{"id":4258,"date":"2024-11-21T15:51:41","date_gmt":"2024-11-21T08:51:41","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=4258"},"modified":"2024-11-21T15:51:41","modified_gmt":"2024-11-21T08:51:41","slug":"bang-ghi-diem-lam-sang","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/bang-ghi-diem-lam-sang\/","title":{"rendered":"B\u1ea2NG GHI \u0110I\u1ec2M L\u00c2M S\u00c0NG"},"content":{"rendered":"<p><strong>B\u1ea2NG GHI \u0110I\u1ec2M L\u00c2M S\u00c0NG<\/strong><\/p>\n<p><strong>KHOA NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/strong><\/p>\n<p><strong>NH\u00d3M 14<\/strong><\/p>\n<table width=\"666\">\n<tbody>\n<tr>\n<td width=\"52\">\n<p><strong>STT<\/strong><\/p>\n<\/td>\n<td width=\"242\">\n<p><strong>H\u1ecc V\u00c0 T\u00caN<\/strong><\/p>\n<\/td>\n<td width=\"165\">\n<p><strong>MSSV<\/strong><\/p>\n<\/td>\n<td width=\"113\">\n<p><strong>L\u1edaP<\/strong><\/p>\n<\/td>\n<td width=\"94\">\n<p><strong>\u0110I\u1ec2M<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"52\">\n<p><strong>1<\/strong><\/p>\n<\/td>\n<td width=\"242\">\n<p>Nguy\u1ec5n Th\u1ecb Mai Trinh<\/p>\n<\/td>\n<td width=\"165\">\n<p>116019280<\/p>\n<\/td>\n<td width=\"113\">\n<p>DA19YKE<\/p>\n<\/td>\n<td width=\"94\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"52\">\n<p><strong>2<\/strong><\/p>\n<\/td>\n<td width=\"242\">\n<p>Ph\u1ea1m D\u01b0\u01a1ng T\u00f9ng<\/p>\n<\/td>\n<td width=\"165\">\n<p>116019288<\/p>\n<\/td>\n<td width=\"113\">\n<p>DA19YKE<\/p>\n<\/td>\n<td width=\"94\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 X\u00e1c nh\u1eadn c\u1ee7a gi\u1ea3ng vi\u00ean<\/p>\n<p><strong>KHOA NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/strong><\/p>\n<p><strong>B\u1ec6NH \u00c1N NGO\u1ea0I KHOA<\/strong><\/p>\n<p><strong>\u00a0<\/strong>I.\u00a0\u00a0 PH\u1ea6N H\u00c0NH CH\u00cdNH:<\/p>\n<ol>\n<li>H\u1ecd t\u00ean b\u1ec7nh nh\u00e2n: NGUY\u1ec4N TH\u1eca Y.<\/li>\n<li>Tu\u1ed5i: 84 Gi\u1edbi t\u00ednh: N\u1eef D\u00e2n t\u1ed9c: Kinh<\/li>\n<li>Ngh\u1ec1 nghi\u1ec7p: C\u00e1n b\u1ed9 v\u1ec1 h\u01b0u<\/li>\n<li>\u0110\u1ecba ch\u1ec9: s\u1ed1 nh\u00e0 32\/16, \u0111\u01b0\u1eddng G\u00f2 D\u1ea7u, ph\u01b0\u1eddng T\u00e2n Qu\u00fd, Qu\u1eadn T\u00e2n Ph\u00fa, HCM.<\/li>\n<li>Ng\u00e0y gi\u1edd nh\u1eadp vi\u1ec7n: 11 gi\u1edd 30 ph\u00fat, 23\/09\/2024<\/li>\n<li>Ng\u00e0y gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 12 gi\u1edd 15 ph\u00fat, 23\/09\/2024<\/li>\n<li>Chi thu\u1eadn: tay ch\u00e2n ph\u1ea3i.<\/li>\n<li><strong>L\u00dd DO NH\u1eacP VI\u1ec6N: <\/strong>\u0110au h\u00e1ng ph\u1ea3i<\/li>\n<\/ol>\n<h1>III.\u00a0 B\u1ec6NH S\u1eec<\/h1>\n<p>* B\u1ec7nh nh\u00e2n v\u00e0 ng\u01b0\u1eddi nh\u00e0 khai b\u1ec7nh:<\/p>\n<p>C\u00e1ch nh\u1eadp vi\u1ec7n #10 ng\u00e0y, b\u1ec7nh nh\u00e2n \u0111ang \u0111i b\u1ed9 th\u00ec tr\u01b0\u1ee3t ch\u00e2n, ng\u00e3 ti\u1ebfp \u0111\u1ea5t v\u1edbi t\u01b0 th\u1ebf ng\u1ed3i, va \u0111\u1eadp v\u00f9ng m\u00f4ng ph\u1ea3i xu\u1ed1ng s\u00e0n nh\u00e0, kh\u00f4ng ch\u1ed1ng tay, kh\u00f4ng va \u0111\u1eadp \u0111\u1ea7u v\u00e0 c\u00e1c v\u00f9ng kh\u00e1c. Sau ng\u00e3, b\u1ec7nh nh\u00e2n th\u1ea5y \u0111au v\u00f9ng h\u00e1ng v\u00e0 m\u00f4ng ph\u1ea3i, kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng b\u1ea7m t\u00edm, b\u1ec7nh nh\u00e2n kh\u00f4ng t\u1ef1 \u0111\u1ee9ng d\u1eady \u0111\u01b0\u1ee3c, kh\u00f4ng tr\u1ee5 \u0111\u01b0\u1ee3c b\u1eb1ng ch\u00e2n ph\u1ea3i,\u00a0 c\u1ea7n ng\u01b0\u1eddi nh\u00e0 \u0111\u1ee1 d\u1eady. B\u1ec7nh nh\u00e2n u\u1ed1ng thu\u1ed1c (Paracetamol 500mg 1 vi\u00ean s\u00e1ng &#8211; 1 vi\u00ean chi\u1ec1u) v\u00e0 xoa b\u00f3p th\u00ec th\u1ea5y gi\u1ea3m \u0111au sau \u0111\u00f3 kh\u00f4ng x\u1eed tr\u00ed g\u00ec th\u00eam.<\/p>\n<p>Trong 9 ng\u00e0y ti\u1ebfp theo, b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111i l\u1ea1i do \u0111au, ch\u1ec9 \u0111i v\u1ec7 sinh nh\u01b0ng c\u1ea7n ng\u01b0\u1eddi \u0111\u1ee1, kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng b\u1ea7m t\u00edm v\u00f9ng h\u00e1ng. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ng\u01b0\u1eddi nh\u00e0 khuy\u00ean nh\u1eadp vi\u1ec7n nh\u01b0ng t\u1eeb ch\u1ed1i n\u00ean ti\u1ebfp t\u1ee5c d\u00f9ng thu\u1ed1c gi\u1ea3m \u0111au nh\u01b0 tr\u00ean.<\/p>\n<p>C\u00f9ng ng\u00e0y nh\u1eadp vi\u1ec7n, b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u v\u00f9ng h\u00e1ng ph\u1ea3i v\u00e0 kh\u00f4ng th\u1ec3 co du\u1ed7i ch\u00e2n ph\u1ea3i, ng\u01b0\u1eddi nh\u00e0 th\u1ea5y lo l\u1eafng n\u00ean \u0111\u00e3 \u0111\u01b0a b\u1ec7nh nh\u00e2n t\u1edbi nh\u1eadp vi\u1ec7n t\u1ea1i \u00a0B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/p>\n<p>* T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n: (khoa C\u1ea5p c\u1ee9u)<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, GCS 15 \u0111i\u1ec3m<\/li>\n<li>Da ni\u00eam m\u1ea1c h\u1ed3ng, chi \u1ea5m, m\u1ea1ch r\u00f5.<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<\/ul>\n<p>M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat;<\/p>\n<p>Huy\u1ebft \u00e1p: 120\/60mmHg;<\/p>\n<p>Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ph\u00fat;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>SpO2: 96%<\/p>\n<p>Nhi\u1ec7t \u0111\u1ed9: 36,5 \u0111\u1ed9 C<\/p>\n<ul>\n<li>\u0110au ch\u00f3i v\u00f9ng h\u00e1ng b\u00ean (P), ch\u00e2n (P) xoay ngo\u00e0i.<\/li>\n<li>X\u1eed tr\u00ed:<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0 + Paracetamol 1g 01 chai (TTM) C gi\u1ecdt\/ph\u00fat.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0 + Ch\u1ee5p Xquang c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng th\u1eb3ng &#8211; nghi\u00eang, Xquang khung ch\u1eadu th\u1eb3ng, Xquang x\u01b0\u01a1ng \u0111\u00f9i th\u1eb3ng &#8211; nghi\u00eang<\/p>\n<h1>IV.\u00a0 TI\u1ec0N S\u1eec:<\/h1>\n<ol>\n<li>B\u1ea3n th\u00e2n:<\/li>\n<\/ol>\n<ol>\n<li>N\u1ed9i khoa:<\/li>\n<\/ol>\n<ul>\n<li>T\u0103ng huy\u1ebft \u00e1p: ch\u1ea9n \u0111o\u00e1n #10 n\u0103m, t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, tu\u00e2n th\u1ee7 m\u1ed7i ng\u00e0y. Huy\u1ebft \u00e1p cao nh\u1ea5t t\u1eebng ghi nh\u1eadn 160mmHg, huy\u1ebft \u00e1p t\u00e2m thu d\u1ec5 ch\u1ecbu \u0110ang d\u00f9ng Amlodipin 5mg 01 vi\u00ean (s\u00e1ng)<\/li>\n<li>Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u1ea1i b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t c\u00e1ch \u0111\u00e2y 4 n\u0103m, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00f4ng r\u00f5 lo\u1ea1i.<\/li>\n<\/ul>\n<ol>\n<li>Ngo\u1ea1i khoa: Ch\u01b0a ghi nh\u1eadn ti\u1ec1n s\u1eed ph\u1eabu thu\u1eadt<\/li>\n<li>S\u1ea3n khoa: PARA 4004, m\u00e3n kinh n\u0103m 55 tu\u1ed5i.<\/li>\n<li>Th\u00f3i quen: kh\u00f4ng th\u00f3i quen h\u00fat thu\u1ed1c, u\u1ed1ng r\u01b0\u1ee3u<\/li>\n<li>D\u1ecb \u1ee9ng: ch\u01b0a ghi nh\u1eadn d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n.\n<ol start=\"2\">\n<li>Gia \u0111\u00ecnh: ch\u01b0a ghi nh\u1eadn ti\u1ec1n s\u1eed li\u00ean<\/li>\n<\/ol>\n<\/li>\n<\/ol>\n<h1>V.\u00a0\u00a0\u00a0\u00a0 KH\u00c1M L\u00c2M S\u00c0NG: L\u00fac 12 gi\u1edd 15 ng\u00e0y 23\/9\/2024<\/h1>\n<ol>\n<li><strong>T\u1ed5ng tr\u1ea1ng<\/strong><\/li>\n<\/ol>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/li>\n<li>Da ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>Chi \u1ea5m, m\u1ea1ch r\u00f5, CRT &lt;2s<\/li>\n<li>D\u1ea5u v\u00e9o da m\u1ea5t nhanh (&lt;2s)<\/li>\n<li>Ph\u00f9 (-)<\/li>\n<li>H\u1ea1ch ngo\u1ea1i vi s\u1edd kh\u00f4ng ch\u1ea1m, tuy\u1ebfn gi\u00e1p kh\u00f4ng to.<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<\/ul>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 M\u1ea1ch: 80 l\u1ea7n\/ ph\u00fat\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Huy\u1ebft \u00e1p: 120\/70mmHg;<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ ph\u00fat;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nhi\u1ec7t \u0111\u1ed9: 37<sup>\u25cb<\/sup>C.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 SpO2: 98%<\/p>\n<ul>\n<li>Th\u1ec3 tr\u1ea1ng trung b\u00ecnh: BMI: 19.03kg\/m<sup>2 <\/sup>theo IDI&amp;WPRO (CN:40kg. CC:145cm)<\/li>\n<\/ul>\n<ol>\n<li><strong>Kh\u00e1m tu\u1ea7n ho\u00e0n: <\/strong><\/li>\n<\/ol>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169.<\/li>\n<li>M\u1ecfm tim \u1edf khoang li\u00ean s\u01b0\u1eddn V \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i, di\u1ec7n \u0111\u1eadp 1,5&#215;1.5cm.<\/li>\n<li>Rung mi\u00eau (-). D\u1ea5u Harzer (-)<\/li>\n<li>Tim \u0111\u1ec1u t\u1ea7n s\u1ed1 80 l\u1ea7n\/ph\u00fat, T<sub>1<\/sub><sub>,<\/sub>T<sub>2<\/sub> r\u00f5, kh\u00f4ng \u00e2m th\u1ed5i.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li><strong>Kh\u00e1m h\u00f4 h\u1ea5p: <\/strong><\/li>\n<\/ol>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5.<\/li>\n<li>Rung thanh \u0111\u1ec1u 2 b\u00ean<\/li>\n<li>G\u00f5 trong 2 ph\u1ed5i<\/li>\n<li>Ph\u1ed5i kh\u00f4ng ran, r\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu hai ph\u1ebf tr\u01b0\u1eddng<\/li>\n<\/ul>\n<ol start=\"3\">\n<li><strong>Kh\u00e1m c\u01a1 x\u01b0\u01a1ng kh\u1edbp:<\/strong><\/li>\n<\/ol>\n<p>BN n\u1eb1m tr\u00ean gi\u01b0\u1eddng, \u0111ang \u0111eo n\u1eb9p \u0111\u00f9i &#8211; c\u1eb3ng &#8211; b\u00e0n ch\u00e2n (P) ch\u1ed1ng xoay, th\u00e1o n\u1eb9p \u0111\u00e1nh gi\u00e1:<\/p>\n<p><strong>Nh\u00ecn:<\/strong><\/p>\n<ul>\n<li>Ch\u00e2n (T) ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li>Ch\u00e2n (P):<\/li>\n<\/ul>\n<p>+ Kh\u00f4ng v\u1ebft th\u01b0\u01a1ng, kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng b\u1ea7m t\u00edm<\/p>\n<p>+ Kh\u00f4ng sang th\u01b0\u01a1ng, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169.<\/p>\n<p>+ C\u00e1c \u0111\u1ea7u ng\u00f3n ch\u00e2n h\u1ed3ng<\/p>\n<p>+ Ch\u00e2n (P) ng\u1eafn h\u01a1n ch\u00e2n (T) #2cm<\/p>\n<p>+ Ch\u00e2n ph\u1ea3i xoay ngo\u00e0i.<\/p>\n<p><strong>S\u1edd:<\/strong><\/p>\n<p>&#8211;\u00a0\u00a0 C\u00e1c chi \u1ea5m, CRT &lt;2s<\/p>\n<p>&#8211; S\u1ee9c c\u01a1 ch\u00e2n (T): 5\/5, (P): kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do \u0111au<\/p>\n<p>&#8211; Tr\u01b0\u01a1ng l\u1ef1c c\u01a1:<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + \u0110\u1ed9 ch\u1eafc: \u0110\u1ec1u 2 b\u00ean<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + \u0110\u1ed9 ve v\u1ea9y: ch\u00e2n (P) kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do \u0111au, b\u00ean (T) ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + \u0110\u1ed9 do\u00e3i: ch\u00e2n (P) kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do \u0111au, b\u00ean (T) ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>&#8211;\u00a0\u00a0 S\u1edd \u0111\u01b0\u1ee3c c\u00e1c m\u1ed1c x\u01b0\u01a1ng l\u00e0: gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean 2 b\u00ean, m\u1ea5u chuy\u1ec3n l\u1edbn 2 b\u00ean<\/p>\n<p>&#8211;\u00a0 Kh\u00f3 kh\u00e1m l\u1ea1o x\u1ea1o x\u01b0\u01a1ng do b\u1ec7nh nh\u00e2n \u0111au<\/p>\n<p>&#8211;\u00a0 \u1ea4n \u0111au v\u00f9ng tam gi\u00e1c Scarpa ch\u00e2n (P)<\/p>\n<p>&#8211; Tam gi\u00e1c Bryant bi\u1ebfn d\u1ea1ng<\/p>\n<p>&#8211; \u0110\u01b0\u1eddng Nelaton-Roser kh\u00f4ng th\u1eb3ng h\u00e0ng.<\/p>\n<p>&#8211;\u00a0 \u0110\u1ed9ng m\u1ea1ch \u0111\u00f9i, mu ch\u00e2n, ch\u00e0y sau b\u1eaft r\u00f5 \u0111\u1ec1u 2 b\u00ean.<\/p>\n<p>&#8211; C\u1ea3m gi\u00e1c s\u1edd, \u0111au \u1edf v\u00f9ng tr\u01b0\u1edbc \u0111\u00f9i v\u00e0 trong c\u1eb3ng ch\u00e2n c\u00f2n, kh\u00f4ng t\u00ea kh\u00f4ng d\u1ecb c\u1ea3m.<\/p>\n<p><strong>&#8211;\u00a0\u00a0 \u0110o:<\/strong><\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td width=\"274\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"161\">\n<p>Ch\u00e2n (P) (cm)<\/p>\n<\/td>\n<td width=\"151\">\n<p>Ch\u00e2n (T) (cm)<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"274\">\n<p>Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng \u0111\u00f9i<\/p>\n<p>( \u0110o t\u1eeb gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean t\u1edbi l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i)<\/p>\n<\/td>\n<td width=\"161\">\n<p>44<\/p>\n<\/td>\n<td width=\"151\">\n<p>44<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"274\">\n<p>Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i ( \u0110o t\u1eeb m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i t\u1edbi l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i)<\/p>\n<\/td>\n<td width=\"161\">\n<p>37<\/p>\n<\/td>\n<td width=\"151\">\n<p>39<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"274\">\n<p>Chu vi \u0111\u00f9i ( \u0110o t\u1eeb gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean xu\u1ed1ng 15cm)<\/p>\n<\/td>\n<td width=\"161\">\n<p>36<\/p>\n<\/td>\n<td width=\"151\">\n<p>36<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p><strong>&#8211; V\u1eadn \u0111\u1ed9ng:<\/strong><\/p>\n<p>+ H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng (P): Kh\u00f4ng g\u1ea5p-du\u1ed7i, d\u1ea1ng-kh\u00e9p, xoay trong-xoay ngo\u00e0i \u0111\u01b0\u1ee3c do \u0111au.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + V\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng (T): trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/p>\n<ol start=\"5\">\n<li><strong> Kh\u00e1m th\u1ea7n kinh:<\/strong><\/li>\n<\/ol>\n<p>&#8211; B\u1ec7nh nh\u00e2n t\u1ec9nh, GCS 15 \u0111i\u1ec3m<\/p>\n<p>&#8211; Kh\u00f4ng d\u1ea5u th\u1ea7n kinh khu tr\u00fa<\/p>\n<p>&#8211; Kh\u00f4ng d\u1ea5u m\u00e0ng n\u00e3o:<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + C\u1ed5 m\u1ec1m<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + Kernig (-)<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + Brudzinski (-)<\/p>\n<p>&#8211; Nghi\u1ec7m ph\u00e1p Las\u00e8gue (-)<\/p>\n<ol start=\"6\">\n<li><strong> Kh\u00e1m ti\u00eau h\u00f3a:<\/strong><\/li>\n<\/ol>\n<p>&#8211; B\u1ee5ng c\u00e2n \u0111\u1ed1i,di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng b\u00e1ng, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0ng b\u00e0ng h\u1ec7<\/p>\n<p>&#8211; Nhu \u0111\u1ed9ng ru\u1ed9t 8 l\u1ea7n\/2 ph\u00fat, kh\u00f4ng nghe \u00e2m th\u1ed5i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng<\/p>\n<p>&#8211; G\u00f5 trong kh\u1eafp b\u1ee5ng.<\/p>\n<p>&#8211; B\u1ee5ng m\u1ec1m, kh\u00f4ng \u0111i\u1ec3m \u0111au b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>&#8211; Gan kh\u00f4ng to, l\u00e1ch s\u1edd kh\u00f4ng ch\u1ea1m<\/p>\n<ol start=\"7\">\n<li><strong> Kh\u00e1m ti\u1ebft ni\u1ec7u<\/strong><\/li>\n<\/ol>\n<p>&#8211; H\u1ed1 th\u1eaft l\u01b0ng c\u00e2n \u0111\u1ed1i, kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng u c\u1ee5c b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>&#8211; Kh\u00f4ng nghe \u00e2m th\u1ed5i \u0111\u1ed9ng m\u1ea1ch th\u1eadn 2 b\u00ean<\/p>\n<p>&#8211; Ch\u1ea1m th\u1eadn (-)<\/p>\n<p>&#8211; C\u1ea7u b\u00e0ng quang (-)<\/p>\n<ol start=\"8\">\n<li><strong> C\u00e1c c\u01a1 quan kh\u00e1c:<\/strong> ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li><strong> T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N:<\/strong><\/li>\n<\/ol>\n<p>B\u1ec7nh nh\u00e2n n\u1eef, 84 tu\u1ed5i, v\u00e0o vi\u1ec7n v\u00ec \u0111au h\u00e1ng (P) do tai n\u1ea1n sinh ho\u1ea1t ng\u00e0y th\u1ee9 10. Qua th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:<\/p>\n<p>&#8211;\u00a0 C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng:\u00a0 Ng\u00e3 ng\u1ed3i, va \u0111\u1eadp v\u00f9ng m\u00f4ng ph\u1ea3i xu\u1ed1ng s\u00e0n nh\u00e0.<\/p>\n<p>&#8211; D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng: Bi\u1ebfn d\u1ea1ng chi (chi\u1ec1u d\u00e0i ch\u00e2n P&lt;T #2cm), c\u1eed \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng (ch\u00e2n P xoay ngo\u00e0i)<\/p>\n<p>&#8211; D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng: \u1ea4n \u0111au tam gi\u00e1c Scarpa b\u00ean (P), gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng h\u00e1ng (P)<\/p>\n<p>&#8211; Ti\u1ec1n s\u1eed: T\u0103ng huy\u1ebft \u00e1p,tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/p>\n<p><strong>VII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0<\/strong><\/p>\n<p>&#8211; D\u1ea5u hi\u1ec7u g\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i\u00a0 (P)<\/p>\n<p>&#8211; T\u0103ng huy\u1ebft \u00e1p<\/p>\n<p>&#8211; Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/p>\n<p><strong>VI<\/strong><strong>II. CH\u1ea8N \u0110O\u00c1N<\/strong><\/p>\n<ol>\n<li><strong> Ch\u1ea9n \u0111o\u00e1n s\u01a1 b\u1ed9: <\/strong>G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i b\u00ean (P) ng\u00e0y 10 do tai n\u1ea1n sinh ho\u1ea1t, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng &#8211; Theo d\u00f5i lo\u00e3ng x\u01b0\u01a1ng \/ T\u0103ng huy\u1ebft \u00e1p ph\u00e2n \u0111\u1ed9 1 theo ESC 2023 &#8211; Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/li>\n<li><strong>B<\/strong>. <strong>Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:<\/strong> G\u00e3y k\u00edn li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (P) ng\u00e0y 10 do TNSH, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng &#8211; Theo d\u00f5i lo\u00e3ng x\u01b0\u01a1ng \/ T\u0103ng huy\u1ebft \u00e1p ph\u00e2n \u0111\u1ed9 1 theo ESC 2023 &#8211; Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/li>\n<\/ol>\n<p><strong>VIII. BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG:<\/strong><\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Nghi\u0303 nhi\u00ea\u0300u b\u1ec7nh nh\u00e2n g\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i ph\u1ea3i:<\/p>\n<p>+ G\u00e3y x\u01b0\u01a1ng: C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng b\u1ec7nh nh\u00e2n ng\u00e3 ng\u1ed3i, va \u0111\u1eadp v\u00f9ng m\u00f4ng ph\u1ea3i xu\u1ed1ng s\u00e0n nh\u00e0, kha\u0301m co\u0301 d\u00e2\u0301u hi\u00ea\u0323u ch\u0103\u0301c ch\u0103\u0301n ga\u0303y x\u01b0\u01a1ng (bi\u1ebfn d\u1ea1ng chi \u201cchi\u1ec1u d\u00e0i ch\u00e2n P&lt;T #2cm\u201d, c\u1eed \u0111\u1ed9ng b\u1ea5t th\u01b0\u1eddng\u00a0 \u201cch\u00e2n P xoay ngo\u00e0i\u201d) ke\u0300m 2 d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng (\u00e2\u0301n \u0111au ha\u0301ng b\u00ean P, gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng h\u00e1ng P).<\/p>\n<p>+ G\u00e3y k\u00edn v\u00ec kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng h\u1edf t\u1ea1i v\u00f9ng nghi g\u00e3y.<\/p>\n<p>+ Ngh\u0129 nhi\u00ea\u0300u vi\u0323 tri\u0301 g\u00e3y \u01a1\u0309 c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i v\u00ec kha\u0301m l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n co\u0301 d\u00e2\u0301u hi\u00ea\u0323u l\u00e0: \u0111au v\u00f9ng h\u00e1ng (P), \u1ea5n \u0111au v\u00f9ng tam gi\u00e1c Scarpa (P), k\u00e8m kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng b\u1ea7m t\u00edm d\u01b0\u1edbi da v\u00f9ng h\u00e1ng, \u0111\u00f9i (P) \u0111\u00ea\u0300 nghi\u0323 Xquang x\u01b0\u01a1ng \u0111u\u0300i th\u0103\u0309ng\/ nghi\u00eang (chu\u0301 y\u0301 l\u00e2\u0301y qua hai kh\u01a1\u0301p) \u0111\u00ea\u0309 ki\u00ea\u0309m tra.<\/p>\n<p>+ \u00cdt ngh\u0129 g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (P) v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 s\u01b0ng n\u1ec1 nhi\u1ec1u, kh\u00f4ng b\u1ea7m t\u00edm d\u01b0\u1edbi da. Tuy nhi\u00ean c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng \u0111\u1eadp v\u00f9ng m\u00f4ng (P) xu\u1ed1ng n\u1ec1n nh\u00e0, tr\u00ean BN n\u1eef, l\u1edbn tu\u1ed5i n\u00ean ch\u01b0a th\u1ec3 lo\u1ea1i tr\u1eeb.<\/p>\n<p>&#8211; Ngh\u0129 \u0111\u1ebfn lo\u00e3ng x\u01b0\u01a1ng do b\u1ec7nh nh\u00e2n n\u1eef, l\u1edbn tu\u1ed5i k\u00e8m theo g\u00e3y x\u01b0\u01a1ng , c\u00f3 ti\u1ec1n s\u1eed tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng =&gt; \u0111\u1ec1 ngh\u1ecb \u0111o m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p Dexa \u0111\u1ec3 ki\u1ec3m tra v\u00e0 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<p>&#8211; Hi\u1ec7n ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng sau g\u00e3y x\u01b0\u01a1ng:<\/p>\n<p>+ H\u1ed9i ch\u1ee9ng ch\u00e8n \u00e9p khoang: kh\u00e1m v\u00f9ng h\u00e1ng \u0111\u00f9i (P) kh\u00f4ng s\u01b0ng, kh\u00f4ng c\u1ea3m gi\u00e1c t\u00ea b\u00ec, d\u1ecb c\u1ea3m, kh\u00f4ng m\u1ea5t m\u1ea1ch, kh\u00f4ng t\u00e1i nh\u1ee3t, s\u1edd kh\u00f4ng l\u1ea1nh (d\u1ea5u hi\u1ec7u 5P)-&gt; \u00edt ngh\u0129, \u0111\u1ec1 ngh\u1ecb theo d\u00f5i th\u00eam t\u00ecnh tr\u1ea1ng ch\u00e8n \u00e9p khoang di\u1ec5n ti\u1ebfn sau n\u00e0y.<\/p>\n<p>+ R\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng sau ch\u1ea5n th\u01b0\u01a1ng: \u00cdt ngh\u0129 t\u1edbi v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng s\u01b0ng, kh\u00f4ng m\u1ea5t c\u1ea3m gi\u00e1c, kh\u00f4ng teo c\u01a1, m\u00e0u da v\u00e0 nhi\u1ec7t \u0111\u1ed9 c\u1ee7a chi kh\u00f4ng thay \u0111\u1ed5i so v\u1edbi b\u00ean c\u00f2n l\u1ea1i.<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: \u00cdt ngh\u0129 v\u00ec \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i, khoeo, mu ch\u00e2n, ch\u00e0y sau b\u1eaft r\u00f5 2 b\u00ean; chi \u1ea5m.<\/p>\n<p>+ T\u00f4\u0309n th\u01b0\u01a1ng th\u1ea7n kinh: i\u0301t nghi\u0303 t\u01a1\u0301i vi\u0300 b\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c n\u00f4ng &#8211; s\u00e2u, c\u1ea3m gi\u00e1c \u0111au \u1edf v\u00f9ng tr\u01b0\u1edbc \u0111\u00f9i v\u00e0 m\u1eb7t trong c\u1eb3ng ch\u00e2n, \u0111\u1ecbnh h\u01b0\u1edbng \u0111\u01b0\u1ee3c v\u1ecb tr\u00ed, t\u01b0 th\u1ebf c\u00e1c ng\u00f3n ch\u00e2n, kh\u00f4ng c\u1ea3m gi\u00e1c t\u00ea b\u00ec.<\/p>\n<p>&#8211; B\u1ec7nh nh\u00e2n n\u01b0\u0303 l\u01a1\u0301n tu\u00f4\u0309i nghi\u0303 nhi\u00ea\u0300u ga\u0303y c\u00f4\u0309 x\u01b0\u01a1ng \u0111u\u0300i (P) #10 nga\u0300y, ha\u0323n ch\u00ea\u0301 v\u00e2\u0323n \u0111\u00f4\u0323ng va\u0300 \u0111i la\u0323i n\u00ean ch\u01b0a th\u00ea\u0309 loa\u0323i tr\u01b0\u0300 ca\u0301c bi\u00ea\u0301n ch\u01b0\u0301ng b\u00e2\u0301t \u0111\u00f4\u0323ng do ga\u0303y x\u01b0\u01a1ng:<\/p>\n<p>+ Vi\u00eam ph\u00f4\u0309i: B\u1ec7nh nh\u00e2n kh\u00f4ng co\u0301 d\u00e2\u0301u hi\u00ea\u0323u vi\u00eam long \u0111\u01b0\u01a1\u0300ng h\u00f4 h\u00e2\u0301p tr\u00ean, kh\u00f4ng co\u0301 d\u00e2\u0301u hi\u00ea\u0323u nhi\u00ea\u0303m tru\u0300ng, kha\u0301m c\u01a1 quan h\u00f4 h\u00e2\u0301p ch\u01b0a ghi nh\u00e2\u0323n b\u00e2\u0301t th\u01b0\u01a1\u0300ng n\u00ean i\u0301t nghi\u0303 \u0111\u00ea\u0301n -&gt; \u0111\u00ea\u0300 nghi\u0323 Xquang ng\u01b0\u0323c th\u0103\u0309ng \u0111\u00ea\u0309 ki\u00ea\u0309m tra.<\/p>\n<p>+ Nhi\u00ea\u0303m tru\u0300ng ti\u00ea\u0301t ni\u00ea\u0323u: B\u1ec7nh nh\u00e2n kh\u00f4ng co\u0301 ti\u00ea\u0309u g\u0103\u0301t, ti\u00ea\u0309u bu\u00f4\u0301t, kh\u00f4ng co\u0301 d\u00e2\u0301u hi\u00ea\u0323u nhi\u00ea\u0303m tru\u0300ng, kha\u0301m c\u01a1 quan th\u00e2\u0323n-ti\u00ea\u0301t ni\u00ea\u0323u ch\u01b0a ghi nh\u00e2\u0323n b\u00e2\u0301t th\u01b0\u01a1\u0300ng n\u00ean i\u0301t nghi\u0303 \u0111\u00ea\u0301n -&gt; \u0111\u00ea\u0300 nghi\u0323 T\u00f4\u0309ng ph\u00e2n ti\u0301ch n\u01b0\u01a1\u0301c ti\u00ea\u0309u \u0111\u00ea\u0309 ki\u00ea\u0309m tra.<\/p>\n<p>+ Huy\u00ea\u0301t kh\u00f4\u0301i ti\u0303nh ma\u0323ch s\u00e2u: \u0111a\u0301nh gia\u0301 theo thang \u0111i\u00ea\u0309m Padua &gt; 4 (BN 84 tu\u00f4\u0309i, m\u01a1\u0301i bi\u0323 ch\u00e2\u0301n th\u01b0\u01a1ng #10 nga\u0300y, b\u1ea5t \u0111\u1ed9ng do b\u1ec7nh nh\u00e2n \u0111au 3\u0111. T\u00f4\u0309ng \u0111i\u00ea\u0309m 7 \u0111i\u00ea\u0309m) co\u0301 nguy c\u01a1 cao thuy\u00ean t\u0103\u0301c huy\u00ea\u0301t kh\u00f4\u0301i ti\u0303nh ma\u0323ch s\u00e2u n\u00ean c\u1ea7n \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p d\u1ef1 ph\u00f2ng b\u1eb1ng thu\u1ed1c.<\/p>\n<p>+ Loe\u0301t ti\u0300 \u0111e\u0300: kha\u0301m b\u00ea\u0323nh nh\u00e2n hi\u00ea\u0323n ta\u0323i ch\u01b0a ghi nh\u00e2\u0323n b\u00e2\u0301t th\u01b0\u01a1\u0300ng (vu\u0300ng cu\u0300ng cu\u0323t, khuy\u0309u tay, vu\u0300ng vai,..\u00a0 ch\u01b0a ghi nh\u00e2\u0323n v\u00ea\u0301t th\u01b0\u01a1ng, ma\u0300u s\u0103\u0301c da kh\u00f4ng thay \u0111\u00f4\u0309i) tuy nhi\u00ean v\u01a1\u0301i b\u00ea\u0323nh nh\u00e2n ga\u0303y c\u00f4\u0309 x\u01b0\u01a1ng \u0111u\u0300i ha\u0323n ch\u00ea\u0301 v\u00e2\u0323n \u0111\u00f4\u0323ng, \u0111i la\u0323i ch\u01b0a th\u00ea\u0309 loa\u0323i tr\u01b0\u0300, \u0111\u00ea\u0309 \u0111\u00ea\u0300 pho\u0300ng t\u01b0 v\u00e2\u0301n ng\u01b0\u01a1\u0300i nha\u0300 th\u01b0\u01a1\u0300ng xuy\u00ean thay \u0111\u00f4\u0309i t\u01b0 th\u00ea\u0301 cho BN tra\u0301nh ti\u0300nh tra\u0323ng ti\u0300 \u0111e\u0300 d\u00e2\u0303n \u0111\u00ea\u0301n loe\u0301t.<\/p>\n<p>+ Ta\u0301o bo\u0301n: B\u1ec7nh nh\u00e2n n\u0103\u0300m b\u00e2\u0301t \u0111\u00f4ng l\u00e2u nga\u0300y d\u00ea\u0303 d\u00e2\u0303n \u0111\u00ea\u0301n ti\u0300nh tra\u0323ng ta\u0301o bo\u0301n, t\u01b0 v\u00e2\u0301n b\u00ea\u0323nh nh\u00e2n n\u00ean b\u00f4\u0309 sung th\u01b0\u0323c ph\u00e2\u0309m nhi\u00ea\u0300u ch\u00e2\u0301t x\u01a1, u\u00f4\u0301ng \u0111u\u0309 n\u01b0\u01a1\u0301c \u0111\u00ea\u0309 \u0111\u00ea\u0300 pho\u0300ng ta\u0301o bo\u0301n<\/p>\n<p>+ Teo c\u01a1, c\u01b0\u0301ng kh\u01a1\u0301p: B\u1ec7nh nh\u00e2n ha\u0323n ch\u00ea\u0301 v\u00e2\u0323n \u0111\u00f4\u0323ng \u0111i la\u0323i d\u00ea\u0303 d\u00e2\u0303n \u0111\u00ea\u0301n ti\u0300nh tra\u0323ng teo c\u01a1, c\u01b0\u0301ng kh\u01a1\u0301p do bi\u00ea\u0301n ch\u01b0\u0301ng b\u00e2\u0301t \u0111\u00f4\u0323ng l\u00e2u nga\u0300y, \u0111\u00ea\u0309 d\u01b0\u0323 pho\u0300ng t\u01b0 v\u00e2\u0301n BN t\u00e2\u0323p v\u00e2\u0323t ly\u0301 tri\u0323 li\u00ea\u0323u &#8211; phu\u0323c h\u00f4\u0300i ch\u01b0\u0301c n\u0103ng sau \u0111i\u00ea\u0300u tri\u0323 ga\u0303y x\u01b0\u01a1ng.<\/p>\n<ol>\n<li><strong> C\u1eacN L\u00c2M S\u00c0NG <\/strong><\/li>\n<li><strong> \u0110\u1ec1 ngh\u1ecb c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/li>\n<\/ol>\n<p>&#8211; \u0110o m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p DEXA<\/p>\n<p>&#8211; C\u00e1c x\u00e9t nghi\u1ec7m th\u01b0\u1eddng quy:<\/p>\n<p>T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi, sinh h\u00f3a m\u00e1u (Glucose, Ure, Creatinin, AST,ALT), \u0111\u00f4ng c\u1ea7m m\u00e1u, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3, \u0111o \u0111i\u1ec7n tim, xquang ng\u1ef1c th\u1eb3ng, t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u.<\/p>\n<ol>\n<li><strong> C\u1eadn l\u00e2m s\u00e0ng \u0111\u00e3 c\u00f3<\/strong><\/li>\n<li><strong> T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi &#8211; \u0110\u00f4ng c\u1ea7m m\u00e1u.<\/strong><\/li>\n<\/ol>\n<table>\n<tbody>\n<tr>\n<td width=\"128\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p><strong>K\u1ebft qu\u1ea3<\/strong><\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>WBC<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>9.54<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>4.01 &#8211; 11.42<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>NEU#<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>6.10<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>1.7 &#8211; 7.5<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>LYM#<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>2.55<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>1.2 &#8211; 4.0<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>MONO#<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>0.72<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>0.2 &#8211; 0.8<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>EOS#<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>1.5<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>0.0 &#8211; 0.6<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>BASO#<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>0.03<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>0.0 &#8211; 0.1<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>RBC<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>4.21<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>4.01 &#8211; 5.79<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>M\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>HGB<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>11.8<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>11.5 &#8211; 15.0<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>g\/dL<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>PLT<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>302<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>150-450<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>K\/uL<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u00a0K\u1ebft lu\u1eadn: <\/strong>C\u00e1c ch\u1ec9 s\u1ed1 trong gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng<\/p>\n<ol start=\"2\">\n<li><strong>Sinh h\u00f3a m\u00e1u, \u0111i\u1ec7n gi\u1ea3i \u0111\u1ed3:<\/strong><\/li>\n<\/ol>\n<table>\n<tbody>\n<tr>\n<td width=\"128\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p><strong>K\u1ebft qu\u1ea3<\/strong><\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Glucose<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>4.7<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>4.1 &#8211; 5.9<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Ur\u00ea<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>6.7<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>2.8 &#8211; 7.2<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Creatinin<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>11.8<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>umol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>eGFR<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>302<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>&gt;=60<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>ml\/ph\u00fat<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>AST<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>19<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>&lt;35<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>U\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>ALT<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>14<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>&lt;35<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>U\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" width=\"602\">\n<p><strong>\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Na+<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>142<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>135 &#8211; 145<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>K+<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>3.6<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>3.5 &#8211; 5.0<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Cl-<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>103<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>98 &#8211; 106<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>Calci<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>2.18<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>2.15 &#8211; 2.6<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>mmol\/L<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" width=\"602\">\n<p><strong>\u0110\u00f4ng m\u00e1u<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>aPTT<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>25.7<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>25 &#8211; 37<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>s<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>PT<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>14<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>9.3 &#8211; 14.3<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>s<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>TL Prothrombin<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>95<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>&gt;70<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>%<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>INR<\/strong><\/p>\n<\/td>\n<td width=\"128\">\n<p>1.03<\/p>\n<\/td>\n<td width=\"213\">\n<p><strong>0.84-1.29<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u00a0K\u1ebft lu\u1eadn: <\/strong>C\u00e1c ch\u1ec9 s\u1ed1 trong gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng<\/p>\n<ol start=\"3\">\n<li><strong>T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/strong><\/li>\n<\/ol>\n<p><strong>\u00a0K\u1ebft lu\u1eadn: <\/strong>C\u00e1c ch\u1ec9 s\u1ed1 trong gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng<\/p>\n<p>&nbsp;<\/p>\n<ol start=\"4\">\n<li><strong>Si\u00eau \u00e2m doppler tim:<\/strong><\/li>\n<\/ol>\n<p><strong>K\u1ebft lu\u1eadn:\u00a0\u00a0\u00a0\u00a0 <\/strong>&#8211; Ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i b\u1ea3o t\u1ed3n, EF 77 %<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; H\u1edf van 3 l\u00e1\u00a0 1\/4, H\u1edf van \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 &lt; 1\/4<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; Van \u0110MC d\u00e0y, v\u00f4i h\u00f3a.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; C\u00e1c bu\u1ed3ng tim kh\u00f4ng d\u00e3n<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<ol start=\"5\">\n<li><strong>X-quang khung ch\u1eadu th\u1eb3ng.<\/strong><\/li>\n<\/ol>\n<figure id=\"attachment_4259\" aria-describedby=\"caption-attachment-4259\" style=\"width: 717px\" class=\"wp-caption alignnone\"><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/x-quang.png\" height=\"701\" width=\"717\" class=\"size-full wp-image-4259\" alt=\"2. H\u00ecnh X-quang b\u1ee5ng ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng, th\u1ec3 hi\u1ec7n x\u01b0\u01a1ng ch\u1eadu, c\u1ed9t s\u1ed1ng v\u00e0 c\u00e1c t\u1ed5n th\u01b0\u01a1ng n\u1ed9i t\u1ea1ng.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/x-quang.png 717w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/x-quang-300x293.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/x-quang-12x12.png 12w\" sizes=\"(max-width: 717px) 100vw, 717px\" \/><figcaption id=\"caption-attachment-4259\" class=\"wp-caption-text\">X-quang<\/figcaption><\/figure>\n<p><strong>* M\u00d4 T\u1ea2:<\/strong><\/p>\n<p>Phim Xquang \u1ee7a b\u1ec7nh nh\u00e2n NGUY\u1ec4N TH\u1eca Y 84 tu\u1ed5i, ch\u1ee5p ng\u00e0y 23\/9\/2024<\/p>\n<p>T\u01b0 th\u1ebf ch\u1ee5p: th\u1eb3ng<\/p>\n<p>Ch\u1ea5t l\u01b0\u1ee3ng phim: 100%<\/p>\n<p>C\u01b0\u1eddng \u0111\u1ed9 tia: \u0111\u1ee7<\/p>\n<p>\u0110\u1ecdc phim:<\/p>\n<p>&#8211; Kh\u00f4ng ph\u00f9 n\u1ec1 m\u00f4 m\u1ec1m xung quanh kh\u1edbp h\u00e1ng (P)<\/p>\n<p>&#8211; \u0110\u01b0\u1eddng Shenton (P) m\u1ea5t li\u00ean t\u1ee5c<\/p>\n<p>&#8211; Kh\u00f4ng ghi nh\u1eadn h\u00ecnh \u1ea3nh tr\u1eadt kh\u1edbp h\u00e1ng<\/p>\n<p>&#8211; Kh\u00f4ng ghi nh\u1eadn h\u00ecnh \u1ea3nh g\u1ee3i \u00fd g\u00e3y x\u01b0\u01a1ng ch\u1eadu k\u00e8m theo<\/p>\n<p>&#8211; X\u01b0\u01a1ng g\u00e3y: X\u01b0\u01a1ng \u0111\u00f9i (P)<\/p>\n<p>&#8211; V\u1ecb tr\u00ed g\u00e3y: C\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i<\/p>\n<p>&#8211; \u0110\u01b0\u1eddng g\u00e3y: ch\u00e9o<\/p>\n<p>&#8211; Di l\u1ec7ch: ch\u1ed3ng ng\u1eafn<\/p>\n<p><strong>K\u1ebft lu\u1eadn<\/strong>: G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i ph\u00e2n \u0111\u1ed9 III theo Garden ng\u00e0y th\u1ee9 10<\/p>\n<ol start=\"6\">\n<li><strong>X-quang x\u01b0\u01a1ng \u0111\u00f9i th\u1eb3ng nghi\u00eang.<\/strong><\/li>\n<\/ol>\n<figure id=\"attachment_4260\" aria-describedby=\"caption-attachment-4260\" style=\"width: 602px\" class=\"wp-caption alignnone\"><img decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/xuong-dui-nghieng.png\" height=\"702\" width=\"602\" class=\"size-full wp-image-4260\" alt=\"H\u00ecnh \u1ea3nh X-quang x\u01b0\u01a1ng \u0111\u00f9i t\u1edbi b\u00e0n ch\u00e2n, \u0111\u00e1nh gi\u00e1 c\u1ea5u tr\u00fac v\u00e0 ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd x\u01b0\u01a1ng kh\u1edbp.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/xuong-dui-nghieng.png 602w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/xuong-dui-nghieng-257x300.png 257w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/xuong-dui-nghieng-10x12.png 10w\" sizes=\"(max-width: 602px) 100vw, 602px\" \/><figcaption id=\"caption-attachment-4260\" class=\"wp-caption-text\">Xuong Dui Nghieng<\/figcaption><\/figure>\n<ol start=\"7\">\n<li><strong>X-quang c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng th\u1eb3ng &#8211; nghi\u00eang<\/strong><\/li>\n<\/ol>\n<figure id=\"attachment_4261\" aria-describedby=\"caption-attachment-4261\" style=\"width: 451px\" class=\"wp-caption alignnone\"><img decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/X-quang-cot-song-that-lung-thang-nghieng.png\" height=\"701\" width=\"451\" class=\"size-full wp-image-4261\" alt=\"H\u00ecnh ch\u1ee5p X-quang b\u1ee5ng gi\u00fap \u0111\u00e1nh gi\u00e1 ch\u00ednh x\u00e1c c\u1ea5u tr\u00fac v\u00e0 t\u1ed5n th\u01b0\u01a1ng trong \u1ed5 b\u1ee5ng.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/X-quang-cot-song-that-lung-thang-nghieng.png 451w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/X-quang-cot-song-that-lung-thang-nghieng-193x300.png 193w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/X-quang-cot-song-that-lung-thang-nghieng-8x12.png 8w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><figcaption id=\"caption-attachment-4261\" class=\"wp-caption-text\">X-quang C\u1ed9t S\u1ed1ng Th\u1eaft L\u01b0ng Th\u1eb3ng &#8211; Nghi\u00eang<\/figcaption><\/figure>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong><\/p>\n<p>&#8211; Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng, tho\u00e1i h\u00f3a kh\u1edbp h\u00e1ng.<\/p>\n<p>&#8211; Tr\u01b0\u1ee3t \u0111\u1ed1t s\u1ed1ng L5 ra tr\u01b0\u1edbc \u0111\u1ed9 II<\/p>\n<p>&#8211; X\u1eb9p T12, L3, L4, L5.<\/p>\n<ol start=\"8\">\n<li><strong>Xquang ng\u1ef1c th\u1eb3ng<\/strong><\/li>\n<\/ol>\n<figure id=\"attachment_4262\" aria-describedby=\"caption-attachment-4262\" style=\"width: 588px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Xquang-nguc-thang.png\" height=\"588\" width=\"588\" class=\"size-full wp-image-4262\" alt=\"Ch\u1ea9n \u0111o\u00e1n h\u00ecnh \u1ea3nh ph\u1ed5i ch\u1ea5t l\u01b0\u1ee3ng cao, b\u00e1c s\u0129 V\u00f5 Th\u00e0nh To\u00e0n, \u0111\u00e1nh gi\u00e1 chi ti\u1ebft.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Xquang-nguc-thang.png 588w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Xquang-nguc-thang-300x300.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Xquang-nguc-thang-150x150.png 150w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Xquang-nguc-thang-12x12.png 12w\" sizes=\"(max-width: 588px) 100vw, 588px\" \/><figcaption id=\"caption-attachment-4262\" class=\"wp-caption-text\">Xquang Ng\u1ef1c Th\u1eb3ng<\/figcaption><\/figure>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong> Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng tr\u00ean phim xquang<\/p>\n<ol start=\"9\">\n<li><strong>\u0110o m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng.<\/strong><\/li>\n<\/ol>\n<p><figure id=\"attachment_4263\" aria-describedby=\"caption-attachment-4263\" style=\"width: 1057px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3.png\" height=\"445\" width=\"1057\" class=\"size-full wp-image-4263\" alt=\"H\u00ecnh \u1ea3nh ki\u1ec3m tra l\u00e2m s\u00e0ng PGS. TS. BS V\u00f5 Th\u00e0nh To\u00e0n.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3.png 1057w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3-300x126.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3-1024x431.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3-768x323.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-3-18x8.png 18w\" sizes=\"(max-width: 1057px) 100vw, 1057px\" \/><figcaption id=\"caption-attachment-4263\" class=\"wp-caption-text\">\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 3<\/figcaption><\/figure> <figure id=\"attachment_4264\" aria-describedby=\"caption-attachment-4264\" style=\"width: 1138px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4264\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2.png\" alt=\"\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 2\" width=\"1138\" height=\"312\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2.png 1138w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2-300x82.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2-1024x281.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2-768x211.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-2-18x5.png 18w\" sizes=\"(max-width: 1138px) 100vw, 1138px\" \/><figcaption id=\"caption-attachment-4264\" class=\"wp-caption-text\">\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 2<\/figcaption><\/figure> <figure id=\"attachment_4265\" aria-describedby=\"caption-attachment-4265\" style=\"width: 1084px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4265\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1.png\" alt=\"\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 1\" width=\"1084\" height=\"508\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1.png 1084w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1-300x141.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1-1024x480.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1-768x360.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-1-18x8.png 18w\" sizes=\"(max-width: 1084px) 100vw, 1084px\" \/><figcaption id=\"caption-attachment-4265\" class=\"wp-caption-text\">\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 1<\/figcaption><\/figure> <figure id=\"attachment_4266\" aria-describedby=\"caption-attachment-4266\" style=\"width: 1166px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-4266\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4.png\" alt=\"\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 4\" width=\"1166\" height=\"325\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4.png 1166w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4-300x84.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4-1024x285.png 1024w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4-768x214.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/11\/Do-mat-do-xuong-4-18x5.png 18w\" sizes=\"(max-width: 1166px) 100vw, 1166px\" \/><figcaption id=\"caption-attachment-4266\" class=\"wp-caption-text\">\u0110o M\u1eadt \u0111\u1ed9 X\u01b0\u01a1ng 4<\/figcaption><\/figure><\/p>\n<p><strong>=&gt; K\u1ebft lu\u1eadn: Lo\u00e3ng x\u01b0\u01a1ng n\u1eb7ng do c\u00f3 T-score &lt;-2.5 v\u00e0 g\u00e3y x\u01b0\u01a1ng k\u00e8m theo.<\/strong><\/p>\n<ol>\n<li><strong> CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong><\/li>\n<\/ol>\n<p>G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i (P) ph\u00e2n \u0111\u1ed9 III theo Garden ng\u00e0y 10 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\u00a0 &#8211; Tho\u00e1i h\u00f3a kh\u1edbp h\u00e1ng &#8211; Lo\u00e3ng x\u01b0\u01a1ng n\u1eb7ng\/ T\u0103ng huy\u1ebft \u00e1p ph\u00e2n \u0111\u1ed9 1 theo ESC 2023 &#8211; Tho\u00e1i h\u00f3a c\u1ed9t s\u1ed1ng th\u1eaft l\u01b0ng<\/p>\n<ol>\n<li><strong> \u0110I\u1ec0U TR\u1eca<\/strong><\/li>\n<li><strong> H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/strong><\/li>\n<\/ol>\n<p>&#8211; B\u1ea5t \u0111\u1ed9ng chi g\u00e3y<\/p>\n<p>&#8211; Gi\u1ea3m \u0111au<\/p>\n<p>&#8211; Ki\u1ec3m so\u00e1t b\u1ec7nh l\u00fd n\u1ec1n: Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p<\/p>\n<p>&#8211; D\u1ef1 ph\u00f2ng huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch.<\/p>\n<p>&#8211; \u0110i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 t\u00ecnh tr\u1ea1ng lo\u00e3ng x\u01b0\u01a1ng<\/p>\n<p>&#8211; \u0110i\u1ec1u tr\u1ecb g\u00e3y x\u01b0\u01a1ng: Ph\u1eabu thu\u1eadt<\/p>\n<ol>\n<li>\u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/li>\n<\/ol>\n<p>&#8211; N\u1eb9p \u0111\u00f9i &#8211; c\u1eb3ng &#8211; b\u00e0n ch\u00e2n (P) ch\u1ed1ng xoay<\/p>\n<p>&#8211; Paracetamol 500mg 01 vi\u00ean x 3 u\u1ed1ng ( 8g-14g-20g)<\/p>\n<p>&#8211; Amlodipine: 5mg 01 vi\u00ean u\u1ed1ng (8g)<\/p>\n<p>&#8211; Levonox 40mg\/0.4ml 01 \u1ed1ng (ti\u00eam d\u01b0\u1edbi da)<\/p>\n<p>&#8211; Caldihasan 1250mg + 125IU\u00a0[\u00a0Calci carbonat + vitamin D3\u00a0] 01 vi\u00ean u\u1ed1ng (s\u00e1ng)<\/p>\n<p>&#8211; T\u01b0 v\u1ea5n ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng b\u00e1n ph\u1ea7n<\/p>\n<p>Ch\u0103m s\u00f3c c\u1ea5p III<\/p>\n<p>Theo d\u00f5i sinh hi\u1ec7u, tri gi\u00e1c\/12 gi\u1edd<\/p>\n<p>Dinh d\u01b0\u1ee1ng: C\u01a1m TM01<\/p>\n<ol>\n<li><strong> TI\u00caN L\u01af\u1ee2NG<\/strong>:<\/li>\n<\/ol>\n<ol>\n<li>G\u1ea7n: trung b\u00ecnh.<\/li>\n<\/ol>\n<p>Hi\u1ec7n t\u1ed5ng tr\u1ea1ng \u1ed5n, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng. Tuy nhi\u00ean b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, c\u00f3 b\u1ec7nh n\u1ec1n, nguy c\u01a1 t\u00e9 ng\u00e3 cao. C\u1ea7n t\u01b0 v\u1ea5n nguy c\u01a1 g\u00e2y m\u00ea, g\u00e2y t\u00ea, nguy c\u01a1 ch\u1ea3y m\u00e1u trong khi m\u1ed5 v\u00e0 nhi\u1ec5m tr\u00f9ng sau m\u1ed5<\/p>\n<ol start=\"2\">\n<li>Xa: trung b\u00ecnh.<\/li>\n<\/ol>\n<p>C\u00e1c bi\u1ebfn ch\u1ee9ng b\u1ea5t \u0111\u1ed9ng sau m\u1ed5 nh\u01b0 teo c\u01a1, c\u1ee9ng kh\u1edbp, lo\u00e9t t\u00ec \u0111\u00e8, vi\u00eam ph\u1ed5i. Kh\u1ea3 n\u0103ng \u0111i l\u1ea1i ph\u1ee5 thu\u1ed9c v\u00e0o s\u1ef1 ph\u1ed1i h\u1ee3p t\u1eadp v\u1eadt l\u00fd tr\u1ecb li\u1ec7u c\u1ee7a b\u1ec7nh nh\u00e2n<\/p>\n<ol>\n<li><strong> D\u1ef0 PH\u00d2NG:<\/strong><\/li>\n<\/ol>\n<p>&#8211; Theo d\u00f5i h\u00e0ng ng\u00e0y sau m\u1ed5, ph\u00f2ng tr\u00e1nh nhi\u1ec5m tr\u00f9ng<\/p>\n<p>&#8211; T\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng s\u1edbm sau \u0111i\u1ec1u tr\u1ecb g\u00e3y x\u01b0\u01a1ng<\/p>\n<p>&#8211; Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p<\/p>\n<p>&#8211; Ph\u00f2ng ng\u1eeba t\u00e9 ng\u00e3<\/p>\n<p>&#8211; Dinh d\u01b0\u1ee1ng h\u1ee3p l\u00fd<\/p>\n<p>&#8211; Tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb v\u00e0 t\u00e1i kh\u00e1m \u0111\u00fang l\u1ecbch<\/p>\n","protected":false},"featured_media":4267,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4258","bai-giang","type-bai-giang","status-publish","has-post-thumbnail","hentry","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4258","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang"}],"about":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/types\/bai-giang"}],"replies":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/comments?post=4258"}],"version-history":[{"count":2,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4258\/revisions"}],"predecessor-version":[{"id":4269,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4258\/revisions\/4269"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4267"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4258"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4258"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4258"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}