{"id":34673,"date":"2023-06-07T15:16:28","date_gmt":"2023-06-07T08:16:28","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=34673"},"modified":"2023-06-07T15:16:28","modified_gmt":"2023-06-07T08:16:28","slug":"viem-ruot-thua-cap-chan-doan-lam-sang-va-phac-do-dieu-tri-moi","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/07\/viem-ruot-thua-cap-chan-doan-lam-sang-va-phac-do-dieu-tri-moi\/","title":{"rendered":"Vi\u00eam ru\u1ed9t th\u1eeba c\u1ea5p: ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb m\u1edbi"},"content":{"rendered":"

Vi\u00eam ru\u1ed9t th\u1eeba (VRT) c\u1ea5p l\u00e0 c\u1ea5p c\u1ee9u ngo\u1ea1i khoa th\u01b0\u1eddng g\u1eb7p, bi\u1ec3u hi\u1ec7n <\/strong>l\u00e2m s\u00e0ng \u0111a d\u1ea1ng, d\u1ec5 l\u1ea7m v\u1edbi nhi\u1ec1u<\/strong> b\u1ec7nh kh\u00e1c. N\u1ebfu \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n s\u1edb v\u00e0 m\u1ed5<\/strong> s\u1edbm th\u00ec t\u1ec9 l\u1ec7 t\u1eed vong th\u1ea5p, nh\u01b0ng n\u1ebfu<\/strong> mu\u1ed9n th\u00ec nhi\u1ec1u bi\u1ebfn ch\u1ee9ng x\u1ea3y ra, t\u1eed<\/strong> vong c\u00f3 th\u1ec3 l\u00ean t\u1edbi 10%.<\/strong> B\u00e0i vi\u1ebft d\u01b0\u1edbi \u0111\u00e2y tr\u00ecnh b\u00e0y v\u1ec1 ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb Vi\u00eam ru\u1ed9t th\u1eeba c\u1ea5p theo c\u00e1c khuy\u1ebfn c\u00e1o m\u1edbi nh\u1ea5t.<\/strong><\/p>\n

\"Vi\u00eam<\/p>\n

1. Sinh l\u00fd b\u1ec7nh<\/u><\/strong>:<\/u><\/strong><\/h2>\n

VRT xu\u1ea5t ti\u1ebft:<\/strong><\/p>\n

\u1ede nh\u1eefng tr\u01b0\u1eddng h\u1ee3p VRT kh\u00f4ng t\u1eafc ngh\u1ebdn, th\u01b0\u01a1ng t\u00f4n vi\u00eam c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u t\u1eeb m\u1ed9t ch\u1ed7 lo\u00e9t \u1edf ni\u00eam m\u1ea1c ru\u1ed9t th\u1eeba. Lo\u00e9t g\u00e2y k\u00edch th\u00edch l\u00e0m t\u0103ng ti\u1ebft, r\u1ed3i qu\u00e1 tr\u00ecnh vi\u00eam lan d\u1ea7n theo h\u01b0\u1edbng xuy\u00ean th\u00e0nh \u0111\u1ebfn l\u1edbp c\u01a1 v\u00e0 l\u1edbp thanh m\u1ea1c. Th\u00e0nh ru\u1ed9t th\u1eeba vi\u00eam ph\u00f9 n\u1ec1 \u1edf m\u1ee9c \u0111\u1ed9 n\u1eb7ng s\u1ebd g\u00e2y t\u1eafc c\u00e1c nh\u00e1nh t\u1eadn c\u1ee7a \u0111\u1ed9ng m\u1ea1ch ru\u1ed9t th\u1eeba, \u0111\u01b0a \u0111\u1ebfn t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u nu\u00f4i v\u00e0 ho\u1ea1i t\u1eed ru\u1ed9t th\u1eeba. C\u01a1 ch\u1ebf n\u00e0y c\u00f2n g\u1ecdi l\u00e0 VRT xu\u1ea5t ti\u1ebft.<\/p>\n

Vi khu\u1ea9n x\u00e2m nh\u1eadp m\u00f4 lympho RT g\u00e2y vi\u00eam ni\u00eam m\u1ea1c, d\u01b0\u1edbi ni\u00eam m\u1ea1c, v\u1edbi h\u00ecnh \u1ea3nh: ph\u00f9 n\u1ec1, \u0111\u1ecf, sung huy\u1ebft => mu\u1ed9n\u00a0 h\u01a1n s\u1ebd xu\u1ea5t hi\u1ec7n c\u00e1c \u1ed5 ho\u1ea1i t\u1eed: n\u00e2u s\u1eabm v\u00e0 m\u1ea3ng ho\u1ea1i t\u1eed x\u00e1m-l\u1ee5c.<\/p>\n

VRT t\u1eafc ngh\u1ebdn:<\/strong><\/p>\n

T\u1eafc ngh\u1ebdn l\u00f2ng ru\u1ed9t th\u1eeba \u0111\u01b0\u1ee3c xem l\u00e0 s\u1ef1 ki\u1ec7n ch\u00ednh trong b\u1ec7nh sinh \u1edf h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n VRT. L\u00f2ng ru\u1ed9t th\u1eeba c\u00f3 th\u1ec3 b\u1ecb t\u1eafc do nhi\u1ec1u nguy\u00ean nh\u00e2n nh\u01b0 s\u1ecfi ph\u00e2n, t\u0103ng s\u1ea3n m\u00f4 b\u1ea1ch huy\u1ebft, d\u1ecb v\u1eadt (t\u1eeb th\u1ee9c \u0103n nh\u01b0 h\u1ea1t tr\u00e1i c\u00e2y, s\u1ee3i rau.., hay barium sau ch\u1ee5p c\u1ea3n quang \u0111\u01b0\u1eddng ti\u00eau h\u00f3a), k\u00fd sinh tr\u00f9ng, kh\u1ed1i u ho\u1eb7c kh\u1ed1i h\u1ea1ch ph\u00ec \u0111\u1ea1i. T\u1eafc ngh\u1ebdn l\u00f2ng ru\u1ed9t th\u1eeba g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng \u1ee9 \u0111\u1ecdng d\u1ecbch, l\u00e0m \u00e1p l\u1ef1c trong l\u00f2ng ru\u1ed9t th\u1eeba t\u0103ng. \u0110\u1ed3ng th\u1eddi, do \u1ee9 \u0111\u1ecdng, vi khu\u1ea9n trong l\u00f2ng ru\u1ed9t th\u1eeba s\u1ebd t\u0103ng s\u1ed1 l\u01b0\u1ee3ng, s\u1ea3n sinh \u0111\u1ed9c t\u1ed1.<\/p>\n

\u00a0<\/strong>– C\u00e1c nguy\u00ean nh\u00e2n g\u00e2y t\u1eafc ngh\u1ebdn nh\u01b0 : giun, s\u1ecfi ph\u00e2n, m\u00f4 lympho vi\u00eam,.. g\u00e2y \u1ee9 \u0111\u1ecdng ch\u1ea5t ti\u1ebft\u00e0 t\u0103ng \u00e1p l\u1ef1c trong l\u00f2ng ru\u1ed9t th\u1eeba + vi khu\u1ea9n trong l\u00f2ng ru\u1ed9t th\u1eeba ph\u00e1t tri\u1ec3n t\u1ea1o m\u1ee7 v\u00e0 t\u1ee5 t\u1eadp nhi\u1ec1u b\u1ea1ch c\u1ea7u l\u00e0m t\u0103ng th\u00eam \u00e1p l\u1ef1c trong l\u00f2ng ru\u1ed9t th\u1eeba \u00e0 ni\u00eam m\u1ea1c teo, th\u00e0nh ru\u1ed9t th\u1eeba vi\u00eam v\u1edbi huy\u1ebft kh\u1ed1i trong mao m\u1ea1ch d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed v\u00e0 th\u1ee7ng.<\/p>\n

– Di\u1ec5n bi\u1ebfn ph\u1ee5 thu\u1ed9c v\u00e0o 4 y\u1ebfu t\u1ed1 :<\/p>\n

+ Th\u1ec3 t\u00edch l\u00f2ng ru\u1ed9t th\u1eeba<\/p>\n

+ M\u1ee9c \u0111\u1ed9 t\u1eafc ngh\u1ebdn<\/p>\n

+ Xu\u1ea5t ti\u1ebft c\u1ee7a ni\u00eam m\u1ea1c ru\u1ed9t th\u1eeba.<\/p>\n

+ T\u00ednh \u0111\u00e0n h\u1ed3i c\u1ee7a thanh m\u1ea1c ru\u1ed9t th\u1eeba.<\/p>\n

2. L\u00e2m s\u00e0ng vi\u00eam ru\u1ed9t th\u1eeba c\u1ea5p<\/u><\/strong>:<\/u><\/strong><\/h2>\n

2.1 Vi\u00eam ru\u1ed9t th\u1eeba sung huy\u1ebft<\/strong><\/p>\n

\u00a0<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
TRI\u1ec6U CH\u1ee8NG TO\u00c0N TH\u00c2N<\/strong><\/td>\n<\/tr>\n
-S\u1ed1t nh\u1eb9: 37.5- 38o<\/sup> C, m\u1ea1ch 90-100l\/p.<\/p>\n

– H\u1ed9i ch\u1ee9ng nhi\u1ec5m tr\u00f9ng: m\u00f4i kh\u00f4, l\u01b0\u1ee1i b\u1ea9n<\/p>\n

– S\u1ed1t >39o<\/sup> C th\u01b0\u1eddng VRT c\u00f3 b\u1ebfn ch\u1ee9ng: VPM , \u00e1pxe RT<\/td>\n<\/tr>\n

TRI\u1ec6U CH\u1ee8NG C\u01a0 N\u0102NG<\/strong><\/td>\nTRI\u1ec6U CH\u1ee8NG TH\u1ef0C TH\u1ec2<\/strong><\/td>\n<\/tr>\n
1.\u00a0\u00a0\u00a0 <\/strong>\u0110au b\u1ee5ng:<\/strong><\/p>\n

– \u0110au h\u1ed1 ch\u1eadu ph\u1ea3i, quanh r\u1ed1n, th\u01b0\u1ee3ng v\u1ecb => v\u00e0i gi\u1edd sau: \u0111au khu tr\u00fa h\u1ed1 ch\u1eadu ph\u1ea3i<\/p>\n

– Th\u01b0\u1eddng \u0111au \u00e2m \u1ec9, t\u0103ng khi ho, ho\u1eb7c khi thay \u0111\u1ed5i t\u01b0 th\u1ebf<\/p>\n

– \u0110au chuy\u1ec3n: \u0111au quanh r\u1ed1n\/th\u01b0\u1ee3ng v\u1ecb sau \u0111\u00f3 \u0111au khu tr\u00fa \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i l\u00e0 tri\u1ec7u ch\u1ee9ng ph\u00e2n bi\u1ec7t t\u1ed1t nh\u1ea5t ( c\u00f3 \u0111\u1ed9 nh\u1ea1y v\u00e0 \u0111\u1ed9 \u0111\u1eb7c hi\u1ec7u kho\u1ea3ng 80%)<\/td>\n

1. Nh\u00ecn:<\/strong><\/p>\n

– Giai \u0111o\u1ea1n \u0111\u1ea7u: b\u1ee5ng di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf<\/p>\n

– Di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf k\u00e9m khi v\u00e0o tr\u1ec5 ho\u1eb7c \u0111\u00e3 c\u00f3 bi\u1ebfn ch\u1ee9ng<\/td>\n<\/tr>\n

2.\u00a0\u00a0\u00a0 <\/strong>R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a<\/strong>:<\/strong><\/p>\n

– Ch\u00e1n \u0103n: tuy kh\u00f4ng \u0111i\u1ec3n h\u00ecnh nh\u01b0ng h\u1ea7u nh\u01b0 lu\u00f4n c\u00f3.<\/p>\n

– Bu\u1ed3n n\u00f4n, n\u00f4n: n\u00f4n th\u01b0\u01a1ng \u0111i sau \u0111au b\u1ee5ng , n\u1ebfu kh\u00f4ng \u0111\u00fang di\u1ec5n ti\u1ebfn n\u00e0y n\u00ean \u00a0xem l\u1ea1i ch\u1ea9n \u0111o\u00e1n<\/p>\n

– Ti\u00eau l\u1ecfng: th\u01b0\u1eddng g\u1eb7p \u1edf tr\u1ebb em ho\u1eb7c \u00a0VRT nhi\u1ec5m \u0111\u1ed9c ho\u1eb7c VRT g\u00e2y k\u00edch th\u00edch \u0111\u1ea1i tr\u00e0ng ch\u1eadu \u2013 h\u00f4ng.<\/p>\n

– T\u00e1o b\u00f3n<\/td>\n

2. S\u1edd n\u1eafn:<\/strong><\/p>\n

– Ph\u1ea3n \u1ee9ng d\u1ed9i (d\u1ea5u hi\u1ec7u Blumberg): \u1ea5n nh\u1eb9 v\u00e0 s\u00e2u \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i sau \u0111\u00f3 th\u1ea3 tay \u0111\u1ed9t ng\u1ed9t b\u1ec7nh nh\u00e2n th\u1ea5y \u0111au<\/p>\n

– D\u1ea5u Rovsing: \u1ea5n s\u00e2u v\u00e0o h\u1ed1 ch\u1eadu tr\u00e1i b\u1ec7nh nh\u00e2n \u0111au \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i<\/p>\n

– Co c\u1ee9ng, \u0111\u1ec1 kh\u00e1ng th\u00e0nh b\u1ee5ng: th\u01b0\u1eddng \u1edf giai \u0111o\u1ea1n tr\u1ec5 khi ru\u1ed9t th\u1eeba \u0111\u00e3 v\u1ee1.<\/p>\n

– D\u1ea5u th\u1eaft l\u01b0ng ch\u1eadu: ch\u1ea9n \u0111o\u00e1n VRT sau manh tr\u00e0ng<\/p>\n

– D\u1ea5u c\u01a1 b\u1ecbt: ch\u1ea9n \u0111o\u00e1n VRT n\u1eb1m s\u00e1t c\u01a1 b\u1ecbt trong<\/p>\n

– D\u1ea5u hi\u1ec7u ho g\u00e2y \u0111au nhi\u1ec1u h\u1ed1 ch\u1eadu ph\u1ea3i, \u0111au khi g\u00f5: trong vi\u00eam ph\u00fac m\u1ea1c khu tr\u00fa<\/td>\n<\/tr>\n

3.\u00a0\u00a0\u00a0 <\/strong>Ti\u1ec3u kh\u00f3, ti\u1ec3u g\u1eaft:<\/strong><\/p>\n

– V\u00ec ru\u1ed9t th\u1eeba g\u1ea7n b\u00e0ng quang, ni\u1ec7u qu\u1ea3n => ti\u1ec3u l\u1eaft nh\u1eaft, ti\u1ec3u m\u00e1u, ti\u1ec3u \u0111\u1ee5c\u2026<\/p>\n

– \u1ede tr\u1ebb nam c\u00f3 th\u1ec3 c\u00f3 vi\u00eam tinh ho\u00e0n 1 b\u00ean do m\u1ee7 c\u1ee7a ru\u1ed9t th\u1eeba vi\u00eam ch\u1ea3y theo \u1ed1ng ph\u00fac tinh m\u1ea1c xu\u1ed1ng b\u00ecu.<\/td>\n

3. C\u00e1c \u0111i\u1ec3m \u0111au:<\/strong><\/p>\n

– Mc Burney<\/u>: tr\u00ean \u0111\u01b0\u1eddng n\u1ed1i r\u1ed1n- gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean b\u00ean P, c\u00e1ch gai n\u00e0y #5cm hay ch\u00ednh gi\u1eefa \u0111\u01b0\u1eddng n\u1ed1i n\u00e0y<\/p>\n

-Lanz<\/u>: \u0111i\u1ec3m n\u1ed1i 1\/3 Ph\u1ea3i v\u00e0 2\/3 Tr\u00e1i \u0111\u01b0\u1eddng n\u1ed1i 2 gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean<\/p>\n

– Clado<\/u>: giao \u0111i\u1ec3m b\u1edd ngo\u00e0i c\u01a1 th\u1eb3ng b\u1ee5ng ph\u1ea3i v\u00e0 \u0111\u01b0\u1eddng n\u1ed1i 2 gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean<\/p>\n

– \u0110i\u1ec3m tr\u00ean m\u00e0o ch\u1eadu:<\/u> khi ru\u1ed9t th\u1eeba n\u1eb1m sau manh tr\u00e0ng<\/p>\n

 <\/td>\n<\/tr>\n

<\/td>\n4.\u00a0\u00a0\u00a0\u00a0\u00a0 <\/strong>Th\u0103m kh\u00e1m \u00e2m \u0111\u1ea1o- tr\u1ef1c tr\u00e0n<\/strong>g (A\u0110-TT)<\/strong>:<\/strong><\/p>\n

Th\u0103m A\u0110-TT: l\u00e0 \u0111\u1ed9ng t\u00e1c b\u1eaft bu\u1ed9c khi nghi ng\u1edd VRT ti\u1ec3u khung (th\u00e0nh b\u1ee5ng kh\u00f4ng co c\u1ee9ng, kh\u00f4ng \u0111au ). Th\u0103m A\u0110 hay TT \u00e0 \u0110au \u1edf ph\u00eda tr\u01b0\u1edbc c\u00f9ng \u0111\u1ed3 ph\u1ea3i\u00a0\u00a0\u00a0 ( ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi vi\u00eam ph\u1ea7n ph\u1ee5 )<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

2.2 Vi\u00eam ru\u1ed9t th\u1eeba <\/strong>v\u1ee1<\/strong><\/p>\n

Ngh\u0129 \u0111\u1ebfn VRT v\u1ee1<\/em><\/strong> khi<\/em><\/strong> :\u00a0 S\u1ed1t >39o<\/sup> C, b\u1ea1ch c\u1ea7u > 15000. V\u1ee1 c\u00f3 th\u1ec3 khu tr\u00fa hay lan t\u1ecfa.<\/p>\n

Di\u1ec5n ti\u1ebfn:<\/em><\/strong><\/p>\n

\u00a0<\/u><\/strong><\/p>\n\n\n\n\n\n
Vi\u00eam ph\u00fac m\u1ea1c to\u00e0n th\u1ec3<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Th\u01b0\u1edbng x\u1ea3y ra sau 12- 24h, \u0111au c\u00e0ng l\u00fac c\u00e0ng t\u0103ng.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110au kh\u1eafp b\u1ee5ng, b\u1ee5ng co c\u1ee9ng, ch\u01b0\u1edbng, kh\u00f4ng nghe \u00e2m ru\u1ed9t<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Trong nh\u00ecu tr\u01b0\u1eddng h\u1ee3p, tri\u1ec7u ch\u1ee9ng \u0111au c\u00f3 th\u1ec3 x\u1ea3y ra 2 th\u00ec: \u0111au (th\u00ec 1)\u00e0 h\u1ebft \u0111au \u201c time gi\u1ea3m \u0111au \u0111\u00e1nh l\u1eeba \u201d\u00e0 \u0110au d\u1eef d\u1ed9i do ru\u1ed9t th\u1eeba v\u1ee1 (th\u00ec2)<\/p>\n

 <\/td>\n<\/tr>\n

\u00c1pxe <\/strong>ru\u1ed9t th\u1eeba<\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Ru\u1ed9t th\u1eeba v\u1ee1 \u0111\u01b0\u1ee3c th\u00e0nh h\u00f3a b\u1edfi: ru\u1ed9t, m\u1ea1c n\u1ed1i,..\u00a0 \u00e0 \u00c1pxe ru\u1ed9t th\u1eeba ch\u1ee9a nh\u00ecu m\u1ee7 b\u00ean trong<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Kh\u00e1m: v\u00f9ng s\u01b0ng r\u1ea5t \u0111au \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i, gi\u1edbi h\u1ea1n r\u00f5, th\u0103m tr\u1ef1c tr\u00e0ng : s\u1edd th\u1ea5y 1 kh\u1ed1i l\u00f9ng nh\u00f9ng.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Ph\u1ea7n b\u1ee5ng c\u00f2n l\u1ea1i m\u1ec1m, kh\u00f4ng \u0111au, c\u00f2n ti\u1ebfng ru\u1ed9t.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ti\u00eau ch\u1ea3y, ti\u1ec3u d\u1eaft.<\/td>\n<\/tr>\n

\u0110\u00e1m qu\u00e1nh <\/strong>ru\u1ed9t th\u1eeba<\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Ru\u1ed9t th\u1eeba vi\u00eam \u0111\u01b0\u1ee3c c\u1ea5u tr\u00fac xung quang bao b\u1ecdc, kh\u00f4ng c\u00f3 ho\u1eb7c \u00edt m\u1ee7<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 H\u1ed1 ch\u1eadu ph\u1ea3i c\u1ee9ng 1 m\u1ea3ng, s\u1edd nh\u01b0 t\u1ea5m b\u00eca d\u1ea7y, b\u1edd kh\u00f4ng r\u00f5, \u0111au \u00edt r\u1ed3i t\u1ef1 h\u1ebft h\u1eb3n.<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 C\u00f3 th\u1ec3 vi\u00eam l\u1ea1i v\u1ec1 sau<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

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

\u00a0<\/strong><\/p>\n\n\n\n\n\n\n
C\u00f4ng th\u1ee9c m\u00e1u<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 BC > 10.000\/mm3<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 NEU > 75% ( trong 78% TH)<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 BC > 15.000\/mm3 => ngh\u0129 c\u00f3 bi\u1ebfn ch\u1ee9ng<\/p>\n

 <\/td>\n<\/tr>\n

CRP<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 T\u0103ng trong v\u00f2ng 6- 12h<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 CRP b\u00ecnh th\u01b0\u1eddng + BC < 10,500\/mm3 <\/sup>+ NEU < 75% c\u00f3 g\u00eda tr\u1ecb ti\u00eau \u0111o\u00e1n \u00e2m 100%<\/td>\n<\/tr>\n

Si\u00eau \u00e2m<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 \u01afu \u0111i\u1ec3m: th\u1eddi gian th\u1ef1c hi\u1ec7n ng\u1eafn, kh\u00f4ng ti\u1ebfp x\u00fac v\u1edbi tia, ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c c\u00e1c nguy\u00ean nh\u00e2n \u0111au b\u1ee5ng kh\u00e1c<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Nh\u01b0\u1ee3c \u0111i\u1ec3m: ph\u1ee5 thu\u1ed9c v\u00e0o ng\u01b0\u1eddi si\u00eau \u00e2m<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110\u1eb7c \u0111i\u1ec3m tr\u00ean si\u00eau \u00e2m c\u1ee7a Vi\u00eam ru\u1ed9t th\u1eeba c\u1ea5p<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u1ea5u tr\u00fac kh\u00f4ng th\u1ec3 l\u00e0m x\u1eb9p, kh\u00f4ng nhu \u0111\u1ed9ng, c\u00f3 l\u00f2ng b\u00ean trong d\u00e3n to d > 6cm<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vi\u1ec1n ph\u00eda trong l\u00e0 l\u1edbp ni\u00eam m\u1ea1c c\u00f3 ph\u1ea3n \u00e2m t\u0103ng<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Vi\u1ec1n ngo\u00e0i ph\u00f9 n\u1ec1 \u00edt ph\u1ea3n \u00e2m<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u1eaft ngang: th\u1ea5y d\u1ea1ng h\u00ecnh bia (Target Sign)<\/p>\n

–\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u1eaft d\u1ecdc: d\u1ea5u hi\u1ec7u ng\u00f3n tay<\/td>\n<\/tr>\n

CT- Scan<\/strong><\/td>\n\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c\u00a0 VRT kh\u00f4ng \u0111i\u1ec3n h\u00ecnh<\/p>\n

\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0 Kh\u1ea9u k\u00ednh ru\u1ed9t th\u1eeba t\u0103ng, th\u00e0nh ru\u1ed9t th\u1eeba d\u00e0y h\u01a1n b\u00ecnh th\u01b0\u1eddng, xung quanh c\u00f3 t\u1ee5 d\u1ecbch.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

3. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/h2>\n