{"id":4356,"date":"2024-12-23T15:22:27","date_gmt":"2024-12-23T08:22:27","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=4356"},"modified":"2024-12-23T15:22:27","modified_gmt":"2024-12-23T08:22:27","slug":"benh-an-ngoai-chan-thuong-chinh-hinh","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-an-ngoai-chan-thuong-chinh-hinh\/","title":{"rendered":"B\u1ec6NH \u00c1N NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH"},"content":{"rendered":"
B\u1ec6NH \u00c1N\u00a0<\/div>\n
KHOA: NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH – B\u1ec6NH VI\u1ec6N TH\u1ed0NG NH\u1ea4T<\/div>\n
L\u1edaP: Y2020<\/div>\n
NH\u00d3M: 1<\/div>\n
N\u0102M H\u1eccC: 2023 – 2024<\/div>\n
H\u1ecc V\u00c0 T\u00caN MSSV<\/div>\n
1. NGUY\u1ec4N TR\u1ea6N VI\u1ec6T B\u00ccNH 207720101002<\/div>\n
2. TR\u1ea6N NG\u1eccC B\u1ed8I 207720101003<\/div>\n
3. NGUY\u1ec4N L\u00ca MINH CH\u00c2U 207720101006<\/div>\n
4. NGUY\u1ec4N QU\u00c2N \u0110\u1ea0T 207720101011<\/div>\n
\u00a0<\/div>\n
B\u1ec6NH \u00c1N NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/div>\n
\u00a0<\/div>\n
I. H\u00e0nh ch\u00ednh:<\/strong><\/div>\n
– H\u1ecd t\u00ean: L\u00ca TH\u1eca A.<\/div>\n
– Tu\u1ed5i: 94 tu\u1ed5i (1930)<\/div>\n
– Gi\u1edbi t\u00ednh: N\u1eef<\/div>\n
– M\u00e3 s\u1ed1 BN: 13051529<\/div>\n
– \u0110\u1ecba ch\u1ec9: 38A, \u0111\u01b0\u1eddng 61, ph\u01b0\u1eddng Ph\u01b0\u1edbc Long B, TP. Th\u1ee7 \u0110\u1ee9c.<\/div>\n
– Ngh\u1ec1 nghi\u1ec7p: H\u01b0u tr\u00ed<\/div>\n
– Ng\u00e0y gi\u1edd nh\u1eadp vi\u1ec7n: 12h45, 27\/03\/2024.<\/div>\n
– Nga\u0300y gi\u01a1\u0300 la\u0300m BA: 20h00, 27\/03\/2024.<\/div>\n
\u00a0<\/div>\n
II. L\u00fd do nh\u1eadp vi\u1ec7n: \u0110au \u0111\u00f9i v\u00e0 h\u00e1ng tr\u00e1i\/TNSH ng\u00e0y 1.<\/strong><\/div>\n
\u00a0<\/div>\n
III. B\u1ec7nh s\u1eed:<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n (BN) khai:<\/div>\n
C\u00e1ch nh\u1eadp vi\u1ec7n 6 gi\u1edd, BN \u0111ang ng\u1ee7 tr\u00ean gi\u01b0\u1eddng, t\u01b0 th\u1ebf nghi\u00eang tr\u00e1i, v\u1ecb tr\u00ed s\u00e1t c\u1ea1nh gi\u01b0\u1eddng, \u0111\u1ed9t ng\u1ed9t ng\u00e3 t\u1eeb tr\u00ean gi\u01b0\u1eddng xu\u1ed1ng n\u1ec1n, gi\u01b0\u1eddng cao kho\u1ea3ng 40cm, \u0111\u1eadp \u0111\u00f9i v\u00e0 m\u00f4ng (T) xu\u1ed1ng n\u1ec1n, t\u01b0 th\u1ebf \u0111\u00f9i g\u1eadp kh\u00e9p. Khi ng\u00e3, BN gi\u1eadt m\u00ecnh t\u1ec9nh d\u1eady. Sau ng\u00e3, BN \u0111au nhi\u1ec1u \u0111\u00f9i v\u00e0 h\u00e1ng (T), kh\u00f4ng th\u1ec3 t\u1ef1 \u0111\u1ee9ng l\u00ean \u0111\u01b0\u1ee3c n\u00ean nh\u1edd ng\u01b0\u1eddi nh\u00e0 \u0111\u1ee1, kh\u00f4ng \u0111i l\u1ea1i \u0111\u01b0\u1ee3c. BN kh\u00f4ng b\u1ecb va \u0111\u1eadp v\u00f9ng \u0111\u1ea7u, tay, kh\u1edbp g\u1ed1i khi ng\u00e3. Sau \u0111\u00f3, BN kh\u00f4ng x\u1eed tr\u00ed g\u00ec th\u00eam, BN \u0111\u01b0\u1ee3c ng\u01b0\u1eddi nh\u00e0 \u0111\u01b0a v\u00e0o khoa c\u1ea5p c\u1ee9u b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/div>\n
Trong qua\u0301 tri\u0300nh tr\u00ean, BN ti\u0309nh, kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng t\u00ea bi\u0300, kh\u00f4ng co\u0301 ca\u0309m gia\u0301c la\u0323nh \u0111\u00e2\u0300u chi, kh\u00f4ng n\u00f4n – bu\u1ed3n n\u00f4n, kh\u00f4ng \u0111au bu\u0323ng, kh\u00f4ng s\u1ee5t c\u00e2n kh\u00f4ng ch\u1ee7 \u00fd.<\/div>\n
T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp khoa C\u1ea5p c\u1ee9u BV Th\u1ed1ng Nh\u1ea5t:<\/div>\n
– B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c.<\/div>\n
– Da, ni\u00eam m\u1ea1c h\u1ed3ng.<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
+ M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat<\/div>\n
+ Huy\u1ebft \u00e1p: 130\/80 mmHg<\/div>\n
\u2192 SI = 0,62<\/div>\n
+ Nhi\u1ec7t \u0111\u1ed9: 36.5 \u0111\u1ed9 C<\/div>\n
+ Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ph\u00fat<\/div>\n
+ SpO2: 98%<\/div>\n
+ Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00e2n \u0111o \u0111\u01b0\u1ee3c<\/div>\n
– Tim nh\u1ecbp \u0111\u1ec1u, ph\u1ed5i trong kh\u00f4ng ran, b\u1ee5ng m\u1ec1m kh\u00f4ng \u0111i\u1ec3m \u0111au.<\/div>\n
– B\u00e0n ch\u00e2n (T) xoay ngo\u00e0i<\/div>\n
– X\u01b0\u0309 tri\u0301:\u00a0<\/div>\n
+ N\u1eb9p \u0111\u00f9i ch\u1ed1ng xoay (T)<\/div>\n
+ Ch\u0103m s\u00f3c c\u1ea5p 2<\/div>\n
\u00a0Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng (15h00 ng\u00e0y 27\/03\/2024):<\/div>\n
– B\u1ec7nh t\u1ec9nh, da, ni\u00eam m\u1ea1c h\u1ed3ng nh\u1ea1t<\/div>\n
– M\u1ea1ch: 100 l\u1ea7n\/ph\u00fat<\/div>\n
– Huy\u1ebft \u00e1p: 130\/80 mmHg<\/div>\n
– \u0110au h\u00e1ng (T)<\/div>\n
– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng (T)<\/div>\n
– L\u00e3ng tai<\/div>\n
– \u0110\u1ee5c thu\u1ef7 tinh th\u1ec3 m\u1eaft (P).<\/div>\n
\u00a0<\/div>\n
IV. Ti\u1ec1n c\u0103n:<\/strong><\/div>\n
A.B\u1ea3n th\u00e2n<\/div>\n
1. N\u1ed9i khoa:<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 11 n\u0103m (2013), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n THA t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, kh\u00f4ng r\u00f5 HA t\u1ed1i \u0111a, kh\u00f4ng r\u00f5 HA th\u00edch nghi. BN tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, t\u00e1i kh\u00e1m \u0111\u1ecbnh k\u1ef3 t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t. \u0110ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Amlodipine 5mg, Lostad T50 50mg<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 11 n\u0103m (2013), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t. BN tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, t\u00e1i kh\u00e1m \u0111\u1ecbnh k\u1ef3 t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t. \u0110ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Janumet 50mg\/500mg\u00a0<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 3 n\u0103m (2021), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n lo\u00e3ng x\u01b0\u01a1ng t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, kh\u00f4ng \u0111i\u1ec1u tr\u1ecb.<\/div>\n
2. Ngo\u1ea1i khoa:\u00a0<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n h\u01a1n 10 n\u0103m, BN c\u00f3 ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng do g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i (P), BN kh\u00f4ng nh\u1edb r\u00f5 b\u1ec7nh vi\u1ec7n n\u01a1i th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt.<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 8 n\u0103m (2016), BN c\u00f3 ph\u1eabu thu\u1eadt \u0111\u1ee5c thu\u1ef7 tinh th\u1ec3 m\u1eaft (T), BN kh\u00f4ng nh\u1edb r\u00f5 b\u1ec7nh vi\u1ec7n n\u01a1i th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt.<\/div>\n
3. PARA: 2002, sinh th\u01b0\u1eddng<\/div>\n
4. D\u1ecb \u1ee9ng: Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n.<\/div>\n
5. Th\u00f3i quen: BN kh\u00f4ng h\u00fat thu\u1ed1c, kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u bia.<\/div>\n
\u00a0<\/div>\n
B. Gia \u0111\u00ecnh<\/div>\n
– Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng v\u1ec1 b\u1ec7nh di truy\u1ec1n, chuy\u1ec3n h\u00f3a, n\u1ed9i ti\u1ebft.<\/div>\n
\u00a0<\/div>\n
V.\u00a0 L\u01b0\u1ee3c qua c\u00e1c c\u01a1 quan: L\u00fac 20h ng\u00e0y 27\/03\/2024 (11 gi\u1edd sau TNSH)<\/strong><\/div>\n
– Tim m\u1ea1ch: kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, kh\u00f4ng \u0111au ng\u1ef1c<\/div>\n
– H\u00f4 h\u1ea5p: kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng ho<\/div>\n
– Ti\u00eau ho\u00e1: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng n\u00f4n \u00f3i<\/div>\n
– Ti\u1ebft ni\u1ec7u: kh\u00f4ng ti\u1ec3u g\u1eaft bu\u1ed1t , n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong.<\/div>\n
– C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0111au v\u00f9ng \u0111\u00f9i (T), ha\u0323n ch\u00ea\u0301 v\u00e2\u0323n \u0111\u00f4\u0323ng h\u00e1ng (T)<\/div>\n
– Th\u1ea7n kinh: kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n.<\/div>\n
– C\u01a1 quan kh\u00e1c: l\u00e3ng tai, nh\u00ecn m\u1edd m\u1eaft (P)<\/div>\n
VI. Kh\u00e1m l\u00e2m s\u00e0ng: L\u00fac 20h ng\u00e0y 27\/03\/2024 (11 gi\u1edd sau TNSH)<\/strong><\/div>\n
A. T\u1ed5ng tr\u1ea1ng:<\/div>\n
– B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c, GCS 15 \u0111i\u1ec3m<\/div>\n
– Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/div>\n
– Kh\u00f4ng ph\u00f9, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da<\/div>\n
– Chi \u1ea5m<\/div>\n
– CRT < 2s<\/div>\n
– H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
\u25cf M\u1ea1ch 80 l\u1ea7n\/ph\u00fat<\/div>\n
\u25cf Huy\u1ebft \u00e1p 130\/80 mmHg<\/div>\n
\u25cf Nh\u1ecbp th\u1edf 16 l\u1ea7n\/ph\u00fat<\/div>\n
\u25cf Nhi\u1ec7t \u0111\u1ed9 36.5 \u0111\u1ed9 C<\/div>\n
\u25cf SpO2%: 99%\/KT<\/div>\n
– Th\u1ec3 tr\u1ea1ng: Ng\u01b0\u1eddi b\u1ec7nh kh\u00f4ng c\u00e2n \u0111o \u0111\u01b0\u1ee3c, th\u1ec3 tr\u1ea1ng g\u1ea7y.<\/div>\n
\u00a0<\/div>\n
B. Kh\u00e1m c\u00e1c c\u01a1 quan:<\/div>\n
1. C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/div>\n
NHI\u0300N: BN n\u1eb1m du\u1ed7i th\u1eb3ng 2 ch\u00e2n tr\u00ean gi\u01b0\u1eddng, th\u00e1o n\u1eb9p ch\u00e2n (T)<\/div>\n
– Ch\u00e2n (P): ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
– Ch\u00e2n (T):\u00a0 \u00a0 \u00a0 \u00a0\u00a0<\/div>\n
\u25cf B\u00e0n ch\u00e2n \u0111\u1ed5 ngo\u00e0i.<\/div>\n
\u25cf Ng\u1eafn h\u01a1n ch\u00e2n (P).<\/div>\n
\u25cf Kh\u00f4ng s\u01b0ng n\u00ea\u0300, kh\u00f4ng no\u0301ng \u0111o\u0309, kh\u00f4ng b\u00e2\u0300m ti\u0301m v\u00f9ng g\u1ed1i, \u0111n\u0110\u1ea7u ca\u0301c ngo\u0301n ch\u00e2n h\u00f4\u0300ng.<\/div>\n
S\u01a0\u0300:<\/div>\n
– Ch\u00e2n (P): ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
– Ch\u00e2n (T):\u00a0<\/div>\n
\u25cf Chi \u1ea5m, CRT < 2s<\/div>\n
\u25cf \u1ea4n \u0111au v\u00f9ng 1\/2 tr\u00ean \u0111\u00f9i (T)<\/div>\n
\u25cf \u1ea4n \u0111au cho\u0301i m\u1ea5u chuy\u1ec3n l\u1edbn \u0111\u00f9i (T)<\/div>\n
\u25cf \u1ea4n \u0111au tam gi\u00e1c Scarpa \u0111\u00f9i (T)<\/div>\n
\u25cf Kh\u1edbp g\u1ed1i 2 b\u00ean kh\u00f4ng \u0111au<\/div>\n
\u25cf D\u1ea5u l\u00f2 xo (-)<\/div>\n
\u25cf D\u1ea5u \u1ed5 kh\u1edbp r\u1ed7ng (-)<\/div>\n
\u25cf \u0110au gi\u1ea3m khi b\u1ea5t \u0111\u1ed9ng<\/div>\n
\u25cf Ma\u0323ch mu ch\u00e2n, ma\u0323ch cha\u0300y sau \u0111\u00ea\u0300u, ro\u0303<\/div>\n
\u25cf C\u1ea3m gi\u00e1c n\u00f4ng, c\u1ea3m gi\u00e1c s\u00e2u b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
\u0110O:<\/div>\n
Ch\u00e2n (P)Ch\u00e2n (T)<\/div>\n
Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (\u0111o t\u1eeb gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean – l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i) 44cm 40cm<\/div>\n
Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (\u0111o t\u1eeb m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i – l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i) 36cm 32cm<\/div>\n
\u0110o v\u00f2ng chi 40cm 40cm<\/div>\n
\u00a0<\/div>\n
=> BN c\u00f3 ng\u1eafn chi (T) so v\u1edbi chi (P). Tuy nhi\u00ean BN c\u00f3 ti\u1ec1n c\u0103n g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i (P), \u0111\u00e3 ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng \u0111\u00f9i h\u01a1n 10 n\u0103m => Kh\u00f4ng th\u1ec3 so s\u00e1nh chi t\u1ed5n th\u01b0\u01a1ng hi\u1ec7n t\u1ea1i so v\u1edbi chi l\u00e0nh.<\/div>\n
V\u00c2N \u0110\u00d4\u0323NG:<\/div>\n
– H\u1ea1n ch\u1ebf v\u00e2\u0323n \u0111\u00f4\u0323ng kh\u1edbp h\u00e1ng (T) g\u00e2\u0301p – du\u00f4\u0303i kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c, d\u1ea1ng – kh\u00e9p, xoay trong – xoay ngoa\u0300i kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c do \u0111au<\/div>\n
– \u0110\u1ea7u g\u1ed1i, c\u1ed5 ch\u00e2n c\u1eed \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
2. Kh\u00e1m ng\u1ef1c:<\/div>\n
– Nh\u00ecn: l\u1ed3ng ng\u1ef1c 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 \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng<\/div>\n
– Kh\u00e1m tim:<\/div>\n
\u25cf S\u1edd: m\u1ecfm tim \u1edf khoang li\u00ean s\u01b0\u1eddn 5 \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i, kh\u00f4ng d\u1ea5u n\u1ea3y ng\u1ef1c, harzer (-)<\/div>\n
\u25cf Nghe: tim \u0111\u1ec1u, T1 T2 nghe r\u00f5,\u00a0 t\u1ea7n s\u1ed1 80l\/p, kh\u00f4ng \u00e2m th\u1ed5i<\/div>\n
– Kh\u00e1m ph\u1ed5i:<\/div>\n
\u25cf S\u1edd: rung thanh \u0111\u1ec1u, r\u00f5 2 b\u00ean ph\u1ebf tr\u01b0\u1eddng<\/div>\n
\u25cf G\u00f5: trong<\/div>\n
\u25cf Nghe: r\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, kh\u00f4ng ran.<\/div>\n
3. Kh\u00e1m b\u1ee5ng:<\/div>\n
– Nh\u00ecn: b\u1ee5ng to b\u00e8 c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7<\/div>\n
– G\u00f5: trong kh\u1eafp b\u1ee5ng<\/div>\n
– S\u1edd: b\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au, gan l\u00e1ch s\u1edd kh\u00f4ng ch\u1ea1m<\/div>\n
– Nghe: nhu \u0111\u1ed9ng ru\u1ed9t 6 l\u1ea7n\/ph\u00fat<\/div>\n
4. Ti\u1ebft ni\u1ec7u:<\/div>\n
– Ch\u1ea1m th\u1eadn (-)<\/div>\n
– C\u1ea7u b\u00e0ng quang (-)<\/div>\n
– Kh\u00f4ng \u0111i\u1ec3m \u0111au ni\u1ec7u qu\u1ea3n.<\/div>\n
5. Kh\u00e1m th\u1ea7n kinh:<\/div>\n
– C\u1ed5 m\u1ec1m.<\/div>\n
– Babinski (-)<\/div>\n
\u00a0<\/div>\n
VII. T\u00f3m t\u1eaft b\u1ec7nh \u00e1n:<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n n\u1eef, 94 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au \u0111\u00f9i v\u00e0 h\u00e1ng (T) sau TNSH ng\u00e0y th\u1ee9 1. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:<\/div>\n
– TCCN<\/div>\n
\u25cf \u0110au \u0111\u00f9i v\u00e0 h\u00e1ng (T)<\/div>\n
\u25cf H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng ch\u00e2n (T)<\/div>\n
– TCTT<\/div>\n
\u25cf B\u00e0n ch\u00e2n (T) \u0111\u1ed5 ngo\u00e0i<\/div>\n
\u25cf \u1ea4n \u0111au v\u00f9ng 1\/2 tr\u00ean \u0111\u00f9i (T)\u00a0<\/div>\n
\u25cf \u1ea4n \u0111au ch\u00f3i m\u1ea5u chuy\u1ec3n l\u1edbn \u0111\u00f9i (T)<\/div>\n
\u25cf \u1ea4n \u0111au tam gi\u00e1c Scarpa \u0111\u00f9i (T)<\/div>\n
\u25cf Chi\u1ec1u d\u00e0i \u0111\u00f9i (T) ng\u1eafn h\u01a1n \u0111\u00f9i (P)<\/div>\n
\u25cf Gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng g\u1ea5p – du\u1ed7i, d\u1ea1ng – kh\u00e9p, xoay trong- xoay ngoa\u0300i kh\u1edbp h\u00e1ng (T)<\/div>\n
\u25cf M\u1ea1ch \u0111u\u0300i, mu ch\u00e2n, m\u1ea1ch cha\u0300y sau \u0111\u1ec1u r\u00f5 2 b\u00ean<\/div>\n
– Ti\u1ec1n c\u0103n: THA, \u0110T\u0110 type 2, Lo\u00e3ng x\u01b0\u01a1ng, K\u1ebft h\u1ee3p x\u01b0\u01a1ng \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
\u00a0<\/div>\n
VIII. \u0110\u1eb7t v\u1ea5n \u0111\u1ec1<\/strong><\/div>\n
– G\u00e3y k\u00edn x\u01b0\u01a1ng \u0111\u00f9i T<\/div>\n
– Ti\u1ec1n c\u0103n: THA, \u0110T\u0110 type 2, Lo\u00e3ng x\u01b0\u01a1ng, K\u1ebft h\u1ee3p x\u01b0\u01a1ng \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
\u00a0<\/div>\n
IX. Ch\u1ea9n \u0111o\u00e1n s\u01a1 b\u1ed9<\/strong><\/div>\n
G\u00e3y k\u00edn li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) ng\u00e0y th\u1ee9 1 do TNSH, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/T\u0103ng huy\u1ebft \u00e1p – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Lo\u00e3ng x\u01b0\u01a1ng – KHX \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
\u00a0<\/div>\n
X. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/strong><\/div>\n
G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i (T) ng\u00e0y th\u1ee9 1 do TNSH, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/T\u0103ng huy\u1ebft \u00e1p – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Lo\u00e3ng x\u01b0\u01a1ng – KHX \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
Tr\u1eadt kh\u1edbp h\u00e1ng (T) ng\u00e0y th\u1ee9 1 do TNSH, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/T\u0103ng huy\u1ebft \u00e1p – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Lo\u00e3ng x\u01b0\u01a1ng – KHX \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
\u00a0<\/div>\n
XI. Bi\u1ec7n lu\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n n\u1eef 94 tu\u1ed5i v\u00e0o vi\u1ec7n v\u00ec \u0110au v\u00f9ng \u0111\u00f9i (T) sau tai n\u1ea1n sinh ho\u1ea1t ng\u00e0y 1 qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m ghi nh\u1eadn:<\/div>\n
1. G\u00e3y k\u00edn v\u00ec: T\u1ea1i v\u1ecb tr\u00ed ch\u1ea5n th\u01b0\u01a1ng kh\u00f4ng co\u0301 x\u00e2y xa\u0301t ngo\u00e0i da, kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng th\u00f4ng v\u01a1\u0301i \u00f4\u0309 ga\u0303y, kh\u00f4ng l\u1ed9 \u0111\u1ea7u x\u01b0\u01a1ng.<\/div>\n
2. G\u00e3y x\u01b0\u01a1ng \u0111\u00f9i T v\u00ec BN c\u00f3 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng r\u00f5 (ng\u00e3 \u0111\u1eadp ph\u1ea7n \u0111\u00f9i xu\u1ed1ng \u0111\u1ea5t + b\u1ec7nh l\u00fd n\u1ec1n lo\u00e3ng x\u01b0\u01a1ng v\u00e0 b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i) v\u00e0 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng l\u00e0 bi\u1ebfn d\u1ea1ng b\u00e0n ch\u00e2n (T) xoay ngo\u00e0i, c\u00f9ng c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn l\u00e0 \u0111au ch\u00f3i v\u00f9ng m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i (T) v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng. C\u00e1c v\u1ecb tr\u00ed g\u00e3y x\u01b0\u01a1ng ngh\u0129 \u0111\u1ebfn l\u00e0:<\/div>\n
\u25cf G\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i T: Ngh\u0129 nhi\u1ec1u do chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 tuy\u1ec7t \u0111\u1ed1i \u0111\u00f9i T ng\u1eafn h\u01a1n \u0111\u00f9i P, b\u00e0n ch\u00e2n \u0111\u1ed5 ngo\u00e0i, \u1ea5n \u0111au m\u1ea5u chuy\u1ec3n l\u1edbn \u0111\u00f9i T v\u00e0 tam gi\u00e1c Scarpa => \u0110\u1ec1 ngh\u1ecb ch\u1ee5p Xquang khung ch\u1eadu th\u1eb3ng, Xquang \u0111\u00f9i tr\u00e1i th\u1eb3ng – nghi\u00eang.<\/div>\n
\u25cf G\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i T: T\u01b0\u01a1ng t\u1ef1 g\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i nh\u01b0ng \u00edt ngh\u0129 h\u01a1n do chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i b\u1ecb gi\u1ea3m, nh\u01b0ng kh\u00f4ng lo\u1ea1i tr\u1eeb g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i ph\u1ed1i h\u1ee3p g\u00e3y m\u1ea5u chuy\u1ec3n l\u1edbn.<\/div>\n
\u25cf B\u1ec7nh nh\u00e2n c\u00f3 d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn tr\u1eadt kh\u1edbp l\u00e0 \u0111au h\u00e1ng (T) v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng h\u00e1ng (T), \u1ea5n \u0111au tam gi\u00e1c Scarpa, kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn tr\u1eadt kh\u1edbp. \u00cdt ngh\u0129 BN tr\u1eadt kh\u1edbp h\u00e1ng (T) nh\u01b0ng ch\u01b0a lo\u1ea1i tr\u1eeb.<\/div>\n
3. Nguy\u00ean nh\u00e2n: BN l\u1edbn tu\u1ed5i, c\u00f3 ti\u1ec1n c\u0103n lo\u00e3ng x\u01b0\u01a1ng kh\u00f4ng \u0111i\u1ec1u tr\u1ecb, tuy nhi\u00ean BN c\u00f3 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng r\u00f5 r\u00e0ng, kh\u00f4ng c\u00f3 s\u1ee5t c\u00e2n kh\u00f4ng ch\u1ee7 \u00fd, h\u1ea1ch ngo\u1ea1i bi\u00ean kh\u00f4ng s\u1edd ch\u1ea1m => Ngh\u0129 nhi\u1ec1u g\u00e3y x\u01b0\u01a1ng do tai n\u1ea1n sinh ho\u1ea1t. => \u0110\u1ec1 ngh\u1ecb \u0111\u1ecbnh l\u01b0\u1ee3ng 25OH Vitamin D (D3) m\u00e1u, \u0111o m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng.<\/div>\n
4. C\u00e1c bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p trong ng\u00e0y th\u1ee9 nh\u1ea5t c\u1ee7a b\u1ec7nh:<\/div>\n
\u25cf Choa\u0301ng, s\u00f4\u0301c m\u00e2\u0301t ma\u0301u: BN kh\u00f4ng co\u0301 v\u00ea\u0301t th\u01b0\u01a1ng do m\u00e2\u0301t ma\u0301u nhi\u00ea\u0300u, kh\u00f4ng cho\u0301ng m\u0103\u0323t, b\u00ea\u0323nh nh\u00e2n ti\u0309nh, sinh hi\u00ea\u0323u \u00f4\u0309n : Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf T\u0103\u0301c ma\u0323ch ma\u0301u do m\u01a1\u0303: b\u0103\u0301t ma\u0323ch \u0111u\u0300i, mu ch\u00e2n, ma\u0323ch cha\u0300y \u0111\u00ea\u0300u, ro\u0303, SpO2 98% : Ch\u01b0a nghi\u0303<\/div>\n
\u25cf Che\u0300n e\u0301p khoang: b\u1ec7nh nh\u00e2n \u0111au gi\u1ea3m sau khi b\u00e2\u0301t \u0111\u00f4\u0323ng, \u0111\u00f9i kh\u00f4ng s\u01b0ng, b\u1ea7m t\u00edm, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng m\u1ea5t m\u1ea1ch kh\u00f4ng gi\u1ea3m t\u01b0\u1edbi m\u00e1u chi : Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf\u00a0 T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: BN co\u0300n c\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u, kh\u00f4ng co\u0301 ca\u0309m gia\u0301c t\u00ea bi\u0300, c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c c\u00e1c ng\u00f3n ch\u00e2n : Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf\u00a0 T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: \u00edt ngh\u0129 do kh\u00f4ng v\u1ebft b\u1ea7m v\u00f9ng ch\u00e2n , s\u1edd \u1ea5m , c\u00e1c \u0111\u1ea7u ng\u00f3n tay h\u1ed3ng, b\u1eaft m\u1ea1ch \u0111u\u0300i, quay r\u00f5 : Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf\u00a0 R\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng c\u1ea5p t\u00ednh: \u00edt ngh\u0129 do kh\u00f4ng c\u00f3 b\u00f3ng n\u01b0\u1edbc: Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf\u00a0 G\u00e3y k\u00edn chuy\u1ec3n g\u00e3y h\u1edf: t\u1ea1i \u1ed5 g\u00e3y kh\u00f4ng ghi nh\u1eadn \u0111\u1ecf da, kh\u00f4ng ghi nh\u00e2\u0323n v\u1ebft th\u01b0\u01a1ng th\u00f4ng v\u1edbi \u1ed5 g\u00e3y : Kh\u00f4ng nghi\u0303<\/div>\n
\u25cf L\u00e0m n\u1eb7ng th\u00eam b\u1ec7nh n\u1ec1n: hi\u1ec7n t\u1ea1i huy\u1ebft \u00e1p c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c \u1ed5n \u0111\u1ecbnh, b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au \u0111\u1ea7u, ch\u00f3ng m\u1eb7t n\u00ean: Kh\u00f4ng nghi\u0303.<\/div>\n
\u00a0<\/div>\n
XII. \u0110\u1ec1 ngh\u1ecb c\u1eadn l\u00e2m s\u00e0ng:<\/strong><\/div>\n
1. C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n:<\/div>\n
\u25cf Xquang x\u01b0\u01a1ng \u0111\u00f9i (T) th\u0103\u0309ng – nghi\u00eang<\/div>\n
\u25cf Xquang khung ch\u1eadu th\u1eb3ng<\/div>\n
2. C\u1eadn l\u00e2m s\u00e0ng h\u00f4\u0303 tr\u01a1\u0323 \u0111i\u00ea\u0300u tri\u0323:<\/div>\n
\u25cf C\u00f4ng th\u1ee9c m\u00e1u<\/div>\n
\u25cf Sinh ho\u00e1 m\u00e1u (AST, ALT, Creatinine, Glucose, Ure m\u00e1u)<\/div>\n
\u25cf \u0110\u00f4ng c\u1ea7m m\u00e1u<\/div>\n
\u25cf Nh\u00f3m m\u00e1u ABO, Rh<\/div>\n
\u25cf \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/div>\n
\u25cf ECG<\/div>\n
\u25cf Xquang ng\u1ef1c th\u1eb3ng<\/div>\n
\u25cf TPTNT<\/div>\n
\u25cf Si\u00eau \u00e2m tim<\/div>\n
\u25cf 25OH Vitamin D (D3)<\/div>\n
\u25cf \u0110o m\u1eadt \u0111\u1ed9 x\u01b0\u01a1ng<\/div>\n
\u25cf Bilan lipid m\u00e1u<\/div>\n
\u25cf Bilirubin m\u00e1u<\/div>\n
\u25cf Protein, Albumin m\u00e1u.<\/div>\n
\u00a0<\/div>\n
XIII. K\u1ebft qu\u1ea3 c\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
1. Xquang x\u01b0\u01a1ng \u0111\u00f9i (T) th\u1eb3ng – nghi\u00eang<\/div>\n
\n
\"G\u00e3y
1<\/figcaption><\/figure>
\"X-quang
2<\/figcaption><\/figure>\n<\/div>\n
\u0110\u1ecdc phim<\/div>\n
\u25cf H\u1ecd v\u00e0 t\u00ean BN: LE THI A.,\u00a0 n\u1eef, 94 tu\u1ed5i.<\/div>\n
\u25cf Ng\u00e0y th\u00e1ng n\u0103m ch\u1ee5p: 27\/03\/2024.<\/div>\n
\u25cf T\u01b0 th\u1ebf phim: Xquang \u0111\u00f9i (T) th\u1eb3ng – nghi\u00eang<\/div>\n
\u25cf Ch\u1ea5t l\u01b0\u1ee3ng tia: chu\u1ea9n<\/div>\n
\u25cf M\u00f4 m\u1ec1m: kh\u00f4ng c\u00f3 ph\u00f9 n\u1ec1 m\u00f4 m\u1ec1m<\/div>\n
\u25cf V\u1ecb tr\u00ed g\u00e3y: li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) v\u00e0 m\u1ea5u chuy\u1ec3n nh\u1ecf x\u01b0\u01a1ng \u0111\u00f9i (T)<\/div>\n
\u25cf \u0110\u01b0\u1eddng g\u00e3y: che\u0301o va\u0300 co\u0301 ma\u0309nh th\u01b0\u0301 3.<\/div>\n
\u25cf Di l\u00ea\u0323ch: di l\u1ec7ch ch\u1ed3ng ng\u1eafn<\/div>\n
\u25cf Type 31-A2.2 theo ph\u00e2n \u0111\u00f4\u0323 AO.<\/div>\n
\u25cf Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m.<\/div>\n
K\u1ebft lu\u1eadn: G\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) Type 31-A2.2 theo ph\u00e2n \u0111\u1ed9 AO.<\/div>\n
2. Xquang khung ch\u1eadu th\u1eb3ng<\/div>\n
\n
\"H\u00ecnh
3<\/figcaption><\/figure>\n<\/div>\n
\u0110\u1ecdc phim<\/div>\n
\u25cf H\u1ecd v\u00e0 t\u00ean BN: LE THI A.,\u00a0 n\u1eef, 94 tu\u1ed5i.<\/div>\n
\u25cf Ng\u00e0y th\u00e1ng n\u0103m ch\u1ee5p: 27\/03\/2024.<\/div>\n
\u25cf T\u01b0 th\u1ebf phim: Xquang khung ch\u1eadu th\u1eb3ng<\/div>\n
\u25cf Ch\u1ea5t l\u01b0\u1ee3ng tia: chu\u1ea9n<\/div>\n
\u25cf M\u00f4 m\u1ec1m: kh\u00f4ng c\u00f3 ph\u00f9 n\u1ec1 m\u00f4 m\u1ec1m<\/div>\n
\u25cf \u0110\u01b0\u1eddng Shenton m\u1ea5t li\u00ean t\u1ee5c<\/div>\n
\u25cf Kh\u00f4ng m\u1ea5t li\u00ean t\u1ee5c c\u00e1c \u0111\u01b0\u1eddng nh\u01b0: b\u1edd tr\u01b0\u1edbc \u1ed5 c\u1ed1i, tr\u1ea7n \u1ed5 c\u1ed1i, \u0111\u01b0\u1eddng ch\u1eadu ng\u1ed3i, \u0111\u01b0\u1eddng ch\u1eadu l\u01b0\u1ee3c => kh\u00f4ng g\u1ee3i \u00fd g\u00e3y x\u01b0\u01a1ng ch\u1eadu k\u00e8m theo<\/div>\n
\u25cf K\u1ebft h\u1ee3p x\u01b0\u01a1ng \u0111\u00f9i P b\u1eb1ng v\u00edt \u00e9p DHS<\/div>\n
\u25cf X\u01b0\u01a1ng g\u00e3y: x\u01b0\u01a1ng \u0111\u00f9i T<\/div>\n
\u25cf V\u1ecb tr\u00ed g\u00e3y: li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) v\u00e0 m\u1ea5u chuy\u1ec3n nh\u1ecf x\u01b0\u01a1ng \u0111\u00f9i (T)<\/div>\n
\u25cf \u0110\u01b0\u1eddng g\u00e3y: che\u0301o va\u0300 co\u0301 ma\u0309nh th\u01b0\u0301 3.<\/div>\n
\u25cf Di l\u00ea\u0323ch: di l\u1ec7ch ch\u1ed3ng ng\u1eafn<\/div>\n
\u25cf Type 31-A2.2 theo ph\u00e2n \u0111\u00f4\u0323 AO.<\/div>\n
\u25cf Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m.<\/div>\n
K\u1ebft lu\u1eadn: G\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) Type 31-A2.2 theo ph\u00e2n \u0111\u1ed9 AO<\/div>\n
3. CTM (27\/03\/2034)<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m K\u1ebft qu\u1ea3 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
WBC 10.79 4.01 – 11.42 K\/uL<\/div>\n
NEU% 89.7 40 – 74 %<\/div>\n
LYM% 6.2 19 – 48 %<\/div>\n
MONO% 3.8 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# 9.68 1.7 – 7.5 k\/uL<\/div>\n
LYM# 0.67 1.2 – 4.0 K\/uL<\/div>\n
MONO# 0.41 0.2 – 2.8 K\/uL<\/div>\n
EOS# 0.01 0.0 – 0.5 K\/uL<\/div>\n
BASO# 0.02 0.0 – 0.1 K\/uL<\/div>\n
RBC 4.08 4.01 – 5.79 M\/uL<\/div>\n
HGB 11.4 11.5 – 15.0 g\/dL<\/div>\n
HCT 33.2 34.4 – 48.5 %<\/div>\n
MCV 81.4 80 – 99 fL<\/div>\n
MCH 28.0 27 – 33 pg<\/div>\n
MCHC 34.4 32 – 36 g\/dL<\/div>\n
RDW 13.4 11.5 – 15.5 %<\/div>\n
PLT 230.0 150 – 450 K\/uL<\/div>\n
MPV 8.9 7.4 – 10.9 fL<\/div>\n
Nh\u00f3m m\u00e1u B+<\/div>\n
K\u1ebft lu\u1eadn: Ch\u01b0a ghi nh\u1eadn k\u1ebft qu\u1ea3 b\u1ea5t th\u01b0\u1eddng.<\/div>\n
4. Sinh ho\u00e1 m\u00e1u (27\/03\/2024)<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m K\u1ebft qu\u1ea3 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
Glucose [M\u00e1u] 18.2 4.1 – 5.9 mmol\/L<\/div>\n
HbA1c [M\u00e1u] 7.6 <6 %Hb<\/div>\n
Ure m\u00e1u [M\u00e1u] 6.6 2.8 – 7.2 mmol\/L<\/div>\n
Creatinine m\u00e1u [M\u00e1u] 69 > 50T: 72 – 127 umol\/L<\/div>\n
eGFR 73.04 >= 60 ml\/ph\u00fat\/1.72m2 da<\/div>\n
AST (GOT) [M\u00e1u] 20 < 50 U\/L<\/div>\n
ALT (GPT) [M\u00e1u] 14 < 50 U\/L<\/div>\n
Na+ 142 134 – 145 mmol\/L<\/div>\n
K+ 3.7 3.5 – 5.0 mmol\/L<\/div>\n
Cl-\u00a0 104 98 – 106 mmol\/L<\/div>\n
Ca 2.41 2.15 – 2.6 mmol\/L<\/div>\n
Troponin Ths [M\u00e1u] 12.2 <14 pg\/mL<\/div>\n
\u0110\u1ecbnh l\u01b0\u1ee3ng 25OH Vitamin D (D3) [M\u00e1u] 18.28 30 – 100 ng\/mL<\/div>\n
Cholesterol to\u00e0n ph\u1ea7n [M\u00e1u] 4.2 < 5.2 mmol\/L<\/div>\n
Triglyceride [M\u00e1u] 1.4 < 1.7 mmol\/L<\/div>\n
HDL – cholesterol 1.4 > 1.03 mmol\/L<\/div>\n
non HDL cholesterol 2.8 < 3.4 mmol\/L<\/div>\n
LDL – cholesterol 2.16 < 2.6 mmol\/L<\/div>\n
Bilirubin to\u00e0n ph\u1ea7n [M\u00e1u] 7.86 <= 17 umol\/L<\/div>\n
Bilirubin tr\u1ef1c ti\u1ebfp [M\u00e1u] 1.9 <= 4.3 umol\/L<\/div>\n
Albumin [M\u00e1u] 34.7 35 – 50 g\/L<\/div>\n
Protein to\u00e0n ph\u1ea7n [M\u00e1u] 62 65 – 82 g\/L<\/div>\n
\u00a0<\/div>\n
K\u1ebft lu\u1eadn:<\/div>\n
– Glucose, HbA1c cao => BN c\u00f3 ti\u1ec1n c\u0103n \u0110T\u0110 type 2, tu\u1ea9n th\u1ee7 \u0111i\u1ec1u tr\u1ecb, c\u00f3 th\u1ec3 t\u0103ng do \u0111au => C\u1ea7n theo d\u00f5i glucose \u0111\u1ec1 ph\u00f2ng bi\u1ebfn ch\u1ee9ng c\u1ee7a \u0110T\u0110\u00a0<\/div>\n
– \u0110\u1ecbnh l\u01b0\u1ee3ng 25OH Vitamin D (D3) th\u1ea5p => BN c\u00f3 ti\u1ec1n c\u0103n lo\u00e3ng x\u01b0\u01a1ng<\/div>\n
– Albumin, Protein to\u00e0n ph\u1ea7n gi\u1ea3m nh\u1eb9 => Ngh\u0129 do BN l\u1edbn tu\u1ed5i, th\u1ec3 tr\u1ea1ng suy ki\u1ec7t.<\/div>\n
5. ECG<\/div>\n
\n
\"V\u00f5
4 (1)<\/figcaption><\/figure>\n<\/div>\n
\u25cf T\u1ed1c \u0111\u1ed9 gi\u1ea5y: 25mm\/s, test millivolt: 10 mV<\/div>\n
\u25cf Nh\u1ecbp xoang, \u0111\u1ec1u, t\u1ea7n s\u1ed1 100 l\u1ea7n\/ph\u00fat. P:QRS = 1:1<\/div>\n
\u25cf Tr\u1ee5c \u0111i\u1ec7n tim trung gian\u00a0<\/div>\n
\u25cf S\u00f3ng P (+) \u1edf DI, DII, th\u1eddi gian 0.08s, bi\u00ean \u0111\u1ed9 0.15 mV -> b\u00ecnh th\u01b0\u1eddng<\/div>\n
\u25cf Kho\u1ea3ng PR 0.16s -> kh\u00f4ng d\u00e3n r\u1ed9ng\u00a0<\/div>\n
\u25cf Ph\u1ee9c b\u1ed9 QRS 0.1s -> kh\u00f4ng d\u00e3n r\u1ed9ng\u00a0<\/div>\n
\u25cf ST kh\u00f4ng ch\u00eanh<\/div>\n
\u25cf S\u00f3ng T (+) \u1edf DI, DII, V3 – V6, aVF\u00a0<\/div>\n
\u25cf Ch\u1ec9 s\u1ed1 Sokolow – Lyon: S V1 + R V5 = 9 mm -> kh\u00f4ng d\u00e0y th\u1ea5t\u00a0\u00a0<\/div>\n
\u00a0<\/div>\n
XIV. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/div>\n
G\u00e3y k\u00edn li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i (T) ph\u00e2n \u0111\u1ed9 31-A2.2 ng\u00e0y th\u1ee9 1 do TNSH, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/T\u0103ng huy\u1ebft \u00e1p – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Lo\u00e3ng x\u01b0\u01a1ng – KHX \u0111\u00f9i (P) > 10 n\u0103m.<\/div>\n
\u00a0<\/div>\n
XV. H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/div>\n
– N\u1eb9p \u0111\u00f9i – c\u1eb3ng – b\u00e0n ch\u00e2n (T) ch\u1ed1ng xoay<\/div>\n
– Gi\u1ea3m \u0111au<\/div>\n
– N\u00e2ng t\u1ed5ng tr\u1ea1ng BN tr\u01b0\u1edbc m\u1ed5<\/div>\n
– \u1ed4n \u0111\u1ecbnh \u0111\u01b0\u1eddng huy\u1ebft<\/div>\n
– Ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng b\u1eb1ng n\u1eb9p v\u00edt n\u00e9n \u00e9p<\/div>\n
– Theo d\u00f5i sinh hi\u1ec7u, bi\u1ebfn ch\u1ee9ng g\u00e3y x\u01b0\u01a1ng.<\/div>\n
\u00a0<\/div>\n
XVI. Ti\u00ean l\u01b0\u1ee3ng:<\/div>\n
– Ti\u00ean l\u01b0\u1ee3ng g\u1ea7n: Trung b\u00ecnh v\u00ec BN n\u1eef, l\u1edbn tu\u1ed5i, c\u00f3 th\u1ec3 g\u1eb7p c\u00e1c bi\u1ebfn ch\u1ee9ng trong g\u00e2y m\u00ea, ch\u1ea3y m\u00e1u, nhi\u1ec5m tr\u00f9ng sau ph\u1eabu thu\u1eadt.<\/div>\n
– Ti\u00ean l\u01b0\u1ee3ng xa: Trung b\u00ecnh v\u00ec ph\u1eabu thu\u1eadt gi\u00fap BN c\u00f3 th\u1ec3 xoay tr\u1edf, \u0111\u1ee9ng t\u1ea1i ch\u1ed7, tr\u00e1nh c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb1m l\u00e2u. Th\u1eddi gian li\u1ec1n x\u01b0\u01a1ng d\u00e0i do BN c\u00f3 ti\u1ec1n c\u0103n lo\u00e3ng x\u01b0\u01a1ng, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2.<\/div>\n","protected":false},"featured_media":4364,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4356","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\/4356","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=4356"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4356\/revisions"}],"predecessor-version":[{"id":4365,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4356\/revisions\/4365"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4364"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4356"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4356"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4356"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}