{"id":34438,"date":"2023-05-30T18:04:31","date_gmt":"2023-05-30T11:04:31","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=34438"},"modified":"2023-05-30T18:04:31","modified_gmt":"2023-05-30T11:04:31","slug":"lam-sang-tim-bam-sinh-o-tre-em-nhung-dau-hieu-can-chu-y-va-cach-phong-ngua","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/30\/lam-sang-tim-bam-sinh-o-tre-em-nhung-dau-hieu-can-chu-y-va-cach-phong-ngua\/","title":{"rendered":"L\u00e2m s\u00e0ng tim b\u1ea9m sinh \u1edf tr\u1ebb em: nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba"},"content":{"rendered":"

B\u1ec7nh tim b\u1ea9m sinh (congenital heart disease) l\u00e0 m\u1ed9t trong c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh hay g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng . B\u1ec7nh tim b\u1ea9m sinh (BTBS) l\u00e0 nh\u1eefng d\u1ecb t\u1eadt \u1edf tim v\u00e0 nh\u1eefng m\u1ea1ch m\u00e1u l\u1edbn t\u1ea1o n\u00ean do nh\u1eefng b\u1ea5t th\u01b0\u1eddng trong b\u00e0o thai \u1edf th\u00e1ng th\u1ee9 2-3 c\u1ee7a thai k\u1ef3, v\u00e0o giai \u0111o\u1ea1n h\u00ecnh th\u00e0nh c\u00e1c m\u1ea1ch m\u00e1u l\u1edbn t\u1eeb \u1ed1ng tim nguy\u00ean th\u1ee7y. T\u1ef7 l\u1ec7 ch\u1eebng 5% \u1edf tr\u1ebb s\u01a1 sinh theo t\u00e0i li\u1ec7u Ph\u00e1p, M\u1ef9, \u1edf Vi\u1ec7t nam hi\u1ec7n ch\u01b0a c\u00f3 m\u1ed9t th\u1ed1ng k\u00ea c\u1ee5 th\u1ec3 n\u00e0o ( Quy\u1ebft \u0111\u1ecbnh 5732\/Q\u0110-BYT n\u0103m 2017<\/a>.).<\/strong><\/p>\n

\"l\u00e2m<\/p>\n

C\u00e1c t\u1eadt tim \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i chung d\u1ef1a tr\u00ean lu\u1ed3ng shunt: shunt Tr\u00e1i \u2013 Ph\u1ea3i (T-P), Ph\u1ea3i \u2013 Tr\u00e1i (P-T). Tuy nhi\u00ean l\u00e2u ng\u00e0y do t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i n\u1eb7ng n\u1ec1 c\u00f3 th\u1ec3 \u0111\u1ea3o shunt l\u00fac \u0111\u00f3 ng\u01b0\u1eddi ta g\u1ecdi l\u00e0 h\u1ed9i ch\u1ee9ng Eisenmenger. Trong nh\u00f3m n\u00e0y hay g\u1eb7p th\u00f4ng li\u00ean nh\u0129, th\u00f4ng li\u00ean th\u1ea5t, c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch.<\/strong><\/p>\n

 <\/p>\n

1. Nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd v\u1ec1 ti\u1ebfp c\u1eadn l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh<\/h2>\n

1.1\u00a0 D\u1ea5u hi\u1ec7u g\u1ee3i \u00fd TBS?<\/strong><\/h3>\n
    \n
  • Ho, kh\u00f2 kh\u00e8 k\u00e9o d\u00e0i, t\u00e1i \u0111i t\u00e1i l\u1ea1i nhi\u1ec1u l\u1ea7n<\/li>\n
  • Th\u1edf nhanh, th\u1edf co l\u00f5m ng\u1ef1c, kh\u00f3 th\u1edf, c\u01a1n ng\u01b0ng th\u1edf, th\u1edf kh\u00e1c th\u01b0\u1eddng ngay c\u1ea3 l\u00fac kh\u00f4ng b\u1ec7nh.<\/li>\n
  • Nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p t\u00e1i \u0111i t\u00e1i l\u1ea1i<\/li>\n
  • Xanh xao hay v\u00e3 m\u1ed3 h\u00f4i<\/li>\n
  • T\u00edm (th\u01b0\u1eddng xuy\u00ean ho\u1eb7c khi kh\u00f3c), \u0111\u1eb7c bi\u1ec7t ch\u00fa \u00fd \u0111\u1ebfn c\u01a1m t\u00edm thi\u1ebfu oxy.<\/li>\n
  • Ch\u1eadm ph\u00e1t tri\u1ec3n th\u1ec3 ch\u1ea5t, v\u1eadn \u0111\u1ed9ng so v\u1edbi l\u1ee9a tu\u1ed5i<\/li>\n
  • C\u00f3 d\u1ecb t\u1eadt b\u1ea9m sinh kh\u00e1c ngo\u00e0i tim (h\u1ed9i ch\u1ee9ng Down, Rubella\u2026)<\/li>\n<\/ul>\n

     <\/p>\n

    1.2\u00a0 Ti\u1ebfp c\u1eadn 5 b\u01b0\u1edbc tim b\u1ea9m sinh tr\u00ean l\u00e2m s\u00e0ng?<\/h3>\n

    Khi ti\u1ebfp c\u1eadn m\u1ed9t b\u1ec7nh nh\u00e2n tim b\u1ea9m sinh c\u1ea7n tr\u1ea3 l\u1eddi nh\u1eefng c\u00e2u h\u1ecfi sau:<\/p>\n

    1.2.1\u00a0\u00a0\u00a0\u00a0\u00a0 T\u00edm<\/strong><\/p>\n

    T\u00edm xu\u1ea5t hi\u1ec7n tr\u00ean l\u00e2m s\u00e0ng b\u1ec7nh tim b\u1ea9m sinh khi Hemoglobin (Hb) kh\u1eed trong m\u00e1u TM d\u01b0\u1edbi da >5 g\/dl<\/p>\n

    B\u00ecnh th\u01b0\u1eddng Hb kh\u1eed trong m\u00e1u \u00a0# 2g\/dl<\/p>\n

    Ph\u00e2n bi\u1ec7t t\u00edm trung \u01b0\u01a1ng v\u00e0 t\u00edm ngo\u1ea1i bi\u00ean<\/p>\n\n\n\n\n
    T\u00edm trung \u01b0\u01a1ng<\/td>\nT\u00edm ngo\u1ea1i bi\u00ean<\/td>\n<\/tr>\n
    \u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u00f3 shunt P-T trong\/ngo\u00e0i tim\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 SaO2<\/sub>, PaO2<\/sub> gi\u1ea3m\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nguy\u00ean nh\u00e2n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – Suy h\u00f4 h\u1ea5p, b\u1ec7nh ph\u1ed5i\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – TBS shunt P-T, KH\u00d4NG \u0111\u00e1p \u1ee9ng O2<\/sub>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – Methemoglobin BS, m\u1eafc ph\u1ea3i\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tri\u1ec7u ch\u1ee9ng\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – T\u00edm da ni\u00eam, r\u00f5 khi SaO2<\/sub><80%\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – M\u00f3ng khum, \u0111\u1ea7u chi d\u00f9i tr\u1ed1ng (tr\u1ebb l\u1edbn)\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – Hct \u00ad\u00ad khi l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i gi\u1ea3m nhi\u1ec1u\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – Hct \u00ad \u00edt khi thi\u1ebfu m\u00e1u, kh\u00f4ng c\u00f3 gi\u1ea3m l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i<\/td>\n\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u01b0\u1edbi m\u00e1u ngo\u1ea1i bi\u00ean gi\u1ea3m\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 SaO2<\/sub>, PaO2 <\/sub>b\u00ecnh th\u01b0\u1eddng\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nguy\u00ean nh\u00e2n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – L\u1ea1nh, b\u1ec7nh Raynaud\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – Suy tim, s\u1ed1c\u2022\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tri\u1ec7u ch\u1ee9ng\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 – T\u00edm da, \u0111\u1ea7u chi<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

    .T\u00edm chuy\u00ean bi\u1ec7t<\/p>\n

      \n
    • SaO2<\/sub>, PaO2 <\/sub>c\u1ee7a m\u00e1u nu\u00f4i chi tr\u00ean v\u00e0 chi d\u01b0\u1edbi kh\u00e1c nhau<\/li>\n
    • Chi tr\u00ean t\u00edm, chi d\u01b0\u1edbi h\u1ed3ng<\/li>\n<\/ul>\n

      Th\u01b0\u1eddng g\u1eb7p trong: Ho\u00e1n v\u1ecb \u0111\u1ea1i \u0111\u1ed9ng m\u1ea1ch + c\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch + T\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (\u0110MP)<\/p>\n

        \n
      • Chi tr\u00ean h\u1ed3ng, chi d\u01b0\u1edbi t\u00edm: g\u1eb7p trong:\n
          \n
        • C\u00f2n \u1ed1ng \u0110M \u0111\u1ea3o shunt<\/li>\n
        • \u0110\u1ee9t \u0111o\u1ea1n \u0110MC, h\u1eb9p eo \u0110MC + C\u00f2n \u1ed1ng \u0110M<\/li>\n
        • H\u1ed9i ch\u1ee9ng thi\u1ec3u s\u1ea3n tim tr\u00e1i + C\u00f2n \u1ed1ng \u0110M<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

           <\/p>\n

          1.2.2\u00a0\u00a0\u00a0\u00a0\u00a0 Tu\u1ea7n ho\u00e0n ph\u1ed5i th\u1ebf n\u00e0o?<\/strong><\/p>\n

          Tri\u1ec7u ch\u1ee9ng t\u0103ng l\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i <\/em><\/p>\n

            \n
          • L\u00e2m s\u00e0ng\n
              \n
            • Nhi\u1ec5m tr\u00f9ng ph\u1ed5i t\u00e1i ph\u00e1t nhi\u1ec1u l\u1ea7n<\/li>\n
            • Th\u1edf nhanh, l\u00f5m ng\u1ef1c t\u1eeb sau sanh<\/li>\n
            • Ho, kh\u00f2 kh\u00e8<\/li>\n
            • Rale \u1ea9m, ng\u00e1y, r\u00edt \u1edf ph\u1ed5i<\/li>\n<\/ul>\n<\/li>\n
            • XQ ng\u1ef1c: tu\u1ea7n ho\u00e0n ph\u1ed5i ra 1\/3 ngo\u00e0i c\u1ee7a ph\u1ebf tr\u01b0\u1eddng<\/li>\n
            • \u00dd ngh\u0129a: C\u00f3 shunt T-P<\/li>\n
            • Tri\u1ec7u ch\u1ee9ng gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i <\/em><\/li>\n<\/ul>\n

              L\u00e2m s\u00e0ng<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p tr\u00ean t\u00e1i \u0111i t\u00e1i l\u1ea1i<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Th\u1edf nhanh s\u00e2u<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u00edm<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u00f3ng tay, ch\u00e2n khum m\u1eb7t k\u00ednh \u0111\u1ed3ng h\u1ed3<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110\u1ea7u chi d\u00f9i tr\u1ed1ng<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D\u1ea5u hi\u1ec7u \u0111a h\u1ed3ng c\u1ea7u<\/p>\n

              C\u1eadn l\u00e2m s\u00e0ng<\/p>\n

              –\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 XQ ph\u1ed5i: gi\u1ea3m tu\u1ea7n ho\u00e0n ph\u1ed5i<\/p>\n

                \n
              • HCT t\u0103ng cao<\/li>\n
              • ECG ph\u00ec \u0111\u1ea1i th\u1ea5t ph\u1ea3i<\/li>\n<\/ul>\n

                Ph\u00e2n bi\u1ec7t tr\u00ean Xquang ng\u1ef1c th\u1eb3ng:<\/p>\n\n\n\n\n\n\n\n
                T\u0103ng tu\u1ea7n ho\u00e0n ph\u1ed5i<\/td>\nGi\u1ea3m tu\u1ea7n ho\u00e0n ph\u1ed5i<\/td>\n<\/tr>\n
                Cung \u0110MP ph\u1ed5i ph\u1ed3ng- Li\u00ean s\u01b0\u1eddn 4 ph\u00eda sau- \u0110\u1ec9nh \u2013 ch\u00e2n cung >4 mm
                \nph\u1ed3ng nhi\u1ec1u >9 mm<\/td>\n                		Cung \u0110MP l\u00f5m<\/td>\n<\/tr>\n
                R\u1ed1n ph\u1ed5i l\u1edbn >1.5 khoang li\u00ean s\u01b0\u1eddn<\/td>\nR\u1ed1n ph\u1ed5i nh\u1ecf<\/td>\n<\/tr>\n
                \u0110MP Ph\u1ea3i l\u1edbn<\/td>\n<\/td>\n<\/tr>\n
                M\u1ea1ch ma1u ph\u1ed5i ra 1\/3 ngo\u00e0i ph\u1ebf tr\u01b0\u1eddng<\/td>\nM\u1ea1ch m\u00e1u ph\u1ed5i kh\u00f4ng qu\u00e1 1\/3 trong<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                 <\/p>\n

                1.2.3\u00a0\u00a0\u00a0\u00a0\u00a0 Tim n\u00e0o b\u1ecb \u1ea3nh h\u01b0\u1edfng?<\/strong><\/p>\n\n\n\n\n\n\n\n
                <\/td>\nTim tr\u00e1i<\/td>\nTim Ph\u1ea3i<\/td>\nTo\u00e0n b\u1ed9<\/td>\n<\/tr>\n
                Nh\u00ecn<\/td>\nNg\u1ef1c \u1ee9c g\u00e0, kh\u00f4ng \u0111\u1ed1i x\u1ee9ng<\/td>\nNg\u1ef1c \u1ee9c g\u00e0, \u0111\u1ed1i x\u1ee9ng<\/td>\nGi\u1ed1ng tim T b\u1ecb \u1ea3nh h\u01b0\u1edfng<\/td>\n<\/tr>\n
                S\u1edd<\/td>\nM\u1ecfm tim l\u1ec7ch xu\u1ed1ng d\u01b0\u1edbi, ra ngo\u00e0i<\/td>\nHarzer (+)<\/p>\n

                D\u1ea5u n\u1ea3y tr\u01b0\u1edbc ng\u1ef1c (+)<\/td>\n

                		C\u1ea3 2<\/td>\n<\/tr>\n
                X quang<\/td>\nM\u1ecfm tim \u00e0 D\u1ef1a v\u00e0o cung s\u01b0\u1eddn tr\u01b0\u1edbc l\u1ec7ch xu\u1ed1ng d\u01b0\u1edbi, ra ngo\u00e0i<\/td>\nM\u1ecfm tim h\u1ebfch l\u00ean<\/td>\n<\/td>\n<\/tr>\n
                <\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                 <\/p>\n

                1.2.4\u00a0\u00a0\u00a0\u00a0\u00a0 C\u00f3 t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (\u0110MP) kh\u00f4ng?<\/strong><\/p>\n

                  \n
                • \u00c1p l\u1ef1c \u0110MP t\u00f9y thu\u1ed9c v\u00e0o nh\u1eefng y\u1ebfu t\u1ed1 sau\n
                    \n
                  • L\u01b0u l\u01b0\u1ee3ng m\u00e1u l\u00ean ph\u1ed5i<\/li>\n
                  • \u0110\u1ed9 \u0111\u00e0n h\u1ed3i m\u1ea1ch m\u00e1u ph\u1ed5i (kh\u00e1ng l\u1ef1c m\u1ea1ch ph\u1ed5i)<\/li>\n<\/ul>\n<\/li>\n
                  • \u00c1p l\u1ef1c m\u1ea1ch ph\u1ed5i \u00a0(mmHg) kh\u00e1c v\u1edbi \u00a0Kh\u00e1ng l\u1ef1c m\u1ea1ch ph\u1ed5i\u00a0\u00a0 (IU\/m2<\/sup> BSA)<\/li>\n<\/ul>\n

                    + \u00a0Kh\u00e1ng l\u1ef1c m\u1ea1ch ph\u1ed5i cao d\u1eabn \u0111\u1ebfn \u00e1p l\u1ef1c m\u1ea1ch ph\u1ed5i cao<\/p>\n

                    + \u00c1p l\u1ef1c m\u1ea1ch ph\u1ed5i cao c\u00f3 th\u1ec3 kh\u00e1ng l\u1ef1c m\u1ea1ch m\u00e1u ph\u1ed5i cao ho\u1eb7c kh\u00f4ng.<\/p>\n

                      \n
                    • T\u0103ng \u00e1p \u0110MP khi \u00e1p l\u1ef1c m\u1ea1ch ph\u1ed5i\u00a0 \u00b3 25 mmHg l\u00fac ngh\u1ec9 v\u00e0 \u00b3 30 mmHg l\u00fac g\u1eafng s\u1ee9c<\/li>\n<\/ul>\n

                      C\u00f3 3 giai \u0111o\u1ea1n t\u0103ng \u00e1p \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/p>\n

                        \n
                      • Kh\u00e1ng l\u1ef1c m\u1ea1ch ph\u1ed5i < kh\u00e1ng l\u1ef1c ch\u1ee7 \u00e0t\u1ea1o shunt T \u00e0 P<\/li>\n
                      • Kh\u00e1ng l\u1ef1c m\u1ea1ch\u00a0 ph\u1ed5i = kh\u00e1ng l\u1ef1c ch\u1ee7 \u00e0 t\u1ea1o shunt 2 chi\u1ec1u<\/li>\n
                      • Kh\u00e1ng l\u1ef1c m\u1ea1ch ph\u1ed5i > kh\u00e1ng l\u1ef1c ch\u1ee7 \u00e0 t\u1ea1o shunt P \u00e0 T<\/li>\n<\/ul>\n

                        1.2.5\u00a0\u00a0\u00a0\u00a0\u00a0 T\u1eadt tim n\u1eb1m \u1edf \u0111\u00e2u?<\/strong><\/p>\n

                        X\u00e1c \u0111\u1ecbnh d\u1ef1a tr\u00ean<\/p>\n

                          \n
                        • 4 c\u00e2u tr\u1ea3 l\u1eddi cho 4 c\u00e2u h\u1ecfi tr\u00ean<\/li>\n
                        • C\u00e1ch ph\u00e2n lo\u1ea1i TBS<\/li>\n
                        • Ki\u1ebfn th\u1ee9c l\u00e2m s\u00e0ng, c\u1eadn l\u00e2m s\u00e0ng c\u1ee7a t\u1eebng t\u1eadt tim b\u1ea9m sinh<\/li>\n<\/ul>\n

                          Ph\u00e2n lo\u1ea1i Tim b\u1ea9m sinh<\/p>\n

                           <\/p>\n\n\n\n\n
                          \u00a0Tim b\u1ea9m sinh t\u00edm<\/td>\nT\u1ee9 ch\u1ee9ng Fallot<\/p>\n

                          Chuy\u1ec3n g\u1ed1c \u0111\u1ed9ng m\u1ea1ch<\/p>\n

                          Teo van ba l\u00e1Teo ph\u1ed5i<\/p>\n

                          Th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/p>\n

                          B\u1ea5t th\u01b0\u1eddng t\u0129nh m\u1ea1ch ph\u1ed5i tr\u1edf v\u1ec1 ho\u00e0n to\u00e0n (TAPVR)<\/td>\n<\/tr>\n

                          Tim b\u1ea9m sinh kh\u00f4ng t\u00edm<\/td>\nTh\u00f4ng li\u00ean th\u1ea5t<\/p>\n

                          Th\u00f4ng li\u00ean nh\u0129<\/p>\n

                          C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch<\/p>\n

                          Th\u00f4ng s\u00e0n nh\u0129 th\u1ea5t<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

                          2. C\u00e1ch ph\u00f2ng ng\u1eeba b\u1ec7nh tim b\u1ea9m sinh<\/h2>\n

                          2.1 Bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba c\u1ea5p 0:<\/strong><\/p>\n

                            \n
                          • \n
                              \n
                            • Gi\u00e1o d\u1ee5c v\u1ec1 b\u1ec7nh tim b\u1ea9m sinh li\u00ean quan \u0111\u1ebfn m\u00f4i tr\u01b0\u1eddng, gia \u0111\u00ecnh, y\u1ebfu t\u1ed1 nguy c\u01a1 di truy\u1ec1n, y\u1ebfu t\u1ed1 ngo\u1ea1i c\u1ea3nh, ph\u00e1t hi\u1ec7n s\u1edbm, ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb v\u00e0 d\u1ef1 ph\u00f2ng tr\u01b0\u1edbc, trong v\u00e0 sau khi ..<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                              2.2 Bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba c\u1ea5p 1:<\/strong><\/p>\n

                              Nh\u00e2n vi\u00ean y t\u1ebf \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, v\u00ed d\u1ee5:<\/p>\n

                              – C\u00e2n nh\u1eafc t\u1ea7m so\u00e1t tr\u01b0\u1edbc trong v\u00e0 sau khi mang thai n\u1ebfu anh, ch\u1ecb, em ru\u1ed9t v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 m\u1eb9 m\u1eafc c\u00e1c b\u1ec7nh di truy\u1ec1n li\u00ean quan \u0111\u1ebfn tim b\u1ea9m sinh, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, lupus ban \u0111\u1ecf h\u1ec7 th\u1ed1ng…<\/p>\n

                              – Ho\u1eb7c trong th\u1eddi k\u1ef3 mang thai, ti\u1ebfp x\u00fac v\u1edbi c\u00e1c ch\u1ea5t v\u1eadt l\u00fd, h\u00f3a h\u1ecdc, \u0111\u1ed9c ch\u1ea5t, thu\u1ed1c an th\u1ea7n, h\u1ec7 n\u1ed9i ti\u1ebft, r\u01b0\u1ee3u bia, thu\u1ed1c l\u00e1, v.v.<\/p>\n

                              – N\u00ean tr\u00e1nh c\u00e1c lo\u1ea1i nhi\u1ec5m tr\u00f9ng (th\u1ee7y \u0111\u1eadu, quai b\u1ecb, v.v.) li\u00ean quan \u0111\u1ebfn herpes cytomegalovirus, Coxsackie B.. . . \u0111\u1ed1i v\u1edbi b\u1ec7nh tim b\u1ea9m sinh.<\/p>\n

                              – Ti\u00eam ph\u00f2ng s\u1edfi, rubella… tr\u01b0\u1edbc khi mang thai.<\/p>\n

                              – C\u1ea3i thi\u1ec7n m\u00f4i tr\u01b0\u1eddng s\u1ed1ng, tr\u00e1nh \u00f4 nhi\u1ec5m, ti\u1ebfp x\u00fac v\u1edbi kh\u00f3i b\u1ee5i, h\u00f3a ch\u1ea5t trong m\u00f4i tr\u01b0\u1eddng l\u00e0m vi\u1ec7c.<\/p>\n

                              2.3 Bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba c\u1ea5p 2:<\/strong><\/p>\n

                              B\u1ec7nh nh\u00e2n tim b\u1ea9m sinh ph\u1ea3i \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n s\u1edbm \u0111\u1ec3:<\/strong><\/p>\n

                              – \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u00e0 ngo\u1ea1i khoa c\u00e0ng nhanh v\u00e0 hi\u1ec7u qu\u1ea3 c\u00e0ng t\u1ed1t: V\u00ed d\u1ee5 ch\u1ea9n \u0111o\u00e1n th\u1eddi k\u1ef3 b\u00e0o thai, h\u1eadu s\u1ea3n v\u00e0 nh\u0169 nhi;<\/p>\n

                              – Ph\u00f2ng bi\u1ebfn ch\u1ee9ng: ph\u1ea3i ti\u00eam ph\u00f2ng theo l\u1ecbch v\u00e0 c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng kh\u00e1c, tr\u00e1nh suy dinh d\u01b0\u1ee1ng, vi\u00eam \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p t\u00e1i ph\u00e1t, ph\u00f2ng ng\u1eeba BV,\u2026<\/p>\n

                              – Khuy\u1ebfn kh\u00edch gia \u0111\u00ecnh tu\u00e2n th\u1ee7 t\u1ed1t vi\u1ec7c \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa ho\u1eb7c ngo\u1ea1i khoa v\u00e0 t\u00e1i kh\u00e1m \u0111\u00fang th\u1eddi h\u1ea1n<\/p>\n

                              S\u00e0ng l\u1ecdc, ph\u00e1t hi\u1ec7n b\u1ec7nh tim b\u1ea9m sinh thai nhi (n\u1ebfu c\u00f3 \u0111i\u1ec1u ki\u1ec7n).<\/strong><\/p>\n

                                \n
                              • S\u00e0ng l\u1ecdc tr\u1ebb ngay sau sinh \u0111\u1ec3 ph\u00e1t hi\u1ec7n s\u1edbm b\u1ec7nh tim b\u1ea9m sinh, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ec7nh t\u00edm t\u00e1i.<\/li>\n
                              • \u0110i\u1ec1u tr\u1ecb v\u00e0 theo d\u00f5i l\u00e2u d\u00e0i tr\u1ebb m\u1eafc b\u1ec7nh tim b\u1ea9m sinh.<\/li>\n<\/ul>\n

                                2.4 Bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba c\u1ea5p 3: <\/strong><\/p>\n

                                Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng v\u00e0 \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c c\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a b\u1ec7nh tim b\u1ea9m sinh c\u00f3 th\u1ec3 x\u1ea3y ra sau khi \u0111\u00e3 c\u00f3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh nh\u1eb1m mang ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng t\u1ed1t nh\u1ea5t cho b\u1ec7nh nh\u00e2n Tim b\u1ea9m sinh.<\/p>\n","protected":false},"excerpt":{"rendered":"

                                B\u1ec7nh tim b\u1ea9m sinh (congenital heart disease) l\u00e0 m\u1ed9t trong c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh hay g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng . B\u1ec7nh tim b\u1ea9m sinh (BTBS) l\u00e0 nh\u1eefng d\u1ecb t\u1eadt \u1edf tim v\u00e0 nh\u1eefng m\u1ea1ch m\u00e1u l\u1edbn t\u1ea1o n\u00ean do nh\u1eefng b\u1ea5t th\u01b0\u1eddng trong b\u00e0o thai \u1edf th\u00e1ng th\u1ee9 2-3 c\u1ee7a thai k\u1ef3, v\u00e0o […]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[7,33],"tags":[],"yoast_head":"\nL\u00e2m s\u00e0ng tim b\u1ea9m sinh \u1edf tr\u1ebb em: nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba - Vinmec<\/title>\n<meta name=\"description\" content=\"B\u1ec7nh tim b\u1ea9m sinh l\u00e0 m\u1ed9t trong c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh hay g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng . B\u1ec7nh tim b\u1ea9m sinh l\u00e0 nh\u1eefng d\u1ecb t\u1eadt \u1edf tim c\u1ee7a tr\u1ebb.\" \/>\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=\"L\u00e2m s\u00e0ng tim b\u1ea9m sinh \u1edf tr\u1ebb em: nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba - Vinmec\" \/>\n<meta property=\"og:description\" content=\"B\u1ec7nh tim b\u1ea9m sinh l\u00e0 m\u1ed9t trong c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh hay g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng . B\u1ec7nh tim b\u1ea9m sinh l\u00e0 nh\u1eefng d\u1ecb t\u1eadt \u1edf tim c\u1ee7a tr\u1ebb.\" \/>\n<meta property=\"og:url\" content=\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/30\/lam-sang-tim-bam-sinh-o-tre-em-nhung-dau-hieu-can-chu-y-va-cach-phong-ngua\/\" \/>\n<meta property=\"og:site_name\" content=\"Vinmec\" \/>\n<meta property=\"article:published_time\" content=\"2023-05-30T11:04:31+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/05\/519c1375-330e-4615-97f4-1d5de0ca675a-300x300.jpg\" \/>\n<meta name=\"author\" content=\"Dai Tran Van\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Dai Tran Van\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/30\/lam-sang-tim-bam-sinh-o-tre-em-nhung-dau-hieu-can-chu-y-va-cach-phong-ngua\/\",\"url\":\"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/30\/lam-sang-tim-bam-sinh-o-tre-em-nhung-dau-hieu-can-chu-y-va-cach-phong-ngua\/\",\"name\":\"L\u00e2m s\u00e0ng tim b\u1ea9m sinh \u1edf tr\u1ebb em: nh\u1eefng d\u1ea5u hi\u1ec7u c\u1ea7n ch\u00fa \u00fd v\u00e0 c\u00e1ch ph\u00f2ng ng\u1eeba - Vinmec\",\"isPartOf\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#website\"},\"datePublished\":\"2023-05-30T11:04:31+00:00\",\"dateModified\":\"2023-05-30T11:04:31+00:00\",\"author\":{\"@id\":\"https:\/\/noithathoaphat.in\/ctv\/#\/schema\/person\/b99bd843f29d91903ec9b6d18e47b0e2\"},\"description\":\"B\u1ec7nh tim b\u1ea9m sinh l\u00e0 m\u1ed9t trong c\u00e1c b\u1ea5t th\u01b0\u1eddng b\u1ea9m sinh hay g\u1eb7p nh\u1ea5t tr\u00ean l\u00e2m s\u00e0ng . 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