{"id":30726,"date":"2023-05-03T15:00:44","date_gmt":"2023-05-03T08:00:44","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30726"},"modified":"2023-05-03T15:00:44","modified_gmt":"2023-05-03T08:00:44","slug":"bat-thuong-mach-mau-bam-sinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/03\/bat-thuong-mach-mau-bam-sinh\/","title":{"rendered":"B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh"},"content":{"rendered":"<p><strong><a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/cach-dieu-tri-va-cham-soc-benh-nhan-di-dang-mach-mau\/\">B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u<\/a> bao g\u1ed3m u m\u1ea1ch m\u00e1u v\u00e0 d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ea3 h\u1ec7 th\u1ed1ng \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch v\u00e0\/ho\u1eb7c m\u1ea1ch b\u1ea1ch huy\u1ebft. B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf \u0111\u1ea7u, m\u1eb7t, c\u1ed5 th\u00e2n m\u00ecnh ho\u1eb7c ch\u00e2n tay, v\u1edbi bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng.<\/strong><\/p>\n<h2>1.Ph\u00e2n lo\u1ea1i<\/h2>\n<p>Ph\u00e2n lo\u1ea1i \u0111\u1ea7u ti\u00ean l\u00e0 c\u1ee7a Mulliken v\u00e0 Glowacki n\u0103m 1982, d\u1ef1a v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m l\u00e2m s\u00e0ng, ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh v\u00e0 h\u00f3a m\u00f4 mi\u1ec5n d\u1ecbch. Hi\u1ec7p h\u1ed9i qu\u1ed1c t\u1ebf nghi\u00ean c\u1ee9u v\u1ec1 b\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u <em>(International Society For the Study of vascular anomalies) <\/em>\u0111\u00e3 c\u00f4ng nh\u1eadn ph\u00e2n lo\u1ea1i n\u00e0y (1996) v\u00e0 \u0111\u01b0a ra b\u1ea3ng ph\u00e2n lo\u1ea1i c\u00f3 hi\u1ec7u ch\u1ec9nh nh\u01b0 sau (2018):<\/p>\n<p>B\u1ea3ng ph\u00e2n lo\u1ea1i b\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh<\/p>\n<table>\n<tbody>\n<tr>\n<td rowspan=\"2\" width=\"204\"><strong>C\u00e1c kh\u1ed1i u<\/strong><\/td>\n<td colspan=\"2\" width=\"496\"><strong>D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"383\">\u0110\u01a1n gi\u1ea3n<\/td>\n<td width=\"112\">Ph\u1ed1i h\u1ee3p<\/td>\n<\/tr>\n<tr>\n<td rowspan=\"5\" width=\"204\"><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>L\u00e0nh t\u00ednh<\/p>\n<p>Ti\u1ebfn tri\u1ec3n khu tr\u00fa ho\u1eb7c ranh gi\u1edbi<\/p>\n<p>\u00c1c t\u00ednh<\/td>\n<td width=\"383\">D\u1ecb d\u1ea1ng mao m\u1ea1ch (CM)<\/td>\n<td width=\"112\">CVM<\/td>\n<\/tr>\n<tr>\n<td width=\"383\"><strong>\u00a0<\/strong><\/p>\n<p>D\u1ecb d\u1ea1ng b\u1ea1ch m\u1ea1ch (LM)<\/td>\n<td width=\"112\"><strong>\u00a0<\/strong><\/p>\n<p>CLVM<\/td>\n<\/tr>\n<tr>\n<td width=\"383\">D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch (VM)<\/td>\n<td width=\"112\">LVM<\/td>\n<\/tr>\n<tr>\n<td width=\"383\">Th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch (AVF)<\/td>\n<td width=\"112\">CAVM<\/td>\n<\/tr>\n<tr>\n<td width=\"383\"><strong>\u00a0<\/strong><\/p>\n<p>D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch (AVM)<\/td>\n<td width=\"112\"><strong>\u00a0<\/strong><\/p>\n<p>CLAVM<\/td>\n<\/tr>\n<tr>\n<td width=\"204\"><strong>\u0110\u1eb7c \u0111i\u1ec3m<\/strong><\/td>\n<td colspan=\"2\" width=\"496\"><strong>C\u00e1c th\u1ec3 b\u1ec7nh<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"204\"><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u \u0111\u01a1n<\/p>\n<p>thu\u1ea7n<\/td>\n<td colspan=\"2\" width=\"496\">D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch th\u01b0\u1eddng g\u1eb7p (Common VM)<\/p>\n<p>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch da &#8211; ni\u00eam m\u1ea1ch c\u00f3 t\u00ednh ch\u1ea5t gia \u0111\u00ecnh H\u1ed9i ch\u1ee9ng Blue rubber bleb nevus (H\u1ed9i ch\u1ee9ng Bean)<\/p>\n<p>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch d\u1ea1ng b\u00fai (Glomuvenous malformation &#8211; GVM)<\/p>\n<p>D\u1ecb\u00a0\u00a0 d\u1ea1ng\u00a0\u00a0\u00a0 xoang\u00a0\u00a0\u00a0 t\u0129nh\u00a0\u00a0\u00a0 m\u1ea1ch\u00a0\u00a0 n\u00e3o\u00a0\u00a0\u00a0 (Cerebral\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 cavernous malformation &#8211; CCM)<\/p>\n<p>Kh\u00e1c<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2><strong>2.D\u1ecbch t\u1ec5 h\u1ecdc<\/strong><\/h2>\n<ul>\n<li><strong>U m\u00e1u<\/strong>: U m\u00e1u c\u00f3 th\u1ec3 l\u00e0 b\u1ea9m sinh ho\u1eb7c m\u1eafc ph\u1ea3i, trong \u0111\u00f3 u m\u00e1u tr\u1ebb em th\u01b0\u1eddng g\u1eb7p nh\u1ea5t. \u0110\u1eb7c tr\u01b0ng c\u1ee7a u m\u00e1u: (1) T\u0103ng sinh t\u1ebf b\u00e0o n\u1ed9i m\u00f4, (2) xu\u1ea5t hi\u1ec7n ngay sau sinh trong kho\u1ea3ng 40% tr\u01b0\u1eddng h\u1ee3p, (3) ti\u1ebfn tri\u1ec3n nhanh sau khi sinh, (4) tho\u00e1i tri\u1ec3n d\u1ea7n sau n\u0103m \u0111\u1ea7u ti\u00ean nh\u01b0ng c\u00f3 th\u1ec3 t\u1ed3n t\u1ea1i \u0111\u1ebfn khi tr\u1ebb 10 tu\u1ed5i, (5) t\u1ef7 l\u1ec7 n\u1eef\/nam l\u00e0 5\/1.<\/li>\n<li><strong>D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u<\/strong>: Xu\u1ea5t hi\u1ec7n ngay sau sinh trong kho\u1ea3ng 90% tr\u01b0\u1eddng h\u1ee3p, t\u1ebf b\u00e0o n\u1ed9i m\u00f4 ph\u00e1t tri\u1ec3n b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng th\u1ec3 t\u1ef1 tho\u00e1i tri\u1ec3n, m\u00e0 ph\u00e1t tri\u1ec3n t\u1ef7 l\u1ec7 thu\u1eadn v\u1edbi s\u1ef1 t\u0103ng tr\u01b0\u1edfng c\u1ee7a tr\u1ebb, b\u1ecb k\u00edch ho\u1ea1t b\u1edfi nh\u1eefng bi\u1ebfn \u0111\u1ed5i n\u1ed9i ti\u1ebft, ch\u1ea5n th\u01b0\u01a1ng, nhi\u1ec5m tr\u00f9ng. T\u1ef7 l\u1ec7 n\u1eef\/nam l\u00e0 1\/1. Theo b\u1ea3n ch\u1ea5t c\u1ee7a c\u00e1c k\u00eanh m\u1ea1ch m\u00e1u m\u00e0 d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u \u0111\u01b0\u1ee3c ph\u00e2n chia th\u00e0nh d\u1ecb d\u1ea1ng mao m\u1ea1ch, t\u0129nh m\u1ea1ch, \u0111\u1ed9ng m\u1ea1ch, b\u1ea1ch m\u1ea1ch ho\u1eb7c th\u1ec3 ph\u1ed1i h\u1ee3p.<\/li>\n<\/ul>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"size-medium wp-image-30753 aligncenter\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/2-Congenital-vascular-malformation-b918820f-2c26-46f5-9ffe-654fa155ace8-1-291x300.jpg\" alt=\"B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh\" width=\"291\" height=\"300\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/2-Congenital-vascular-malformation-b918820f-2c26-46f5-9ffe-654fa155ace8-1-291x300.jpg 291w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/2-Congenital-vascular-malformation-b918820f-2c26-46f5-9ffe-654fa155ace8-1.jpg 440w\" sizes=\"(max-width: 291px) 100vw, 291px\" \/><\/p>\n<p style=\"text-align: center;\"><strong>B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh<\/strong><\/p>\n<h2>3.Ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n ph\u1ea7n l\u1edbn d\u1ef1a v\u00e0o c\u00e1c th\u00f4ng s\u1ed1 l\u00e2m s\u00e0ng, th\u1eddi gian xu\u1ea5t hi\u1ec7n, \u0111\u1eb7c tr\u01b0ng v\u00e0 ti\u1ebfn tri\u1ec3n c\u1ee7a t\u1ed5n th\u01b0\u01a1ng.<\/p>\n<p><strong>U m\u1ea1ch m\u00e1u<\/strong>: Xu\u1ea5t hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng m\u1ed9t v\u1ebft \u0111\u1ecf, ph\u1eb3ng ho\u1eb7c l\u1ed3i l\u00ean tr\u00ean m\u1eb7t da, t\u0103ng nhi\u1ec7t \u0111\u1ed9, c\u00f3 th\u1ec3 c\u00f3 rung miu, th\u1ed5i ho\u1eb7c kh\u00f4ng.<\/p>\n<p>D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u l\u01b0u l\u01b0\u1ee3ng th\u1ea5p bao g\u1ed3m:<\/p>\n<p><em>D\u1ecb d\u1ea1ng mao m\u1ea1ch <\/em>c\u00f2n g\u1ecdi l\u00e0 b\u1edbt r\u01b0\u1ee3u vang, l\u00e0 lo\u1ea1i d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u th\u01b0\u1eddng g\u1eb7p nh\u1ea5t; do gi\u00e3n b\u1ea5t th\u01b0\u1eddng mao m\u1ea1ch v\u00e0 ti\u1ec3u t\u0129nh m\u1ea1ch h\u1eadu mao m\u1ea1ch; xu\u1ea5t hi\u1ec7n ngay t\u1eeb khi sinh, l\u1edbn l\u00ean c\u00f9ng s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a c\u01a1 th\u1ec3 v\u00e0 kh\u00f4ng c\u00f3 xu h\u01b0\u1edbng t\u1ef1 tho\u00e1i tri\u1ec3n; v\u1ecb tr\u00ed th\u01b0\u1eddng g\u1eb7p nh\u1ea5t l\u00e0 \u0111\u1ea7u, c\u1ed5, d\u01b0\u1edbi d\u1ea1ng c\u00e1c \u0111\u00e1m m\u00e0u \u0111\u1ecf nh\u1ea1t, ph\u1eb3ng, v\u1ec1 sau c\u00e1c mao m\u1ea1ch gi\u00e3n nhi\u1ec1u h\u01a1n, l\u00e0m t\u1ed5n th\u01b0\u01a1ng n\u1ed5i cao, m\u00e0u \u0111\u1ecf th\u0201m. D\u1ecb d\u1ea1ng mao m\u1ea1ch c\u00f3 th\u1ec3 \u0111\u01a1n \u0111\u1ed9c, ho\u1eb7c ph\u1ed1i h\u1ee3p v\u1edbi c\u00e1c d\u1ecb d\u1ea1ng kh\u00e1c trong h\u1ed9i ch\u1ee9ng <strong>Klippel Trenaunay (H13.12) <\/strong>, Sturge Weber&#8230;<\/p>\n<p><em>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch<\/em> : \u0110\u01b0\u1ee3c chia l\u00e0m c\u00e1c th\u1ec3 sau:<\/p>\n<ul>\n<li>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch \u0111\u01a1n thu\u1ea7n: Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n kh\u1ed1i ph\u00ecnh, b\u1ec1 m\u1eb7t da m\u1ecfng, h\u01a1i xanh, \u1ea5n m\u1ec1m, kh\u00f4ng \u0111au (tr\u1eeb khi c\u00f3 huy\u1ebft kh\u1ed1i ho\u1eb7c v\u00f4i h\u00f3a), kh\u00f4ng t\u0103ng nhi\u1ec7t \u0111\u1ed9, kh\u00f4ng c\u00f3 rung miu hay th\u1ed5i. N\u1ebfu kh\u1ed1i d\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch \u1edf s\u00e2u trong c\u01a1, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111au khi v\u1eadn \u0111\u1ed9ng, c\u0103ng c\u01a1, nh\u01b0ng kh\u00e1m kh\u00f4ng th\u1ea5y b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch da &#8211; ni\u00eam m\u1ea1c \u0111a d\u1ea1ng: C\u00f3 t\u00ednh di truy\u1ec1n, c\u00f3 d\u1ea1ng nh\u1eefng n\u1ed1t nh\u1ecf (&lt; 2 cm), xanh, nhi\u1ec1u v\u1ecb tr\u00ed, r\u1ea5t hi\u1ebfm khi xu\u1ea5t hi\u1ec7n \u1edf c\u00e1c c\u1ea5u tr\u00fac s\u00e2u, m\u00e0 ch\u1ee7 y\u1ebfu g\u1eb7p \u1edf v\u00f9ng c\u1ed5 m\u1eb7t ho\u1eb7c \u0111\u1ea7u<\/li>\n<\/ul>\n<ul>\n<li>D\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch cu\u1ed9n: L \u00e0 nh\u1eefng d\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch d\u1ea1ng ch\u1ea5m \u1edf tr\u00ean da ho\u1eb7c d\u01b0\u1edbi da, xu\u1ea5t hi \u1ec7n t\u1ef1 ph\u00e1t ho\u1eb7c sau ch\u1ea5n th\u01b0\u01a1ng, th\u01b0\u1eddng c\u00f3 y\u1ebfu t\u1ed1 gia \u0111\u00ecnh. T\u1ed5n th\u01b0\u01a1ng d\u1ea1ng n\u1ed1t xanh t\u00edm ho\u1eb7c \u0111\u1ecf t\u00eda, lan t\u1ecfa ho\u1eb7c t\u1eadp h\u1ee3p th\u00e0nh m\u1ea3ng, c\u1ee9ng, \u00edt \u0111\u00e0n h\u1ed3i v\u00e0 r\u1ea5t \u0111au khi \u1ea5n. B\u1ec7nh c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n khi m\u1edbi sinh ho\u1eb7c mu\u1ed9n h\u01a1n. K\u00edch th\u01b0\u1edbc v\u00e0 s\u1ed1 l\u01b0\u1ee3ng c\u00e1c d\u1ecb d\u1ea1ng th\u01b0\u1eddng r\u1ea5t thay \u0111\u1ed5i, nh\u01b0ng v\u1ecb tr\u00ed th\u01b0\u1eddng g\u1eb7p l\u00e0 \u1edf chi<\/li>\n<\/ul>\n<p>Nh\u1eefng h\u1ed9i ch\u1ee9ng d\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch:<\/p>\n<p>H\u1ed9i ch\u1ee9ng Bean ho\u1eb7c Blue rubber bleb nevus: L\u00e0 t\u1eadp h\u1ee3p c\u00e1c d\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch lan t\u1ecfa tr\u00ean da kh\u1eafp c\u01a1 th\u1ec3, \u0111\u1eb7c bi\u1ec7t l\u00e0 gan b\u00e0n ch\u00e2n b\u00e0n tay. B\u1ec7nh bi\u1ec3u hi\u1ec7n ngay t\u1eeb khi sinh v\u1edbi c\u00e1c n\u1ed1t xanh m\u1ec1m, gi\u1ed1ng nh\u01b0 \u0111\u1ea7u v\u00fa cao su tr\u00ean da, v\u00e0 \u1edf c\u00e1c t\u1ea1ng (\u1edf d\u1ea1 d\u00e0y ru\u1ed9t, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra ch\u1ea3y m\u00e1u m\u1ea1n t\u00ednh).<\/p>\n<p>H\u1ed9i ch\u1ee9ng Klippel &#8211; Trenaunay: D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u b\u1ea9m sinh bao g\u1ed3m c\u00e1c b\u00fai gi\u00e3n t\u0129nh m\u1ea1ch, b\u1ea5t th\u01b0\u1eddng \u1edf th\u00e2n t\u0129nh m\u1ea1ch s\u00e2u, d\u1ecb d\u1ea1ng mao m\u1ea1ch, t\u0129nh m\u1ea1ch, m\u1ea1ch b\u1ea1ch huy\u1ebft, ph\u00ec \u0111\u1ea1i x\u01b0\u01a1ng v\u00e0 m\u00f4 m\u1ec1m.<\/p>\n<p><strong>D\u1ecb d\u1ea1ng b\u1ea1ch m\u1ea1ch<\/strong>: C\u00f3 ngu\u1ed3n g\u1ed1c t\u1eeb s\u1ef1 gi\u00e3n b\u1ea5t th\u01b0\u1eddng c\u1ee7a \u1ed1ng b\u1ea1ch huy\u1ebft th\u00e0nh c\u00e1c nang, b\u00ean trong ch\u1ee9a \u0111\u1ea7y d\u1ecbch b\u1ea1ch huy\u1ebft. Tr\u00ean l\u00e2m s\u00e0ng chia l\u00e0m 3 th\u1ec3: Nang l\u1edbn, nang nh\u1ecf, h\u1ed7n h\u1ee3p; th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n tr\u01b0\u1edbc 2 tu\u1ed5i, kh\u00f4ng bao gi\u1edd tho\u00e1i tri\u1ec3n; v\u1ecb tr\u00ed \u1edf \u0111\u1ea7u c\u1ed5 (70%), n\u00e1ch (20%), th\u00e2n m\u00ecnh v\u00e0 chi (10%).<\/p>\n<p><strong>D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u l\u01b0u l\u01b0\u1ee3ng cao: <\/strong>\u00cdt g\u1eb7p nh\u1ea5t nh\u01b0ng l\u00e0 lo\u1ea1i d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u tr\u1ea7m tr\u1ecdng nh\u1ea5t; l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a s\u1ef1 n\u1ed1i t\u1eaft b\u1ea5t th\u01b0\u1eddng gi\u1eefa \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch, c\u00f3 th\u1ec3 tr\u1ef1c ti\u1ebfp (th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch), ho\u1eb7c qua m\u1ed9t \u0111\u00e1m r\u1ed1i m\u1ea1ch m\u00e1u b\u1ea5t th\u01b0\u1eddng (nidus). Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n th\u1ea5y kh\u1ed1i ph\u00ecnh, t\u0103ng nhi\u1ec7t \u0111\u1ed9, s\u1edd c\u00f3 rung miu v\u00e0 nghe th\u1ea5y ti\u1ebfng th\u1ed5i (t\u00e2m thu &#8211; t\u00e2m tr\u01b0\u01a1ng). D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch c\u00f3 th\u1ec3 g\u00e2y thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 l\u00e0m b\u1ec7nh nh\u00e2n \u0111au, lo\u00e9t da, ch\u1ea3y m\u00e1u, suy tim t\u0103ng cung l\u01b0\u1ee3ng. D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c chia l\u00e0m 2 lo\u1ea1i:<\/p>\n<ul>\n<li><em>D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch khu tr\u00fa: <\/em>Bi\u1ec3u hi\u1ec7n d\u01b0\u1edbi d\u1ea1ng n\u1ed1t ho\u1eb7c kh\u1ed1i d\u01b0\u1edbi da m\u00e0u h\u1ed3ng, c\u00f3 th\u1ec3 r\u1eadm l\u00f4ng, \u0111\u1eadp theo nh\u1ecbp m\u1ea1ch, rung miu, t\u0103ng ti\u1ebft m\u1ed3 h\u00f4i, t\u0103ng th\u00e2n nhi\u1ec7t t\u1ea1i ch\u1ed7.<\/li>\n<li><em>D\u1ecb d\u1ea1ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch lan t\u1ecfa <strong>: <\/strong><\/em>Th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf chi d\u01b0\u1edbi. Trong h\u1ed9i ch\u1ee9ng Parkes &#8211; Weber, d\u1ecb d\u1ea1ng n\u00e0y th\u01b0\u1eddng ph\u1ed1i h\u1ee3p v\u1edbi ph\u00ec \u0111\u1ea1i x\u01b0\u01a1ng ho\u1eb7c d\u1ecb d\u1ea1ng mao m\u1ea1ch.<\/li>\n<\/ul>\n<h2>4. Vai tr\u00f2 c\u1ee7a c\u00e1c th\u0103m d\u00f2 h\u00ecnh \u1ea3nh<\/h2>\n<p><strong>Si\u00eau \u00e2m Doppler: <\/strong>L\u00e0 th\u0103m d\u00f2 h\u00ecnh \u1ea3nh \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ea7u ti\u00ean, c\u00f3 vai tr\u00f2 quan tr\u1ecdng \u0111\u1ec3 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u thu\u1ed9c nh\u00f3m l\u01b0u l\u01b0\u1ee3ng d\u00f2ng ch\u1ea3y nhanh hay d\u00f2ng ch\u1ea3y ch\u1eadm.<\/p>\n<p><strong>C\u1ed9ng h\u01b0\u1edfng t\u1eeb: <\/strong>C\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u r\u1ea5t cao \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n v\u00e0 ph\u00e2n lo\u1ea1i d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u, \u0111\u1eb7c bi\u1ec7t ch\u1ec9 ra m\u1ee9c \u0111\u1ed9 lan t\u1ecfa c\u1ee7a d\u1ecb d\u1ea1ng, s\u1ef1 \u1ea3nh h\u01b0\u1edfng t\u1edbi c\u00e1c c\u1ea5u tr\u00fac m\u00f4 m\u1ec1m v\u00e0 x\u01b0\u01a1ng.<\/p>\n<p><strong>Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh \u0111a d\u00e3y v\u00e0 ch\u1ee5p m\u1ea1ch m\u00e1u c\u1ea3n quang: <\/strong>Ch\u1ec9 \u0111\u1ecbnh \u01b0u ti\u00ean trong ch\u1ea9n \u0111o\u00e1n d\u1ecb d\u1ea1ng \u0111\u1ed9ng &#8211; t\u0129nh m\u1ea1ch. Ch\u1ee5p m\u1ea1ch m\u00e1u c\u1ea3n quang \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p can thi\u1ec7p b\u00edt d\u1ecb d\u1ea1ng\/th\u00f4ng \u0111\u1ed9ng t\u0129nh m\u1ea1ch.<\/p>\n<h2>5. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/h2>\n<p>T\u1ed5n th\u01b0\u01a1ng da do vi\u00eam (u h\u1ea1t sinh m\u1ee7), d\u1ecb \u1ee9ng.<\/p>\n<p>U l\u00e0nh t\u00ednh t\u0103ng sinh m\u1ea1ch m\u00e1u (leiomyoma, adenofibroma).<\/p>\n<p>U \u00e1c t\u00ednh t\u0103ng sinh m\u1ea1ch m\u00e1u. Sarcom Kaposi.<\/p>\n<p>H\u1ed3ng ban trong lupus ban \u0111\u1ecf, thi\u1ebfu m\u00e1u thi\u1ebfu s\u1eaft, thi\u1ebfu vitamin B.<\/p>\n<h2>6. \u0110i\u1ec1u tr\u1ecb<\/h2>\n<h3><strong>6.1 U m\u00e1u<\/strong><\/h3>\n<p>H\u1ea7u h\u1ebft u m\u00e1u tho\u00e1i tri\u1ec3n t\u1ef1 nhi\u00ean, ch\u1ec9 c\u1ea7n theo d\u00f5i \u0111\u1ecbnh k\u1ef3. Kho\u1ea3ng 20% u m\u00e1u c\u00f3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn l\u00e2m s\u00e0ng, vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb t\u00f9y v\u00e0o b\u1ea3n ch\u1ea5t v\u00e0 v\u1ecb tr\u00ed c\u1ee7a kh\u1ed1i u:<\/p>\n<p><em>N\u1ed9i khoa<\/em>: Ch\u1eb9n beta giao c\u1ea3m v\u1edbi propranolol, \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh s\u1edbm v\u00e0 duy tr\u00ec t\u1edbi khi tr\u1ebb \u0111\u01b0\u1ee3c \u00edt nh\u1ea5t 1 tu\u1ed5i.<\/p>\n<p>C\u01a1 ch\u1ebf: Tri\u1ec7t ti\u00eau c\u00e1c \u0111\u01b0\u1eddng d\u0201n t\u00edn hi\u1ec7u c\u1ee7a y\u1ebfu t\u1ed1 t\u0103ng tr\u01b0\u1edfng n\u1ed9i m\u00f4 m\u1ea1ch m\u00e1u v\u00e0 STAT 3 ( <em>signal transducer and activator of transcription 3) <\/em>.<\/p>\n<p><em>Ngo\u1ea1i khoa<\/em>: Ch\u1ec9 \u0111\u1ecbnh v\u1edbi nh\u1eefng u m\u00e1u nguy c\u01a1 cao g\u00e2y bi\u1ebfn ch\u1ee9ng: Ch\u00e8n \u00e9p c\u00e1c \u0111\u01b0\u1eddng th\u1edf, m\u1eaft, n\u1ed9i t\u1ea1ng; lo\u00e9t, ch\u1ea3y m\u00e1u; ho\u1eb7c \u1ea3nh h\u01b0\u1edfng th\u1ea9m m\u1ef9 n\u1eb7ng n\u1ec1.<\/p>\n<h2>6.2 D\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u<\/h2>\n<p><strong>Nguy\u00ean t\u1eafc chung:<\/strong><\/p>\n<p>M\u1ecdi d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u c\u1ea7n ph\u1ea3i \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c v\u00e0 theo d\u00f5i \u0111\u1ecbnh k\u1ef3.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb s\u1edbm v\u00e0 t\u00edch c\u1ef1c \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho nh\u1eefng tr\u01b0\u1eddng h\u1ee3p d\u1ecb d\u1ea1ng ph\u1ee9c t\u1ea1p g\u00e2y \u1ea3nh h\u01b0\u1edfng th\u1ea9m m\u1ef9 n\u1eb7ng n\u1ec1, ho\u1eb7c nguy c\u01a1 bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda ch\u1ee9c n\u0103ng s\u1ed1ng v\u00e0 v\u1eadn \u0111\u1ed9ng chi. Tuy nhi\u00ean c\u1ea7n ph\u1ea3i \u0111\u1ea3m b\u1ea3o l\u1ee3i \u00edch c\u1ee7a can thi\u1ec7p, ph\u0201u thu\u1eadt v\u01b0\u1ee3t tr\u1ed9i h\u01a1n nguy c\u01a1 bi\u1ebfn ch\u1ee9ng, v\u00ec m\u1ecdi \u0111i\u1ec1u tr\u1ecb kh\u00f4ng c\u00f3 k\u1ebf ho\u1ea1ch s\u1ebd g\u00e2y kh\u00f3 kh\u0103n cho c\u00e1c ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb kh\u00e1c v\u1ec1 sau.<\/p>\n<p>V\u00ec v\u1eady, l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00ean \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n b\u1edfi nh\u00f3m chuy\u00ean gia \u0111a ng\u00e0nh: Tim m\u1ea1ch, nhi khoa, ph\u0201u thu\u1eadt, da li\u1ec5u, \u0111i\u1ec7n quang.<\/p>\n<p><strong>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb:<\/strong><\/p>\n<p>B\u0103ng \u00e9p, t\u1ea5t chun \u00e1p l\u1ef1c.<\/p>\n<p>N\u1ed9i khoa: Sirolimus, thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng&#8230;<\/p>\n<p>Can thi\u1ec7p g\u00e2y n\u00fat kh\u1ed1i d\u1ecb d\u1ea1ng b\u1eb1ng h\u1ea1t, keo ho\u1eb7c coil.<\/p>\n<p>Ti\u00eam x\u01a1 b\u1eb1ng c\u1ed3n tuy\u1ec7t \u0111\u1ed1i, polidocanol (v\u1edbi d\u1ecb d\u1ea1ng t\u0129nh m\u1ea1ch), picibanil (v\u1edbi d\u1ecb d\u1ea1ng b\u1ea1ch m\u1ea1ch).<\/p>\n<p>Ph\u0201u thu\u1eadt l\u1ea5y b\u1ecf kh\u1ed1i d\u1ecb d\u1ea1ng.<\/p>\n<p>Laser m\u00e0u v\u1edbi d\u1ecb d\u1ea1ng mao m\u1ea1ch: \u0110i\u1ec1u tr\u1ecb nh\u1eb1m m\u1ee5c ti\u00eau th\u1ea9m m\u1ef9.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u bao g\u1ed3m u m\u1ea1ch m\u00e1u v\u00e0 d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ea3 h\u1ec7 th\u1ed1ng \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch v\u00e0\/ho\u1eb7c m\u1ea1ch b\u1ea1ch huy\u1ebft. B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n \u1edf \u0111\u1ea7u, m\u1eb7t, c\u1ed5 th\u00e2n m\u00ecnh ho\u1eb7c ch\u00e2n tay, v\u1edbi bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng r\u1ea5t \u0111a d\u1ea1ng. 1.Ph\u00e2n lo\u1ea1i [&hellip;]<\/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":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u bao g\u1ed3m u m\u1ea1ch m\u00e1u v\u00e0 d\u1ecb d\u1ea1ng m\u1ea1ch m\u00e1u, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ea3 h\u1ec7 th\u1ed1ng \u0111\u1ed9ng m\u1ea1ch, t\u0129nh m\u1ea1ch v\u00e0\/ho\u1eb7c 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=\"B\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u b\u1ea9m sinh - 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