{"id":1668,"date":"2022-06-11T23:39:10","date_gmt":"2022-06-11T23:39:10","guid":{"rendered":"https:\/\/lieuphapyhoctaitao.com\/?p=1668"},"modified":"2025-08-16T02:39:31","modified_gmt":"2025-08-16T02:39:31","slug":"tac-tinh-mach-huyet-khoi-o-benh-nhan-ton-thuong-tuy-song","status":"publish","type":"post","link":"https:\/\/lieuphapyhoctaitao.com\/?p=1668","title":{"rendered":"\ud83c\udfaf\ud83c\udfaf\ud83c\udfaf T\u1eaeC T\u0128NH M\u1ea0CH HUY\u1ebeT KH\u1ed0I \u1ede B\u1ec6NH NH\u00c2N T\u1ed4N TH\u01af\u01a0NG T\u1ee6Y S\u1ed0NG"},"content":{"rendered":"
    \n
  1. \u0110\u1ea0I C\u01af\u01a0NG<\/strong><\/span><\/li>\n<\/ol>\n

    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u1eafc t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i (VTE), bao g\u1ed3m c\u1ea3 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u (DVT) v\u00e0 thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (PE), l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong v\u00e0 di ch\u1ee9ng sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng c\u1ea5p t\u00ednh v\u00e0 th\u01b0\u1eddng g\u00e2y kh\u00f3 ch\u1ecbu, ch\u1eadm ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng v\u1edbi ng\u01b0\u1eddi b\u1ec7nh.<\/span><\/p>\n

    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u00e1c bi\u1ebfn ch\u1ee9ng do t\u1eafc t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i c\u00f3 th\u1ec3 k\u1ec3 \u0111\u1ebfn suy t\u0129nh m\u1ea1ch, h\u1ed9i ch\u1ee9ng h\u1eadu huy\u1ebft kh\u1ed1i, thuy\u00ean t\u1eafc ph\u1ed5i. C\u00e1c tr\u01b0\u1eddng h\u1ee3p huy\u1ebfn kh\u1ed1i c\u1ea5p t\u00ednh kh\u00f4ng can thi\u1ec7p c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn ho\u1ea1i t\u1eed, ph\u1ea3i c\u1eaft c\u1ee5t chi.<\/span><\/p>\n

    \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe c\u00f3 t\u00ednh to\u00e0n c\u1ea7u, h\u1ea7u h\u1ebft x\u1ea3y ra \u1edf nh\u00f3m b\u1ec7nh nh\u00e2n thanh ni\u00ean t\u1eeb 16-30 tu\u1ed5i. T\u1ea7n su\u1ea5t DVT v\u00e0 PE \u1edf b\u1ec7nh nh\u00e2n ch\u1ea5n th\u01b0\u01a1ng c\u1ed9t s\u1ed1ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb (c\u00f3 ho\u1eb7c kh\u00f4ng k\u00e8m li\u1ec7t t\u1ee7y) \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o trong kho\u1ea3ng 67%-100%.Thuy\u00ean t\u1eafc m\u1ea1ch ph\u1ed5i l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn th\u1ee9 ba g\u00e2y t\u1eed vong \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f2n s\u1ed1ng sau 24 gi\u1edd x\u1ea3y ra t\u1ed5n th\u01b0\u01a1ng.<\/span><\/p>\n

     <\/p>\n

      \n
    1. M\u1ed8T S\u1ed0 Y\u1ebeU T\u1ed0 NGUY C\u01a0 T\u1eaeC M\u1ea0CH HUY\u1ebeT KH\u1ed0I <\/strong><\/span><\/li>\n<\/ol>\n
        \n
      • Tu\u1ed5i cao<\/span><\/li>\n
      • Gi\u1edbi nam<\/span><\/li>\n
      • Th\u00f3i quen h\u00fat thu\u1ed1c<\/span><\/li>\n
      • C\u00e1c b\u1ec7nh n\u1ec1n: b\u00e9o ph\u00ec, t\u0103ng huy\u1ebft \u00e1p, suy tim, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, ung th\u01b0<\/span><\/li>\n
      • Ch\u1ea5n th\u01b0\u01a1ng: g\u00e2y t\u0103ng \u0111\u00f4ng m\u00e1u, \u1ee9 tr\u1ec7 m\u00e1u, g\u00e2y b\u1ea5t \u0111\u1ed9ng<\/span><\/li>\n
      • C\u00e1c v\u1ea5n \u0111\u1ec1 ph\u1eabu thu\u1eadt: x\u00e2m l\u1ea5n m\u1ea1ch m\u00e1u, t\u01b0 th\u1ebf, b\u1ea5t \u0111\u1ed9ng l\u00e2u d\u00e0i sau ph\u1eabu thu\u1eadt<\/span><\/li>\n<\/ul>\n

         <\/p>\n

         <\/p>\n

        III. TRI\u1ec6U CH\u1ee8NG V\u00c0 CH\u1ea8N \u0110O\u00c1N<\/strong><\/span><\/p>\n

        C\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng:<\/em><\/strong><\/span><\/p>\n

          \n
        • Ph\u00f9 chi d\u01b0\u1edbi<\/span><\/li>\n
        • T\u0103ng \u0111\u01b0\u1eddng k\u00ednh b\u1eafp ch\u00e2n<\/span><\/li>\n
        • S\u01b0ng \u0111au d\u1ecdc h\u1ec7 t\u0129nh m\u1ea1ch s\u00e2u<\/span><\/li>\n
        • S\u01b0ng \u0111au c\u1eb3ng ch\u00e2n, gi\u1ea3m t\u01b0\u1edbi m\u00e1u \u0111\u1ea7u ng\u00f3n \u1edf giai \u0111o\u1ea1n mu\u1ed9n.<\/span><\/li>\n
        • Kh\u00f3 th\u1edf, \u0111au ng\u1ef1c ki\u1ec3u m\u00e0ng ph\u1ed5i trong thuy\u00ean t\u1eafc ph\u1ed5i.<\/span><\/li>\n<\/ul>\n

           <\/p>\n

           <\/p>\n

          \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Ti\u00eau chu\u1ea9n v\u00e0ng<\/em><\/strong> hi\u1ec7n nay l\u00e0 ch\u1ee5p huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch \u0111\u1ed3, tuy nhi\u00ean c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng si\u00eau \u00e2m, ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh (CT) hay c\u1ed9ng h\u01b0\u1edfng t\u1eeb (MRI). Ngo\u00e0i ra, x\u00e9t nghi\u1ec7m D-Dimer c\u0169ng gi\u00fap ph\u00e1t hi\u1ec7n v\u00e0 ph\u1ea3n \u00e1nh t\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00f4ng, huy\u1ebft kh\u1ed1i trong l\u00f2ng m\u1ea1ch.<\/span><\/p>\n

          \"\"<\/p>\n

           <\/p>\n

            \n
          1. D\u1ef0 PH\u00d2NG HUY\u1ebeT KH\u1ed0I T\u0128NH M\u1ea0CH S\u00c2U<\/strong><\/span><\/li>\n<\/ol>\n

            \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u00ecnh tr\u1ea1ng t\u0103ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1ee3c ch\u1ee9ng minh b\u1eaft \u0111\u1ea7u trong v\u00f2ng v\u00e0i gi\u1edd sau SCI v\u00e0 k\u00e9o d\u00e0i trong \u00edt nh\u1ea5t 2-3 tu\u1ea7n. Do \u0111\u00f3, n\u00ean k\u00ea thu\u1ed1c d\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i s\u1edbm nh\u1ea5t c\u00f3 th\u1ec3 sau t\u1ed5n th\u01b0\u01a1ng, l\u00fd t\u01b0\u1edfng l\u00e0 trong v\u00f2ng 72 gi\u1edd \u0111\u1ea7u.<\/span><\/p>\n

            \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng bi\u1ec3u hi\u1ec7n t\u1eafc m\u1ea1ch huy\u1ebft kh\u1ed1i trong v\u00f2ng 3 th\u00e1ng \u0111\u1ea7u sau th\u01b0\u01a1ng t\u1ed5n, c\u00e1c nghi\u00ean c\u1ee9u c\u0169ng \u0111\u1ec1 xu\u1ea5t d\u1ef1 ph\u00f2ng b\u1eb1ng heparin trong 3 th\u00e1ng. Th\u1eddi gian d\u1ef1 ph\u00f2ng v\u1edbi b\u1ec7nh nh\u00e2n t\u1eebng c\u00f3 ti\u1ec1n s\u1eed m\u1eafc DVT\/PE c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 6-12 th\u00e1ng.<\/span><\/p>\n

            \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 \u0111\u1ec1 xu\u1ea5t d\u1ef1 ph\u00f2ng c\u01a1 h\u1ecdc: t\u1eadp PHCN th\u1ee5 \u0111\u1ed9ng\/ch\u1ee7 \u0111\u1ed9ng, m\u00e1y n\u00e9n ph\u1ed5i, tuy nhi\u00ean hi\u1ec7n nay ch\u01b0a c\u00f3 quy tr\u00ecnh c\u1ee5 th\u1ec3 tr\u00ean l\u00e2m s\u00e0ng.<\/span><\/p>\n

             <\/p>\n

            \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110\u1eb7t l\u01b0\u1edbi l\u1ecdc t\u0129nh mach ch\u1ee7 d\u01b0\u1edbi (IVC) l\u00e0 m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p ng\u00e0y c\u00e0ng ph\u1ed5 bi\u1ebfn \u0111\u1ed1i v\u1edbi c\u00e1c b\u1ec7nh nh\u00e2n li\u1ec7t t\u1ee7y cao (t\u1ee7y c\u1ed5), ti\u1ec1n s\u1eed t\u1eebng m\u1eafc huy\u1ebft kh\u1ed1i, hay hi\u1ec7n kh\u00f4ng \u0111\u00e1p \u1ee9ng\/ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh d\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c n\u1ed9i khoa. \u0110\u1eb7t l\u01b0\u1edbi l\u1ecdc t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi gi\u00fap ng\u0103n ch\u1eb7n c\u1ee5c m\u00e1u \u0111\u00f4ng t\u1eeb h\u1ec7 t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi \u0111i v\u1ec1 tu\u1ea7n ho\u00e0n ph\u1ed5i v\u00e0 bu\u1ed3ng tim. Hai ph\u01b0\u01a1ng ph\u00e1p \u0111\u1eb7t ch\u1ee7 y\u1ebfu l\u00e0 qua t\u0129nh m\u1ea1ch c\u1ea3nh trong ph\u1ea3i v\u00e0 t\u0129nh m\u1ea1ch \u0111\u00f9i chung, ch\u1ec9 d\u1eabn b\u1eb1ng ch\u1ee5p m\u1ea1ch s\u1ed1 h\u00f3a x\u00f3a n\u1ec1n.<\/span><\/p>\n

             <\/p>\n

              \n
            1. \u0110I\u1ec0U TR\u1eca<\/strong><\/span><\/li>\n<\/ol>\n

               <\/p>\n

                \n
              • Ch\u1ed1ng \u0111\u00f4ng m\u00e1u: m\u1ed9t s\u1ed1 thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u th\u01b0\u1eddng s\u1eed d\u1ee5ng g\u1ed3m:<\/span><\/li>\n
              • Heparin kh\u1ed1i l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p (LMWH)<\/span><\/li>\n
              • Heparin kh\u00f4ng ph\u00e2n \u0111o\u1ea1n (\u00d9H)<\/span><\/li>\n
              • Fondaparinux<\/span><\/li>\n
              • Warfarin<\/span><\/li>\n
              • Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u kh\u00f4ng ch\u1ee9a warfarin: ch\u1ea5t \u1ee9c ch\u1ebf y\u1ebfu t\u1ed1 Xa (v\u00ed d\u1ee5 rivaroxaban, apixaban), ch\u1ea5t \u1ee9c ch\u1ebf thrombin tr\u1ef1c ti\u1ebfp (dabigatran)<\/span><\/li>\n<\/ul>\n

                 <\/p>\n

                  \n
                • Ph\u00f2ng ng\u1eeba thuy\u00ean t\u1eafc ph\u1ed5i, d\u1ef1 ph\u00f2ng bi\u1ebfn ch\u1ee9ng<\/span><\/li>\n
                • H\u1ed7 tr\u1ee3 v\u00e0 n\u00e2ng cao th\u1ec3 tr\u1ea1ng: gi\u1ea3m \u0111au, ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng & t\u1eadp luy\u1ec7n, ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng, ki\u1ec3m so\u00e1t b\u1ec7nh n\u1ec1n<\/span><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"

                  \u0110\u1ea0I C\u01af\u01a0NG \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u1eafc t\u0129nh m\u1ea1ch huy\u1ebft kh\u1ed1i (VTE), bao g\u1ed3m c\u1ea3 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u (DVT) v\u00e0 thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i (PE), l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y t\u1eed vong v\u00e0 di ch\u1ee9ng sau t\u1ed5n th\u01b0\u01a1ng t\u1ee7y s\u1ed1ng c\u1ea5p t\u00ednh v\u00e0 th\u01b0\u1eddng g\u00e2y kh\u00f3 ch\u1ecbu, ch\u1eadm ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng v\u1edbi ng\u01b0\u1eddi […]\n","protected":false},"author":2,"featured_media":1670,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[3],"tags":[],"_links":{"self":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1668"}],"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=1668"}],"version-history":[{"count":3,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1668\/revisions"}],"predecessor-version":[{"id":2187,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/posts\/1668\/revisions\/2187"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=\/wp\/v2\/media\/1670"}],"wp:attachment":[{"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1668"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1668"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lieuphapyhoctaitao.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1668"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}