{"id":8526,"date":"2020-05-23T04:56:10","date_gmt":"2020-05-22T21:56:10","guid":{"rendered":"https:\/\/yhoccongdong.org\/ung-thu\/hoi-chung-ly-giai-u\/"},"modified":"2020-05-23T04:56:10","modified_gmt":"2020-05-22T21:56:10","slug":"hoi-chung-ly-giai-u","status":"publish","type":"post","link":"https:\/\/yhoccongdong.com\/ung-thu\/hoi-chung-ly-giai-u\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u"},"content":{"rendered":"<h2>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u l\u00e0 g\u00ec?<\/h2>\n<p>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u (TLS) l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 x\u1ea3y ra trong giai \u0111o\u1ea1n \u0111\u1ea7u khi \u0111i\u1ec1u tr\u1ecb ung th\u01b0. Khi c\u00e1c t\u1ebf b\u00e0o ung th\u01b0 ch\u1ebft \u0111i v\u00e0 v\u1ee1 ra, ch\u00fang gi\u1ea3i ph\u00f3ng c\u00e1c ch\u1ea5t v\u00e0o m\u00e1u bao g\u1ed3m kali, photpho v\u00e0 axit nucleic. N\u1ed3ng \u0111\u1ed9 cao c\u1ee7a c\u00e1c ch\u1ea5t n\u00e0y g\u00e2y ra nh\u1eefng bi\u1ebfn \u0111\u1ed5i v\u1ec1 chuy\u1ec3n h\u00f3a m\u00e0 c\u00f3 th\u1ec3 g\u00e2y h\u1ea1i cho tim, th\u1eadn, gan v\u00e0 c\u00e1c c\u01a1 quan kh\u00e1c. H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u li\u00ean quan \u0111\u1ebfn ung th\u01b0.<\/p>\n<p>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u ph\u1ed5 bi\u1ebfn nh\u1ea5t \u1edf b\u1ec7nh nh\u00e2n<a href=\"https:\/\/yhoccongdong.com\/thongtin\/u-lympho-khong-hodgkin-o-tre-em-gioi-thieu\/\" target=\"_blank\" rel=\"noopener\"> U lympho Non-Hodgkin<\/a> ho\u1eb7c<a href=\"https:\/\/yhoccongdong.com\/thongtin\/gioi-thieu-ve-benh-bach-cau-cap-dong-lympho-o-tre-em\/\" target=\"_blank\" rel=\"noopener\"> b\u1ec7nh b\u1ea1ch c\u1ea7u c\u1ea5p<\/a>. Tuy nhi\u00ean, n\u00f3 c\u00f3 th\u1ec3 x\u1ea3y ra khi \u0111i\u1ec1u tr\u1ecb b\u1ea5t k\u1ef3 ung th\u01b0 ti\u1ebfn tri\u1ec3n nhanh kh\u00e1c. N\u1ebfu h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u x\u1ea3y ra sau khi b\u1eaft \u0111\u1ea7u li\u1ec7u ph\u00e1p \u0111i\u1ec1u tr\u1ecb ung th\u01b0, n\u00f3 th\u01b0\u1eddng bi\u1ec3u hi\u1ec7n trong v\u00f2ng 1-3 ng\u00e0y \u0111\u1ea7u. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 nh\u1eefng bi\u1ebfn \u0111\u1ed5i v\u1ec1 chuy\u1ec3n h\u00f3a n\u00e0y ngay c\u1ea3 tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb do s\u1ef1 chuy\u1ec3n h\u00f3a nhanh c\u1ee7a c\u00e1c t\u1ebf b\u00e0o ung th\u01b0. H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n r\u1ea5t nhanh, v\u00e0 b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c y t\u1ebf ngay l\u1eadp t\u1ee9c. C\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u th\u01b0\u1eddng quy \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb bi\u1ebfn \u0111\u1ed5i v\u1ec1 chuy\u1ec3n h\u00f3a tr\u01b0\u1edbc khi ch\u00fang tr\u1edf th\u00e0nh v\u1ea5n \u0111\u1ec1 ho\u1eb7c g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3.<\/p>\n<p>B\u1ec7nh nh\u00e2n m\u1eafc m\u1ed9t s\u1ed1 lo\u1ea1i ung th\u01b0 nh\u01b0 u lympho Burkitt, b\u1ea1ch c\u1ea7u c\u1ea5p d\u00f2ng lympho (ALL), b\u1ea1ch c\u1ea7u c\u1ea5p d\u00f2ng t\u1ee7y (AML) ho\u1eb7c c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd trong giai \u0111o\u1ea1n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. \u0110i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng c\u00f3 th\u1ec3 g\u1ed3m d\u1ecbch truy\u1ec1n t\u0129nh m\u1ea1ch \u0111\u1ec3 b\u00f9 d\u1ecbch v\u00e0 c\u00e1c lo\u1ea1i thu\u1ed1c nh\u01b0 rasburicase ho\u1eb7c allopurinol \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ef1 gia t\u0103ng axit uric, anthanum ho\u1eb7c nh\u00f4m hydroxide (Amphojel\u00ae) \u0111\u1ec3 ki\u1ec3m so\u00e1t s\u1ef1 gia t\u0103ng ph\u1ed1t pho.<\/p>\n<h2>Ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u<\/h2>\n<p>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u c\u00f3 th\u1ec3 g\u00e2y t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan v\u0129nh vi\u1ec5n ho\u1eb7c th\u1eadm ch\u00ed g\u00e2y \u0111\u1ed9t t\u1eed. Tr\u1ebb em c\u00f3 nguy c\u01a1 cao s\u1ebd \u0111\u01b0\u1ee3c theo d\u00f5i m\u1ed9t c\u00e1ch ch\u1eb7t ch\u1ebd.<\/p>\n<p>Ch\u1ea9n \u0111o\u00e1n h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng c\u00e1c <a href=\"https:\/\/yhoccongdong.com\/thongtin\/huong-dan-cho-cac-bac-cha-me-xet-nghiem-va-thu-thuat-y-khoa\/\" target=\"_blank\" rel=\"noopener\">x\u00e9t nghi\u1ec7m m\u00e1u<\/a>. C\u00e1c b\u00e1c s\u0129 t\u00ecm xem c\u00f3 s\u1ef1 bi\u1ebfn \u0111\u1ed5i bao g\u1ed3m:<\/p>\n<ul>\n<li>L\u01b0\u1ee3ng Kali cao<\/li>\n<li>L\u01b0\u1ee3ng Axit uric cao<\/li>\n<li>L\u01b0\u1ee3ng Phospho cao<\/li>\n<li>L\u01b0\u1ee3ng canxi th\u1ea5p<\/li>\n<\/ul>\n<h2>Tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u<\/h2>\n<p>Tri\u1ec7u ch\u1ee9ng c\u1ee7a h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u l\u00e0 do m\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a trong c\u01a1 th\u1ec3. Tr\u1ebb c\u00f3 nguy c\u01a1 m\u1eafc h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd. Trong h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p, s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb tr\u01b0\u1edbc khi c\u00e1c tri\u1ec7u ch\u1ee9ng x\u1ea3y ra. Tuy nhi\u00ean, c\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u c\u00f3 th\u1ec3 bao g\u1ed3m:<\/p>\n<ul>\n<li>Bu\u1ed3n n\u00f4n<\/li>\n<li>N\u00f4n<\/li>\n<li>Ti\u00eau ch\u1ea3y<\/li>\n<li>\u0102n m\u1ea5t ngon<\/li>\n<li>Co gi\u1eadt<\/li>\n<li>Thay \u0111\u1ed5i nh\u1ecbp tim<\/li>\n<li>Chu\u1ed9t r\u00fat ho\u1eb7c co th\u1eaft c\u01a1<\/li>\n<li>Ng\u1ea5t x\u1ec9u<\/li>\n<li>Y\u1ebfu<\/li>\n<li>M\u1ec7t m\u1ecfi ho\u1eb7c li b\u00ec<\/li>\n<li>\u0110au b\u1ee5ng ho\u1eb7c l\u01b0ng<\/li>\n<li>Gi\u1eef n\u01b0\u1edbc, s\u01b0ng n\u1ec1 ho\u1eb7c ph\u00f9<\/li>\n<\/ul>\n<p>Nhi\u1ec1u tri\u1ec7u ch\u1ee9ng trong s\u1ed1 n\u00e0y c\u0169ng c\u00f3 th\u1ec3 l\u00e0 t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a h\u00f3a tr\u1ecb li\u1ec7u ho\u1eb7c c\u00f3 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.<\/p>\n<h2>Y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u<\/h2>\n<p>Lo\u1ea1i ung th\u01b0 th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u \u1edf tr\u1ebb em bao g\u1ed3m b\u1ea1ch c\u1ea7u c\u1ea5p Burkitt hay u lympho Burkitt, b\u1ea1ch c\u1ea7u c\u1ea5p d\u00f2ng lympho (ALL), b\u1ea1ch c\u1ea7u m\u1ea1n d\u00f2ng t\u1ee7y (CML)<\/p>\n<p>C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u1ee7a h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u bao g\u1ed3m:<\/p>\n<ul>\n<li>Ung th\u01b0 \u0111ang ph\u00e1t tri\u1ec3n nhanh<\/li>\n<li>Ung th\u01b0 \u0111\u00e1p \u1ee9ng nhanh v\u1edbi h\u00f3a tr\u1ecb<\/li>\n<li>Kh\u1ed1i u l\u1edbn<\/li>\n<li>Ung th\u01b0 giai \u0111o\u1ea1n ti\u1ebfn tri\u1ec3n<\/li>\n<li>G\u00e1nh n\u1eb7ng ung th\u01b0 l\u1edbn<\/li>\n<\/ul>\n<p>C\u00e1c b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 g\u00e1nh n\u1eb7ng ung th\u01b0 b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng k\u00edch th\u01b0\u1edbc kh\u1ed1i u, s\u1ed1 l\u01b0\u1ee3ng b\u1ea1ch c\u1ea7u, m\u1ee9c Lactac dehydrogenase (LDH) v\u00e0 li\u00ean quan c\u1ee7a t\u1ee7y x\u01b0\u01a1ng.<\/p>\n<p><em><strong>M\u1ed9t s\u1ed1 \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1. Bao g\u1ed3m:<\/strong><\/em><\/p>\n<ul>\n<li>N\u1ed3ng \u0111\u1ed9 axit uric ho\u1eb7c phosphat cao tr\u01b0\u1edbc \u0111i\u1ec1u tr\u1ecb<\/li>\n<li>Ch\u1ee9c n\u0103ng th\u1eadn k\u00e9m<\/li>\n<li>B\u00e0i ni\u1ec7u \u00edt<\/li>\n<li>N\u01b0\u1edbc ti\u1ec3u c\u00f3 t\u00ednh axit<\/li>\n<li>Huy\u1ebft \u00e1p th\u1ea5p<\/li>\n<li>M\u1ea5t n\u01b0\u1edbc<\/li>\n<li>Kh\u1ed1i trung th\u1ea5t<\/li>\n<li>L\u00e1ch l\u1edbn<\/li>\n<\/ul>\n<h2>D\u1ef1 ph\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u<\/h2>\n<p>C\u00e1c b\u01b0\u1edbc sau c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 gi\u00fap d\u1ef1 ph\u00f2ng h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u v\u00e0 \u0111i\u1ec1u tr\u1ecb m\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a n\u1ebfu ch\u00fang x\u1ea3y ra. B\u00f9 d\u1ecbch \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch v\u00e0 thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng cho tr\u1ebb c\u00f3 nguy c\u01a1 cao. \u0110\u1ed1i v\u1edbi m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n, h\u00f3a tr\u1ecb \u00edt x\u00e2m nh\u1eadp c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n trong m\u1ed9t th\u1eddi gian ng\u1eafn tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u tr\u1ecb li\u1ec7u t\u00edch c\u1ef1c \u0111\u1ec3 kh\u1ed1i u ly gi\u1ea3i x\u1ea3y ra ch\u1eadm h\u01a1n. \u0110i\u1ec1u n\u00e0y c\u00f3 th\u1ec3 gi\u00fap x\u1eed tr\u00ed d\u1ec5 d\u00e0ng h\u01a1n, gi\u00fap c\u01a1 th\u1ec3 duy tr\u00ec c\u00e2n b\u1eb1ng h\u00f3a h\u1ecdc v\u00e0 ng\u0103n ng\u1eeba t\u1ed5n th\u01b0\u01a1ng th\u1eadn. \u0110i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u bao g\u1ed3m theo d\u00f5i c\u00e1c x\u00e9t nghi\u1ec7m m\u00e1u, \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u m\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a v\u00e0 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng th\u1eadn.<\/p>\n<h3>X\u00e9t nghi\u1ec7m v\u00e0 theo d\u00f5i tri\u1ec7u ch\u1ee9ng<\/h3>\n<p>B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 cao m\u1eafc h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u n\u00ean \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd, \u0111\u1eb7c bi\u1ec7t l\u00e0 trong tu\u1ea7n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb. Ch\u0103m s\u00f3c y t\u1ebf k\u1ecbp th\u1eddi c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m c\u00e1c t\u00e1c \u0111\u1ed9ng \u0111\u1ed9c h\u1ea1i tr\u00ean c\u01a1 th\u1ec3.<\/p>\n<p>Theo d\u00f5i h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u n\u00ean bao g\u1ed3m:<\/p>\n<ul>\n<li>\u0110\u00e1nh gi\u00e1 c\u00e1c tri\u1ec7u ch\u1ee9ng<\/li>\n<li>\u0110o l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u<\/li>\n<li>X\u00e9t nghi\u1ec7m \u0111\u1ec3 ki\u1ec3m tra n\u1ed3ng \u0111\u1ed9 kali, phosphat, canxi, axit uric, ur\u00ea m\u00e1u (BUN), creatinine v\u00e0 lactate dehydrogenase<\/li>\n<\/ul>\n<p>L\u1ecbch tr\u00ecnh theo d\u00f5i s\u1ebd ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c coi l\u00e0 nguy c\u01a1 cao, trung b\u00ecnh hay th\u1ea5p.<\/p>\n<h3>B\u00f9 d\u1ecbch \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch<\/h3>\n<p>Truy\u1ec1n d\u1ecbch \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch th\u01b0\u1eddng b\u1eaft \u0111\u1ea7u khi ch\u1ea9n \u0111o\u00e1n v\u00e0 ti\u1ebfp t\u1ee5c xuy\u00ean su\u1ed1t qu\u00e1 tr\u00ecnh h\u00f3a tr\u1ecb. B\u00f9 d\u1ecbch \u0111\u1ea7y \u0111\u1ee7 l\u00e0 r\u1ea5t quan tr\u1ecdng \u0111\u1ec3 ng\u0103n ng\u1eeba s\u1ef1 m\u1ea5t c\u00e2n b\u1eb1ng h\u00f3a h\u1ecdc trong m\u00e1u v\u00e0 h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng th\u1eadn. B\u1ec7nh nh\u00e2n c\u00f3 l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u th\u1ea5p s\u1ebd \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n thu\u1ed1c \u0111\u1ec3 gi\u00fap \u0111i ti\u1ec3u (thu\u1ed1c l\u1ee3i ti\u1ec3u) ho\u1eb7c th\u1eadm ch\u00ed th\u1ea9m ph\u00e2n m\u00e1u \u0111\u1ec3 gi\u00fap l\u1ecdc m\u00e1u cho \u0111\u1ebfn khi th\u1eadn c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i.<\/p>\n<h3>Thu\u1ed1c l\u00e0m gi\u1ea3m axit uric<\/h3>\n<p>Thu\u1ed1c d\u00f9ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb axit uric m\u00e1u cao trong h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u \u1edf tr\u1ebb em bao g\u1ed3m allopurinol v\u00e0 rasburicase.<\/p>\n<p>Allopurinol ng\u0103n ng\u1eeba s\u1ef1 h\u00ecnh th\u00e0nh axit uric. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng d\u00f9ng allopurinol 2-3 ng\u00e0y tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u h\u00f3a tr\u1ecb v\u00e0 ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c trong v\u00f2ng 10 &#8211; 14 ng\u00e0y. N\u00f3 ch\u1ee7 y\u1ebfu \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng nh\u01b0 m\u1ed9t lo\u1ea1i thu\u1ed1c d\u1ef1 ph\u00f2ng.<\/p>\n<p>Rasburicase ho\u1ea1t \u0111\u1ed9ng b\u1eb1ng c\u00e1ch ph\u00e2n gi\u1ea3i v\u00e0 l\u00e0m h\u1ea1 axit uric trong m\u00e1u. Thu\u1ed1c t\u00e1c d\u1ee5ng nhanh, th\u01b0\u1eddng c\u00f3 t\u00e1c d\u1ee5ng trong v\u00f2ng 4 gi\u1edd. Rasburicase c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 d\u1ef1 ph\u00f2ng ho\u1eb7c \u0111i\u1ec1u tr\u1ecb axit uric cao. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n b\u1ecb thi\u1ebfu G6PD kh\u00f4ng n\u00ean d\u00f9ng thu\u1ed1c n\u00e0y. Rasburicase c\u0169ng l\u00e0 m\u1ed9t \u0111i\u1ec1u tr\u1ecb c\u00f3 gi\u00e1 th\u00e0nh cao h\u01a1n khi so v\u1edbi allopurinol v\u00e0 nhi\u1ec1u n\u01a1i kh\u00f4ng c\u00f3 s\u1eb5n.<\/p>\n<h3>Thu\u1ed1c l\u00e0m gi\u1ea3m Phosphate<\/h3>\n<p>Thu\u1ed1c c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 l\u00e0m h\u1ea1 n\u1ed3ng \u0111\u1ed9 phosphate trong m\u00e1u. Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0y \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 ch\u1ea5t k\u1ebft d\u00ednh phosphate, g\u1eafn v\u00e0o phosphate \u0111\u1ec3 ng\u0103n ch\u1eb7n n\u00f3 \u0111\u01b0\u1ee3c h\u1ea5p th\u1ee5 t\u1ea1i h\u1ec7 th\u1ed1ng ti\u00eau h\u00f3a. V\u00ed d\u1ee5 v\u1ec1 c\u00e1c lo\u1ea1i thu\u1ed1c n\u00e0y bao g\u1ed3m lanthanum v\u00e0 nh\u00f4m hydroxit (Amphojel\u00ae).<\/p>\n<h3>\u0110i\u1ec1u tr\u1ecb m\u1ea5t c\u00e2n b\u1eb1ng \u0111i\u1ec7n gi\u1ea3i<\/h3>\n<p>M\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a (kali cao, phosphate cao v\u00e0 canxi th\u1ea5p) th\u01b0\u1eddng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch h\u1ed7 tr\u1ee3 ch\u1ee9c n\u0103ng th\u1eadn. Tuy nhi\u00ean, nh\u1eefng m\u1ea5t c\u00e2n b\u1eb1ng n\u00e0y c\u00f3 th\u1ec3 l\u00e0 nguy c\u01a1 t\u1ee9c th\u1eddi cho b\u1ec7nh nh\u00e2n v\u00e0 c\u00f3 th\u1ec3 c\u1ea7n \u0111i\u1ec1u tr\u1ecb \u0111\u1eb7c hi\u1ec7u. Duy tr\u00ec l\u01b0\u1ee3ng d\u1ecbch \u0111\u1ea7y \u0111\u1ee7 l\u00e0 r\u1ea5t quan tr\u1ecdng. M\u1ed9t s\u1ed1 ch\u1ea5t b\u1ed5 sung \u0111i\u1ec7n gi\u1ea3i n\u00ean \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf kh\u1ecfi dich truy\u1ec1n trong qu\u00e1 tr\u00ecnh x\u1eed tr\u00ed h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u.<\/p>\n<h3>Ch\u1ea1y th\u1eadn nh\u00e2n t\u1ea1o<\/h3>\n<p>T\u1ed5n th\u01b0\u01a1ng th\u1eadn l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng ph\u1ed5 bi\u1ebfn c\u1ee7a h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u. Axit uric cao c\u00f3 th\u1ec3 khi\u1ebfn c\u00e1c tinh th\u1ec3 h\u00ecnh th\u00e0nh trong \u1ed1ng th\u1eadn-nh\u1eefng v\u00f9ng nh\u1ecf c\u1ee7a th\u1eadn gi\u00fap l\u1ecdc m\u00e1u. C\u00e1c b\u01b0\u1edbc \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n \u0111\u1ec3 b\u1ea3o v\u1ec7 th\u1eadn bao g\u1ed3m b\u00f9 d\u1ecbch, s\u1eed d\u1ee5ng thu\u1ed1c l\u1ee3i ti\u1ec3u v\u00e0 \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng b\u1eb1ng allopurinol ho\u1eb7c rasburicase. Tuy v\u1eady, ngay c\u1ea3 khi \u0111\u01b0\u1ee3c ch\u0103m s\u00f3c y t\u1ebf \u0111\u1ea7y \u0111\u1ee7, th\u1eadn v\u1eabn c\u00f3 th\u1ec3 ng\u1eebng ho\u1ea1t \u0111\u1ed9ng. B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea7n th\u1ea9m ph\u00e2n m\u00e1u \u0111\u1ec3 l\u1ecdc m\u00e1u cho \u0111\u1ebfn khi th\u1eadn l\u00e0nh. \u0110\u1ed1i v\u1edbi h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n, ch\u1ee9c n\u0103ng th\u1eadn s\u1ebd c\u1ea3i thi\u1ec7n t\u1eeb t\u1eeb theo th\u1eddi gian. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 b\u1ecb t\u1ed5n th\u01b0\u01a1ng th\u1eadn k\u00e9o d\u00e0i sau h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u, ngay c\u1ea3 v\u1edbi c\u00e1c bi\u1ec7n ph\u00e1p d\u1ef1 ph\u00f2ng.<\/p>\n<p>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i kh\u1ed1i u l\u00e0 hi\u1ebfm. Tuy nhi\u00ean, n\u00f3 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng. B\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i ch\u1eb7t ch\u1ebd \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb m\u1ea5t c\u00e2n b\u1eb1ng chuy\u1ec3n h\u00f3a k\u1ecbp th\u1eddi. \u0110i\u1ec1u quan tr\u1ecdng l\u00e0 ph\u1ea3i l\u00e0m theo h\u01b0\u1edbng d\u1eabn v\u1ec1 l\u01b0\u1ee3ng d\u1ecbch \u0111\u01b0a v\u00e0o, ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng v\u00e0 thu\u1ed1c. B\u00e1c s\u0129 c\u00f3 th\u1ec3 gi\u00fap b\u1ea1n hi\u1ec3u h\u1ed9i ch\u1ee9ng ly gi\u1ea3i u v\u00e0 cho bi\u1ebft li\u1ec7u con b\u1ea1n c\u00f3 nguy c\u01a1 hay kh\u00f4ng. Lu\u00f4n lu\u00f4n n\u00f3i chuy\u1ec7n v\u1edbi \u0111\u1ed9i ch\u0103m s\u00f3c c\u1ee7a b\u1ea1n v\u1ec1 b\u1ea5t k\u1ef3 m\u1ed1i quan t\u00e2m s\u1ee9c kh\u1ecfe n\u00e0o v\u00e0 b\u00e1o l\u1ea1i nh\u1eefng thay \u0111\u1ed5i v\u1ec1 tri\u1ec7u ch\u1ee9ng x\u1ea3y ra trong ho\u1eb7c sau \u0111i\u1ec1u tr\u1ecb.<\/p>\n<h1>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/h1>\n<p><a href=\"https:\/\/together.stjude.org\/en-us\/diagnosis-treatment\/side-effects\/tumor-lysis-syndrome.html\" target=\"_blank\" rel=\"noopener\">Tumor Lysis Syndrome<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 x\u1ea3y ra trong giai \u0111o\u1ea1n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb ung th\u01b0. B\u1ec7nh c\u00f3 th\u1ec3 \u0111e d\u1ecda t\u00ednh m\u1ea1ng b\u1ec7nh nh\u00e2n v\u00e0 \u0111\u01b0\u1ee3c coi l\u00e0 tr\u01b0\u1eddng h\u1ee3p c\u1ea5p c\u1ee9u. <\/p>\n","protected":false},"author":471,"featured_media":8527,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[3239],"tags":[2541,3261,2550],"series":[2108],"coauthors":[],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u - D\u1ef1 \u00e1n Ung Th\u01b0<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng ly gi\u1ea3i u l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng nghi\u00eam tr\u1ecdng c\u00f3 th\u1ec3 x\u1ea3y ra trong giai \u0111o\u1ea1n \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb ung th\u01b0. 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