{"id":30995,"date":"2023-05-04T17:14:51","date_gmt":"2023-05-04T10:14:51","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=30995"},"modified":"2023-05-08T12:52:10","modified_gmt":"2023-05-08T05:52:10","slug":"kho","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/04\/kho\/","title":{"rendered":"Ti\u1ebfp c\u1eadn l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf"},"content":{"rendered":"

Kh\u00f3 th\u1edf l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a nhi\u1ec1u b\u1ec7nh l\u00fd. Vi\u1ec7c ti\u1ebfp c\u1eadn v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf \u0111\u00f3ng vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n c\u1ee7a tri\u1ec7u ch\u1ee9ng v\u00e0 quy\u1ebft \u0111\u1ecbnh ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/strong><\/p>\n

1. H\u1ecfi b\u1ec7nh<\/strong><\/h1>\n

– H\u1ecfi ti\u1ec1n s\u1eed b\u1ea3n th\u00e2n: h\u00fat thu\u1ed1c l\u00e1, m\u1eafc c\u00e1c b\u1ec7nh h\u00f4 h\u1ea5p m\u1ea1n t\u00ednh (BPTNMT, hen ph\u1ebf qu\u1ea3n, gi\u00e3n ph\u1ebf qu\u1ea3n), b\u1ec7nh tim m\u1ea1ch (t\u0103ng huy\u1ebft \u00e1p, suy tim), b\u1ec7nh d\u1ecb \u1ee9ng (d\u1ecb \u1ee9ng th\u1eddi ti\u1ebft, d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n).<\/p>\n

– C\u01a1n kh\u00f3 th\u1edf xu\u1ea5t hi\u1ec7n \u0111\u1ed9t ng\u1ed9t hay t\u1eeb t\u1eeb.<\/p>\n

– Ti\u1ebfn tri\u1ec3n c\u1ee7a c\u01a1n kh\u00f3 th\u1edf: Li\u00ean t\u1ee5c hay t\u1eebng c\u01a1n, li\u00ean quan \u0111\u1ebfn nh\u1ecbp ng\u00e0y \u0111\u00eam hay theo m\u00f9a.<\/p>\n

– Ho\u00e0n c\u1ea3nh xu\u1ea5t hi\u1ec7n: L\u00fac ngh\u1ec9 ng\u01a1i hay khi g\u1eafng s\u1ee9c, m\u1ee9c \u0111\u1ed9 g\u1eafng s\u1ee9c l\u00e0m xu\u1ea5t hi\u1ec7n kh\u00f3 th\u1edf.<\/p>\n

– Di\u1ec5n bi\u1ebfn c\u01a1n kh\u00f3 th\u1edf: C\u1ea5p t\u00ednh, m\u1ea1n t\u00ednh ho\u1eb7c t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n.<\/p>\n

– Kh\u00f3 th\u1edf thay \u0111\u1ed5i theo t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n: Kh\u00f3 th\u1edf khi n\u1eb1m, khi thay \u0111\u1ed5i t\u1eeb t\u01b0 th\u1ebf n\u1eb1m sang t\u01b0 th\u1ebf ng\u1ed3i ho\u1eb7c \u0111\u1ee9ng.<\/p>\n

– Bi\u1ebfn \u0111\u1ed5i theo c\u00e1c y\u1ebfu t\u1ed1 m\u00f4i tr\u01b0\u1eddng: Kh\u00ed h\u1eadu, n\u01a1i \u1edf, n\u01a1i l\u00e0m vi\u1ec7c<\/p>\n

– Kh\u00f3 th\u1edf l\u00fac h\u00edt v\u00e0o hay th\u1edf ra hay kh\u00f3 th\u1edf c\u1ea3 hai th\u00ec.<\/p>\n

– Ph\u00e1t hi\u1ec7n nh\u1eefng y\u1ebfu t\u1ed1 l\u00e0m cho c\u01a1n kh\u00f3 th\u1edf n\u1eb7ng th\u00eam (h\u00fat thu\u1ed1c l\u00e1, d\u1ecb nguy\u00ean, b\u1ee5i kh\u00f3i) ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 l\u00e0m kh\u00f3 th\u1edf gi\u1ea3m \u0111i: t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n (n\u1eb1m \u0111\u1ea7u cao, t\u01b0 th\u1ebf ng\u1ed3i) ho\u1eb7c do d\u00f9ng thu\u1ed1c (thu\u1ed1c gi\u00e3n ph\u1ebf qu\u1ea3n, thu\u1ed1c l\u1ee3i ti\u1ec3u, thu\u1ed1c tr\u1ee3 tim…).<\/p>\n

– Tri\u1ec7u ch\u1ee9ng k\u00e8m theo kh\u00e1c: \u0111au ng\u1ef1c, ho, kh\u1ea1c \u0111\u1eddm, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, ti\u1ebfng th\u1edf r\u00edt, ti\u1ebfng ng\u00e1y l\u00fac ng\u1ee7. S\u1ed1t, m\u1ec7t m\u1ecfi, s\u00fat c\u00e2n, r\u1ed1i lo\u1ea1n \u00fd th\u1ee9c, t\u00e2m th\u1ea7n.<\/p>\n

\"\"
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 Ngu\u1ed3n: Cleveland Clinic<\/strong><\/figcaption><\/figure>\n

2. Kh\u00e1m l\u00e2m s\u00e0ng<\/em><\/strong><\/h2>\n

– Quan s\u00e1t ki\u1ec3u th\u1edf, th\u1ec3 tr\u1ea1ng, t\u01b0 th\u1ebf b\u1ec7nh nh\u00e2n gi\u00fap ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n kh\u00f3 th\u1edf.<\/p>\n

– Bi\u1ebfn d\u1ea1ng l\u1ed3ng ng\u1ef1c<\/strong>:<\/p>\n

+ L\u1ed3ng ng\u1ef1c h\u00ecnh th\u00f9ng: kh\u00ed ph\u1ebf th\u0169ng, b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u00e3n t\u00ednh, hen ph\u1ebf qu\u1ea3n.<\/p>\n

+ L\u1ed3ng ng\u1ef1c kh\u00f4ng c\u00e2n \u0111\u1ed1i: L\u1ed3ng ng\u1ef1c b\u00ean b\u1ec7nh b\u1ecb l\u00e9p, khoang li\u00ean s\u01b0\u1eddn h\u1eb9p do x\u1eb9p ph\u1ed5i. L\u1ed3ng ng\u1ef1c v\u1ed3ng l\u00ean \u1edf 1 b\u00ean, x\u01b0\u01a1ng s\u01b0\u1eddn n\u1eb1m ngang, khoang li\u00ean s\u01b0\u1eddn gi\u00e3n r\u1ed9ng do tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i ho\u1eb7c tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i nhi\u1ec1u.<\/p>\n

+ Bi\u1ebfn d\u1ea1ng l\u1ed3ng ng\u1ef1c do g\u00f9 v\u1eb9o c\u1ed9t s\u1ed1ng ho\u1eb7c l\u1ed3ng ng\u1ef1c h\u00ecnh ng\u1ef1c g\u00e0.<\/p>\n

– \u0110\u1ebfm t\u1ea7n s\u1ed1 th\u1edf:<\/strong> B\u00ecnh th\u01b0\u1eddng t\u1ea7n s\u1ed1 th\u1edf 16-20 l\u1ea7n\/ph\u00fat. N\u1ebfu t\u1ea7n s\u1ed1 th\u1edf > 20 l\u1ea7n\/ph\u00fat l\u00e0 c\u00f3 kh\u00f3 th\u1edf nhanh n\u1ebfu t\u1ea7n s\u1ed1 th\u1edf < 16 l\u1ea7n\/ph\u00fat \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 kh\u00f3 th\u1edf ch\u1eadm.<\/p>\n

– R\u1ed1i lo\u1ea1n nh\u1ecbp th\u1edf<\/strong>:<\/p>\n

+ Kh\u00f3 th\u1edf ki\u1ec3u Kussmaul: 04 th\u00ec ( H\u00edt v\u00e0o – Ngh\u1ec9 – Th\u1edf ra – Ngh\u1ec9 )<\/p>\n

+ Kh\u00f3 th\u1edf ki\u1ec3u Cheynes- stokes: th\u1edf nhanh, c\u01b0\u1eddng \u0111\u1ed9 th\u1edf t\u0103ng d\u1ea7n, sau \u0111\u00f3 c\u01b0\u1eddng \u0111\u1ed9 th\u1edf gi\u1ea3m d\u1ea7n r\u1ed3i ngh\u1ec9.<\/p>\n

2.1. D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng c\u1ee7a suy h\u00f4 h\u1ea5p – suy tu\u1ea7n ho\u00e0n c\u1ea5p<\/em><\/strong><\/h3>\n

– T\u00edm m\u00f4i, \u0111\u1ea7u chi, ho\u1eb7c t\u00edm to\u00e0n th\u00e2n.<\/p>\n

– R\u1ed1i lo\u1ea1n \u00fd th\u1ee9c: ng\u1ee7 g\u00e0, l\u00fa l\u1eabn, h\u00f4n m\u00ea, ho\u1eb7c k\u00edch th\u00edch, v\u1eadt v\u00e3.<\/p>\n

– Co k\u00e9o c\u00e1c c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5: co k\u00e9o c\u00e1c c\u01a1 li\u00ean s\u01b0\u1eddn, r\u00fat l\u00f5m h\u1ed1 tr\u00ean \u0111\u00f2n, h\u00f5m \u1ee9c. H\u00f4 h\u1ea5p ngh\u1ecbch th\u01b0\u1eddng v\u1edbi s\u1ef1 di \u0111\u1ed9ng ng\u01b0\u1ee3c chi\u1ec1u c\u1ee7a c\u01a1 ng\u1ef1c v\u00e0 b\u1ee5ng trong th\u00ec h\u00edt v\u00e0o.<\/p>\n

– R\u1ed1i lo\u1ea1n nh\u1ecbp tim: nh\u1ecbp tim nhanh ch\u1eadm kh\u00f4ng \u0111\u1ec1u, khi nh\u1ecbp tim ch\u1eadm c\u00f3 th\u1ec3 l\u00e0 tri\u1ec7u ch\u1ee9ng b\u00e1o hi\u1ec7u s\u1eafp ng\u1eebng tim.<\/p>\n

– T\u1ee5t HA, c\u00f3 d\u1ea5u hi\u1ec7u s\u1ed1c: n\u1ed5i v\u00e2n t\u00edm, v\u00e3 m\u1ed3 h\u00f4i, \u0111\u1ea7u chi l\u1ea1nh.<\/p>\n

– Co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p v\u00e0 c\u00f3 ti\u1ebfng r\u00edt khi h\u00edt v\u00e0o c\u00f3 th\u1ec3 l\u00e0 b\u1eb1ng ch\u1ee9ng c\u1ee7a t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng th\u1edf \u1edf cao: d\u1ecb v\u1eadt, vi\u00eam n\u1eafp thanh qu\u1ea3n…<\/p>\n

– Kh\u00f3 th\u1edf th\u00ec th\u1edf ra g\u1ee3i \u00fd c\u00f3 t\u1eafc ngh\u1ebdn ph\u1ebf qu\u1ea3n.<\/p>\n

2.2. Ki\u1ec3u xu\u1ea5t hi\u1ec7n t\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf<\/em><\/strong><\/h3>\n

– \u0110\u1ed9t ng\u1ed9t: d\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf, nh\u1ed3i m\u00e1u ph\u1ed5i, tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i.<\/p>\n

– Ti\u1ebfn tri\u1ec3n nhanh: ph\u00f9 ph\u1ed5i c\u1ea5p, c\u01a1n hen ph\u1ebf qu\u1ea3n, vi\u00eam n\u1eafp thanh qu\u1ea3n, vi\u00eam ph\u1ed5i.<\/p>\n

– Kh\u00f3 th\u1edf t\u0103ng d\u1ea7n: U ph\u1ed5i g\u00e2y t\u1eafc ngh\u1ebdn ph\u1ebf qu\u1ea3n, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i, suy tim tr\u00e1i.<\/p>\n

2.3. Ho\u00e0n c\u1ea3nh xu\u1ea5t hi\u1ec7n kh\u00f3 th\u1edf<\/em><\/strong><\/h3>\n

– Kh\u00f3 th\u1edf khi n\u1eb1m: g\u1ee3i \u00fd ph\u00f9 ph\u1ed5i c\u1ea5p, suy tim tr\u00e1i, nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p trong BPTNMT, hen ph\u1ebf qu\u1ea3n, li\u1ec7t c\u01a1 ho\u00e0nh, c\u1ed5 tr\u01b0\u1edbng.<\/p>\n

– Kh\u00f3 th\u1edf khi \u0111\u1ee9ng hay n\u1eb1m v\u1ec1 m\u1ed9t ph\u00eda: Kh\u00f3 th\u1edf lo\u1ea1i n\u00e0y hi\u1ebfm g\u1eb7p h\u01a1n, nguy\u00ean nh\u00e2n th\u01b0\u1eddng do t\u1eafc ngh\u1ebdn, thay \u0111\u1ed5i t\u1ef7 l\u1ec7 th\u00f4ng kh\u00ed \/t\u01b0\u1edbi m\u00e1u li\u00ean quan v\u1edbi t\u01b0 th\u1ebf, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i.<\/p>\n

– Kh\u00f3 th\u1edf k\u1ecbch ph\u00e1t (hen, ph\u00f9 ph\u1ed5i c\u1ea5p), nh\u1ea5t l\u00e0 kh\u00f3 th\u1edf v\u1ec1 \u0111\u00eam (ph\u00f9 ph\u1ed5i c\u1ea5p).<\/p>\n

– Khi g\u1eafng s\u1ee9c: suy tim tr\u00e1i, hen g\u1eafng s\u1ee9c, BPTNMT, t\u00e2m ph\u1ebf m\u1ea1n…<\/p>\n

– Ch\u1ec9 xu\u1ea5t hi\u1ec7n khi ngh\u1ec9 ng\u01a1i: th\u01b0\u1eddng g\u1ee3i \u00fd nguy\u00ean nh\u00e2n c\u01a1 n\u0103ng.<\/p>\n

– Kh\u00f3 th\u1edf khi \u0103n: s\u1eb7c, h\u00edt ph\u1ea3i d\u1ecb v\u1eadt.<\/p>\n

2.4. Kh\u00f3 th\u1edf thanh qu\u1ea3n<\/em><\/strong><\/h3>\n

– Ch\u1ea9n \u0111o\u00e1n d\u1ef1a v\u00e0o: kh\u00f3 th\u1edf khi h\u00edt v\u00e0o, co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5, \u0111\u00f4i khi c\u00f3 ti\u1ebfng th\u1edf r\u00edt, kh\u00e0n ti\u1ebfng ho\u1eb7c m\u1ea5t ti\u1ebfng.<\/p>\n

– T\u00ecm c\u00e1c d\u1ea5u hi\u1ec7u n\u1eb7ng tr\u00ean l\u00e2m s\u00e0ng: d\u1ea5u hi\u1ec7u suy h\u00f4 h\u1ea5p c\u1ea5p, ki\u1ec7t s\u1ee9c, b\u1ec7nh nh\u00e2n ph\u1ea3i \u1edf t\u01b0 th\u1ebf ng\u1ed3i.<\/p>\n

– B\u1ec7nh c\u1ea3nh l\u00e2m s\u00e0ng tr\u00ean c\u00f3 th\u1ec3 do:<\/p>\n

+ D\u1ecb v\u1eadt \u0111\u01b0\u1eddng th\u1edf: x\u1ea3y ra khi \u0111ang \u0103n, tr\u00ean m\u1ed9t ng\u01b0\u1eddi cao tu\u1ed5i.<\/p>\n

+ Vi\u00eam s\u1ee5n n\u1eafp thanh qu\u1ea3n do nhi\u1ec5m khu\u1ea9n.<\/p>\n

+ Ph\u00f9 Quincke<\/span>: b\u1ec7nh c\u1ea3nh d\u1ecb \u1ee9ng.<\/p>\n

+ Do u: kh\u00f3 th\u1edf t\u0103ng d\u1ea7n \u1edf b\u1ec7nh nh\u00e2n trung ni\u00ean, nghi\u1ec7n thu\u1ed1c l\u00e1.<\/p>\n

+ Ch\u1ea5n th\u01b0\u01a1ng thanh qu\u1ea3n.<\/p>\n

+ Di ch\u1ee9ng c\u1ee7a th\u1ee7 thu\u1eadt \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n hay m\u1edf kh\u00ed qu\u1ea3n.<\/p>\n

2.5. Kh\u00f3 th\u1edf k\u1ebft h\u1ee3p v\u1edbi \u0111au ng\u1ef1c c\u00f3 th\u1ec3 do<\/em><\/strong><\/h3>\n

–\u00a0Nh\u1ed3i m\u00e1u ph\u1ed5i<\/strong>:<\/em>\u00a0L\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 d\u1ea5u hi\u1ec7u vi\u00eam t\u1eafc t\u0129nh m\u1ea1ch chi. B\u1ec7nh nh\u00e2n c\u00f3 \u0111au ng\u1ef1c k\u00e8m theo ho ra m\u00e1u, c\u00f3 th\u1ec3 c\u00f3 s\u1ed1t. X\u00e9t nghi\u1ec7m c\u1ea7n l\u00e0m c\u1ea5p c\u1ee9u bao g\u1ed3m \u0111i\u1ec7n tim, X-quang ph\u1ed5i, kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch, \u0111\u1ecbnh l\u01b0\u1ee3ng D-dimer cung c\u1ea5p nh\u1eefng b\u1eb1ng ch\u1ee9ng \u0111\u1ecbnh h\u01b0\u1edbng hay lo\u1ea1i tr\u1eeb ch\u1ea9n \u0111o\u00e1n nh\u1ed3i m\u00e1u ph\u1ed5i tr\u01b0\u1edbc khi quy\u1ebft \u0111\u1ecbnh ch\u1ec9 \u0111\u1ecbnh c\u00e1c th\u0103m d\u00f2 h\u00ecnh \u1ea3nh chuy\u00ean s\u00e2u: ch\u1ee5p MSCT c\u00f3 t\u00e1i t\u1ea1o 3D \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i, x\u1ea1 h\u00ecnh th\u00f4ng kh\u00ed t\u01b0\u1edbi m\u00e1u ph\u1ed5i.<\/p>\n

–\u00a0Suy th\u1ea5t tr\u00e1i ph\u1ed1i h\u1ee3p v\u1edbi b\u1ec7nh tim thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9<\/strong>:<\/em>\u00a0T\u00ecm ki\u1ebfm c\u00e1c d\u1ea5u hi\u1ec7u thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 tr\u00ean \u0111i\u1ec7n tim (thay \u0111\u1ed5i c\u1ee7a ST v\u00e0 T).<\/p>\n

–\u00a0Tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i t\u1ef1 ph\u00e1t<\/strong>:<\/em> \u0110au ng\u1ef1c \u0111\u1ed9t ng\u1ed9t, th\u01b0\u1eddng x\u1ea3y ra \u1edf ng\u01b0\u1eddi tr\u1ebb tu\u1ed5i. Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 tam ch\u1ee9ng Galliard<\/span>. Ch\u1ea9n \u0111o\u00e1n d\u1ef1a tr\u00ean phim ch\u1ee5p X-quang ph\u1ed5i th\u1eb3ng.<\/p>\n

–\u00a0Vi\u00eam m\u00e0ng ph\u1ed5i<\/strong>:<\/em>\u00a0Ch\u1ea9n \u0111o\u00e1n d\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a \u0111au ng\u1ef1c (c\u00f3 th\u1ec3 kh\u00f4ng \u0111\u1eb7c hi\u1ec7u): \u0111au t\u0103ng l\u00ean khi ho khi h\u1eaft h\u01a1i ho\u1eb7c khi h\u00edt th\u1edf. Kh\u00e1m l\u00e2m s\u00e0ng giai \u0111oan \u0111\u1ea7u c\u00f3 th\u1ec3 c\u00f3 ti\u1ebfng c\u1ecd m\u00e0ng ph\u1ed5i, giai \u0111o\u1ea1n sau c\u00f3 h\u1ed9i ch\u1ee9ng ba gi\u1ea3m. X\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n b\u1eb1ng ch\u1ee5p phim X-quang ng\u1ef1c th\u1eb3ng v\u00e0 nghi\u00eang.<\/p>\n

2.6. N\u1ebfu c\u00f3 s\u1ed1t k\u00e8m theo ph\u1ea3i h\u01b0\u1edbng \u0111\u1ebfn c\u00e1c nguy\u00ean nh\u00e2n nhi\u1ec5m tr\u00f9ng<\/em><\/strong><\/h3>\n

– Vi\u00eam ph\u1ed5i:<\/strong> Nghe th\u1ea5y ran \u1ea9m, ran n\u1ed5 khu tr\u00fa v\u1edbi ti\u1ebfng th\u1ed5i \u1ed1ng, \u0111\u00f4i khi b\u1ec7nh nh\u00e2n kh\u1ea1c \u0111\u1eddm m\u1ee7. Ch\u1ee5p phim X-quang ph\u1ed5i l\u00e0 x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n \u0111\u1ec3 kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n v\u00e0 c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n nguy\u00ean nh\u00e2n: vi\u00eam ph\u1ed5i thu\u1ef3 do ph\u1ebf c\u1ea7u khu\u1ea9n, b\u1ec7nh ph\u1ed5i k\u1ebd, lao ph\u1ed5i…<\/p>\n

–\u00a0Tr\u00e0n m\u1ee7 m\u00e0ng ph\u1ed5i:<\/em>\u00a0<\/strong>Kh\u00f3 th\u1edf t\u0103ng d\u1ea7n, ho kh\u1ea1c \u0111\u1eddm m\u1ee7, kh\u00f3 th\u1edf. Ch\u1ee5p X-quang ph\u1ed5i th\u1ea5y h\u00ecnh tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i. Ch\u1ecdc d\u00f2 m\u00e0ng ph\u1ed5i th\u1ea5y m\u1ee7.<\/p>\n

–\u00a0C\u00e1c b\u1ec7nh ph\u1ed5i nhi\u1ec5m tr\u00f9ng kh\u00e1c<\/strong>:<\/em>\u00a0\u00c1p xe ph\u1ed5i, \u0111\u1ee3t b\u1ed9i nhi\u1ec5m c\u1ee7a c\u00e1c b\u1ec7nh ph\u1ed5i m\u1ea1n t\u00ednh: gi\u00e3n ph\u1ebf qu\u1ea3n b\u1ed9i nhi\u1ec5m, \u0111\u1ee3t c\u1ea5p BPTNMT do b\u1ed9i nhi\u1ec5m.<\/p>\n

2.7. R\u1ed1i lo\u1ea1n \u00fd th\u1ee9c ho\u1eb7c c\u00f3 c\u00e1c b\u1ec7nh l\u00fd th\u1ea7n kinh<\/em><\/h3>\n

G\u1ee3i \u00fd t\u1edbi kh\u1ea3 n\u0103ng b\u1ec7nh nh\u00e2n b\u1ecb vi\u00eam ph\u1ed5i do h\u00edt ph\u1ea3i. C\u1ea7n kh\u1eb3ng \u0111\u1ecbnh b\u1eb1ng phim X-quang v\u00e0 t\u1ed1t nh\u1ea5t ph\u1ea3i n\u1ed9i soi ph\u1ebf qu\u1ea3n b\u1eb1ng \u1ed1ng soi m\u1ec1m \u0111\u1ec3 h\u00fat d\u1ecbch v\u00e0 g\u1eafp d\u1ecb v\u1eadt.<\/p>\n

2.8. To\u00e0n tr\u1ea1ng b\u1ecb bi\u1ebfn \u0111\u1ed5i<\/em><\/h3>\n

G\u1ee3i \u00fd m\u1ed9t c\u0103n nguy\u00ean ung th\u01b0 (nh\u1ea5t l\u00e0 khi b\u1ec7nh nh\u00e2n c\u00f3 kh\u00f3 th\u1edf t\u0103ng d\u1ea7n), ho\u1eb7c do lao (ho, s\u1ed1t, c\u01a1 \u0111\u1ecba gi\u00e0 y\u1ebfu, suy gi\u1ea3m mi\u1ec5n d\u1ecbch, c\u00f3 ti\u1ec1n s\u1eed ti\u1ebfp x\u00fac v\u1edbi ngu\u1ed3n l\u00e2y). Ch\u1ee5p phim X-quang ng\u1ef1c l\u00e0 x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng ch\u1ea9n \u0111o\u00e1n.<\/p>\n

2.9. C\u01a1n hen ph\u1ebf qu\u1ea3n<\/em><\/h3>\n

Th\u01b0\u1eddng d\u1ec5 ch\u1ea9n \u0111o\u00e1n khi ti\u1ec1n s\u1eed bi\u1ebft r\u00f5, c\u01a1n kh\u00f3 th\u1edf x\u1ea3y ra \u0111\u1ed9t ng\u1ed9t, kh\u00f3 th\u1edf ra v\u1edbi ran r\u00edt. Trong c\u1ea5p c\u1ee9u ban \u0111\u1ea7u, v\u1ea5n \u0111\u1ec1 c\u01a1 b\u1ea3n l\u00e0 ph\u00e1t hi\u1ec7n v\u00e0 nh\u1eadn \u0111\u1ecbnh c\u00e1c d\u1ea5u hi\u1ec7u \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a c\u01a1n hen<\/p>\n

2.10. Ph\u00f9 ph\u1ed5i c\u1ea5p do tim<\/em><\/h3>\n

Ti\u1ec1n s\u1eed b\u1ec7nh tim t\u1eeb tr\u01b0\u1edbc (b\u1ec7nh c\u01a1 tim do thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, b\u1ec7nh van tim, b\u1ec7nh c\u01a1 tim). C\u01a1n kh\u00f3 th\u1edf th\u01b0\u1eddng x\u1ea3y ra v\u00e0o ban \u0111\u00eam, nghe th\u1ea5y c\u00f3 ran \u1ea9m \u1edf c\u1ea3 2 tr\u01b0\u1eddng ph\u1ed5i, c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n nhanh qua c\u00e1c l\u1ea7n kh\u00e1m. Ch\u1ee5p phim X-quang: h\u00ecnh m\u1edd c\u00e1nh b\u01b0\u1edbm, ph\u00f9 c\u00e1c ph\u1ebf nang lan to\u1ea3 \u1edf c\u1ea3 hai b\u00ean, \u0111\u00f4i khi th\u1ea5y c\u00e1c \u0111\u01b0\u1eddng Kerley B hay t\u00e1i ph\u00e2n b\u1ed1 l\u1ea1i m\u1ea1ch m\u00e1u v\u1ec1 ph\u00eda \u0111\u1ec9nh ph\u1ed5i. Kh\u00f4ng n\u00ean ch\u1ea7n ch\u1eeb x\u1eed tr\u00ed c\u1ea5p c\u1ee9u khi ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng r\u00f5 r\u00e0ng.<\/p>\n

2.11. Ph\u00f9 ph\u1ed5i c\u1ea5p t\u1ed5n th\u01b0\u01a1ng (ARDS)<\/em><\/h3>\n

V\u1edbi b\u1ec7nh c\u1ea3nh suy h\u00f4 h\u1ea5p c\u1ea5p ph\u1ed1i h\u1ee3p v\u1edbi gi\u1ea3m oxy m\u00e1u n\u1eb7ng, X-quang ph\u1ed5i c\u00f3 h\u00ecnh \u1ea3nh ph\u00f9 ph\u1ed5i ki\u1ec3u t\u1ed5n th\u01b0\u01a1ng (ph\u1ed5i tr\u1eafng x\u00f3a c\u1ea3 hai b\u00ean), kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u suy tim tr\u00e1i. M\u1ed9t s\u1ed1 b\u1ec7nh c\u1ea3nh c\u1ea5p t\u00ednh v\u00e0 n\u1eb7ng g\u1eb7p trong nhi\u1ec1u t\u00ecnh hu\u1ed1ng kh\u00e1c nhau d\u1ec5 g\u00e2y ARDS bao g\u1ed3m:<\/p>\n

– T\u1ed5n th\u01b0\u01a1ng ph\u1ed5i: b\u1ec7nh ph\u1ed5i nhi\u1ec5m khu\u1ea9n, h\u00edt ph\u1ea3i kh\u00ed \u0111\u1ed9c, d\u1ecbch v\u1ecb, \u0111u\u1ed1i n\u01b0\u1edbc, \u0111\u1ee5ng d\u1eadp ph\u1ed5i.<\/p>\n

– B\u1ec7nh l\u00fd ngo\u00e0i ph\u1ed5i: t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u1ea9n n\u1eb7ng, vi\u00eam tu\u1ef5 c\u1ea5p, \u0111a ch\u1ea5n th\u01b0\u01a1ng, t\u1eafc m\u1ea1ch m\u1ee1…<\/p>\n

– C\u1ea7n chuy\u1ec3n ngay b\u1ec7nh nh\u00e2n \u0111\u1ebfn khoa h\u1ed3i s\u1ee9c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p chuy\u00ean khoa.<\/p>\n

2.12. Ph\u1ea7n l\u1edbn c\u00e1c c\u01a1n kh\u00f3 th\u1edf g\u1eb7p t\u1ea1i ph\u00f2ng kh\u00e1m c\u1ea5p c\u1ee9u l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a \u0111\u1ee3t m\u1ea5t b\u00f9 c\u1ea5p c\u1ee7a b\u1ec7nh hen ph\u1ebf qu\u1ea3n ho\u1eb7c b\u1ec7nh ph\u1ed5i t\u1eafc ngh\u1ebdn m\u00e3n t\u00ednh. <\/em><\/h3>\n

Ti\u1ec1n s\u1eed b\u1ec7nh nh\u00e2n b\u1ecb b\u1ec7nh l\u00fd ph\u1ebf qu\u1ea3n ph\u1ed5i t\u1eafc ngh\u1ebdn m\u1ea1n t\u00ednh. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng c\u00f3 bi\u1ec3u hi\u1ec7n kh\u00f3 th\u1edf ra v\u1edbi ran r\u00edt v\u00e0 ran ng\u00e1y. \u0110o c\u00e1c kh\u00ed trong m\u00e1u \u0111\u1ed9ng m\u1ea1ch l\u00e0 x\u00e9t nghi\u1ec7m c\u01a1 b\u1ea3n \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p: th\u01b0\u1eddng th\u1ea5y gi\u1ea3m oxy m\u00e1u n\u1eb7ng, t\u0103ng CO2 m\u00e1u v\u00e0 t\u0103ng d\u1ef1 tr\u1eef ki\u1ec1m ch\u1ee9ng t\u1ecf c\u00f3 gi\u1ea3m th\u00f4ng kh\u00ed ph\u1ebf nang m\u1ea1n t\u00ednh, pH m\u00e1u gi\u1ea3m ch\u1ee9ng t\u1ecf b\u1ec7nh nh\u00e2n \u0111ang trong giai \u0111o\u1ea1n m\u1ea5t b\u00f9 h\u00f4 h\u1ea5p. Kh\u00e1m l\u00e2m s\u00e0ng ph\u00e1t hi\u1ec7n d\u1ea5u hi\u1ec7u suy tim ph\u1ea3i (t\u00e2m ph\u1ebf m\u1ea1n) v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 g\u00e2y \u0111\u1ee3t m\u1ea5t b\u00f9 c\u1ea5p \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ed9i nhi\u1ec5m ph\u1ed5i. Phim X-quang ph\u1ed5i th\u1ea5y t\u00ecnh tr\u1ea1ng gi\u00e3n ph\u1ebf nang v\u00e0 gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng nguy\u00ean nh\u00e2n g\u00e2y \u0111\u1ee3t m\u1ea5t b\u00f9 nh\u01b0 d\u1ea5u hi\u1ec7u nhi\u1ec5m khu\u1ea9n, ph\u00f9 ph\u1ed5i, tr\u00e0n kh\u00ed m\u00e0ng ph\u1ed5i.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o<\/strong>: H\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh h\u00f4 h\u1ea5p c\u1ee7a B\u1ed9 Y t\u1ebf 2012<\/p>\n","protected":false},"excerpt":{"rendered":"

Kh\u00f3 th\u1edf l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a nhi\u1ec1u b\u1ec7nh l\u00fd. Vi\u1ec7c ti\u1ebfp c\u1eadn v\u1ec1 m\u1eb7t l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf \u0111\u00f3ng vai tr\u00f2 r\u1ea5t quan tr\u1ecdng trong vi\u1ec7c x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n c\u1ee7a tri\u1ec7u ch\u1ee9ng v\u00e0 quy\u1ebft \u0111\u1ecbnh ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[20,33],"tags":[],"yoast_head":"\nTi\u1ebfp c\u1eadn l\u00e2m s\u00e0ng \u1edf b\u1ec7nh nh\u00e2n kh\u00f3 th\u1edf - Vinmec<\/title>\n<meta name=\"description\" content=\"Kh\u00f3 th\u1edf l\u00e0 m\u1ed9t tri\u1ec7u ch\u1ee9ng \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng v\u00e0 th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi l\u00e0 h\u1eadu qu\u1ea3 c\u1ee7a nhi\u1ec1u b\u1ec7nh l\u00fd. 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