{"id":4305,"date":"2024-12-01T18:00:29","date_gmt":"2024-12-01T11:00:29","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=4305"},"modified":"2024-12-01T18:00:29","modified_gmt":"2024-12-01T11:00:29","slug":"benh-an-ngoai-khoa","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-an-ngoai-khoa\/","title":{"rendered":"B\u1ec6NH \u00c1N NGO\u1ea0I KHOA"},"content":{"rendered":"
H\u1ecd v\u00e0 t\u00ean:<\/div>\n
Quan Ng\u1ecdc Ph\u01b0\u01a1ng Ng\u00e2n – 207720101054<\/div>\n
Ng\u00f4 \u0110\u00ecnh \u0110\u00f4ng Nghi – 207720101055<\/div>\n
Nguy\u1ec5n Minh Ng\u1ecdc – 207720101056<\/div>\n
Nguy\u1ec5n\u00a0 Th\u1ea3o Nguy\u00ean – 207720101058<\/div>\n
L\u1edbp: Y2020<\/div>\n
Module: Ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh<\/div>\n
\u2003<\/div>\n
I. H\u00c0NH CH\u00cdNH:<\/strong><\/div>\n
\u00a0<\/div>\n
1. H\u1ecd v\u00e0 t\u00ean: TRI\u0323NH QU\u00d4\u0301C BA\u0309O T.<\/div>\n
2. Gi\u1edbi t\u00ednh: Nam<\/div>\n
3. Tu\u1ed5i: 27 tu\u1ed5i (1997)<\/div>\n
4. Ngh\u1ec1 nghi\u1ec7p: Nh\u00e2n vi\u00ean v\u0103n pho\u0300ng (l\u1eadp tr\u00ecnh vi\u00ean)<\/div>\n
5. \u0110\u1ecba ch\u1ec9: 01 Tr\u00e2\u0300n V\u0103n D\u00e2n, ph\u01b0\u01a1\u0300ng 13, qu\u00e2\u0323n T\u00e2n Bi\u0300nh, tha\u0300nh ph\u00f4\u0301 H\u00f4\u0300 Chi\u0301 Minh.<\/div>\n
6. Th\u1eddi gian nh\u1eadp khoa c\u1ea5p c\u1ee9u: 22h50 ng\u00e0y 23\/05\/2024<\/div>\n
7. Th\u1eddi gian nh\u1eadp khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh: 01h10 ng\u00e0y 24\/05\/2024<\/div>\n
8. Th\u1eddi gian l\u00e0m b\u1ec7nh \u00e1n: 08h00 ng\u00e0y 24\/05\/2024<\/div>\n
\u00a0<\/div>\n
II. L\u00dd DO NH\u1eacP VI\u1ec6N:\u00a0<\/strong><\/div>\n
\u00a0<\/div>\n
\u0110au c\u0103\u0309ng tay pha\u0309i.\u00a0<\/div>\n
\u00a0<\/div>\n
III. B\u1ec6NH S\u1eec:<\/strong><\/div>\n
\u00a0<\/div>\n
B\u1ec7nh nh\u00e2n tr\u1ef1c ti\u1ebfp khai b\u1ec7nh:<\/div>\n
C\u00e1ch nh\u1eadp vi\u1ec7n 1 gi\u1edd, b\u1ec7nh nh\u00e2n tham gia th\u00ea\u0309 thao thi\u0300 b\u1ecb tr\u01b0\u01a1\u0323t qua\u0309 bo\u0301ng khi\u1ebfn b\u1ec7nh nh\u00e2n t\u00e9 v\u1ec1 ph\u00eda tr\u01b0\u01a1\u0301c \u01a1\u0309 t\u01b0 th\u00ea\u0301 s\u00e2\u0301p, ch\u00f4\u0301ng c\u00f4\u0309 tay pha\u0309i xu\u00f4\u0301ng n\u00ea\u0300n \u0111\u00e2\u0301t, ngoa\u0300i ra kh\u00f4ng va cha\u0323m ca\u0301c vi\u0323 tri\u0301 kha\u0301c tr\u00ean c\u01a1 th\u00ea\u0309 xu\u00f4\u0301ng d\u01b0\u01a1\u0301i n\u00ea\u0300n \u0111\u00e2\u0301t. Sau t\u00e9 b\u1ec7nh nh\u00e2n t\u1ec9nh, ca\u0309m th\u00e2\u0301y \u0111au nhi\u00ea\u0300u va\u0300 s\u01b0ng n\u00ea\u0300 vu\u0300ng c\u0103\u0309ng tay pha\u0309i. B\u00ea\u0323nh nh\u00e2n \u0111au vu\u0300ng gi\u01b0\u0303a c\u0103\u0309ng tay pha\u0309i, c\u01b0\u01a1\u0300ng \u0111\u00f4\u0323 10\/10, \u0111au kh\u00f4ng lan, \u0111au t\u0103ng khi cha\u0323m va\u0300o ho\u0103\u0323c c\u01b0\u0309 \u0111\u00f4\u0323ng g\u00e2\u0323p, du\u00f4\u0303i, s\u1ea5p, ng\u1eeda c\u0103\u0309ng tay. Ngoa\u0300i ra vu\u0300ng c\u0103\u0309ng tay pha\u0309i cu\u0309a b\u00ea\u0323nh nh\u00e2n s\u01b0ng to h\u01a1n c\u0103\u0309ng tay tra\u0301i, bi\u00ea\u0301n da\u0323ng va\u0300 co\u0301 v\u00ea\u0301t th\u01b0\u01a1ng cha\u0309y ma\u0301u \u01a1\u0309 vi\u0323 tri\u0301 m\u0103\u0323t sau, phi\u0301a d\u01b0\u01a1\u0301i trong c\u0103\u0309ng tay pha\u0309i. B\u00ea\u0323nh nh\u00e2n \u0111\u01b0\u01a1\u0323c x\u1eed tr\u00ed \u0111eo ne\u0323p g\u00f4\u0303 c\u00f4\u0301 \u0111i\u0323nh tr\u00ean xe c\u00e2\u0301p c\u01b0\u0301u\u00a0 => Nh\u1eadp vi\u1ec7n khoa C\u1ea5p c\u1ee9u BV Th\u1ed1ng Nh\u1ea5t.<\/div>\n
Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n kh\u00f4ng t\u00ea c\u00e1nh tay, b\u00e0n tay, kh\u00f4ng \u0111au \u0111\u00e2\u0300u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f3 th\u1edf, kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng bu\u1ed3n n\u00f4n – n\u00f4n, ch\u01b0a \u0111i ti\u00eau, ch\u01b0a \u0111i ti\u1ec3u.<\/div>\n
\u00a0** T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n: t\u1ea1i khoa C\u1ea5p c\u1ee9u (22h50 ng\u00e0y 23\/05\/2024)<\/div>\n
– B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/div>\n
– Da h\u1ed3ng, ni\u00eam m\u1ea1c m\u1eaft h\u1ed3ng.<\/div>\n
– Tim \u0111\u1ec1u.<\/div>\n
– Ph\u1ed5i kh\u00f4ng rale.<\/div>\n
– B\u1ee5ng m\u1ec1m.<\/div>\n
– Gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay (P).<\/div>\n
– V\u1ebft th\u01b0\u01a1ng c\u1eb3ng tay (P) d# 0.5 cm.<\/div>\n
\u00a0 \u00a0 \u00a0 \u00a0 \u00a0** X\u1eed tr\u00ed t\u1ea1i c\u1ea5p c\u1ee9u:<\/div>\n
– Ch\u00edch SAT 1500 UI.<\/div>\n
– Thu\u1ed1c gi\u1ea3m \u0111au Disomic 50mg.<\/div>\n
– N\u1eb9p c\u00e1nh c\u1eb3ng tay ph\u1ea3i.<\/div>\n
\u00a0 \u00a0 \u00a0** T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh: 01h30 ng\u00e0y 24\/05\/024<\/div>\n
– B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/div>\n
– Sinh hi\u1ec7u \u1ed5n.<\/div>\n
– \u0110au v\u00e0 gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– Bi\u1ebfn d\u1ea1ng c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– M\u1ea1ch quay r\u00f5, \u0111\u1ea7u ng\u00f3n h\u1ed3ng, kh\u00f4ng t\u00ea tay.<\/div>\n
\u00a0<\/div>\n
IV. TI\u1ec0N S\u1eec:<\/strong><\/div>\n
\u00a0<\/div>\n
1. C\u00e1 nh\u00e2n:<\/div>\n
– N\u1ed9i khoa: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd.<\/div>\n
– Ngo\u1ea1i khoa: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd.<\/div>\n
– Sinh ho\u1ea1t:<\/div>\n
+ Kh\u00f4ng h\u00fat thu\u1ed1c l\u00e1<\/div>\n
+ Kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u bia<\/div>\n
– D\u1ecb \u1ee9ng: di\u0323 \u01b0\u0301ng kha\u0301ng sinh kh\u00f4ng ro\u0303 loa\u0323i, di\u0323 \u01b0\u0301ng ha\u0309i sa\u0309n va\u0300 thi\u0323t bo\u0300.<\/div>\n
\u00a0<\/div>\n
V. L\u01af\u1ee2C QUA C\u00c1C C\u01a0 QUAN:<\/strong><\/div>\n
\u00a0<\/div>\n
1. Th\u1ea7n kinh: kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t.<\/div>\n
2. Tim m\u1ea1ch: kh\u00f4ng \u0111au ng\u1ef1c.<\/div>\n
3. H\u00f4 h\u1ea5p: kh\u00f4ng kh\u00f3 th\u1edf.<\/div>\n
4. Ti\u00eau ho\u00e1: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng bu\u1ed3n n\u00f4n.<\/div>\n
5. Th\u1eadn ni\u1ec7u: n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong, ti\u1ec3u kh\u00f4ng g\u1eaft bu\u1ed1t.<\/div>\n
6. C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0111au v\u00e0 gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay (P).<\/div>\n
7. C\u00e1c c\u01a1 quan kh\u00e1c: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
\u00a0<\/div>\n
VI. KH\u00c1M<\/strong> (7h30 ng\u00e0y 24\/05\/2024)<\/div>\n
\u00a0<\/div>\n
1. To\u00e0n th\u00e2n:<\/div>\n
– B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/div>\n
– Da h\u1ed3ng, ni\u00eam m\u1ea1c m\u1eaft h\u1ed3ng\u00a0<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
M\u1ea1ch: 76 l\u1ea7n\/ph\u00fat<\/div>\n
Nhi\u1ec7t \u0111\u1ed9: 36,5 \u0111\u1ed9 C<\/div>\n
Huy\u1ebft \u00e1p:\u00a0 120\/70 mmHg<\/div>\n
Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/div>\n
Spo2: 98%\/kh\u00ed tr\u1eddi<\/div>\n
– T\u1ed5ng tr\u1ea1ng: Chi\u1ec1u cao: 170cm, c\u00e2n n\u1eb7ng: 60kg \u2192 BMI: 20,76 kg\/m2\u21d2 Th\u1ec3 tr\u1ea1ng b\u00ecnh th\u01b0\u1eddng theo IDI & WPRO<\/div>\n
– Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/div>\n
– H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m.<\/div>\n
2. Tu\u1ea7n ho\u00e0n:<\/div>\n
– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, \u0111\u1ec1u 2 b\u00ean, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7.<\/div>\n
– Kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng. Di\u1ec7n \u0111\u1eadp m\u1ecfm tim khoang li\u00ean s\u01b0\u1eddn V \u0111\u01b0\u1eddng trung \u0111\u00f2n (T), di\u1ec7n \u0111\u1eadp 1×2 cm2.<\/div>\n
– T1, T2 \u0111\u1ec1u r\u00f5. Kh\u00f4ng \u00e2m th\u1ed5i.<\/div>\n
3. H\u00f4 h\u1ea5p:<\/div>\n
– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf.\u00a0<\/div>\n
– Rung thanh \u0111\u1ec1u 2 b\u00ean.<\/div>\n
– Ph\u1ed5i trong, kh\u00f4ng nghe rale.<\/div>\n
– G\u00f5 trong.<\/div>\n
4. Ti\u00eau ho\u00e1:<\/div>\n
– B\u1ee5ng c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng sao m\u1ea1ch.<\/div>\n
– Nhu \u0111\u1ed9ng ru\u1ed9t: 8 l\u1ea7n\/ ph\u00fat. Kh\u00f4ng nghe \u00e2m th\u1ed5i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, \u0111\u1ed9ng m\u1ea1ch th\u1eadn.<\/div>\n
– G\u00f5 trong.<\/div>\n
– B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au. Gan, l\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m.<\/div>\n
5. Th\u1eadn \u2013 ni\u1ec7u \u2013 sinh d\u1ee5c:<\/div>\n
– Ch\u1ea1m th\u1eadn (-)<\/div>\n
– Kh\u00f4ng c\u1ea7u b\u00e0ng quang.<\/div>\n
– Kh\u00f4ng \u0111i\u1ec3m \u0111au ni\u1ec7u qu\u1ea3n tr\u00ean, gi\u1eefa.<\/div>\n
6. Th\u1ea7n kinh:<\/div>\n
– C\u1ed5 m\u1ec1m.<\/div>\n
– Kh\u00f4ng d\u1ea5u th\u1ea7n kinh khu tr\u00fa.<\/div>\n
7. C\u01a1 x\u01b0\u01a1ng kh\u1edbp:<\/div>\n
Nh\u00ecn:<\/div>\n
– C\u00f3 v\u00ea\u0301t th\u01b0\u01a1ng \u0111\u00e2m ch\u1ecdt \u01a1\u0309 vi\u0323 tri\u0301 m\u0103\u0323t sau, phi\u0301a d\u01b0\u01a1\u0301i trong c\u0103\u0309ng tay pha\u0309i, d\u01b0\u1edbi m\u1ecfm khu\u1ef7u 5cm, ki\u0301ch th\u01b0\u01a1\u0301c \u0111\u01b0\u01a1\u0300ng ki\u0301nh #1cm, b\u1edd g\u1ecdn, \u0111\u00e1y s\u1ea1ch, cha\u0309y ma\u0301u c\u00f3 l\u1eabn v\u00e1ng m\u1ee1 d\u1ea1ng tr\u00e0n tr\u00ean b\u1ec1 m\u1eb7t da v\u00e0 th\u1ea5m qua g\u1ea1c, kh\u00f4ng l\u1ed9 x\u01b0\u01a1ng.<\/div>\n
– Bi\u1ebfn d\u1ea1ng tr\u1ee5c c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– S\u01b0ng n\u1ec1 gi\u1eefa c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– C\u00e1c \u0111\u1ea7u ng\u00f3n tay h\u1ed3ng.<\/div>\n
S\u1edd:<\/div>\n
– Chi \u1ea5m, CRT < 2s<\/div>\n
– M\u1ea1ch quay, tr\u1ee5 r\u00f5.<\/div>\n
– Nghi\u1ec7m ph\u00e1p Allen: d\u01b0\u01a1ng t\u00ednh.<\/div>\n
– \u1ea4n \u0111au ch\u00f3i gi\u1eefa x\u01b0\u01a1ng c\u1eb3ng tay.<\/div>\n
– D\u1ea5u m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i: kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n s\u01b0ng n\u1ec1 v\u00e0 \u0111au nhi\u1ec1u.<\/div>\n
– D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i: kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n s\u01b0ng n\u1ec1 v\u00e0 \u0111au nhi\u1ec1u.<\/div>\n
– C\u1ea3m gi\u00e1c v\u00f9ng c\u1eb3ng tay, b\u00e0n tay, ng\u00f3n tay ph\u1ea3i b\u00ecnh th\u01b0\u1eddng.<\/div>\n
– Kh\u00e1m kh\u1edbp quay – tr\u1ee5 tr\u00ean: kh\u00f4ng s\u1edd \u0111\u01b0\u1ee3c ch\u1ecfm quay v\u00ec b\u1ec7nh nh\u00e2n b\u1ecb gi\u1edbi h\u1ea1n g\u1ea5p – du\u1ed7i do \u0111au.<\/div>\n
\u0110o:\u00a0<\/div>\n
\u00a0<\/div>\n
C\u1eb3ng tay tr\u00e1iC\u1eb3ng tay ph\u1ea3i<\/div>\n
Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i\u00a0 (m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng c\u00e1nh tay- m\u1ecfm tr\u00e2m quay) 28 cm 23 cm<\/div>\n
Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (m\u1ecfm khu\u1ef7u – m\u1ecfm tr\u00e2m tr\u1ee5) 26 cm Kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au, kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c m\u1ed1c gi\u1ea3i ph\u1eabu.<\/div>\n
\u0110o v\u00f2ng c\u1eb3ng tay (v\u1ecb tr\u00ed gi\u1eefa c\u1eb3ng tay, d\u01b0\u1edbi n\u1ebfp khu\u1ef7u 10cm) 22 cm 24cm<\/div>\n
\u00a0<\/div>\n
\u21d2 C\u1eb3ng tay ph\u1ea3i ng\u1eafn h\u01a1n v\u00e0 s\u01b0ng n\u1ec1 so v\u1edbi c\u1eb3ng tay tr\u00e1i.\u00a0<\/div>\n
V\u1eadn \u0111\u1ed9ng:<\/div>\n
– Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c c\u00e1c \u0111\u1ed9ng t\u00e1c g\u1eadp – du\u1ed7i, s\u1ea5p-ng\u1eeda kh\u1edbp khu\u1ef7u do BN \u0111au.<\/div>\n
– V\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 tay, kh\u1edbp ng\u00f3n tay ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
8. Tai m\u0169i h\u1ecdng:<\/div>\n
– H\u1ecdng s\u1ea1ch.<\/div>\n
9. R\u0103ng h\u00e0m m\u1eb7t:<\/div>\n
– Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
10. N\u1ed9i ti\u1ebft – dinh d\u01b0\u1ee1ng v\u00e0 b\u1ec7nh l\u00fd kh\u00e1c:<\/div>\n
– Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
\u00a0<\/div>\n
VII. T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N<\/strong><\/div>\n
\u00a0<\/div>\n
B\u1ec7nh nh\u00e2n nam 27 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec\u00a0 \u0111au c\u1eb3ng tay ph\u1ea3i gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m ghi nh\u1eadn:<\/div>\n
\u25cf Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:<\/div>\n
– \u0110au gi\u1eefa c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00f9ng c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– Kh\u00f4ng t\u00ea c\u00e1nh tay, b\u00e0n tay.<\/div>\n
\u25cf Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:\u00a0<\/div>\n
– V\u00ea\u0301t th\u01b0\u01a1ng \u0111\u00e2m ch\u1ecdt \u01a1\u0309 vi\u0323 tri\u0301 m\u0103\u0323t sau, phi\u0301a d\u01b0\u01a1\u0301i trong c\u0103\u0309ng tay pha\u0309i, d\u01b0\u1edbi m\u1ecfm khu\u1ef7u tay 5cm, ki\u0301ch th\u01b0\u01a1\u0301c \u0111\u01b0\u01a1\u0300ng ki\u0301nh #1cm, b\u1edd g\u1ecdn, \u0111\u00e1y s\u1ea1ch, cha\u0309y ma\u0301u c\u00f3 l\u1eabn v\u00e1ng m\u1ee1 d\u1ea1ng tr\u00e0n tr\u00ean b\u1ec1 m\u1eb7t da v\u00e0 th\u1ea5m qua g\u1ea1c, kh\u00f4ng l\u1ed9 x\u01b0\u01a1ng.<\/div>\n
– Bi\u1ebfn d\u1ea1ng tr\u1ee5c c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– S\u01b0ng n\u1ec1 gi\u1eefa c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– \u1ea4n \u0111au ch\u00f3i gi\u1eefa c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– M\u1ea1ch quay, tr\u1ee5 r\u00f5. Chi \u1ea5m.<\/div>\n
– Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i c\u1eb3ng tay ph\u1ea3i ng\u1eafn h\u01a1n so v\u1edbi c\u1eb3ng tay tr\u00e1i.<\/div>\n
– Chu vi c\u1eb3ng tay ph\u1ea3i to h\u01a1n c\u1eb3ng tay tr\u00e1i \u1edf v\u1ecb tr\u00ed d\u01b0\u1edbi n\u1ebfp khu\u1ef7u 10cm.<\/div>\n
– V\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 tay, kh\u1edbp ng\u00f3n tay ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
– C\u1ea3m gi\u00e1c v\u00f9ng c\u1eb3ng tay, b\u00e0n tay, ng\u00f3n tay ph\u1ea3i b\u00ecnh th\u01b0\u1eddng.<\/div>\n
\u25cf Ti\u1ec1n c\u0103n: Kh\u00f4ng.<\/div>\n
\u00a0<\/div>\n
VIII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0<\/strong><\/div>\n
\u00a0<\/div>\n
– V\u1ebft th\u01b0\u01a1ng m\u1eb7t sau c\u1eb3ng tay, d\u01b0\u1edbi m\u1ecfm khu\u1ef7u 5 cm, ch\u1ea3y m\u00e1u v\u00e1ng m\u1ee1 tr\u00ean da v\u00e0 th\u1ea5m qua g\u1ea1c.<\/div>\n
– D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng (bi\u1ebfn d\u1ea1ng tr\u1ee5c c\u1eb3ng tay ph\u1ea3i).<\/div>\n
– D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng (\u0111au, s\u01b0ng n\u1ec1, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00f9ng c\u1eb3ng tay ph\u1ea3i)<\/div>\n
\u00a0<\/div>\n
IX. CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8<\/strong><\/div>\n
\u00a0<\/div>\n
G\u00e3y h\u1edf th\u00e2n 2 x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i \u0111\u1ed9 I theo Gustilo gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng.<\/div>\n
\u00a0<\/div>\n
X. CH\u1ea8N \u0110O\u00c1N PH\u00c2N BI\u1ec6T<\/strong><\/div>\n
\u00a0<\/div>\n
G\u00e3y tr\u1eadt Monteggia c\u1eb3ng tay ph\u1ea3i gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng.<\/div>\n
\u00a0<\/div>\n
XI. BI\u1ec6N LU\u1eacN<\/strong><\/div>\n
\u00a0<\/div>\n
B\u1ec7nh nh\u00e2n nam, 27 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au v\u00f9ng c\u1eb3ng tay ph\u1ea3i gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao. Ngh\u0129 b\u1ec7nh nh\u00e2n c\u00f3 g\u00e3y h\u1edf th\u00e2n 2 x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i \u0111\u1ed9 I theo Gustilo gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng v\u00ec:<\/div>\n
\u25cf G\u00e3y h\u1edf v\u00ec c\u00f3 v\u1ebft th\u01b0\u01a1ng \u0111\u00e2m ch\u1ecdt d\u01b0\u1edbi m\u1ecfm khu\u1ef7u ph\u1ea3i 5cm, ki\u0301ch th\u01b0\u01a1\u0301c \u0111\u01b0\u01a1\u0300ng ki\u0301nh #1cm, b\u1edd g\u1ecdn, \u0111\u00e1y s\u1ea1ch, cha\u0309y ma\u0301u c\u00f3 l\u1eabn v\u00e1ng m\u1ee1 d\u1ea1ng tr\u00e0n tr\u00ean b\u1ec1 m\u1eb7t da v\u00e0 th\u1ea5m qua g\u1ea1c. V\u1ebft th\u01b0\u01a1ng k\u00edch th\u01b0\u1edbc #1cm \u21d2 \u0110\u1ed9 1 theo Gustilo.<\/div>\n
\u25cf B\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y th\u00e2n x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i bao g\u1ed3m bi\u1ebfn d\u1ea1ng tr\u1ee5c c\u1eb3ng tay ph\u1ea3i, k\u00e8m d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn bao g\u1ed3m \u1ea5n \u0111au ch\u00f3i v\u00e0 s\u01b0ng n\u1ec1 gi\u1eefa c\u1eb3ng tay ph\u1ea3i. \u21d2 \u0110\u1ec1 ngh\u1ecb: X-quang c\u1eb3ng tay ph\u1ea3i th\u1eb3ng, nghi\u00eang.<\/div>\n
\u25cf Bi\u1ebfn ch\u1ee9ng g\u00e3y x\u01b0\u01a1ng:\u00a0<\/div>\n
\u25cb T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: kh\u00f4ng ngh\u0129 v\u00ec b\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c v\u00f9ng \u1edf c\u1eb3ng tay v\u00e0 b\u00e0n tay, v\u1eadn \u0111\u1ed9ng du\u1ed7i, d\u1ea1ng ng\u00f3n tay ph\u1ea3i b\u00ecnh th\u01b0\u1eddng. V\u1eadn \u0111\u1ed9ng c\u1eb3ng tay ph\u1ea3i h\u1ea1n ch\u1ebf do b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u.<\/div>\n
\u25cb T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: kh\u00f4ng ngh\u0129 v\u00ec b\u1ec7nh nh\u00e2n c\u00f3 sinh hi\u1ec7u \u1ed5n, chi \u1ea5m, CRT <2s, b\u00e0n tay v\u00e0 c\u1eb3ng tay v\u1eabn h\u1ed3ng v\u00e0 s\u1edd \u1ea5m – \u0111\u01b0\u1ee3c t\u01b0\u1edbi m\u00e1u t\u1ed1t, b\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch quay, tr\u1ee5 \u0111\u1ec1u r\u00f5 2 b\u00ean.<\/div>\n
\u25cb T\u1eafc m\u1ea1ch m\u00e1u do m\u1ee1: kh\u00f4ng ngh\u0129 do b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng suy h\u00f4 h\u1ea5p, l\u01a1 m\u01a1, tuy nhi\u00ean c\u1ea7n ph\u1ea3i theo d\u00f5i t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n th\u00eam v\u00ec bi\u1ebfn ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u t\u1eeb 12h \u0111\u1ebfn 3 ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng.<\/div>\n
\u25cb Ch\u00e8n \u00e9p khoang: kh\u00f4ng ngh\u0129 do b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u1ea3m \u0111au, m\u1ea1ch quay, tr\u1ee5 \u0111\u1ec1u, r\u00f5 2 b\u00ean, \u0111\u1ea7u ng\u00f3n tay h\u1ed3ng, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng t\u00ea li\u1ec7t chi.<\/div>\n
\u00a0<\/div>\n
Ch\u01b0a lo\u1ea1i tr\u1eeb G\u00e3y tr\u1eadt Monteggia v\u00ec b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ebfn d\u1ea1ng tr\u1ee5c chi, tuy nhi\u00ean kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c d\u1ea5u hi\u1ec7u tr\u1eadt kh\u1edbp quay – tr\u1ee5 tr\u00ean do kh\u00f4ng x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c ch\u1ecfm quay do h\u1ea1n ch\u1ebf g\u1eadp, du\u1ed7i khu\u1ef7u \u21d2 \u0110\u1ec1 ngh\u1ecb: X-quang x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i th\u1eb3ng, nghi\u00eang.<\/div>\n
\u00a0<\/div>\n
XII. \u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/div>\n
\u00a0<\/div>\n
1. CLS ch\u1ea9n \u0111o\u00e1n:\u00a0<\/div>\n
– X-quang x\u01b0\u01a1ng c\u1eb3ng tay ph\u1ea3i th\u1eb3ng, nghi\u00eang.<\/div>\n
2. CLS ti\u1ec1n ph\u1eabu:\u00a0<\/div>\n
– C\u00f4ng th\u1ee9c m\u00e1u, nh\u00f3m m\u00e1u, \u0111\u00f4ng c\u1ea7m m\u00e1u.<\/div>\n
– Sinh h\u00f3a m\u00e1u: Glucose, AST, ALT, Ure, Creatinine, ion \u0111\u1ed3.<\/div>\n
– T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/div>\n
– ECG<\/div>\n
– X-quang ng\u1ef1c th\u1eb3ng.<\/div>\n
\u00a0<\/div>\n
XIII. K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/div>\n
\u00a0<\/div>\n
1. X-quang c\u1eb3ng tay: (23\/05\/2024)<\/div>\n
\u00a0
\n
\"Alt
1<\/figcaption><\/figure>
\"H\u00ecnh
2<\/figcaption><\/figure>\n<\/div>\n
\u25cf H\u00e0nh ch\u00ednh:<\/div>\n
B\u1ec7nh nh\u00e2n Tr\u1ecbnh Qu\u1ed1c B\u1ea3o T, nam, 27 tu\u1ed5i, ch\u1ee5p ng\u00e0y 24\/05\/2024.<\/div>\n
\u25cf Ti\u00eau chu\u1ea9n phim:<\/div>\n
C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7. Phim ch\u1ee5p \u0111\u1ee7 hai kh\u1edbp qua hai \u0111\u1ea7u \u1ed5 g\u00e3y, b\u00ecnh di\u1ec7n th\u1eb3ng.<\/div>\n
\u25cf T\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng:<\/div>\n
\u00a0<\/div>\n
X\u01b0\u01a1ng quay ph\u1ea3iX\u01b0\u01a1ng tr\u1ee5 ph\u1ea3i<\/div>\n
V\u1ecb tr\u00ed g\u00e3y \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng \u2153 gi\u1eefa th\u00e2n x\u01b0\u01a1ng<\/div>\n
\u0110\u01b0\u1eddng g\u00e3y Ngang, c\u00f3 m\u1ea3nh th\u1ee9 3 Ngang<\/div>\n
Di l\u1ec7ch Ch\u1ed3ng ng\u1eafn<\/div>\n
Tr\u1eadt kh\u1edbp Kh\u00f4ng tr\u1eadt kh\u1edbp quay – tr\u1ee5 tr\u00ean v\u00e0 d\u01b0\u1edbi.<\/div>\n
\u00a0<\/div>\n
\u25cf T\u1ed5n th\u01b0\u01a1ng kh\u1edbp v\u00e0 m\u00f4 m\u1ec1m:\u00a0<\/div>\n
Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng kh\u1edbp v\u00e0 m\u00f4 m\u1ec1m k\u00e8m theo.<\/div>\n
\u00a0<\/div>\n
2. X-quang ng\u1ef1c th\u1eb3ng: (24\/05\/2024)<\/div>\n
\n
\"H\u00ecnh
3<\/figcaption><\/figure>\n<\/div>\n
\u00a0<\/div>\n
\u25cf B\u1ec7nh nh\u00e2n TR\u1ecaNH QU\u1ed0C B\u1ea2O T, nam, 27 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 24\/05\/2024 ch\u1ee5p t\u01b0 th\u1ebf AP.<\/div>\n
\u25cf T\u01b0 th\u1ebf kh\u00f4ng l\u1ec7ch<\/div>\n
\u25cf Kh\u00ed qu\u1ea3n kh\u00f4ng \u0111\u1ea9y l\u1ec7ch, g\u00f3c Carina < 100 \u0111\u1ed9<\/div>\n
\u25cf B\u00f3ng tim kh\u00f4ng l\u1edbn<\/div>\n
\u25cf V\u00f2m ho\u00e0nh kh\u00f4ng d\u1eb9t, g\u00f3c s\u01b0\u1eddn ho\u00e0nh kh\u00f4ng m\u1edd, kh\u00f4ng th\u1ea5y h\u00ecnh \u1ea3nh tr\u00e0n kh\u00ed, tr\u00e0n d\u1ecbch m\u00e0ng ph\u1ed5i hai b\u00ean.<\/div>\n
\u25cf Kh\u00f4ng th\u1ea5y t\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 ph\u1ed5i.<\/div>\n
\u25cf Kh\u00f4ng g\u00e3y x\u01b0\u01a1ng tr\u00ean phim X-quang ng\u1ef1c th\u1eb3ng.<\/div>\n
\u00a0<\/div>\n
3. C\u00f4ng th\u1ee9c m\u00e1u:<\/div>\n
24\/05\/2024Kho\u1ea3ng tham chi\u1ebfu\u0110\u01a1n v\u1ecb<\/div>\n
WBC 13.49 4.01 – 11.42 K\/uL<\/div>\n
NEU% 91.1 40 -74 %<\/div>\n
LYMPHO% 5.7 19 – 48 %<\/div>\n
MONO% 3.0 3.4 – 9.0 %<\/div>\n
EOS% 0.1 0.0 – 7.0 %<\/div>\n
BASO% 0.2 0.0 – 1.5 %<\/div>\n
NEU# 12.3 1.7 – 7.5 K\/uL<\/div>\n
LYM# 0.77 1.2 – 4.0 K\/uL<\/div>\n
MONO# 0.4 0.2 – 0.8 K\/uL<\/div>\n
EOS# 0.013 0.0 – 0.6 K\/uL<\/div>\n
BASO# 0.02 0.0 – 0.1 K\/uL<\/div>\n
RBC 5.31 4.01 – 5.79 M\/uL<\/div>\n
HGB 14.5 11.5 – 15.0 g\/dL<\/div>\n
HCT 44.0 34.4 – 48.6 %<\/div>\n
MCV 82.8 80 – 99 fL<\/div>\n
MCH 27.3 27 – 33 pg<\/div>\n
MCHC 32.9 32 – 36 g\/dL<\/div>\n
RDW 13.4 11.5 – 15.5 %<\/div>\n
PLT 277.0 150 – 450 K\/uL<\/div>\n
MPV 11.9 7.4 – 10.9 fL<\/div>\n
\u00a0K\u1ebft lu\u1eadn: b\u1ea1ch c\u1ea7u m\u00e1u t\u0103ng nh\u1eb9 ngh\u0129 t\u0103ng do stress \u2192 theo d\u00f5i l\u1ea1i sau 24h.<\/div>\n
4. Sinh ho\u00e1 m\u00e1u:<\/div>\n
24\/05\/2024Kho\u1ea3ng tham chi\u1ebfu\u0110\u01a1n v\u1ecb<\/div>\n
Glucose 6.2 4.1-5.9 mmol\/L<\/div>\n
Ure m\u00e1u 6.9 2.8 – 7.2 mmol\/L<\/div>\n
Creatinine m\u00e1u 120.0 58 – 96 umol\/L<\/div>\n
eGFR 66.95 >=60 mL\/ph\u00fat<\/div>\n
AST 43 <35 U\/L – 37oC<\/div>\n
ALT 59 <35 U\/L – 37oC<\/div>\n
Na+ 133 135 – 145 mmol\/L<\/div>\n
K+ 3.1 3.5 – 5.0 mmol\/L<\/div>\n
Cl- 100 98 – 106 mmol\/L<\/div>\n
K\u1ebft lu\u1eadn: c\u00e1c ch\u1ec9 s\u1ed1 trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/div>\n
5. \u0110\u00f4ng m\u00e1u:<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m K\u1ebft qu\u1ea3 (6h29\u2019 24\/05\/2024) Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
aPTT (TCK) 28.4 25-37 Gi\u00e2y\u00a0<\/div>\n
Th\u1eddi gian prothrombin (PT: Prothrombin Time)\u00a0<\/div>\n
TQ (Th\u1eddi gian Quick) 13.5 9.3-14.3 Gi\u00e2y\u00a0<\/div>\n
TL. Prothrombine 96 >70 %<\/div>\n
INR1.020.84-1.29<\/div>\n
K\u1ebft lu\u1eadn: ch\u1ee9c n\u0103ng \u0111\u00f4ng m\u00e1u b\u00ecnh th\u01b0\u1eddng.<\/div>\n
6. Huy\u1ebft h\u1ecdc:<\/div>\n
\u0110\u1ecbnh nh\u00f3m m\u00e1u h\u1ec7 RH (D) +<\/div>\n
Nh\u00f3m m\u00e1u h\u1ec7 ABO A<\/div>\n
\u00a0<\/div>\n
7. T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u:<\/div>\n
24\/05\/2024Kho\u1ea3ng tham chi\u1ebfu\u0110\u01a1n v\u1ecb<\/div>\n
URO norm 0-25 \u03bcmol\/L<\/div>\n
GLU neg 0-3.3 \u03bcmol\/L<\/div>\n
BIL neg 0-5.9 \u03bcmol\/L<\/div>\n
KETneg0-0.75<\/div>\n
S.G1.0260-1.015<\/div>\n
BLDneg0-15<\/div>\n
pH8.54.8-7.4<\/div>\n
PRO neg 0-0.25 g\/L<\/div>\n
NITnegNegative<\/div>\n
LEU neg 0-50 \u03bcg\/dl<\/div>\n
K\u1ebft lu\u1eadn: c\u00e1c ch\u1ec9 s\u1ed1 trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/div>\n
8. ECG: (23\/05\/2024)<\/div>\n
\n
\"4\"
4<\/figcaption><\/figure>\n<\/div>\n
– H\u00e0nh ch\u00ednh: TR\u1ecaNH QU\u1ed0C B\u1ea2O T., nam, 27 tu\u1ed5i, ECG \u0111o ng\u00e0y 23\/5\/2024<\/div>\n
– Test millivolt: 10 mm\/mV<\/div>\n
– T\u1ed1c \u0111\u1ed9 ch\u1ea1y gi\u1ea5y 25mm\/s<\/div>\n
– Nh\u1ecbp xoang \u0111\u1ec1u, t\u1ea7n s\u1ed1 83 l\u1ea7n\/ph\u00fat<\/div>\n
– Tr\u1ee5c QRS trung gian<\/div>\n
– Kho\u1ea3ng PR kh\u00f4ng gi\u00e3n <0.2 s<\/div>\n
– S\u00f3ng P <0.12 s => kh\u00f4ng l\u1edbn nh\u0129 tr\u00e1i<\/div>\n
– DII P < 3mm => kh\u00f4ng l\u1edbn nh\u0129 ph\u1ea3i<\/div>\n
– Sokolow – Lyon kh\u00f4ng \u0111\u1ee7 ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n l\u1edbn th\u1ea5t T v\u00e0 P.<\/div>\n
– ST kh\u00f4ng ch\u00eanh \u1edf t\u1ea5t c\u1ea3 c\u00e1c chuy\u1ec3n \u0111\u1ea1o<\/div>\n
– Kh\u00f4ng th\u1ea5y s\u00f3ng U, Q b\u1ec7nh l\u00fd.<\/div>\n

\nXIV. CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH<\/p>\n

<\/strong><\/div>\n

G\u00e3y h\u1edf \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng quay ph\u1ea3i, \u2153 gi\u1eefa th\u00e2n x\u01b0\u01a1ng tr\u1ee5 ph\u1ea3i \u0111\u1ed9 I theo Gustilo gi\u1edd th\u1ee9 1 do tai n\u1ea1n th\u1ec3 thao ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng.<\/div>\n
\nXV. H\u01af\u1edaNG X\u1eec TR\u00cd<\/strong><\/p>\n<\/div>\n
1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb:<\/div>\n
– N\u1eafn ch\u1ec9nh x\u01b0\u01a1ng v\u1ec1 v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu.<\/div>\n
– B\u1ea5t \u0111\u1ed9ng t\u1ed1t.<\/div>\n
– T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm<\/div>\n
2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3:<\/div>\n
– Gi\u1ea3m \u0111au<\/div>\n
– L\u00ean ch\u01b0\u01a1ng tr\u00ecnh ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng c\u1ed1 \u0111\u1ecbnh. Trong th\u1eddi gian ch\u1edd ph\u1eabu thu\u1eadt ti\u1ebfp t\u1ee5c \u0111eo n\u1eb9p c\u00e1nh c\u1eb3ng tay ph\u1ea3i.<\/div>\n
– Sau ph\u1eabu thu\u1eadt cho t\u1eadp ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng – v\u1eadt l\u00fd tr\u1ecb li\u1ec7u\u2003<\/div>","protected":false},"featured_media":4256,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4305","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\/4305","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=4305"}],"version-history":[{"count":1,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4305\/revisions"}],"predecessor-version":[{"id":4310,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4305\/revisions\/4310"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4256"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4305"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4305"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4305"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}