{"id":30676,"date":"2023-05-03T15:02:39","date_gmt":"2023-05-03T08:02:39","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30676"},"modified":"2023-05-03T15:02:39","modified_gmt":"2023-05-03T08:02:39","slug":"benh-buerger","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/benh-buerger\/","title":{"rendered":"B\u1ec7nh Buerger ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb"},"content":{"rendered":"

B\u1ec7nh Buerger (vi\u00eam t\u1eafc m\u1ea1ch m\u00e1u do huy\u1ebft kh\u1ed1i) \u0111\u01b0\u1ee3c Leo-Buerger b\u00e1o c\u00e1o l\u1ea7n \u0111\u1ea7u n\u0103m 1908, l\u00e0 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1ch kh\u00f4ng x\u01a1 v\u1eefa, c\u1ee7a c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf – trung b\u00ecnh, k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh \u1edf c\u1ea3 \u0111\u1ea7u chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi.<\/strong><\/p>\n

1. D\u1ecbch t\u1ec5 v\u00e0 y\u1ebfu t\u1ed1 nguy c\u01a1<\/h2>\n

B\u1ec7nh Buerger g\u1eb7p tr\u00ean to\u00e0n th\u1ebf gi\u1edbi nh\u01b0ng ph\u1ed5 bi\u1ebfn h\u01a1n \u1edf nh\u1eefng n\u01b0\u1edbc c\u00f3 s\u1eed d\u1ee5ng nhi\u1ec1u thu\u1ed1c l\u00e1, nh\u01b0 v\u00f9ng \u0110\u1ecba Trung H\u1ea3i, Trung \u0110\u00f4ng v\u00e0 Ch\u00e2u \u00c1. C\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t l\u1edbn v\u1ec1 t\u1ef7 l\u1ec7 b\u1ec7nh gi\u1eefa c\u00e1c n\u01b0\u1edbc, t\u1eeb 0,5 – 5,6% \u1edf T\u00e2y \u00c2u, 15 – 66% \u1edf H\u00e0n Qu\u1ed1c, cao nh\u01b0 \u1ea4n \u0110\u1ed9 t\u1eeb 15 – 66%.<\/p>\n

H\u00fat thu\u1ed1c l\u00e1 (ch\u1ee7 \u0111\u1ed9ng ho\u1eb7c th\u1ee5 \u0111\u1ed9ng) \u0111\u01b0\u1ee3c coi l\u00e0 c\u0103n nguy\u00ean ch\u00ednh c\u1ee7a b\u1ec7nh. Nam gi\u1edbi th\u01b0\u1eddng b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u h\u01a1n (70 – 91% l\u00e0 nam gi\u1edbi, 11 – 30% l\u00e0 n\u1eef gi\u1edbi). Ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n bi\u1ec3u hi\u1ec7n b\u1ec7nh \u1edf tu\u1ed5i tr\u01b0\u1edbc 45.<\/p>\n

2.L\u00e2m s\u00e0ng<\/h2>\n

B\u1ec7nh nh\u00e2n Buerger \u0111i\u1ec3n h\u00ecnh th\u01b0\u1eddng l\u00e0 nam, tu\u1ed5i t\u1eeb 20 – 45, h\u00fat thu\u1ed1c l\u00e1, thu\u1ed1c l\u00e0o nhi\u1ec1u, nh\u1eadp vi\u1ec7n v\u00e0o m\u00f9a \u0111\u00f4ng.<\/p>\n

Tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p tr\u00ean l\u00e2m s\u00e0ng l\u00e0:<\/p>\n

    \n
  • Hi\u1ec7n t\u01b0\u1ee3ng Raynaud: <\/em>S\u1ef1 nh\u1ea1y c\u1ea3m v\u1edbi l\u1ea1nh xu\u1ea5t hi\u1ec7n \u1edf giai \u0111o\u1ea1n ban \u0111\u1ea7u c\u1ee7a b\u1ec7nh, th\u01b0\u1eddng v\u00e0o m\u00f9a \u0111\u00f4ng, g\u1eb7p \u1edf kho\u1ea3ng 40% b\u1ec7nh nh\u00e2n.<\/li>\n
  • Thi\u1ebfu m\u00e1u \u0111\u1ea7u chi <\/em>(ng\u00f3n tay, ng\u00f3n ch\u00e2n) : T ri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t (70 – 80%), bi\u1ec3u hi\u1ec7n b\u1eb1ng tri\u1ec7u ch\u1ee9ng \u0111au bu\u1ed1t, k\u00e8m theo bi\u1ebfn \u0111\u1ed5i m\u00e0u s\u1eafc da (\u0111\u1ecf da, t\u00edm t\u00e1i, g\u1ecdi l\u00e0 Buerger’s color). Thi\u1ebfu m\u00e1u c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh lo\u00e9t, ho\u1ea1i t\u1eed \u1edf \u0111\u1ea7u chi tr\u00ean ho\u1eb7c chi d\u01b0\u1edbi.<\/li>\n
  • Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch n\u00f4ng <\/em>: Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch n\u00f4ng di chuy\u1ec3n c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf giai \u0111o\u1ea1n r\u1ea5t s\u1edbm, tr\u01b0\u1edbc c\u1ea3 nh\u1eefng bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng c\u1ee7a thi\u1ebfu m\u00e1u ngo\u1ea1i vi.<\/li>\n
  • Thi\u1ebfu m\u00e1u c\u00e1c c\u01a1 quan kh\u00e1c: <\/em>D o b\u1ec7nh Buerger r\u1ea5t hi\u1ebfm g\u1eb7p .<\/li>\n<\/ul>\n

    Test Allen d\u01b0\u01a1ng t\u00ednh \u1edf ng\u01b0\u1eddi tr\u1ebb h\u00fat thu\u1ed1c v\u00e0 c\u00f3 tri\u1ec7u ch\u1ee9ng ngo\u1ea1i vi th\u00ec g\u1ee3i \u00fd nhi\u1ec1u \u0111\u1ebfn b\u1ec7nh Buerger.<\/p>\n

    Kh\u00e1m m\u1ea1ch m\u00e1u y\u00eau c\u1ea7u h\u1ebft s\u1ee9c chi ti\u1ebft, \u0111\u1eb7c bi\u1ec7t l\u00e0 t\u1ee9 chi. Ki\u1ec3m tra c\u00e1c n\u1ed1t v\u00e0 th\u1eebng gi\u00e3n t\u0129nh m\u1ea1ch n\u00f4ng \u1edf b\u00e0n tay, b\u00e0n ch\u00e2n. Kh\u00e1m th\u1ea7n kinh ngo\u1ea1i bi\u00ean ph\u00e1t hi\u1ec7n nh\u1eefng b\u1ea5t th\u01b0\u1eddng v\u1ec1 c\u1ea3m gi\u00e1c (70%).<\/p>\n

    \"B\u1ec7nh<\/p>\n

    B\u1ec7nh Buerger<\/strong><\/p>\n

    3. C\u1eadn l\u00e2m s\u00e0ng<\/h2>\n

    Kh\u00f4ng c\u00f3 x\u00e9t nghi\u1ec7m \u0111\u1eb7c hi\u1ec7u n\u00e0o ch\u1ea9n \u0111o\u00e1n vi\u00eam m\u1ea1ch m\u00e1u. M\u1ee5c ti\u00eau l\u00e0m x\u00e9t nghi\u1ec7m l\u00e0 \u0111\u1ec3 lo\u1ea1i tr\u1eeb nh\u1eefng nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y t\u1eafc m\u1ea1ch nh\u01b0 x\u01a1 v\u1eefa, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, vi\u00eam m\u1ea1ch trong b\u1ec7nh l\u00fd h\u1ec7 th\u1ed1ng (lupus, b\u1ec7nh m\u00f4 li\u00ean k\u1ebft h\u1ed7n h\u1ee3p, x\u01a1 c\u1ee9ng b\u00ec, h\u1ed9i ch\u1ee9ng CREST).<\/p>\n

    \u0110o ABI (ch\u1ec9 s\u1ed1 c\u00e1nh tay – c\u1ed5 ch\u00e2n) v\u00e0 WBI (ch\u1ec9 s\u1ed1 c\u00e1nh tay – c\u1ed5 tay). ABI hay WBI b\u00ecnh th\u01b0\u1eddng c\u0169ng kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c b\u1ec7nh, v\u00ec b\u1ec7nh c\u00f3 th\u1ec3 gi\u1edbi h\u1ea1n \u1edf nh\u1eefng m\u1ea1ch m\u00e1u xa.<\/p>\n

    Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh m\u1ea1ch m\u00e1u nh\u01b0 si\u00eau \u00e2m, ch\u1ee5p c\u1eaft l\u1edbp hay c\u1ed9ng h\u01b0\u1edfng t\u1eeb m\u1ea1ch m\u00e1u: C\u00f3 vai tr\u00f2 h\u1ea1n ch\u1ebf trong ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Buerger.<\/p>\n

    Ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch c\u1ea3n quang c\u00f3 th\u1ec3 \u0111\u01b0a ra nh\u1eefng h\u00ecnh \u1ea3nh g\u1ee3i \u00fd ngay c\u1ea3 khi ch\u01b0a c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng, bao g\u1ed3m:<\/p>\n

      \n
    • Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng c\u1ee7a x\u01a1 v\u1eefa; kh\u00f4ng c\u00f3 ngu\u1ed3n t\u1ea1o huy\u1ebft kh\u1ed1i (ph\u00ecnh m\u1ea1ch)<\/li>\n
    • T \u1ed5n th\u01b0\u01a1ng ch\u1ee7 y\u1ebfu \u1edf nh\u1eefng m\u1ea1ch m\u00e1u trung b\u00ecnh nh\u01b0 \u0111\u1ed9ng m\u1ea1ch b\u00e0n ch\u00e2n, ch\u00e0y, m\u00e1c, b\u00e0n tay, quay, tr\u1ee5 .<\/li>\n
    • H\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng l\u00e0 n h\u1eefng \u0111o\u1ea1n \u0111\u1ed9ng m\u1ea1ch b\u1ecb t\u1eafc xen k\u1ebd v\u1edbi nh\u1eefng \u0111o\u1ea1n \u0111\u1ed9ng m\u1ea1ch b\u00ecnh th\u01b0\u1eddng, k\u00e8m theo tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7 (xo\u1eafn \u1ed1c) xung quanh v\u1ecb tr\u00ed t\u1eafc m\u1ea1ch.<\/li>\n<\/ul>\n

      4.Ch\u1ea9n \u0111o\u00e1n<\/h2>\n

      4.1 Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh b\u1ec7nh Buerger d\u1ef1a v\u00e0o c\u00e1c ti\u00eau chu\u1ea9n sau<\/strong>:<\/h3>\n
        \n
      • Tu\u1ed5i nh\u1ecf h\u01a1n 45.<\/li>\n
      • Hi\u1ec7n t\u1ea1i ho\u1eb7c ti\u1ec1n s\u1eed tr\u01b0\u1edbc \u0111\u00e2y s\u1eed d\u1ee5ng thu\u1ed1c l\u00e1. Thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 \u1edf ng\u1ecdn chi.<\/li>\n
      • H\u00ecnh \u1ea3nh ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch \u0111i\u1ec3n h\u00ecnh c\u1ee7a Buerger.<\/li>\n
      • Lo\u1ea1i tr\u1eeb nh\u1eefng nguy\u00ean nh\u00e2n kh\u00e1c: B\u1ec7nh t\u1ef1 mi\u1ec5n, t\u0103ng \u0111\u00f4ng m \u00e1u , \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, thuy\u00ean t\u1eafc t\u1eeb tim…<\/li>\n
      • Ch\u1ea9n \u0111o\u00e1n b\u1ec7nh Buerger \u00edt \u0111\u01b0\u1ee3c \u0111\u1eb7t ra v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 c\u01a1 tim, thi\u1ebfu m\u00e1u n\u00e3o, b\u1ec7nh l\u00fd t\u0103ng \u0111\u00f4ng hay b\u1ec7nh m\u00f4 li\u00ean k\u1ebft.<\/li>\n<\/ul>\n

        Sinh thi\u1ebft<\/em>: Hi\u1ebfm khi th\u1ef1c hi\u1ec7n, nh\u01b0ng \u0111\u00e2y l\u00e0 c\u00e1ch duy nh\u1ea5t \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh. B\u1ec7nh nh\u00e2n nghi ng\u1edd Buerger c\u00f3 nh\u1eefng n\u1ed1t t\u0129nh m\u1ea1ch n\u00f4ng d\u01b0\u1edbi da ho\u1eb7c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch n\u00f4ng n\u00ean \u0111\u01b0\u1ee3c sinh thi\u1ebft.<\/p>\n

        4.2 Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/h3>\n
          \n
        • B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean do x\u01a1 v\u1eefa : B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 x\u01a1 v\u1eefa \u0111\u1ed9ng m\u1ea1ch ch\u00ednh, tu\u1ed5i cao, th\u01b0\u1eddng b\u1ecb \u1edf \u0111\u1ed9ng m\u1ea1ch l\u1edbn v\u00e0 trung b\u00ecnh c\u1ee7a chi d\u01b0\u1edbi.<\/li>\n
        • T\u1eafc m\u1ea1ch do thuy\u00ean t\u1eafc c\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb tim, ho\u1eb7c b\u1ec7nh l\u00fd t\u0103ng \u0111\u00f4ng. Vi\u00eam m\u1ea1ch kh\u00e1c.<\/li>\n
        • Ch\u1ea5n th\u01b0\u01a1ng: Vi ch\u1ea5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u, l\u1eb7p \u0111i l\u1eb7p l\u1ea1i (li\u00ean quan \u0111\u1ebfn ngh\u1ec1 nghi\u1ec7p).<\/li>\n<\/ul>\n

          5.\u0110i\u1ec1u tr\u1ecb<\/h2>\n

          5.1 Ng\u1eebng h\u00fat thu\u1ed1c<\/strong><\/h3>\n

          Ng\u1eebng ho\u00e0n to\u00e0n vi\u1ec7c h\u00fat thu\u1ed1c l\u00e1 (g\u1ed3m c\u1ea3 h\u00fat thu\u1ed1c l\u00e1 th\u1ee5 \u0111\u1ed9ng) l\u00e0 c\u00e1ch duy nh\u1ea5t \u0111\u1ec3 ng\u0103n ch\u1eb7n s\u1ef1 ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh.<\/p>\n

          B\u1ec7nh nh\u00e2n ph\u1ee5 thu\u1ed9c nicotine c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb thay th\u1ebf b\u1eb1ng bupropion v\u00e0 varenicline, t\u01b0 v\u1ea5n chuy\u00ean gia t\u00e2m l\u00fd \u0111\u1ec3 b\u1ecf thu\u1ed1c v\u00e0 kh\u00f4ng t\u00e1i nghi\u1ec7n.<\/p>\n

          5.2 \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa<\/h3>\n

          Thu\u1ed1c gi\u00e3n m\u1ea1ch: <\/strong>Thu\u1ed1c gi\u00e3n m\u1ea1ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf b\u1ec7nh nh\u00e2n vi\u00eam t\u1eafc m\u1ea1ch m\u00e1u \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng:<\/p>\n

            \n
          • Prostaglandin \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch <\/em>: Iloprost truy\u1ec1n t\u0129nh m\u1ea1ch (li\u00ean t\u1ee5c 6 gi\u1edd\/ng\u00e0y, li\u1ec7u tr\u00ecnh c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1edbi 28 ng\u00e0y) c\u00f3 t\u00e1c d\u1ee5ng kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u v\u00e0 gi\u00e3n m\u1ea1ch, m\u1eb7c d\u00f9 ch\u01b0a \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o trong c\u00e1c th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng, nh\u01b0ng t\u1ecf ra hi\u1ec7u qu\u1ea3 v\u1edbi b\u1ec7nh nh\u00e2n Buerger b\u1ecb thi\u1ebfu m\u00e1u \u0111\u1ea7u chi tr\u1ea7m tr\u1ecdng.<\/li>\n
          • Ch\u1ea5t \u1ee9c ch\u1ebf phosphodiesterase: <\/em>Cilostazol, l\u00e0 ch\u1ea5t \u1ee9c ch\u1ebf phosphodiesterase lo\u1ea1i 3 c\u00f3 t\u00e1c d\u1ee5ng gi\u00e3n m\u1ea1ch, l\u00e0m gi\u1ea3m ti\u1ebft c\u00e1c ch\u1ea5t trung gian g\u00e2y vi\u00eam trong huy\u1ebft t\u01b0\u01a1ng c\u1ee7a b\u1ec7nh nh\u00e2n b\u1ecb Buerger v\u00e0 c\u1ea3i thi\u1ec7n s\u1ef1 h\u1ed3i ph\u1ee5c lo\u00e9t \u0111\u1ea7u chi.<\/li>\n
          • Thu\u1ed1c ch\u1eb9n k\u00eanh canxi: <\/em>Nh\u00f3m dihydropyridine t\u00e1c d\u1ee5ng ng\u1eafn (nifedipine) gi\u1ea3m tri\u1ec7u ch\u1ee9ng Raynaud th\u1ee9 ph\u00e1t do co th\u1eaft m\u1ea1ch m\u00e1u.<\/li>\n<\/ul>\n

            Thu\u1ed1c kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u: <\/strong>M\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 khuy\u1ebfn c\u00e1o v\u1ec1 l\u1ee3i \u00edch l\u00e2m s\u00e0ng th\u1ef1c s\u1ef1, aspirin \u0111\u01b0\u1ee3c ch\u1ea5p nh\u1eadn s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i do gi\u00e1 th\u00e0nh th\u1ea5p v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5.<\/p>\n

            Thu\u1ed1c gi\u1ea3m \u0111au: <\/strong>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n Buerger \u0111au d\u1eef d\u1ed9i do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, \u0111\u00f2i h\u1ecfi ph\u1ea3i d\u00f9ng \u0111\u1ebfn thu\u1ed1c gi\u1ea3m \u0111au g\u00e2y nghi\u1ec7n, ho\u1eb7c gi\u1ea3m \u0111au ngo\u00e0i m\u00e0ng c\u1ee9ng.<\/p>\n

            5.3 Li\u1ec7u ph\u00e1p gen v\u00e0 t\u1ebf b\u00e0o g\u1ed1c<\/h3>\n

            Nh\u01b0 c\u1ea5y gh\u00e9p t\u1ebf b\u00e0o \u0111\u01a1n nh\u00e2n ngu\u1ed3n g\u1ed1c t\u1ee7y x\u01b0\u01a1ng, li\u1ec7u ph\u00e1p t\u00e1i t\u1ea1o m\u1ea1ch b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng v\u00e0 k\u00edch th\u00edch t\u1ee7y x\u01b0\u01a1ng t\u1ef1 th\u00e2n, \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u trong m\u1ed9t s\u1ed1 th\u1eed nghi\u1ec7m l\u00e2m s\u00e0ng.<\/p>\n

            5.4 B\u01a1m h\u01a1i \u00e1p l\u1ef1c ng\u1eaft qu\u00e3ng<\/h3>\n

            L\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn cho b\u1ec7nh nh\u00e2n \u0111au do lo\u00e9t khi kh\u00f4ng th\u1ec3 t\u00e1i th\u00f4ng m\u1ea1ch kh\u00f4ng kh\u1ea3 thi, nh\u1eb1m t\u0103ng d\u00f2ng m\u00e1u trong \u0111\u1ed9ng m\u1ea1ch khoeo th\u00f4ng qua gi\u1ea3m s\u1ee9c c\u1ea3n \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean. M\u1eb7c d\u00f9 c\u00f3 hi\u1ec7u qu\u1ea3, ph\u1ea3i m\u1ea5t h\u00e0ng th\u00e1ng \u0111\u1ec3 \u0111\u1ea1t t\u1edbi s\u1ef1 h\u1ed3i ph\u1ee5c c\u1ee7a v\u1ebft lo\u00e9t v\u00e0 b\u1ec7nh nh\u00e2n ph\u1ea3i s\u1eed d\u1ee5ng d\u1ee5ng c\u1ee5 b\u01a1m h\u01a1i \u00e1p l\u1ef1c ng\u1eaft qu\u00e3ng m\u1ed7i 6 gi\u1edd nh\u01b0ng c\u1ea3m gi\u00e1c \u0111au c\u00f3 th\u1ec3 gi\u1ea3m tr\u01b0\u1edbc khi v\u1ebft lo\u00e9t thi\u1ebfu m\u00e1u kh\u1ecfi ho\u00e0n to\u00e0n.<\/p>\n

            5.5 Can thi\u1ec7p t\u00e1i th\u00f4ng m\u1ea1ch m\u00e1u<\/h3>\n

            Th\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh b\u1edfi v\u00ec t\u1ed5n th\u01b0\u01a1ng \u1edf nh\u1eefng m\u1ea1ch m\u00e1u qu\u00e1 xa, ph\u00eda ngo\u1ea1i vi, \u1edf ng\u00f3n tay, ng\u00f3n ch\u00e2n.<\/p>\n

            5.6 Ph\u1eabu thu\u1eadt<\/h3>\n
              \n
            • Ph\u1eabu thu\u1eadt t\u00e1i t\u01b0\u1edbi m\u00e1u <\/em>: H\u1ea7u nh\u01b0 kh\u00f4ng kh\u1ea3 thi do \u0111\u1eb7c \u0111i\u1ec3m t\u1ed5n th\u01b0\u01a1ng l\u00e0 t\u1eafc m\u1ea1ch \u0111\u1ea7u chi, lan t\u1ecfa, t\u1eebng \u0111o\u1ea1n.<\/li>\n
            • C\u1eaft h\u1ea1ch giao c\u1ea3m: <\/em>Nh\u1eb1m c\u1ea3i thi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 ki\u1ec3m so\u00e1t \u0111au \u1edf b\u1ec7nh nh\u00e2n Buerger, m\u1eb7c d\u00f9 c\u00f3 l\u1ee3i cho m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n nh\u01b0ng c\u0169ng kh\u00f4ng c\u00f3 h\u01b0\u1edbng d\u0201n c\u1ee5 th\u1ec3 v\u1ec1 ch\u1ec9 \u0111\u1ecbnh.<\/li>\n
            • C\u1eaft c\u1ee5t chi: <\/em>Nguy c\u01a1 c\u1eaft c\u1ee5t chi r\u1ea5t th\u1ea5p n\u1ebfu b\u1ec7nh ph\u00e1t hi\u1ec7n s\u1edbm v\u00e0 b\u1ec7nh nh\u00e2n b\u1ecf thu\u1ed1c l\u00e1 tuy\u1ec7t \u0111\u1ed1i. Tuy nhi\u00ean, n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng tu\u00e2n th\u1ee7 vi\u1ec7c b\u1ecf thu\u1ed1c, theo Mayo Clinic, nguy c\u01a1 c\u1eaft c\u1ee5t chi l\u00e0 25% sau 5 n\u0103m v\u00e0 38% sau 10 n\u0103m.<\/li>\n<\/ul>\n

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

              B\u1ec7nh Buerger (vi\u00eam t\u1eafc m\u1ea1ch m\u00e1u do huy\u1ebft kh\u1ed1i) \u0111\u01b0\u1ee3c Leo-Buerger b\u00e1o c\u00e1o l\u1ea7n \u0111\u1ea7u n\u0103m 1908, l\u00e0 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1ch kh\u00f4ng x\u01a1 v\u1eefa, c\u1ee7a c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf – trung b\u00ecnh, k\u00e8m theo t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh \u1edf c\u1ea3 \u0111\u1ea7u chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi. 1. D\u1ecbch […]<\/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 Buerger ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh Buerger l\u00e0 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1ch kh\u00f4ng x\u01a1 v\u1eefa, c\u1ee7a c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf - trung b\u00ecnh.\" \/>\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 Buerger ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh Buerger l\u00e0 b\u1ec7nh l\u00fd vi\u00eam m\u1ea1ch kh\u00f4ng x\u01a1 v\u1eefa, c\u1ee7a c\u00e1c \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf - 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