{"id":28993,"date":"2023-04-29T14:00:35","date_gmt":"2023-04-29T07:00:35","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=28993"},"modified":"2023-04-29T14:00:35","modified_gmt":"2023-04-29T07:00:35","slug":"phan-loai-do-nang-nhuoc-co-theo-osserman-cai-tien","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/phan-loai-do-nang-nhuoc-co-theo-osserman-cai-tien\/","title":{"rendered":"Ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn"},"content":{"rendered":"

\u0110\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 l\u00e0 m\u1ed9t trong c\u00e1c ti\u00eau ch\u00ed \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh th\u1ea7n kinh c\u01a1 b\u1ea3n. Osserman \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t m\u1ed9t ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean \u0111\u1ed9 n\u1eb7ng c\u1ee7a tri\u1ec7u ch\u1ee9ng<\/a> nh\u01b0\u1ee3c c\u01a1. Ph\u00e2n lo\u1ea1i n\u00e0y gi\u00fap x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh th\u1ea7n kinh c\u01a1 b\u1ea3n v\u00e0 \u0111\u01b0a ra nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p. Tuy nhi\u00ean, n\u00ean l\u01b0u \u00fd r\u1eb1ng ph\u00e2n lo\u1ea1i n\u00e0y ch\u1ec9 \u0111\u01b0a ra m\u1ed9t c\u00e1i nh\u00ecn chung v\u1ec1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh v\u00e0 kh\u00f4ng ph\u1ea3n \u00e1nh to\u00e0n b\u1ed9 t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n.<\/strong><\/p>\n

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H\u00ecnh \u1ea3nh minh h\u1ecda ng\u01b0\u1eddi b\u1ec7nh nh\u01b0\u1ee3c c\u01a1<\/figcaption><\/figure>\n

1. T\u1ed5ng quan v\u1ec1 b\u1ec7nh nh\u01b0\u1ee3c c\u01a1<\/h2>\n

Hi\u1ec7n nay, \u0111\u1ec3 thu\u1eadn ti\u1ec7n cho nghi\u00ean c\u1ee9u v\u00e0 theo d\u00f5i di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh, b\u1ea3ng ph\u00e2n lo\u1ea1i Osserman c\u1ea3i ti\u1ebfn dang \u0111\u01b0\u1ee3c nhi\u1ec1u t\u00e1c gi\u1ea3 \u0111\u1ec1 ngh\u1ecb s\u1eed d\u1ee5ng.<\/p>\n

L\u01b0u \u00fd b\u1ec7nh nh\u01b0\u1ee3c c\u01a1 kh\u00f4ng ph\u1ea3i l\u00e0 b\u1ec7nh c\u01a1, m\u00e0 l\u00e0 b\u1ec7nh c\u1ee7a synap th\u1ea7n kinh –\u00a0\u00a0 c\u01a1. B\u1ec7nh c\u00f3 \u0111\u1eb7c tr\u01b0ng l\u00e0 y\u1ebfu s\u1ee9c c\u01a1 v\u00e2n x\u01b0\u01a1ng, y\u1ebfu c\u01a1 t\u0103ng l\u00ean khi v\u1eadn \u0111\u1ed9ng, ph\u1ee5c h\u1ed3i khi ngh\u1ec9 ng\u01a1i v\u00e0 thuy\u00ean gi\u1ea3m r\u00f5 r\u1ec7t khi d\u00f9ng thu\u1ed1c kh\u00e1ng cholinesterase. B\u1ec7nh do t\u1ef1 mi\u1ec5n, do t\u1ef1 kh\u00e1ng th\u1ec3 tr\u1ef1c ti\u1ebfp ch\u1ed1ng l\u1ea1i th\u1ee5 c\u1ea3m th\u1ec3 acetylcholine \u1edf m\u00e0ng sau synap c\u1ee7a synap th\u1ea7n kinh – c\u01a1. 10-15% tr\u01b0\u1eddng h\u1ee3p c\u00f3 u t\u00e2n sinh c\u1ee7a tuy\u1ebfn \u1ee9c, 65% c\u00f3 t\u0103ng s\u1ea3n c\u00e1c nang lympho \u1edf th\u00f9y tuy\u1ebfn \u1ee9c. Kh\u00e1ng th\u1ec3 kh\u00e1ng protein c\u1ee7a th\u1ee5 c\u1ea3m th\u1ec3 Acetylcholine th\u1ea5y c\u00f3 \u1edf kho\u1ea3ng 85% b\u1ec7nh nh\u00e2n nh\u01b0\u1ee3c c\u01a1 to\u00e0n th\u00e2n v\u00e0 60% b\u1ec7nh nh\u00e2n nh\u01b0\u1ee3c c\u01a1 \u1ed5 m\u1eaft. C\u00e1c kh\u00e1ng th\u1ec3 n\u00e0y phong t\u1ecfa kh\u00f4ng cho c\u00e1c ph\u00e2n t\u1eed Acetylcholine g\u1eafn v\u00e0o v\u1edbi th\u1ee5 c\u1ea3m th\u1ec3 v\u00e0 l\u00e0m gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng th\u1ee5 c\u1ea3m th\u1ec3 Acetylcholine.<\/p>\n

T\u1ea7n su\u1ea5t b\u1ec7nh kho\u1ea3ng 1\/10 000 d\u00e2n, n\u1eef nhi\u1ec1u h\u01a1n nam (t\u1ef7 l\u1ec7 2\/1). Tr\u1ebb em d\u01b0\u1edbi 10 tu\u1ed5i chi\u1ebfm t\u1ef7 l\u1ec7 kho\u1ea3ng 10% t\u1ed5ng s\u1ed1 b\u1ec7nh nh\u00e2n.<\/p>\n

L\u00e2m s\u00e0ng: Kh\u1edfi ph\u00e1t \u1edf b\u1ea5t k\u1ef3 tu\u1ed5i n\u00e0o, th\u01b0\u1eddng ph\u1ee5 n\u1eef \u1edf <\/em>\u0111\u1ed9 tu\u1ed5i 20-30 v\u00e0 nam gi\u1edbi \u1edf \u0111\u1ed9 tu\u1ed5i 60-70. Kh\u1edfi \u0111\u1ea7u th\u01b0\u1eddng \u00e2m th\u1ea7m, \u0111\u00f4i khi b\u1ed9c l\u1ed9 sau m\u1ed9t stress hay b\u1ec7nh nhi\u1ec5m tr\u00f9ng (th\u01b0\u1eddng l\u00e0 nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p).<\/p>\n

Y\u1ebfu c\u01a1 kh\u00f4ng ph\u00f9 h\u1ee3p v\u1edbi b\u1ea5t k\u1ef3 \u0111\u1ecbnh khu th\u1ea7n kinh n\u00e0o. Th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n \u0111\u1ea7u ti\u00ean \u1edf c\u00e1c c\u01a1 \u1ed5 m\u1eaft, v\u1edbi s\u1ee5p mi ho\u1eb7c nh\u00ecn \u0111\u00f4i. C\u0169ng c\u00f3 khi bi\u1ec3u hi\u1ec7n \u0111\u1ea7u ti\u00ean \u1edf c\u01a1 nhai, nu\u1ed1t v\u00e0 n\u00f3i. Hi\u1ebfm khi bi\u1ec3u hi\u1ec7n \u0111\u1ea7u ti\u00ean \u1edf c\u01a1 t\u1ee9 chi. Nhung khi b\u1ec7nh \u0111\u00e3 ph\u00e1t tr\u1ec3n, t\u1ea5t c\u1ea3 c\u00e1c c\u01a1 \u0111\u1ec1u c\u00f3 th\u1ec3 b\u1ecb y\u1ebfu, bao g\u1ed3m c\u1ea3 c\u00e1c c\u01a1 h\u00f4 h\u1ea5p nh\u01b0 c\u01a1 ho\u00e0nh, c\u01a1 li\u00ean s\u01b0\u1eddn, c\u01a1 th\u00e0nh b\u1ee5ng. Trong c\u00e1c c\u01a1 \u1edf t\u1ee9 chi, th\u00ec c\u00e1c c\u01a1 g\u1ed1c chi (vai – n\u00e1ch v\u00e0 ch\u1eadu – \u0111\u00f9i) th\u01b0\u1eddng b\u1ecb n\u1eb7ng h\u01a1n c\u00e1c c\u01a1 \u1edf ngo\u1ea1i vi (b\u00e0n tay – c\u1eb3ng tay v\u00e0 b\u00e0n ch\u00e2n – c\u1eb3ng ch\u00e2n). Trong m\u1ed9t ng\u00e0y, th\u01b0\u1eddng y\u1ebfu c\u01a1 nh\u1eb9 v\u00e0o bu\u1ed5i s\u00e1ng v\u00e0 n\u1eb7ng l\u00ean v\u00e0o bu\u1ed5i chi\u1ec1u t\u1ed1i.<\/p>\n

Ph\u1ea3n x\u1ea1 g\u00e2n x\u01b0\u01a1ng \u0111a s\u1ed1 b\u00ecnh th\u01b0\u1eddng. C\u01a1 tim v\u00e0 c\u00e1c c\u01a1 tr\u01a1n kh\u00f4ng b\u1ecb \u1ea3nh h\u01b0\u1edfng.<\/p>\n

Ph\u1ea3n x\u1ea1 \u0111\u1ed3ng t\u1eed v\u1edbi \u00e1nh s\u00e1ng v\u00e0 \u0111i\u1ec1u ti\u1ebft b\u00ecnh th\u01b0\u1eddng.<\/p>\n

Di\u1ec5n ti\u1ebfn c\u1ee7a b\u1ec7nh nh\u01b0\u1ee3c c\u01a1 r\u1ea5t kh\u00e1c nhau. C\u00f3 ng\u01b0\u01a1i y\u1ebfu c\u01a1 ti\u1ebfn tri\u1ec3n v\u00e0 lan r\u1ed9ng ra r\u1ea5t nhanh, c\u00f3 ng\u01b0\u1eddi th\u00ec ch\u1ec9 y\u1ebfu khu tr\u00fa m\u1ed9t nh\u00f3m c\u01a1 k\u00e9o d\u00e0i h\u00e0ng nhi\u1ec1u th\u00e1ng. C\u00f3 th\u1ec3 c\u00f3 \u0111\u1ee3t thuy\u00ean gi\u1ea3m t\u1ef1 ph\u00e1t \u1edf kho\u1ea3ng 25% s\u1ed1 b\u1ec7nh nh\u00e2n, nh\u01b0ng th\u01b0\u1eddng ch\u1ec9 trong giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a b\u1ec7nh v\u00e0 hi\u1ebfm khi l\u00e2u qu\u00e1 2 n\u0103m. Khi n\u1eb7ng, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1eed vong do bi\u1ebfn ch\u1ee9ng h\u00f4 h\u1ea5p.<\/p>\n

2. Ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn<\/h2>\n

\u00a0<\/em><\/p>\n\n\n\n\n\n\n\n\n
\u0110 \u1ed9<\/td>\nM\u1ee9c \u0111\u1ed9 n\u1eb7ng<\/td>\n<\/tr>\n
I<\/td>\nCh\u1ec9 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1eaft<\/td>\n<\/tr>\n
II<\/td>\nY\u1ebfu c\u01a1 to\u00e0n th\u00e2n nh\u1eb9. C\u00f3 th\u1ec3 c\u00f3 \u1ea3nh h\u01b0\u1edfng m\u1eaft ho\u1eb7c h\u1ea7u h\u1ecdng.<\/td>\n<\/tr>\n
III<\/td>\nY\u1ebfu c\u01a1 to\u00e0n th\u00e2n trung b\u00ecnh. C\u00f3 th\u1ec3 c\u00f3 \u1ea3nh h\u01b0\u1edfng m\u1eaft ho\u1eb7c h\u1ea7u h\u1ecdng. C\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng c\u00e1c c\u01a1 h\u00f4 h\u1ea5p<\/td>\n<\/tr>\n
IV<\/td>\nY\u1ebfu c\u01a1 to\u00e0n th\u00e2n n\u1eb7ng. C\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u01a1ng m\u1eaft ho\u1eb7c h\u1ea7u h\u1ecdng. C\u00f3 \u1ea3nh h\u01b0\u01a1ng c\u00e1c c\u01a1 h\u01a1 h\u1ea5p<\/td>\n<\/tr>\n
V<\/td>\nPh\u1ea3i \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, c\u1ea7n ho\u1eb7c kh\u00f4ng c\u1ea7n gi\u00fap th\u1edf<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

3. \u01afu \u0111i\u1ec3m c\u1ee7a ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn<\/h2>\n

\u01afu \u0111i\u1ec3m c\u1ee7a ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn bao g\u1ed3m:<\/p>\n

– D\u1ec5 s\u1eed d\u1ee5ng: Ph\u00e2n lo\u1ea1i n\u00e0y d\u1ef1a tr\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1 c\u01a1 b\u1ea3n v\u00e0 d\u1ec5 hi\u1ec3u, gi\u00fap c\u00e1c b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh m\u1ed9t c\u00e1ch nhanh ch\u00f3ng v\u00e0 d\u1ec5 d\u00e0ng.<\/p>\n

– H\u1eefu \u00edch \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb: C\u00e1c nh\u00f3m c\u1ee7a ph\u00e2n lo\u1ea1i n\u00e0y c\u00f3 th\u1ec3 gi\u00fap b\u00e1c s\u0129 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u1edbi t\u1eebng b\u1ec7nh nh\u00e2n, nh\u1eb1m c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1 v\u00e0 t\u0103ng kh\u1ea3 n\u0103ng ho\u1ea1t \u0111\u1ed9ng h\u00e0ng ng\u00e0y.<\/p>\n

– T\u01b0\u01a1ng \u0111\u1ed1i \u0111\u1ea7y \u0111\u1ee7: Ph\u00e2n lo\u1ea1i n\u00e0y chia nh\u01b0\u1ee3c c\u01a1 th\u00e0nh n\u0103m nh\u00f3m, bao g\u1ed3m t\u1ea5t c\u1ea3 c\u00e1c m\u1ee9c \u0111\u1ed9 n\u1eb7ng t\u1eeb kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111\u1ebfn nh\u01b0\u1ee3c c\u01a1 n\u1eb7ng.<\/p>\n

4. H\u1ea1n ch\u1ebf<\/h2>\n

Ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf nh\u01b0:<\/p>\n

– Kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c: Ph\u00e2n lo\u1ea1i n\u00e0y ch\u1ec9 d\u1ef1a tr\u00ean tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1, kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c, nh\u01b0 \u0111au, b\u1ea5t th\u01b0\u1eddng c\u1ea3m gi\u00e1c v\u00e0 b\u1ea5t th\u01b0\u1eddng v\u1eadn \u0111\u1ed9ng.<\/p>\n

– Kh\u00f4ng ph\u1ea3n \u00e1nh s\u1ef1 thay \u0111\u1ed5i c\u1ee7a b\u1ec7nh trong th\u1eddi gian: Ph\u00e2n lo\u1ea1i n\u00e0y ch\u1ec9 \u0111\u01b0a ra m\u1ed9t b\u1ee9c tranh chung v\u1ec1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh t\u1ea1i m\u1ed9t th\u1eddi \u0111i\u1ec3m, kh\u00f4ng ph\u1ea3n \u00e1nh \u0111\u01b0\u1ee3c s\u1ef1 thay \u0111\u1ed5i c\u1ee7a b\u1ec7nh trong th\u1eddi gian.<\/p>\n

– Kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n c\u1ee7a nh\u01b0\u1ee3c c\u01a1: Ph\u00e2n lo\u1ea1i n\u00e0y kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n c\u1ee7a nh\u01b0\u1ee3c c\u01a1, c\u00f3 th\u1ec3 x\u1ea3y ra do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau nh\u01b0 b\u1ec7nh th\u1ea7n kinh, b\u1ec7nh c\u01a1 ho\u1eb7c b\u1ec7nh li\u00ean quan \u0111\u1ebfn c\u1ea3 hai nguy\u00ean nh\u00e2n n\u00e0y.<\/p>\n

T\u00f3m l\u1ea1i, ph\u00e2n lo\u1ea1i \u0111\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 theo Osserman c\u1ea3i ti\u1ebfn l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh th\u1ea7n kinh c\u01a1 b\u1ea3n d\u1ef1a tr\u00ean c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1. Ph\u00e2n lo\u1ea1i n\u00e0y c\u00f3 nh\u1eefng \u01b0u \u0111i\u1ec3m nh\u01b0 d\u1ec5 s\u1eed d\u1ee5ng, h\u1eefu \u00edch \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u01b0\u01a1ng \u0111\u1ed1i \u0111\u1ea7y \u0111\u1ee7. Tuy nhi\u00ean, ph\u00e2n lo\u1ea1i n\u00e0y c\u0169ng c\u00f3 nh\u1eefng h\u1ea1n ch\u1ebf nh\u01b0 kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c, kh\u00f4ng ph\u1ea3n \u00e1nh s\u1ef1 thay \u0111\u1ed5i c\u1ee7a b\u1ec7nh trong th\u1eddi gian v\u00e0 kh\u00f4ng ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c nguy\u00ean nh\u00e2n c\u1ee7a nh\u01b0\u1ee3c c\u01a1.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o: Th\u1ea7n kinh h\u1ecdc – \u0110H Y TP H\u1ed3 Ch\u00ed Minh<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

\u0110\u1ed9 n\u1eb7ng nh\u01b0\u1ee3c c\u01a1 l\u00e0 m\u1ed9t trong c\u00e1c ti\u00eau ch\u00ed \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh th\u1ea7n kinh c\u01a1 b\u1ea3n. Osserman \u0111\u00e3 \u0111\u1ec1 xu\u1ea5t m\u1ed9t ph\u00e2n lo\u1ea1i d\u1ef1a tr\u00ean \u0111\u1ed9 n\u1eb7ng c\u1ee7a tri\u1ec7u ch\u1ee9ng nh\u01b0\u1ee3c c\u01a1. 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