{"id":28715,"date":"2023-04-28T18:15:39","date_gmt":"2023-04-28T11:15:39","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28715"},"modified":"2023-04-28T18:15:39","modified_gmt":"2023-04-28T11:15:39","slug":"dieu-tri-va-du-phong-roi-loan-tam-than-do-ruou","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/28\/dieu-tri-va-du-phong-roi-loan-tam-than-do-ruou\/","title":{"rendered":"\u0110i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u"},"content":{"rendered":"

S\u1eed d\u1ee5ng r\u01b0\u1ee3u bia \u0111ang r\u1ea5t ph\u1ed5 bi\u1ebfn trong cu\u1ed9c s\u1ed1ng c\u1ee7a ch\u00fang ta, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong x\u00e3 h\u1ed9i hi\u1ec7n \u0111\u1ea1i nh\u01b0 ng\u00e0y nay. \u0110i\u1ec1u n\u00e0y g\u00f3p ph\u1ea7n d\u1eabn t\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u \u0111ang l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 nh\u1ee9c nh\u1ed1i. Qua b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta h\u00e3y c\u0169ng t\u00ecm hi\u1ec3u v\u00e0 c\u00e1c d\u1ef1 ph\u00f2ng r\u1ed1i lo\u1ea1n n\u00e0y.<\/strong><\/p>\n

1. \u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u<\/h2>\n

1.1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/b><\/p>\n

\u0110i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c to\u00e0n di\u1ec7n v\u00e0 l\u00e2u d\u00e0i;<\/p>\n

\u0110i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p b\u1eb1ng h\u00f3a d\u01b0\u1ee3c v\u00e0 t\u00e2m l\u00fd, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ea1i c\u1ed9ng \u0111\u1ed3ng;<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1eb1ng h\u00f3a d\u01b0\u1ee3c;<\/p>\n

H\u1ed9i ch\u1ee9ng cai r\u01b0\u1ee3u (b\u00f9 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i, vitamin nh\u00f3m B li\u1ec1u cao, thu\u1ed1c b\u00ecnh th\u1ea7n, an th\u1ea7n kinh)<\/p>\n

Lo\u1ea1n th\u1ea7n do r\u01b0\u1ee3u (thu\u1ed1c an th\u1ea7n kinh, b\u00ecnh th\u1ea7n, b\u00f9 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i, vitamin nh\u00f3m B li\u1ec1u cao)<\/p>\n

Tr\u1ea7m c\u1ea3m do r\u01b0\u1ee3u (thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m, b\u00f9 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i, vitamin nh\u00f3m B li\u1ec1u cao)<\/p>\n

Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd:<\/p>\n

–\u00a0Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd c\u00e1 nh\u00e2n, gia \u0111\u00ecnh<\/p>\n

–\u00a0Li\u1ec7u ph\u00e1p nh\u1eadn th\u1ee9c h\u00e0nh vi<\/p>\n

Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ea1i c\u1ed9ng \u0111\u1ed3ng: Li\u1ec7u ph\u00e1p t\u00e1i th\u00edch \u1ee9ng x\u00e3 h\u1ed9i<\/p>\n

\u0110i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd c\u01a1 th\u1ec3 \u0111i k\u00e8m (b\u1ec7nh l\u00fd gan, d\u1ea1 d\u00e0y, h\u00f4 h\u1ea5p\u2026)<\/p>\n

1.2. S\u01a1 \u0111\u1ed3\/ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb<\/b><\/p>\n

Gi\u1ea3i \u0111\u1ed9c v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng cai b\u1eb1ng thu\u1ed1c<\/p>\n

T\u1ea1o ph\u1ea3n x\u1ea1 gh\u00e9t s\u1ee3 r\u01b0\u1ee3u b\u1eb1ng thu\u1ed1c v\u00e0\/ho\u1eb7c \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng t\u00e1i s\u1eed d\u1ee5ng r\u01b0\u1ee3u<\/p>\n

Ch\u1ed1ng lo\u1ea1n th\u1ea7n \u0111\u1ed1i lo\u1ea1n th\u1ea7n do r\u01b0\u1ee3u v\u1edbi hoang t\u01b0\u1edfng, \u1ea3o gi\u00e1c<\/p>\n

Ch\u1ed1ng tr\u1ea7m c\u1ea3m \u0111\u1ed1i v\u1edbi r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m do r\u01b0\u1ee3u.<\/p>\n

Thu\u1ed1c b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan: aminoleban, silymarin, boganic\u2026<\/p>\n

Thu\u1ed1c t\u0103ng c\u01b0\u1eddng v\u00e0 nu\u00f4i d\u01b0\u1ee1ng n\u00e3o: piracetam, ginkgo giloba, cholin alfoscerate, vinpocetin\u2026<\/p>\n

\"Roi-loan-tam-than-do-ruou\"
R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u<\/figcaption><\/figure>\n

1.3. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/b><\/p>\n

1.3.1. H\u1ed9i ch\u1ee9ng cai r\u01b0\u1ee3u<\/em><\/p>\n

Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n ph\u1ea3i nh\u1eadp vi\u1ec7n \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa.<\/p>\n

\u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng cai b\u1eb1ng c\u00e1c thu\u1ed1c b\u00ecnh th\u1ea7n: benzodiazepin (10-30mg\/ng\u00e0y) d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c ti\u00eam b\u1eafp, ti\u00eam t\u0129nh m\u1ea1ch, b\u1ed5 sung thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n n\u1ebfu c\u00f3 hoang t\u01b0\u1edfng, \u1ea3o gi\u00e1c, r\u1ed1i lo\u1ea1n h\u00e0nh vi\u2026.<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n:\u00a0<\/b>ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau (\u01b0u ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u, n\u1ebfu \u00edt hi\u1ec7u qu\u1ea3 xem x\u00e9t chuy\u1ec3n lo\u1ea1i thu\u1ed1c ho\u1eb7c k\u1ebft h\u1ee3p t\u1ed1i \u0111a 3 lo\u1ea1i thu\u1ed1c \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n).<\/p>\n

Thu\u1ed1c an th\u1ea7n kinh \u0111i\u1ec3n h\u00ecnh (c\u1ed5 \u0111i\u1ec3n):<\/i><\/b><\/p>\n

Haloperidol: vi\u00ean 1,5mg, vi\u00ean 5 mg, \u1ed1ng 5mg, li\u1ec1u 5-30mg\/24 gi\u1edd<\/p>\n

C\u00e1c thu\u1ed1c an th\u1ea7n kinh kh\u00f4ng \u0111i\u1ec3n h\u00ecnh (m\u1edbi):<\/i><\/b><\/p>\n

Risperidon: vi\u00ean 1mg, 2mg, li\u1ec1u 1-12mg\/24 gi\u1edd.<\/p>\n

Olanzapin: vi\u00ean 5mg, 10mg, li\u1ec1u 5-60mg\/24 gi\u1edd<\/p>\n

Quetiapin 50mg, 200mg, 300mg, li\u1ec1u 600-800 mg\/ ng\u00e0y<\/p>\n

Clozapin: vi\u00ean 25mg, 100mg, li\u1ec1u 50-800mg\/24 gi\u1edd<\/p>\n

Aripiprazol 5mg, 10 mg, 15mg, 30mg, li\u1ec1u 10-30 mg\/ng\u00e0y,<\/p>\n

B\u1ed3i ph\u1ee5 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i: dung d\u1ecbch ringer lactat, natriclorua 0,9%, glucose 5% s\u1ed1 l\u01b0\u1ee3ng 2-4 l\u00edt\/ng\u00e0y \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch, c\u00f3 th\u1ec3 b\u00f9 d\u1ecbch \u0111\u01b0\u1eddng u\u1ed1ng b\u1eb1ng oresol.<\/p>\n

B\u1ed5 sung vitamin nh\u00f3m B (B1, B6, B12) \u0111\u1eb7c bi\u1ec7t l\u00e0 vitamin B1 li\u1ec1u cao 1 g\/ng\u00e0y n\u00ean d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam.<\/p>\n

Thu\u1ed1c h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng gan: aminoleban, silymarin, boganic, c\u00e1c amin ph\u00e2n nh\u00e1nh kh\u00e1c\u2026<\/p>\n

B\u1ed5 sung dinh d\u01b0\u1ee1ng, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch<\/p>\n

Thu\u1ed1c dinh d\u01b0\u1ee1ng th\u1ea7n kinh:<\/p>\n

Thu\u1ed1c t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c:<\/p>\n

\u0110i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n c\u01a1 th\u1ec3 k\u00e8m theo. Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd<\/p>\n

V\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u, ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u\u2026<\/p>\n

Giai \u0111o\u1ea1n ti\u1ebfp theo c\u00f3 th\u1ec3 cho \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa disulfiram 125-250 mg\/ng\u00e0y, naltrexol 25-50mg\/ng\u00e0y\u2026<\/p>\n

1.3.2. \u0110i\u1ec1u tr\u1ecb s\u1ea3ng r\u01b0\u1ee3u trong tr\u1ea1ng th\u00e1i ca<\/em>i<\/p>\n

Diazepam10-30mg\/ng\u00e0y d\u00f9ng \u0111\u01b0\u1eddng u\u1ed1ng ho\u1eb7c ti\u00eam b\u1eafp, ti\u00eam t\u0129nh m\u1ea1ch<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n:<\/b>ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau (\u01b0u ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u, n\u1ebfu \u00edt hi\u1ec7u qu\u1ea3 xem x\u00e9t chuy\u1ec3n lo\u1ea1i thu\u1ed1c ho\u1eb7c k\u1ebft h\u1ee3p t\u1ed1i \u0111a 3 lo\u1ea1i thu\u1ed1c \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n)<\/p>\n

Thu\u1ed1c an th\u1ea7n kinh \u0111i\u1ec3n h\u00ecnh (c\u1ed5 \u0111i\u1ec3n):<\/i><\/b><\/p>\n

Haloperidol: vi\u00ean 1,5 mg, vi\u00ean 5 mg, \u1ed1ng 5 mg, li\u1ec1u 5-30 mg\/24 gi\u1edd<\/p>\n

C\u00e1c thu\u1ed1c an th\u1ea7n kinh kh\u00f4ng \u0111i\u1ec3n h\u00ecnh (m\u1edbi):<\/i><\/b><\/p>\n

Risperidon: vi\u00ean 1 mg, 2 mg, li\u1ec1u 1 – 12 mg\/24 gi\u1edd.<\/p>\n

Olanzapin: vi\u00ean 5 mg, 10 mg, li\u1ec1u 5 – 60 mg\/24 gi\u1edd<\/p>\n

Clozapin: vi\u00ean 25 mg, 100 mg, li\u1ec1u 50 – 800 mg\/24 gi\u1edd<\/p>\n

Quetiapin: vi\u00ean 50 mg, 200 mg, 300 mg, li\u1ec1u 600 – 800 mg\/ng\u00e0y<\/p>\n

Aripiprazol: vi\u00ean 5 mg, 10 mg, 15 mg, 30 mg, li\u1ec1u 10 – 30 mg\/ng\u00e0y,<\/p>\n

B\u00f9 \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i: dung d\u1ecbch ringer lactat, natriclorua 0,9%, glucose 5% s\u1ed1 l\u01b0\u1ee3ng 2 – 4 l\u00edt\/ng\u00e0y \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c b\u00f9 \u0111\u01b0\u1eddng u\u1ed1ng b\u1eb1ng oresol.<\/p>\n

B\u1ed5 sung vitamin nh\u00f3m B (B1, B6, B12) \u0111\u1eb7c bi\u1ec7t l\u00e0 vitamin B1 li\u1ec1u cao 1 g\/ng\u00e0y n\u00ean d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam.<\/p>\n

Thu\u1ed1c b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan: Aminoleban, Silymarin, Boganic, c\u00e1c amin ph\u00e2n nh\u00e1nh kh\u00e1c\u2026<\/p>\n

B\u1ed5 sung dinh d\u01b0\u1ee1ng, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch<\/p>\n

Thu\u1ed1c dinh d\u01b0\u1ee1ng th\u1ea7n kinh<\/p>\n

Thu\u1ed1c t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c<\/p>\n

\u0110i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd c\u01a1 th\u1ec3 k\u00e8m theo<\/p>\n

Tr\u01b0\u1eddng h\u1ee3p s\u1ea3ng n\u1eb7ng c\u1ea7n ph\u1ea3i ti\u1ebfn h\u00e0nh c\u00e1c bi\u1ec7n ph\u00e1p h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c ho\u1eb7c chuy\u1ec3n khoa \u0111i\u1ec1u tr\u1ecb h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n

Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd<\/p>\n

V\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u, ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u \u2026<\/p>\n

1.3.3. \u0110i\u1ec1u tr\u1ecb lo\u1ea1n th\u1ea7n do r\u01b0\u1ee3u<\/em><\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n:\u00a0<\/b>ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau (\u01b0u ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u, n\u1ebfu \u00edt hi\u1ec7u qu\u1ea3 xem x\u00e9t chuy\u1ec3n lo\u1ea1i thu\u1ed1c ho\u1eb7c k\u1ebft h\u1ee3p t\u1ed1i \u0111a 3 lo\u1ea1i thu\u1ed1c \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n)<\/p>\n

Thu\u1ed1c an th\u1ea7n kinh \u0111i\u1ec3n h\u00ecnh (c\u1ed5 \u0111i\u1ec3n):<\/i><\/b><\/p>\n

Haloperidol: vi\u00ean 1,5mg, vi\u00ean 5 mg, \u1ed1ng 5mg, li\u1ec1u 5-30mg\/24 gi\u1edd<\/p>\n

Chlorpromazin: vi\u00ean 25mg, \u1ed1ng 25mg, li\u1ec1u 50-250mg\/24 gi\u1edd<\/p>\n

Levomepromazin: vi\u00ean 25mg, li\u1ec1u 25-500mg\/24 gi\u1edd.<\/p>\n

Thioridazin: vi\u00ean 50mg, li\u1ec1u 100-300mg\/24 gi\u1edd<\/p>\n

C\u00e1c thu\u1ed1c an th\u1ea7n kinh kh\u00f4ng \u0111i\u1ec3n h\u00ecnh (m\u1edbi):<\/b><\/p>\n

Risperidon: vi\u00ean 1mg, 2 mg, li\u1ec1u 1-12mg\/24 gi\u1edd<\/p>\n

Olanzapin: vi\u00ean 5 mg, 10 mg, li\u1ec1u 5-60mg\/24 gi\u1edd<\/p>\n

Amisulprid: vi\u00ean 50mg, 200mg, 400mg, li\u1ec1u 200-800mg\/24gi\u1edd<\/p>\n

Clozapin: vi\u00ean 25mg, 100mg, li\u1ec1u 50-800mg\/24 gi\u1edd<\/p>\n

Quetiapin: vi\u00ean 50mg, 200mg, 300mg, li\u1ec1u 600-800 mg\/ ng\u00e0y<\/p>\n

Aripiprazol: vi\u00ean 5mg, 10 mg, 15mg, 30mg, li\u1ec1u 10-30 mg\/ng\u00e0y<\/p>\n

Thu\u1ed1c gi\u1ea3i lo \u00e2u:\u00a0<\/b>l\u1ef1a ch\u1ecdn m\u1ed9t trong s\u1ed1 c\u00e1c thu\u1ed1c sau: benzodiazepin 5- 30mg\/ng\u00e0y, lorazepam, bromazepam\u2026.<\/p>\n

Thu\u1ed1c gi\u1ea3i lo \u00e2u non-benzodiazepin: l\u1ef1a ch\u1ecdn m\u1ed9t trong s\u1ed1 c\u00e1c thu\u1ed1c sau: etifoxine 50-200mg\/ng\u00e0y, cao l\u1ea1c ti\u00ean.<\/p>\n

B\u00f9 \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i: dung d\u1ecbch ringer lactat, natriclorua 0,9%, glucose 5% s\u1ed1 l\u01b0\u1ee3ng 1-3 l\u00edt\/ng\u00e0y \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c b\u00f9 \u0111\u01b0\u1eddng u\u1ed1ng b\u1eb1ng oresol.<\/p>\n

B\u1ed5 sung vitamin nh\u00f3m B (B1, B6, B12) \u0111\u1eb7c bi\u1ec7t l\u00e0 vitamin b1 li\u1ec1u cao 1 g\/ng\u00e0y n\u00ean d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam.<\/p>\n

Thu\u1ed1c b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan: aminoleban, silymarin, boganic, c\u00e1c amin ph\u00e2n nh\u00e1nh kh\u00e1c\u2026<\/p>\n

B\u1ed5 sung dinh d\u01b0\u1ee1ng, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch<\/p>\n

Thu\u1ed1c dinh d\u01b0\u1ee1ng th\u1ea7n kinh:<\/p>\n

Thu\u1ed1c t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c:<\/p>\n

M\u1ed9t s\u1ed1 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7: l\u1ef1a ch\u1ecdn m\u1ed9t trong s\u1ed1 c\u00e1c thu\u1ed1c sau: zopiclon 3,75-15mg\/ng\u00e0y, melatonin\u2026<\/p>\n

Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd, v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u, ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u..<\/p>\n

K\u1ebft h\u1ee3p c\u00e1c bi\u1ec7n ph\u00e1p h\u00f3a d\u01b0\u1ee3c, t\u00e2m l\u00fd v\u00e0 x\u00e3 h\u1ed9i \u0111\u1ec3 kh\u00f4ng t\u00e1i s\u1eed d\u1ee5ng r\u01b0\u1ee3u. C\u00f3 th\u1ec3 ph\u1ed1i h\u1ee3p Disulfiram 125-250 mg\/ ng\u00e0y, Naltrexol 25-50mg\/ng\u00e0y.<\/p>\n

1.3.4. \u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n tr\u1ea7m c\u1ea3m do r\u01b0\u1ee3u<\/em>:<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m:<\/b>ch\u1ecdn m\u1ed9t ho\u1eb7c hai ho\u1eb7c ba thu\u1ed1c trong s\u1ed1 c\u00e1c thu\u1ed1c sau (\u01b0u ti\u00ean \u0111\u01a1n tr\u1ecb li\u1ec7u, n\u1ebfu \u00edt hi\u1ec7u qu\u1ea3 xem x\u00e9t chuy\u1ec3n lo\u1ea1i thu\u1ed1c ho\u1eb7c k\u1ebft h\u1ee3p t\u1ed1i \u0111a 3 lo\u1ea1i thu\u1ed1c \u0111\u1ec3 h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n).<\/p>\n

Thu\u1ed1c \u1ee9c ch\u1ebf t\u00e1i h\u1ea5p thu ch\u1ecdn l\u1ecdc serotonin:<\/i><\/b><\/p>\n

Fluoxetin 20mg, li\u1ec1u 10-40 mg\/ng\u00e0y<\/p>\n

Paroxetin 20mg, li\u1ec1u 20-60mg\/ng\u00e0y<\/p>\n

Sertralin 50mg, li\u1ec1u 50-200mg\/ng\u00e0y<\/p>\n

Fluvoxamin 100mg, li\u1ec1u 100-300mg\/ng\u00e0y<\/p>\n

Escitalopram 10\/20 mg, li\u1ec1u 10-20mg\/ng\u00e0y<\/p>\n

Citalopram, li\u1ec1u 10-60mg\/ng\u00e0y<\/p>\n

Thu\u1ed1c t\u00e1c \u0111\u1ed9ng k\u00e9p:<\/i><\/b><\/p>\n

Venlafaxin 37,5mg, li\u1ec1u 75-225mg\/ng\u00e0y<\/p>\n

Mirtazapin 30mg, li\u1ec1u 30-60mg\/ng\u00e0y<\/p>\n

C\u00e1c thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m 3 v\u00f2ng:<\/i><\/b><\/p>\n

Amitriptylin 25mg, li\u1ec1u 50-100mg\/ng\u00e0y<\/p>\n

Clomipramin 25mg, li\u1ec1u 50-75mg\/ng\u00e0y<\/p>\n

Imipramin, li\u1ec1u 10-150mg\/ng\u00e0y<\/p>\n

C\u00e1c lo\u1ea1i ch\u1ed1ng tr\u1ea7m c\u1ea3m kh\u00e1c<\/i><\/b>:<\/i><\/p>\n

Tianeptin, li\u1ec1u t\u1eeb 12,5 -50mg\/ng\u00e0y<\/p>\n

Ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c nh\u00f3m thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n, gi\u1ea3i lo \u00e2u nh\u00f3m benzodiazepin ho\u1eb7c Non-benzodiazepin trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft.<\/p>\n

B\u00f9 \u0111\u1ee7 n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i: dung d\u1ecbch ringer lactat, natriclorua 0,9%, glucose 5% s\u1ed1 l\u01b0\u1ee3ng 1-3 l\u00edt\/ng\u00e0y \u0111\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch ho\u1eb7c b\u00f9 \u0111\u01b0\u1eddng u\u1ed1ng b\u1eb1ng oresol.<\/p>\n

B\u1ed5 sung vitamin nh\u00f3m B (B1, B6, B12) \u0111\u1eb7c bi\u1ec7t l\u00e0 vitamin B1 li\u1ec1u cao 1 g\/ng\u00e0y n\u00ean d\u00f9ng \u0111\u01b0\u1eddng ti\u00eam.<\/p>\n

Thu\u1ed1c b\u1ea3o v\u1ec7 t\u1ebf b\u00e0o gan: aminoleban, silymarin, boganic, c\u00e1c amin ph\u00e2n nh\u00e1nh kh\u00e1c\u2026<\/p>\n

B\u1ed5 sung dinh d\u01b0\u1ee1ng, nu\u00f4i d\u01b0\u1ee1ng \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch<\/p>\n

Thu\u1ed1c dinh d\u01b0\u1ee1ng th\u1ea7n kinh:<\/p>\n

Thu\u1ed1c t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng nh\u1eadn th\u1ee9c:<\/p>\n

Li\u1ec7u ph\u00e1p t\u00e2m l\u00fd<\/b>: Li\u1ec7u ph\u00e1p c\u00e1 nh\u00e2n, li\u1ec7u ph\u00e1p gia \u0111\u00ecnh, li\u1ec7u ph\u00e1p t\u1ea1o \u0111\u1ed9ng l\u1ef1c, li\u1ec7u ph\u00e1p nh\u1eadn th\u1ee9c h\u00e0nh vi.<\/p>\n

Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng t\u1ea1i c\u1ed9ng \u0111\u1ed3ng:\u00a0<\/b>li\u1ec7u ph\u00e1p t\u00e1i th\u00edch \u1ee9ng x\u00e3 h\u1ed9i\u00a0(<\/b>v\u1eadn \u0111\u1ed9ng tr\u1ecb li\u1ec7u, ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u, t\u1ea1o c\u00f4ng \u0103n vi\u1ec7c l\u00e0m cho ng\u01b0\u1eddi b\u1ec7nh\u2026)<\/p>\n

Ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng:<\/b><\/p>\n

Trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n kh\u00f4ng \u0103n \u0111\u01b0\u1ee3c th\u00ec b\u00f9 b\u1eb1ng truy\u1ec1n d\u1ecbch<\/p>\n

B\u1ec7nh nh\u00e2n \u0103n b\u1eb1ng \u0111\u01b0\u1eddng mi\u1ec7ng: th\u1ee9c \u0103n gi\u00e0u ch\u1ea5t dinh d\u01b0\u1ee1ng, d\u1ec5 ti\u00eau h\u00f3a, \u0111\u1ea7y \u0111\u1ee7 4 nh\u00f3m<\/p>\n

\u0110i\u1ec1u tr\u1ecb b\u1ec7nh l\u00fd k\u1ebft h\u1ee3p.<\/b><\/p>\n

2. TI\u00caN L\u01af\u1ee2NG V\u00c0 BI\u1ebeN CH\u1ee8NG<\/b><\/h2>\n

Nghi\u1ec7n r\u01b0\u1ee3u l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd ti\u1ebfn tri\u1ec3n m\u1ea1n t\u00ednh, c\u1ea7n \u0111i\u1ec1u tr\u1ecb l\u00e2u d\u00e0i v\u00e0 c\u00f3 s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a gia \u0111\u00ecnh, nhi\u1ec1u c\u01a1 quan, \u0111o\u00e0n th\u1ec3, c\u1ed9ng \u0111\u1ed3ng.<\/p>\n

Nghi\u1ec7n r\u01b0\u1ee3u th\u01b0\u1eddng d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn \u0111\u1ed5i v\u1ec1 t\u00ednh c\u00e1ch, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n v\u00e0 g\u00e2y nhi\u1ec1u h\u1eadu qu\u1ea3 v\u1ec1 c\u00e1c b\u1ec7nh c\u01a1 th\u1ec3.<\/p>\n

3. PH\u00d2NG B\u1ec6NH<\/b><\/h2>\n

3.1. Ph\u00f2ng b\u1ec7nh nghi\u1ec7n r\u01b0\u1ee3u:<\/b><\/p>\n

Ph\u1ed5 bi\u1ebfn r\u1ed9ng r\u00e3i trong c\u1ed9ng \u0111\u1ed3ng t\u00e1c h\u1ea1i c\u1ee7a r\u01b0\u1ee3u v\u1edbi c\u01a1 th\u1ec3, t\u00e2m th\u1ea7n v\u00e0 x\u00e3 h\u1ed9i.<\/p>\n

C\u00f3 quy \u0111\u1ecbnh ch\u1eb7t ch\u1ebd trong vi\u1ec7c s\u1ea3n xu\u1ea5t, ph\u00e2n ph\u1ed1i v\u00e0 s\u1eed d\u1ee5ng r\u01b0\u1ee3u.<\/p>\n

Ch\u00fa tr\u1ecdng \u0111\u1ebfn c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng: gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi nghi\u1ec7n r\u01b0\u1ee3u, kh\u1ee7ng ho\u1ea3ng trong cu\u1ed9c s\u1ed1ng, ng\u01b0\u1eddi b\u1ec7nh t\u00e2m th\u1ea7n\u2026<\/p>\n

3.2. Ph\u00f2ng b\u1ec7nh lo\u1ea1n th\u1ea7n do r\u01b0\u1ee3u:<\/b><\/p>\n

\u0110i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c cho c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng l\u1ea1m d\u1ee5ng r\u01b0\u1ee3u, nghi\u1ec7n r\u01b0\u1ee3u; d\u1ef1 ph\u00f2ng t\u00e1i nghi\u1ec7n.<\/p>\n

\u0110i\u1ec1u tr\u1ecb c\u00e1c r\u1ed1i lo\u1ea1n c\u01a1 th\u1ec3, t\u0103ng c\u01b0\u1eddng vitamin nh\u00f3m B.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: B\u1ed9 Y t\u1ebf<\/p>\n

Xem th\u00eam: R\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u: Nh\u1eefng \u0111i\u1ec1u c\u1ea7n nh\u1edb<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

S\u1eed d\u1ee5ng r\u01b0\u1ee3u bia \u0111ang r\u1ea5t ph\u1ed5 bi\u1ebfn trong cu\u1ed9c s\u1ed1ng c\u1ee7a ch\u00fang ta, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong x\u00e3 h\u1ed9i hi\u1ec7n \u0111\u1ea1i nh\u01b0 ng\u00e0y nay. \u0110i\u1ec1u n\u00e0y g\u00f3p ph\u1ea7n d\u1eabn t\u1edbi c\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u \u0111ang l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 nh\u1ee9c nh\u1ed1i. Qua b\u00e0i vi\u1ebft n\u00e0y ch\u00fang ta h\u00e3y c\u0169ng t\u00ecm hi\u1ec3u […]<\/p>\n","protected":false},"author":26,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"\n\u0110i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u00e1c r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n do r\u01b0\u1ee3u \u0111ang l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 nh\u1ee9c nh\u1ed1i. 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