{"id":1223,"date":"2022-03-31T13:55:39","date_gmt":"2022-03-31T13:55:39","guid":{"rendered":"https:\/\/lieuphapyhoctaitao.com\/?p=1223"},"modified":"2022-03-31T13:55:39","modified_gmt":"2022-03-31T13:55:39","slug":"kiem-soat-dau-sau-ton-thuong-tuy-song","status":"publish","type":"post","link":"https:\/\/lieuphapyhoctaitao.com\/?p=1223","title":{"rendered":"Ki\u1ec3m so\u00e1t \u0111au sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng"},"content":{"rendered":"<p><strong><em>Sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng, m\u1ed9t ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n s\u1ebd bi\u1ec3u hi\u1ec7n \u0111au \u0111a d\u1ea1ng, do nhi\u1ec1u nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf kh\u00e1c nhau. T\u00ecnh tr\u1ea1ng \u0111au c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng nghi\u00eam tr\u1ecdng \u0111\u1ebfn cu\u1ed9c s\u1ed1ng v\u00e0 sinh ho\u1ea1t \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh.<\/em><\/strong><\/p>\n<p><strong><em>Ki\u1ec3m so\u00e1t \u0111au l\u00e0 c\u00f4ng t\u00e1c gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au, kh\u1eafc ph\u1ee5c c\u0103n nguy\u00ean g\u00e2y \u0111au b\u1eb1ng c\u00e1c ph\u01b0\u01a1ng ph\u00e1p nh\u01b0: n\u1ed9i khoa, v\u1eadt l\u00fd tr\u1ecb li\u1ec7u, h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd, ngo\u1ea1i khoa, ho\u1eb7c k\u1ebft h\u1ee3p nhi\u1ec1u ph\u01b0\u01a1ng ph\u00e1p.<\/em><\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n<p>\u0110au dai d\u1eb3ng l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p nh\u1ea5t v\u00e0 \u1ea3nh h\u01b0\u1edfng n\u1eb7ng n\u1ec1 nh\u1ea5t do t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng (SCI) g\u00e2y n\u00ean. C\u00e1c y\u1ebfu t\u1ed1 t\u00e2m l\u00fd v\u00e0 t\u00ecnh tr\u1ea1ng \u0111au c\u00f3 m\u1ed1i quan h\u1ec7 t\u01b0\u01a1ng h\u1ed7: \u0111au g\u00e2y suy ki\u1ec7t, r\u1ed1i lo\u1ea1n gi\u1ea5c ng\u1ee7, th\u01b0\u01a1ng t\u1eadt t\u00e2m l\u00fd; v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 n\u1eb7ng n\u1ec1 t\u00e2m l\u00fd c\u00e0ng khi\u1ebfn b\u1ec7nh nh\u00e2n t\u1eadp trung v\u00e0o t\u00ecnh tr\u1ea1ng \u0111au c\u1ee7a b\u1ea3n th\u00e2n.<\/p>\n<p>T\u1ef7 l\u1ec7 hi\u1ec7n m\u1eafc c\u1ee7a \u0111au m\u1ea1n t\u00ednh sau SCI l\u00e0 kho\u1ea3ng 40-75%, trong \u0111\u00f3 25-60% s\u1ed1 b\u1ec7nh nh\u00e2n b\u00e1o \u0111au trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng, th\u01b0\u1eddng \u0111i k\u00e8m c\u00e1c b\u1ec7nh \u0111\u1ed3ng m\u1eafc v\u1ec1 t\u00e2m l\u00fd-t\u00e2m th\u1ea7n \u0111\u1ee7 nghi\u00eam tr\u1ecdng \u0111\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng sinh ho\u1ea1t. V\u1ecb tr\u00ed \u0111au ph\u1ed5 bi\u1ebfn nh\u1ea5t l\u00e0 l\u01b0ng (61%), h\u00f4ng v\u00e0 m\u00f4ng (61%), chi d\u01b0\u1edbi (58%). \u0110au chi tr\u00ean g\u1eb7p \u1edf 76% b\u1ec7nh nh\u00e2n sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y c\u1ed5.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>Ph\u00e2n lo\u1ea1i m\u1ed9t s\u1ed1 d\u1ea1ng \u0111au c\u01a1 b\u1ea3n<\/strong><\/p>\n<p>\u0110au th\u1ee5 th\u1ec3 (th\u1ee5 th\u1ec3 c\u01a1 x\u01b0\u01a1ng\/th\u1ee5 th\u1ec3 t\u1ea1ng): l\u00e0 t\u00ecnh tr\u1ea1ng \u0111au do c\u00e1c th\u01b0\u01a1ng t\u1ed5n tr\u1ef1c ti\u1ebfp k\u00edch th\u00edch \u0111\u1ea7u m\u00fat d\u00e2y th\u1ea7n kinh (th\u1ee5 th\u1ec3).<\/p>\n<p>\u0110au th\u1ee5 th\u1ec3 c\u01a1 x\u01b0\u01a1ng \u0111i\u1ec3n h\u00ecnh x\u1ea3y ra do g\u00e3y x\u01b0\u01a1ng, lo\u00e3ng x\u01b0\u01a1ng, co c\u1ee9ng c\u01a1, hay \u0111au v\u00f9ng m\u1ed5 x\u01b0\u01a1ng sau ph\u1eabu thu\u1eadt.<\/p>\n<p>\u0110au th\u1ee5 th\u1ec3 t\u1ea1ng bi\u1ec3u hi\u1ec7n nh\u01b0 \u0111au v\u00f9ng b\u00e0ng quang, \u0111\u01b0\u1eddng ru\u1ed9t, bi\u1ec3u hi\u1ec7n \u0111au \u00e2m \u1ec9 hay chu\u1ed9t r\u00fat, c\u00f3 th\u1ec3 \u0111i k\u00e8m n\u00f4n.<\/p>\n<p>\u0110au th\u1ea7n kinh xu\u1ea5t hi\u1ec7n do k\u00edch \u1ee9ng, ch\u00e8n \u00e9p, t\u1ed5n th\u01b0\u01a1ng m\u00f4 th\u1ea7n kinh (t\u1ee7y s\u1ed1ng, r\u1ec5 th\u1ea7n kinh), bi\u1ec3u hi\u1ec7n t\u00ea b\u00ec, d\u1ecb c\u1ea3m lan theo \u0111\u01b0\u1eddng d\u1eabn truy\u1ec1n th\u1ea7n kinh.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p v\u00e0 chi\u1ebfn l\u01b0\u1ee3c ki\u1ec3m so\u00e1t \u0111au<\/strong><\/p>\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa gi\u1ea3m \u0111au<\/em><\/strong><\/p>\n<p>\u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa (d\u00f9ng thu\u1ed1c) l\u00e0 ph\u01b0\u01a1ng ph\u00e1p h\u00e0ng \u0111\u1ea7u \u0111\u1ec3 ki\u1ec3m so\u00e1t \u0111au cho h\u1ea7u h\u1ebft c\u00e1c b\u1ec7nh l\u00fd. Tuy nhi\u00ean, kh\u00f3 kh\u0103n \u1edf b\u1ec7nh nh\u00e2n t\u1ed5n th\u01b0\u01a1ng t\u1ee7y l\u00e0 do t\u1ed5n th\u01b0\u01a1ng n\u1eb1m \u1edf m\u00f4 th\u1ea7n kinh, ch\u1ecbu tr\u00e1ch nhi\u1ec7m d\u1eabn truy\u1ec1n v\u00e0 chi ph\u1ed1i, n\u00ean kh\u00f4ng ph\u1ea3i b\u1ec7nh nh\u00e2n n\u00e0o c\u0169ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb n\u1ed9i.<\/p>\n<p>B\u00ean c\u1ea1nh c\u00e1c thu\u1ed1c gi\u1ea3m \u0111au (pregabalin, opioids), b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c k\u00ea c\u00e1c thu\u1ed1c h\u1ea1n ch\u1ebf t\u00e1c d\u1ee5ng ph\u1ee5 (v\u00ed d\u1ee5 benzodiazepine \u0111i k\u00e8m ketamine tr\u00e1nh g\u00e2y \u1ea3o gi\u00e1c).<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>V\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u00e0 ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u<\/em><\/strong><\/p>\n<p>M\u1ee5c ti\u00eau v\u1eadt l\u00fd tr\u1ecb li\u1ec7u v\u1edbi b\u1ec7nh nh\u00e2n li\u1ec7t t\u1ee7y l\u00e0 n\u1ed7 l\u1ef1c duy tr\u00ec, th\u1eadm ch\u00ed t\u0103ng c\u01a1 l\u1ef1c, bi\u00ean \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng, th\u0103ng b\u1eb1ng, ph\u1ed1i h\u1ee3p v\u1eadn \u0111\u1ed9ng. Ho\u1ea1t \u0111\u1ed9ng tr\u1ecb li\u1ec7u t\u1eadp trung t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng th\u00f4ng qua th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng sinh ho\u1ea1t \u0111\u01a1n gi\u1ea3n v\u00e0 ph\u1ee9c t\u1ea1p. Ngo\u00e0i ra, c\u00f3 m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng gi\u00fap t\u1eadp luy\u1ec7n v\u1ec1 m\u1eb7t c\u1ea3m gi\u00e1c, gi\u00fap gi\u1ea3m r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c, gi\u1ea3m t\u00ecnh tr\u1ea1ng \u0111au to\u00e0n th\u1ec3. M\u1ed9t s\u1ed1 c\u01a1 s\u1edf c\u00f2n nghi\u00ean c\u1ee9u ki\u1ec3m so\u00e1t \u0111au nh\u1edd xoa b\u00f3p, ch\u00e2m c\u1ee9u, v\u1edbi k\u1ebft qu\u1ea3 s\u1ebd d\u1ea7n \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n trong t\u01b0\u01a1ng lai. Tuy nhi\u00ean, c\u00e1c ph\u01b0\u01a1ng ph\u00e1p tr\u1ecb li\u1ec7u n\u00e0y mang t\u00ednh b\u1ed5 tr\u1ee3, \u00edt khi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ed9c l\u1eadp v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n \u0111au n\u1eb7ng.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>Ti\u1ebfp c\u1eadn t\u00e2m th\u1ea7n, t\u00e2m l\u00fd<\/em><\/strong><\/p>\n<p>Nh\u01b0 \u0111\u00e3 bi\u1ebft, t\u00ecnh tr\u1ea1ng \u0111au v\u00e0 g\u00e1nh n\u1eb7ng t\u00e2m l\u00fd th\u01b0\u1eddng \u0111i \u0111\u00f4i v\u1edbi nhau \u1edf c\u00e1c b\u1ec7nh nh\u00e2n li\u1ec7t t\u1ee7y, do \u0111\u00f3 h\u1ed7 tr\u1ee3 t\u00e2m l\u00fd cho b\u1ec7nh nh\u00e2n l\u00e0 m\u1ed9t trong c\u00e1c m\u0169i nh\u1ecdn quan tr\u1ecdng trong ki\u1ec3m so\u00e1t \u0111au. \u00a0M\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a \u0111i\u1ec1u tr\u1ecb t\u00e2m th\u1ea7n-t\u00e2m l\u00fd nh\u00ecn chung li\u00ean quan \u0111\u1ebfn c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 s\u1edbm t\u00e1i h\u00f2a nh\u1eadp x\u00e3 h\u1ed9i, \u0111\u00f2i h\u1ecfi \u00edt nhi\u1ec1u t\u1eadp luy\u1ec7n c\u00e1c k\u1ef9 n\u0103ng th\u00edch nghi v\u1edbi \u0111au v\u00e0 tr\u1ecb li\u1ec7u nh\u1eadn th\u1ee9c h\u00e0nh vi, c\u0169ng nh\u01b0 th\u00edch nghi v\u1ec1 k\u1ef9 n\u0103ng x\u00e3 h\u1ed9i, t\u00ecnh d\u1ee5c, giao ti\u1ebfp.<\/p>\n<p>M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p t\u00e2m th\u1ea7n, t\u00e2m l\u00fd bao g\u1ed3m t\u01b0 v\u1ea5n t\u00e2m l\u00fd, li\u1ec7u ph\u00e1p t\u00e2m l\u00fd, s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng tr\u1ea7m c\u1ea3m, ch\u1ed1ng lo\u1ea1n th\u1ea7n, tr\u1ecb li\u1ec7u h\u00e0nh vi v\u00e0 giao ti\u1ebfp.<\/p>\n<p>&nbsp;<\/p>\n<p><strong><em>\u0110i\u1ec1u tr\u1ecb x\u00e2m l\u1ea5n<\/em><\/strong><\/p>\n<p>Ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb x\u00e2m l\u1ea5n th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u01b0a ra khi b\u1ec7nh nh\u00e2n \u0111au qu\u00e1 n\u1eb7ng, kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c ph\u01b0\u01a1ng th\u1ee9c \u0111i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n (n\u1ed9i khoa, PHCN, can thi\u1ec7p t\u00e2m l\u00fd).<\/p>\n<p>Can thi\u1ec7p ngo\u1ea1i khoa bao g\u1ed3m m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p nh\u01b0: c\u1eaft r\u1ec5 th\u1ea7n kinh, c\u1eaft l\u1ecdc t\u1ee7y s\u1ed1ng, c\u00e1c h\u00ecnh th\u1ee9c ti\u00eam phong b\u1ebf, k\u00edch th\u00edch n\u00e3o s\u00e2u v\u00e0 k\u00edch th\u00edch t\u1ee7y s\u1ed1ng.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb x\u00e2m l\u1ea5n th\u01b0\u1eddng gi\u00fap gi\u1ea3m \u0111au trong th\u1eddi gian d\u00e0i, c\u00f3 th\u1ec3 tri\u1ec7t ti\u00eau c\u0103n nguy\u00ean \u0111au trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, tuy nhi\u00ean c\u0169ng \u0111i k\u00e8m c\u00e1c bi\u1ebfn ch\u1ee9ng nh\u01b0 m\u1ea5t m\u00e1u, t\u1ed5n th\u01b0\u01a1ng m\u00f4 l\u00e0nh, nhi\u1ec5m khu\u1ea9n.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng, m\u1ed9t ph\u1ea7n l\u1edbn b\u1ec7nh nh\u00e2n s\u1ebd bi\u1ec3u hi\u1ec7n \u0111au \u0111a d\u1ea1ng, do nhi\u1ec1u nguy\u00ean nh\u00e2n v\u00e0 c\u01a1 ch\u1ebf kh\u00e1c nhau. T\u00ecnh tr\u1ea1ng \u0111au c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng nghi\u00eam tr\u1ecdng \u0111\u1ebfn cu\u1ed9c s\u1ed1ng v\u00e0 sinh ho\u1ea1t \u1edf m\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh. Ki\u1ec3m so\u00e1t \u0111au l\u00e0 c\u00f4ng t\u00e1c gi\u1ea3m tri\u1ec7u ch\u1ee9ng \u0111au, [&#8230;]\n","protected":false},"author":2,"featured_media":1224,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[6],"tags":[],"_links":{"self":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1223"}],"collection":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1223"}],"version-history":[{"count":1,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1223\/revisions"}],"predecessor-version":[{"id":1225,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1223\/revisions\/1225"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/media\/1224"}],"wp:attachment":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}