{"id":29979,"date":"2023-05-01T22:57:34","date_gmt":"2023-05-01T15:57:34","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=29979"},"modified":"2023-05-01T22:57:34","modified_gmt":"2023-05-01T15:57:34","slug":"benh-van-ba-la-trong-thuc-hanh-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-van-ba-la-trong-thuc-hanh-lam-sang\/","title":{"rendered":"B\u1ec7nh van ba l\u00e1 trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng"},"content":{"rendered":"

B\u1ec7nh van ba l\u00e1 bao g\u1ed3m: h\u1edf van ba l\u00e1 c\u01a1 n\u0103ng v\u00e0 h\u1edf van ba l\u00e1 th\u1ef1c th\u1ec3, h\u1eb9p van ba l\u00e1. \u0110\u00e2y l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Nguy\u00ean nh\u00e2n, \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u0169ng nh\u01b0 \u0111i\u1ec1u tr\u1ecb c\u00f3 trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y.<\/strong><\/p>\n

\"Van<\/p>\n

Van ba l\u00e1<\/strong><\/p>\n

1.H\u1edf van ba l\u00e1<\/h2>\n

1.1 Nguy\u00ean nh\u00e2n<\/strong><\/h3>\n

H\u1edf van ba l\u00e1 c\u01a1 n\u0103ng ho\u1eb7c th\u1ee9 ph\u00e1t (l\u00e1 van b\u00ecnh th\u01b0\u1eddng, gi\u00e3n v\u00f2ng van th\u1ea5t ph\u1ea3i do b\u1ec7nh l\u00fd van hai l\u00e1, b\u1ec7nh tim b\u1ea9m sinh) kh\u00e1 ph\u1ed5 bi\u1ebfn. T\u1ed5n th\u01b0\u01a1ng van ba l\u00e1 c\u1ea5u tr\u00fac ho\u1eb7c ti\u00ean ph\u00e1t: Th\u01b0\u1eddng g\u1eb7p nh\u1ea5t do vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n (\u0111\u1eb7c bi\u1ec7t l\u00e0 \u1edf b\u1ec7nh nh\u00e2n nghi\u1ec7n ch\u00edch), \u0111\u1eb7t d\u00e2y m\u00e1y t\u1ea1o nh\u1ecbp qua van, h\u1ed9i ch\u1ee9ng Marfan, b\u1ec7nh Ebstein, th\u1ea5p tim, carcinoid.<\/p>\n

1.2 \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng<\/h3>\n

Th\u01b0\u1eddng \u00edt bi\u1ec3u hi\u1ec7n trong giai \u0111o\u1ea1n \u0111\u1ea7u. Ph\u00f9 ngo\u1ea1i bi\u00ean, c\u1ed5 tr\u01b0\u1edbng, bu\u1ed3n n\u00f4n, ch\u00e1n<\/p>\n

\u0103n, \u0111au b\u1ee5ng (do gan to \u1ee9 huy\u1ebft) l\u00e0 nh\u1eefng d\u1ea5u hi\u1ec7u mu\u1ed9n.<\/p>\n

1.3 Kh\u00e1m th\u1ef1c th\u1ec3<\/h3>\n

Suy ki\u1ec7t, v\u00e0ng da, ph\u00f9, rung nh\u0129 th\u01b0\u1eddng g\u1eb7p, t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i v\u1edbi s\u00f3ng t\u0129nh m\u1ea1ch c\u1ea3nh th\u00ec t\u00e2m thu, gan to v\u00e0 ch\u1eafc c\u1ea3m nh\u1eadn theo m\u1ea1ch \u0111\u1eadp. Nghe tim-ti\u1ebfng T3 th\u1ea5t ph\u1ea3i th\u01b0\u1eddng nghe th\u1ea5y (t\u0103ng khi h\u00edt v\u00e0o), ti\u1ebfng th\u1ed5i ti\u1ec1n t\u00e2m thu nghe \u0111\u01b0\u1ee3c \u1edf c\u1ea1nh \u1ee9c b\u00ean tr\u00e1i (t\u0103ng khi h\u00edt v\u00e0o). Ti\u1ebfng th\u1ed5i nghe r\u00f5 nh\u1ea5t khi h\u1edf van ba l\u00e1 th\u1ee9 ph\u00e1t trong t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/p>\n

1.4 C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n
    \n
  • \u0110i\u1ec7n t\u00e2m \u0111\u1ed3 th\u01b0\u1eddng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, c\u00f3 th\u1ec3 th\u1ea5y b\u1eb1ng ch\u1ee9ng c\u1ee7a nguy\u00ean nh\u00e2n g\u00e2y h\u1edf van ba l\u00e1.<\/li>\n
  • X-quang ng\u1ef1c th\u1eb3ng \u1edf b\u1ec7nh nh\u00e2n h\u1edf van ba l\u00e1 ch\u1ee9c n\u0103ng c\u00f3 h\u00ecnh tim to, \u0111\u00f4i khi c\u00f3 gi\u00e3n t\u0129nh m\u1ea1ch \u0111\u01a1n, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/li>\n
  • Si\u00eau \u00e2m tim: D \u00f9ng D oppler m\u00e0u kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n, Doppler li\u00ean t\u1ee5c qua ph\u1ed5 h\u1edf van ba l\u00e1 c\u00f3 th\u1ec3 \u0111\u00e1nh gi\u00e1 \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i t\u00e2m thu. H\u00ecnh \u1ea3nh si \u00eau \u00e2m 2D c\u00f3 th\u1ec3 g\u1ee3i \u00fd nguy\u00ean nh\u00e2n c\u1ee7a h\u1edf van ba l\u00e1 (nh\u1ed3i m\u00e1u th\u1ea5t ph\u1ea3i, d\u1ecb t\u1eadt v\u00e1ch li\u00ean th\u1ea5t, Ebstein…). H\u1edf van ba l\u00e1 n\u1eb7ng: \u0110 \u1ed9 r\u1ed9ng c\u1ee7a d\u00f2ng h\u1edf > 0,7 cm v\u00e0 c \u00f3 d\u00f2ng ph\u1ee5t ng\u01b0\u1ee3c t\u00e2m thu trong t\u0129nh m\u1ea1ch gan.<\/li>\n<\/ul>\n

    1.5 \u0110i\u1ec1u tr\u1ecb<\/h3>\n
      \n
    • N\u1ebfu kh\u00f4ng c\u00f3 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, h\u1edf van ba l\u00e1 th \u01b0\u1eddng dung n\u1ea1p t\u1ed1t v\u00e0 kh\u00f4ng y\u00eau c\u1ea7u \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c bi\u1ec7t (trong vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n b\u00e1n c\u1ea5p c\u1ee7a van ba l\u00e1, ph \u0201u thu\u1eadt c\u1eaft b\u1ecf van \u0111\u00f4i khi \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n mang l\u1ea1 i s \u1ef1 ph\u1ee5c h \u1ed3i t\u1ed1t).<\/li>\n
    • Tri\u1ec7u ch\u1ee9ng c\u1ee7a suy th\u1ea5t ph\u1ea3i th\u01b0\u1eddng \u0111\u00e1p \u1ee9ng v\u1edbi l\u1ee3i ti\u1ec3u v\u00e0 h\u1ea1n ch\u1ebf d\u1ecbch\/mu\u1ed1i.<\/li>\n
    • N\u1ebfu b\u1ec7nh van hai l\u00e1 \u0111\u1ed3ng m\u1eafc \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt v\u00e0 h\u1edf van ba l\u00e1 m\u1ee9c \u0111\u1ed9 nh\u1eb9 (v\u1edbi \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u00ecnh th\u01b0\u1eddng), t\u00ecnh tr\u1ea1ng h\u1edf van ba l\u00e1 sau m\u1ed5 th\u01b0\u1eddng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n do \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i gi\u1ea3m.<\/li>\n
    • T\u1ea1o h\u00ecnh v\u00f2ng van ba l\u00e1 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u1edf b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt van hai l\u00e1 k\u00e8m h\u1edf van ba l\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng ho\u1eb7c trung b\u00ecnh v\u00e0 c\u00f3 gi\u00e3n v\u00f2ng van ho\u1eb7c t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i.<\/li>\n
    • H\u1edf van ba l\u00e1 th\u1ee9 ph\u00e1t do b\u1ec7nh l\u00fd van tim (b\u1ec7nh Ebstein, carcinoid) c\u00f3 th\u1ec3 c\u1ea7n ph\u1ea3i thay van, \u01b0u ti\u00ean d\u00f9ng van sinh h\u1ecdc \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 huy\u1ebft kh\u1ed1i (tuy nhi\u00ean t \u1ef7 l\u1ec7 t\u1eed vong do ph\u0201u thu\u1eadt cao kho\u1ea3ng 15%).<\/li>\n<\/ul>\n

      2.H\u1eb9p van ba l\u00e1<\/strong><\/h2>\n

      2.1 Nguy\u00ean nh\u00e2n<\/h3>\n

      B\u1ec7nh th\u1ea5p tim (ph\u1ea7n l\u1edbn th\u01b0\u1eddng ph\u1ed1i h\u1ee3p v\u1edbi h\u1eb9p van hai l\u00e1), b\u1ea9m sinh, carcinoid, c\u1ea5y m\u00e1y t\u1ea1o nh\u1ecbp.<\/p>\n

      2.2 \u0110\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng<\/h3>\n

      C\u01a1 n\u0103ng<\/u><\/strong><\/p>\n

      M\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, ph\u00f9 ngo\u1ea1i vi.<\/p>\n

      Kh\u00e1m l\u00e2m s\u00e0ng<\/u><\/strong><\/p>\n

      Suy ki\u1ec7t, ph\u00f9, gan to, t\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i, ti\u1ebfng th\u1ed5i gi\u1eefa th\u00ec t\u00e2m tr\u01b0\u01a1ng \u1edf b\u1edd d\u01b0\u1edbi c\u1ea1nh \u1ee9c tr\u00e1i, t\u0103ng l\u00ean khi h\u00edt v\u00e0o.<\/p>\n

      2.3 C\u1eadn l\u00e2m s\u00e0ng<\/h3>\n
        \n
      • \u0110i\u1ec7n t\u00e2m \u0111\u1ed3: <\/strong>D\u1ea5u hi\u1ec7u gi\u00e3n nh\u0129 ph\u1ea3i (s\u00f3ng \u2018P’ cao DII, V1) nh\u01b0ng kh\u00f4ng c\u00f3 d\u00e0y th\u1ea5t ph\u1ea3i.<\/li>\n
      • X-quang ng\u1ef1c th\u1eb3ng: <\/strong>Nh\u0129 ph\u1ea3i l\u1edbn nh\u01b0ng k\u00edch th\u01b0\u1edbc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i b\u00ecnh th\u01b0\u1eddng.<\/li>\n
      • Si\u00eau \u00e2m tim: <\/strong>Si\u00eau \u00e2m 2D cho th\u1ea5y c\u00e1c l\u00e1 van d\u00e0y, m\u1edf h\u1ea1n ch\u1ebf. Si\u00eau \u00e2m Doppler li\u00ean t\u1ee5c d\u00f9ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n. H\u1eb9p van ba l\u00e1 n\u1eb7ng – di\u1ec7n t\u00edch van < 1,0 cm 2 . L\u01b0u \u00fd t\u00ecm h\u1eb9p van hai l\u00e1 k\u00e8m theo.<\/li>\n<\/ul>\n

        2.4 \u0110i\u1ec1u tr\u1ecb<\/h3>\n

        H\u1ea1n ch\u1ebf mu\u1ed1i v\u00e0 d\u00f9ng thu\u1ed1c l\u1ee3i ti\u1ec3u. N\u1ebfu ph\u0201u thu\u1eadt h\u1eb9p van hai l\u00e1 \u0111\u1ed3ng m\u1eafc \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u00ec c\u00f3 th\u1ec3 t\u1ea1o h\u00ecnh l\u1ea1i van ba l\u00e1 ho\u1eb7c thay van ba l\u00e1. Van ba l\u00e1 sinh h\u1ecdc cho k\u1ebft qu\u1ea3 t\u1ed1t h\u01a1n van c\u01a1 h\u1ecdc. Hi\u1ec7n nay c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c nong b\u00f3ng van ba l\u00e1 tuy nhi\u00ean v\u1ea5n \u0111\u1ec1 n\u00e0y c\u00f2n g\u00e2y nhi\u1ec1u tranh c\u00e3i.<\/p>\n

        3. K\u1ebft lu\u1eadn<\/h2>\n

        B\u1ec7nh l\u00fd van ba l\u00e1 l\u00e0 m\u1ed9t trong nh\u1eefng b\u1ec7nh l\u00fd tim m\u1ea1ch ph\u1ed5 bi\u1ebfn nh\u1ea5t tr\u00ean th\u1ebf gi\u1edbi, l\u00e0m t\u0103ng nguy c\u01a1 \u0111\u1ed9t qu\u1ef5, suy tim v\u00e0 t\u1eed vong. B\u1ec7nh l\u00fd n\u00e0y l\u00e0 do s\u1ef1 b\u1ea5t th\u01b0\u1eddng c\u1ee7a van ba l\u00e1, khi\u1ebfn cho van kh\u00f4ng \u0111\u00f3ng k\u00edn ho\u00e0n to\u00e0n v\u00e0 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn tr\u1edf ng\u1ea1i l\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u1eeb tim \u0111\u1ebfn c\u01a1 th\u1ec3.<\/p>\n

        C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh l\u00fd van ba l\u00e1 th\u01b0\u1eddng kh\u00f4ng r\u00f5 r\u00e0ng v\u00e0 kh\u00f3 ph\u00e1t hi\u1ec7n \u1edf giai \u0111o\u1ea1n \u0111\u1ea7u. Tuy nhi\u00ean, khi b\u1ec7nh ti\u1ebfn tri\u1ec3n, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 tr\u1ea3i qua c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ec7t m\u1ecfi, kh\u00f3 th\u1edf, \u0111au th\u1eaft ng\u1ef1c, ho\u1eb7c ch\u00f3ng m\u1eb7t.<\/p>\n

        \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n b\u1ec7nh l\u00fd van ba l\u00e1, ph\u01b0\u01a1ng ph\u00e1p si\u00eau \u00e2m tim \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ea7u tay.<\/p>\n

        \u0110i\u1ec1u tr\u1ecb cho b\u1ec7nh l\u00fd van ba l\u00e1 ph\u1ee5 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a b\u1ec7nh.\u00a0Vi\u1ec7c ph\u00f2ng ng\u1eeba b\u1ec7nh l\u00fd van ba l\u00e1 bao g\u1ed3m duy tr\u00ec m\u1ed9t l\u1ed1i s\u1ed1ng l\u00e0nh m\u1ea1nh, \u0103n u\u1ed1ng \u0111\u00fang c\u00e1ch v\u00e0 t\u1eadp th\u1ec3 d\u1ee5c th\u01b0\u1eddng xuy\u00ean. Ngo\u00e0i ra, \u0111i\u1ec1u quan tr\u1ecdng nh\u1ea5t l\u00e0 kh\u00e1m s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3 \u0111\u1ec3 ph\u00e1t hi\u1ec7n b\u1ec7nh s\u1edbm v\u00e0 ng\u0103n ng\u1eeba c\u00e1c bi\u1ebfn ch\u1ee9ng nguy hi\u1ec3m.<\/p>\n

         <\/p>\n","protected":false},"excerpt":{"rendered":"

        B\u1ec7nh van ba l\u00e1 bao g\u1ed3m: h\u1edf van ba l\u00e1 c\u01a1 n\u0103ng v\u00e0 h\u1edf van ba l\u00e1 th\u1ef1c th\u1ec3, h\u1eb9p van ba l\u00e1. \u0110\u00e2y l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng. Nguy\u00ean nh\u00e2n, \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng c\u0169ng nh\u01b0 \u0111i\u1ec1u tr\u1ecb c\u00f3 trong b\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y. Van ba l\u00e1 1.H\u1edf van […]<\/p>\n","protected":false},"author":7,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nB\u1ec7nh van ba l\u00e1 trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh van ba l\u00e1 bao g\u1ed3m: h\u1edf van ba l\u00e1 c\u01a1 n\u0103ng v\u00e0 h\u1edf van ba l\u00e1 th\u1ef1c th\u1ec3, h\u1eb9p van ba l\u00e1. \u0110\u00e2y l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng.\" \/>\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=\"B\u1ec7nh van ba l\u00e1 trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh van ba l\u00e1 bao g\u1ed3m: h\u1edf van ba l\u00e1 c\u01a1 n\u0103ng v\u00e0 h\u1edf van ba l\u00e1 th\u1ef1c th\u1ec3, h\u1eb9p van ba l\u00e1. \u0110\u00e2y l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-van-ba-la-trong-thuc-hanh-lam-sang\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-01T15:57:34+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/Tricuspid-Valve-FINAL-300x239.png\" \/>\n<meta name=\"author\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"L\u01b0\u01a1ng Vi\u1ebft T\u00e0i\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-van-ba-la-trong-thuc-hanh-lam-sang\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/01\/benh-van-ba-la-trong-thuc-hanh-lam-sang\/\",\"name\":\"B\u1ec7nh van ba l\u00e1 trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng - 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