u00ean l\u00e0m l\u1ea1i si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n sau 7 – 10 ng\u00e0y.<\/p>\n

        C\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n tr\u00ean si\u00eau \u00e2m tim d\u1ef1a theo ti\u00eau chu\u1ea9n Duke:<\/p>\n

          \n
        • C\u00f3 t\u1ed5n th\u01b0\u01a1ng s\u00f9i.<\/li>\n
        • H\u00ecnh \u1ea3nh \u00e1p xe: H\u1ea7u h\u1ebft ch\u1ec9 x\u1ea3y ra \u1edf v\u00f9ng g\u1ed1c \u0110M ch\u1ee7 , sau \u0111\u00f3 \u0111\u1ebfn v\u00e1ch li\u00ean th\u1ea5t, van hai l\u00e1 v\u00e0 c\u1ed9t c\u01a1 nh\u00fa. Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n c\u00f3 \u0111\u1ed9 nh\u1ea1y 80% so v\u1edbi \u0111\u1ed9 nh\u1ea1y 30% c\u1ee7a si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c.<\/li>\n
        • Bong v\u00f2ng van nh\u00e2n t\u1ea1o.<\/li>\n<\/ul>\n

          Ho\u1eb7c:<\/p>\n

            \n
          • H\u1edf van m\u1edbi xu\u1ea5t hi\u1ec7n.<\/li>\n
          • Ho\u1eb7c c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0: Th\u1ee7ng l\u00e1 van, r\u00f2, \u0111\u1ee9t d\u00e2y ch\u1eb1ng.<\/li>\n
          • C\u00e1c m\u1eb7t c\u1eaft ch\u00ednh c\u1ea7n l\u01b0u \u00fd<\/li>\n
          • Quan s\u00e1t \u00e1p xe g\u1ed1c \u0110M ch\u1ee7 (m\u1eb7t c\u1eaft tr\u1ee5c ng\u1eafn qua van \u0110M ch\u1ee7 \u1edf v\u1ecb tr\u00ed 60 o m\u1ee9c th\u1ef1c qu\u1ea3n gi\u1eefa).<\/li>\n
          • Quan s\u00e1t van hai l\u00e1 ( Xem m\u1ee5c 12. Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n trong h\u1edf van hai l\u00e1 )<\/li>\n
          • Van ba l\u00e1 (m\u1eb7t c\u1eaft b\u1ed1n bu\u1ed3ng \u1edf v\u1ecb tr\u00ed 0\u00b0 m\u1ee9c th\u1ef1c qu\u1ea3n gi\u1eefa, m\u1eb7t c\u1eaft tr\u1ee5c d\u1ecdc t\u1eeb d\u1ea1 d\u00e0y \u1edf v\u1ecb tr\u00ed 120\u00b0 ).<\/li>\n
          • Van \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (m\u1eb7t c\u1eaft quan s\u00e1t bu\u1ed3ng nh\u1eadn v\u00e0 \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i \u1edf v\u1ecb tr\u00ed 90\u00b0m\u1ee9c th\u1ef1c qu\u1ea3n gi\u1eefa).<\/li>\n<\/ul>\n

            Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n tr\u01b0\u1edbc ph\u0201u thu\u1eadt r\u1ea5t c\u1ea7n thi\u1ebft \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u1ed5n th\u01b0\u01a1ng tr\u00ean c\u00e1c van c\u00f2n l\u1ea1i v\u00e0 \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00f3 \u1ed5 \u00e1p xe hay kh\u00f4ng, gi\u00fap ph\u0201u thu\u1eadt vi\u00ean c\u00f3 th\u1ec3 d\u1ef1 ki\u1ebfn c\u00e1c x\u1eed tr\u00ed c\u1ea7n thi\u1ebft kh\u00e1c.<\/p>\n

            \"Vi\u00eam<\/p>\n

            Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n tr\u00ean si\u00eau \u00e2m tim<\/strong><\/p>\n

              \n
            • Nh\u1eefng \u0111i\u1ec1u c\u1ea7n ch\u00fa \u00fd:<\/li>\n<\/ul>\n

              C\u00e1c c\u1ea5u tr\u00fac b\u00ecnh th\u01b0\u1eddng kh\u00e1c c\u00f3 th\u1ec3 quan s\u00e1t tr\u00ean van (v\u00ed d\u1ee5 nh\u01b0 d\u1ea3i Lamb), c\u00e1c c\u1ea5u tr\u00fac c\u1ee7a d\u00e2y ch\u1eb1ng trong tr\u01b0\u1eddng h\u1ee3p c\u00f3 tho\u00e1i h\u00f3a nh\u1ea7y, ho\u1eb7c t\u00ecnh tr\u1ea1ng d\u00e0y l\u00ean kh\u00f4ng \u0111\u1eb7c hi\u1ec7u c\u1ee7a van c\u00f3 th\u1ec3 nh\u1ea7m v\u1edbi t\u1ed5 ch\u1ee9c s\u00f9i van, d\u0201n t\u1edbi ch\u1ea9n \u0111o\u00e1n nh\u1ea7m vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n tr\u00ean si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n.<\/p>\n

              Nh\u1eefng d\u1ea5u hi\u1ec7u tr\u00ean si\u00eau \u00e2m c\u1ea7n ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt s\u1edbm\/c\u1ea5p c\u1ee9u<\/p>\n

                \n
              • H\u1edf ch\u1ee7 ho\u1eb7c h\u1edf hai l\u00e1 c\u1ea5p g\u00e2y suy ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i. T\u00ecnh tr\u1ea1ng n\u00e0y c\u00f3 th\u1ec3 li\u00ean quan \u0111\u1ebfn t\u1ed5n th\u01b0\u01a1ng c\u1ea5u tr\u00fac van nh\u01b0 th\u1ee7ng l\u00e1 van hay \u0111\u1ee9t d\u00e2y ch\u1eb1ng. H\u1edf c\u1ea1nh van nh\u00e2n t\u1ea1o g\u00e2y r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng.<\/li>\n
              • \u1ed4 \u00e1p xe l\u1edbn ho\u1eb7c \u00e1p xe ti\u1ebfn tri\u1ec3n m\u1eb7c d\u00f9 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh. T\u1ed5n th\u01b0\u01a1ng s\u00f9i – g\u00e2y thuy\u00ean t\u1eafc m\u1ea1ch t\u00e1i ph\u00e1t.<\/li>\n
              • Nguy c\u01a1 g\u00e2y thuy\u00ean t\u1eafc m\u1ea1ch cao v\u1edbi t\u1ed5n th\u01b0\u01a1ng s\u00f9i \u1edf van hai l\u00e1 > 10 mm .<\/li>\n
              • K\u00edch th\u01b0\u1edbc s\u00f9i t\u0103ng l\u00ean m\u1eb7c d\u00f9 \u0111\u00e3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng sinh \u0111\u1ee7 4 tu\u1ea7n.<\/li>\n<\/ul>\n

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

                Vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n l\u00e0 v\u1ea5n \u0111\u1ec1 th\u01b0\u1eddng g\u1eb7p trong th\u1ef1c h\u00e0nh tim m\u1ea1ch. Ng\u00e0y nay, m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 r\u1ea5t nhi\u1ec1u ti\u1ebfn b\u1ed9 v\u1ec1 b\u1ec7nh nguy\u00ean, ch\u1ea9n \u0111o\u00e1n, ti\u00ean l\u01b0\u1ee3ng v\u00e0 \u0111i\u1ec1u tr\u1ecb vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n (VNTMNK), nh\u01b0ng hi\u1ec3u bi\u1ebft c\u1ee7a ch\u00fang ta v\u1ec1 VNTMNK r\u00f5 r\u00e0ng c\u00f2n nhi\u1ec1u […]<\/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":"\nVi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n tr\u00ean si\u00eau \u00e2m qua th\u1ef1c qu\u1ea3n<\/title>\n<meta name=\"description\" content=\"Si\u00eau \u00e2m tim qua th\u1ef1c qu\u1ea3n c\u00f3 \u0111\u1ed9 nh\u1ea1y cao h\u01a1n so v\u1edbi si\u00eau \u00e2m tim qua th\u00e0nh ng\u1ef1c \u0111\u1ec3 ph\u00e1t hi\u1ec7n t\u1ed5n th\u01b0\u01a1ng s\u00f9i trong vi\u00eam n\u1ed9i 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