{"id":29898,"date":"2023-05-04T17:22:27","date_gmt":"2023-05-04T10:22:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29898"},"modified":"2023-05-10T12:20:03","modified_gmt":"2023-05-10T05:20:03","slug":"ha-huyet-ap","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/ha-huyet-ap\/","title":{"rendered":"Nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed h\u1ea1 huy\u1ebft \u00e1p trong th\u1eadn nh\u00e2n t\u1ea1o"},"content":{"rendered":"

H\u1ea1 huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 ph\u1ed5 bi\u1ebfn m\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n th\u1eadn nh\u00e2n t\u1ea1o th\u01b0\u1eddng g\u1eb7p ph\u1ea3i. V\u00ec v\u1eady, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed h\u1ea1 huy\u1ebft \u00e1p \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb cho c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ea1 huy\u1ebft \u00e1p \u0111\u00f2i h\u1ecfi s\u1ef1 chuy\u00ean m\u00f4n v\u00e0 kinh nghi\u1ec7m c\u1ee7a c\u00e1c chuy\u00ean gia th\u1eadn, v\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n n\u00ean th\u01b0\u1eddng xuy\u00ean ki\u1ec3m tra v\u00e0 \u0111i\u1ec1u ch\u1ec9nh \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 duy tr\u00ec s\u1ee9c kh\u1ecfe t\u1ed1t nh\u1ea5t.<\/strong><\/p>\n

1. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h1>\n

– C\u00e1c d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd: Xu\u1ea5t hi\u1ec7n ch\u00f3ng m\u1eb7t ,\u0111au \u0111\u1ea7u nh\u1eb9 ho\u1eb7c n\u00f4n, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 th\u1ea5y d\u1ea5u hi\u1ec7u co r\u00fat c\u00e1c c\u01a1. M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng r\u00f5 r\u1ec7t , m\u00e0 ch\u1ec9 c\u00f3 bi\u1ec3u hi\u1ec7n r\u00f5 khi HA \u0111\u00e3 xu\u1ed1ng qu\u00e1 th\u1ea5p.<\/p>\n

– \u0110o HA cho ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh khi HA <90\/60 mmHg.<\/p>\n

– C\u1ea7n theo d\u00f5i huy\u1ebft \u00e1p th\u01b0\u1eddng xuy\u00ean trong su\u1ed1t qu\u00e1 tr\u00ecnh l\u1ecdc m\u00e1u, nh\u1ea5t l\u00e0 \u0111\u1ed1i v\u1edbi c\u00e1c ng\u01b0\u1eddi b\u1ec7nh c\u00f3 xu h\u01b0\u1edbng h\u1ea1 HA trong l\u1ecdc m\u00e1u.<\/p>\n

\"\"
Ngu\u1ed3n: Masaki Mogi, \u201cPrediction of intradialytic hypotension\u201d<\/strong>, Hypertension Research volume 46, p774\u2013775 (2023).<\/em><\/figcaption><\/figure>\n

2. X\u1eed tr\u00ed ban \u0111\u1ea7u<\/strong><\/h2>\n

T\u00f9y theo nguy\u00ean nh\u00e2n c\u1ee5 th\u1ec3 g\u00e2y h\u1ea1 HA m\u00e0 x\u1eed tr\u00ed kh\u00e1c nhau. C\u1ea7n nh\u1edb r\u1eb1ng h\u1ea1 HA trong l\u1ecdc m\u00e1u c\u1ea7n ph\u1ea3i x\u1eed tr\u00ed nhanh v\u00e0 ch\u00ednh x\u00e1c.<\/p>\n

C\u00e1c vi\u1ec7c c\u1ea7n l\u00e0m ngay:<\/p>\n

    \n
  • \u0110\u1ec3 ng\u01b0\u1eddi b\u1ec7nh n\u1eb1m t\u01b0 th\u1ebf \u0111\u1ea7u th\u1ea5p n\u1ebfu t\u00ecnh tr\u1ea1ng h\u00f4 h\u1ea5p cho ph\u00e9p.<\/li>\n
  • Cho th\u1edf oxy gi\u00fap c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng tim m\u1ea1ch<\/li>\n
  • Truy\u1ec1n nhanh 100 ml ho\u1eb7c nhi\u1ec1u h\u01a1n dung d\u1ecbch Natriclorua 0.9% qua \u0111\u01b0\u1eddng m\u00e1u v\u1ec1 ng\u01b0\u1eddi b\u1ec7nh. C\u00f3 th\u1ec3 d\u00f9ng dung d\u1ecbch Natriclorua \u01b0u tr\u01b0\u01a1ng, dung d\u1ecbch glucose \u01b0u tr\u01b0\u01a1ng, manitol ho\u1eb7c albumin.<\/li>\n
  • Gi\u1ea3m si\u00eau l\u1ecdc xu\u1ed1ng 0 ho\u1eb7c g\u1ea7n 0 n\u1ebfu c\u00f3 th\u1ec3 b\u1edfi m\u1ed9t s\u1ed1 lo\u1ea1i m\u00e1y kh\u00f4ng cho ph\u00e9p \u0111\u01b0a si\u00eau l\u1ecdc v\u1ec1 0. C\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111\u01b0a si\u00eau l\u1ecdc v\u1ec1 theo ch\u1ec9 \u0111\u1ecbnh ban \u0111\u1ea7u n\u1ebfu nh\u01b0 t\u00ecnh trang HA \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n.<\/li>\n
  • \u0110i\u1ec1u ch\u1ec9nh t\u1ed1c \u0111\u1ed9 d\u00f2ng m\u00e1u ch\u1eadm l\u1ea1i.<\/li>\n<\/ul>\n

    3. Ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed<\/strong><\/h2>\n

    3.1. Nh\u1eefng nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p.<\/strong><\/h3>\n

    3.1.1. Do s\u1ee5t c\u00e2n nhi\u1ec1u ho\u1eb7c do t\u1ed1c \u0111\u1ed9 si\u00eau l\u1ecdc nhanh.<\/strong><\/p>\n

    Do gi\u1ea3m th\u1ec3 t\u00edch tu\u1ea7n ho\u00e0n d\u1eabn \u0111\u1ebfn gi\u1ea3m cung l\u01b0\u1ee3ng tim v\u00e0 g\u00e2y h\u1ea1 HA . C\u00e1c nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 :<\/p>\n

    3.1.1.1. Do s\u1eed d\u1ee5ng b\u1ed9 ph\u1eadn \u0111i\u1ec1u khi\u1ec3n si\u00eau l\u1ecdc kh\u00f4ng ph\u00f9 h\u1ee3p ho\u1eb7c m\u00e1y kh\u00f4ng c\u00f3 b\u1ed9 ph\u1eadn n\u00e0y<\/strong>.<\/p>\n

    X\u1eed tr\u00ed:<\/strong> S\u1eed d\u1ee5ng m\u00e1y TNT c\u00f3 b\u1ed9 ph\u1eadn \u0111i\u1ec1u khi\u1ec3n h\u1ec7 s\u1ed1 si\u00eau l\u1ecdc, trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 thi\u1ebft b\u1ecb n\u00e0y c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng lo\u1ea1i m\u00e0ng l\u1ecdc c\u00f3 t\u00ednh th\u1ea5m v\u1edbi n\u01b0\u1edbc th\u1ea5p.<\/p>\n

    3.1.1.2. Do t\u0103ng c\u00e2n qu\u00e1 nhi\u1ec1u gi\u1eefa 2 l\u1ea7n l\u1ecdc m\u00e1u ho\u1eb7c th\u1eddi gian c\u1ee7a bu\u1ed5i l\u1ecdc m\u00e1u ng\u1eafn<\/strong>.<\/p>\n

    Trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y t\u1ed5ng th\u1ec3 t\u00edch d\u1ecbch c\u1ea7n lo\u1ea1i b\u1ecf s\u1ebd r\u1ea5t l\u1edbn trong khi \u0111\u00f3 th\u1eddi gian c\u1ee7a bu\u1ed5i l\u1ecdc kh\u00f4ng t\u0103ng s\u1ebd d\u1eabn \u0111\u1ebfn t\u0103ng.<\/p>\n

    X\u1eed tr\u00ed<\/strong>: Kh\u00f4ng \u0111\u1ec3 cho b\u1ec7nh nh\u00e2n t\u0103ng c\u00e2n nhi\u1ec1u gi\u1eefa 2 l\u1ea7n l\u1ecdc m\u00e1u , n\u00ean duy tr\u00ec m\u1ee9c \u0111\u1ed9 t\u0103ng <1 kg\/ng\u00e0y.<\/p>\n

    3.1.1.3. R\u00fat qu\u00e1 nhi\u1ec1u n\u01b0\u1edbc g\u00e2y tr\u1ecdng l\u01b0\u1ee3ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh gi\u1ea3m d\u01b0\u1edbi trong l\u01b0\u1ee3ng kh\u00f4.<\/strong><\/p>\n

    X\u1eed tr\u00ed<\/strong>: Kh\u00f4ng n\u00ean r\u00fat c\u00e2n d\u01b0\u1edbi m\u1ee9c c\u00e2n n\u1eb7ng l\u00fd t\u01b0\u1edfng \u0111\u00f3.<\/p>\n

    3.1.1.4. D\u00f9ng d\u1ecbch l\u1ecdc c\u00f3 n\u1ed3ng \u0111\u1ed9 Natri th\u1ea5p:<\/strong><\/p>\n

    Khi n\u1ed3ng \u0111\u1ed9 Na d\u1ecbch l\u1ecdc th\u1ea5p h\u01a1n trong huy\u1ebft t\u01b0\u01a1ng s\u1ebd d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng d\u00f2ng m\u00e1u sau khi qua qu\u1ea3 l\u1ecdc tr\u1edf v\u1ec1 c\u01a1 th\u1ec3 s\u1ebd nh\u01b0\u1ee3c tr\u01b0\u01a1ng h\u01a1n so v\u1edbi c\u00e1c m\u00f4 xung quanh n\u01b0\u1edbc s\u1ebd tho\u00e1t kh\u1ecfi l\u00f2ng m\u1ea1ch v\u00e0o c\u00e1c m\u00f4 xung quanh g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng gi\u1ea3m kh\u1ed1i l\u01b0\u1ee3ng tu\u1ea7n ho\u00e0n, hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y th\u01b0\u1eddng g\u1eb7p \u1edf giai \u0111o\u1ea1n \u0111\u1ea7u c\u1ee7a ca l\u1ecdc m\u00e1u.<\/p>\n

    X\u1eed tr\u00ed<\/strong>: D\u00f9ng d\u1ecbch l\u1ecdc c\u00f3 n\u1ed3ng \u0111\u1ed9 Na t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nh\u01b0 Na trong m\u00e1u, trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft m\u00e0 ph\u1ea3i d\u00f9ng Na d\u1ecbch l\u1ecdc th\u1ea5p h\u01a1n Na m\u00e1u >4 mmol\/l, khi \u0111\u00f3 \u0111\u1ec3 tr\u00e1nh h\u1ea1 HA, c\u1ea7n ph\u1ea3i gi\u1ea3m si\u00eau l\u1ecdc xu\u1ed1ng th\u1ea5p trong th\u1eddi gian \u0111\u1ea7u c\u1ee7a ca l\u1ecdc m\u00e1u.<\/p>\n

    3.1.2. H\u1ea1 huy\u1ebft \u00e1p c\u00f3 li\u00ean quan \u0111\u1ebfn gi\u1ea3m tr\u01b0\u01a1ng l\u1ef1c m\u1ea1ch m\u00e1u.<\/strong><\/p>\n

    T\u1ea5t c\u1ea3 nh\u1eefng y\u1ebfu t\u1ed1 d\u00f9 nh\u1ecf nh\u1ea5t g\u00e2y gi\u1ea3m s\u1ee9c c\u1ea3n m\u1ea1ch m\u00e1u ngo\u1ea1i vi ho\u1eb7c l\u00e0m gi\u1ea3m th\u1ec3 t\u00edch \u0111\u1ed5 \u0111\u1ea7y c\u1ee7a tim \u0111\u1ec1u c\u00f3 th\u1ec3 g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng h\u1ea1 huy\u1ebft \u00e1p.<\/p>\n

    Tr\u00ean 80% th\u1ec3 t\u00edch m\u00e1u trong c\u01a1 th\u1ec3 l\u01b0u th\u00f4ng trong h\u1ec7 t\u0129nh m\u1ea1ch, do \u0111\u00f3 khi c\u00f3 s\u1ef1 thay \u0111\u1ed5i v\u1ec1 t\u00ecnh tr\u1ea1ng ch\u1ee9a m\u00e1u \u1edf h\u1ec7 t\u0129nh m\u1ea1ch s\u1ebd g\u00e2y n\u00ean gi\u1ea3m th\u1ec3 t\u00edch \u0111\u1ed5 \u0111\u1ea7y c\u1ee7a tim v\u00e0 g\u00e2y n\u00ean h\u1ea1 HA.<\/p>\n

    M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng tr\u00ean c\u00f3 th\u1ec3 l\u00e0:<\/p>\n

    3.1.3. S\u1eed d\u1ee5ng d\u1ecbch l\u1ecdc acetate<\/strong><\/p>\n

    Acetate \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 g\u00e2y gi\u00e3n m\u1ea1ch, n\u1ed3ng \u0111\u1ed9 acetate huy\u1ebft t\u01b0\u01a1ng trong qu\u00e1 tr\u00ecnh l\u1ecdc th\u01b0\u1eddng duy tr\u00ec trong kho\u1ea3ng t\u1eeb 3-10 mmol. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh hay g\u1eb7p t\u00ecnh tr\u1ea1ng h\u1ea1 HA trong l\u1ecdc m\u00e1u khi d\u00f9ng d\u1ecbch l\u1ecdc n\u00e0y ( \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi b\u1ec7nh n\u1eef ho\u1eb7c ng\u01b0\u1eddi b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng).<\/p>\n

    D\u00f9ng d\u1ecbch l\u1ecdc acetate c\u0169ng c\u00f3 th\u1ec3 l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y h\u1ea1 huy\u1ebft \u00e1p \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh l\u1ecdc m\u00e1u d\u00f9ng qu\u1ea3 l\u1ecdc c\u00f3 \u0111\u1ed9 si\u00eau l\u1ecdc cao. Tuy nhi\u00ean kh\u00f4ng \u00edt nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n h\u1ea1 HA khi d\u00f9ng lo\u1ea1i d\u1ecbch n\u00e0y k\u1ec3 c\u1ea3 nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 huy\u1ebft \u00e1p n\u1ec1n th\u01b0\u1eddng th\u1ea5p.<\/p>\n

    X\u1eed tr\u00ed<\/strong>: Thay b\u1eb1ng d\u1ecbch l\u1ecdc Bicacbonate.<\/p>\n

    3.1.4. D\u1ecbch l\u1ecdc \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u1edf nhi\u1ec7t \u0111\u1ed9 th\u01b0\u1eddng.<\/strong><\/p>\n

    Th\u00f4ng th\u01b0\u1eddng d\u1ecbch l\u1ecdc \u0111\u01b0\u1ee3c duy tr\u00ec \u1edf m\u1ee9c 38 \u0111\u1ed9 C, ng\u01b0\u1eddi b\u1ec7nh l\u1ecdc m\u00e1u th\u01b0\u1eddng \u1edf trong t\u00ecnh tr\u1ea1ng c\u00f3 gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 m\u1ee9c \u0111\u1ed9 nh\u1eb9. Trong qu\u00e1 tr\u00ecnh l\u1ecdc m\u00e1u nhi\u1ec7t \u0111\u1ed9 c\u01a1 th\u1ec3 th\u01b0\u1eddng t\u0103ng m\u1ed9t ch\u00fat. Nhi\u1ec7t \u0111\u1ed9 c\u1ee7a d\u1ecbch l\u1ecdc t\u0103ng s\u1ebd d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u00e3n c\u1ea3 t\u0129nh m\u1ea1ch v\u00e0 \u0111\u1ed9ng m\u1ea1ch.<\/p>\n

    X\u1eed tr\u00ed<\/strong>: D\u00f9ng b\u1ed9 ph\u1eadn l\u00e0m gi\u1ea3m nhi\u1ec7t \u0111\u1ed9 c\u1ee7a d\u1ecbch l\u1ecdc ho\u1eb7c \u0111i\u1ec1u ch\u1ec9nh nhi\u1ec7t \u0111\u1ecd d\u1ecbch l\u1ecdc \u1edf m\u1ee9c 34-36 \u0111\u1ed9 C. Ch\u00fa \u00fd khi d\u00f9ng d\u1ecbch l\u1ecdc c\u00f3 nhi\u1ec7t \u0111\u1ed9 th\u1ea5p nh\u01b0 v\u1eady ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu nh\u01b0 \u1edbn l\u1ea1nh.<\/p>\n

    3.1.5. Qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a th\u1ee9c \u0103n khi l\u1ecdc m\u00e1u.<\/strong><\/p>\n

      \n
    • Qu\u00e1 tr\u00ecnh ti\u00eau h\u00f3a t\u00edch c\u1ef1c trong qu\u00e1 tr\u00ecnh l\u1ecdc m\u00e1u c\u00f3 th\u1ec3 g\u00e2y n\u00ean h\u1ea1 HA.<\/li>\n
    • Qu\u00e1 tr\u00ecnh n\u00e0y g\u00e2y n\u00ean gi\u1ea3m s\u1ee9c c\u1ea3n th\u00e0nh m\u1ea1ch nh\u1ea5t l\u00e0 c\u00e1c m\u1ea1ch m\u00e1u n\u1ed9i t\u1ea1ng.<\/li>\n
    • \u0110\u1eb7c bi\u1ec7t g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng l\u00e0m t\u0103ng th\u1ec3 t\u00edch t\u0129nh m\u1ea1ch v\u00e0 g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng h\u1ea1 huy\u1ebft \u00e1p.<\/li>\n<\/ul>\n

      X\u1eed tr\u00ed<\/strong>: Khuy\u00ean ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng n\u00ean \u0103n ngay tr\u01b0\u1edbc l\u1ecdc m\u00e1u ho\u1eb7c trong th\u1eddi\u00a0 gian l\u1ecdc m\u00e1u v\u00ec hi\u1ec7u \u1ee9ng n\u00e0y th\u01b0\u1eddng k\u00e9o d\u00e0i trong v\u00f2ng 2 h k\u1ec3 t\u1eeb khi b\u1eaft \u0111\u1ea7u \u0103n.<\/p>\n

      3.1.6. Nguy\u00ean nh\u00e2n thi\u1ebfu m\u00e1u<\/strong><\/p>\n

      T\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng h\u1ea1 HA \u0111\u1ec1u g\u00e2y n\u00ean thi\u1ebfu m\u00e1u t\u1ed5 ch\u1ee9c, m\u1eb7t kh\u00e1c khi thi\u1ebfu m\u00e1u t\u1ed5 ch\u1ee9c s\u1ebd d\u1eabn \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u1ea3i ph\u00f3ng adenosine, khi \u0111\u00f3 adenosine s\u1ebd ng\u0103n c\u1ea3n qu\u00e1 tr\u00ecnh gi\u1ea3i ph\u00f3ng Norepinephrine t\u1eeb h\u1ec7 th\u1ed1ng th\u1ea7n kinh giao c\u1ea3m v\u00e0 th\u01b0\u1eddng g\u00e2y n\u00ean hi\u1ec7n t\u01b0\u1ee3ng gi\u00e3n m\u1ea1ch. Ch\u00ednh v\u00ec v\u1eady t\u00ecnh tr\u1ea1ng h\u1ea1 HA s\u1ebd c\u00e0ng th\u00eam tr\u1ea7m tr\u1ecdng .Tr\u00ean l\u00e2m s\u00e0ng t\u00ecnh tr\u1ea1ng tr\u00ean th\u01b0\u1eddng x\u1ea3y ra \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 n\u1ed3ng \u0111\u1ed9 Ht <20-25 %.<\/p>\n

      X\u1eed tr\u00ed<\/strong>: \u0110i\u1ec1u ch\u1ec9nh thi\u1ebfu m\u00e1u , c\u1ea7n d\u00f9ng Epo v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 c\u1ea7n thi\u1ebft cho qu\u00e1 tr\u00ecnh t\u1ea1o m\u00e1u, trong nh\u1eefng tr\u01b0\u1eddng h\u1ee3p l\u1ecdc m\u00e1u c\u1ea5p c\u1ea7n truy\u1ec1n m\u00e1u b\u1ed5 sung khi ti\u1ebfn h\u00e0nh l\u1ecdc m\u00e1u \u0111\u1ec3 l\u00e0m tr\u00e1nh h\u1ea1 HA.<\/p>\n

      3.1.7. T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh t\u1ef1 \u0111\u1ed9ng.<\/strong><\/p>\n

      \u0110\u1eb7c bi\u1ec7t hay g\u1eb7p \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. \u1ede nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh n\u00e0y ph\u1ea3n \u1ee9ng co m\u1ea1ch nh\u1ea5t l\u00e0 \u0111\u1ed9ng m\u1ea1ch khi \u0111\u1ed1i ph\u00f3 v\u1edbi t\u00ecnh tr\u1ea1ng gi\u1ea3m kh\u1ed1i l\u01b0\u1ee3ng tu\u1ea7n ho\u00e0n b\u1ecb gi\u1ea3m \u0111i \u0111\u00e1ng k\u1ec3, do \u0111\u00f3 khi cung l\u01b0\u1ee3ng tim gi\u1ea3m kh\u1ea3 n\u0103ng duy tr\u00ec huy\u1ebft \u00e1p qua con \u0111\u01b0\u1eddng co m\u1ea1ch g\u1ea7n nh\u01b0 kh\u00f4ng c\u00f2n gi\u00e1 tr\u1ecb.<\/p>\n

      X\u1eed tr\u00ed<\/strong> : D\u00f9ng m\u1ed9t s\u1ed1 t\u00e1c nh\u00e2n co m\u1ea1ch, tuy nhi\u00ean hi\u1ec7u qu\u1ea3 c\u00f2n th\u1ea5p.<\/p>\n

      3.1.8. Do d\u00f9ng thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p.<\/strong><\/p>\n

      C\u1ea7n ch\u1ecdn thu\u1ed1c h\u1ea1 huy\u1ebft \u00e1p ph\u00f9 h\u1ee3p c\u0169ng nh\u01b0 th\u1eddi gian d\u00f9ng thu\u1ed1c, n\u00ean tr\u00e1nh d\u00f9ng thu\u1ed1c h\u1ea1 \u00e1p tr\u01b0\u1edbc l\u1ecdc m\u00e1u \u1edf nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 xu h\u01b0\u1edbng h\u1ea1 HA khi l\u1ecdc. Tuy nhi\u00ean th\u1eddi gian d\u00f9ng, kho\u1ea3ng c\u00e1ch d\u00f9ng, ph\u1ee5 thu\u1ed9c v\u00e0o d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc c\u1ee7a t\u1eebng lo\u1ea1i thu\u1ed1c v\u00e0 kh\u1ea3 n\u0103ng dung n\u1ea1p.<\/p>\n

      3.1.9. H\u1ea1 huy\u1ebft \u00e1p do tim.<\/strong><\/p>\n

      Do r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng: <\/strong>T\u00ecnh tr\u1ea1ng ph\u00ec \u0111\u1ea1i c\u1ee7a c\u01a1 tim s\u1ebd d\u1eabn \u0111\u1ebfn gi\u1ea3m cung l\u01b0\u1ee3ng tim khi ph\u1ea3n \u1ee9ng v\u1edbi t\u00ecnh tr\u1ea1ng gi\u1ea3m \u00e1p l\u1ef1c \u0111\u1ed5 \u0111\u1ea7y. Ph\u00ec \u0111\u1ea1i t\u00e2m th\u1ea5t ph\u1ea3i v\u00e0 r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng t\u00e2m tr\u01b0\u01a1ng l\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n th\u01b0\u1eddng g\u1eb7p \u1edf ng\u01b0\u1eddi b\u1ec7nh l\u1ecdc m\u00e1u. \u0110i\u1ec1u tr\u1ecb c\u1ea7n d\u00f9ng c\u00e1c thu\u1ed1c tr\u1ee3 tim l\u00e0m t\u0103ng s\u1ee9c co b\u00f3p c\u1ee7a c\u01a1 tim, ch\u00fa \u00fd t\u00ecnh tr\u1ea1ng \u0111i\u1ec7n gi\u1ea3i\u2026nh\u1ecbp tim ch\u1eadm<\/p>\n

      Do r\u1ed1i lo\u1ea1n nh\u1ecbp tim v\u00e0 kh\u1ea3 n\u0103ng co b\u00f3p<\/strong>: Cung l\u01b0\u1ee3ng tim kh\u00f4ng ph\u1ea3i ch\u1ec9 \u1ea3nh h\u01b0\u1edfng b\u1eddi kh\u1ea3 n\u0103ng \u0111\u1ed5 \u0111\u1ea7y m\u00e0 c\u00f2n b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi nh\u1ecbp tim v\u00e0 kh\u1ea3 n\u0103ng co b\u00f3p. M\u1eb7c d\u00f9 h\u1ea7u h\u1ebft h\u1ea1 HA trong l\u1ecdc m\u00e1u l\u00e0 c\u00f3 li\u00ean quan \u0111\u1ebfn t\u00ecnh tr\u1ea1ng gi\u1ea3m th\u1ec3 t\u00edch \u0111\u1ed5 \u0111\u1ea7y, tuy nhi\u00ean kh\u00f4ng ph\u1ea3i l\u00e0 trong m\u1ecdi tr\u01b0\u1eddng h\u1ee3p.<\/p>\n

      X\u1eed tr\u00ed<\/strong>: D\u00f9ng c\u00e1c t\u00e1c nh\u00e2n t\u0103ng nh\u1ecbp tim n\u1ebfu nh\u1ecbp ch\u1eadm, \u0111i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n c\u1ee7a r\u1ed1i lo\u1ea1n nh\u1ecbp tim\u2026t\u0103ng kh\u1ea3 n\u0103ng co b\u00f3p c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u00ecnh tr\u1ea1ng h\u1ea1 HA.<\/p>\n

      3.2. Nh\u1eefng nguy\u00ean nh\u00e2n hi\u1ebfm g\u1eb7p g\u00e2y h\u1ea1 huy\u1ebft \u00e1p<\/strong><\/h3>\n

      H\u1ea1 HA trong l\u1ecdc m\u00e1u c\u00f3 th\u1ec3 l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd kh\u00e1c kh\u00f4ng li\u00ean quan \u0111\u1ebfn qu\u00e1 tr\u00ecnh l\u1ecdc m\u00e1u nh\u01b0: Tr\u00e0n d\u1ecbch m\u00e0ng ngo\u00e0i tim, nh\u1ed3i m\u00e1u c\u01a1 tim,ch\u1ea3y m\u00e1u trong,nhi\u1ec5m khu\u1ea9n huy\u1ebft,r\u1ed1i lo\u1ea1n nh\u1ecbp tim,ph\u1ea3n \u1ee9ng c\u1ee7a c\u01a1 th\u1ec3 v\u1edbi m\u00e0ng l\u1ecdc,tan m\u00e1u,t\u1eafc m\u1ea1ch kh\u00ed\u2026<\/p>\n

      X\u1eed tr\u00ed:<\/strong> theo nguy\u00ean nh\u00e2n c\u1ee5 th\u1ec3<\/p>\n

      3.3. H\u1ea1 huy\u1ebft \u00e1p c\u00f3 li\u00ean quan \u0111\u1ebfn m\u00e0ng l\u1ecdc<\/strong><\/h3>\n

      S\u1eed d\u1ee5ng m\u00e0ng l\u1ecdc cellulose c\u00f3 th\u1ec3 g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng h\u1ea1 HA , c\u01a1 ch\u1ebf \u0111\u01b0\u1ee3c cho l\u00e0 do qu\u00e1 tr\u00ecnh ho\u1ea1t h\u00f3a b\u1ed5 th\u1ec3 v\u00e0 c\u00e1c cytokines.Ph\u1ea3n \u1ee9ng d\u1ea1ng n\u00e0y th\u01b0\u1eddng x\u1ea3y ra khi ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c d\u00f9ng qu\u1ea3 l\u1ecdc l\u1ea7n \u0111\u1ea7u ti\u00ean. Tuy nhi\u00ean v\u1ea5n \u0111\u1ec1 n\u00e0y v\u1eabn c\u00f2n c\u1ea7n nhi\u1ec1u nghi\u00ean c\u1ee9u th\u00eam \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh.<\/p>\n

      X\u1eed tr\u00ed<\/strong>: n\u1ebfu nghi ng\u1edd h\u1ea1 HA do m\u00e0ng l\u1ecdc c\u1ea7n : D\u1eebng ngay qu\u00e1 tr\u00ecnh l\u1ecdc, b\u1ecf ho\u00e0n to\u00e0n qu\u1ea3 l\u1ecdc v\u00e0 d\u00e2y l\u1ecdc, c\u1ea5p c\u1ee9u nh\u01b0 tr\u01b0\u1eddng h\u1ee3p h\u1ea1 HA do s\u1ed1c ph\u1ea3n v\u1ec7.<\/p>\n

      Ngu\u1ed3n tham kh\u1ea3o<\/strong>: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ed9t s\u1ed1 b\u1ec7nh th\u1eadn \u2013 ti\u1ebft ni\u1ec7u c\u1ee7a B\u1ed9 Y t\u1ebf 2015<\/p>\n","protected":false},"excerpt":{"rendered":"

      H\u1ea1 huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 ph\u1ed5 bi\u1ebfn m\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n th\u1eadn nh\u00e2n t\u1ea1o th\u01b0\u1eddng g\u1eb7p ph\u1ea3i. V\u00ec v\u1eady, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed h\u1ea1 huy\u1ebft \u00e1p \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c \u0111i\u1ec1u tr\u1ecb cho c\u00e1c b\u1ec7nh nh\u00e2n n\u00e0y. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ea1 […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[29,33],"tags":[],"yoast_head":"\nNguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed h\u1ea1 huy\u1ebft \u00e1p trong th\u1eadn nh\u00e2n t\u1ea1o - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ea1 huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 ph\u1ed5 bi\u1ebfn m\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n th\u1eadn nh\u00e2n t\u1ea1o th\u01b0\u1eddng g\u1eb7p ph\u1ea3i. V\u00ec v\u1eady, vi\u1ec7c ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed\" \/>\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=\"Nguy\u00ean nh\u00e2n v\u00e0 x\u1eed tr\u00ed h\u1ea1 huy\u1ebft \u00e1p trong th\u1eadn nh\u00e2n t\u1ea1o - Vinmec\" \/>\n<meta property=\"og:description\" content=\"H\u1ea1 huy\u1ebft \u00e1p l\u00e0 m\u1ed9t trong nh\u1eefng v\u1ea5n \u0111\u1ec1 ph\u1ed5 bi\u1ebfn m\u00e0 c\u00e1c b\u1ec7nh nh\u00e2n th\u1eadn nh\u00e2n t\u1ea1o th\u01b0\u1eddng g\u1eb7p ph\u1ea3i. 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