{"id":6152,"date":"2018-07-27T03:19:24","date_gmt":"2018-07-26T20:19:24","guid":{"rendered":"https:\/\/yhoccongdong.org\/du-an-khac\/2018\/07\/27\/thuyen-tac-phoi\/"},"modified":"2024-03-17T04:23:10","modified_gmt":"2024-03-16T21:23:10","slug":"thuyen-tac-phoi","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/du-an-khac\/thuyen-tac-phoi\/","title":{"rendered":"Thuy\u00ean t\u1eafc ph\u1ed5i"},"content":{"rendered":"<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng <strong>nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng<\/strong>, x\u1ea3y ra do s\u1ef1 <strong>t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u trong ph\u1ed5i<\/strong>. Thuy\u00ean t\u1eafc ph\u1ed5i g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au ng\u1ef1c, kh\u00f3 th\u1edf nh\u01b0ng c\u0169ng c\u00f3 th\u1ec3 kh\u00f4ng h\u1ec1 c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00e0o v\u00e0 r\u1ea5t kh\u00f3 \u0111\u1ec3 ph\u00e1t hi\u1ec7n. M\u1ed9t thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn c\u00f3 th\u1ec3 l\u00e0m b\u1ec7nh nh\u00e2n cho\u00e1ng v\u00e0 t\u1eed vong.<\/p>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i th\u01b0\u1eddng x\u1ea3y ra do m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng (huy\u1ebft kh\u1ed1i) ti\u1ec1m \u1ea9n n\u1eb1m \u1edf ch\u00e2n trong b\u1ec7nh l\u00fd <a href=\"https:\/\/yhoccongdong.com\/thongtin\/huyet-khoi-tinh-mach-sau\/\" target=\"_blank\" rel=\"noopener\">huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u<\/a>. \u0110i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 c\u00f3 th\u1ec3 c\u1ee9u s\u1ed1ng b\u1ec7nh nh\u00e2n. Thai k\u1ef3, m\u1ed9t s\u1ed1 thu\u1ed1c v\u00e0 b\u1ec7nh l\u00fd, t\u00ecnh tr\u1ea1ng b\u1ea5t \u0111\u1ed9ng hay ph\u1eabu thu\u1eadt l\u1edbn \u0111\u1ec1u l\u00e0m t\u0103ng nguy c\u01a1 thuy\u00ean t\u1eafc ph\u1ed5i. C\u00e1c <a href=\"https:\/\/yhoccongdong.com\/du-an-khac\/chude\/cac-thuoc-chong-dong\/\" target=\"_blank\" rel=\"noopener\">thu\u1ed1c kh\u00e1ng \u0111\u00f4ng<\/a>, \u0111\u1ea7u ti\u00ean l\u00e0 heparin v\u00e0 sau \u0111\u00f3 warfarin, l\u00e0 nh\u1eefng thu\u1ed1c th\u01b0\u1eddng d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i.<\/p>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"alignnone size-full wp-image-11627 aligncenter\" src=\"\/\/yhoccongdong.com\/wp-content\/uploads\/2016\/10\/huyet-khoi-tinh-mach-sau.png\" alt=\"huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u\" width=\"600\" height=\"357\" \/><\/p>\n<h2>Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch<\/h2>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t th\u00e0nh ph\u1ea7n (th\u1ec3 l\u00e2m s\u00e0ng) trong m\u1ed9t nh\u00f3m c\u00e1c b\u1ec7nh li\u00ean quan \u0111\u1ebfn thuy\u00ean t\u1eafc do huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch.<\/p>\n<p><strong>T\u0129nh m\u1ea1ch<\/strong> l\u00e0 h\u1ec7 th\u1ed1ng c\u00e1c m\u1ea1ch m\u00e1u d\u1eabn m\u00e1u tr\u1edf v\u1ec1 tim sau khi \u0111i nu\u00f4i c\u01a1 th\u1ec3. <strong>Huy\u1ebft kh\u1ed1i<\/strong> l\u00e0 c\u1ee5c m\u00e1u \u0111\u00f4ng. S\u1ef1 <strong>thuy\u00ean t\u1eafc<\/strong> x\u1ea3y ra khi m\u1ed9t c\u1ee5c huy\u1ebft kh\u1ed1i t\u00e1ch ra kh\u1ecfi n\u01a1i m\u00e0 n\u00f3 \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh v\u00e0 tr\u00f4i theo d\u00f2ng m\u00e1u cho \u0111\u1ebfn khi n\u00f3 b\u1ecb m\u1eafc k\u1eb9t l\u1ea1i trong m\u1ed9t m\u1ea1ch m\u00e1u h\u1eb9p h\u01a1n \u1edf m\u1ed9t n\u01a1i kh\u00e1c trong c\u01a1 th\u1ec3. Do \u0111\u00f3, <strong>thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch<\/strong> l\u00e0 m\u1ed9t thu\u1eadt ng\u1eef ch\u1ec9 c\u1ee5c m\u00e1u \u0111\u00f4ng h\u00ecnh th\u00e0nh trong t\u0129nh m\u1ea1ch g\u00e2y t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u \u1edf m\u1ed9t n\u01a1i n\u00e0o \u0111\u00f3 trong c\u01a1 th\u1ec3.<\/p>\n<p>Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i, l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng m\u00e0 trong \u0111\u00f3 c\u1ee5c m\u00e1u \u0111\u00f4ng h\u00ecnh th\u00e0nh trong t\u0129nh m\u1ea1ch s\u00e2u \u1edf ch\u00e2n, v\u00e0 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u c\u0169ng l\u00e0 m\u1ed9t th\u00e0nh ph\u1ea7n trong nh\u00f3m thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch.<\/p>\n<h2>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 g\u00ec?<\/h2>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 s\u1ef1 t\u1eafc ngh\u1ebdn t\u1ea1i m\u1ea1ch m\u00e1u (\u0111\u1ed9ng m\u1ea1ch) c\u1ee7a ph\u1ed5i &#8211; th\u01b0\u1eddng do c\u1ee5c m\u00e1u \u0111\u00f4ng. Thuy\u00ean t\u1eafc ph\u1ed5i c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf \u0111\u1ed9ng m\u1ea1ch \u1edf trung t\u00e2m c\u1ee7a ph\u1ed5i ho\u1eb7c g\u1ea7n r\u00eca ph\u1ed5i. C\u1ee5c m\u00e1u \u0111\u00f4ng c\u00f3 th\u1ec3 l\u1edbn ho\u1eb7c nh\u1ecf v\u00e0 c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u h\u01a1n m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng. Trong tr\u01b0\u1eddng h\u1ee3p x\u1ea3y ra nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u1eb7ng, do c\u1ee5c m\u00e1u \u0111\u00f4ng l\u1edbn t\u1eafc \u1edf v\u1ecb tr\u00ed g\u1ea7n trung t\u00e2m c\u1ee7a ph\u1ed5i, g\u1ecdi l\u00e0 thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn. \u0110\u00e2y l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng r\u1ea5t n\u1eb7ng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/p>\n<h2>Nguy\u00ean nh\u00e2n g\u00e2y ra thuy\u00ean t\u1eafc ph\u1ed5i?<\/h2>\n<h3>Nguy\u00ean nh\u00e2n th\u01b0\u1eddng g\u1eb7p l\u00e0 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u<\/h3>\n<p>H\u00ecnh d\u01b0\u1edbi \u0111\u00e2y minh h\u1ecda r\u00f5 th\u00eam v\u1ec1 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u<\/p>\n<p><img decoding=\"async\" class=\"wp-image-11631 aligncenter\" src=\"\/\/yhoccongdong.com\/wp-content\/uploads\/2016\/10\/hktms.png\" alt=\"hktms\" width=\"621\" height=\"380\" \/><\/p>\n<p>Nguy\u00ean nh\u00e2n ch\u00ednh trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p l\u00e0 do m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng (huy\u1ebft kh\u1ed1i) \u0111\u00e3 h\u00ecnh th\u00e0nh trong m\u1ed9t t\u0129nh m\u1ea1ch s\u00e2u (g\u1ecdi l\u00e0 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u), c\u1ee5c m\u00e1u \u0111\u00f4ng n\u00e0y \u0111i theo v\u00f2ng tu\u1ea7n ho\u00e0n m\u00e1u v\u00e0 cu\u1ed1i c\u00f9ng b\u1ecb m\u1eafc k\u1eb9t l\u1ea1i trong m\u1ed9t trong nh\u1eefng m\u1ea1ch m\u00e1u \u1edf ph\u1ed5i. H\u1ea7u h\u1ebft huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u \u0111\u1ebfn t\u1eeb t\u0129nh m\u1ea1ch ch\u00e2n ho\u1eb7c t\u0129nh m\u1ea1ch ch\u1eadu. Th\u1ec9nh tho\u1ea3ng, thuy\u00ean t\u1eafc ph\u1ed5i c\u00f3 th\u1ec3 do c\u1ee5c m\u00e1u \u0111\u00f4ng trong m\u1ed9t t\u0129nh m\u1ea1ch c\u00e1nh tay, ho\u1eb7c t\u1eeb tim.<\/p>\n<pre><em><strong>Xem th\u00eam b\u00e0i vi\u1ebft <a href=\"https:\/\/yhoccongdong.com\/thongtin\/huyet-khoi-tinh-mach-sau\/\" target=\"_blank\" rel=\"noopener\">Huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u<\/a> c\u1ee7a\u00a0<a href=\"https:\/\/yhoccongdong.com\/profile\/nguyen-thi-thu-trang\/\" target=\"_blank\" rel=\"noopener\">TS. Nguy\u1ec5n Th\u1ecb Thu Trang<\/a><\/strong><\/em><\/pre>\n<h3>C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c<\/h3>\n<p>Trong m\u1ed9t s\u1ed1 hi\u1ebfm tr\u01b0\u1eddng h\u1ee3p, t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u ph\u1ed5i kh\u00f4ng ph\u1ea3i do c\u1ee5c m\u00e1u \u0111\u00f4ng m\u00e0 l\u00e0 do t\u00e1c nh\u00e2n kh\u00e1c nh\u01b0:<\/p>\n<ul>\n<li>Gi\u1ecdt m\u1ee1 t\u1eeb t\u1ee7y c\u1ee7a x\u01b0\u01a1ng b\u1ecb g\u00e3y (n\u1ebfu x\u01b0\u01a1ng g\u00e3y l\u00e0 m\u1ed9t x\u01b0\u01a1ng l\u1edbn v\u00e0 d\u00e0i nh\u01b0 x\u01b0\u01a1ng \u0111\u00f9i)<\/li>\n<li>D\u1ecb v\u1eadt t\u1eeb b\u01a1m ti\u00eam kh\u00f4ng s\u1ea1ch nh\u01b0 b\u01a1m ti\u00eam ch\u00edch ma t\u00fay<\/li>\n<li>N\u01b0\u1edbc \u1ed1i trong thai k\u1ef3 ho\u1eb7c trong l\u00fac sinh &#8211; t\u1eafc m\u1ea1ch \u1ed1i (hi\u1ebfm g\u1eb7p)<\/li>\n<li>B\u00f3ng kh\u00ed l\u1edbn trong t\u0129nh m\u1ea1ch (hi\u1ebfm g\u1eb7p)<\/li>\n<li>M\u1ed9t m\u1ea3nh nh\u1ecf kh\u1ed1i u b\u1ecb v\u1ee1 ra t\u1eeb m\u1ed9t kh\u1ed1i u l\u1edbn trong c\u01a1 th\u1ec3 nh\u01b0 trong ung th\u01b0<\/li>\n<\/ul>\n<h2>Ai c\u00f3 th\u1ec3 m\u1eafc thuy\u00ean t\u1eafc ph\u1ed5i?<\/h2>\n<p>\u0110a s\u1ed1 c\u00e1c tr\u01b0\u1eddng h\u1ee3p thuy\u00ean t\u1eafc ph\u1ed5i g\u00e2y ra b\u1edfi huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u. V\u00ec v\u1eady, ng\u01b0\u1eddi c\u00f3 nhi\u1ec1u nguy c\u01a1 m\u1eafc thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 ch\u00ednh l\u00e0 nh\u1eefng ng\u01b0\u1eddi d\u1ec5 b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u. C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u s\u1ebd \u0111\u01b0\u1ee3c gi\u1ea3i th\u00edch trong m\u1ed9t trang kh\u00e1c. M\u1ed9t s\u1ed1 y\u1ebfu t\u1ed1 nguy c\u01a1 quan tr\u1ecdng l\u00e0 b\u1ea5t \u0111\u1ed9ng l\u00e2u, m\u1eafc b\u1ec7nh l\u00fd nghi\u00eam tr\u1ecdng, v\u00e0 ph\u1eabu thu\u1eadt l\u1edbn (\u0111\u1eb7c bi\u1ec7t l\u00e0 ph\u1eabu thu\u1eadt ph\u1ee5 khoa hay ph\u1eabu thu\u1eadt v\u00f9ng x\u01b0\u01a1ng ch\u1eadu v\u00e0 ch\u00e2n). Nguy c\u01a1 ph\u00e1t tri\u1ec3n huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u hay thuy\u00ean t\u1eafc ph\u1ed5i trong b\u1ec7nh vi\u1ec7n c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c gi\u1ea3m \u0111\u00e1ng k\u1ec3 nh\u1edd v\u1eadn \u0111\u1ed9ng s\u1edbm v\u00e0 s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c ng\u0103n h\u00ecnh th\u00e0nh huy\u1ebft kh\u1ed1i \u1edf nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 \u0111\u1eb7c bi\u1ec7t.<\/p>\n<h2>Thuy\u00ean t\u1eafc ph\u1ed5i ph\u1ed5 bi\u1ebfn nh\u01b0 th\u1ebf n\u00e0o<\/h2>\n<p>\u01af\u1edbc t\u00ednh c\u00f3 kho\u1ea3ng 1 tr\u00ean 1.000 ng\u01b0\u1eddi b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u m\u1ed7i n\u0103m \u1edf Anh. N\u1ebfu kh\u00f4ng \u0111i\u1ec1u tr\u1ecb th\u00ec trong 10 ng\u01b0\u1eddi b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u s\u1ebd c\u00f3 kho\u1ea3ng 1 ng\u01b0\u1eddi b\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i. M\u1ed9t n\u1eeda s\u1ed1 ca thuy\u00ean t\u1eafc ph\u1ed5i x\u1ea3y ra khi b\u1ec7nh nh\u00e2n \u0111ang n\u1eb1m vi\u1ec7n. 25.000 ca t\u1eed vong m\u1ed7i n\u0103m \u1edf Anh l\u00e0 do c\u1ee5c m\u00e1u \u0111\u00f4ng ph\u00e1t tri\u1ec3n trong l\u00fac b\u1ec7nh nh\u00e2n \u0111ang \u1edf trong b\u1ec7nh vi\u1ec7n.<\/p>\n<p>T\u1ea1i Vi\u1ec7t Nam, tuy ch\u01b0a c\u00f3 s\u1ed1 li\u1ec7u ch\u00ednh x\u00e1c, nh\u01b0ng nghi\u00ean c\u1ee9u INCIMEDI\u00a0\u0111\u00e3 ch\u1ee9ng minh t\u1ef7 l\u1ec7 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u kh\u00f4ng hi\u1ebfm g\u1eb7p \u1edf n\u01b0\u1edbc ta. K\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u cho th\u1ea5y c\u00f3 \u0111\u1ebfn 22% b\u1ec7nh nh\u00e2n n\u1ed9i khoa nh\u1eadp vi\u1ec7n c\u00f3 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u kh\u00f4ng tri\u1ec7u ch\u1ee9ng d\u1ef1a tr\u00ean si\u00eau \u00e2m m\u1ea1ch m\u00e1u chi d\u01b0\u1edbi.<\/p>\n<h2>C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 g\u00ec?<\/h2>\n<p>Tri\u1ec7u ch\u1ee9ng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i ph\u1ee5 thu\u1ed9c v\u00e0o v\u00f9ng \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u1ee5c m\u00e1u \u0111\u00f4ng l\u1edbn hay nh\u1ecf v\u00e0 t\u00ecnh tr\u1ea1ng ph\u1ed5i c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u1ed1i ph\u00f3 v\u1edbi n\u00f3 \u0111\u1ebfn m\u1ee9c n\u00e0o. Nh\u1eefng ng\u01b0\u1eddi \u0111ang y\u1ebfu ho\u1eb7c c\u00f3 b\u1ec7nh t\u1eeb tr\u01b0\u1edbc th\u00ec tri\u1ec7u ch\u1ee9ng s\u1ebd n\u1eb7ng h\u01a1n nh\u1eefng ng\u01b0\u1eddi kh\u1ecfe m\u1ea1nh. Tri\u1ec7u ch\u1ee9ng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i th\u01b0\u1eddng x\u1ea3y ra \u0111\u1ed9t ng\u1ed9t.<\/p>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i nh\u1ecf c\u00f3 th\u1ec3 g\u00e2y ra:<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng g\u00ec c\u1ea3 (th\u01b0\u1eddng g\u1eb7p).<\/li>\n<li>Kh\u00f3 th\u1edf v\u1edbi m\u1ee9c \u0111\u1ed9 thay \u0111\u1ed5i t\u1eeb nh\u1eb9 \u0111\u1ebfn r\u1ea5t n\u1eb7ng (suy h\u00f4 h\u1ea5p)<\/li>\n<li>\u0110au ng\u1ef1c ki\u1ec3u m\u00e0ng ph\u1ed5i, l\u00e0 c\u1ea3m gi\u00e1c \u0111au nh\u00f3i khi h\u00edt v\u00e0o. B\u1ea1n c\u1ea3m th\u1ea5y d\u01b0\u1eddng nh\u01b0 kh\u00f4ng th\u1ec3 h\u00edt th\u1edf s\u00e2u, v\u00ec c\u01a1n \u0111au l\u00e0m cho b\u1ea1n ph\u1ea3i n\u00edn th\u1edf l\u1ea1i. L\u00fd do l\u00e0 c\u1ee5c m\u00e1u \u0111\u00f4ng k\u00edch th\u00edch l\u1edbp m\u00e0ng ph\u1ed5i bao xung quanh ph\u1ed5i. Th\u1edf n\u00f4ng s\u1ebd tho\u1ea3i m\u00e1i h\u01a1n l\u00e0 th\u1edf s\u00e2u.<\/li>\n<li>Ho ra m\u00e1u.<\/li>\n<li>Nhi\u1ec7t \u0111\u1ed9 t\u0103ng nh\u1eb9 (s\u1ed1t nh\u1eb9).<\/li>\n<li>Tim \u0111\u1eadp nhanh.<\/li>\n<\/ul>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn ho\u1eb7c nhi\u1ec1u c\u1ee5c m\u00e1u \u0111\u00f4ng (g\u00e2y thuy\u00ean t\u1eafc nhi\u1ec1u m\u1ea1ch m\u00e1u) c\u00f3 th\u1ec3 g\u00e2y ra:<\/p>\n<ul>\n<li>Kh\u00f3 th\u1edf n\u1eb7ng (suy h\u00f4 h\u1ea5p).<\/li>\n<li>\u0110au ng\u1ef1c: thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn c\u00f3 th\u1ec3 g\u00e2y \u0111au gi\u1eefa ng\u1ef1c sau x\u01b0\u01a1ng \u1ee9c.<\/li>\n<li>C\u1ea3m th\u1ea5y y\u1ebfu \u1edbt, kh\u00f4ng kh\u1ecfe, ho\u1eb7c cho\u00e1ng. Do c\u1ee5c m\u00e1u \u0111\u00f4ng l\u1edbn c\u1ea3n tr\u1edf tu\u1ea7n ho\u00e0n v\u00e0 ho\u1ea1t \u0111\u1ed9ng b\u01a1m m\u00e1u c\u1ee7a tim l\u00e0m huy\u1ebft \u00e1p gi\u1ea3m \u0111\u00e1ng k\u1ec3.<\/li>\n<li>Hi\u1ebfm g\u1eb7p h\u01a1n, trong nh\u1eefng ca r\u1ea5t n\u1eb7ng, thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn c\u00f3 th\u1ec3 g\u00e2y ng\u1eebng tim (tim ng\u1eebng \u0111\u1eadp) c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u1eed vong, th\u1eadm ch\u00ed khi \u0111\u00e3 n\u1ed7 l\u1ef1c h\u1ebft s\u1ee9c \u0111\u1ec3 c\u1ee9u b\u1ec7nh nh\u00e2n.<\/li>\n<\/ul>\n<p>M\u1ed9t s\u1ed1 tri\u1ec7u ch\u1ee9ng c\u1ee7a huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u ch\u1eb3ng h\u1ea1n nh\u01b0 \u0111au \u0111\u1ed9t ng\u1ed9t \u1edf b\u1eafp ch\u00e2n, \u0111au c\u01a1 b\u1eafp ch\u00e2n, s\u01b0ng m\u1ed9t ch\u00e2n ho\u1eb7c b\u00e0n ch\u00e2n, b\u1eafp ch\u00e2n n\u00f3ng v\u00e0 \u0111\u1ecf, c\u00f3 th\u1ec3 c\u00f3 d\u1ea5u b\u1ea7m tr\u00ean da.<\/p>\n<p>M\u1ed9t thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 l\u1edbn kh\u00f4ng ph\u1ea3i do k\u00edch th\u01b0\u1edbc th\u1ef1c t\u1ebf c\u1ee7a c\u00e1c c\u1ee5c m\u00e1u \u0111\u00f4ng m\u00e0 do k\u00edch th\u01b0\u1edbc v\u00f9ng t\u1ed5n th\u01b0\u01a1ng m\u00e0 n\u00f3 g\u00e2y ra. G\u1ecdi l\u00e0 thuy\u00ean t\u1eafc ph\u1ed5i nguy c\u01a1 cao n\u1ebfu n\u00f3 g\u00e2y ra v\u1ea5n \u0111\u1ec1 nghi\u00eam tr\u1ecdng nh\u01b0 cho\u00e1ng hay t\u1ee5t huy\u1ebft \u00e1p. Thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn l\u00e0 m\u1ed9t thuy\u00ean t\u1eafc ph\u1ed5i nguy c\u01a1 cao. H\u1eadu qu\u1ea3 l\u00e0 trong 7 ng\u01b0\u1eddi b\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn s\u1ebd c\u00f3 1 ng\u01b0\u1eddi t\u1eed vong.<\/p>\n<h2>Ch\u1ea9n \u0111o\u00e1n thuy\u00ean t\u1eafc ph\u1ed5i nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n<p>Ch\u1ea9n \u0111o\u00e1n thuy\u00ean t\u1eafc ph\u1ed5i th\u01b0\u1eddng \u0111\u01b0\u1ee3c ngh\u0129 \u0111\u1ebfn d\u1ef1a tr\u00ean tri\u1ec7u ch\u1ee9ng v\u00e0 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd c\u1ee7a b\u1ea1n. V\u00ed d\u1ee5 nh\u01b0, m\u1ed9t ng\u01b0\u1eddi v\u1eeba tr\u1ea3i qua ph\u1eabu thu\u1eadt l\u1edbn, \u0111\u01b0\u1ee3c b\u1ea5t \u0111\u1ed9ng trong b\u1ec7nh vi\u1ec7n v\u00e0 sau \u0111\u00f3 \u0111\u1ed9t ng\u1ed9t b\u1ecb kh\u00f3 th\u1edf, ng\u01b0\u1eddi \u0111\u00f3 c\u00f3 th\u1ec3 b\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i.<\/p>\n<p>Nh\u1eefng x\u00e9t nghi\u1ec7m kh\u00e1c nhau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n.<\/p>\n<h3>Si\u00eau \u00e2m m\u1ea1ch m\u00e1u chi d\u01b0\u1edbi<\/h3>\n<p>Si\u00eau \u00e2m doppler t\u0129nh m\u1ea1ch chi d\u01b0\u1edbi \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 gi\u00fap b\u00e1c s\u0129 quan s\u00e1t d\u00f2ng ch\u1ea3y c\u1ee7a m\u00e1u trong t\u0129nh m\u1ea1ch ch\u00e2n v\u00e0 n\u01a1i b\u1ecb t\u1eafc ngh\u1ebdn. \u0110\u00e2y l\u00e0 m\u1ed9t x\u00e9t nghi\u1ec7m h\u1eefu \u00edch v\u00ec n\u00f3 \u0111\u01a1n gi\u1ea3n, kh\u00f4ng x\u00e2m l\u1ea5n v\u00e0 c\u00f3 th\u1ec3 cho th\u1ea5y \u0111\u01b0\u1ee3c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u. N\u1ebfu ph\u00e1t hi\u1ec7n huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u th\u00ec c\u00f3 th\u1ec3 nghi ng\u1edd thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c (nh\u01b0 kh\u00f3 th\u1edf ho\u1eb7c \u0111au ng\u1ef1c). \u0110i\u1ec1u tr\u1ecb (v\u1edbi thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u2013 xem ph\u00eda d\u01b0\u1edbi) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u ngay l\u1eadp t\u1ee9c cho c\u1ea3 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u v\u00e0 nghi ng\u1edd thuy\u00ean t\u1eafc ph\u1ed5i, n\u00f3i chung \u0111i\u1ec1u tr\u1ecb th\u00ec nh\u01b0 nhau cho c\u1ea3 hai. Nh\u1eefng x\u00e9t nghi\u1ec7m th\u00eam c\u00f3 th\u1ec3 kh\u00f4ng c\u1ea7n thi\u1ebft trong t\u00ecnh hu\u1ed1ng n\u00e0y.<\/p>\n<p>Tuy nhi\u00ean, n\u1ebfu si\u00eau \u00e2m cho k\u1ebft qu\u1ea3 \u00e2m t\u00ednh (kh\u00f4ng nh\u00ecn th\u1ea5y c\u1ee5c m\u00e1u \u0111\u00f4ng), th\u00ec kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u hay thuy\u00ean t\u1eafc ph\u1ed5i, b\u1edfi v\u00ec c\u00f3 th\u1ec3 kh\u00f4ng nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c c\u1ee5c m\u00e1u \u0111\u00f4ng tr\u00ean si\u00eau \u00e2m, tr\u01b0\u1eddng h\u1ee3p n\u00e0y c\u1ea7n l\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c.<\/p>\n<h3>X\u00e9t nghi\u1ec7m D-dimer trong m\u00e1u<\/h3>\n<p>X\u00e9t nghi\u1ec7m n\u00e0y gi\u00fap ph\u00e1t hi\u1ec7n s\u1ea3n ph\u1ea9m ph\u00e2n h\u1ee7y m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng. N\u1ebfu n\u1ed3ng \u0111\u1ed9 D-dimer trong m\u00e1u cao, nhi\u1ec1u kh\u1ea3 n\u0103ng c\u00f3 m\u1ed9t c\u1ee5c m\u00e1u \u0111\u00f4ng trong t\u0129nh m\u1ea1ch. Tuy nhi\u00ean kh\u00f4ng may l\u00e0 x\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 th\u1ec3 d\u01b0\u01a1ng t\u00ednh trong m\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng kh\u00e1c, ch\u1eb3ng h\u1ea1n nh\u01b0 b\u1ea1n m\u1edbi ph\u1eabu thu\u1eadt g\u1ea7n \u0111\u00e2y, ho\u1eb7c \u0111ang mang thai.<\/p>\n<p>M\u1ed9t x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh kh\u00f4ng c\u00f3 ngh\u0129a l\u00e0 b\u1ea1n b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u hay thuy\u00ean t\u1eafc ph\u1ed5i, tuy nghi\u00ean k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m n\u00e0y c\u00f3 th\u1ec3 g\u1ee3i \u00fd kh\u1ea3 n\u0103ng b\u1ea1n b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u hay thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u1ebfn m\u1ee9c n\u00e0o \u0111\u1ec3 gi\u00fap b\u00e1c s\u0129 quy\u1ebft \u0111\u1ecbnh l\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c n\u1ebfu c\u1ea7n. Khi k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m D-dimer \u00e2m t\u00ednh th\u00ec kh\u1ea3 n\u0103ng cao b\u1ea1n kh\u00f4ng b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u hay thuy\u00ean t\u1eafc ph\u1ed5i. Tuy v\u1eady, n\u1ebfu b\u1ea1n c\u00f3 nguy c\u01a1 cao c\u1ee7a thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch v\u00e0 b\u00e1c s\u0129 \u0111ang r\u1ea5t nghi ng\u1edd b\u1ea1n c\u00f3 c\u1ee5c m\u00e1u \u0111\u00f4ng th\u00ec m\u1eb7c d\u00f9 x\u00e9t nghi\u1ec7m D-dimer \u00e2m t\u00ednh, b\u1ea1n v\u1eabn s\u1ebd c\u1ea7n l\u00e0m x\u00e9t nghi\u1ec7m th\u00eam \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<h3>Si\u00eau \u00e2m tim<\/h3>\n<p>Si\u00eau \u00e2m tim r\u1ea5t h\u1eefu \u00edch cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb thuy\u00ean t\u1eafc l\u1edbn, v\u00ec si\u00eau \u00e2m c\u00f3 th\u1ec3 gi\u00fap nh\u00ecn th\u1ea5y c\u1ee5c m\u00e1u \u0111\u00f4ng l\u1edbn trong ph\u1ed5i v\u00e0 ho\u1eb7c gi\u00e1n ti\u1ebfp th\u1ea5y \u0111\u01b0\u1ee3c \u1ea3nh h\u01b0\u1edfng c\u1ee7a n\u00f3 tr\u00ean tim. Si\u00eau \u00e2m tim c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i gi\u01b0\u1eddng b\u1ec7nh. Tuy nhi\u00ean, n\u00f3 kh\u00f4ng gi\u00fap th\u1ea5y \u0111\u01b0\u1ee3c thuy\u00ean t\u1eafc ph\u1ed5i nh\u1ecf.<\/p>\n<h3>X\u1ea1 h\u00ecnh ph\u1ed5i v\u00e0 ch\u1ee5p CT scanner \u0111a \u0111\u1ea7u d\u00f2 c\u00f3 c\u1ea3n quang (CTPA)<\/h3>\n<p>X\u1ea1 h\u00ecnh c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 V\/Q scan, hay x\u1ea1 h\u00ecnh th\u00f4ng kh\u00ed\/t\u01b0\u1edbi m\u00e1u ph\u1ed5i l\u00e0 ph\u01b0\u01a1ng ph\u00e1p qu\u00e9t chuy\u00ean bi\u1ec7t gi\u00fap nh\u00ecn \u0111\u01b0\u1ee3c tu\u1ea7n ho\u00e0n ph\u1ed5i. Ch\u00fang h\u1eefu \u00edch v\u00ec c\u00f3 th\u1ec3 cho k\u1ebft qu\u1ea3 kh\u00e1 ch\u00ednh x\u00e1c l\u00e0 c\u00f3 hay kh\u00f4ng c\u00f3 thuy\u00ean t\u1eafc ph\u1ed5i. T\u1eebng \u0111\u01b0\u1ee3c coi l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc nay, nh\u01b0ng hi\u1ec7n nay \u00edt n\u01a1i c\u00f2n s\u1eed d\u1ee5ng x\u00e9t nghi\u1ec7m n\u00e0y.<\/p>\n<p>CTPA m\u1ed9t lo\u1ea1i CTscan \u0111a \u0111\u1ea7u d\u00f2, ch\u1ee5p \u0111\u01b0\u1ee3c m\u1ea1ch m\u00e1u ph\u1ed5i nh\u1edd thu\u1ed1c c\u1ea3n quang gi\u00fap nh\u00ecn th\u1ea5y c\u00e1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i r\u00f5 h\u01a1n. CTPA hi\u1ec7n nay \u0111\u01b0\u1ee3c xem l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng kh\u00f4ng x\u00e2m l\u1ea5n \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n thuy\u00ean t\u1eafc ph\u1ed5i. C\u1ea3 hai \u0111\u1ec1u li\u00ean quan \u0111\u1ebfn tia X, CTPA l\u00e0 x\u00e9t nghi\u1ec7m c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c cao, c\u00f2n x\u1ea1 h\u00ecnh th\u00f4ng kh\u00ed t\u01b0\u1edbi m\u00e1u th\u00ec \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1eb7c bi\u1ec7t, nh\u01b0 d\u1ecb \u1ee9ng v\u1edbi thu\u1ed1c c\u1ea3n quang (thu\u1ed1c \u0111\u01b0\u1ee3c b\u01a1m v\u00e0o m\u1ea1ch m\u00e1u \u0111\u1ec3 l\u00e0m t\u0103ng \u0111\u1ed9 t\u01b0\u01a1ng ph\u1ea3n gi\u00fap th\u1ea5y r\u00f5 h\u00ecnh \u1ea3nh m\u1ea1ch m\u00e1u h\u01a1n) v\u1ed1n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong CTPA scan, b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh, ho\u1eb7c n\u1ebfu CTPA scan kh\u00f4ng c\u00f3 s\u1eb5n. Tuy nhi\u00ean ch\u1ee5p x\u1ea1 h\u00ecnh ph\u1ed5i hi\u1ec7n n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng MRI n\u1ebfu kh\u00f4ng ch\u1ee5p \u0111\u01b0\u1ee3c b\u1eb1ng CTscan c\u00f3 c\u1ea3n quang.<\/p>\n<h3>C\u00e1c x\u00e9t nghi\u1ec7m th\u01b0\u1eddng quy kh\u00e1c<\/h3>\n<p>C\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c v\u1ec1 tim, ph\u1ed5i v\u00e0 m\u00e1u th\u01b0\u1eddng \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh \u0111\u1ec3 c\u00f3 th\u1ec3 gi\u00fap ch\u1ea9n \u0111o\u00e1n b\u1ec7nh ho\u1eb7c l\u00e0 ph\u00e1t hi\u1ec7n ra t\u00ecnh tr\u1ea1ng b\u1ec7nh kh\u00e1c.<\/p>\n<ul>\n<li>\u0110i\u1ec7n tim (\u0111i\u1ec7n t\u00e2m \u0111\u1ed3, ho\u1eb7c ECG) th\u01b0\u1eddng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n. Tr\u00ean \u0111i\u1ec7n tim ng\u01b0\u1eddi ta t\u00ecm ki\u1ebfm d\u1ea5u hi\u1ec7u c\u1ee7a t\u0103ng g\u00e1nh th\u1ea5t ph\u1ea3i (x\u1ea3y ra trong thuy\u00ean t\u1eafc ph\u1ed5i) v\u00e0 b\u1ea5t k\u1ef3 s\u1ef1 b\u1ea5t th\u01b0\u1eddng n\u00e0o c\u1ee7a nh\u1ecbp tim nh\u01b0 rung ngh\u0129, l\u00e0 m\u1ed9t h\u1eadu qu\u1ea3 c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i.<\/li>\n<li>X\u00e9t nghi\u1ec7m m\u00e1u \u0111\u1ec3 t\u00ecm ki\u1ebfm d\u1ea5u hi\u1ec7u c\u1ee7a m\u1ed9t c\u01a1n \u0111au tim (nh\u1ed3i m\u00e1u c\u01a1 tim), t\u00ecnh tr\u1ea1ng vi\u00eam nhi\u1ec5m. Ngo\u00e0i ra, x\u00e9t nghi\u1ec7m kh\u00ed m\u00e1u \u0111\u1ed9ng m\u1ea1ch c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n, ng\u01b0\u1eddi ta l\u1ea5y m\u1eabu m\u00e1u t\u1eeb \u0111\u1ed9ng m\u1ea1ch \u0111\u1ec3 ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 oxy trong m\u00e1u.<\/li>\n<li>Ch\u1ee5p X quang ng\u1ef1c \u0111\u1ec3 t\u00ecm vi\u00eam ph\u1ed5i ho\u1eb7c b\u1ec7nh l\u00fd kh\u00e1c \u1edf ng\u1ef1c.<\/li>\n<\/ul>\n<h2>\u0110i\u1ec1u tr\u1ecb cho thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 g\u00ec?<\/h2>\n<p>Ph\u1ea7n n\u00e0y ch\u1ec9 b\u00e0n v\u1ec1 thuy\u00ean t\u1eafc ph\u1ed5i do c\u1ee5c m\u00e1u \u0111\u00f4ng m\u00e0 kh\u00f4ng b\u00e0n \u0111\u1ebfn nh\u1eefng nguy\u00ean nh\u00e2n hi\u1ebfm \u0111\u01b0\u1ee3c li\u1ec7t k\u00ea \u1edf tr\u00ean. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ch\u1ee7 y\u1ebfu l\u00e0:<\/p>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng m\u00e1u.<\/li>\n<li>Th\u1edf oxy trong giai \u0111o\u1ea1n \u0111\u1ea7u \u0111\u1ec3 c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng kh\u00f3 th\u1edf v\u00e0 gi\u1ea3m oxy m\u00e1u.<\/li>\n<\/ul>\n<h3>\u0110i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng<\/h3>\n<p>Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 thu\u1ed1c l\u00e0m lo\u00e3ng m\u00e1u. Tuy nhi\u00ean, n\u00f3 kh\u00f4ng th\u1ef1c s\u1ef1 l\u00e0m lo\u00e3ng m\u00e1u. N\u00f3 l\u00e0m thay \u0111\u1ed5i m\u1ed9t s\u1ed1 ch\u1ea5t trong m\u00e1u \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u00e1c c\u1ee5c m\u00e1u \u0111\u00f4ng h\u00ecnh th\u00e0nh d\u1ec5 d\u00e0ng. N\u00f3 c\u0169ng kh\u00f4ng h\u00f2a tan \u0111\u01b0\u1ee3c c\u1ee5c m\u00e1u \u0111\u00f4ng \u0111\u00e3 h\u00ecnh th\u00e0nh (nh\u01b0 m\u1ed9t s\u1ed1 ng\u01b0\u1eddi nh\u1ea7m l\u1eabn). Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng <strong>ng\u0103n ch\u1eb7n c\u1ee5c m\u00e1u \u0111\u00f4ng \u1edf ph\u1ed5i tr\u1edf n\u00ean l\u1edbn h\u01a1n<\/strong>\u00a0v\u00e0 <strong>ng\u0103n ng\u1eeba h\u00ecnh th\u00e0nh c\u1ee5c m\u00e1u \u0111\u00f4ng m\u1edbi<\/strong>. Sau \u0111\u00f3 c\u01a1 ch\u1ebf t\u1ef1 s\u1eeda ch\u1eefa c\u1ee7a c\u01a1 th\u1ec3 c\u00f3 th\u1ec3 l\u00e0m vi\u1ec7c \u0111\u1ec3 ph\u00e1 v\u1ee1 c\u00e1c c\u1ee5c m\u00e1u \u0111\u00f4ng.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng th\u01b0\u1eddng \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u ngay l\u1eadp t\u1ee9c (ngay sau khi nghi ng\u1edd thuy\u00ean t\u1eafc ph\u1ed5i) \u0111\u1ec3 ng\u0103n ng\u1eeba di\u1ec5n ti\u1ebfn n\u1eb7ng h\u01a1n trong khi ch\u1edd \u0111\u1ee3i k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m.<\/p>\n<p>Thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng c\u00f3 hai d\u1ea1ng tr\u00ecnh b\u00e0y l\u00e0 d\u1ea1ng ti\u00eam v\u00e0 vi\u00ean u\u1ed1ng (ho\u1eb7c xi-r\u00f4 cho nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng th\u1ec3 nu\u1ed1t vi\u00ean thu\u1ed1c).<\/p>\n<p>D\u1ea1ng ti\u00eam l\u00e0 heparin chu\u1ea9n (heparin kh\u00f4ng ph\u00e2n \u0111o\u1ea1n) ho\u1eb7c heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p (LMWH). Heparin chu\u1ea9n \u0111\u01b0\u1ee3c ti\u00eam t\u0129nh m\u1ea1ch (IV), c\u00f3 ngh\u0129a l\u00e0 b\u01a1m thu\u1ed1c tr\u1ef1c ti\u1ebfp v\u00e0o t\u0129nh m\u1ea1ch &#8211; th\u01b0\u1eddng \u1edf c\u00e1nh tay. N\u00f3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng cho thuy\u00ean t\u1eafc ph\u1ed5i c\u00f3 nguy c\u01a1 cao v\u00e0 nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd nh\u1ea5t \u0111\u1ecbnh &#8211; ch\u1eb3ng h\u1ea1n nh\u01b0 b\u1ec7nh th\u1eadn m\u1ea1n t\u00ednh. Heparin tr\u1ecdng l\u01b0\u1ee3ng ph\u00e2n t\u1eed th\u1ea5p (LMWH \u2013 t\u00ean th\u01b0\u01a1ng m\u1ea1i th\u01b0\u1eddng d\u00f9ng lovenox\u00ae) \u0111\u01b0\u1ee3c ti\u00eam d\u01b0\u1edbi da v\u00f9ng b\u1ee5ng.<\/p>\n<p><u>L\u01b0u \u00fd<\/u>: LMWH\u00a0c\u0169ng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng v\u1edbi li\u1ec1u l\u01b0\u1ee3ng th\u1ea5p h\u01a1n, \u0111\u1ec3 ng\u0103n ng\u1eeba thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch (thuy\u00ean t\u1eafc ph\u1ed5i v\u00e0 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u) \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n n\u1eb1m vi\u1ec7n, \u0111\u1eb7c bi\u1ec7t l\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111ang ho\u1eb7c \u0111\u00e3 tr\u1ea3i qua ph\u1eabu thu\u1eadt l\u1edbn.<\/p>\n<p>M\u1ed9t lo\u1ea1i thu\u1ed1c g\u1ecdi l\u00e0 natri fondaparinux (arixtra\u00ae) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c d\u00f9ng b\u1eb1ng \u0111\u01b0\u1eddng ti\u00eam trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, ho\u1eb7c l\u00e0 \u0111\u1ec3 ng\u0103n ng\u1eeba thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch ho\u1eb7c \u0111i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i hay huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u.<\/p>\n<p>Nh\u1eefng vi\u00ean thu\u1ed1c ho\u1eb7c xi-r\u00f4 th\u01b0\u1eddng d\u00f9ng \u0111\u1ec3 d\u1ef1 ph\u00f2ng thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 warfarin, sintrom\u00ae (acenocoumarol). Ngo\u00e0i ra c\u00f3 th\u00eam m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1c c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng t\u1ef1 nh\u01b0 warfarin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1ng \u0111\u00f4ng m\u1edbi \u0111\u01b0\u1eddng u\u1ed1ng (NOAC) nh\u01b0 rivaroxaban, apixapan c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng thay th\u1ebf warfarin.<\/p>\n<p>Th\u00f4ng th\u01b0\u1eddng, thu\u1ed1c ti\u00eam \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi kh\u1edfi \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb, b\u1edfi v\u00ec ch\u00fang c\u00f3 hi\u1ec7u qu\u1ea3 ngay l\u1eadp t\u1ee9c. Sau khi ti\u00eam v\u00e0 vi\u1ec7c ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn, warfarin u\u1ed1ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c b\u1eaft \u0111\u1ea7u. Warfarin m\u1ea5t v\u00e0i ng\u00e0y \u0111\u1ec3 c\u00f3 th\u1ec3 ph\u00e1t huy t\u00e1c d\u1ee5ng \u0111\u1ea7y \u0111\u1ee7.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng m\u00e1u \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c cho \u0111\u1ebfn ba th\u00e1ng sau thuy\u00ean t\u1eafc ph\u1ed5i trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p. \u0110\u00f4i khi \u0111i\u1ec1u tr\u1ecb l\u00e2u h\u01a1n \u0111\u01b0\u1ee3c khuy\u00ean \u00e1p d\u1ee5ng, \u0111\u1eb7c bi\u1ec7t n\u1ebfu c\u00f3 nguy c\u01a1 cao b\u1ecb thuy\u00ean t\u1eafc tr\u1edf l\u1ea1i. Ph\u00f2ng kh\u00e1m ho\u1eb7c b\u00e1c s\u0129 qu\u1ea3n l\u00fd vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng s\u1ebd t\u01b0 v\u1ea5n th\u00eam cho b\u1ea1n. N\u1ebfu b\u1ea1n \u0111ang mang thai, ti\u00eam heparin n\u00ean \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng h\u01a1n l\u00e0 warfarin. L\u00fd do l\u00e0 warfarin c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i (d\u1ecb t\u1eadt b\u1ea9m sinh) cho thai nhi, \u0111\u1eb7c bi\u1ec7t trong giai \u0111o\u1ea1n 3 th\u00e1ng \u0111\u1ea7u c\u1ee7a thai k\u00ec.<\/p>\n<h3>\u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3<\/h3>\n<p>Ngh\u0129a l\u00e0 c\u00e1c bi\u1ec7n ph\u00e1p \u0111i\u1ec1u tr\u1ecb \u0111\u1ec3 gi\u00fap c\u01a1 th\u1ec3 \u0111\u1ed1i ph\u00f3 v\u1edbi nh\u1eefng \u1ea3nh h\u01b0\u1edfng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i.<\/p>\n<ul>\n<li>Oxy \u0111\u1ec3 gi\u1ea3m kh\u00f3 th\u1edf.<\/li>\n<li>Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, truy\u1ec1n d\u1ecbch t\u0129nh m\u1ea1ch \u0111\u1ec3 h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n.<\/li>\n<li>Theo d\u00f5i s\u00e1t v\u00e0 nh\u1eadp \u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c t\u00edch c\u1ef1c c\u00f3 th\u1ec3 c\u1ea7n thi\u1ebft n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng kh\u1ecfe ho\u1eb7c thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn.<\/li>\n<\/ul>\n<h3>C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung<\/h3>\n<p>Bi\u1ec7n ph\u00e1p n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn ho\u1eb7c nguy c\u01a1 cao trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n r\u1ea5t y\u1ebfu, ho\u1eb7c kh\u00f4ng th\u1ec3 \u0111i\u1ec1u tr\u1ecb kh\u00e1ng \u0111\u00f4ng.<\/p>\n<p><strong>Thu\u1ed1c ti\u00eau huy\u1ebft kh\u1ed1i (thrombolysis)<\/strong><\/p>\n<p>\u0110\u00e2y l\u00e0 lo\u1ea1i thu\u1ed1c gi\u00fap h\u00f2a tan c\u00e1c c\u1ee5c m\u00e1u \u0111\u00f4ng \u0111\u00e3 h\u00ecnh th\u00e0nh. Alteplase l\u00e0 thu\u1ed1c th\u01b0\u1eddng \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng; streptokinase ho\u1eb7c urokinase l\u00e0 l\u1ef1a ch\u1ecdn thay th\u1ebf. Ch\u00fang m\u1ea1nh h\u01a1n so v\u1edbi ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb kh\u00e1ng \u0111\u00f4ng heparin v\u00e0 warfarin m\u00f4 t\u1ea3 \u1edf tr\u00ean tuy nhi\u00ean l\u1ea1i c\u00f3 nguy c\u01a1 cao h\u01a1n b\u1ecb t\u00e1c d\u1ee5ng ph\u1ee5 ch\u1ea3y m\u00e1u kh\u00f4ng mong mu\u1ed1n, bao g\u1ed3m c\u1ea3 ch\u1ea3y m\u00e1u v\u00e0o n\u00e3o (xu\u1ea5t huy\u1ebft n\u00e3o) &#8211; \u0111\u00e2y c\u0169ng l\u00e0 m\u1ed9t d\u1ea1ng \u0111\u1ed9t qu\u1ef5. Xem th\u00eam b\u00e0i \u201c<a href=\"https:\/\/yhoccongdong.com\/thongtin\/dot-quy-do-xuat-huyet\/\" target=\"_blank\" rel=\"noopener\">\u0111\u1ed9t qu\u1ef5 do xu\u1ea5t huy\u1ebft<\/a>\u201d \u0111\u1ec3 bi\u1ebft th\u00eam th\u00f4ng tin.<\/p>\n<p><strong>B\u1ed9 l\u1ecdc<\/strong><\/p>\n<p>B\u1ed9 l\u1ecdc hay m\u00e0ng l\u1ecdc t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi, c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ng\u0103n ch\u1eb7n c\u1ee5c m\u00e1u \u0111\u00f4ng tr\u00f4i v\u1ec1 ph\u1ed5i. B\u1ed9 l\u1ecdc \u0111\u01b0\u1ee3c \u0111\u1eb7t trong m\u1ed9t t\u0129nh m\u1ea1ch l\u1edbn g\u1ecdi l\u00e0 t\u0129nh m\u1ea1ch ch\u1ee7 d\u01b0\u1edbi (t\u0129nh m\u1ea1ch l\u1edbn d\u1eabn m\u00e1u v\u1ec1 tim) n\u00f3 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o th\u00f4ng qua m\u1ed9t \u1ed1ng m\u1ecfng, nh\u1ecf lu\u1ed3n v\u00e0o trong t\u0129nh m\u1ea1ch l\u1edbn v\u00e0 sau \u0111\u00f3 \u0111i d\u1ecdc theo t\u0129nh m\u1ea1ch \u0111\u00f3 t\u1edbi \u0111\u00fang v\u1ecb tr\u00ed. Th\u1ee7 thu\u1eadt n\u00e0y kh\u00f4ng c\u1ea7n g\u00e2y m\u00ea v\u00e0 c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1ea1i gi\u01b0\u1eddng b\u1ec7nh.<\/p>\n<p>B\u1ed9 l\u1ecdc h\u1eefu \u00edch trong tr\u01b0\u1eddng h\u1ee3p m\u1ed9t m\u00ecnh thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng kh\u00f4ng \u0111\u1ee7 t\u00e1c d\u1ee5ng ho\u1eb7c v\u00ec m\u1ed9t l\u00fd do g\u00ec \u0111\u00f3 b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng \u0111\u01b0\u1ee3c.<\/p>\n<p><strong>Ph\u1eabu thu\u1eadt l\u1ea5y huy\u1ebft kh\u1ed1i<\/strong><\/p>\n<p>Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, c\u00f3 th\u1ec3 l\u1ecdai b\u1ecf huy\u1ebft kh\u1ed1i b\u1eb1ng ph\u1eabu thu\u1eadt g\u1ecdi l\u00e0 ph\u1eabu thu\u1eadt l\u1ea5y huy\u1ebft kh\u1ed1i (embolectomy). \u0110\u00e2y l\u00e0 m\u1ed9t ph\u1eabu thu\u1eadt l\u1edbn \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh b\u00ean trong l\u1ed3ng ng\u1ef1c, g\u1ea7n v\u1edbi tim n\u00ean n\u00f3 \u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 \u0111\u1ed9i ng\u0169 ph\u1eabu thu\u1eadt kinh nghi\u1ec7m v\u00e0 th\u1ef1c hi\u1ec7n t\u1ea1i b\u1ec7nh vi\u1ec7n c\u00f3 chuy\u00ean khoa. Th\u01b0\u1eddng \u0111\u01b0\u1ee3c coi nh\u01b0 l\u00e0 ph\u01b0\u01a1ng s\u00e1ch cu\u1ed1i c\u00f9ng cho b\u1ec7nh nh\u00e2n r\u1ea5t n\u1eb7ng. Cu\u1ed9c m\u1ed5 l\u00e0m t\u0103ng nguy c\u01a1 t\u1eed vong m\u1ed9t c\u00e1ch r\u00f5 r\u1ec7t, tuy nhi\u00ean, n\u00f3 s\u1ebd \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc nh\u01b0 l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn khi thuy\u00ean t\u1eafc ph\u1ed5i r\u1ea5t l\u1edbn m\u00e0 ch\u00ednh b\u1ea3n th\u00e2n n\u00f3 \u0111\u00e3 \u0111em \u0111\u1ebfn nguy c\u01a1 t\u1eed vong r\u1ea5t cao n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c ph\u1eabu thu\u1eadt.<\/p>\n<p>Ph\u1eabu thu\u1eadt c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 s\u1eed d\u1ee5ng \u0111\u01b0\u1ee3c thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng ho\u1eb7c thu\u1ed1c l\u00e0m tan huy\u1ebft kh\u1ed1i, th\u01b0\u1eddng l\u00e0 do h\u1ecd c\u00f3 nguy c\u01a1 ch\u1ea3y m\u00e1u cao.<\/p>\n<p>M\u00e1y tim ph\u1ed5i nh\u00e2n t\u1ea1o (h\u1ed7 tr\u1ee3 tu\u1ea7n ho\u00e0n ngo\u00e0i c\u01a1 th\u1ec3) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn (hi\u1ebfm)<\/p>\n<p><strong>Lo\u1ea1i b\u1ecf c\u1ee5c m\u00e1u \u0111\u00f4ng qua \u1ed1ng nh\u1ecf (catheter)<\/strong><\/p>\n<p>Ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 lo\u1ea1i b\u1ecf huy\u1ebft kh\u1ed1i qua \u1ed1ng th\u00f4ng (catheter embolectomy) ho\u1eb7c ph\u00e1 v\u1ee1 huy\u1ebft kh\u1ed1i qua \u1ed1ng th\u00f4ng (catheter fragmentation of the clot). N\u00f3 \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh b\u1eb1ng c\u00e1ch lu\u1ed3n m\u1ed9t \u1ed1ng th\u00f4ng nh\u1ecf v\u00e0o m\u1ea1ch m\u00e1u cho \u0111\u1ebfn khi n\u00f3 ti\u1ebfp c\u1eadn \u0111\u01b0\u1ee3c c\u1ee5c m\u00e1u \u0111\u00f4ng, ng\u01b0\u1eddi ta c\u00f3 th\u1ec3 l\u1ea5y c\u1ee5c m\u00e1u \u0111\u00f4ng ra ngo\u00e0i ho\u1eb7c ph\u00e1 v\u1ee1 c\u1ee5c m\u00e1u \u0111\u00f4ng b\u1eb1ng nh\u1eefng thi\u1ebft b\u1ecb \u0111\u01b0a qua \u1ed1ng \u0111\u00f3. \u0110\u00e2y l\u00e0 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb chuy\u00ean s\u00e2u v\u00e0 ch\u1ec9 c\u00f3 s\u1eb5n \u1edf m\u1ed9t v\u00e0i b\u1ec7nh vi\u1ec7n nh\u1ea5t \u0111\u1ecbnh.<\/p>\n<h2>Mang thai v\u00e0 giai \u0111o\u1ea1n sau sinh<\/h2>\n<p>C\u00f3 s\u1ef1 gia t\u0103ng nguy c\u01a1 b\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i \u1edf ph\u1ee5 n\u1eef <strong>trong su\u1ed1t qu\u00e1 tr\u00ecnh mang thai v\u00e0 cho \u0111\u1ebfn 6 tu\u1ea7n sau sinh<\/strong>. B\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng n\u00e0o c\u1ee7a huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u ho\u1eb7c thuy\u00ean t\u1eafc ph\u1ed5i x\u1ea3y ra tr\u00ean m\u1ed9t ng\u01b0\u1eddi ph\u1ee5 n\u1eef mang thai ho\u1eb7c sau sinh c\u1ea7n \u0111\u01b0\u1ee3c h\u1ebft s\u1ee9c l\u01b0u \u00fd v\u00e0 \u0111\u00e1nh gi\u00e1 ngay l\u1eadp t\u1ee9c.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i trong thai k\u1ef3 th\u01b0\u1eddng d\u00f9ng heparin ti\u00eam h\u01a1n warfarin u\u1ed1ng. \u0110i\u1ec1u n\u00e0y do warfarin c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i (d\u1ecb t\u1eadt b\u1ea9m sinh) cho thai nhi. \u0110\u1ed1i v\u1edbi m\u1ed9t thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn, trong tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh nh\u00e2n di\u1ec5n bi\u1ebfn kh\u00f4ng t\u1ed1t, nh\u1eefng ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ed5 sung (\u0111\u00e3 n\u00f3i ph\u00eda tr\u00ean) c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng.<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb trong th\u1eddi k\u1ef3 mang thai \u0111\u01b0\u1ee3c ti\u1ebfp t\u1ee5c cho \u0111\u1ebfn ba th\u00e1ng sau thuy\u00ean t\u1eafc ho\u1eb7c cho \u0111\u1ebfn s\u00e1u tu\u1ea7n sau sinh, t\u00f9y th\u1eddi gian n\u00e0o d\u00e0i h\u01a1n.<\/p>\n<p>Sau sinh, warfarin c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c kh\u1edfi \u0111\u1ed9ng thay cho heparin, m\u1ed9t khi vi\u1ec7c m\u1ea5t m\u00e1u do sinh \u0111\u1ebb \u0111\u00e3 \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft.<\/p>\n<p>Heparin v\u00e0 warfarin c\u00f3 th\u1ec3 d\u00f9ng \u0111\u01b0\u1ee3c tr\u00ean ph\u1ee5 n\u1eef \u0111ang cho con b\u00fa. N\u1ebfu d\u00f9ng warfarin, n\u00ean \u0111\u1ea3m b\u1ea3o r\u1eb1ng em b\u00e9 \u0111\u00e3 \u0111\u01b0\u1ee3c ti\u00eam li\u1ec1u vitamin k th\u01b0\u1eddng quy sau sanh v\u00ec vitamin k gi\u00fap ch\u1ed1ng l\u1ea1i t\u00e1c d\u1ee5ng c\u1ee7a warfarin. (T\u1ea1i Anh, t\u1ea5t c\u1ea3 tr\u1ebb em \u0111\u01b0\u1ee3c ti\u00eam vitamin k ngay sau khi sinh m\u1ed9t c\u00e1ch th\u01b0\u1eddng quy, tr\u1eeb khi ph\u1ee5 huynh ph\u1ea3n \u0111\u1ed1i. Vitamin K\u00a0gi\u00fap ng\u0103n ch\u1eb7n c\u00e1c v\u1ea5n \u0111\u1ec1 \u0111\u00f4ng m\u00e1u \u1edf tr\u1ebb s\u01a1 sinh b\u1ea5t k\u1ec3 ng\u01b0\u1eddi m\u1eb9 c\u00f3 \u0111ang \u0111i\u1ec1u tr\u1ecb warfarin hay kh\u00f4ng).<\/p>\n<h2>C\u00e1c bi\u1ebfn ch\u1ee9ng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 g\u00ec?<\/h2>\n<p>Ph\u1ea7n l\u1edbn thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng v\u00e0 kh\u00f4ng c\u00f3 bi\u1ebfn ch\u1ee9ng. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 x\u1ea3y ra bao g\u1ed3m:<\/p>\n<ul>\n<li>Cho\u00e1ng: do \u1ea3nh h\u01b0\u1edfng c\u1ee7a c\u1ee5c m\u00e1u \u0111\u00f4ng tr\u00ean tim v\u00e0 h\u1ec7 tu\u1ea7n ho\u00e0n. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 khi\u1ebfn tim ng\u1eebng \u0111\u1eadp v\u00e0 c\u00f3 th\u1ec3 g\u00e2y t\u1eed vong.<\/li>\n<li>Thuy\u00ean t\u1eafc ph\u1ed5i c\u00f3 th\u1ec3 t\u1ea1o ra m\u1ed9t g\u00e1nh n\u1eb7ng tr\u00ean tim d\u1eabn \u0111\u1ebfn m\u1ed9t t\u00ecnh tr\u1ea1ng g\u1ecdi l\u00e0 suy tim, ngh\u0129a l\u00e0 tim kh\u00f4ng c\u00f2n ho\u1ea1t \u0111\u1ed9ng m\u1ea1nh nh\u01b0 l\u00fac b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c<\/li>\n<li>Thuy\u00ean t\u1eafc c\u00f3 th\u1ec3 x\u1ea3y ra th\u00eam m\u1ed9t l\u1ea7n n\u1eefa g\u1ecdi l\u00e0 thuy\u00ean t\u1eafc ph\u1ed5i t\u00e1i ph\u00e1t. \u0110i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng gi\u00fap ng\u0103n ch\u1eb7n \u0111i\u1ec1u n\u00e0y.<\/li>\n<li>C\u00e1c bi\u1ebfn ch\u1ee9ng do \u0111i\u1ec1u tr\u1ecb: vi\u1ec7c \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng c\u00f3 th\u1ec3 c\u00f3 t\u00e1c d\u1ee5ng ph\u1ee5. M\u1ed9t trong nh\u1eefng t\u00e1c d\u1ee5ng ph\u1ee5 ch\u00ednh l\u00e0 ch\u1ea3y m\u00e1u \u1edf nh\u1eefng n\u01a1i kh\u00e1c trong c\u01a1 th\u1ec3 &#8211; v\u00ed d\u1ee5 nh\u01b0 ch\u1ea3y m\u00e1u t\u1eeb m\u1ed9t v\u1ebft lo\u00e9t d\u1ea1 d\u00e0y. Kho\u1ea3ng 3 trong 100 b\u1ec7nh nh\u00e2n s\u1ebd b\u1ecb ch\u1ea3y m\u00e1u \u0111\u00e1ng k\u1ec3 do s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb thuy\u00ean t\u1eafc ph\u1ed5i. Th\u01b0\u1eddng lo\u1ea1i ch\u1ea3y m\u00e1u n\u00e0y c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng v\u00e0 hi\u1ebfm khi g\u00e2y t\u1eed vong (kho\u1ea3ng 3 tr\u00ean 1000 tr\u01b0\u1eddng h\u1ee3p thuy\u00ean t\u1eafc ph\u1ed5i). N\u00f3i chung, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng v\u1eabn an to\u00e0n h\u01a1n l\u00e0 kh\u00f4ng \u0111i\u1ec1u tr\u1ecb, \u0111\u1ec3 ng\u0103n ch\u1eb7n thuy\u00ean t\u1eafc ph\u1ed5i nghi\u00eam tr\u1ecdng.<\/li>\n<li>N\u1ebfu thuy\u00ean t\u1eafc ph\u1ed5i nh\u1ecf nh\u01b0ng l\u1eb7p \u0111i l\u1eb7p l\u1ea1i c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p trong m\u1ea1ch m\u00e1u ph\u1ed5i (g\u1ecdi l\u00e0 t\u0103ng \u00e1p ph\u1ed5i)<\/li>\n<\/ul>\n<h2><strong>Ti\u00ean l\u01b0\u1ee3ng c\u1ee7a thuy\u00ean t\u1eafc ph\u1ed5i nh\u01b0 th\u1ebf n\u00e0o?<\/strong><\/h2>\n<p>\u0110i\u1ec1u n\u00e0y ph\u1ee5 thu\u1ed9c v\u00e0o lo\u1ea1i thuy\u00ean t\u1eafc ph\u1ed5i v\u00e0 s\u1ef1 hi\u1ec7n c\u1ee7a b\u1ec7nh l\u00fd kh\u00e1c k\u00e8m theo<\/p>\n<p>N\u1ebfu thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ecbp th\u1eddi, ti\u00ean l\u01b0\u1ee3ng n\u00f3i chung l\u00e0 t\u1ed1t, v\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i ho\u00e0n to\u00e0n.<\/p>\n<p>Ti\u00ean l\u01b0\u1ee3ng s\u1ebd x\u1ea5u h\u01a1n n\u1ebfu c\u00f3 m\u1ed9t b\u1ec7nh l\u00fd n\u1ec1n nghi\u00eam tr\u1ecdng t\u1eeb tr\u01b0\u1edbc d\u1eabn \u0111\u1ebfn thuy\u00ean t\u1eafc &#8211; v\u00ed d\u1ee5 nh\u01b0 ung th\u01b0 giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n. Thuy\u00ean t\u1eafc ph\u1ed5i l\u1edbn th\u00ec kh\u00f3 \u0111i\u1ec1u tr\u1ecb h\u01a1n v\u00e0 c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng nghi\u00eam tr\u1ecdng v\u00e0 c\u00f3 nguy c\u01a1 t\u1eed vong cao nh\u01b0ng \u0111i\u1ec1u n\u00e0y s\u1ebd gi\u1ea3m \u0111\u00e1ng k\u1ec3 n\u1ebfu \u0111i\u1ec1u tr\u1ecb s\u1edbm t\u1ea1i b\u1ec7nh vi\u1ec7n.<\/p>\n<p>Th\u1eddi gian nguy hi\u1ec3m nh\u1ea5t c\u00f3 th\u1ec3 x\u1ea3y ra bi\u1ebfn ch\u1ee9ng ho\u1eb7c t\u1eed vong l\u00e0 v\u00e0i gi\u1edd \u0111\u1ea7u sau khi thuy\u00ean t\u1eafc x\u1ea3y ra. Ngo\u00e0i ra, c\u00f3 m\u1ed9t nguy c\u01a1 cao thuy\u00ean t\u1eafc ph\u1ed5i th\u1ee9 hai x\u1ea3y ra trong v\u00f2ng s\u00e1u tu\u1ea7n l\u1ec5 \u0111\u1ea7u sau l\u1ea7n thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u1ea7u ti\u00ean. \u0110\u00e2y l\u00e0 l\u00fd do t\u1ea1i sao c\u1ea7n \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng \u0111\u00f4ng ngay l\u1eadp t\u1ee9c v\u00e0 k\u00e9o d\u00e0i ti\u1ebfp t\u1ee5c trong kho\u1ea3ng ba th\u00e1ng sau<\/p>\n<h2>Thuy\u00ean t\u1eafc ph\u1ed5i \u0111\u01b0\u1ee3c ph\u00f2ng ng\u1eeba nh\u01b0 th\u1ebf n\u00e0o?<\/h2>\n<p>\u0110i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn vi\u1ec7c ng\u0103n ng\u1eeba huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u. Tham kh\u1ea3o th\u00eam ph\u1ea7n ph\u00f2ng ng\u1eeba trong b\u00e0i \u201c<a href=\"https:\/\/yhoccongdong.com\/thongtin\/huyet-khoi-tinh-mach-sau\/\" target=\"_blank\" rel=\"noopener\">huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u<\/a>\u201d.<\/p>\n<p>Ng\u01b0\u1eddi s\u1eafp tr\u1ea3i qua ph\u1eabu thu\u1eadt l\u1edbn n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 nguy c\u01a1 b\u1ecb huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u, v\u00e0 nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao c\u1ea7n li\u1ec1u ph\u00f2ng ng\u1eeba (d\u1ef1 ph\u00f2ng) heparin ho\u1eb7c m\u1ed9t thu\u1ed1c t\u01b0\u01a1ng t\u1ef1 tr\u01b0\u1edbc v\u00e0 sau khi ph\u1eabu thu\u1eadt. C\u00e1c bi\u1ec7n ph\u00e1p ph\u00f2ng ng\u1eeba kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng khi \u1edf b\u1ec7nh vi\u1ec7n.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ol>\n<li><a href=\"http:\/\/patient.info\/health\/pulmonary-embolism-leaflet\" target=\"_blank\" rel=\"noopener\">http:\/\/patient.info\/health\/pulmonary-embolism-leaflet<\/a><\/li>\n<li><a href=\"https:\/\/yhoccongdong.com\/thongtin\/huyet-khoi-tinh-mach-sau\/\" target=\"_blank\" rel=\"noopener\">https:\/\/yhoccongdong.com\/thongtin\/huyet-khoi-tinh-mach-sau\/<\/a><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng, x\u1ea3y ra do s\u1ef1 t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u trong ph\u1ed5i. <\/p>\n","protected":false},"author":293,"featured_media":6153,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3703,5210,5148,5209,5149],"tags":[3450,4486,3342],"series":[1342],"coauthors":[2376],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Thuy\u00ean t\u1eafc ph\u1ed5i - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng, x\u1ea3y ra do s\u1ef1 t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u trong ph\u1ed5i\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/yhoccongdong.com\/du-an-khac\/thuyen-tac-phoi\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Thuy\u00ean t\u1eafc ph\u1ed5i - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng\" \/>\n<meta property=\"og:description\" content=\"Thuy\u00ean t\u1eafc ph\u1ed5i l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng, x\u1ea3y ra do s\u1ef1 t\u1eafc ngh\u1ebdn m\u1ea1ch m\u00e1u trong ph\u1ed5i\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/du-an-khac\/thuyen-tac-phoi\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n kh\u00e1c\" \/>\n<meta property=\"article:author\" content=\"https:\/\/facebook.com\/luu.kim.han?ref=bookmarks\" \/>\n<meta property=\"article:published_time\" content=\"2018-07-26T20:19:24+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-03-16T21:23:10+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/du-an-khac\/wp-content\/uploads\/sites\/6\/2016\/10\/thuyen-tac-phoi.jpg\" \/>\n\t<meta property=\"og:image:width\" content=\"660\" \/>\n\t<meta property=\"og:image:height\" content=\"330\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/jpeg\" \/>\n<meta name=\"author\" content=\"BS. 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