{"id":30488,"date":"2023-05-02T22:13:35","date_gmt":"2023-05-02T15:13:35","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30488"},"modified":"2023-05-02T22:13:35","modified_gmt":"2023-05-02T15:13:35","slug":"can-lam-sang-2","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/02\/can-lam-sang-2\/","title":{"rendered":"C\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p"},"content":{"rendered":"

T\u1eafc \u0111\u1ed9ng <\/span><\/span>m\u1ea1ch chi d\u01b0\u1edbi<\/span><\/span><\/a> c\u1ea5p l\u00e0 b\u1ec7nh l\u00fd c\u00f3 th\u1ec3 nghi ng\u1edd ch\u1ec9 c\u1ea7n kh\u00e1m ph\u00e1 <\/span><\/span>\u00e2m thanh s\u1eb5n s\u00e0ng<\/span><\/span><\/em> . <\/span>C\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p gi\u00fap x\u00e1c \u0111\u1ecbnh ph\u1ecfng \u0111o\u00e1n c\u0169ng nh\u01b0 \u0111\u00e1nh gi\u00e1 \u0111\u1ecbnh m\u1ee9c, v\u1ecb tr\u00ed t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi, c\u00e1c bi\u1ebfn ch\u1ee9ng, b\u1ec7nh l\u00fd \u0111i k\u00e8m… Tuy nhi\u00ean, vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c th\u0103m d\u00f2 n\u00e0y kh\u00f4ng n\u00ean l\u00e0m ch\u1eadm tr\u1ec5 quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt cho b\u1ec7nh nh\u00e2n do nguy\u00ean c\u01a1 c\u1eaft c\u1ee5t chi v\u00e0 t\u1eed vong cao theo th\u1eddi gian. <\/span>C\u1ea7n c\u00f3 s\u1ef1 \u0111i\u1ec1u ph\u1ed1i h\u1ee3p l\u00fd th\u1eddi gian ti\u1ebfn h\u00e0nh c\u00e1c th\u0103m d\u00f2 n\u00e0y.<\/span><\/span><\/strong><\/p>\n

\"C\u1eadn
C\u1eadn l\u00e2m s\u00e0ng t\u00e1c \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p<\/figcaption><\/figure>\n

1. Si\u00eau \u00e2m Doppler m\u1ea1ch chi d\u01b0\u1edbi<\/span><\/span><\/h2>\n

1.1. Gi\u00e1 tr\u1ecb ph\u01b0\u01a1ng ph\u00e1p<\/span>:<\/span><\/span><\/h3>\n

Ch\u1ea9n \u0111o\u00e1n nhanh v\u1ecb tr\u00ed t\u1eafc m\u1ea1ch
\nC\u00f3 th\u1ec3 ti\u1ebfn h\u00e0nh ngay t\u1ea1i gi\u01b0\u1eddng.
\nPh\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi c\u1ea5p do huy\u1ebft kh\u1ed1i t\u1eeb xa hay huy\u1ebft kh\u1ed1i tr\u00ean n\u1ec1n x\u01a1 v\u1eefa.
\n\u0110\u00e1nh gi\u00e1 t\u01b0\u1edbi m\u00e1u chi \u0111o\u1ea1n xa.<\/p>\n

1.2. <\/span>H\u00ecnh \u1ea3nh si\u00eau \u00e2m c\u1ee7a t\u1eafc \u0111\u1ed9ng chi d\u01b0\u1edbi c\u1ea5p:<\/span><\/span><\/h3>\n


\n<\/em>Si\u00eau \u00e2m 2D: H\u00ecnh \u1ea3nh huy\u1ebft kh\u1ed1i gi\u1ea3m \u00e2m b\u00f9 \u0111\u1ea7y \u0111\u1ee7 l\u00f2ng m\u1ea1ch, m\u1ee9c \u0111\u1ed9 \u00e2m thanh \u0111\u1ed3ng nh\u1ea5t n\u1ebfu huy\u1ebft kh\u1ed1i t\u1eeb xa, kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t n\u1ebfu huy\u1ebft kh\u1ed1i tr\u00ean n\u1ec1n s\u01a1 s\u00e0i. <\/span>Tr\u00ean h\u00ecnh \u1ea3nh si\u00eau \u00e2m \u0111\u1ed9ng th\u1ea5y bi\u1ec3u t\u01b0\u1ee3ng rung l\u00ean c\u1ee7a ph\u1ea7n huy\u1ebft kh\u1ed1i ti\u1ebfp gi\u00e1p v\u1edbi l\u00f2ng m\u1ea1ch c\u00f2n l\u1ea1i ph\u00eda tr\u01b0\u1edbc. <\/span><\/span>
\nSi\u00eau \u00e2m Doppler: M\u1ea5t t\u00edn hi\u1ec7u Doppler m\u00e0u v\u00e0 xung \u0111\u1ed9t tr\u00ean \u0111o\u1ea1n m\u1ea1ch c\u00f3 xung huy\u1ebft to\u00e0n kh\u1ed1i. <\/span>Ph\u1ed5 Doppler ngay tr\u01b0\u1edbc v\u1ecb tr\u00ed t\u1eafc ngh\u1ebdn c\u00f3 d\u1ea1ng t\u0103ng s\u1ee9c c\u1ea3n v\u00e0 gi\u1ea3m t\u1ed1c \u0111\u1ed9. <\/span>Ph\u1ed5 Doppler sau v\u1ecb tr\u00ed t\u1eafc ngh\u1ebdn c\u00f3 d\u1ea1ng t\u0129nh m\u1ea1ch, ho\u1eb7c kh\u00f4ng ghi \u0111\u01b0\u1ee3c n\u1ebfu kh\u00f4ng\u00a0 <\/span><\/span>c\u00f3 tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7. <\/span><\/span>
\nKhi si\u00eau \u00e2m \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi, c\u1ea7n \u0111\u1eb7c bi\u1ec7t l\u01b0u \u00fd c\u00e1c v\u1ecb tr\u00ed t\u1ea1i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 B\u1ee5ng v\u00e0 \u0111\u1ed9ng m\u1ea1ch khoeo xem c\u00f3 v\u1eadt ch\u1ea5t g\u00e2y ra t\u00ecnh tr\u1ea1ng huy\u1ebft kh\u1ed1i hay kh\u00f4ng.<\/span><\/span><\/p>\n

2. Ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi qua da ho\u1eb7c ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh:<\/span><\/span><\/h2>\n

Tr\u1ee3 gi\u00fap ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh, cho ph\u00e9p x\u00e2y d\u1ef1ng h\u00ecnh c\u00e2y m\u1ea1ch m\u00e1u \u0111\u1ec3 \u0111\u1ecbnh h\u01b0\u1edbng cho ph\u1eabu thu\u1eadt v\u00e0 ph\u00e2n bi\u1ec7t t\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i t\u1eeb xa hay huy\u1ebft kh\u1ed1i t\u1ea1i ch\u1ed7: T\u1eafc m\u1ea1ch do huy\u1ebft kh\u1ed1i t\u1eeb xa cho th\u1ea5y h\u00ecnh \u1ea3nh c\u1eaft \u0111\u1ed9t <\/span><\/span>
\nng\u1ed9t , head tubing. <\/span>Huy\u1ebft kh\u1ed1i th\u01b0\u1eddng n\u1eb1m \u1edf v\u1ecb tr\u00ed ph\u00e2n nh\u00e1nh (nh\u01b0 \u0111\u1ed9ng m\u1ea1ch chung \u0111\u00f9i n\u1ed1i gi\u1eefa \u0111\u1ed9ng m\u1ea1ch n\u00f4ng v\u00e0 \u0111\u00f9i s\u00e2u, \u0111\u1ed9ng m\u1ea1ch khoeo, th\u00e2n m\u00e1c). <\/span>C\u00e1c m\u1ea1ch <\/span><\/span>
\nm\u00e1u kh\u00e1c th\u01b0\u1eddng kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u s\u01a1 s\u00e0i, tr\u1ee5c t\u1eafc. <\/span>Kh\u00f4ng nh\u00ecn th\u1ea5y tu\u1ea7n ho\u00e0n b\u00e0ng quan c\u1ea5p m\u00e1u cho \u0111o\u1ea1n xa. <\/span><\/span>
\nT\u1eafc m\u1ea1ch l\u00e0m huy\u1ebft kh\u1ed1i t\u1ea1i ch\u1ed7 th\u01b0\u1eddng th\u1ea5y h\u00ecnh \u1ea3nh c\u1eaft c\u00e1nh ho\u1eb7c h\u00ecnh n\u00f3n. <\/span>X\u01a1 bu\u00f4ng \u0111\u1ed9ng m\u1ea1ch lan t\u1ecfa v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n m\u1ea1nh m\u1ebd c\u1ee7a tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7.<\/span><\/span><\/p>\n

3. \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/span><\/span><\/h2>\n

\u0110\u00e1nh gi\u00e1 c\u00f3 rung nh\u0129 hay kh\u00f4ng. <\/span><\/span>
\nN\u1ebfu \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 l\u00e0 nh\u1ecbp xoang, m\u00e0 t\u1ed5n th\u01b0\u01a1ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p do huy\u1ebft kh\u1ed1i t\u1eeb xa, c\u1ea7n l\u00e0m \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 24h sau khi ph\u1eabu thu\u1eadt \u1ed5n \u0111\u1ecbnh \u0111\u1ec3 lo\u1ea1i tr\u1eeb rung t\u00e2m nh\u0129.<\/span><\/span><\/p>\n

4. Ki\u1ec3m tra m\u00e1u<\/span><\/span><\/h2>\n

X\u00e9t nghi\u1ec7m m\u00e1u d\u1ef1a v\u00e0o \u0111\u00e1nh gi\u00e1 c\u00e1c ch\u1ee9c n\u0103ng c\u01a1 b\u1ea3n, chu\u1ea9n b\u1ecb ph\u1eabu thu\u1eadt v\u00e0 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng nghi\u00eam tr\u1ecdng c\u1ee7a t\u1eafc m\u1ea1ch c\u1ea5p: C\u00f4ng th\u1ee9c m\u00e1u, \u0111\u00f4ng m\u00e1u c\u01a1 b\u1ea3n, HIV, Vi\u00eam gan B, C, sinh h\u00f3a m\u00e1u c\u01a1 b\u1ea3n ( \u0111i\u1ec7n gi\u1ea3i, men creatine phosphokinase, creatinin m\u00e1u, CRP). <\/span><\/span>
\nTh\u1eed nghi\u1ec7m m\u00e1u \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n: M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n t\u0103ng th\u00eam kh\u00e1ng th\u1ec3 kh\u00e1ng nh\u00e2n, \u0111\u1ecbnh l\u01b0\u1ee3ng protein C, protein S, antithrombin III, beta2- glycoprotein, kh\u00e1ng th\u1ec3 kh\u00e1ng cardiolipin, \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00f4ng.<\/span><\/span><\/p>\n

 <\/p>\n

5. Vai tr\u00f2 c\u1eadn l\u00e2m s\u00e0ng<\/span><\/span><\/h2>\n
    \n
  • X\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed v\u00e0 \u0111\u1ecbnh m\u1ee9c quy t\u1eafc \u0111\u1ed9ng m\u1ea1ch: <\/span><\/span>
    \nC\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u1eadn l\u00e2m s\u00e0ng nh\u01b0 x-quang chi d\u01b0\u1edbi, si\u00eau \u00e2m Doppler m\u1ea1ch m\u00e1u chi d\u01b0\u1edbi, CT scan chi d\u01b0\u1edbi v\u00e0 \u0111o \u00e1p su\u1ea5t m\u1ea1ch gi\u00fap x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed v\u00e0 \u0111\u1ecbnh m\u1ee9c t\u1eafc ngh\u1ebdn m\u1ea1ch. <\/span>Vi\u1ec7c x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed ch\u00ednh x\u00e1c v\u00e0 m\u1ee9c \u0111\u1ed9 t\u1eafc \u0111\u1ed9ng m\u1ea1ch l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 \u0111\u01b0a ra ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c bi\u1ebfn ch\u1ee9ng.<\/span><\/span><\/li>\n
  • \u0110\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u00ednh to\u00e1n c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb: <\/span><\/span>
    \nC\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u1eadn l\u00e2m s\u00e0ng s\u1eb5n s\u00e0ng gi\u00fap \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u00ednh to\u00e1n c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb nh\u01b0 d\u00f9ng thu\u1ed1c gi\u00e3n m\u1ea1ch, oxy h\u00f3a m\u00e1u, \u0111\u1eb7t stent hay ph\u1eabu thu\u1eadt. <\/span>Vi\u1ec7c \u0111\u00e1nh gi\u00e1 n\u00e0y gi\u00fap c\u00e1c b\u00e1c s\u0129 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p nh\u1ea5t v\u00e0 gi\u1ea3m thi\u1ec3u c\u00e1c r\u1ee7i ro v\u00e0 bi\u1ebfn ch\u1ee9ng.<\/span><\/span><\/li>\n
  • Gi\u00fap quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt n\u1ebfu c\u1ea7n thi\u1ebft: <\/span><\/span>
    \nN\u1ebfu c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1c kh\u00f4ng hi\u1ec7u qu\u1ea3, ph\u1eabu thu\u1eadt c\u00f3 th\u1ec3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p cu\u1ed1i c\u00f9ng \u0111\u1ec3 c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n. <\/span>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u1eadn l\u00e2m s\u00e0ng gi\u00fap \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u00ednh to\u00e1n c\u1ee7a ph\u1eabu thu\u1eadt v\u00e0 gi\u00fap c\u00e1c b\u00e1c s\u0129 quy\u1ebft \u0111\u1ecbnh li\u1ec7u tr\u00ecnh ph\u1eabu thu\u1eadt c\u00f3 ph\u00f9 h\u1ee3p v\u1edbi b\u1ec7nh nh\u00e2n hay kh\u00f4ng.<\/span><\/span><\/li>\n<\/ul>\n

    6. K\u1ebft lu\u1eadn<\/span><\/span><\/h2>\n

    T\u00f3m l\u1ea1i, c\u1eadn l\u00e2m s\u00e0ng l\u00e0 m\u1ed9t b\u01b0\u1edbc quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh nghi ng\u1edd v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1eafc h\u1ec7 th\u1ed1ng chi d\u01b0\u1edbi c\u1ea5p t\u00ednh. <\/span>Nh\u1edd c\u00e1c ph\u01b0\u01a1ng ph\u00e1p c\u1eadn l\u00e2m s\u00e0ng nh\u01b0 x-quang chi d\u01b0\u1edbi, si\u00eau \u00e2m Doppler m\u1ea1ch m\u00e1u chi d\u01b0\u1edbi, CT scan chi d\u01b0\u1edbi \u0111\u1ec3 c\u00e1c b\u00e1c s\u0129 c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh v\u1ecb tr\u00ed v\u00e0 quy t\u1eafc \u0111\u1ed9ng m\u1ea1ch, \u0111\u00e1nh gi\u00e1 kh\u1ea3 n\u0103ng t\u00ednh to\u00e1n c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u00e1p \u0111i\u1ec1u tr\u1ecb v\u00e0 quy\u1ebft \u0111\u1ecbnh ph\u1eabu thu\u1eadt n\u1ebfu c\u1ea7n thi\u1ebft.<\/span><\/span><\/p>\n

    Vi\u1ec7c s\u1eed d\u1ee5ng \u0111\u00fang c\u00e1c ph\u01b0\u01a1ng ph\u00e1p l\u00e2m s\u00e0ng gi\u00fap \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh c\u1eadn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb ch\u00ednh x\u00e1c, t\u1eeb \u0111\u00f3 gi\u00fap c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe v\u00e0 gi\u1ea3m thi\u1ec3u t\u1eed vong c\u1ee7a b\u1ec7nh nh\u00e2n. <\/span>Do \u0111\u00f3, vi\u1ec7c \u00e1p d\u1ee5ng c\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p \u0111\u00fang c\u00e1ch l\u00e0 v\u00f4 c\u00f9ng quan tr\u1ecdng trong qu\u00e1 tr\u00ecnh nghi ng\u1edd v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p t\u00ednh.<\/span><\/span><\/p>\n

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

    T\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p l\u00e0 b\u1ec7nh l\u00fd c\u00f3 th\u1ec3 nghi ng\u1edd ch\u1ec9 c\u1ea7n kh\u00e1m ph\u00e1 \u00e2m thanh s\u1eb5n s\u00e0ng . C\u00e1c th\u0103m d\u00f2 c\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p gi\u00fap x\u00e1c \u0111\u1ecbnh ph\u1ecfng \u0111o\u00e1n c\u0169ng nh\u01b0 \u0111\u00e1nh gi\u00e1 \u0111\u1ecbnh m\u1ee9c, v\u1ecb tr\u00ed t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi, c\u00e1c bi\u1ebfn ch\u1ee9ng, […]<\/p>\n","protected":false},"author":25,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nC\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p - Vinmec<\/title>\n<meta name=\"description\" content=\"C\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p gi\u00fap kh\u1eb3ng ch\u1ea9n \u0111o\u00e1n \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9, v\u1ecb tr\u00ed t\u1eafc, c\u00e1c bi\u1ebfn ch\u1ee9ng, b\u1ec7nh l\u00fd \u0111i k\u00e8m.\" \/>\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=\"C\u1eadn l\u00e2m s\u00e0ng t\u1eafc \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi c\u1ea5p - 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