{"id":32935,"date":"2023-05-11T20:27:10","date_gmt":"2023-05-11T13:27:10","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=32935"},"modified":"2023-05-11T20:27:10","modified_gmt":"2023-05-11T13:27:10","slug":"truyen-che-pham-mau-chi-dinh-va-huong-dan-lam-sang","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/11\/truyen-che-pham-mau-chi-dinh-va-huong-dan-lam-sang\/","title":{"rendered":"Truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u: ch\u1ec9 \u0111\u1ecbnh v\u00e0 h\u01b0\u1edbng d\u1eabn l\u00e2m s\u00e0ng"},"content":{"rendered":"<div class=\"PrimarySection__Root-sc-1cczl3y-0 fkSDgk\">\n<div><strong>Ng\u00e0y nay, truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u th\u00f4ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng h\u01a1n so v\u1edbi <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/mau-toan-phan-la-gi-va-duoc-dung-trong-truong-hop-nao\/\">truy\u1ec1n m\u00e1u to\u00e0n ph\u1ea7n<\/a>. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u t\u00f9y thu\u1ed9c th\u00e0nh ph\u1ea7n thi\u1ebfu h\u1ee5t. Kh\u1ed1i h\u1ed3ng c\u1ea7u \u0111\u01b0\u1ee3c truy\u1ec1n nh\u1eb1m c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng mang oxy c\u1ee7a m\u00e1u. Truy\u1ec1n m\u00e1u h\u1ea1n ch\u1ebf v\u1edbi ng\u01b0\u1ee1ng hemoglobin th\u1ea5p t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1ec1 l\u00e2m s\u00e0ng v\u1edbi truy\u1ec1n m\u00e1u t\u1ef1 do. Truy\u1ec1n huy\u1ebft t\u01b0\u01a1ng nh\u1eb1m \u0111i\u1ec1u ch\u1ec9nh r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u. Truy\u1ec1n ti\u1ec3u c\u1ea7u nh\u1eb1m \u0111i\u1ec1u tr\u1ecb ho\u1eb7c ng\u0103n ng\u1eeba ch\u1ea3y m\u00e1u do ti\u1ec3u c\u1ea7u th\u1ea5p, suy ch\u1ee9c n\u0103ng ti\u1ec3u c\u1ea7u.<\/strong><\/div>\n<h2>1. Truy\u1ec1n ch\u1ebf ph\u1ea9m <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/nhung-dieu-can-biet-ve-truyen-hong-cau-khoi\/\">kh\u1ed1i h\u1ed3ng c\u1ea7u.\u00a0<\/a><\/h2>\n<h3>1.1. Th\u00e0nh ph\u1ea7n.<\/h3>\n<ul>\n<li>H\u1ed3ng c\u1ea7u.<\/li>\n<li>Dung d\u1ecbch b\u1ea3o qu\u1ea3n, th\u01b0\u1eddng ch\u1ee9a citrate.<\/li>\n<li>Th\u1ec3 t\u00edch m\u1ed9t \u0111\u01a1n v\u1ecb <span class=\"nowrap\">\u223c200\u2013350 mL<\/span><\/li>\n<\/ul>\n<h3>1.2. Y\u00eau c\u1ea7u v\u1ec1 thu\u1eadn h\u1ee3p nh\u00f3m m\u00e1u.<\/h3>\n<ul>\n<li>Ph\u1ea3i <a href=\"https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/tim-hieu-quy-trinh-phan-ung-hoa-hop-day-du-trong-truyen-mau\/\">ph\u00f9 h\u1ee3p h\u1ec7 th\u1ed1ng nh\u00f3m m\u00e1u ABO.<\/a><\/li>\n<li>D\u00f9ng kh\u1ed1i h\u1ed3ng c\u1ea7u Rh(D) \u00e2m n\u1ebfu ng\u01b0\u1eddi nh\u1eadn Rh(D) \u00e2m.<\/li>\n<li><a href=\"https:\/\/vinmecdr.com\/quy-trinh-xet-nghiem-dinh-nhom-mau-he-abo-rh-tren-he-thong-tu-dong-hoan-toan-ortho-vision\/\">\u0110\u1ecbnh nh\u00f3m m\u00e1u v\u00e0 s\u00e0ng l\u1ecdc, th\u1eed ph\u1ea3n \u1ee9ng ch\u00e9o tr\u01b0\u1edbc khi truy\u1ec1n.<\/a><\/li>\n<\/ul>\n<h3>1.3. C\u00e1c ch\u1ec9 \u0111\u1ecbnh truy\u1ec1n ch\u1ebf ph\u1ea9m kh\u1ed1i h\u1ed3ng c\u1ea7u th\u01b0\u1eddng g\u1eb7p:<\/h3>\n<\/div>\n<div class=\"PrimarySection__Root-sc-1cczl3y-0 fkSDgk\">\n<div>\n<div class=\"content--kLKAu baseStyles-2133108132--disableImagePointerEventOnTutorial-3958995088--anchorLinkStyles-27620709\">\n<div class=\"condensed-hidden paragraph\">Quy\u1ebft \u0111\u1ecbnh truy\u1ec1n t\u00f9y thu\u1ed9c v\u00e0o t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3:<\/div>\n<ul>\n<li>Cho\u00e1ng m\u1ea5t m\u00e1u ho\u1eb7c \u0111ang m\u1ea5t m\u00e1u ti\u1ebfp di\u1ec5n nhanh.<\/li>\n<li>Thay m\u00e1u: trong b\u1ec7nh h\u1ed3ng c\u1ea7u h\u00ecnh li\u1ec1m n\u1eb7ng ho\u1eb7c methemoglobin.<\/li>\n<li>Thi\u1ebfu m\u00e1u n\u1eb7ng (ngay c\u1ea3 khi kh\u00f4ng tri\u1ec7u ch\u1ee9ng).\n<ul>\n<li><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\"><span class=\"step-1-imppact2 usmle-gs-imppact2 step-1-condensed strongImpactHighlight--qLdOc\">Hb\u00a0\u2264 7 g\/dL<\/span><\/span>\u00a0<span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">n\u1ebfu kh\u00f4ng c\u00f3 y\u1ebfu t\u1ed1 kh\u00e1c.<\/span><\/li>\n<li class=\"condensed-hidden-step1\"><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">Hb \u2264 8 g\/dL n\u1ebfu c\u00f3 b\u1ec7nh tim m\u1ea1ch n\u1ec1n ho\u1eb7c c\u1ea7n ph\u1eabu thu\u1eadt tim, ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh.<\/span><\/li>\n<\/ul>\n<\/li>\n<li>Thi\u1ebfu m\u00e1u v\u1eeba v\u00e0 k\u00e8m theo m\u1ed9t trong c\u00e1c y\u1ebfu t\u1ed1:\n<ul>\n<li>C\u00f3 tri\u1ec7u ch\u1ee9ng thi\u1ebfu m\u00e1u.<\/li>\n<li class=\"condensed-hidden\">Nguy c\u01a1 bi\u1ebfn ch\u1ee9ng cao nh\u01b0: kh\u1edfi ph\u00e1t c\u1ea5p, tu\u1ed5i cao, nhi\u1ec1u b\u1ec7nh \u0111\u1ed3ng m\u1eafc.<\/li>\n<li class=\"condensed-hidden\">Tri\u1ec7u ch\u1ee9ng c\u1ee7a gi\u1ea3m oxy m\u00f4.<\/li>\n<li class=\"condensed-hidden\">D\u1ef1 ki\u1ebfn ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<div class=\"condensed-hidden-step1\">\n<div class=\"merke content-box green\">Ch\u1ec9 \u0111\u1ecbnh truy\u1ec1n kh\u1ed1i h\u1ed3ng c\u1ea7u kh\u00f4ng ch\u1ec9 d\u1ef1a v\u00e0o ch\u1ec9 s\u1ed1 Hb m\u00e0 \u0111\u00e1nh gi\u00e1 theo t\u00ecnh hu\u1ed1ng l\u00e2m s\u00e0ng v\u00e0 t\u00ecnh tr\u1ea1ng t\u1ed5ng th\u1ec3 b\u1ec7nh nh\u00e2n.<\/div>\n<div>Ng\u01b0\u1ee1ng truy\u1ec1n m\u00e1u h\u1ea1n ch\u1ebf (Hb <span class=\"nowrap\">7\u20138 g\/dL) \u1edf b\u1ec7nh nh\u00e2n huy\u1ebft \u0111\u1ed9ng \u1ed5n \u0111\u1ecbnh cho k\u1ebft c\u1ee5c l\u00e2m s\u00e0ng t\u01b0\u01a1ng t\u1ef1 v\u00e0 nh\u01b0ng \u00edt nhu c\u1ea7u m\u00e1u v\u00e0 t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n h\u01a1n ng\u01b0\u1ee1ng truy\u1ec1n m\u00e1u t\u1ef1 do 9\u201310 g\/dL.<\/span><\/div>\n<\/div>\n<h3>1.4. Li\u1ec1u truy\u1ec1n.<\/h3>\n<p>D\u00f9ng th\u1ec3 t\u00edch th\u1ea5p nh\u1ea5t c\u1ea7n \u0111\u1ec3 gi\u1ea3m tri\u1ec7u ch\u1ee9ng v\u00e0\/ho\u1eb7c h\u1ed3i ph\u1ee5c Hb tr\u00ean ng\u01b0\u1ee1ng truy\u1ec1n m\u00e1u. Khi kh\u00f4ng c\u00f3 ch\u1ea3y m\u00e1u ho\u1ea1t \u0111\u1ed9ng, \u0111\u00e1nh gi\u00e1 l\u00e2m s\u00e0ng ng\u01b0\u1eddi b\u1ec7nh l\u1ea1i sau m\u1ed7i \u0111\u01a1n v\u1ecb v\u00e0 ki\u1ec3m tra c\u00f4ng th\u1ee9c m\u00e1u.<\/p>\n<p>T\u1ed1c \u0111\u1ed9 truy\u1ec1n th\u01b0\u1eddng d\u00f9ng: 90 &#8211; 120 ph\u00fat\/ \u0111\u01a1n v\u1ecb. Truy\u1ec1n nhanh n\u1ebfu xu\u1ea5t huy\u1ebft l\u01b0\u1ee3ng l\u1edbn, truy\u1ec1n ch\u1eadm h\u01a1n n\u1ebfu c\u00f3 nguy c\u01a1 qu\u1ea3 t\u1ea3i tu\u1ea7n ho\u00e0n do truy\u1ec1n m\u00e1u (nh\u01b0 suy tim, thi\u1ebfu m\u00e1u m\u1ea1n n\u1eb7ng).<\/p>\n<h3>1.5. T\u00e1c d\u1ee5ng.<\/h3>\n<ul>\n<li>T\u0103ng Hb v\u00e0 kh\u1ea3 n\u0103ng chuy\u00ean ch\u1edf oxy c\u1ee7a m\u00e1u.<\/li>\n<li>1 \u0111\u01a1n v\u1ecb kh\u1ed1i h\u1ed3ng c\u1ea7u l\u00e0m t\u0103ng Hb <span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\"><span class=\"nowrap\">\u223c 1 g\/dL.<\/span><\/span><\/li>\n<li>Th\u1ec3 t\u00edch n\u1ed9i m\u1ea1ch t\u0103ng l\u00ean t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi th\u1ec3 t\u00edch m\u00e1u truy\u1ec1n.<\/li>\n<\/ul>\n<h3>1.6. Bi\u1ebfn ch\u1ee9ng.<\/h3>\n<ul>\n<li>Truy\u1ec1n m\u00e1u nhi\u1ec1u l\u1ea7n c\u00f3 th\u1ec3 g\u00e2y qu\u00e1 t\u1ea3i s\u1eaft.<\/li>\n<li>C\u00e1c ph\u1ea3n \u1ee9ng truy\u1ec1n m\u00e1u.<\/li>\n<\/ul>\n<h2>2. Truy\u1ec1n ch\u1ebf ph\u1ea9m ti\u1ec3u c\u1ea7u.<\/h2>\n<h3>2.1. Th\u00e0nh ph\u1ea7n c\u1ee7a ch\u1ebf ph\u1ea9m ti\u1ec3u c\u1ea7u.<\/h3>\n<ul>\n<li>Ti\u1ec3u c\u1ea7u trong huy\u1ebft t\u01b0\u01a1ng ho\u1eb7c ti\u1ec3u c\u1ea7u trong dung d\u1ecbch m\u00f4i tr\u01b0\u1eddng dinh d\u01b0\u1ee1ng.<\/li>\n<li>Ch\u1ebf ph\u1ea9m ti\u1ec3u c\u1ea7u thu\u1ed9c m\u1ed9t trong hai:\n<ul>\n<li>\u0110\u01a1n v\u1ecb ti\u1ec3u c\u1ea7u g\u1ea1n t\u00e1ch t\u1eeb m\u1ed9t ng\u01b0\u1eddi hi\u1ebfn: chi\u1ebft xu\u1ea5t t\u1eeb m\u1ed9t \u0111\u01a1n v\u1ecb m\u00e1u to\u00e0n ph\u1ea7n c\u1ee7a m\u1ed9t ng\u01b0\u1eddi hi\u1ebfn ch\u1ee9a<span class=\"additional\"><span class=\"nowrap\">\u223c 310 x 10<sup>9<\/sup><\/span> ti\u1ec3u c\u1ea7u trong\u00a0<span class=\"nowrap\">\u223c300 mL<\/span><\/span><\/li>\n<li>T\u00fai ti\u1ec3u c\u1ea7u g\u1ed9p b\u1ea5t k\u1ef3: chi\u1ebft xu\u1ea5t t\u1eeb 4 &#8211; 6 \u0111\u01a1n v\u1ecb m\u00e1u to\u00e0n ph\u1ea7n t\u1eeb nhi\u1ec1u ng\u01b0\u1eddi hi\u1ebfn v\u00e0 ch\u1ee9a <span class=\"additional\"><span class=\"nowrap\">\u223c 280 X 10<sup>9<\/sup><\/span> ti\u1ec3u c\u1ea7u trong<span class=\"nowrap\">\u223c200 mL.<\/span><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 id=\"Y7cf8eebc4fc1a9f4baae3468ad914c61\" class=\"condensed-hidden\">2.2. Y\u00eau c\u1ea7u v\u1ec1 t\u01b0\u01a1ng \u0111\u1ed3ng nh\u00f3m m\u00e1u.<\/h3>\n<div class=\"condensed-hidden paragraph\">Ti\u1ec3u c\u1ea7u t\u01b0\u01a1ng \u0111\u1ed3ng nh\u00f3m m\u00e1u c\u00f3 th\u1ec3 \u00edt th\u00f4ng d\u1ee5ng do ngu\u1ed3n cung c\u1ea5p h\u1ea1n ch\u1ebf.\u00a0 Nguy c\u01a1 khi truy\u1ec1n ti\u1ec3u c\u1ea7u kh\u00f4ng t\u01b0\u01a1ng h\u1ee3p th\u1ea5p h\u01a1n so v\u1edbi kh\u1ed1i h\u1ed3ng c\u1ea7u.<\/div>\n<ul>\n<li>T\u01b0\u01a1ng h\u1ee3p nh\u00f3m m\u00e1u ABO: khuy\u00ean d\u00f9ng nh\u01b0ng kh\u00f4ng c\u1ea7n thi\u1ebft d\u00f9ng th\u01b0\u1eddng quy.<\/li>\n<li>Ph\u00f9 h\u1ee3p Rh(D): n\u00ean d\u00f9ng ti\u1ec3u c\u1ea7u Rh(D) \u00e2m cho ng\u01b0\u1eddi nh\u1eadn Rh(D) \u00e2m \u0111\u1ec3 tr\u00e1nh d\u1ecb mi\u1ec5n d\u1ecbch.<\/li>\n<li>Xem x\u00e9t thu\u1eadn h\u1ee3p v\u1ec1 huy\u1ebft t\u01b0\u01a1ng khi truy\u1ec1n nhi\u1ec1u \u0111\u01a1n v\u1ecb.<\/li>\n<\/ul>\n<h3>2.3. Ch\u1ec9 \u0111\u1ecbnh truy\u1ec1n ch\u1ebf ph\u1ea9m ti\u1ec3u c\u1ea7u.<\/h3>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb ch\u1ea3y m\u00e1u \u0111ang ho\u1ea1t \u0111\u1ed9ng k\u00e8m theo m\u1ed9t trong c\u00e1c y\u1ebfu t\u1ed1:\n<ul>\n<li class=\"condensed-hidden-step1\"><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\"><span class=\"nowrap\">Ti\u1ec3u c\u1ea7u&lt; 50,000\/mm<sup>3<\/sup><\/span><\/span><\/li>\n<li class=\"condensed-hidden\"><span class=\"nowrap\">Ti\u1ec3u c\u1ea7u&lt; 100,000\/mm<sup>3<\/sup><\/span> v\u00e0 c\u00f3 ch\u1ea5n th\u01b0\u01a1ng n\u00e3o ho\u1eb7c \u0111a ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li class=\"condensed-hidden-step2\"><span class=\"condensed-hidden\">C\u00e1c r\u1ed1i lo\u1ea1n ti\u1ec3u c\u1ea7u \u0111\u1ecbnh t\u00ednh nh\u01b0 h\u1ed9i ch\u1ee9ng <\/span><span class=\"nowrap condensed-hidden\">Bernard-Soulier<\/span><\/li>\n<li class=\"condensed-hidden\">H\u1ed3i s\u1ee9c c\u00e2n b\u1eb1ng trong xu\u1ea5t huy\u1ebft l\u01b0\u1ee3ng l\u1edbn.<\/li>\n<\/ul>\n<\/li>\n<li>D\u1ef1 ph\u00f2ng ch\u1ea3y m\u00e1u trong b\u1ea5t k\u1ef3 t\u00ecnh hu\u1ed1ng sau:\n<ul>\n<li><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">Gi\u1ea3m ti\u1ec3u c\u1ea7u n\u1eb7ng <span class=\"nowrap\">&lt; 10,000\/mm<sup>3 <\/sup><\/span>\u00a0th\u1ee9 ph\u00e1t do \u0111i\u1ec1u tr\u1ecb \u1ee9c ch\u1ebf t\u1ee7y.<\/span><\/li>\n<li class=\"condensed-hidden-step1\">Gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00e0 c\u1ea7n l\u00e0m th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n\/ph\u1eabu thu\u1eadt:\n<ul class=\"condensed-hidden-step1\">\n<li class=\"condensed-hidden\"><span class=\"nowrap\">\u0110\u1eb7t catheter t\u0129nh m\u1ea1ch trung t\u00e2m ch\u1ecdn l\u1ecdc ho\u1eb7c ch\u1ecdc h\u00fat t\u1ee7y x\u01b0\u01a1ng khi &lt; 20,000\/mm<sup>3<\/sup><\/span><\/li>\n<li class=\"condensed-hidden\"><span class=\"nowrap\">Ph\u1eabu thu\u1eadt th\u1ea7n kinh khi ti\u1ec3u c\u1ea7u&lt; 100,000\/mm<sup>3<\/sup><\/span><\/li>\n<li><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">C\u00e1c th\u1ee7 thu\u1eadt x\u00e2m l\u1ea5n kh\u00e1c khi ti\u1ec3u c\u1ea7u <span class=\"nowrap\">&lt; 50,000\/mm<sup>3<\/sup><\/span><\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"condensed-hidden\">Sinh th\u01b0\u1eddng khi ti\u1ec3u c\u1ea7u\u00a0<span class=\"nowrap\">&lt; 50,000\/mm<sup>3<\/sup><\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 id=\"Y5e95ee0e38891c751f25ff6530d5ef6e\" class=\"additional condensed-hidden\">2.4. C\u00e1c th\u1eadn tr\u1ecdng khi truy\u1ec1n ti\u1ec3u c\u1ea7u.<\/h3>\n<p>Truy\u1ec1n ti\u1ec3u c\u1ea7u kh\u00f4ng khuy\u1ebfn c\u00e1o cho \u0111i\u1ec1u tr\u1ecb gi\u1ea3m ti\u1ec3u c\u1ea7u v\u00f4 c\u0103n ho\u1eb7c t\u1ef1 mi\u1ec5n \u1edf b\u1ec7nh nh\u00e2n kh\u00f4ng ch\u1ea3y m\u00e1u nh\u01b0:<\/p>\n<ul>\n<li>Gi\u1ea3m ti\u1ec3u c\u1ea7u do suy t\u1ee7y m\u1ea1n kh\u00f4ng li\u00ean quan thu\u1ed1c \u1ee9c ch\u1ebf t\u1ee7y (h\u00f3a tr\u1ecb, x\u1ea1 tr\u1ecb).<\/li>\n<li>Gi\u1ea3m ti\u1ec3u c\u1ea7u do heparin.<\/li>\n<li>TTP\/HUS.<\/li>\n<li>Gi\u1ea3m ti\u1ec3u c\u1ea7u do mi\u1ec5n d\u1ecbch.<\/li>\n<li>Gi\u1ea3m ti\u1ec3u c\u1ea7u do vaccin.<\/li>\n<\/ul>\n<div class=\"additional condensed-hidden\">\n<h3 class=\"cave content-box red\">2.5. Li\u1ec1u truy\u1ec1n.<\/h3>\n<\/div>\n<ul class=\"additional condensed-hidden\">\n<li>Li\u1ec1u\n<ul>\n<li><span class=\"nowrap\">Truy\u1ec1n m\u1ed9t \u0111\u01a1n v\u1ecb ti\u1ec3u c\u1ea7u g\u1ea1n t\u00e1ch ho\u1eb7c ti\u1ec3u c\u1ea7u pool khi ti\u1ec3u c\u1ea7u&lt; 10,000\/mm<sup>3<\/sup><\/span><\/li>\n<li>Trong xu\u1ea5t huy\u1ebft l\u01b0\u1ee3ng l\u1edbn, truy\u1ec1n ti\u1ec3u c\u1ea7u theo t\u1ec9 l\u1ec7 theo c\u00e1c protocol v\u1ec1 truy\u1ec1n m\u00e1u l\u01b0\u1ee3ng l\u1edbn.<\/li>\n<li>C\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c: truy\u1ec1n li\u1ec1u th\u1ea5p nh\u1ea5t \u0111\u1ec3 h\u1ed3i ph\u1ee5c ti\u1ec3u c\u1ea7u \u0111\u1ebfn ng\u01b0\u1ee1ng c\u1ea7n \u0111\u1ea1t.<\/li>\n<\/ul>\n<\/li>\n<li>T\u1ed1c \u0111\u1ed9 th\u01b0\u1eddng d\u00f9ng: 30 &#8211; 60 ph\u00fat cho m\u1ed9t \u0111\u01a1n v\u1ecb ti\u1ec3u c\u1ea7u g\u1ea1n t\u00e1ch\/pool.<\/li>\n<\/ul>\n<h3 id=\"Yf5fe2bf78090f6c490baa0e3c0490c30\" class=\"condensed-hidden-step2\">2.6. T\u00e1c d\u1ee5ng<\/h3>\n<ul class=\"condensed-hidden-step2\">\n<li><span class=\"step-1-imppact2 usmle-gs-imppact2 step-1-condensed strongImpactHighlight--qLdOc\">M\u1ed9t \u0111\u01a1n v\u1ecb ti\u1ec3u c\u1ea7u g\u1ea1n t\u00e1ch ho\u1eb7c m\u1ed9t t\u00fai ti\u1ec3u c\u1ea7u pool t\u0103ng \u0111\u01b0\u1ee3c <span class=\"nowrap\">20\u201360,000\/mm<sup>3<\/sup><\/span>.<\/span><span class=\"condensed-hidden\"><sup data-type=\"Reference\" data-eid=\"_sX5xz\" data-page=\"\" data-cmt=\"\">[17]<\/sup><\/span><\/li>\n<li class=\"condensed-hidden\">Th\u1ec3 t\u00edch n\u1ed9i m\u1ea1ch t\u0103ng l\u00ean t\u01b0\u01a1ng \u0111\u01b0\u01a1ng th\u1ec3 t\u00edch truy\u1ec1n.<\/li>\n<\/ul>\n<h2>3. Truy\u1ec1n ch\u1ebf ph\u1ea9m huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1i \u0111\u00f4ng l\u1ea1nh v\u00e0 t\u1ee7a l\u1ea1nh.<\/h2>\n<h3>3.1. Huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1i \u0111\u00f4ng l\u1ea1nh.<\/h3>\n<ul>\n<li><span class=\"leitwort\">Th\u00e0nh ph\u1ea7n<\/span>\n<ul>\n<li>Huy\u1ebft t\u01b0\u01a1ng, g\u1ed3m y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u v\u00e0 protein huy\u1ebft t\u01b0\u01a1ng.<\/li>\n<li><span class=\"step-1-imppact2 usmle-gs-imppact2 step-1-condensed strongImpactHighlight--qLdOc\"><span class=\"step-2-imppact2 imppact2 usmle-gs-imppact2 step-2-condensed strongImpactHighlight--qLdOc\">C\u00e1c th\u00e0nh ph\u1ea7n t\u1ebf b\u00e0o \u0111\u00e3 \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf.<\/span><\/span><\/li>\n<li class=\"condensed-hidden\">M\u1ed9t \u0111\u01a1n v\u1ecb th\u1ec3 t\u00edch <span class=\"nowrap\">\u223c200\u2013300 mL<\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"condensed-hidden-step1\">Y\u00eau c\u1ea7u v\u1ec1 t\u01b0\u01a1ng \u0111\u1ed3ng nh\u00f3m m\u00e1u.\n<ul class=\"condensed-hidden-step1\">\n<li>T\u01b0\u01a1ng \u0111\u1ed3ng ABO c\u00f3 th\u1ec3 xem x\u00e9t.<\/li>\n<li class=\"condensed-hidden\">Rh(D): kh\u00f4ng c\u1ea7n t\u01b0\u01a1ng h\u1ee3p.<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/suc-khoe-tong-quat\/mot-so-chi-dinh-cua-huyet-tuong-tuoi-dong-lanh\/#:~:text=Huy%E1%BA%BFt%20t%C6%B0%C6%A1ng%20t%C6%B0%C6%A1i%20%C4%91%C3%B4ng%20l%E1%BA%A1nh%20%C4%91%C6%B0%E1%BB%A3c%20t%C3%A1ch%20ra%20t%E1%BB%AB%20m%C3%A1u,l%C6%B0u%20tr%E1%BB%AF%20trong%20m%E1%BB%99t%20n%C4%83m.\">Ch\u1ec9 \u0111\u1ecbnh<\/a>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u do thi\u1ebfu h\u1ee5t nhi\u1ec1u y\u1ebfu t\u1ed1 (x\u01a1 gan, DIC).\n<ul class=\"additional condensed-hidden\">\n<li><span class=\"nowrap\">Th\u01b0\u1eddng c\u00e2n nh\u1eafc d\u00f9ng cho b\u1ec7nh nh\u00e2n c\u00f3 INR\u2265 2.0<\/span> \u0111ang ch\u1ea3y m\u00e1u ho\u1ea1t \u0111\u1ed9ng ho\u1eb7c l\u00e0m th\u1ee7 th\u1eadp x\u00e2m l\u1ea5n.<\/li>\n<li><span class=\"nowrap\">Kh\u00f4ng khuy\u1ebfn c\u00e1o d\u00f9ng cho INR t\u0103ng nh\u1eb9 t\u1eeb\u00a0 1.1\u20131.9<\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"condensed-hidden\">D\u1ef1 ph\u00f2ng r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u do h\u00f2a lo\u00e3ng trong h\u1ed3i s\u1ee9c m\u1ea5t m\u00e1u l\u01b0\u1ee3ng l\u1edbn.<\/li>\n<li class=\"condensed-hidden\">Thay huy\u1ebft t\u01b0\u01a1ng trong TTP.<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb thay th\u1ebf:\n<ul>\n<li class=\"condensed-hidden\">X\u1eed tr\u00ed thi\u1ebfu protein huy\u1ebft t\u01b0\u01a1ng n\u1ebfu c\u00e1c ch\u1ebf ph\u1ea9m t\u00e1i t\u1ed5 h\u1ee3p kh\u00f4ng c\u00f3 s\u1eb5n.<\/li>\n<li><span class=\"condensed-hidden\">X\u1eed tr\u00ed h\u00f3a gi\u1ea3i warfarin\/sintrom kh\u1ea9n c\u1ea5p khi kh\u00f4ng c\u00f3 thu\u1ed1c h\u00f3a gi\u1ea3i <\/span><span class=\"nowrap condensed-hidden\">4-factor PCC.<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"additional condensed-hidden\">Li\u1ec1u\n<ul>\n<li>Li\u1ec1u: <span class=\"nowrap\">10\u201320 mL\/kg<\/span><\/li>\n<li>T\u1ed1c \u0111\u1ed9: <span class=\"nowrap\">10\u201320 mL\/kg\/h.<\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"condensed-hidden\">T\u00e1c d\u1ee5ng\n<ul>\n<li>\u0110i\u1ec1u ch\u1ec9nh thi\u1ebfu h\u1ee5t m\u1ed9t ho\u1eb7c nhi\u1ec1u y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u.<\/li>\n<li>T\u0103ng th\u1ec3 t\u00edch n\u1ed9i m\u1ea1ch t\u01b0\u01a1ng \u0111\u01b0\u01a1ng th\u1ec3 t\u00edch truy\u1ec1n.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3 id=\"Yeeb37a43a454e5ef2275b779fcaf6a18\" class=\"condensed-hidden-step2\">3.2. Truy\u1ec1n ch\u1ebf ph\u1ea9m t\u1ee7a l\u1ea1nh.<\/h3>\n<ul class=\"condensed-hidden-step2\">\n<li><span class=\"step-1-imppact2 usmle-gs-imppact2 step-1-condensed strongImpactHighlight--qLdOc\">Th\u00e0nh ph\u1ea7n: y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u fibrinogen,\u00a0<span class=\"nowrap\">factor VIII<\/span>,\u00a0<span class=\"nowrap\">factor XIII<\/span>,\u00a0vWF, v\u00e0 fibronectin<\/span><\/li>\n<li class=\"condensed-hidden\"><span class=\"leitwort\">Y\u00eau c\u1ea7u v\u1ec1 thu\u1eadn h\u1ee3p.<\/span>\n<ul>\n<li>Thu\u1eadn h\u1ee3p ABO: n\u00ean c\u00f3 nh\u01b0ng kh\u00f4ng c\u1ea7n thi\u1ebft.<\/li>\n<li>Rh(D): kh\u00f4ng c\u1ea7n thi\u1ebft.<\/li>\n<\/ul>\n<\/li>\n<li><span class=\"leitwort\">Ch\u1ec9 \u0111\u1ecbnh.<\/span>\n<ul>\n<li><span class=\"nowrap condensed-hidden\">Ch\u1ea3y m\u00e1u c\u00f3 thi\u1ebfu h\u1ee5t fibrinogen (x\u01a1 gan, DIC) v\u1edbi fibrinogen&lt; 100\u2013150 mg\/dL<\/span><\/li>\n<li><span class=\"condensed-hidden\">Li\u1ec7u ph\u00e1p thay th\u1ebf trong \u0111i\u1ec1u tr\u1ecb thi\u1ebfu y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u nh\u01b0 <\/span>vWF<span class=\"condensed-hidden\">,\u00a0<\/span><span class=\"step-1-imppact2 usmle-gs-imppact2 step-1-condensed strongImpactHighlight--qLdOc\"><span class=\"nowrap\">factor VIII<\/span><\/span><span class=\"condensed-hidden\">, v\u00e0 y\u1ebfu t\u1ed1<\/span><span class=\"nowrap condensed-hidden\">\u00a0XIII<\/span><\/li>\n<li class=\"condensed-hidden\">\u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng xu\u1ea5t huy\u1ebft t\u0103ng ure m\u00e1u.<\/li>\n<\/ul>\n<\/li>\n<li class=\"additional condensed-hidden\"><span class=\"leitwort\">Li\u1ec1u<\/span>\n<ul>\n<li>Li\u1ec1u: 1 \u0111\u01a1n v\u1ecb cho <span class=\"nowrap\">7\u201310 kg<\/span> c\u00e2n n\u1eb7ng.<\/li>\n<li>T\u1ed1c \u0111\u1ed9: <span class=\"nowrap\">10\u201320 mL\/kg\/h.<\/span><\/li>\n<\/ul>\n<\/li>\n<li class=\"condensed-hidden\"><span class=\"nowrap\">T\u00e1c d\u1ee5ng: 1 \u0111\u01a1n v\u1ecb t\u1ee7a l\u1ea1nh cho 7\u201310 kg<\/span> c\u00e2n n\u1eb7ng l\u00e0m t\u0103ng fibrinogen huy\u1ebft thanh l\u00ean <span class=\"nowrap\">\u223c 50\u201375 mg\/dL<\/span>.<\/li>\n<\/ul>\n<\/div>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o:\u00a0<\/strong><\/p>\n<p>Tranfusion, Amboss.<\/p>\n<div>\n<aside class=\"tooltipContainer-1547484803--filterShadow-3387428294--hidden-661153127\" data-e2e-test-id=\"tooltip-container\">\n<div class=\"children-2286806230--childrenDefault-4239998497\">\n<div>\n<div>Carson JL, Guyatt G, Heddle NM, et al. Clinical Practice Guidelines From the AABB<span class=\"subtitle\"><span class=\"colon-for-citation-subtitle\">:\u00a0<\/span>Red Blood Cell Transfusion Thresholds and Storage<\/span>.\u00a0<em>JAMA.<\/em>\u00a02016;316(19):2025\u20132035.<\/div>\n<\/div>\n<\/div>\n<\/aside>\n<\/div>\n<\/div>\n<div class=\"css-1x17ya eyueia0\">\n<div class=\"css-1lbpfmz e1tnky2o1\">\n<div class=\"css-139mn3x e1tnky2o0\">\n<div class=\"css-hyaldf e1tnky2o1\">\n<div class=\"css-r8skn2 e1tnky2o0\">\n<div class=\"css-kb7nvz e1vkw3t42\">\n<div class=\"css-rodj39 e1tnky2o1\">\n<div class=\"css-84ablj e1tnky2o0\">\n<div class=\"css-dhmirf e1pr7vjj0\" data-variant=\"inherit\"><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Ng\u00e0y nay, truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u th\u00f4ng d\u1ee5ng tr\u00ean l\u00e2m s\u00e0ng h\u01a1n so v\u1edbi truy\u1ec1n m\u00e1u to\u00e0n ph\u1ea7n. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u t\u00f9y thu\u1ed9c th\u00e0nh ph\u1ea7n thi\u1ebfu h\u1ee5t. Kh\u1ed1i h\u1ed3ng c\u1ea7u \u0111\u01b0\u1ee3c truy\u1ec1n nh\u1eb1m c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng mang oxy c\u1ee7a m\u00e1u. Truy\u1ec1n m\u00e1u h\u1ea1n ch\u1ebf v\u1edbi ng\u01b0\u1ee1ng hemoglobin th\u1ea5p t\u01b0\u01a1ng \u0111\u01b0\u01a1ng [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[23,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u: ch\u1ec9 \u0111\u1ecbnh v\u00e0 h\u01b0\u1edbng d\u1eabn l\u00e2m s\u00e0ng - Vinmec<\/title>\n<meta name=\"description\" content=\"Truy\u1ec1n ch\u1ebf ph\u1ea9m m\u00e1u t\u00f9y theo th\u00e0nh ph\u1ea7n thi\u1ebfu h\u1ee5t. 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