{"id":30470,"date":"2023-05-03T15:09:59","date_gmt":"2023-05-03T08:09:59","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30470"},"modified":"2023-05-03T15:09:59","modified_gmt":"2023-05-03T08:09:59","slug":"kham-lam-sang-he-mach-mau-ngoai-vi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/kham-lam-sang-he-mach-mau-ngoai-vi\/","title":{"rendered":"Kh\u00e1m l\u00e2m s\u00e0ng h\u1ec7 m\u1ea1ch m\u00e1u ngo\u1ea1i vi"},"content":{"rendered":"

M\u1ea1ch m\u00e1u \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n<\/a>, bao g\u1ed3m h\u1ec7 \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch, mao m\u1ea1ch v\u00e0 m\u1ea1ch b\u1ea1ch huy\u1ebft. \u0110\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch v\u00e0 b\u1ea1ch m\u1ea1ch c\u00f3 m\u1eb7t \u1edf kh\u1eafp n\u01a1i trong c\u01a1 th\u1ec3, v\u00ec v\u1eady, b\u1ec7nh m\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf b\u1ea5t k\u1ef3 m\u1ed9t b\u1ed9 ph\u1eadn n\u00e0o<\/strong>.<\/em><\/p>\n

\"\"<\/p>\n

H\u1ec7 m\u1ea1ch m\u00e1u ngo\u1ea1i bi\u00ean v\u00e0 b\u1ec7nh l\u00fd<\/strong><\/p>\n

1. H\u1ec7 \u0111\u1ed9ng m\u1ea1ch<\/h2>\n

1.1 H\u1ecfi b\u1ec7nh<\/strong><\/h3>\n

Trong ti\u1ec1n s\u1eed c\u1ea7n t\u1eadp trung khai th\u00e1c c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch<\/em><\/strong>.<\/p>\n

B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi: <\/strong>Tri\u1ec7u ch\u1ee9ng \u1edf chi d\u01b0\u1edbi li\u00ean quan \u0111\u1ebfn g\u1eafng s\u1ee9c (\u0111au c\u00e1ch h\u1ed3i \u0111i\u1ec3n h\u00ecnh ho\u1eb7c kh\u00f4ng \u0111i\u1ec3n h\u00ecnh) ho\u1eb7c \u0111au khi ngh\u1ec9 do gi\u1ea3m t\u01b0\u1edbi m\u00e1u. Khai th\u00e1c v\u1ecb tr\u00ed \u0111au \u0111\u1ea7u ti\u00ean: V\u00f9ng m\u00f4ng, ch\u1eadu h\u00f4ng, \u0111\u00f9i, b\u1eafp ch\u00e2n, b\u00e0n ch\u00e2n. T\u00ednh ch\u1ea5t \u0111au li\u00ean quan \u0111\u1ebfn m\u1ee9c \u0111\u1ed9 g\u1eafng s\u1ee9c v\u00e0 qu\u00e3ng \u0111\u01b0\u1eddng \u0111i \u0111\u01b0\u1ee3c.<\/p>\n

B\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh: <\/strong>Ti\u1ec1n s\u1eed \u0111\u1ed9t qu\u1ef5 v\u00e0\/ho\u1eb7c tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o tho\u00e1ng qua (tri\u1ec7u ch\u1ee9ng xu\u1ea5t hi\u1ec7n v\u00e0 bi\u1ebfn m\u1ea5t trong v\u00f2ng 24 gi\u1edd).<\/p>\n

B\u1ec7nh l\u00fd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng: <\/strong>\u0110a s\u1ed1 b\u1ec7nh nh\u00e2n ph\u00ecnh \u0110M ch\u1ee7 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng. \u0110au b\u1ee5ng v\u00e0\/ho\u1eb7c ng\u1ef1c, l\u01b0ng l\u00e0 d\u1ea5u hi\u1ec7u \u0111e d\u1ecda v\u1ee1 ph\u00ecnh. C\u1ea7n h\u1ecfi ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ph\u00ecnh \u0110M ch\u1ee7 b\u1ee5ng.<\/p>\n

1.2 Kh\u00e1m l\u00e2m s\u00e0ng<\/h3>\n

1.2.1 Quan s\u00e1t<\/strong><\/h4>\n
    \n
  • \u0110\u1ed9 l\u1edbn c\u1ee7a chi<\/em>: Chi c\u00f3 th\u1ec3 teo nh\u1ecf trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh.<\/li>\n
  • M\u00e0u s\u1eafc da \u1edf chi<\/em>: B\u00ecnh th\u01b0\u1eddng m\u00e0u v\u00e0ng nh\u1ea1t. N\u1ebfu da t\u00edm v\u00e0 nh\u1ee3t, s\u1edd v\u00e0o th\u1ea5y l\u1ea1nh ch\u1ee9ng t\u1ecf tu\u1ea7n ho\u00e0n k\u00e9m l\u01b0u th\u00f4ng, chi b\u1ecb thi\u1ec3u d\u01b0\u1ee1ng.<\/li>\n<\/ul>\n

    Ph\u00e1t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u thi\u1ec3u d\u01b0\u1ee1ng do b\u1ecb thi\u1ebfu m\u00e1u t\u1ea1i ch\u1ed7, ch\u1ee7 y\u1ebfu \u1edf \u0111\u1ea7u chi:<\/strong><\/p>\n

      \n
    • M\u00f3ng kh\u00f4 d\u1ec5 r\u1ee5ng, r\u1ee5ng l\u00f4ng, lo\u00e9t, ho\u1ea1i t\u1eed \u0111\u1ea7u chi, r\u1ee5ng ng\u00f3n.<\/li>\n<\/ul>\n

      1.2.2 S\u1edd v\u00e0 b\u1eaft m\u1ea1ch<\/h4>\n
        \n
      • Nhi\u1ec7t \u0111\u1ed9 da \u1edf chi<\/em>: N\u1ebfu da l\u1ea1nh l\u00e0 do tu\u1ea7n ho\u00e0n \u0111\u1ed9ng m\u1ea1ch k\u00e9m. Da c\u00f3 th\u1ec3 n\u00f3ng trong tr\u01b0\u1eddng h\u1ee3p ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch, ch\u1ee9ng \u0111\u1ecf \u0111au \u0111\u1ea7u chi, th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch.<\/li>\n
      • B\u1eaft m\u1ea1ch<\/em>: D\u00f9ng \u0111\u1ea7u c\u00e1c ng\u00f3n tay 2, 3, 4 \u0111\u1eb7t v\u00e0o r\u00e3nh \u0111\u1ed9ng m\u1ea1ch \u0111\u1ec3 b\u1eaft m\u1ea1ch, t\u1eeb g\u1ed1c \u0111\u1ebfn ng\u1ecdn chi, \u0111\u1ed1i x\u1ee9ng hai b\u00ean. \u0110\u1ed9ng m\u1ea1ch chi tr\u00ean g\u1ed3m \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n, n\u00e1ch, c\u00e1nh tay, quay v\u00e0 tr\u1ee5. \u0110\u1ed1i v\u1edbi c\u00e1c \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi, c\u1ea7n b\u1eaft m\u1ea1ch \u0111\u00f9i (th\u01b0\u1eddng \u1edf n\u1ebfp l\u1eb1n b\u1eb9n), khoeo, ch\u00e0y sau, mu ch\u00e2n, m\u00e1c.<\/li>\n
      • Nh\u1eadn \u0111\u1ecbnh khi b\u1eaft m\u1ea1ch<\/em>: T\u1ea7n s\u1ed1, nh\u1ecbp, so s\u00e1nh v\u1edbi nh\u1ecbp tim; bi\u00ean \u0111\u1ed9 m\u1ea1ch \u0111\u1eadp v\u00e0 \u0111\u1ed9 c\u1ee9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch; lo\u1ea1i m\u1ea1ch: Ph\u1ea3n \u00e1nh t\u1ed1c \u0111\u1ed9 thay \u0111\u1ed5i \u00e1p su\u1ea5t m\u1ea1ch nhanh hay ch\u1eadm.<\/li>\n
      • Kh\u00e1m \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng<\/em>: S\u1edd \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, d\u01b0\u1edbi d\u1ea1ng m\u1ed9t kh\u1ed1i ph\u00ecnh lan r\u1ed9ng, \u1edf v\u1ecb tr\u00ed d\u1ecdc theo \u0111\u01b0\u1eddng \u0111i c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, kh\u00f4ng di \u0111\u1ed9ng, \u0111\u1eadp theo nh\u1ecbp tim, \u1ea5n nh\u1eb9 kh\u00f4ng \u0111au. Kh\u00f4ng \u0111\u01b0\u1ee3c \u1ea5n\/n\u1eafn n\u1ebfu ng\u01b0\u1eddi b\u1ec7nh c\u00f3 kh\u1ed1i ph\u00ecnh k\u00e8m theo \u0111au \u1edf v\u00f9ng b\u1ee5ng, th\u1eaft l\u01b0ng.<\/li>\n
      • D\u1ea5u hi\u1ec7u De Bakey d\u01b0\u01a1ng t\u00ednh (c\u00f2n \u0111\u01b0a \u0111\u01b0\u1ee3c b\u00e0n tay v\u00e0o d\u01b0\u1edbi s\u01b0\u1eddn \u0111\u1ec3 th\u1ea5y c\u1ef1c tr\u00ean c\u1ee7a kh\u1ed1i ph\u00ecnh) gi\u00fap g\u1ee3i \u00fd kh\u1ed1i ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 \u1edf v\u1ecb tr\u00ed d\u01b0\u1edbi ch\u1ed7 chia \u0111\u1ed9ng m\u1ea1ch th\u1eadn.<\/li>\n<\/ul>\n

        1.2.3 Nghe<\/h4>\n
          \n
        • V\u1ecb tr\u00ed<\/em>: C\u00e1c \u0111\u1ed9ng m\u1ea1ch c\u00f3 k\u00edch th\u01b0\u1edbc l\u1edbn nh\u01b0 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh, d\u01b0\u1edbi \u0111\u00f2n, \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i, \u0111\u1ed9ng m\u1ea1ch c\u00e1nh tay.<\/li>\n
        • B\u00ecnh th\u01b0\u1eddng, \u0111\u1eb7t \u1ed1ng nghe l\u00ean \u0111\u1ed9ng m\u1ea1ch v\u00e0 h\u01a1i \u0111\u00e8 nh\u1eb9 \u1ed1ng nghe c\u00f3 th\u1ec3 nghe \u0111\u01b0\u1ee3c 1 ti\u1ebfng nh\u1ecf \u1edf th\u00ec t\u00e2m thu, ri\u00eang \u1edf c\u00e1c \u0111\u1ed9ng m\u1ea1ch g\u1ea7n tim nh\u01b0 c\u00e1c \u0111\u1ed9ng m\u1ea1ch ch\u1ee7, c\u1ea3nh, d\u01b0\u1edbi \u0111\u00f2n c\u00f2n nghe \u0111\u01b0\u1ee3c ti\u1ebfng th\u1ee9 hai l\u00e0 ti\u1ebfng lan c\u1ee7a ti\u1ebfng tim th\u1ee9 hai (T2).<\/li>\n
        • S\u1ef1 xu\u1ea5t hi\u1ec7n ti\u1ebfng th\u1ed5i ph\u1ea3n \u00e1nh s\u1ef1 t\u0103ng t\u1ed1c c\u1ee7a d\u00f2ng ch\u1ea3y do h\u1eb9p \u0111\u1ed9ng m\u1ea1ch. Nghe \u0110M ch\u1ee7 b\u1ee5ng ph\u00eda tr\u00ean v\u00e0 xung quanh r\u1ed1n, c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n th\u1ea5y th\u1ed5i t\u00e2m thu.<\/li>\n
        • Ti\u1ebfng th\u1ed5i l\u00e0 sinh l\u00fd n\u1ebfu th\u00e0nh b\u1ee5ng b\u1ec7nh nh\u00e2n m\u1ecfng v\u00e0\/ho\u1eb7c \u1ea5n m\u1ea1nh \u1ed1ng nghe.<\/li>\n<\/ul>\n
            \n
          • Ti\u1ebfng th\u1ed5i b\u1ec7nh l\u00fd g\u1eb7p trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p:<\/li>\n<\/ul>\n

            Ph\u00ecnh \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng c\u00f3 huy\u1ebft kh\u1ed1i g\u00e2y h\u1eb9p.<\/p>\n

            H\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng v\u00e0\/ho\u1eb7c c\u00e1c nh\u00e1nh do x\u01a1 v\u1eefa \u1edf ng\u01b0\u1eddi l\u1edbn tu\u1ed5i. Do vi\u00eam \u1edf ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i (Takayasu, giang mai.).<\/p>\n

            T\u0103ng cung l\u01b0\u1ee3ng tim (Basedow, c\u01b0\u1eddng giao c\u1ea3m.).<\/p>\n

            1.3 V\u1ebd s\u01a1 \u0111\u1ed3 \u0111\u1ed9ng m\u1ea1ch<\/h3>\n

            V\u1ebd s\u01a1 \u0111\u1ed3 \u0111\u1ed9ng m\u1ea1ch chi tr\u00ean – chi d\u01b0\u1edbi sau khi k\u1ebft th\u00fac kh\u00e1m \u0111\u1ed9ng m\u1ea1ch, v\u00e0 \u0111\u00e1nh d\u1ea5u v\u00e0o c\u00e1c v\u1ecb tr\u00ed kh\u00e1m m\u1ea1ch theo quy \u01b0\u1edbc.<\/p>\n

            2. H\u1ec7 t\u0129nh m\u1ea1ch v\u00e0 m\u1ea1ch b\u1ea1ch huy\u1ebft<\/h2>\n

            2.1 H\u1ecfi b\u1ec7nh<\/strong><\/h3>\n

            Khai th\u00e1c c\u00e1c tri\u1ec7u ch\u1ee9ng ch\u00ednh:<\/p>\n

              \n
            • Ph\u00f9 chi d\u01b0\u1edbi, nh\u1ea5t l\u00e0 m\u1ed9t b\u00ean.<\/li>\n
            • \u0110au chi d\u01b0\u1edbi: S\u01b0ng \u0111au c\u1ea5p t\u00ednh, ho\u1eb7c \u0111au, n\u1eb7ng chi d\u01b0\u1edbi t\u0103ng l\u00ean v\u00e0o cu\u1ed1i ng\u00e0y.<\/li>\n
            • Lo\u00e9t chi d\u01b0\u1edbi, vi\u00eam qu\u1ea7ng, r\u1ed1i lo\u1ea1n s\u1eafc t\u1ed1 chi d\u01b0\u1edbi. Tri\u1ec7u ch\u1ee9ng kh\u00e1c: T\u00ea b\u00ec, ki\u1ebfn b\u00f2, chu\u1ed9t r\u00fat.<\/li>\n
            • B\u1ec7nh nh\u00e2n nghi ng\u1edd thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch: H\u1ecfi v\u1ec1 c\u00e1c y\u1ebfu t\u1ed1 thu\u1eadn l\u1ee3i (sau \u0111\u1ebb, sau m\u1ed5, b\u1ea5t \u0111\u1ed9ng k\u00e9o d\u00e0i, ti\u1ec1n s\u1eed d\u00f9ng thu\u1ed1c tr\u00e1nh thai v\u1edbi ph\u1ee5 n\u1eef.), b\u1ec7nh l\u00fd d\u0201n \u0111\u1ebfn t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00f4ng (h\u1ed9i ch\u1ee9ng th\u1eadn h\u01b0, b\u1ec7nh h\u1ec7 th\u1ed1ng, ung th\u01b0.), ti\u1ec1n s\u1eed gia \u0111\u00ecnh thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i.<\/li>\n<\/ul>\n

              2.2 Kh\u00e1m l\u00e2m s\u00e0ng<\/h3>\n

              2.2.1 Quan s\u00e1t<\/strong><\/h4>\n

              Ph\u00e1t hi\u1ec7n c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a suy t\u0129nh m\u1ea1ch m\u1ea1n t\u00ednh chi d\u01b0\u1edbi theo t\u1eebng giai \u0111o\u1ea1n b\u1ec7nh: \u0110\u00e1m gi\u00e3n t\u0129nh m\u1ea1ch m\u1ea1ng nh\u1ec7n, ho\u1eb7c b\u00fai gi\u00e3n t\u0129nh m\u1ea1ch n\u1ed5i ngo\u1eb1n ngo\u00e8o, vi\u00eam da s\u1eafc t\u1ed1, th\u1eadm ch\u00ed lo\u00e9t chi d\u01b0\u1edbi (th\u01b0\u1eddng \u1edf v\u1ecb tr\u00ed quanh m\u1eaft c\u00e1).<\/p>\n

              Ph\u00e1t hi\u1ec7n tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau:<\/p>\n

                \n
              • Tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 c\u1eeda – ch\u1ee7: <\/em>G\u1eb7p trong b\u1ec7nh x\u01a1 gan, m\u00e1u trong t\u0129nh m\u1ea1ch c\u1eeda \u1ee9 l\u1ea1i \u0111i v\u00e0o c\u00e1c nh\u00e1nh ph\u1ee5 \u0111\u1ec3 \u0111\u1ed5 v\u00e0o t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean hay ch\u1ee7 d\u01b0\u1edbi.<\/li>\n
              • Tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 ch\u1ee7 – ch\u1ee7: <\/em>G\u1eb7p trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p ch\u00e8n \u00e9p ho\u1eb7c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi, c\u00e1c nh\u00e1nh t\u0129nh m\u1ea1ch n\u00f4ng xu\u1ea5t hi\u1ec7n \u1edf b\u00ean b\u1eb9n, hai b\u00ean b\u1ee5ng d\u01b0\u1edbi \u0111i ng\u01b0\u1ee3c l\u00ean tr\u00ean.<\/li>\n
              • Tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 ch\u1ee7 tr\u00ean: <\/em>G\u1eb7p trong h\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p trung th\u1ea5t, t\u0129nh m\u1ea1ch ch\u1ee7 tr\u00ean b\u1ecb \u0111\u00e8 \u00e9p, m\u00e1u \u0111\u1ed5 v\u00e0o tim ph\u1ea3i qua c\u00e1c nh\u00e1nh ph\u1ee5. Tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 xu\u1ea5t hi\u1ec7n \u1edf ng\u1ef1c, ch\u1ee7 y\u1ebfu b\u00ean ph\u1ea3i, c\u00f3 th\u1ec3 k\u00e8m theo ph\u00f9 \u00e1o kho\u00e1c, t\u0129nh m\u1ea1ch c\u1ea3nh n\u1ed5i to.<\/li>\n<\/ul>\n

                2.2.2 S\u1edd, b\u1eaft m\u1ea1ch<\/h4>\n

                Ph\u00e1t hi\u1ec7n b\u00fai gi\u00e3n t\u0129nh m\u1ea1ch n\u00f4ng: Gi\u00e3n t\u0129nh m\u1ea1ch th\u1eebng tinh, suy t\u0129nh m\u1ea1ch n\u00f4ng chi d\u01b0\u1edbi. N\u1ebfu s\u1edd v\u00e0o b\u00fai gi\u00e3n t\u0129nh m\u1ea1ch th\u1ea5y c\u1ee9ng, \u1ea5n \u0111au, th\u00ec c\u00f3 kh\u1ea3 n\u0103ng \u0111\u00e3 h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch n\u00f4ng trong l\u00f2ng b\u00fai.<\/p>\n

                Rung miu n\u1ebfu c\u00f3 th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch.<\/p>\n

                Tr\u01b0\u1eddng h\u1ee3p b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u chi d\u01b0\u1edbi: B\u00ean chi b\u1ecb huy\u1ebft kh\u1ed1i to h\u01a1n b\u00ean l\u00e0nh, s\u1edd th\u1ea5y n\u00f3ng, \u1ea5n \u0111au, t\u0103ng tr\u01b0\u01a1ng l\u1ef1c c\u01a1.<\/p>\n

                \u0110o \u0111\u01b0\u1eddng k\u00ednh chi d\u01b0\u1edbi v\u00e0 so s\u00e1nh hai b\u00ean: Th\u01b0\u1eddng \u0111o \u1edf 3 v\u1ecb tr\u00ed: Gi\u1eefa \u0111\u00f9i, gi\u1eefa b\u1eafp ch\u00e2n (d\u01b0\u1edbi l\u1ed3i ch\u00e0y 10 cm) v\u00e0 c\u1ed5 ch\u00e2n.<\/p>\n

                2.2.3 Nghe<\/h4>\n

                Ch\u1ec9 nghe khi nghi ng\u1edd c\u00f3 th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch, ph\u00e1t hi\u1ec7n ti\u1ebfng th\u1ed5i li\u00ean t\u1ee5c \u1edf g\u1ea7n ch\u1ed7 th\u00f4ng.<\/p>\n

                  \n
                • M\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u v\u00e0 nghi\u1ec7m ph\u00e1p<\/li>\n<\/ul>\n
                    \n
                  • Nghi\u1ec7m ph\u00e1p Schwartz hay Trendelenburg kh\u00e1m t\u0129nh m\u1ea1ch n\u00f4ng chi d\u01b0\u1edbi \u0111\u1ec3 ph\u00e1t hi\u1ec7n d\u00f2ng tr\u00e0o ng\u01b0\u1ee3c b\u1ec7nh l\u00fd: Hi\u1ec7n kh\u00f4ng c\u00f2n khuy\u1ebfn c\u00e1o \u00e1p d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng.<\/li>\n
                  • D\u1ea5u hi\u1ec7u Homans ph\u00e1t hi\u1ec7n s\u1edbm huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u: Ch\u00e2n \u0111au khi s\u1edd, t\u0103ng l\u00ean khi g\u1ea5p m\u1eb7t mu c\u1ee7a b\u00e0n ch\u00e2n v\u00e0o c\u1eb3ng ch\u00e2n.<\/li>\n
                  • D\u1ea5u hi\u1ec7u Stemmer: L\u00e0 bi\u1ec3u hi\u1ec7n \u0111\u1eb7c tr\u01b0ng c\u1ee7a ph\u00f9 b\u1ea1ch m\u1ea1ch. \u0110\u00f3 l\u00e0 d\u00e0y n\u1ebfp v\u00e9o da \u1edf g\u1ed1c ng\u00f3n tay ho\u1eb7c ng\u00f3n ch\u00e2n th\u1ee9 hai.<\/li>\n<\/ul>\n

                    2.3 M\u1ed9t s\u1ed1 h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n v\u1eadn m\u1ea1ch \u0111\u1ea7u chi<\/h3>\n

                    2.3.1 Hi\u1ec7n t\u01b0\u1ee3ng Raynaud<\/strong><\/h4>\n

                    Hi\u1ec7n t\u01b0\u1ee3ng Raynaud x\u1ea3y ra khi ng\u01b0\u1eddi b\u1ec7nh ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t \u0111\u1ed9 l\u1ea1nh, bi\u1ec3u hi\u1ec7n \u1edf c\u00e1c ng\u00f3n v\u00e0 b\u00e0n tay, \u0111\u00f4i khi \u1edf c\u1ea3 ng\u00f3n ch\u00e2n, m\u0169i v\u00e0 tai, di\u1ec5n bi\u1ebfn theo 3 giai \u0111o\u1ea1n:<\/p>\n

                      \n
                    • Giai \u0111o\u1ea1n \u201c tr\u1eafng nh\u1ee3t <\/em>\u201d : Do co th\u1eaft ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch v\u00e0 c\u01a1 tr\u01a1n ti\u1ec1n mao m\u1ea1ch. C\u00e1c \u0111\u1ea7u ng\u00f3n tay, \u0111\u1eb7c bi\u1ec7t l\u00e0 hai \u0111\u1ed1t xa tr\u1eafng nh\u1ee3t, l\u1ea1nh v\u00e0 t\u00ea b\u00ec.<\/li>\n
                    • Giai \u0111o\u1ea1n \u201c xanh t\u00edm <\/em>\u201d : Do c\u00e1c ti\u1ec3u t\u0129nh m\u1ea1ch b\u1ecb \u1ee9 tr\u1ec7 v\u00ec kh\u00f4ng c\u00f3 l\u1ef1c \u0111\u1ea9y t\u1eeb m\u00e1u t\u1ea1i c\u00e1c mao m\u1ea1ch, n\u00ean c\u00e1c \u0111\u1ea7u ng\u00f3n xanh t\u00edm, \u0111au t\u1ee9c.<\/li>\n
                    • Giai \u0111o\u1ea1n \u201c \u0111\u1ecf\u201d <\/em>: Do m\u1edf c\u00e1c c\u01a1 tr\u01a1n ti\u1ec1n mao m\u1ea1ch v\u00e0 gi\u00e3n c\u00e1c ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch, m\u00e1u \u0111\u1ed5 v\u1ec1 m\u1ea1ng l\u01b0\u1edbi mao m\u1ea1ch, c\u00e1c \u0111\u1ea7u ng\u00f3n tr\u1edf n\u00ean n\u00f3ng \u0111\u1ecf.<\/li>\n
                    • M\u1ed9t s\u1ed1 nguy\u00ean nh\u00e2n g\u00e2y ra hi\u1ec7n t\u01b0\u1ee3ng Raynaud: B\u1ec7nh ch\u1ea5t t\u1ea1o keo (x\u01a1 c\u1ee9ng b\u00ec, lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng…), b\u1ec7nh m\u00e1u (t\u0103ng h\u1ed3ng c\u1ea7u, t\u0103ng ti\u1ec3u c\u1ea7u, r\u1ed1i lo\u1ea1n globulin m\u00e1u…), m\u1ed9t s\u1ed1 thu\u1ed1c (ch\u1eb9n beta giao c\u1ea3m, thu\u1ed1c nh\u00f3m macrolides, nh\u00f3m cyclin…).<\/li>\n<\/ul>\n

                      G\u1ecdi l\u00e0 b\u1ec7nh Raynaud n\u1ebfu kh\u00f4ng t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n.<\/p>\n

                      2.3.2. H\u1ed9i ch\u1ee9ng “\u0110\u1ecf – N\u00f3ng – \u0110au” \u0111\u1ea7u chi<\/h4>\n

                      Ng\u01b0\u1ee3c l\u1ea1i v\u1edbi hi\u1ec7n t\u01b0\u1ee3ng Raynaud. H\u1ed9i ch\u1ee9ng n\u00e0y l\u00e0 do gi\u00e3n ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch, h\u1eadu ti\u1ec3u \u0111\u1ed9ng m\u1ea1ch v\u00e0 mao m\u1ea1ch, x\u1ea3y ra do c\u01a1 th\u1ec3 ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t \u0111\u1ed9 cao. Th\u01b0\u1eddng th\u1ea5y \u1edf b\u00e0n ch\u00e2n h\u01a1n b\u00e0n tay v\u00e0 n\u1eb7ng l\u00ean khi ch\u00e2n bu\u00f4ng th\u00f5ng, b\u1ec7nh b\u1edbt khi c\u01a1 th\u1ec3 ti\u1ebfp x\u00fac v\u1edbi nhi\u1ec7t \u0111\u1ed9 th\u1ea5p, khi d\u00f9ng thu\u1ed1c aspirin.<\/p>\n

                      2.3.3 C\u00e1c h\u1ed9i ch\u1ee9ng v\u1eadn m\u1ea1ch tr\u01b0\u1eddng di\u1ec5n<\/h4>\n
                        \n
                      • T\u00edm \u0111\u1ea7u chi: <\/strong>Hay g\u1eb7p \u1edf ph\u1ee5 n\u1eef tr\u1ebb c\u00f3 r\u1ed1i lo\u1ea1n th\u1ea7n kinh th\u1ef1c v\u1eadt. C\u00e1c \u0111\u1ea7u ng\u00f3n, nh\u1ea5t l\u00e0 \u1edf tay th\u01b0\u1eddng xuy\u00ean xanh t\u00edm, l\u1ea1nh, d\u00ednh m\u1ed3 h\u00f4i. C\u00e1c m\u1ea1ch m\u00e1u n\u1ed9i t\u1ea1ng \u0111\u1ec1u b\u00ecnh th\u01b0\u1eddng.<\/li>\n
                      • M\u1ea1ng l\u01b0\u1edbi xanh t\u00edm (livedo reticularis): <\/strong>Hi\u1ec7n t\u01b0\u1ee3ng xanh t\u00edm nh\u01b0 \u1edf \u0111\u1ea7u chi, nh\u01b0ng xu\u1ea5t hi\u1ec7n \u1edf d\u01b0\u1edbi da. Th\u01b0\u1eddng g\u1eb7p \u1edf ph\u1ee5 n\u1eef, hay th\u1ea5y \u1edf chi d\u01b0\u1edbi h\u01a1n chi tr\u00ean, n\u1eb7ng l\u00ean khi ti\u1ebfp x\u00fac v\u1edbi l\u1ea1nh v\u00e0 \u1edf t\u01b0 th\u1ebf th\u00f5ng ch\u00e2n. Hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y c\u00f3 th\u1ec3 l\u00e0 b\u00ecnh th\u01b0\u1eddng, nh\u01b0ng c\u0169ng g\u1eb7p trong m\u1ed9t s\u1ed1 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1ch m\u00e1u, b\u1ec7nh ch\u1ea5t t\u1ea1o keo, nhi\u1ec5m tr\u00f9ng.<\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                        M\u1ea1ch m\u00e1u \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n, bao g\u1ed3m h\u1ec7 \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch, mao m\u1ea1ch v\u00e0 m\u1ea1ch b\u1ea1ch huy\u1ebft. \u0110\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch v\u00e0 b\u1ea1ch m\u1ea1ch c\u00f3 m\u1eb7t \u1edf kh\u1eafp n\u01a1i trong c\u01a1 th\u1ec3, v\u00ec v\u1eady, b\u1ec7nh m\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf b\u1ea5t k\u1ef3 m\u1ed9t b\u1ed9 ph\u1eadn […]<\/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":"\nKh\u00e1m l\u00e2m s\u00e0ng h\u1ec7 m\u1ea1ch m\u00e1u ngo\u1ea1i vi - Vinmec<\/title>\n<meta name=\"description\" content=\"M\u1ea1ch m\u00e1u \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong h\u1ec7 th\u1ed1ng tu\u1ea7n ho\u00e0n, bao g\u1ed3m h\u1ec7 \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch, mao m\u1ea1ch v\u00e0 m\u1ea1ch b\u1ea1ch huy\u1ebft.\" \/>\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=\"Kh\u00e1m l\u00e2m s\u00e0ng h\u1ec7 m\u1ea1ch m\u00e1u ngo\u1ea1i vi - 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