{"id":29443,"date":"2023-04-29T22:01:51","date_gmt":"2023-04-29T15:01:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29443"},"modified":"2023-04-29T22:32:17","modified_gmt":"2023-04-29T15:32:17","slug":"chan-doan-lam-sang-ve-chet-nao","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/29\/chan-doan-lam-sang-ve-chet-nao\/","title":{"rendered":"Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n ch\u1ebft n\u00e3o"},"content":{"rendered":"<p><strong>Ch\u1ebft n\u00e3o l\u00e0 t\u00ecnh tr\u1ea1ng m\u1ea5t ho\u00e0n to\u00e0n ch\u1ee9c n\u0103ng c\u1ee7a n\u00e3o v\u00e0 th\u00e2n n\u00e3o. Th\u00e2n n\u00e3o l\u00e0 c\u1ea5u tr\u00fac n\u1ed1i gi\u1eefa hai b\u00e1n c\u1ea7u n\u00e3o b\u1ed9 v\u00e0 t\u1ee7y s\u1ed1ng, c\u00f3 ch\u1ee9c n\u0103ng d\u1eabn truy\u1ec1n c\u00e1c t\u00edn hi\u1ec7u th\u1ea7n kinh t\u1eeb n\u00e3o ra ngo\u1ea1i vi th\u00f4ng qua t\u1ee7y s\u1ed1ng. Th\u00e2n n\u00e3o c\u00f2n l\u00e0 n\u01a1i \u0111i\u1ec1u h\u00f2a v\u00e0 ki\u1ec3m so\u00e1t c\u00e1c ho\u1ea1t \u0111\u1ed9ng s\u1ed1ng quan tr\u1ecdng c\u1ee7a c\u01a1 th\u1ec3, bao g\u1ed3m h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n v\u00e0 \u0111i\u1ec1u h\u00f2a th\u00e2n nhi\u1ec7t. M\u1ed9t b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ch\u1ebft n\u00e3o khi ho\u1ea1t \u0111\u1ed9ng ch\u1ee9c n\u0103ng c\u1ee7a n\u00e3o, tim, ph\u1ed5i \u0111\u1ec1u ng\u01b0ng ho\u00e0n to\u00e0n.\u00a0<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-29447 size-full\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/images-4-1.jpg\" alt=\"chet-nao\" width=\"300\" height=\"168\" \/><\/p>\n<h2>1. \u0110\u1ea1i c\u01b0\u01a1ng ch\u1ebft n\u00e3o<\/h2>\n<p>Tr\u01b0\u1edbc khi b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng v\u1ec1 ch\u1ebft n\u00e3o (th\u00e2n), ph\u1ea3i x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n v\u00e0 kh\u00f4ng th\u1ec3 h\u1ed3i ph\u1ee5c c\u1ee7a h\u00f4n m\u00ea v\u00e0 lo\u1ea1i tr\u1eeb t\u1ea5t c\u1ea3 c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u ti\u1ec1m \u1ea9n (v\u00ed d\u1ee5: h\u1ea1 th\u00e2n nhi\u1ec7t, nhi\u1ec5m \u0111\u1ed9c, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a n\u1eb7ng). V\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng, y\u1ebfu t\u1ed1 g\u00e2y nhi\u1ec5u c\u00f3 li\u00ean quan nh\u1ea5t l\u00e0 thu\u1ed1c an th\u1ea7n c\u00f2n t\u1ed3n d\u01b0, \u0111\u1eb7c bi\u1ec7t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c truy\u1ec1n li\u00ean t\u1ee5c thu\u1ed1c an th\u1ea7n, thu\u1ed1c m\u00ea v\u00e0\/ ho\u1eb7c opioid trong th\u1eddi gian ngay tr\u01b0\u1edbc khi \u0111\u00e1nh gi\u00e1 ch\u1ebft n\u00e3o. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i lo\u1ea1i tr\u1eeb t\u1ea5t c\u1ea3 c\u00e1c t\u00e1c d\u1ee5ng d\u01b0\u1ee3c l\u00fd \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y.<\/p>\n<h2>2. L\u00e2m s\u00e0ng<\/h2>\n<p>C\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a ch\u1ebft n\u00e3o l\u00e0 (1) <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/hon-me-la-gi-phan-loai-muc-do-hon-me-o-trieu-chung-lam-sang\/\">h\u00f4n m\u00ea<\/a>, (2) kh\u00f4ng c\u00f3 ph\u1ea3n x\u1ea1 th\u00e2n n\u00e3o v\u00e0 (3) kh\u00f4ng c\u00f3 nh\u1ecbp th\u1edf (ng\u01b0ng th\u1edf).<\/p>\n<ul>\n<li>L\u00fac \u0111\u1ea7u, b\u1ec7nh nh\u00e2n b\u1ecb k\u00edch th\u00edch b\u1eb1ng gi\u1ecdng n\u00f3i, sau \u0111\u00f3 l\u00e0 k\u00edch th\u00edch \u0111au trung t\u00e2m trong khi ng\u01b0\u1eddi kh\u00e1m theo d\u00f5i b\u1ea5t k\u1ef3 ph\u1ea3n \u1ee9ng v\u1eadn \u0111\u1ed9ng n\u00e0o (nh\u0103n m\u1eb7t c\u0169ng nh\u01b0 c\u00e1c chuy\u1ec3n \u0111\u1ed9ng ngo\u1ea1i vi). Khi g\u00e2y ra m\u1ed9t k\u00edch th\u00edch \u0111au trung t\u00e2m (v\u00ed d\u1ee5 b\u1eb1ng c\u00e1ch t\u1ea1o \u00e1p l\u1ef1c l\u00ean g\u1edd tr\u00ean h\u1ed1c m\u1eaft ho\u1eb7c kh\u1edbp th\u00e1i d\u01b0\u01a1ng h\u00e0m), kh\u00f4ng quan s\u00e1t th\u1ea5y ph\u1ea3n \u1ee9ng v\u1eadn \u0111\u1ed9ng. Tuy nhi\u00ean, khi t\u1ea1o m\u1ed9t k\u00edch th\u00edch ngo\u1ea1i vi g\u00e2y \u0111au \u0111\u1edbn (v\u00ed d\u1ee5 nh\u01b0 b\u1eb1ng c\u00e1ch ch\u00e8n \u00e9p chi d\u01b0\u1edbi ho\u1eb7c chi tr\u00ean), c\u00e1c chuy\u1ec3n \u0111\u1ed9ng do ph\u1ea3n x\u1ea1 t\u1ee7y s\u1ed1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c nh\u00ecn th\u1ea5y \u1edf 50% b\u1ec7nh nh\u00e2n, \u0111\u1eb7c bi\u1ec7t khi ch\u1ea9n \u0111o\u00e1n ch\u1ebft n\u00e3o b\u1ecb tr\u00ec ho\u00e3n.<\/li>\n<li>C\u00e1c c\u1eed \u0111\u1ed9ng ph\u1ea3n x\u1ea1 n\u00e0y l\u00e0 r\u1eadp khu\u00f4n v\u00e0 th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn c\u00e1c c\u1eed\u0111\u1ed9ng u\u1ed1n cong ng\u1eafn x\u1ea3y ra ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf chi d\u01b0\u1edbi so v\u1edbi chi tr\u00ean (v\u00ed d\u1ee5: g\u1eadp ng\u00f3ntay). \u1ede m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n th\u1eadm ch\u00ed c\u00f2n x\u1ea3y ra c\u00e1c c\u1eed \u0111\u1ed9ng t\u1ef1 ph\u00e1t c\u1ee7a t\u1ee9 chi. C\u00e1c chuy\u1ec3n \u0111\u1ed9ng n\u00e0y bao g\u1ed3m gi\u1eadt ng\u00f3n tay ho\u1eb7c ng\u00f3n ch\u00e2n, m\u1edf r\u1ed9ng c\u00e1nh tay v\u00e0 vaic\u0169ng nh\u01b0 g\u1eadp c\u00e1nh tay v\u00e0 b\u00e0n ch\u00e2n.<\/li>\n<li>D\u1ea5u hi\u1ec7u Lazarus \u0111\u1ec1 c\u1eadp \u0111\u1ebfn m\u1ed9t chuy\u1ec3n \u0111\u1ed9ngph\u1ee9c t\u1ea1p \u1edf b\u1ec7nh nh\u00e2n ch\u1ebft n\u00e3o hi\u1ebfm khi \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y trong qu\u00e1 tr\u00ecnh ki\u1ec3m tra ng\u01b0ng th\u1edf ho\u1eb7c sau khi ng\u1eaft k\u1ebft n\u1ed1i m\u00e1y th\u1edf sau khi hi\u1ebfn t\u1ea1ng. N\u00f3 b\u1eaft \u0111\u1ea7u b\u1eb1ng\u0111\u1ed9ng t\u00e1c u\u1ed1n cong ch\u1eadm c\u1ee7a m\u1ed9t ho\u1eb7c c\u1ea3 hai khu\u1ef7u tay v\u00e0 sau \u0111\u00f3 c\u00f3 th\u1ec3 n\u00e2ng cao c\u00e1nh tay.<\/li>\n<li>\u00a0Sau \u0111\u00f3, th\u00e2n n\u00e3o \u0111\u01b0\u1ee3c ki\u1ec3m tra b\u1eb1ng c\u00e1ch \u0111\u00e1nh gi\u00e1 h\u1ec7 th\u1ed1ng c\u00e1c d\u00e2y th\u1ea7n kinh s\u1ecd II, III, V, VI, VII, VIII, IX v\u00e0 X. C\u00e1c d\u00e2y th\u1ea7n kinh s\u1ecd I, IV, VI, XI v\u00e0 XII kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m tra v\u00ec \u0111i\u1ec1u n\u00e0y \u0111\u00f2i h\u1ecfi b\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o v\u00e0 h\u1ee3p t\u00e1c. M\u1ed9t test ch\u1ec9 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 l\u00e0 ch\u1ebft n\u00e3o l\u00e0 t\u00e9t ng\u01b0ng th\u1edf. Th\u1eed nghi\u1ec7m n\u00e0y \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng c\u1ee7a trung t\u00e2m h\u00f4 h\u1ea5p.<\/li>\n<li>Theo th\u1ed1ng nh\u1ea5t, ng\u01b0ng th\u1edf \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 kh\u00f4ng th\u1edf (l\u1ed3ng ng\u1ef1c m\u1edf r\u1ed9ng c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c) m\u1eb7c d\u00f9 s\u1ee9c c\u0103ng m\u1ed9t ph\u1ea7n carbon dioxide \u0111\u1ed9ng m\u1ea1ch (PaCO2) &gt; 60 mmHg (&gt; 8 kPa). M\u1ed9t s\u1ed1 bi\u1ebfn th\u1ec3 c\u1ee7a test ng\u01b0ng th\u1edf \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t. T\u1ea5t c\u1ea3 ch\u00fang bao g\u1ed3m gi\u1ea3m th\u00f4ng kh\u00ed ho\u1eb7c \u0111\u1ea1t \u0111\u01b0\u1ee3c b\u1eb1ng c\u00e1ch cho b\u1ec7nh nh\u00e2n th\u1edf m\u00e1y v\u1edbi th\u1ec3 t\u00edch ph\u00fat th\u1ea5p (v\u00ed d\u1ee5 \u1edf b\u1ec7nh nh\u00e2n b\u1ecb suy gi\u1ea3m oxy) ho\u1eb7c ng\u1eaft k\u1ebft n\u1ed1i b\u1ec7nh nh\u00e2n kh\u1ecfi m\u00e1y th\u1edf sau khi oxy h\u00f3a tr\u01b0\u1edbc. Trong giai \u0111o\u1ea1n gi\u1ea3m th\u00f4ng kh\u00ed, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd v\u1ec1 b\u1ea5t k\u1ef3 c\u1eed \u0111\u1ed9ng n\u00e0o c\u1ee7a l\u1ed3ng ng\u1ef1c ho\u1eb7c c\u00e1c n\u1ed7 l\u1ef1c h\u00f4 h\u1ea5p kh\u00e1c. N\u00ean th\u1ef1c hi\u1ec7n \u0111\u1ed3ng th\u1eddi capnometry\/ capnography \u0111\u1ec3 x\u00e1c nh\u1eadn \u0111i\u1ec1u n\u00e0y. Song song v\u1edbi vi\u1ec7c t\u0103ng PaCO2, cung l\u01b0\u1ee3ng tim t\u0103ng. \u0110i\u1ec1u n\u00e0y g\u00e2y ra xung \u0111\u1ed9ng \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh \u1edf c\u1ed5 \u0111\u01b0\u1ee3c quan s\u00e1t th\u1ea5y \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb t\u0103ng \u0111\u1ed9ng tu\u1ea7n ho\u00e0n. Nh\u1eefng xung \u0111\u1ed9ng n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c hi\u1ec3u sai l\u00e0 nh\u1eefng n\u1ed5 l\u1ef1c h\u00edt v\u00e0o n\u00f4ng. Trong qu\u00e1 tr\u00ecnh test ng\u01b0ng th\u1edf, c\u00e1c ph\u00e2n t\u00edch kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch l\u1eb7p l\u1ea1i \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 x\u00e1c minh PaCO2&gt; 60 mmHg (&gt; 8 kPa).<\/li>\n<li>Do t\u1ed1c \u0111\u1ed9 trao \u0111\u1ed5i ch\u1ea5t \u1edf b\u1ec7nh nh\u00e2n ch\u1ebft n\u00e3o l\u00e0 t\u1ed1i thi\u1ec3u, n\u00eanth\u01b0\u1eddng m\u1ea5t m\u1ed9t th\u1eddi gian d\u01b0\u1eddng nh\u01b0 k\u00e9o d\u00e0i (5\u201310 ph\u00fat ho\u1eb7c h\u01a1n) cho \u0111\u1ebfn khi PaCO2 t\u0103ng l\u00ean tr\u00ean 60 mmHg. N\u1ebfu m\u1ed9t b\u1ec7nh nh\u00e2n b\u1ecb suy gi\u1ea3m oxy kh\u00f4ng \u0111\u01b0\u1ee3c ng\u1eaft k\u1ebft n\u1ed1i v\u1edbi m\u00e1y th\u1edf nh\u01b0ng th\u1ec3 t\u00edch ph\u00fat \u0111\u00e3 gi\u1ea3m, \u0111i\u1ec1u c\u1ea7n thi\u1ebft l\u00e0 ng\u1eaft k\u1ebft n\u1ed1i b\u1ec7nh nh\u00e2n kh\u1ecfi m\u00e1y th\u1edf v\u00e0 quan s\u00e1t l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n v\u1ec1 b\u1ea5t k\u1ef3 n\u1ed7 l\u1ef1c h\u00f4 h\u1ea5p n\u00e0o sau khi \u0111\u00e3 \u0111\u1ea1t \u0111\u01b0\u1ee3c m\u1ee9c PaCO2 m\u1ee5c ti\u00eau. \u0110\u1ec3 b\u1ec7nh nh\u00e2n n\u1eb1m tr\u00ean m\u00e1y th\u1edf v\u00e0 quan s\u00e1t c\u00e1c nh\u1ecbp th\u1edf t\u1ef1 ph\u00e1t c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 d\u01b0\u01a1ng t\u00ednh gi\u1ea3 v\u00ec tu\u1ea7n ho\u00e0n c\u01b0\u1eddng \u0111\u1ed9ng ho\u1eb7c lu\u1ed3ng kh\u00f4ng kh\u00ed b\u00ean trong c\u00f3 th\u1ec3 t\u1ef1 ph\u00e1t g\u00e2y ra nh\u1ecbp th\u1edf h\u1ed7 tr\u1ee3 trong m\u1ed9t s\u1ed1 m\u00e1y th\u1edf. \u1ede nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 v\u1ec1 t\u00ecnh tr\u1ea1ng ch\u1ebft n\u00e3o trong khi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ECMO, m\u1ed9t th\u1eed nghi\u1ec7m ng\u01b0ng th\u1edf \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ec1 xu\u1ea5t. \u0110i\u1ec1u n\u00e0y bao g\u1ed3m ng\u1eaft k\u1ebft n\u1ed1i b\u1ec7nh nh\u00e2n kh\u1ecfi m\u00e1y th\u1edf trong khi gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng kh\u00ed c\u1ee7a m\u00e1y th\u1edf oxy (duy tr\u00ec FO2 \u1edf m\u1ee9c 1,0) xu\u1ed1ng 1 L \/ ph\u00fat cho \u0111\u1ebfn khi PaCO2 t\u0103ng l\u00ean&gt; 60 mmHg (&gt; 8 kPa).<\/li>\n<\/ul>\n<h2><strong>3. <\/strong>K\u1ebft<strong> lu\u1eadn<\/strong><\/h2>\n<p><strong>Ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n ch\u1ebft n\u00e3o bao g\u1ed3m c\u00e1c tri\u1ec7u ch\u1ee9ng sau:<\/strong><\/p>\n<ul>\n<li>\u0110i\u1ec3m Glasgow\u00a0: 3 l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ee7a vi\u1ec7c r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng\u00a0h\u00f4n m\u00ea\u00a0s\u00e2u<\/li>\n<li>Ph\u1ea3n x\u1ea1 \u00e1nh s\u00e1ng m\u1ea5t<\/li>\n<li>\u0110\u01b0\u1eddng k\u00ednh \u0111\u1ed3ng t\u1eed gi\u00e3n c\u1ed1 \u0111\u1ecbnh kho\u1ea3ng 4mm c\u1ea3 hai m\u1eaft<\/li>\n<li>Ph\u1ea3n x\u1ea1 gi\u00e1c m\u1ea1c b\u1ea3o v\u1ec7 m\u1eaft bi\u1ebfn m\u1ea5t<\/li>\n<li>Ph\u1ea3n x\u1ea1 ho khi c\u00f3 k\u00edch th\u00edch nh\u01b0 h\u00fat \u0111\u1eddm d\u00e3i kh\u00f4ng c\u00f2n<\/li>\n<li>Ph\u1ea3n x\u1ea1 \u0111\u1ea7u m\u1eaft m\u1ea5t<\/li>\n<li>Ph\u1ea3n x\u1ea1 m\u1eaft ti\u1ec1n \u0111\u00ecnh kh\u00f4ng c\u00f2n<\/li>\n<li>Khi th\u00e1o b\u1ecf m\u00e1y th\u1edf, ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng t\u1ef1 th\u1edf.<\/li>\n<li>Sau khi nghi ng\u1edd m\u1ed9t t\u00ecnh tr\u1ea1ng ch\u1ebft n\u00e3o, b\u00e1c s\u0129 s\u1ebd th\u1ef1c hi\u1ec7n th\u00eam c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng kh\u00e1c \u0111\u1ec3 c\u1ee7ng c\u1ed1 cho ch\u1ea9n \u0111o\u00e1n bao g\u1ed3m:<\/li>\n<li>Th\u1eed nghi\u1ec7m g\u00e2y ho: trong khi ti\u1ebfn h\u00e0nh h\u00fat \u0111\u1eddm d\u00e3i qua\u00a0\u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n, ti\u1ebfn h\u00e0nh k\u00edch th\u00edch ngay t\u1ea1i v\u1ecb tr\u00ed chia nh\u00e1nh c\u1ee7a ph\u1ebf qu\u1ea3n g\u1ed1c nh\u01b0ng ph\u1ea3n x\u1ea1 ho kh\u00f4ng xu\u1ea5t hi\u1ec7n.<\/li>\n<li>Ki\u1ec3m tra ph\u1ea3n x\u1ea1 m\u1eaft \u0111\u1ea7u: ti\u1ebfn h\u00e0nh nghi\u00eang \u0111\u1ea7u ng\u01b0\u1eddi b\u1ec7nh v\u1ec1 m\u1ed9t ph\u00eda nh\u01b0ng nh\u00e3n c\u1ea7u kh\u00f4ng chuy\u1ec3n \u0111\u1ed9ng v\u1ec1 ph\u00eda ng\u01b0\u1ee3c l\u1ea1i.<\/li>\n<li>Ki\u1ec3m tra ph\u1ea3n x\u1ea1 m\u1eaft ti\u1ec1n \u0111\u00ecnh: th\u1ef1c hi\u1ec7n b\u01a1m n\u01b0\u1edbc l\u1ea1nh v\u00e0o hai tai nh\u01b0ng m\u1eaft kh\u00f4ng c\u00f3 \u0111\u00e1p \u1ee9ng b\u1eb1ng c\u00e1ch li\u1ebfc m\u1eaft v\u1ec1 ph\u00eda tai c\u00f3 b\u01a1m n\u01b0\u1edbc. Ph\u1ea3n x\u1ea1 m\u1eaft ti\u1ec1n \u0111\u00ecnh \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n khi ki\u1ec3m tra ph\u1ea3n x\u1ea1 m\u1eaft \u0111\u1ea7u cho k\u1ebft qu\u1ea3 kh\u00f4ng r\u00f5 r\u00e0ng.<\/li>\n<li>Th\u1eed nghi\u1ec7m ng\u1eebng th\u1edf: cho ng\u01b0\u1eddi b\u1ec7nh th\u1edf m\u00e1y trong kho\u1ea3ng 10 ph\u00fat v\u1edbi h\u00e0m l\u01b0\u1ee3ng oxy 100%, sau \u0111\u00f3 th\u00e1o m\u00e1y th\u1edf v\u00e0 cho b\u1ec7nh nh\u00e2n th\u1edf qua\u00a0\u1ed1ng n\u1ed9i kh\u00ed qu\u1ea3n\u00a0trong v\u00f2ng 10 ph\u00fat. Nghi\u1ec7m ph\u00e1p ng\u1eebng th\u1edf d\u01b0\u01a1ng t\u00ednh khi b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 t\u1ef1 h\u00f4 h\u1ea5p tr\u1edf l\u1ea1i.<\/li>\n<\/ul>\n<p><strong>Ngu\u1ed3n:<\/strong><\/p>\n<ol>\n<li><span class=\"fontstyle0\">THS. BS H\u1ed2 HO\u00c0NG KIM &#8211; ICU &#8211; BV NGUY\u1ec4N TRI PH\u01af\u01a0NG (bi\u00ean d\u1ecbch)\u00a0<\/span><\/li>\n<li><span class=\"fontstyle0\"> Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, Truman B, Speroff T, Gautam S, Margolin R, Hart RP, Dittus R (2001) Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU).<\/span><strong><br \/>\n<\/strong><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Ch\u1ebft n\u00e3o l\u00e0 t\u00ecnh tr\u1ea1ng m\u1ea5t ho\u00e0n to\u00e0n ch\u1ee9c n\u0103ng c\u1ee7a n\u00e3o v\u00e0 th\u00e2n n\u00e3o. Th\u00e2n n\u00e3o l\u00e0 c\u1ea5u tr\u00fac n\u1ed1i gi\u1eefa hai b\u00e1n c\u1ea7u n\u00e3o b\u1ed9 v\u00e0 t\u1ee7y s\u1ed1ng, c\u00f3 ch\u1ee9c n\u0103ng d\u1eabn truy\u1ec1n c\u00e1c t\u00edn hi\u1ec7u th\u1ea7n kinh t\u1eeb n\u00e3o ra ngo\u1ea1i vi th\u00f4ng qua t\u1ee7y s\u1ed1ng. Th\u00e2n n\u00e3o c\u00f2n l\u00e0 n\u01a1i \u0111i\u1ec1u [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n ch\u1ebft n\u00e3o - Vinmec<\/title>\n<meta name=\"description\" content=\"Ch\u1ebft n\u00e3o l\u00e0 t\u00ecnh tr\u1ea1ng m\u1ea5t ho\u00e0n to\u00e0n ch\u1ee9c n\u0103ng c\u1ee7a n\u00e3o v\u00e0 th\u00e2n n\u00e3o. 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