{"id":7878,"date":"2018-06-14T10:47:58","date_gmt":"2018-06-14T03:47:58","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/cac-van-de-ve-tim\/"},"modified":"2024-04-29T15:18:08","modified_gmt":"2024-04-29T08:18:08","slug":"cac-van-de-ve-tim","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/cac-van-de-ve-tim\/","title":{"rendered":"C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim"},"content":{"rendered":"<p><img fetchpriority=\"high\" decoding=\"async\" class=\"wp-image-16946 size-full aligncenter\" src=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/06\/cac-van-de-ve-tim-20221011-081311.jpg\" alt=\"c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim\" width=\"660\" height=\"330\" \/><\/p>\n<p style=\"text-align: justify\">V\u1ea5n \u0111\u1ec1 v\u1ec1 tim tuy kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng c\u1ee7a m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0. Ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u1ed9c t\u00ednh l\u00ean tim do h\u00f3a ch\u1ea5t (cardiac toxicity). C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim hi\u1ebfm khi g\u00e2y t\u1eed vong nh\u01b0ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111i\u1ec1u tr\u1ecb v\u00e0 gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng c\u1ee7a b\u1ec7nh nh\u00e2n.<\/p>\n<p style=\"text-align: justify\">Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ec1u li\u00ean quan \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 v\u1ec1 tim. H\u01a1n n\u1eefa c\u0169ng c\u00f3 nhi\u1ec1u c\u00e1ch \u0111\u1ec3 ng\u0103n ng\u1eeba ho\u1eb7c qu\u1ea3n l\u00fd ch\u00fang khi g\u1eb7p ph\u1ea3i.<\/p>\n<p style=\"text-align: justify\">Gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 n\u00e0y v\u00e0 c\u00e1c t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c l\u00e0 m\u1ed9t ph\u1ea7n quan tr\u1ecdng trong ch\u0103m s\u00f3c b\u1ec7nh nh\u00e2n ung th\u01b0. C\u00e1ch ti\u1ebfp c\u1eadn n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u0103m s\u00f3c gi\u1ea3m nh\u1eb9 ho\u1eb7c ch\u0103m s\u00f3c h\u1ed7 tr\u1ee3. H\u00e3y b\u00e1o v\u1edbi b\u00e1c s\u0129 v\u1ec1 b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng m\u1edbi xu\u1ea5t hi\u1ec7n ho\u1eb7c khi c\u00f3 s\u1ef1 thay \u0111\u1ed5i c\u00e1c tri\u1ec7u ch\u1ee9ng m\u00e0 b\u1ea1n \u0111ang m\u1eafc ph\u1ea3i.<\/p>\n<h2 style=\"text-align: justify\"><strong>C\u00e1c tri\u1ec7u ch\u1ee9ng b\u00e1o hi\u1ec7u v\u1ea5n \u0111\u1ec1 v\u1ec1 tim<\/strong><\/h2>\n<p style=\"text-align: justify\">B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng d\u01b0\u1edbi \u0111\u00e2y. N\u1ebfu nh\u1eadn th\u1ea5y b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng n\u00e0o, b\u1ea1n ph\u1ea3i li\u00ean h\u1ec7 v\u1edbi nh\u00f3m ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe b\u00e1c s\u0129 c\u1ee7a b\u1ea1n ngay l\u1eadp t\u1ee9c.<\/p>\n<ul style=\"text-align: justify\">\n<li>Kh\u00f3 th\u1edf<\/li>\n<li>Cho\u00e1ng ho\u1eb7c ch\u00f3ng m\u1eb7t<\/li>\n<li>Kh\u00f3 ch\u1ecbu ho\u1eb7c \u0111au \u1edf ng\u1ef1c<\/li>\n<li>M\u1ec7t m\u1ecfi<\/li>\n<li>S\u01b0ng b\u00e0n tay v\u00e0\/ho\u1eb7c b\u00e0n ch\u00e2n<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\"><strong>Ph\u00e2n lo\u1ea1i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim <\/strong><\/h2>\n<p style=\"text-align: justify\">D\u01b0\u1edbi \u0111\u00e2y l\u00e0 danh s\u00e1ch c\u00e1c b\u1ec7nh tim c\u00f3 th\u1ec3 m\u1eafc ph\u1ea3i sau khi \u0111i\u1ec1u tr\u1ecb ung th\u01b0:<\/p>\n<ul style=\"text-align: justify\">\n<li>B\u1ec7nh c\u01a1 tim v\u00e0 suy tim sung huy\u1ebft (CHF), t\u1ed5n th\u01b0\u01a1ng tim khi\u1ebfn cho n\u00f3 kh\u00f4ng th\u1ec3 b\u01a1m m\u00e1u t\u1ed1t<\/li>\n<li>Vi\u00eam c\u01a1 tim, s\u01b0ng tim c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn nh\u1ecbp tim<\/li>\n<li>B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, t\u1eafc ngh\u1ebdn ho\u1eb7c x\u01a1 s\u1eb9o m\u1ea1ch m\u00e1u c\u1ee7a tim<\/li>\n<li>R\u1ed1i lo\u1ea1n nh\u1ecbp tim hay c\u00f2n g\u1ecdi l\u00e0 nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng van tim, khi\u1ebfn van b\u1ecb h\u1eb9p, x\u01a1 c\u1ee9ng ho\u1eb7c h\u1edf van<\/li>\n<li>C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1edbi m\u00e0ng ngo\u00e0i tim nh\u01b0 s\u01b0ng (vi\u00eam m\u00e0ng ngo\u00e0i tim) hay m\u00e0ng ngo\u00e0i tim d\u00e0y ho\u1eb7c c\u00f3 s\u1eb9o (x\u01a1 h\u00f3a m\u00e0ng ngo\u00e0i tim)<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\"><strong>Nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim<\/strong><\/h2>\n<p style=\"text-align: justify\">Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ho\u1eb7c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ung th\u01b0 \u0111\u1ec1u l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc ph\u1ea3i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim. M\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 sau \u0111\u00e2y c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim:<\/p>\n<p style=\"text-align: justify\">&#8211; H\u00f3a tr\u1ecb v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c thu\u1ed9c nh\u00f3m anthracyclines, bao g\u1ed3m:<\/p>\n<ul>\n<li>Daunorubicin (Cerubidin)<\/li>\n<li>Doxorubicin (Adriamycin, Doxil)<\/li>\n<li>Epirubicin (Ellence)<\/li>\n<li>Idarubicin (Idamycin)<\/li>\n<li>Valrubicin (Valstar)<\/li>\n<\/ul>\n<p>&#8211; H\u00f3a tr\u1ecb v\u1edbi m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c kh\u00e1c, ch\u1eb3ng h\u1ea1n nh\u01b0 mitoxantrone (Novantrone)<\/p>\n<p>&#8211; X\u1ea1 tr\u1ecb ng\u1ef1c<\/p>\n<p>&#8211; M\u1ed9t s\u1ed1 lo\u1ea1i li\u1ec7u ph\u00e1p nh\u1eafm \u0111\u00edch, bao g\u1ed3m:<\/p>\n<ul>\n<li>Bevacizumab (Avastin)<\/li>\n<li>Trastuzumab (Herceptin)<\/li>\n<li>Lapatinib (Tykerb)<\/li>\n<li>Sunitinib (Sutent)<\/li>\n<li>Sorafenib (Nexavar)<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\"><strong>Ai c\u00f3 nguy c\u01a1 m\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim do \u0111i\u1ec1u tr\u1ecb ung th\u01b0?<\/strong><\/h2>\n<ul style=\"text-align: justify\">\n<li>B\u1ec7nh nh\u00e2n t\u1eeb 60 tu\u1ed5i tr\u1edf l\u00ean, tr\u1ebb nh\u1ecf v\u00e0 ph\u1ee5 n\u1eef<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb v\u1edbi anthracyclines li\u1ec1u cao<\/li>\n<li>B\u1ec7nh nh\u00e2n c\u00f3 x\u1ea1 tr\u1ecb li\u1ec1u cao \u1edf ng\u1ef1c<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p anthracycline v\u00e0 x\u1ea1 tr\u1ecb v\u00e0o ng\u1ef1c<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi anthracycline ho\u1eb7c trastuzumab v\u00e0 c\u00f3 ti\u1ec1n s\u1eed h\u00fat thu\u1ed1c, cao huy\u1ebft \u00e1p, ti\u1ec3u \u0111\u01b0\u1eddng, b\u00e9o ph\u00ec v\u00e0\/ho\u1eb7c c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim tr\u01b0\u1edbc khi \u0111i\u1ec1u tr\u1ecb ung th\u01b0<\/li>\n<li>B\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb v\u1edbi anthracyclines sau khi \u0111i\u1ec1u tr\u1ecb v\u1edbi trastuzumab<\/li>\n<\/ul>\n<p style=\"text-align: justify\">Tr\u01b0\u1edbc khi th\u1ef1c hi\u1ec7n c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0 m\u00e0 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim, b\u00e1c s\u0129 s\u1ebd c\u00e1c x\u00e9t nghi\u1ec7m c\u1ea7n thi\u1ebft. Ngo\u00e0i ra, b\u1ea1n v\u00e0 b\u00e1c s\u0129 c\u1ee7a b\u1ea1n n\u00ean th\u1ea3o lu\u1eadn v\u1edbi nhau v\u1ec1 ti\u1ec1n c\u0103n s\u1ee9c kh\u1ecfe (nh\u1eefng b\u1ec7nh \u0111\u00e3 m\u1eafc ph\u1ea3i trong qu\u00e1 kh\u1ee9) c\u1ee7a b\u1ea1n \u0111\u1ec3 t\u00ecm hi\u1ec3u v\u1ec1 b\u1ea5t k\u1ef3 nguy c\u01a1 kh\u00e1c c\u00f3 th\u1ec3 t\u00e1c \u0111\u1ed9ng l\u00ean tim.<\/p>\n<h2 style=\"text-align: justify\"><strong>Ch\u1ea9n \u0111o\u00e1n c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim<\/strong><\/h2>\n<p style=\"text-align: justify\">N\u1ebfu b\u1ea1n g\u1eb7p c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn tim trong ho\u1eb7c sau khi \u0111i\u1ec1u tr\u1ecb, b\u00e1c s\u0129 c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c x\u00e9t nghi\u1ec7m \u0111\u1ec3 t\u00ecm nguy\u00ean nh\u00e2n. T\u00f9y thu\u1ed9c v\u00e0o k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m ho\u1eb7c y\u00eau c\u1ea7u x\u00e9t nghi\u1ec7m c\u1ea7n thi\u1ebft, b\u00e1c s\u0129 c\u1ee7a b\u1ea1n c\u00f3 th\u1ec3 gi\u1edbi thi\u1ec7u b\u1ea1n \u0111\u1ebfn b\u00e1c s\u0129 chuy\u00ean khoa tim m\u1ea1ch l\u00e0 ng\u01b0\u1eddi chuy\u00ean ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 tim.<\/p>\n<ul style=\"text-align: justify\">\n<li><strong>Kh\u00e1m s\u1ee9c kh\u1ecfe:\u00a0<\/strong>B\u00e1c s\u0129 c\u00f3 th\u1ec3 nghe nh\u1ecbp tim c\u1ee7a b\u1ea1n ho\u1eb7c \u00e2m thanh c\u1ee7a d\u00f2ng m\u00e1u di chuy\u1ec3n qua c\u00e1c m\u1ea1ch m\u00e1u ch\u00ednh \u1edf c\u1ed5. Trong khi th\u1ef1c hi\u1ec7n, b\u00e1c s\u0129 t\u00ecm ki\u1ebfm m\u1ecdi \u00e2m thanh th\u00f4ng th\u01b0\u1eddng ho\u1eb7c nh\u1eefng thay \u0111\u1ed5i l\u00ean nh\u1ecbp tim c\u1ee7a b\u1ea1n. K\u1ebft qu\u1ea3 c\u1ee7a \u0111\u1ee3t ki\u1ec3m tra n\u00e0y s\u1ebd cho bi\u1ebft s\u1ebd c\u1ea7n th\u1ef1c hi\u1ec7n th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c hay kh\u00f4ng.<\/li>\n<li><strong>Si\u00eau \u00e2m tim (echo):<\/strong>\u00a0ECHO l\u00e0 m\u1ed9t th\u1eed nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n, b\u00e1c s\u0129 c\u00f3 th\u1ec3 ki\u1ec3m tra c\u1ea5u tr\u00fac v\u00e0 ch\u1ee9c n\u0103ng c\u1ee7a tim th\u00f4ng qua s\u00f3ng \u00e2m v\u00e0 c\u1ea3m bi\u1ebfn \u0111i\u1ec7n t\u1eed.<\/li>\n<li><strong>Qu\u00e9t \u0111a \u0111i\u1ec3m (MUGA):<\/strong>\u00a0Vi\u1ec7c qu\u00e9t MUGA t\u1ea1o ra h\u00ecnh \u1ea3nh video c\u1ee7a c\u00e1c bu\u1ed3ng gi\u1eef m\u00e1u c\u1ee7a tim (g\u1ecdi l\u00e0 \u201ct\u00e2m th\u1ea5t\u201d) \u0111\u1ec3 ki\u1ec3m tra xem li\u1ec7u ch\u00fang c\u00f3 b\u01a1m m\u00e1u b\u00ecnh th\u01b0\u1eddng hay kh\u00f4ng.<\/li>\n<li><strong>Ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb tim (MRI):<\/strong>\u00a0K\u1ef9 thu\u1eadt MRI s\u1eed d\u1ee5ng t\u1eeb tr\u01b0\u1eddng ch\u1ee9 kh\u00f4ng ph\u1ea3i tia X \u0111\u1ec3 t\u1ea1o ra h\u00ecnh \u1ea3nh chi ti\u1ebft c\u1ee7a c\u01a1 th\u1ec3. MRI tim s\u1ebd cho h\u00ecnh \u1ea3nh c\u1ee7a tim. M\u1ed9t lo\u1ea1i thu\u1ed1c nhu\u1ed9m \u0111\u1eb7c bi\u1ec7t g\u1ecdi l\u00e0 ch\u1ea5t t\u01b0\u01a1ng ph\u1ea3n (contrast medium) \u0111\u01b0\u1ee3c \u0111\u01b0a ra tr\u01b0\u1edbc khi ch\u1ee5p \u0111\u1ec3 t\u1ea1o ra h\u00ecnh \u1ea3nh r\u00f5 r\u00e0ng. Thu\u1ed1c nhu\u1ed9m n\u00e0y th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o t\u0129nh m\u1ea1ch c\u1ee7a b\u1ec7nh nh\u00e2n.<\/li>\n<li><strong>X\u00e9t nghi\u1ec7m m\u00e1u:<\/strong>\u00a0M\u1ed9t s\u1ed1 d\u1ea5u hi\u1ec7u t\u1ed5n th\u01b0\u01a1ng tim c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n trong m\u00e1u. B\u00e1c s\u0129 c\u1ee7a b\u1ea1n c\u00f3 th\u1ec3 ki\u1ec3m tra nh\u1eefng \u0111i\u1ec1u n\u00e0y.<\/li>\n<li><strong>K\u1ef9 thu\u1eadt Angiogram:<\/strong>\u00a0K\u1ef9 thu\u1eadt n\u00e0y ch\u1ee5p \u1ea3nh c\u00e1c m\u1ea1ch m\u00e1u th\u00f4ng qua vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c nhu\u1ed9m \u0111\u01b0\u1ee3c ti\u00eam v\u00e0o \u0111\u1ed9ng m\u1ea1ch. Sau \u0111\u00f3, \u0111\u1ed9ng m\u1ea1ch \u0111\u01b0\u1ee3c ki\u1ec3m tra b\u1eb1ng m\u1ed9t thi\u1ebft b\u1ecb ch\u1ee5p X-quang \u0111\u1eb7c bi\u1ec7t g\u1ecdi l\u00e0 fluoroscope.<\/li>\n<li><strong>X-quang ng\u1ef1c:<\/strong>\u00a0K\u1ef9 thu\u1eadt s\u1ebd cho h\u00ecnh \u1ea3nh b\u00ean trong ng\u1ef1c.<\/li>\n<li><strong>\u0110i\u1ec7n t\u00e2m \u0111\u1ed3 (EKG, ECG):<\/strong>\u00a0M\u1ed9t EKG l\u00e0 m\u1ed9t th\u1eed nghi\u1ec7m kh\u00f4ng x\u00e2m l\u1ea5n \u0111\u1ec3 t\u00ecm nh\u1ecbp tim b\u1ea5t th\u01b0\u1eddng ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng tim.<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\"><strong>Theo d\u00f5i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim<\/strong><\/h2>\n<p style=\"text-align: justify\">B\u00e1c s\u0129 c\u00f3 th\u1ec3 khuy\u00ean b\u1ea1n n\u00ean theo d\u00f5i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim ngay c\u1ea3 khi b\u1ea1n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng. \u0110i\u1ec1u n\u00e0y \u0111\u1eb7c bi\u1ec7t quan tr\u1ecdng \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao g\u1eb7p ph\u1ea3i v\u1ea5n \u0111\u1ec1 c\u1ee7a tim ho\u1eb7c \u0111ang \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb li\u00ean t\u1ee5c v\u1edbi trastuzumab nh\u01b0 \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n ung th\u01b0 v\u00fa di c\u0103n. Hi\u1ec7p h\u1ed9i Ung th\u01b0 l\u00e2m s\u00e0ng Hoa K\u1ef3 (ASCO) \u0111\u00e3 cung c\u1ea5p c\u00e1c khuy\u1ebfn c\u00e1o \u0111\u1ec3 theo d\u00f5i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim. Ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o th\u1ef1c hi\u1ec7n l\u00e0 si\u00eau \u00e2m tim, nh\u01b0ng ph\u01b0\u01a1ng ph\u00e1p MRI tim ho\u1eb7c qu\u00e9t MUGA c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng. Th\u1eed nghi\u1ec7m c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ecbnh k\u1ef3 trong khi \u0111i\u1ec1u tr\u1ecb v\u00e0\/ho\u1eb7c 6 \u0111\u1ebfn 12 th\u00e1ng sau khi k\u1ebft th\u00fac \u0111i\u1ec1u tr\u1ecb ung th\u01b0.<\/p>\n<h2 style=\"text-align: justify\"><strong>Ph\u00f2ng ng\u1eeba v\u00e0 qu\u1ea3n l\u00fd c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim m\u1ea1ch<\/strong><\/h2>\n<p style=\"text-align: justify\">B\u00e1c s\u0129 c\u1ee7a b\u1ea1n c\u00f3 th\u1ec3 \u0111\u1ec1 xu\u1ea5t c\u00e1c l\u1ef1a ch\u1ecdn gi\u00fap b\u1ea1n tr\u00e1nh \u0111\u01b0\u1ee3c nguy c\u01a1 m\u1eafc ph\u1ea3i c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim do \u0111i\u1ec1u tr\u1ecb ung th\u01b0. D\u01b0\u1edbi \u0111\u00e2y l\u00e0 danh s\u00e1ch c\u00e1c t\u00f9y ch\u1ecdn c\u00f3 th\u1ec3 c\u00f3:<\/p>\n<ul style=\"text-align: justify\">\n<li><strong>S\u1eed d\u1ee5ng m\u1ed9t lo\u1ea1i thu\u1ed1c kh\u00e1c:<\/strong>\u00a0Kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 c\u00e1c lo\u1ea1i thu\u1ed1c \u0111\u1ec1u g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim. C\u00f3 th\u1ec3 c\u00f3 c\u00e1c lo\u1ea1i thu\u1ed1c c\u00f3 hi\u1ec7u qu\u1ea3 t\u01b0\u01a1ng \u0111\u01b0\u01a1ng nh\u01b0ng kh\u00f4ng li\u00ean quan \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim.<\/li>\n<li><strong>S\u1eed d\u1ee5ng <span style=\"text-decoration: line-through\">\u00edt<\/span> thu\u1ed1c v\u1edbi li\u1ec1u th\u1ea5p h\u01a1n ho\u1eb7c theo m\u1ed9t c\u00e1ch kh\u00e1c:<\/strong>\u00a0B\u1ea1n c\u00f3 th\u1ec3 nh\u1eadn \u0111\u01b0\u1ee3c m\u1ed9t li\u1ec1u th\u1ea5p h\u01a1n m\u00e0 v\u1eabn c\u00f2n hi\u1ec7u qu\u1ea3 \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb ung th\u01b0 nh\u01b0ng \u00edt c\u00f3 kh\u1ea3 n\u0103ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn tim. B\u00e1c s\u0129 c\u0169ng c\u00f3 th\u1ec3 khuy\u1ebfn c\u00e1o s\u1eed d\u1ee5ng thu\u1ed1c theo c\u00e1ch n\u00e0o \u0111\u00f3 c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m t\u1ed5n th\u01b0\u01a1ng tim.<\/li>\n<li><strong>S\u1eed d\u1ee5ng thu\u1ed1c b\u1ed5 sung c\u00f3 th\u1ec3 gi\u00fap b\u1ea3o v\u1ec7 tim b\u1ea1n kh\u1ecfi b\u1ecb t\u1ed5n th\u01b0\u01a1ng:\u00a0<\/strong>Thu\u1ed1c dexarazoxane (Zinecard) c\u00f3 th\u1ec3 gi\u00fap ng\u0103n ng\u1eeba c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim do anthracycline. Ngo\u00e0i ra c\u00f2n c\u00f3 c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c \u0111ang \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u \u0111\u1ec3 gi\u00fap ng\u0103n ng\u1eeba t\u1ed5n th\u01b0\u01a1ng tim.<\/li>\n<li><strong>Gi\u1ea3m \u1ea3nh h\u01b0\u1edfng c\u1ee7a tia x\u1ea1 l\u00ean tim:<\/strong> \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng li\u1ec1u th\u1ea5p h\u01a1n. Hay c\u00f2n c\u00f3 m\u1ed9t s\u1ed1 k\u1ef9 thu\u1eadt c\u0169ng c\u00f3 th\u1ec3 gi\u00fap tr\u00e1nh l\u00e0m t\u1ed5n th\u01b0\u01a1ng tim nh\u01b0 k\u1ef9 thu\u1eadt x\u1ea1 tr\u1ecb k\u1ebft h\u1ee3p gi\u1eef h\u01a1i th\u1edf s\u00e2u v\u00e0 k\u0129 thu\u1eadt x\u1ea1 tr\u1ecb \u0111i\u1ec1u bi\u1ebfn c\u01b0\u1eddng \u0111\u1ed9 (IMRT). Gi\u1eef h\u01a1i th\u1edf s\u00e2u c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n ung th\u01b0 khi tim c\u00f3 th\u1ec3 b\u1ecb t\u00e1c \u0111\u1ed9ng m\u1ed9t c\u00e1ch kh\u00f4ng c\u1ea7n thi\u1ebft trong qu\u00e1 tr\u00ecnh x\u1ea1 tr\u1ecb. Ph\u01b0\u01a1ng ph\u00e1p n\u00e0y bao g\u1ed3m vi\u1ec7c h\u00edt s\u00e2u v\u00e0 gi\u1eef n\u00f3 trong th\u1eddi gian ng\u1eafn trong khi tia x\u1ea1 \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o c\u01a1 th\u1ec3 b\u1ec7nh nh\u00e2n v\u00e0 IMRT l\u00e0 m\u1ed9t k\u0129 thu\u1eadt x\u1ea1 tr\u1ecb \u0111\u01b0a tia x\u1ea1 tr\u1ef1c ti\u1ebfp hay khu tr\u00fa v\u00e0o kh\u1ed1i u v\u1edbi c\u00e1c c\u01b0\u1eddng \u0111\u1ed9 kh\u00e1c nhau c\u1ee7a ch\u00f9m tia m\u00e0 \u00edt \u1ea3nh h\u01b0\u1edfng l\u00ean c\u00e1c m\u00f4 k\u1ebf c\u1eadn.<\/li>\n<\/ul>\n<p style=\"text-align: justify\">N\u1ebfu xu\u1ea5t hi\u1ec7n v\u1ea5n \u0111\u1ec1 v\u1ec1 tim sau khi \u0111i\u1ec1u tr\u1ecb ung th\u01b0, b\u00e1c s\u0129 c\u00f3 th\u1ec3 \u0111\u1ec1 ngh\u1ecb m\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb. Ch\u00fang c\u00f3 th\u1ec3 bao g\u1ed3m 1 ho\u1eb7c nhi\u1ec1u lo\u1ea1i thu\u1ed1c sau \u0111\u00e2y:<\/p>\n<ul style=\"text-align: justify\">\n<li>Thu\u1ed1c l\u1ee3i ti\u1ec3u, l\u00e0 lo\u1ea1i thu\u1ed1c gi\u00fap lo\u1ea1i b\u1ecf ch\u1ea5t l\u1ecfng d\u01b0 th\u1eeba ra kh\u1ecfi c\u01a1 th\u1ec3 b\u1eb1ng c\u00e1ch t\u0103ng s\u1ef1 \u0111i ti\u1ec3u<\/li>\n<li>Thu\u1ed1c huy\u1ebft \u00e1p, ch\u1eb3ng h\u1ea1n nh\u01b0 thu\u1ed1c \u1ee9c ch\u1ebf ACE ho\u1eb7c thu\u1ed1c beta-blockers<\/li>\n<li>Thu\u1ed1c Digitalis, gi\u00fap \u0111i\u1ec1u ch\u1ec9nh nh\u1ecbp tim<\/li>\n<\/ul>\n<h2 style=\"text-align: justify\"><strong>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/strong><\/h2>\n<p style=\"text-align: justify\"><a href=\"https:\/\/www.cancer.net\/navigating-cancer-care\/side-effects\/heart-problems\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cancer.net\/navigating-cancer-care\/side-effects\/heart-problems<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>V\u1ea5n \u0111\u1ec1 v\u1ec1 tim tuy kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng c\u1ee7a m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0. Ch\u00fang c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u0111\u1ed9c t\u00ednh l\u00ean tim do h\u00f3a ch\u1ea5t.<\/p>\n","protected":false},"author":314,"featured_media":4727,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[2812,2813,2814,2815],"series":[1420],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng<\/title>\n<meta name=\"description\" content=\"V\u1ea5n \u0111\u1ec1 v\u1ec1 tim tuy kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng c\u1ee7a m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0.\" \/>\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\/ung-thu\/cac-van-de-ve-tim\/\" \/>\n<meta property=\"og:locale\" content=\"vi_VN\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 tim - Y H\u1ecdc C\u1ed9ng \u0110\u1ed3ng\" \/>\n<meta property=\"og:description\" content=\"V\u1ea5n \u0111\u1ec1 v\u1ec1 tim tuy kh\u00f4ng ph\u1ed5 bi\u1ebfn nh\u01b0ng l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng c\u1ee7a m\u1ed9t s\u1ed1 ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/cac-van-de-ve-tim\/\" \/>\n<meta property=\"og:site_name\" content=\"D\u1ef1 \u00e1n Ung Th\u01b0\" \/>\n<meta property=\"article:author\" content=\"http:\/\/facebook.com\/buixuanson86\" \/>\n<meta property=\"article:published_time\" content=\"2018-06-14T03:47:58+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-04-29T08:18:08+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/yhoccongdong.com\/ung-thu\/wp-content\/uploads\/sites\/2\/2018\/06\/cac-van-de-ve-tim-20221010-090055.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=\"Ths. 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