{"id":29793,"date":"2023-05-03T21:51:33","date_gmt":"2023-05-03T14:51:33","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29793"},"modified":"2023-05-17T00:50:42","modified_gmt":"2023-05-16T17:50:42","slug":"phac-do-chan-doan-va-cham-soc-benh-nhan-sang-ruou","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/phac-do-chan-doan-va-cham-soc-benh-nhan-sang-ruou\/","title":{"rendered":"Ph\u00e1c \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n s\u1ea3ng r\u01b0\u1ee3u"},"content":{"rendered":"<p><b>Qu\u00e1 tr\u00ecnh cai r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u1ee7 \u00fd ch\u00ed v\u00e0 ngh\u1ecb l\u1ef1c. Ngo\u00e0i ra ng\u01b0\u1eddi nghi\u1ec7n r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i t\u00ecnh tr\u1ea1ng\u00a0 s\u1ea3ng r\u01b0\u1ee3u c\u1ea5p hay c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u01a1n \u0111\u1ed9ng kinh do cai r\u01b0\u1ee3u v\u1edbi nguy c\u01a1 t\u1eed vong cao v\u00e0 nh\u1eefng r\u1ed1i lo\u1ea1n th\u1ea7n kinh \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn b\u1ea3n th\u00e2n v\u00e0 nh\u1eefng ng\u01b0\u1eddi xung quanh.<\/b><\/p>\n<h2><strong>1. \u0110\u1ea1i c\u01b0\u01a1ng <\/strong><\/h2>\n<p><strong style=\"font-size: 16px;\">S\u1ea3ng<\/strong><span style=\"font-weight: 400; font-size: 16px;\"> (Delirium) l\u00e0 h\u1ed9i ch\u1ee9ng t\u00e2m th\u1ea7n kinh c\u1ea5p. G\u1ee3i nh\u1edb ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n s\u1ea3ng:\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0D= Disorientation: r\u1ed1i lo\u1ea1n \u0111\u1ecbnh h\u01b0\u1edbng .<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0E= Evidence: B\u1eb1ng ch\u1ee9ng c\u1ee7a thay \u0111\u1ed5i c\u1ea5p trong tr\u1ea1ng th\u00e1i t\u00e2m th\u1ea7n.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0L= level: M\u1ee9c \u0111\u1ed9 c\u1ee7a \u00fd th\u1ee9c b\u1ecb thay \u0111\u1ed5i .<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0I= Inattention: Thi\u1ebfu t\u1eadp trung.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0R= Rhythm: Thay \u0111\u1ed5i nh\u1ecbp chu k\u1ef3 th\u1ee9c ng\u1ee7 .<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0I= Illusion and\/or hallucination: \u1ea2o t\u01b0\u1edfng v\u00e0 ho\u1eb7c \u1ea3o gi\u00e1c.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">U= Unstable level of psychomotor activity: kh\u00f4ng \u1ed5n \u0111\u1ecbnh c\u1ee7a ho\u1ea1t \u0111\u1ed9ng t\u00e2m th\u1ea7n v\u1eadn \u0111\u1ed9ng.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">M= Mood fluctuation: t\u00e2m tr\u1ea1ng b\u1ea5t th\u01b0\u1eddng.<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> S\u1ea3ng r\u01b0\u1ee3u (delirium tremens): <strong>xu\u1ea5t hi\u1ec7n trong 7 ng\u00e0y<\/strong> sau khi cai ho\u1eb7c gi\u1ea3m u\u1ed1ng r\u01b0\u1ee3u nh\u01b0ng th\u01b0\u1eddng trong 24 \u2013 72 gi\u1edd x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi c\u00f3 ti\u1ec1n s\u1eed nghi\u1ec7n r\u01b0\u1ee3u. S\u1ea3ng r\u01b0\u1ee3u l\u00e0 c\u1ea5p c\u1ee9u y khoa n\u00ean \u0111i\u1ec1u tr\u1ecb trong khoa ICU. Khuynh h\u01b0\u1edbng c\u1ee7a b\u00e1c s\u0129 l\u00e2m s\u00e0ng khoa c\u1ea5p c\u1ee9u cho b\u1ec7nh nh\u00e2n nh\u1eadp v\u00e0o \u0111\u01a1n v\u1ecb b\u1ec7nh t\u00e2m th\u1ea7n tr\u01b0\u1edbc khi \u0111\u1ea9y l\u00f9i s\u1ea3ng r\u01b0\u1ee3u (l\u00e0 l\u1ed7i \u0111\u01b0\u1ee3c cho ph\u00e9p c\u1ee7a ph\u00e1n quy\u1ebft l\u00e2m s\u00e0ng th\u1eadm ch\u00ed thi\u1ebfu n\u1ed3ng \u0111\u1ed9 alcohol m\u00e1u. H\u1ed9i ch\u1ee9ng cai th\u01b0\u1eddng t\u00e1c d\u1ee5ng ng\u01b0\u1ee3c v\u1edbi t\u00e1c d\u1ee5ng c\u1ee7a ch\u1ea5t \u0111\u01b0\u1ee3c d\u00f9ng v\u00e0 m\u1ea1nh h\u01a1n v\u00e0 th\u1eddi gian ng\u1eafn h\u01a1n.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> S\u1ea3ng r\u01b0\u1ee3u c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n v\u1edbi nhi\u1ec1u <strong>tri\u1ec7u ch\u1ee9ng t\u00e2m th\u1ea7n<\/strong> v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c nh\u1eadn d\u1ea1ng v\u00e0 \u0111\u1ea9y l\u00f9i nhanh.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">S\u1ea3ng r\u01b0\u1ee3u c\u00f3 th\u1ec3 t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd m\u1ed9t c\u00e1ch th\u00edch \u0111\u00e1ng. Tr\u01b0\u1edbc \u0111\u00e2y t\u1ec9 l\u1ec7 t\u1eed vong 35%, nh\u01b0ng ng\u00e0y nay nh\u1edd ch\u0103m s\u00f3c t\u00edch c\u1ef1c v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u01b0\u1ee3c ti\u00ean ti\u1ebfn n\u00ean t\u1ec9 l\u1ec7 t\u1eed vong c\u00f2n 5- 15%.<\/span><\/p>\n<figure id=\"attachment_29808\" aria-describedby=\"caption-attachment-29808\" style=\"width: 480px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" loading=\"lazy\" class=\"size-full wp-image-29808\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/san-ruou.jpg\" alt=\"benh-nhan-trong-con-sang-ruou\" width=\"480\" height=\"360\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/san-ruou.jpg 480w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/04\/san-ruou-300x225.jpg 300w\" sizes=\"(max-width: 480px) 100vw, 480px\" \/><figcaption id=\"caption-attachment-29808\" class=\"wp-caption-text\">\u1ea2nh m\u00f4 t\u1ea3 b\u1ec7nh nh\u00e2n s\u1ea3ng r\u01b0\u1ee3u<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<h2><span style=\"font-weight: 400;\"><strong>2. Nguy\u00ean nh\u00e2n<\/strong>\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\"><strong>Delirium tremens (s\u1ea3n r\u01b0\u1ee3u)<\/strong>: X\u1ea3y ra trong th\u1eddi gian cai r\u01b0\u1ee3u sau th\u1eddi gian d\u00f9ng r\u01b0\u1ee3u nhi\u1ec1u ho\u1eb7c k\u00e9o d\u00e0i; n\u00f3 c\u0169ng x\u1ea3y ra \u0111\u1ed1i v\u1edbi cai benzodiazepine v\u00e0 barbiturat.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Deficiency states (thi\u1ebfu ch\u1ea5t): Folate, vitamin PP, B1, B12.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ch\u1eef vi\u1ebft t\u1eaft g\u1ee3i nh\u1edb nguy\u00ean nh\u00e2n c\u1ee7a s\u1ea3ng (Delirium):<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><strong> D<\/strong>= Drugs (r\u01b0\u1ee3u, kh\u00e1ng sinh, anticholinergics, thu\u1ed1c ch\u1ed1ng co gi\u1eadt, thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m, thu\u1ed1c ch\u1ed1ng cao huy\u1ebft \u00e1p, thu\u1ed1c ch\u1ed1ng Parkinson, thu\u1ed1c ch\u1ed1ng lo\u1ea1n th\u1ea7n, glycosides tim, cimetidin, clonidine, corticoid, thu\u1ed1c ch\u1ed1ng oxy h\u00f3a, insulin, lithium, NSAIDs, thu\u1ed1c phi\u1ec7n, an th\u1ea7n, thu\u1ed1c ng\u1ee7, salicylates.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> E<\/strong>= Endocrine (n\u1ed9i ti\u1ebft): C\u01b0\u1eddng ho\u1eb7c suy ch\u1ee9c n\u0103ng th\u01b0\u1ee3ng th\u1eadn, t\u1ee5y, tuy\u1ebfn y\u00ean, tuy\u1ebfn gi\u00e1p v\u00e0 c\u1eadn gi\u00e1p.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> L<\/strong>= Liver (gan): B\u1ec7nh gan, vi\u00eam gan, x\u01a1 gan, b\u1ec7nh n\u00e3o gan, ung th\u01b0 gan.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> I<\/strong>= Infection (nhi\u1ec5m tr\u00f9ng): Nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng, vi\u00eam n\u00e3o, vi\u00eam m\u00e0ng n\u00e3o, \u00e1p xe n\u00e3o, nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ni\u1ec7u, nhi\u1ec5m tr\u00f9ng h\u1ec7 th\u1ed1ng .<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> R<\/strong>= Respiratory (H\u00f4 h\u1ea5p): Gi\u1ea3m O2 huy\u1ebft, t\u0103ng CO2.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> I<\/strong>= Intoxication (nhi\u1ec5m \u0111\u1ed9c): Alcohol, c\u00e1c thu\u1ed1c b\u1ecb c\u1ea5m (cannabis, LSD, nh\u1eefng thu\u1ed1c \u1ea3o gi\u00e1c kh\u00e1c, amphetamines, cocaine, thu\u1ed1c phi\u1ec7n bao g\u1ed3m heroin v\u00e0 morphine, PCP, c\u00e1c thu\u1ed1c x\u00f4ng Toxic encephalopathy (b\u1ec7nh n\u00e3o do \u0111\u1ed9c t\u1ed1): CO, kim lo\u1ea1i n\u1eb7ng (ch\u00ec, th\u1ee7y ng\u00e2n, arsenic), ch\u1ea5t \u0111\u1ed9c c\u00f4ng nghi\u1ec7p, thu\u1ed1c tr\u1eeb s\u00e2u, n\u1ea5m, c\u00e2y c\u00e0 \u0111\u1ed9c d\u01b0\u1ee3c, c\u00e2y b\u00ecm b\u00ecm, n\u1ecdc \u0111\u1ed9c c\u1ee7a \u0111\u1ed9ng v\u1eadt.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Uremic encephalopathy (b\u1ec7nh n\u00e3o do t\u0103ng ur\u00ea)<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> U<\/strong>= Unmet needs (nhu c\u1ea7u kh\u00f4ng \u0111\u1ea1t): M\u1ea5t c\u00e2n b\u1eb1ng n\u01b0\u1edbc v\u00e0 \u0111i\u1ec7n gi\u1ea3i, m\u1ea5t n\u01b0\u1edbc n\u1eb7ng, m\u1ea5t ng\u1ee7, b\u00ed ti\u1ec3u.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"><strong> M<\/strong>= Miscellaneous (Linh tinh): Ti\u1ec3u \u0111\u01b0\u1eddng, ch\u1ea5n th\u01b0\u01a1ng, \u0111\u1ed9ng kinh, t\u0103ng th\u00e2n nhi\u1ec7t, u, r\u1ed1i lo\u1ea1n m\u1ea1ch m\u00e1u, bi\u1ebfn ch\u1ee9ng li\u00ean quan ph\u1eabu thu\u1eadt.<\/span><\/li>\n<\/ul>\n<h2><strong>3. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n<h3><strong>3.1. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h3>\n<p><strong><em>a) H\u1ecfi b\u1ec7nh s\u1eed:<\/em><\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> Ti\u1ec1n s\u1eed gia \u0111\u00ecnh: G\u1ed3m cha m\u1eb9 v\u00e0 anh ch\u1ecb em v\u1edbi t\u00ecnh tr\u1ea1ng h\u1ecdc v\u1ea5n, ngh\u1ec1 nghi\u1ec7p, \u0111i\u1ec1u ki\u1ec7n kinh t\u1ebf, t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe \u0111\u1eb7c bi\u1ec7t c\u00e1c b\u1ec7nh t\u00e2m th\u1ea7n, \u0111\u1ed9ng kinh, nghi\u1ec7n r\u01b0\u1ee3u ma tu\u00fd, t\u1ef1 s\u00e1t, \u2026<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Ti\u1ec1n s\u1eed b\u1ea3n th\u00e2n: N\u00ean h\u1ecfi nh\u1eefng c\u00e2u h\u1ecfi m\u1edf h\u01a1n l\u00e0 nh\u1eefng c\u00e2u h\u1ecfi \u0111\u00f3ng v\u00e0 th\u01b0\u1eddng c\u00f3 nh\u1eefng y\u1ebfu t\u1ed1 r\u1ee7i ro nh\u01b0 b\u1ec7nh t\u00e2m th\u1ea7n kh\u00e1c, th\u1ea5t nghi\u1ec7p, ly d\u1ecb ho\u1eb7c \u0111\u1ed9c th\u00e2n, gi\u1edbi t\u00ednh , t\u00ecnh tr\u1ea1ng nh\u00e0 c\u1eeda ho\u1eb7c n\u01a1i \u1edf kh\u00f4ng \u1ed5n \u0111\u1ecbnh\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> H\u1ecfi L\u00fd do nh\u1eadp vi\u1ec7n<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> H\u1ecfi h\u1ed3 s\u01a1 y khoa t\u1ed5ng qu\u00e1t, thu\u1ed1c ho\u1eb7c b\u1ea5t k\u1ef3 \u0111i\u1ec1u ch\u1ec9nh n\u00e0o \u0111\u1ec3 thay \u0111\u1ed5i h\u00e0nh vi\u00a0<\/span><\/li>\n<\/ul>\n<p><strong><em>b) Kh\u00e1m l\u00e2m s\u00e0ng:<\/em>\u00a0<\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> D\u1ea5u hi\u1ec7u sinh t\u1ed3n: M\u1ea1ch, huy\u1ebft \u00e1p,nhi\u1ec7t \u0111\u1ed9, nh\u1ecbp th\u1edf, h\u1ed3 s\u01a1 g\u00e2y m\u00ea n\u1ebfu h\u1eadu ph\u1eabu, pulse oximetry \u0111\u1ec3 ph\u00e1t hi\u1ec7n gi\u1ea3m oxy m\u00e1u<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Kh\u00e1m th\u1ef1c th\u1ec3 v\u00e0 th\u1ea7n kinh: C\u00f3 th\u1ec3 c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a nghi\u1ec7n r\u01b0\u1ee3u sau \u0111\u00e2y nh\u01b0 g\u00e0u b\u00e1m m\u1eb7t v\u00e0 t\u00f3c, d\u1ea5u ch\u1ea5n th\u01b0\u01a1ng nh\u01b0 v\u1ebft b\u1ea7m, s\u01b0ng \u1edf \u0111\u1ea7u, khu\u1ef7u tay, \u0111\u1ea7u g\u1ed1i,.. do t\u00e9, g\u00f2 m\u00e1 \u1eedng \u0111\u1ecf, sao m\u1ea1ch l\u00f2ng b\u00e0n tay, v\u00e0ng da, c\u1ed5 tr\u01b0\u1edbng, thi\u1ebfu m\u00e1u, t\u00ecm b\u1eb1ng ch\u1ee9ng c\u1ee7a suy dinh d\u01b0\u1ee1ng (nh\u1eb9 c\u00e2n), d\u1ea5u m\u1ea5t n\u01b0\u1edbc, d\u1ea5u kim ti\u00eam \u1edf tay kh\u00f4ng v\u00e0 n\u1ebfu c\u00f3 th\u00ec m\u1edbi hay c\u1ee7, v\u00e0 t\u00ecm nh\u1eefng d\u1ea5u ch\u1ee9ng c\u1ee7a b\u1ec7nh n\u1ed9i khoa, n\u1ed9i ti\u1ebft, chuy\u1ec3n ho\u00e1, lao ho\u1eb7c nhi\u1ec5m tr\u00f9ng nhi\u1ec5m \u0111\u1ed9c, ..\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Kh\u00e1m t\u00e2m th\u1ea7n: Ch\u00fa \u00fd h\u00ecnh d\u1ea1ng b\u00ean ngo\u00e0i, \u00fd th\u1ee9c, \u0111\u1ecbnh h\u01b0\u1edbng, kh\u00ed s\u1eafc v\u00e0 c\u1ea3m x\u00fac, m\u1ee9c \u0111\u1ed9 t\u1eadp trung v\u00e0 ch\u00fa \u00fd, tr\u00ed nh\u1edb, t\u01b0 duy, tri gi\u00e1c, h\u00e0nh vi, ph\u00e1n \u0111o\u00e1n v\u00e0 nh\u1eadn th\u1ee9c v\u1ec1 b\u1ec7nh (n\u00ean th\u1ef1c hi\u1ec7n trong th\u1eddi gian h\u1ecfi b\u1ec7nh qua vi\u1ec7c ki\u1ec3m tra c\u00e1c v\u00f2ng \u201cy khoa\u201d \u1edf c\u1ed5, c\u1ed5 tay, c\u1ed5 ch\u00e2n, n\u1ebfu b\u1ec7nh nh\u00e2n c\u1ea3m gi\u00e1c v\u00e0 \u0111\u1ecbnh h\u01b0\u1edbng nh\u01b0ng cho th\u1ea5y c\u00e1c d\u1ea5u hi\u1ec7u r\u00f5 r\u00e0ng c\u1ee7a cai r\u01b0\u1ee3u 3 nh\u01b0 run v\u00e0 t\u0103ng nh\u1ecbp tim n\u00ean cho benzodiazepine IV,IM,PO (u\u1ed1ng) r\u1ed3i m\u1edbi h\u1ecfi b\u1ec7nh ti\u1ebfp).\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\"><strong>Tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c tr\u01b0ng l\u00e2m s\u00e0ng c\u1ee7a s\u1ea3ng r\u01b0\u1ee3u g\u1ed3m:\u00a0<\/strong>\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cac-loai-ao-tuong-ao-giac-thuong-gap\/\">\u1ea2o gi\u00e1c<\/a>: Ch\u1ee7 y\u1ebfu l\u00e0 \u1ea3o th\u1ecb v\u00e0 \u1ea3o thanh\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0T\u00ecnh tr\u1ea1ng c\u1ea5p c\u1ee7a l\u00fa l\u1eabn v\u00e0 r\u1ed1i lo\u1ea1n \u0111\u1ecbnh h\u01b0\u1edbng\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0T\u0103ng ho\u1ea1t \u0111\u1ed9ng th\u1ea7n kinh th\u1ef1c v\u1eadt: Nh\u1ecbp tim nhanh, s\u1ed1t, \u0111\u1ed5 m\u1ed3 h\u00f4i, v\u00e0 cao huy\u1ebft \u00e1p\u00a0\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\">K\u00edch \u0111\u1ed9ng v\u00e0 hoang t\u01b0\u1edfng l\u00e0m ng\u0103n th\u1ef1c hi\u1ec7n kh\u00e1m th\u1ef1c th\u1ec3 v\u00e0 \u0111\u00e1nh gi\u00e1 n\u1ed9i khoa to\u00e0n di\u1ec7n<\/span><\/li>\n<\/ul>\n<p><strong><em>c) X\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng:<\/em><\/strong><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> X\u00e9t nghi\u1ec7m th\u01b0\u1eddng quy:\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">&#8211; C\u00f4ng th\u1ee9c m\u00e1u: <\/span><span style=\"font-weight: 400;\">\u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m tr\u00f9ng v\u00e0 thi\u1ebfu m\u00e1u (s\u1ea3ng r\u01b0\u1ee3u c\u00f3 thi\u1ebfu m\u00e1u nguy\u00ean h\u1ed3ng c\u1ea7u kh\u1ed5ng l\u1ed3, ti\u1ec3u c\u1ea7u gi\u1ea3m, MCV t\u0103ng)<\/span><\/p>\n<p><span style=\"font-weight: 400;\"> Sinh ho\u00e1 m\u00e1u (\u0111i\u1ec7n gi\u1ea3i, glucose, Natrium,Kalium, calcium, Acid folic, B12, albumin, urea nitrogen, creatinine, AST, ALT, GGT, Bilirubin, alkaline phosphatase, magnesium, v\u00e0 phosphate), \u0111\u1ec3 ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng \u0111i\u1ec7n gi\u1ea3i, \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng gan th\u1eadn, v\u00e0 ch\u1ea9n \u0111o\u00e1n h\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft, nhi\u1ec5m ceton acid do ti\u1ec3u \u0111\u01b0\u1eddng, t\u0103ng \u00e1p l\u1ef1c th\u1ea9m th\u1ea5u kh\u00f4ng nhi\u1ec5m ceton<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u00a0X\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p \u0111\u1ec3 lo\u1ea1i tr\u1eeb b\u1ec7nh l\u00fd tuy\u1ebfn gi\u00e1p\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">ECG \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n thi\u1ebfu m\u00e1u v\u00e0 lo\u1ea1n nh\u1ecbp\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">X-quang ph\u1ed5i \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n vi\u00eam ph\u1ed5i<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> X\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u:<\/span><span style=\"font-weight: 400;\"> \u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh theo \u0111i\u1ec1u ki\u1ec7n l\u00e2m s\u00e0ng c\u1ee5 th\u1ec3<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">C\u1ea5y n\u01b0\u1edbc ti\u1ec3u, kim lo\u1ea1i n\u1eb7ng trong n\u01b0\u1edbc ti\u1ec3u, porphyrins n\u01b0\u1edbc ti\u1ec3u, T\u00ecm thu\u1ed1c trong n\u01b0\u1edbc ti\u1ec3u v\u00e0 m\u00e1u, c\u1ea5y m\u00e1u, kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n (ANA test), n\u1ed3ng \u0111\u1ed9 NH3 m\u00e1u, n\u1ed3ng \u0111\u1ed9 thu\u1ed1c v\u00e0 r\u01b0\u1ee3u trong m\u00e1u HIV, VDRL, EEG, CT, MRI, x\u00e9t nghi\u1ec7m d\u1ecbch n\u00e3o tu\u1ef7.<\/span><\/p>\n<h3><span style=\"font-weight: 400;\"><strong>\u00a03.2. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh s\u1ea3ng r\u01b0\u1ee3u d\u1ef1a v\u00e0o<\/strong><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Ti\u1ec1n s\u1eed (r\u1ea5t quan tr\u1ecdng): Th\u01b0\u1eddng b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed c\u1ee7a nghi\u1ec7n r\u01b0\u1ee3u, trong v\u00f2ng 7 ng\u00e0y sau khi cai ho\u1eb7c gi\u1ea3m u\u1ed1ng r\u01b0\u1ee3u ho\u1eb7c b\u1ec7nh nh\u00e2n \u0111ang n\u1eb1m vi\u1ec7n v\u00ec b\u1ec7nh n\u1ed9i khoa ho\u1eb7c ph\u1eabu thu\u1eadt (th\u01b0\u1eddng trong 24 \u2013 72 gi\u1edd) b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a d\u1ea5u hi\u1ec7u s\u1ea3ng r\u01b0\u1ee3u nh\u01b0 \u1ea3o gi\u00e1c ch\u1ee7 y\u1ebfu l\u00e0 \u1ea3o th\u1ecb v\u00e0 \u1ea3o thanh, l\u00fa l\u1eabn v\u00e0 r\u1ed1i lo\u1ea1n \u0111\u1ecbnh h\u01b0\u1edbng, t\u0103ng ho\u1ea1t \u0111\u1ed9ng th\u1ea7n kinh th\u1ef1c v\u1eadt nh\u01b0 nh\u1ecbp tim nhanh, s\u1ed1t, \u0111\u1ed5 m\u1ed3 h\u00f4i, v\u00e0 cao huy\u1ebft \u00e1p, v\u00e0 k\u00edch \u0111\u1ed9ng, hoang t\u01b0\u1edfng, l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 c\u00f3 ascite, v\u00e0ng da, sao mach, c\u1eadn l\u00e2m s\u00e0ng c\u00f3 thi\u1ebfu m\u00e1u nguy\u00ean h\u1ed3ng c\u1ea7u kh\u1ed5ng l\u1ed3, ti\u1ec3u c\u1ea7u gi\u1ea3m, MCV t\u0103ng, PT &amp; PTT d\u00e0i, thi\u1ebfu B12, acid folic, v\u00e0 vi ch\u1ea5t dinh d\u01b0\u1ee1ng kh\u00e1c, AST-ALT &amp; GGT t\u1ea5t c\u1ea3 \u0111\u1ec1u t\u0103ng, v\u00e0 c\u00f3 th\u1ec3 c\u00f3 ascite, c\u00f3 th\u1ec3 c\u00f3 n\u1ed3ng \u0111\u1ed9 alcohol m\u00e1u cao.\u00a0<\/span><\/p>\n<h3><strong>3.3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\"><em>B\u1ec7nh n\u1ed9i khoa:<\/em>\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Ph\u00e2n bi\u1ec7t d\u1ef1a v\u00e0o: B\u1ed9c ph\u00e1t \u0111\u1ed9t ng\u1ed9t, ti\u1ec1n s\u1eed b\u1ec7nh n\u1ed9i khoa c\u01a1 b\u1ea3n \u0111\u01b0\u1ee3c bi\u1ebft tr\u01b0\u1edbc, kh\u00f4ng c\u00f3 ti\u1ec1n s\u1eed c\u00e1 nh\u00e2n v\u00e0 ho\u1eb7c gia \u0111\u00ecnh c\u1ee7a t\u00ecnh tr\u1ea1ng b\u1ec7nh t\u00e2m th\u1ea7n, bi\u1ec3u hi\u1ec7n kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u1ee7a ch\u1ea9n \u0111o\u00e1n b\u1ec7nh t\u00e2m th\u1ea7n \u0111\u1eb7c tr\u01b0ng; n\u1eb7ng kh\u00f4ng t\u01b0\u01a1ng x\u1ee9ng v\u1edbi r\u1ed1i lo\u1ea1n h\u00e0nh vi so v\u1edbi nh\u1eefng g\u00ec \u0111\u01b0\u1ee3c mong \u0111\u1ee3i trong t\u00ecnh tr\u1ea1ng b\u1ec7nh t\u00e2m th\u1ea7n; t\u00ecnh tr\u1ea1ng t\u00e2m th\u1ea7n kh\u00f4ng \u1ed5n \u0111\u1ecbnh, thay \u0111\u1ed5i th\u1ea5t th\u01b0\u1eddng; m\u1ed1i quan h\u1ec7 t\u1ea1m th\u1eddi gi\u1eefa b\u1ed9c ph\u00e1t, di\u1ec5n ti\u1ebfn, v\u00e0 gi\u1ea3m \u0111i ho\u1eb7c n\u1eb7ng th\u00eam c\u1ee7a c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ec7nh t\u00e2m th\u1ea7n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u1ec7nh n\u1ed9i khoa; B\u1ec7nh h\u1ec7 th\u1ed1ng t\u1ed3n t\u1ea1i tr\u01b0\u1edbc; nhi\u1ec5m \u0111\u1ed9c\/cai r\u01b0\u1ee3u ho\u1eb7c ch\u1ea5t c\u1ea5m; s\u1eed d\u1ee5ng thu\u1ed1c k\u00ea \u0111\u01a1n v\u1edbi hi\u1ec7u qu\u1ea3 ph\u1ee5 b\u1ec7nh t\u00e2m th\u1ea7n; H\u01a1n m\u1ed9t d\u1ea5u hi\u1ec7u sinh t\u1ed3n b\u1ea5t th\u01b0\u1eddng; kh\u00e1m th\u1ea5y b\u1ea5t th\u01b0\u1eddng th\u1ea7n kinh; \u0110\u1ec1 kh\u00e1ng v\u1edbi \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ph\u1ea3n \u1ee9ng kh\u00f4ng b\u00ecnh th\u01b0\u1eddng v\u1edbi \u0111i\u1ec1u tr\u1ecb, v\u00e0 c\u00e1c x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng \u0111\u1eb7c hi\u1ec7u c\u1ee7a t\u1eebng b\u1ec7nh n\u1ed9i khoa, u, th\u1ea7n kinh, chuy\u1ec3n h\u00f3a, nhi\u1ec5m tr\u00f9ng nhi\u1ec5m \u0111\u1ed9c,\u2026\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\">\u00a0<a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/benh-nao-wernicke-la-gi\/\">Wernicke\u2019s syndrome<\/a> (thi\u1ebfu B1 tr\u00ean ng\u01b0\u1eddi nghi\u1ec7n r\u01b0\u1ee3u): D\u1ef1a v\u00e0o b\u1ed9 ba tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng: Li\u1ec7t v\u1eadn nh\u00e3n, t\u00ecnh tr\u1ea1ng l\u1eabn l\u1ed9n ho\u00e0n to\u00e0n, m\u1ea5t \u0111i\u1ec1u ho\u00e0, \u0111i\u1ec1u tr\u1ecb v\u1edbi B1 IV tr\u01b0\u1edbc, \u0111i\u1ec1u ch\u1ec9nh c\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i v\u00e0 cung c\u1ea5p d\u01b0\u1ee1ng ch\u1ea5t<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0Korsakoff\u2019s syndrome: Gi\u1ea3m tr\u00ed nh\u1edb v\u00e0 h\u1ecdc t\u1eadp t\u1ed3n t\u1ea1i \u1edf b\u1ec7nh nh\u00e2n b\u1ecb Wernicke\u2019s syndrome, h\u1ed9i ch\u1ee9ng n\u00e0y th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n sau m\u1ed9t c\u01a1n c\u1ea5p c\u1ee7a b\u1ec7nh n\u00e3o Wernicke: \u0110i\u1ec1u tr\u1ecb nh\u01b0 h\u1ed9i ch\u1ee9ng Wernicke <\/span><\/li>\n<li>\u00a0S\u1ea3ng do ch\u1ea5t g\u00e2y nghi\u1ec7n kh\u00e1c ngo\u00e0i thu\u1ed1c an th\u1ea7n\/ng\u1ee7 (g\u1ed3m benzodiazepine) v\u00e0 barbiturat: Ph\u00e2n bi\u1ec7t ch\u1ee7 y\u1ebfu d\u1ef1a v\u00e0o ti\u1ec1n s\u1eed v\u00e0 x\u00e9t nghi\u1ec7m ch\u1ea5t nghi ng\u1edd trong m\u00e1u v\u00e0 n\u01b0\u1edbc ti\u1ec3u<\/li>\n<\/ul>\n<h2><strong>4. \u0110i\u1ec1u tr\u1ecb\u00a0<\/strong><\/h2>\n<h3><strong>4.1. Nguy\u00ean t\u1eafc chung c\u1ee7a \u0111i\u1ec1u tr\u1ecb\u00a0<\/strong><\/h3>\n<ul>\n<li><span style=\"font-weight: 400;\"> S\u1ea3ng c\u00f3 th\u1ec3 l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a nhi\u1ec1u b\u1ec7nh n\u1ed9i khoa v\u00ec v\u1eady c\u1ea7n kh\u00e1m k\u1ef9 v\u00e0 l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 lo\u1ea1i tr\u1eeb nh\u1eefng b\u1ec7nh n\u1ed9i khoa c\u00f3 th\u1ec3 ch\u1eefa kh\u1ecfi v\u00e0 s\u1ea3ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft n\u1ebfu \u0111i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ed9i khoa.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> N\u1ebfu bi\u1ec3u hi\u1ec7n b\u1ec7nh t\u00e2m th\u1ea7n ng\u0103n \u0111\u00e1nh gi\u00e1 b\u1ec7nh n\u1ed9i khoa ch\u00ednh x\u00e1c th\u00ec n\u00ean \u01b0u ti\u00ean \u0111i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng t\u00e2m b\u1ec7nh t\u00e2m th\u1ea7n tr\u00ean t\u00ecnh tr\u1ea1ng b\u1ec7nh n\u1ed9i khoa.\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> B\u1ec7nh t\u00e2m th\u1ea7n c\u00f3 th\u1ec3 c\u00f9ng t\u1ed3n t\u1ea1i tr\u00ean b\u1ec7nh nh\u00e2n b\u1ec7nh n\u1ed9i khoa v\u00ec v\u1eady b\u1ec7nh t\u00e2m th\u1ea7n c\u1ea7n ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb sau khi b\u1ec7nh n\u1ed9i khoa \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u00e0 \u1ed5n \u0111\u1ecbnh.<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> B\u00e1c s\u0129 l\u00e2m s\u00e0ng khoa c\u1ea5p c\u1ee9u c\u1ea7n \u0111i\u1ec1u tr\u1ecb t\u00e2m th\u1ea7n tr\u01b0\u1edbc khi b\u1ed1 tr\u00ed khoa \u0111i\u1ec1u tr\u1ecb cu\u1ed1i c\u00f9ng.<\/span><\/li>\n<li><span style=\"font-weight: 400;\">\u00a0C\u1ea7n h\u1ed9i ch\u1ea9n v\u1edbi c\u00e1c chuy\u00ean khoa kh\u00e1c khi c\u1ea7n thi\u1ebft tr\u01b0\u1edbc khi b\u1ed1 tr\u00ed cu\u1ed1i c\u00f9ng v\u00e0 theo d\u00f5i ch\u0103m s\u00f3c.<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\"><strong>\u00a04.2. <a href=\"https:\/\/www.vinmec.com\/vi\/chu-de\/dieu-tri-sang-ruou\/\">\u0110i\u1ec1u tr\u1ecb s\u1ea3ng r\u01b0\u1ee3u<\/a><\/strong><\/span><\/h3>\n<p><span style=\"font-weight: 400;\">\u0110\u00e1nh gi\u00e1 v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm l\u00e0 c\u00e1ch t\u1ed1t nh\u1ea5t \u0111\u1ec3 ng\u0103n s\u1ea3ng r\u01b0\u1ee3u. N\u1ebfu b\u1ec7nh nh\u00e2n b\u1eaft \u0111\u1ea7u \u1ea3o gi\u00e1c m\u1ea5t \u0111\u1ecbnh h\u01b0\u1edbng, v\u00e0 b\u1ed9c ph\u00e1t s\u1ea3ng r\u01b0\u1ee3u s\u1eafp x\u1ea3y ra. N\u00f3 th\u01b0\u1eddng r\u00f5 r\u00e0ng b\u1edfi nh\u1eefng c\u01a1n co gi\u1eadt to\u00e0n th\u1ec3, gi\u1eadt run li\u00ean t\u1ee5c c\u1ee7a cai nghi\u1ec7n. Lorazepam IM \u0111\u1ec3 ki\u1ec3m so\u00e1t \u0111\u1ed9ng kinh (th\u00edch h\u1ee3p cho ng\u01b0\u1eddi suy gan), Li\u1ec1u cao nh\u1ea5t c\u1ee7a benzodiazepin c\u00f3 th\u1ec3 c\u1ea7n cho th\u1eddi gian 7-10 ng\u00e0y trong \u0111i\u1ec1u ki\u1ec7n ch\u0103m s\u00f3c \u0111i\u1ec1u d\u01b0\u1ee1ng h\u1ed7 tr\u1ee3 s\u00e1t v\u00e0 tr\u00e1nh k\u00edch th\u00edch qu\u00e1 m\u1ee9c th\u1ecb gi\u00e1c v\u00e0 th\u00ednh gi\u00e1c.<\/span><\/p>\n<p><span style=\"font-weight: 400;\"> \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 g\u00f3p ph\u1ea7n quan tr\u1ecdng c\u1ee7a \u0111i\u1ec1u tr\u1ecb s\u1ea3ng r\u01b0\u1ee3u g\u1ed3m:\u00a0<\/span><\/p>\n<ul>\n<li><span style=\"font-weight: 400;\"> X\u1eed tr\u00ed m\u00f4i tr\u01b0\u1eddng nh\u01b0 gi\u1eef m\u00f4i tr\u01b0\u1eddng y\u00ean l\u1eb7ng, \u00e1nh s\u00e1ng th\u00edch h\u1ee3p<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> T\u00e2m l\u00fd li\u1ec7u ph\u00e1p<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Th\u1ef1c hi\u1ec7n \u1ed5n \u0111\u1ecbnh m\u1ea5t c\u00e2n b\u1eb1ng d\u1ecbch v\u00e0 \u0111i\u1ec7n gi\u1ea3i\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> \u0110\u01b0\u1eddng truy\u1ec1n t\u0129nh m\u1ea1ch v\u00e0 n\u01b0\u1edbc mu\u1ed1i \u0111\u1eb3ng tr\u01b0\u01a1ng th\u01b0\u1eddng\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Theo d\u00f5i tim\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Th\u1edf oxy qua catheter m\u0169i (\u1ed1ng th\u00f4ng m\u0169i)<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Truy\u1ec1n t\u0129nh m\u1ea1ch thiamine 100mg<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Ngay l\u1eadp t\u1ee9c \u0111o glucose ngay t\u1ea1i gi\u01b0\u1eddng b\u1ec7nh ho\u1eb7c d\u00f9ng D50\u00a0<\/span><\/li>\n<\/ul>\n<h3><span style=\"font-weight: 400;\"><strong>4.3. Theo d\u00f5i v\u00e0 t\u00e1i kh\u00e1m<\/strong><\/span><\/h3>\n<p><span style=\"font-weight: 400;\"> Nh\u00ecn chung, nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y c\u00f3 c\u00f9ng t\u1ed3n t\u1ea1i b\u1ec7nh n\u1ed9i khoa, ph\u1eabu thu\u1eadt, v\u00e0 nh\u1eefng b\u1ec7nh t\u00e2m th\u1ea7n v\u00ec v\u1eady c\u1ea7n li\u00ean t\u1ee5c theo d\u00f5i ch\u0103m s\u00f3c ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111\u00e1nh gi\u00e1 c\u1ea5p c\u1ee9u v\u00e0 \u0111i\u1ec1u tr\u1ecb nh\u1eefng bi\u1ebfn ch\u1ee9ng do r\u01b0\u1ee3u.<\/span><\/p>\n<p><em>D\u1ef1 th\u1ea3o chung (\u0111\u00f2i h\u1ecfi theo d\u00f5i t\u1ea1i ICU):<\/em><\/p>\n<ol>\n<li><span style=\"font-weight: 400;\"> Diazepam: Li\u1ec1u 10-25mg PO, l\u1eadp l\u1ea1i m\u1ed7i gi\u1edd khi c\u1ea7n l\u00fac m\u00e0 t\u1ec9nh \u0111\u1ebfn khi b\u00ecnh t\u1ec9nh t\u01b0\u01a1ng x\u1ee9ng th\u00ec ng\u01b0ng<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Lorazepam: 1-2mg IV, l\u1eadp l\u1ea1i m\u1ed7i gi\u1edd khi c\u1ea7n l\u00fac m\u00e0 t\u1ec9nh cho 3-5 ng\u00e0y, \u0111\u1ebfn khi b\u00ecnh t\u1ec9nh t\u01b0\u01a1ng x\u1ee9ng th\u00ec ng\u01b0ng\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Chlordiazepoxide: Li\u1ec1u 50-100mg PO\/IM\/IV, l\u1eb7p l\u1ea1i m\u1ed7i 4 gi\u1edd (t\u1ed1i \u0111a 300mg\/day), \u0111\u1ebfn khi b\u00ecnh t\u1ec9nh t\u01b0\u01a1ng x\u1ee9ng th\u00ec ng\u01b0ng.<\/span><\/li>\n<\/ol>\n<p><em><span style=\"font-weight: 400;\">\u00a0X\u00e1c \u0111\u1ecbnh ti\u00eau chu\u1ea9n v\u00e0 ch\u1ec9 \u0111\u1ecbnh h\u1ed7 tr\u1ee3 th\u00eam thu\u1ed1c:<\/span><\/em><\/p>\n<ol>\n<li><span style=\"font-weight: 400;\"> Huy\u1ebft \u00e1p t\u00e2m thu &gt; 200mmHg\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Huy\u1ebft \u00e1p t\u00e2m tr\u01b0\u01a1ng &gt; 140mmHg\u00a0<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Nh\u1ecbp tim &gt; 140 nh\u1ecbp\/ph\u00fat<\/span><\/li>\n<li><span style=\"font-weight: 400;\"> Nhi\u1ec7t \u0111\u1ed9 &gt; 38.3oC (101 oF) 5. Run, m\u1ea5t ng\u1ee7, k\u00edch \u0111\u1ed9ng <\/span><\/li>\n<\/ol>\n<p>L\u01b0u \u0111\u1ed3 ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n s\u1ea3ng r\u01b0\u1ee3u.<\/p>\n<table>\n<tbody>\n<tr>\n<td><span style=\"font-weight: 400;\">B\u01b0\u1edbc 1: \u0110\u00e1nh gi\u00e1 b\u1ec7nh nh\u00e2n S\u1ea3ng<\/span><\/td>\n<td><span style=\"font-weight: 400;\">X\u1eed tr\u00ed: \u0111\u01b0\u1eddng th\u1edf, h\u00f4 h\u1ea5p, tu\u1ea7n ho\u00e0n<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">B\u01b0\u1edbc 2: \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng S\u1ea3ng r\u01b0\u1ee3u\u00a0<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb s\u1ea3ng r\u01b0\u1ee3u<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">B\u01b0\u1edbc 3: \u0110\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng S\u1ea3ng r\u01b0\u1ee3u, b\u1ec7nh n\u1ed9i khoa v\u00e0 t\u00e2m th\u1ea7n k\u1ebft h\u1ee3p<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb S\u1ea3ng r\u01b0\u1ee3u, b\u1ec7nh n\u1ed9i khoa, b\u1ec7nh t\u00e2m th\u1ea7n<\/span><\/td>\n<\/tr>\n<tr>\n<td><span style=\"font-weight: 400;\">B\u01b0\u1edbc 4: \u0110\u00e1nh gi\u00e1 b\u1ec7nh n\u1ed9i khoa v\u00e0 t\u00e2m th\u1ea7n k\u1ebft h\u1ee3p<\/span><\/td>\n<td><span style=\"font-weight: 400;\">\u0110i\u1ec1u tr\u1ecb b\u1ec7nh n\u1ed9i khoa, b\u1ec7nh t\u00e2m th\u1ea7n<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>Xem th\u00eam<\/strong>:<\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cuong-sang-ruou-cap-con-dong-kinh-do-cai-ruou\/\">Cu\u1ed3ng s\u1ea3ng r\u01b0\u1ee3u c\u1ea5p (c\u01a1n \u0111\u1ed9ng kinh do cai r\u01b0\u1ee3u) | Vinmec<\/a><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/nghien-ruou-lau-nam-co-the-dieu-tri-duoc-khong\/\">Nghi\u1ec7n r\u01b0\u1ee3u l\u00e2u n\u0103m c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c kh\u00f4ng? | Vinmec<\/a><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/ket-qua-kiem-tra-nong-do-con-trong-mau-co-y-nghia-gi\/?link_type=related_posts\">K\u1ebft qu\u1ea3 ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 c\u1ed3n trong m\u00e1u c\u00f3 \u00fd ngh\u0129a g\u00ec? | Vinmec<\/a><\/p>\n<p><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/dieu-tri-hoi-chung-cai-ruou\/\">\u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng cai r\u01b0\u1ee3u | Vinmec<\/a><\/p>\n<p>Video \u0111\u1ec1 xu\u1ea5t:<\/p>\n<p><iframe loading=\"lazy\" title=\"Gi\u1ea3i r\u01b0\u1ee3u b\u1eb1ng c\u00e1ch n\u00e0o nhanh nh\u1ea5t?\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/6hPQLqCjJuE?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" allowfullscreen><\/iframe><\/p>\n<p>Gi\u1ea3i r\u01b0\u1ee3u b\u1eb1ng c\u00e1ch n\u00e0o nhanh nh\u1ea5t?<\/p>\n<p><span style=\"font-weight: 400;\"><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong>: Handbook of emergency psychiatry, The Washington manual of medical therapeutics, t\u00e2m th\u1ea7n h\u1ecdc \u0110HYD HCM xu\u1ea5t b\u1ea3n l\u1ea7n 6\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Qu\u00e1 tr\u00ecnh cai r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u1eb7p nhi\u1ec1u kh\u00f3 kh\u0103n \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u1ee7 \u00fd ch\u00ed v\u00e0 ngh\u1ecb l\u1ef1c. Ngo\u00e0i ra ng\u01b0\u1eddi nghi\u1ec7n r\u01b0\u1ee3u c\u00f3 th\u1ec3 g\u1eb7p ph\u1ea3i t\u00ecnh tr\u1ea1ng\u00a0 s\u1ea3ng r\u01b0\u1ee3u c\u1ea5p hay c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 c\u01a1n \u0111\u1ed9ng kinh do cai r\u01b0\u1ee3u v\u1edbi nguy c\u01a1 t\u1eed vong cao v\u00e0 [&hellip;]<\/p>\n","protected":false},"author":17,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[10,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u00e1c \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n s\u1ea3ng r\u01b0\u1ee3u - Vinmec<\/title>\n<meta name=\"description\" content=\"S\u1ea3ng r\u01b0\u1ee3u c\u00f3 th\u1ec3 bi\u1ec3u hi\u1ec7n v\u1edbi nhi\u1ec1u tri\u1ec7u ch\u1ee9ng t\u00e2m th\u1ea7n v\u00e0 c\u00f3 th\u1ec3 t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c nh\u1eadn d\u1ea1ng v\u00e0 \u0111\u1ea9y l\u00f9i nhanh.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Ph\u00e1c \u0111\u1ed3 ch\u1ea9n \u0111o\u00e1n v\u00e0 ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n s\u1ea3ng r\u01b0\u1ee3u - 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