{"id":30610,"date":"2023-05-04T18:40:46","date_gmt":"2023-05-04T11:40:46","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30610"},"modified":"2023-05-04T18:40:46","modified_gmt":"2023-05-04T11:40:46","slug":"danh-gia-lam-sang-benh-nhan-di-tat-tim-bam-sinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/danh-gia-lam-sang-benh-nhan-di-tat-tim-bam-sinh\/","title":{"rendered":"\u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n d\u1ecb t\u1eadt tim b\u1ea9m sinh"},"content":{"rendered":"

D\u1ecb t\u1eadt tim b\u1ea9m sinh<\/a> (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 – 0,8% tr\u1ebb s\u01a1 sinh. T\u1ea1i Vi\u1ec7t Nam, c\u00f3 kho\u1ea3ng 10.000 tr\u1ebb s\u01a1 sinh m\u1eafc tim b\u1ea9m sinh m\u1ed7i n\u0103m.H\u1ea7u h\u1ebft nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt gi\u1ea3m nh\u1eb9 ho\u1eb7c ph\u0201u thu\u1eadt s\u1eeda ch\u1eefa.<\/strong><\/p>\n

\"D\u1ecb<\/p>\n

C\u00e1c v\u1ecb tr\u00ed d\u1ecb t\u1eadt tim b\u1ea9m sinh<\/strong><\/p>\n

1.T\u1ed5ng quan<\/h2>\n

V\u1edbi nh\u1eefng ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb, hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh tim b\u1ea9m sinh \u0111\u00e3 c\u1ea3i thi\u1ec7n \u0111\u00e1ng k\u1ec3, h\u01a1n 85% tr\u1ebb c\u00f3 b\u1ec7nh tim b\u1ea9m sinh c\u00f3 th\u1ec3 s\u1ed1ng \u0111\u1ebfn tu\u1ed5i v\u1ecb th\u00e0nh ni\u00ean v\u00e0 tr\u01b0\u1edfng th\u00e0nh, trong s\u1ed1 \u0111\u00f3 c\u00f3 c\u1ea3 nh\u1eefng b\u1ec7nh tim b\u1ea9m sinh t\u1ed5n th\u01b0\u01a1ng ph\u1ee9c t\u1ea1p. Nh\u1edd s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u0201u thu\u1eadt, can thi\u1ec7p v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa tim m\u1ea1ch nhi, s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh \u0111\u1ea1t \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh ng\u00e0y c\u00e0ng t\u0103ng l\u00ean. Ngo\u00e0i ra, nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh tim c\u1ea5u tr\u00fac ho\u1eb7c b\u1ec7nh van tim b\u1ea9m sinh ti\u1ebfn tri\u1ec3n t\u1eeb t\u1eeb, ch\u1ec9 bi\u1ec3u hi\u1ec7n mu\u1ed9n \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh.<\/p>\n

H\u1ea7u h\u1ebft nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt gi\u1ea3m nh\u1eb9 ho\u1eb7c ph\u0201u thu\u1eadt s\u1eeda ch\u1eefa. Nh\u01b0 v\u1eady, m\u1ed9t v\u1ea5n \u0111\u1ec1 \u0111\u00e1ng quan t\u00e2m trong nh\u00f3m b\u1ec7nh tim b\u1ea9m sinh b\u00ean c\u1ea1nh vi\u1ec7c ho\u00e0n thi\u1ec7n ph\u0201u thu\u1eadt, can thi\u1ec7p v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa tim m\u1ea1ch nhi ch\u00ednh l\u00e0 theo d\u00f5i chuy\u00ean khoa v\u00e0 qu\u1ea3n l\u00fd nh\u00f3m b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh ng\u01b0\u1eddi l\u1edbn sau khi \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt gi\u1ea3m nh\u1eb9\/s\u1eeda ch\u1eefa.<\/p>\n

2. Ti\u1ec1n s\u1eed<\/h2>\n
    \n
  • Ti\u1ec1n s\u1eed gia \u0111\u00ecnh c\u00f3 ng\u01b0\u1eddi b\u1ecb d\u1ecb t\u1eadt tim b\u1ea9m sinh ( TBS)<\/li>\n
  • M\u1eb9 ti\u1ebfp x\u00fac v\u1edbi \u0111\u1ed9c ch\u1ea5t khi mang thai. Trong qu\u00e1 tr\u00ecnh mang thai, m\u1eb9 ti\u1ebfp x\u00fac v\u1edbi c\u00e1c h\u00f3a ch\u1ea5t \u0111\u1ed9c h\u1ea1i c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u1ee9a tr\u1ebb.<\/li>\n
  • Nghi ng\u1edd b\u1ecb tim b\u1ea9m sinh khi ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc sinh ho\u1eb7c khi sinh (h\u1ecfi ng\u01b0\u1eddi m\u1eb9) Ti\u1ec1n s\u1eed l\u00fac nh\u1ecf vi\u00eam ph\u1ed5i nhi\u1ec1u \u0111\u1ee3t<\/li>\n
  • Ph\u0201u thu\u1eadt ho\u1eb7c can thi\u1ec7p tim tr\u01b0\u1edbc \u0111\u00e2y; ho\u1eb7c t\u00ean c\u1ee7a b\u00e1c s\u1ef9 tim m\u1ea1ch nhi, ph\u0201u thu\u1eadt vi\u00ean, \u0111\u01a1n v\u1ecb ph\u0201u thu\u1eadt trong tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng nh\u1edb \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c t\u00ean th\u1ee7 thu\u1eadt\/ph\u0201u thu\u1eadt<\/li>\n
  • V\u1ec7 sinh r\u0103ng mi\u1ec7ng<\/li>\n
  • H\u00fat thu\u1ed1c l\u00e1\/ma t\u00fay, u\u1ed1ng r\u01b0\u1ee3u<\/li>\n<\/ul>\n

    3. Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/h3>\n
      \n
    • Kh\u00f3 th\u1edf: kh \u00f3 th\u1edf khi g\u1eafng s\u1ee9c, kh\u00f3 th\u1edf khi leo c\u1ea7u thang, khi \u0111i b\u1ed9 \u0111\u01b0\u1eddng b\u1eb1ng, kh\u00f3 th\u1edf khi n\u1eb1m.<\/li>\n
    • \u0110au ng\u1ef1c: C\u00e1c y\u1ebfu t\u1ed1 t\u0103ng\/gi\u1ea3m \u0111au.Tri\u1ec7u ch\u1ee9ng \u0111i k\u00e8m khi \u0111au. T\u00ednh ch\u1ea5t \u0111au ng\u1ef1c, m\u1ee9c \u0111\u1ed9 \u0111au ng\u1ef1c, h\u01b0\u1edbng lan, t\u1ea7n su\u1ea5t.<\/li>\n<\/ul>\n
        \n
      • Ng\u1ea5t<\/li>\n
      • H\u1ed3i h\u1ed9p tr\u1ed1ng ng\u1ef1c:<\/li>\n<\/ul>\n

        Kh\u1edfi ph\u00e1t, th\u1eddi gian k\u00e9o d\u00e0i<\/p>\n

        X\u1ea3y ra tr\u01b0\u1edbc c\u01a1n ng\u1ea5t\/\u0111au ng\u1ef1c<\/p>\n

        Khai th\u00e1c t\u1ea7n s\u1ed1 tim, t\u00ednh ch\u1ea5t nh\u1ecbp trong c\u01a1n xu \u1ea5t hi\u1ec7n khi n\u00e0o, khi v\u1eadn \u0111\u1ed9ng hay ngh\u1ec9 ng\u01a1i<\/p>\n

        4.Kh\u00e1m to\u00e0n th\u00e2n<\/h2>\n

        L\u1eadp bi\u1ec3u \u0111\u1ed3 theo d\u00f5i chi\u1ec1u cao, c\u00e2n n\u1eb7ng, huy\u1ebft \u00e1p (b\u00ean tay \u0111\u1ed1i di\u1ec7n v\u1edbi b\u00ean c\u00f3 s\u1eb9o m\u1ed5 l\u1ed3ng ng\u1ef1c) v\u00e0 \u0111\u1ed9 b\u00e3o ho\u00e0 oxy<\/p>\n

        4.1 Kh\u00e1m ph\u00e1t hi\u1ec7n c\u00e1c h\u1ed9i ch\u1ee9ng di truy\u1ec1n:<\/h2>\n

        H\u1ed9i ch \u1ee9ng Down <\/em>(kho\u1ea3ng 1\/3 c\u00f3 k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng TBS, \u0111\u1eb7c bi\u1ec7t th\u00f4ng s\u00e0n nh\u0129 th\u1ea5t)<\/p>\n

        H\u1ed9i ch\u1ee9ng Williams <\/em>( h\u1eb9p tr\u00ean van \u0110M ch\u1ee7 v\u00e0 h\u1eb9p van \u0110M ch\u1ee7)<\/p>\n

        H\u1ed9i ch\u1ee9ng Noonan <\/em>(c\u00f3 th\u1ec3 g\u1eb7p h\u1eb9p van \u0110M ch\u1ee7 do lo\u1ea1n s\u1ea3n, b\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i)<\/p>\n

        H\u1ed9i ch\u1ee9ng Turner <\/em>( c\u00f3 th\u1ec3 g\u1eb7p h\u1eb9p eo \u0111\u1ed9ng m\u1ea1ch ch\u1ee7\/h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7)<\/p>\n

          \n
        • Kh\u00e1m ph\u00e1t hi\u1ec7n thi\u1ebfu m\u00e1u, v\u00e0ng da?<\/li>\n
        • Tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n?<\/li>\n
        • Bi\u1ec3u hi\u1ec7n v\u1ec7 sinh r\u0103ng mi\u1ec7ng k\u00e9m: S \u00e2u r\u0103ng, vi\u00eam l\u1ee3i?<\/li>\n
        • B\u1ec7nh nh\u00e2n c\u00f3 h\u00ecnh x\u0103m, khuy\u00ean ..? (\u0111\u01b0\u1eddng v\u00e0o nguy c\u01a1 c\u1ee7a vi khu\u1ea9n g\u00e2y vi\u00eam n\u1ed9i t\u00e2m m\u1ea1c nhi\u1ec5m khu\u1ea9n)<\/li>\n<\/ul>\n
            \n
          • Kh\u00e1m tim m\u1ed9t c\u00e1ch c\u00f3 h\u1ec7 th\u1ed1ng<\/li>\n<\/ul>\n

            Nghe ti\u1ebfng tim<\/p>\n

              \n
            • Ti\u1ebfng tim T1<\/strong><\/li>\n<\/ul>\n

              T1 m\u1ea1nh c\u00f3 th\u1ec3 g\u1eb7p trong h\u1eb9p van hai l\u00e1 ho\u1eb7c \u0111\u00f4i khi g\u1eb7p trong th\u00f4ng li\u00ean nh\u0129 T1 m\u1edd l\u00e0 m\u1ed9t \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a tim co b\u00f3p y\u1ebfu ho\u1eb7c kho\u1ea3ng PR d\u00e0i<\/p>\n

                \n
              • Ti\u1ebfng tim T2<\/strong><\/li>\n<\/ul>\n

                T2 t\u00e1ch \u0111\u00f4i c\u1ed1 \u0111\u1ecbnh g\u1eb7p trong th\u00f4ng li\u00ean nh\u0129 k\u00edch th\u01b0\u1edbc l\u1edbn, nghe r\u00f5 \u1edf khoang li\u00ean s\u01b0\u1eddn 2 – 3 c\u1ea1nh \u1ee9c tr\u00e1i<\/p>\n

                T2 m\u1ea1nh, t\u00e1ch \u0111\u00f4i g\u1eb7p trong t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/p>\n

                T2 t\u00e1ch \u0111\u00f4 i r\u1ed9ng g\u1eb7p \u1edf b\u1ec7nh nh\u00e2n t\u1ee9 ch\u1ee9ng Fallot sau ph\u0201u thu\u1eadt s\u1eeda to\u00e0n b\u1ed9 , t\u01b0\u01a1ng \u1ee9ng v\u1edbi bi\u1ec3u hi\u1ec7n block nh\u00e1nh ph\u1ea3i tr\u00ean \u0111i\u1ec7n t\u00e2m \u0111\u1ed3 .<\/p>\n

                  \n
                • Ti\u1ebfng th\u1ed5i t\u00e2m thu\/t\u00e2m tr\u01b0\u01a1ng <\/strong>(l\u1ea5y m\u1ed1c l\u00e0 1 \u0111\u01b0\u1eddng t\u01b0\u1edfng t\u01b0\u1ee3ng gi\u1eefa 2 n\u00fam v\u00fa)<\/em><\/li>\n
                • Ti\u1ebfng th\u1ed5i nghe r\u00f5 nh\u1ea5t tr\u00ean \u0111\u01b0\u1eddng n\u1ed1i 2 n\u00fam v\u00fa<\/strong><\/li>\n<\/ul>\n

                  L\u00e0 ki\u1ec3u ti\u1ebfng th\u1ed5i t\u1ed1ng m\u00e1u<\/p>\n

                  Ngu\u1ed3n g\u1ed1c do h\u1eb9p \u0111\u01b0\u1eddng ra th\u1ea5t ph\u1ea3i (\u0110RTP) ho\u1eb7c \u0111\u01b0\u1eddng ra th\u1ea5t tr\u00e1i (\u0110RTT)<\/p>\n

                  Ti\u1ebfng th\u1ed5i n\u1ebfu k\u00e8m theo rung miu \u1edf \u0111\u1ed9ng m\u1ea1ch c\u1ea3nh ho\u1eb7c tr\u00ean h\u00f5m \u1ee9c th\u01b0\u1eddng l\u00e0 h\u1eb9p \u0110RTT<\/p>\n

                  N\u1ebfu nghe th\u1ea5y ti\u1ebfng click t\u1ed1ng m\u00e1u, ti\u1ebfng th\u1ed5i c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb van tim<\/p>\n

                  Ti\u1ebfng click t\u1ed1ng m\u00e1u trong h\u1eb9p van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 nghe r\u00f5 nh\u1ea5t \u1edf m\u1ecfm tim<\/p>\n

                  Ti\u1ebfng th\u1ed5i t\u00e2m thu, nghe r\u00f5 \u1edf sau l\u01b0ng gi\u1eefa hai x\u01b0\u01a1ng b\u1ea3 vai \u1edf b\u1ec7nh nh\u00e2n c\u00f3 s\u1eb9o m\u1ed5 ng\u1ef1c tr\u00e1i l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a d\u00f2ng t\u0103ng t\u1ed1c qua eo \u0110M ch\u1ee7 \u1edf b\u1ec7nh nh\u00e2n h\u1eb9p eo \u0110M ch\u1ee7 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt s\u1eeda ch\u1eefa<\/p>\n

                  Ti\u1ebfng th\u1ed5i li\u00ean t\u1ee5c: C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch, nghe r\u00f5 \u1edf gi\u1eefa khoang li\u00ean s\u01b0\u1eddn 2 b\u00ean<\/p>\n

                  Ti\u1ebfng th\u1ed5i hai th\u00ec nghe r\u00f5 \u1edf khoang li\u00ean s\u01b0\u1eddn 2 b\u1edd tr\u00e1i x\u01b0\u01a1ng \u1ee9c do \u0110RTP k\u00e8m h\u1edf van \u0110MP ph\u1ed5i (\u1edf b\u1ec7nh nh\u00e2n \u0111\u00e3 ph\u0201u thu\u1eadt).<\/p>\n

                    \n
                  • Ti\u1ebfng th\u1ed5i nghe r\u00f5 nh\u1ea5t \u1edf v\u1ecb tr\u00ed d\u01b0\u1edbi \u0111\u01b0\u1eddng n\u1ed1i 2 n\u00fam v\u00fa<\/strong><\/li>\n<\/ul>\n

                    Ti\u1ebfng th\u1ed5i to\u00e0n th\u00ec t\u00e2m thu do h\u1edf van hai l\u00e1\/ba l\u00e1 ho\u1eb7c th\u00f4ng li\u00ean th\u1ea5t Trong h\u1edf van hai l\u00e1 ti\u1ebfng th\u1ed5i t\u00e2m thu t\u1eeb m\u1ecfm tim lan ra v\u00f9ng n\u00e1ch Ti\u1ebfng th\u1ed5i t\u00e2m thu v\u00f9ng gi\u1eefa tim, lan xung quanh trong th\u00f4ng li\u00ean th\u1ea5t.<\/p>\n

                    Ti\u1ebfng click gi\u1eefa th\u00ec t\u00e2m thu v\u00e0 ti\u1ebfng th\u1ed5i t\u00e2m thu trong sa van hai l\u00e1 nghe r\u00f5 h\u01a1n khi b\u1ec7nh nh\u00e2n \u1edf t\u01b0 th\u1ebf \u0111\u1ee9ng<\/p>\n

                    Ti\u1ebfng th\u1ed5i li\u00ean t\u1ee5c: Shunt ch\u1ee7 – ph\u1ed5i ho\u1eb7c th\u00f4ng \u0111\u1ed9ng – t\u0129nh m\u1ea1ch.<\/p>\n

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

                    Nh\u1edd s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a ph\u0201u thu\u1eadt, can thi\u1ec7p v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa tim m\u1ea1ch nhi, s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh \u0111\u1ea1t \u0111\u1ebfn tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh ng\u00e0y c\u00e0ng t\u0103ng l\u00ean. Ngo\u00e0i ra, nhi\u1ec1u b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh tim c\u1ea5u tr\u00fac ho\u1eb7c b\u1ec7nh van tim b\u1ea9m sinh ti\u1ebfn tri\u1ec3n t\u1eeb t\u1eeb, ch\u1ec9 bi\u1ec3u hi\u1ec7n mu\u1ed9n \u1edf tu\u1ed5i tr\u01b0\u1edfng th\u00e0nh.<\/p>\n","protected":false},"excerpt":{"rendered":"

                    D\u1ecb t\u1eadt tim b\u1ea9m sinh (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 – 0,8% tr\u1ebb s\u01a1 sinh. T\u1ea1i Vi\u1ec7t Nam, c\u00f3 kho\u1ea3ng 10.000 tr\u1ebb s\u01a1 sinh m\u1eafc tim b\u1ea9m sinh m\u1ed7i n\u0103m.H\u1ea7u h\u1ebft nh\u1eefng b\u1ec7nh nh\u00e2n n\u00e0y \u0111\u01b0\u1ee3c ph\u0201u thu\u1eadt gi\u1ea3m nh\u1eb9 ho\u1eb7c […]<\/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":"\n\u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n d\u1ecb t\u1eadt tim b\u1ea9m sinh<\/title>\n<meta name=\"description\" content=\"D\u1ecb t\u1eadt tim b\u1ea9m sinh (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 - 0,8% tr\u1ebb s\u01a1 sinh.\" \/>\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=\"\u0110\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n d\u1ecb t\u1eadt tim b\u1ea9m sinh\" \/>\n<meta property=\"og:description\" content=\"D\u1ecb t\u1eadt tim b\u1ea9m sinh (TBS) n\u1eb1m trong nh\u00f3m nh\u1eefng d\u1ecb t\u1eadt b\u1ea9m sinh ph\u1ed5 bi\u1ebfn nh\u1ea5t, \u01b0\u1edbc t\u00ednh t\u1ef7 l\u1ec7 g\u1eb7p kho\u1ea3ng 0,6 - 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