{"id":13216,"date":"2016-05-10T13:19:18","date_gmt":"2016-05-10T06:19:18","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/phu-luc-4-dung-thuoc-cho-nguoi-suy\/"},"modified":"2024-03-17T04:20:51","modified_gmt":"2024-03-16T21:20:51","slug":"phu-luc-4-dung-thuoc-cho-nguoi-suy","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/phu-luc-4-dung-thuoc-cho-nguoi-suy\/","title":{"rendered":"Ph\u1ee5 l\u1ee5c 4: D\u00f9ng thu\u1ed1c cho ng\u01b0\u1eddi suy th\u1eadn"},"content":{"rendered":"<p>Suy gi\u1ea3m ch\u1ee9c n\u0103ng th\u1eadn c\u00f3 th\u1ec3 g\u00e2y nhi\u1ec1u r\u1eafc r\u1ed1i cho vi\u1ec7c d\u00f9ng thu\u1ed1c v\u00ec nh\u1eefng l\u00fd do sau \u0111\u00e2y:<\/p>\n<ol>\n<li>\u0110\u00e0o th\u1ea3i thu\u1ed1c (ho\u1eb7c ch\u1ea5t chuy\u1ec3n ho\u00e1 c\u1ee7a n\u00f3) b\u1ecb c\u1ea3n tr\u1edf, n\u00ean thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y \u0111\u1ed9c;<\/li>\n<li>\u0110\u1ed9 nh\u1ea1y c\u1ea3m v\u1edbi m\u1ed9t s\u1ed1 thu\u1ed1c c\u00f3 th\u1ec3 t\u0103ng l\u00ean, ngay c\u1ea3 khi s\u1ef1 \u0111\u00e0o th\u1ea3i \u1edf th\u1eadn ch\u01b0a b\u1ecb suy y\u1ebfu;<\/li>\n<li>Ng\u01b0\u1eddi b\u1ec7nh suy th\u1eadn kh\u00f3 dung n\u1ea1p v\u1edbi nhi\u1ec1u t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c;<\/li>\n<li>M\u1ed9t s\u1ed1 thu\u1ed1c m\u1ea5t hi\u1ec7u l\u1ef1c khi ch\u1ee9c n\u0103ng th\u1eadn suy gi\u1ea3m.<\/li>\n<\/ol>\n<p>\u1ede ng\u01b0\u1eddi suy th\u1eadn, li\u1ec1u l\u01b0\u1ee3ng c\u1ee7a nhi\u1ec1u thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 tr\u00e1nh t\u00e1c d\u1ee5ng c\u00f3 h\u1ea1i m\u00e0 v\u1eabn b\u1ea3o \u0111\u1ea3m \u0111\u01b0\u1ee3c hi\u1ec7u l\u1ef1c. Khi ch\u1ee9c n\u0103ng th\u1eadn gi\u1ea3m s\u00fat t\u1edbi m\u1ee9c \u0111\u1ed9 n\u00e0o \u0111\u00f3, th\u00ec c\u1ea7n ph\u1ea3i gi\u1ea3m li\u1ec1u c\u1ee7a m\u1ed9t s\u1ed1 thu\u1ed1c; \u0111i\u1ec1u n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o thu\u1ed1c \u0111\u00f3 c\u00f3 \u0111\u1ed9c t\u00ednh nh\u01b0 th\u1ebf n\u00e0o v\u00e0 c\u00f3 b\u1ecb th\u1ea3i ho\u00e0n to\u00e0n qua th\u1eadn hay kh\u00f4ng, ho\u1eb7c c\u00f3 b\u1ecb chuy\u1ec3n h\u00f3a m\u1ed9t ph\u1ea7n \u0111\u1ec3 m\u1ea5t ho\u1ea1t t\u00ednh hay kh\u00f4ng.<\/p>\n<p>Nh\u00ecn chung, v\u1edbi ng\u01b0\u1eddi suy th\u1eadn, li\u1ec1u n\u1ea1p gi\u1ed1ng nh\u01b0 li\u1ec1u v\u1eabn th\u01b0\u1eddng d\u00f9ng cho ng\u01b0\u1eddi c\u00f3 ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng, c\u00f2n nh\u1eefng li\u1ec1u duy tr\u00ec s\u1ebd \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh theo tr\u1ea1ng th\u00e1i l\u00e2m s\u00e0ng. Li\u1ec1u duy tr\u00ec c\u1ee7a m\u1ed9t thu\u1ed1c khi \u0111\u00f3 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3m b\u1eb1ng hai c\u00e1ch:<\/p>\n<ul>\n<li>Ho\u1eb7c gi\u1ea3m t\u1eebng li\u1ec1u ri\u00eang l\u1ebb m\u00e0 v\u1eabn gi\u1eef nguy\u00ean kho\u1ea3ng c\u00e1ch th\u1eddi gian b\u00ecnh th\u01b0\u1eddng gi\u1eefa c\u00e1c li\u1ec1u k\u1ebf ti\u1ebfp<\/li>\n<li>Ho\u1eb7c n\u1edbi r\u1ed9ng kho\u1ea3ng c\u00e1ch th\u1eddi gian b\u00ecnh th\u01b0\u1eddng gi\u1eefa c\u00e1c l\u1ea7n d\u00f9ng k\u1ebf ti\u1ebfp, nh\u01b0ng kh\u00f4ng thay \u0111\u1ed5i li\u1ec1u.<\/li>\n<\/ul>\n<p>Ph\u01b0\u01a1ng ph\u00e1p k\u00e9o d\u00e0i kho\u1ea3ng c\u00e1ch th\u1eddi gian c\u00f3 th\u1ec3 c\u00f3 \u00edch l\u00e0 thu\u1eadn ti\u1ec7n v\u00e0 gi\u1ea3m chi ph\u00ed, c\u00f2n ph\u01b0\u01a1ng ph\u00e1p gi\u1ea3m li\u1ec1u th\u00ec gi\u00fap duy tr\u00ec n\u1ed3ng \u0111\u1ed9 thu\u1ed1c trong huy\u1ebft t\u01b0\u01a1ng h\u1eb1ng \u0111\u1ecbnh h\u01a1n.<\/p>\n<p>Nh\u1eefng thu\u1ed1c trong b\u1ea3ng d\u01b0\u1edbi \u0111\u00e2y \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea theo th\u1ee9 t\u1ef1 a,b,c. B\u1ea3ng n\u00e0y ch\u1ec9 g\u1ed3m nh\u1eefng thu\u1ed1c s\u1eb5n c\u00f3 th\u00f4ng tin \u0111\u1eb7c tr\u01b0ng. Nhi\u1ec1u thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng th\u1eadn tr\u1ecdng khi suy th\u1eadn, nh\u01b0ng l\u1ea1i ch\u01b0a c\u00f3 khuy\u1ebfn ngh\u1ecb c\u1ee5 th\u1ec3 v\u1ec1 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u l\u01b0\u1ee3ng. V\u00ec v\u1eady, c\u1ea7n ph\u1ea3i tham kh\u1ea3o c\u1ea9n th\u1eadn th\u00eam \u1edf chuy\u00ean lu\u1eadn c\u1ee7a t\u1eebng thu\u1ed1c c\u1ee5 th\u1ec3. C\u00e1c khuy\u1ebfn ngh\u1ecb \u0111\u01b0\u1ee3c cung c\u1ea5p theo nh\u1eefng m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau v\u1ec1 ch\u1ee9c n\u0103ng th\u1eadn, \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 b\u1eb1ng \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn, c\u1ee5 th\u1ec3 th\u01b0\u1eddng \u0111o b\u1eb1ng \u0111\u1ed9 thanh th\u1ea3i creatinin. Trong th\u1ef1c t\u1ebf th\u01b0\u1eddng s\u1eed d\u1ee5ng th\u00f4ng s\u1ed1 n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng th\u1eadn nh\u01b0ng \u0111\u00f3 m\u1edbi ch\u1ec9 l\u00e0 ch\u1ec9 d\u1eabn s\u01a1 l\u01b0\u1ee3c, sau \u0111\u00f3 c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ec9nh l\u00fd l\u1ea1i theo tu\u1ed5i, gi\u1edbi t\u00ednh v\u00e0 th\u1ec3 tr\u1ecdng b\u1eb1ng nh\u1eefng to\u00e1n \u0111\u1ed3 \u0111\u1eb7c bi\u1ec7t. Suy th\u1eadn th\u01b0\u1eddng \u0111\u01b0\u1ee3c chia th\u00e0nh ba m\u1ee9c \u0111\u1ed9:<\/p>\n<ul>\n<li>Nh\u1eb9: N\u1ebfu \u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn l\u00e0 20 &#8211; 50 ml\/ph\u00fat, ho\u1eb7c n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh x\u1ea5p x\u1ec9 150 &#8211; 300 micromol\/l\u00edt.<\/li>\n<li>V\u1eeba: \u0110\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn 10 &#8211; 20 ml\/ph\u00fat ho\u1eb7c n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh 300 &#8211; 700 micromol\/l\u00edt.<\/li>\n<li>N\u1eb7ng: \u0110\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn &lt; 10 ml\/ph\u00fat, ho\u1eb7c n\u1ed3ng \u0111\u1ed9 creatinin huy\u1ebft thanh &gt; 700 micromol\/l\u00edt.<\/li>\n<\/ul>\n<p>Trong th\u1ef1c h\u00e0nh, khi tu\u00e2n th\u1ee7 c\u00e1c h\u01b0\u1edbng d\u1eabn v\u1ec1 li\u1ec1u l\u01b0\u1ee3ng, c\u1ea7n ch\u00fa \u00fd t\u1edbi nh\u1eefng \u0111i\u1ec1u sau \u0111\u00e2y:<\/p>\n<ul>\n<li>K\u00ea \u0111\u01a1n thu\u1ed1c ph\u1ea3i gi\u1eef \u1edf m\u1ee9c t\u1ed1i thi\u1ec3u;<\/li>\n<li>N\u1ebfu c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c, n\u00ean tr\u00e1nh m\u1ecdi thu\u1ed1c c\u00f3 \u0111\u1ed9c t\u00ednh v\u1edbi th\u1eadn cho ng\u01b0\u1eddi c\u00f3 b\u1ec7nh th\u1eadn, v\u00ec v\u1edbi nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y, \u0111\u1ed9c t\u00ednh c\u1ee7a thu\u1ed1c v\u1edbi th\u1eadn c\u00f3 th\u1ec3 nghi\u00eam tr\u1ecdng h\u01a1n;<\/li>\n<li>N\u00ean ki\u1ec3m tra ch\u1ee9c n\u0103ng th\u1eadn c\u1ea3 tr\u01b0\u1edbc v\u00e0 \u0111\u1ecbnh k\u1ef3 trong th\u1eddi gian \u0111i\u1ec1u tr\u1ecb, \u0111\u1ec3 \u0111i\u1ec1u ch\u1ec9nh li\u1ec1u duy tr\u00ec n\u1ebfu th\u1ea5y c\u1ea7n.<\/li>\n<\/ul>\n<p>Ch\u1ee9c n\u0103ng th\u1eadn (\u0111\u1ed9 l\u1ecdc c\u1ea7u th\u1eadn, \u0111\u1ed9 thanh th\u1ea3i creatinin) gi\u1ea3m d\u1ea7n theo tu\u1ed5i, cho n\u00ean v\u1edbi ng\u01b0\u1eddi cao tu\u1ed5i (&gt; 80 tu\u1ed5i), ch\u1ee9c n\u0103ng th\u1eadn ch\u1ec9 b\u1eb1ng m\u1ed9t n\u1eeda so v\u1edbi \u1edf ng\u01b0\u1eddi tr\u1ebb kho\u1ebb m\u1ea1nh. V\u00ec v\u1eady, khi k\u00ea \u0111\u01a1n thu\u1ed1c cho ng\u01b0\u1eddi cao tu\u1ed5i, n\u00ean coi \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y \u00edt ra l\u00e0 \u0111\u00e3 b\u1ecb suy th\u1eadn nh\u1eb9.<\/p>\n<p>V\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u00f3 n\u1ed3ng \u0111\u1ed9 ur\u00ea huy\u1ebft cao, c\u1ea7n ph\u1ea3i theo d\u00f5i c\u1ea9n th\u1eadn v\u1ec1 \u0111\u1ed9c t\u00ednh b\u1ea5t ng\u1edd c\u1ee7a thu\u1ed1c. \u1edf nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng n\u00e0y, t\u00ednh ph\u1ee9c t\u1ea1p v\u1ec1 tr\u1ea1ng th\u00e1i l\u00e2m s\u00e0ng v\u00e0 c\u1ea3 v\u1ec1 nh\u1eefng bi\u1ebfn \u0111\u1ed5i kh\u00e1c, v\u00ed d\u1ee5: nh\u1eefng thay \u0111\u1ed5i v\u1ec1 d\u01b0\u1ee3c \u0111\u1ed9ng h\u1ecdc (h\u1ea5p thu, g\u1eafn k\u1ebft v\u00e0o protein huy\u1ebft t\u01b0\u01a1ng, ph\u00e2n b\u1ed1 thu\u1ed1c, chuy\u1ec3n ho\u00e1) v\u1ec1 ch\u1ee9c n\u0103ng gan, v\u1ec1 tr\u1ecb li\u1ec7u v\u1edbi nh\u1eefng thu\u1ed1c kh\u00e1c kh\u00f4ng nh\u01b0 b\u00ecnh th\u01b0\u1eddng, n\u00ean kh\u00f4ng cho ph\u00e9p s\u1eed d\u1ee5ng li\u1ec1u l\u01b0\u1ee3ng thu\u1ed1c c\u1ed1 \u0111\u1ecbnh, m\u00e0 c\u1ea7n c\u00f3 s\u1ef1 ti\u1ebfp c\u1eadn ri\u00eang bi\u1ec7t v\u1edbi nh\u1eefng ng\u01b0\u1eddi b\u1ec7nh c\u1ee5 th\u1ec3 v\u1edbi l\u00fd do ch\u01b0a c\u00f3 \u0111\u1ea7y \u0111\u1ee7 d\u1eef li\u1ec7u v\u1ec1 an to\u00e0n thu\u1ed1c, n\u00ean c\u00f3 nh\u1eefng thu\u1ed1c n\u00e0o ch\u01b0a \u0111\u01b0\u1ee3c n\u00eau \u1edf b\u1ea3ng n\u00e0y, th\u00ec kh\u00f4ng n\u00ean hi\u1ec3u l\u00e0 thu\u1ed1c \u0111\u00f3 \u0111\u00e3 an to\u00e0n. B\u1ea1n \u0111\u1ecdc r\u1ea5t c\u1ea7n tham kh\u1ea3o k\u1ef9 \u1edf ph\u1ea7n c\u1ee5 th\u1ec3 vi\u1ebft v\u1ec1 t\u1eebng thu\u1ed1c.<\/p>\n<p><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-1.gif\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-736\" title=\"4-1\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-1.gif\" alt=\"\" width=\"530\" height=\"880\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-2.gif\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-737\" title=\"4-2\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-2.gif\" alt=\"\" width=\"530\" height=\"887\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-3.gif\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-738\" title=\"4-3\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-3.gif\" alt=\"\" width=\"530\" height=\"883\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-4.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-739\" title=\"4-4\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-4.gif\" alt=\"\" width=\"530\" height=\"878\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-5.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-740\" title=\"4-5\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-5.gif\" alt=\"\" width=\"530\" height=\"894\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-6.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-741\" title=\"4-6\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-6.gif\" alt=\"\" width=\"530\" height=\"884\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-7.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-742\" title=\"4-7\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-7.gif\" alt=\"\" width=\"530\" height=\"887\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-8.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-743\" title=\"4-8\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-8.gif\" alt=\"\" width=\"530\" height=\"888\" \/><\/a><a href=\"http:\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-9.gif\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-744\" title=\"4-9\" src=\"\/\/nidqc.org.vn\/duocthu\/wp-content\/uploads\/2012\/10\/4-9.gif\" alt=\"\" width=\"530\" height=\"652\" \/><\/a><\/p>\n<p><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/p>\n<p><a href=\"http:\/\/www.nidqc.org.vn\/duocthu\/phu-luc-4-dung-thuoc-cho-nguoi-suy-than.html\" target=\"_blank\" rel=\"noopener\">http:\/\/www.nidqc.org.vn\/duocthu\/phu-luc-4-dung-thuoc-cho-nguoi-suy-than.html<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u1ede ng\u01b0\u1eddi suy th\u1eadn, li\u1ec1u l\u01b0\u1ee3ng c\u1ee7a nhi\u1ec1u thu\u1ed1c c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ec3 tr\u00e1nh t\u00e1c d\u1ee5ng c\u00f3 h\u1ea1i m\u00e0 v\u1eabn b\u1ea3o \u0111\u1ea3m \u0111\u01b0\u1ee3c hi\u1ec7u l\u1ef1c. Khi ch\u1ee9c n\u0103ng th\u1eadn gi\u1ea3m s\u00fat t\u1edbi m\u1ee9c \u0111\u1ed9 n\u00e0o \u0111\u00f3, th\u00ec c\u1ea7n ph\u1ea3i gi\u1ea3m li\u1ec1u c\u1ee7a m\u1ed9t s\u1ed1 thu\u1ed1c; \u0111i\u1ec1u n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o thu\u1ed1c \u0111\u00f3 c\u00f3 \u0111\u1ed9c t\u00ednh nh\u01b0 th\u1ebf n\u00e0o v\u00e0 c\u00f3 b\u1ecb th\u1ea3i ho\u00e0n to\u00e0n qua th\u1eadn hay kh\u00f4ng, ho\u1eb7c c\u00f3 b\u1ecb chuy\u1ec3n h\u00f3a m\u1ed9t ph\u1ea7n \u0111\u1ec3 m\u1ea5t ho\u1ea1t t\u00ednh hay kh\u00f4ng.<\/p>\n","protected":false},"author":143,"featured_media":13217,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5316,5317],"tags":[],"series":[],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Ph\u1ee5 l\u1ee5c 4: D\u00f9ng thu\u1ed1c cho ng\u01b0\u1eddi suy th\u1eadn - 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