{"id":4366,"date":"2024-12-23T15:34:25","date_gmt":"2024-12-23T08:34:25","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=4366"},"modified":"2024-12-23T15:39:41","modified_gmt":"2024-12-23T08:39:41","slug":"chan-thuong-chinh-hinh","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/chan-thuong-chinh-hinh\/","title":{"rendered":"CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH"},"content":{"rendered":"
B\u1ec6NH \u00c1N CU\u1ed0I KHOA<\/div>\n
MODULE: CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/div>\n
GVHD: ThS. BS. Nguy\u1ec5n Thi\u00ean \u0110\u1ee9c\u00a0<\/div>\n
L\u1edbp: Y2020<\/div>\n
TR\u1ea6N HO\u00c0NG \u0110\u00d4NG 207720101013<\/div>\n
NGUY\u1ec4N H\u1eeeU PH\u01af\u01a0NG 207720101100<\/div>\n
NGUY\u1ec4N NG\u1eccC XU\u00c2N AN 207720101101<\/div>\n
\u00a0<\/div>\n
I. H\u00e0nh ch\u00ednh<\/strong><\/div>\n
H\u1ecd v\u00e0 t\u00ean: L\u00c2M NG\u1eccC K.<\/div>\n
N\u0103m sinh: 1999 (25 tu\u1ed5i)<\/div>\n
Gi\u1edbi t\u00ednh: Nam<\/div>\n
D\u00e2n t\u1ed9c: Kinh<\/div>\n
Ngh\u1ec1 nghi\u1ec7p: Nh\u00e2n vi\u00ean v\u0103n ph\u00f2ng<\/div>\n
\u0110\u1ecba ch\u1ec9: X\u00e3 Ph\u01b0\u1edbc S\u01a1n, huy\u1ec7n Ninh Ph\u01b0\u1edbc, t\u1ec9nh Ninh Thu\u1eadn<\/div>\n
Ng\u00e0y nh\u1eadp vi\u1ec7n: 15h06 ng\u00e0y 25 th\u00e1ng 03 n\u0103m 2024\u00a0<\/div>\n
Ng\u00e0y l\u00e0m b\u1ec7nh \u00e1n: 20h00 ng\u00e0y 26 th\u00e1ng 03 n\u0103m 2024<\/div>\n
\u00a0<\/div>\n
II. L\u00fd do nh\u1eadp vi\u1ec7n: \u0110au c\u1ed5 ch\u00e2n (P) ng\u00e0y th\u1ee9 5<\/strong><\/div>\n
\u00a0<\/div>\n
III. B\u1ec7nh s\u1eed:<\/strong><\/div>\n
C\u00e1ch nh\u1eadp vi\u1ec7n 5 ng\u00e0y, BN tr\u01b0\u1ee3t t\u00e9 1 b\u1eadc c\u1ea7u thang khi \u0111ang \u0111i xu\u1ed1ng, c\u1ed5 ch\u00e2n ph\u1ea3i b\u1ecb l\u1eadt v\u00e0o trong, b\u1edd ngo\u00e0i c\u1ed5 ch\u00e2n \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng, BN l\u1ea5y tr\u1ee5 b\u1eb1ng ch\u00e2n c\u00f2n l\u1ea1i n\u00ean kh\u00f4ng b\u1ecb ng\u00e3 c\u1ea3 ng\u01b0\u1eddi, kh\u00f4ng x\u00e2y x\u00e1t da. Sau ng\u00e3 BN th\u1ea5y \u0111au nh\u00f3i li\u00ean t\u1ee5c v\u00f9ng c\u1ed5 ch\u00e2n, gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng, kh\u00f4ng ch\u1ecbu l\u1ef1c b\u1eb1ng ch\u00e2n ph\u1ea3i \u0111\u01b0\u1ee3c, BN ra ti\u1ec7m thu\u1ed1c t\u00e2y mua thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng r\u00f5 lo\u1ea1i u\u1ed1ng th\u00ec th\u1ea5y \u0111\u1ee1 \u0111au, sau kho\u1ea3ng 6 ti\u1ebfng th\u00ec \u0111au l\u1ea1i, BN u\u1ed1ng thu\u1ed1c 2 l\u1ea7n\/ng\u00e0y cho t\u1edbi khi nh\u1eadp vi\u1ec7n.<\/div>\n
C\u00e1ch nh\u1eadp vi\u1ec7n 4 ng\u00e0y, BN th\u1ea5y c\u1ed5 ch\u00e2n b\u1eaft \u0111\u1ea7u s\u01b0ng n\u1ec1, b\u1ea7m t\u00edm, BN ch\u01b0\u1eddm \u0111\u00e1 th\u00ec th\u1ea5y kh\u00f4ng \u0111\u1ee1 s\u01b0ng. BN th\u1ea5y c\u1ed5 ch\u00e2n s\u01b0ng to nh\u1ea5t khi c\u00e1ch nh\u1eadp vi\u1ec7n 2 ng\u00e0y. BN v\u1eabn \u0111i l\u1ea1i \u0111\u01b0\u1ee3c nh\u01b0ng kh\u1eadp khi\u1ec5ng, \u00edt \u0111\u1eb7t l\u1ef1c b\u00ean ch\u00e2n ph\u1ea3i do \u0111au.<\/div>\n
C\u00f9ng ng\u00e0y nh\u1eadp vi\u1ec7n, BN th\u1ea5y ch\u00e2n v\u1eabn c\u00f2n \u0111au, s\u01b0ng n\u1ec1, b\u1ea7m t\u00edm n\u00ean nh\u1eadp vi\u1ec7n t\u1ea1i b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/div>\n
Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, BN kh\u00f4ng s\u1ed1t, kh\u00f4ng bu\u1ed3n n\u00f4n – n\u00f4n, kh\u00f4ng ho, kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng \u0111au ng\u1ef1c, \u0111i ti\u00eau ph\u00e2n v\u00e0ng \u0111\u00f3ng khu\u00f4n. BN v\u1eabn c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c c\u00e1c ng\u00f3n ch\u00e2n, kh\u00f4ng c\u1ea3m th\u1ea5y t\u00ea b\u00ec, kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c l\u1ea1nh \u0111\u1ea7u chi.<\/div>\n
\u00a0<\/div>\n
T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n:<\/div>\n
– BN t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/div>\n
– Da ni\u00eam m\u1ea1c h\u1ed3ng.<\/div>\n
– H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m.<\/div>\n
– Tuy\u1ebfn gi\u00e1p kh\u00f4ng to.<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
+ M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat<\/div>\n
+ Huy\u1ebft \u00e1p: 120\/70 mmHg<\/div>\n
+ Nhi\u1ec7t \u0111\u1ed9: 36,6 oC<\/div>\n
+ Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/div>\n
+ SpO2: 98%<\/div>\n
– Tim \u0111\u1ec1u, ph\u1ed5i trong, b\u1ee5ng m\u1ec1m, kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb.<\/div>\n
– C\u1ed5 ch\u00e2n (P) s\u01b0ng n\u1ec1 b\u1ea7m t\u00edm, bi\u1ebfn d\u1ea1ng c\u1ed5 ch\u00e2n (P).<\/div>\n
X\u1eed tr\u00ed t\u1ea1i khoa C\u1ea5p c\u1ee9u:<\/div>\n
– \u0110eo n\u1eb9p c\u1eb3ng b\u00e0n ch\u00e2n.<\/div>\n
– L\u1ea5y m\u00e1u l\u00e0m XN c\u00f4ng th\u1ee9c m\u00e1u v\u00e0 sinh ho\u00e1.<\/div>\n
– CSC II.<\/div>\n
Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng:<\/div>\n
– BN t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/div>\n
– Da ni\u00eam m\u1ea1c h\u1ed3ng.<\/div>\n
– Sinh hi\u1ec7u \u1ed5n.<\/div>\n
– C\u1ed5 ch\u00e2n (P) s\u01b0ng nh\u1eb9, b\u1ea7m t\u00edm, \u0111au, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng.<\/div>\n
– BN \u0111eo n\u1eb9p c\u1eb3ng b\u00e0n ch\u00e2n.<\/div>\n
\u00a0<\/div>\n
IV. Ti\u1ec1n c\u0103n<\/strong><\/div>\n
1. C\u00e1 nh\u00e2n<\/div>\n
– N\u1ed9i khoa:<\/div>\n
+ Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd n\u1ed9i khoa.<\/div>\n
– Ngo\u1ea1i khoa: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n li\u00ean quan.<\/div>\n
– Th\u00f3i quen:\u00a0<\/div>\n
+ Kh\u00f4ng h\u00fat thu\u1ed1c l\u00e1.<\/div>\n
+ S\u1eed d\u1ee5ng 1-2 \u0111\u01a1n v\u1ecb r\u01b0\u1ee3u bia\/tu\u1ea7n.<\/div>\n
– D\u1ecb \u1ee9ng: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n li\u00ean quan.<\/div>\n
2. Gia \u0111\u00ecnh<\/div>\n
– Gia \u0111\u00ecnh ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n li\u00ean quan.<\/div>\n
\u00a0<\/div>\n
V. L\u01b0\u1ee3c qua c\u00e1c c\u01a1 quan (20h ng\u00e0y 26 th\u00e1ng 03 n\u0103m 2024)<\/strong><\/div>\n
– H\u1ec7 tim m\u1ea1ch: kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.<\/div>\n
– H\u1ec7 h\u00f4 h\u1ea5p: kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng ho.<\/div>\n
– H\u1ec7 ti\u00eau h\u00f3a: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng n\u00f4n \u00f3i, kh\u00f4ng ti\u00eau ch\u1ea3y.<\/div>\n
– H\u1ec7 ti\u1ebft ni\u1ec7u: ti\u1ec3u v\u00e0ng trong, kh\u00f4ng ti\u1ec3u g\u1eaft bu\u1ed1t.<\/div>\n
– H\u1ec7 th\u1ea7n kinh: kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t.<\/div>\n
– H\u1ec7 c\u01a1 x\u01b0\u01a1ng kh\u1edbp: s\u01b0ng \u0111au c\u1ed5 ch\u00e2n (P), gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 ch\u00e2n (P).<\/div>\n
\u00a0<\/div>\n
VI. Kh\u00e1m l\u00e2m s\u00e0ng (20h ng\u00e0y 26 th\u00e1ng 03 n\u0103m 2024)<\/strong><\/div>\n
1. T\u1ed5ng qu\u00e1t<\/div>\n
– T\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t.<\/div>\n
– Da ni\u00eam nh\u1ea1t, kh\u00f4ng ph\u00f9.<\/div>\n
– Chi \u1ea5m, m\u1ea1ch r\u00f5.<\/div>\n
– H\u1ea1ch ngo\u1ea1i bi\u00ean kh\u00f4ng s\u1edd ch\u1ea1m.<\/div>\n
– C\u00e2n n\u1eb7ng 59 kg, chi\u1ec1u cao 1m62 -> BMI: 22,5 \u2014> b\u00ecnh th\u01b0\u1eddng theo IDI & WPRO<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
+ M\u1ea1ch: 76 l\u1ea7n\/ph\u00fat<\/div>\n
+ Huy\u1ebft \u00e1p: 110\/70 mmHg<\/div>\n
+ Nhi\u1ec7t \u0111\u1ed9: 37 oC<\/div>\n
+ Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/div>\n
+ SpO2: 98%\/kh\u00ed tr\u1eddi<\/div>\n
2. C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/div>\n
– Nh\u00ecn: BN n\u1eb1m ng\u1eeda, ch\u00e2n du\u1ed7i, \u0111eo n\u1eb9p c\u1eb3ng b\u00e0n ch\u00e2n \u2014> th\u00e1o n\u1eb9p.<\/div>\n
+ S\u01b0ng n\u1ec1 v\u00f9ng c\u1ed5, b\u00e0n ch\u00e2n (P), kh\u00f4ng b\u00f3ng n\u01b0\u1edbc, kh\u00f4ng v\u1ebft th\u01b0\u01a1ng.<\/div>\n
+ B\u1ea7m t\u00edm #8x3cm ph\u00eda d\u01b0\u1edbi v\u00f9ng m\u1eaft c\u00e1 trong (P).<\/div>\n
+ Chi\u1ec1u d\u00e0i 2 ch\u00e2n b\u1eb1ng nhau khi so ngang g\u00f3t ch\u00e2n.<\/div>\n
+ Ch\u00e2n (T) kh\u00f4ng ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
– S\u1edd:<\/div>\n
+ \u1ea4n \u0111au ch\u00f3i m\u1eaft c\u00e1 ngo\u00e0i (P).<\/div>\n
+ Chi \u1ea5m, CRT<2s.<\/div>\n
+ M\u1ea1ch ch\u00e0y sau, m\u1ea1ch mu ch\u00e2n b\u1eaft r\u00f5, \u0111\u1ec1u 2 b\u00ean.<\/div>\n
+ C\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u 2 ch\u00e2n b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng t\u00ea, kh\u00f4ng d\u1ecb c\u1ea3m.<\/div>\n
+ S\u1edd m\u1ea5t li\u00ean t\u1ee5c m\u1eaft c\u00e1 ngo\u00e0i (P), kh\u00f3 kh\u00e1m l\u1ea1o x\u1ea1o x\u01b0\u01a1ng.<\/div>\n
+ \u0110\u1ea7u ng\u00f3n ch\u00e2n (P) \u1ea5n h\u1ed3ng, c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c, kh\u00f4ng t\u00ea.<\/div>\n
– \u0110o:<\/div>\n
Ch\u00e2n (P)Ch\u00e2n (T)<\/div>\n
X\u01b0\u01a1ng ch\u00e0y:<\/div>\n
– Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (l\u1ed3i c\u1ee7 ch\u00e0y – m\u1eaft c\u00e1 trong)<\/div>\n
-Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (l\u1ed3i c\u1ea7u trong x\u01b0\u01a1ng \u0111\u00f9i – m\u1eaft c\u00e1 trong)<\/div>\n
37<\/div>\n
\u00a0<\/div>\n
44<\/div>\n
37<\/div>\n
\u00a0<\/div>\n
44<\/div>\n
X\u01b0\u01a1ng m\u00e1c:<\/div>\n
– Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (ch\u1ecfm m\u00e1c – m\u1eaft c\u00e1 ngo\u00e0i)<\/div>\n
-Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i – m\u1eaft c\u00e1 ngo\u00e0i)<\/div>\n
33<\/div>\n
\u00a0<\/div>\n
37<\/div>\n
33<\/div>\n
\u00a0<\/div>\n
37<\/div>\n
\u00a0<\/div>\n
C\u00e1c chi c\u00f2n l\u1ea1i ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
– Kh\u00e1m v\u1eadn \u0111\u1ed9ng:<\/div>\n
+ Kh\u1edbp c\u1ed5 ch\u00e2n:\u00a0<\/div>\n
\u25cf (P): H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng (g\u1eadp l\u01b0ng – g\u1eadp l\u00f2ng, l\u1eadt s\u1ea5p – l\u1eadt ng\u1eeda, d\u1ea1ng – kh\u00e9p b\u00e0n ch\u00e2n).<\/div>\n
\u25cf (T): V\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.\u00a0<\/div>\n
+ Test ng\u0103n k\u00e9o tr\u01b0\u1edbc (test d\u00e2y ch\u1eb1ng m\u00e1c – s\u00ean tr\u01b0\u1edbc): \u00e2m t\u00ednh<\/div>\n
3. H\u1ec7 tim m\u1ea1ch<\/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
– M\u1ecfm tim n\u1eb1m \u1edf li\u00ean s\u01b0\u1eddn 5 \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i, di\u1ec7n \u0111\u1eadp 1×2 cm2.<\/div>\n
– Kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng, rung miu (-), d\u1ea5u Harzer (-).<\/div>\n
– T1, T2 r\u00f5, \u0111\u1ec1u, t\u1ea7n s\u1ed1 76 l\u1ea7n\/ph\u00fat, kh\u00f4ng \u00e2m th\u1ed5i b\u1ea5t th\u01b0\u1eddng.<\/div>\n
4. H\u1ec7 h\u00f4 h\u1ea5p:<\/div>\n
– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, \u0111\u1ec1u 2 b\u00ean, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf. Kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5.<\/div>\n
– Rung thanh \u0111\u1ec1u 2 b\u00ean.<\/div>\n
– G\u00f5 trong 2 ph\u1ebf tr\u01b0\u1eddng.<\/div>\n
– R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, kh\u00f4ng ran b\u1ec7nh l\u00fd.<\/div>\n
5. H\u1ec7 ti\u00eau h\u00f3a:<\/div>\n
– B\u1ee5ng 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
– B\u1ee5ng m\u1ec1m, kh\u00f4ng \u0111i\u1ec3m \u0111au khu tr\u00fa.<\/div>\n
– G\u00f5 trong.<\/div>\n
– Nhu \u0111\u1ed9ng ru\u1ed9t 8 l\u1ea7n\/ph\u00fat. Kh\u00f4ng nghe \u00e2m th\u1ed5i b\u1ea5t th\u01b0\u1eddng.<\/div>\n
– Gan l\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m.<\/div>\n
6. H\u1ec7 ti\u1ebft ni\u1ec7u:<\/div>\n
– C\u1ea7u b\u00e0ng quang (-).<\/div>\n
– Ch\u1ea1m th\u1eadn (-).<\/div>\n
– Rung th\u1eadn (-).<\/div>\n
7. H\u1ec7 th\u1ea7n kinh:<\/div>\n
– C\u1ed5 m\u1ec1m.<\/div>\n
– Kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb.<\/div>\n
8. C\u00e1c c\u01a1 quan kh\u00e1c: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
\u00a0<\/div>\n
I. T\u00f3m t\u1eaft b\u1ec7nh \u00e1n<\/div>\n
BN nam, 25 tu\u1ed5i nh\u1eadp vi\u1ec7n v\u00ec \u0111au c\u1ed5 ch\u00e2n (P) ng\u00e0y th\u1ee9 5. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m ghi nh\u1eadn nh\u01b0 sau:<\/div>\n
– Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:<\/div>\n
+ S\u01b0ng, \u0111au c\u1ed5, b\u00e0n ch\u00e2n (P).<\/div>\n
+ B\u1ea7m t\u00edm v\u00f9ng m\u1eaft c\u00e1 trong (P).<\/div>\n
+ V\u1eadn \u0111\u1ed9ng h\u1ea1n ch\u1ebf kh\u1edbp c\u1ed5 ch\u00e2n (P).<\/div>\n
– Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:<\/div>\n
+ M\u1ea5t li\u00ean t\u1ee5c m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P).<\/div>\n
+ \u1ea4n \u0111au m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P).<\/div>\n
\u00a0<\/div>\n
VII. \u0110\u1eb7t v\u1ea5n \u0111\u1ec1<\/strong><\/div>\n
– D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i (P).<\/div>\n
\u00a0<\/div>\n
VIII. Ch\u1ea9n \u0111o\u00e1n<\/strong><\/div>\n
– Ch\u1ea9n \u0111o\u00e1n s\u01a1 b\u1ed9: G\u00e3y k\u00edn x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P) ng\u00e0y th\u1ee9 5 do TNSH ch\u01b0a\u00a0 bi\u1ebfn ch\u1ee9ng.<\/div>\n
– Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t:\u00a0 G\u00e3y k\u00edn x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P) ng\u00e0y th\u1ee9 5 do TNSH k\u00e8m \u0111\u1ee9t d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i<\/div>\n
\u00a0<\/div>\n
IX. Bi\u1ec7n lu\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
BN nam, 25 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au c\u1ed5 ch\u00e2n (P) ng\u00e0y th\u1ee9 5 sau TNSH. Ngh\u0129 nhi\u1ec1u tr\u00ean BN n\u00e0y c\u00f3 t\u00ecnh tr\u1ea1ng g\u00e3y k\u00edn x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i v\u00ec:<\/div>\n
– D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng: S\u1edd m\u1ea5t li\u00ean t\u1ee5c m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P).<\/div>\n
– D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng:<\/div>\n
+ S\u01b0ng n\u1ec1, \u0111au c\u1ed5, b\u00e0n ch\u00e2n (P), b\u1ea7m t\u00edm m\u1eaft c\u00e1 trong ch\u00e2n (P).<\/div>\n
+ Gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 ch\u00e2n (g\u1eadp l\u01b0ng – g\u1eadp l\u00f2ng, xoay trong – xoay ngo\u00e0i).<\/div>\n
+ \u1ea4n \u0111au m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P).<\/div>\n
– BN c\u00f3 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng l\u00e0 l\u1eadt – xo\u1eafn v\u1eb7n c\u1ed5 ch\u00e2n v\u00e0 m\u1eaft c\u00e1 ngo\u00e0i \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng.<\/div>\n
– Kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng th\u00f4ng v\u1edbi \u1ed5 g\u00e3y n\u00ean ngh\u0129 nhi\u1ec1u l\u00e0 g\u00e3y k\u00edn.<\/div>\n
– Bi\u1ebfn ch\u1ee9ng:<\/div>\n
+ Ch\u00e8n \u00e9p khoang: BN kh\u00f4ng \u0111au c\u1ed5 ch\u00e2n d\u1eef d\u1ed9i, kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c t\u00ea b\u00ec, \u0111\u1ed9ng m\u1ea1ch mu ch\u00e2n v\u00e0 ch\u00e0y sau b\u1eaft \u0111\u01b0\u1ee3c n\u00ean \u00edt ngh\u0129.<\/div>\n
+ T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: Kh\u00e1m chi \u1ea5m, b\u1eaft \u0111\u01b0\u1ee3c \u0111\u1ed9ng m\u1ea1ch mu ch\u00e2n v\u00e0 ch\u00e0y sau r\u00f5, \u0111\u1ea7u ng\u00f3n ch\u00e2n ph\u1ea3i \u1ea5n h\u1ed3ng, c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c, kh\u00f4ng t\u00ea n\u00ean \u00edt ngh\u0129.<\/div>\n
+ T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: Kh\u00e1m c\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u b\u00e0n ch\u00e2n (P) b\u00ecnh th\u01b0\u1eddng n\u00ean \u00edt ngh\u0129.<\/div>\n
+ \u0110\u1ee9t d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i: g\u1ed3m d\u00e2y ch\u1eb1ng s\u00ean – m\u00e1c sau, s\u00ean – m\u00e1c tr\u01b0\u1edbc v\u00e0 g\u00f3t – m\u00e1c. Do c\u01a1 ch\u1ebf ch\u00e2n th\u01b0\u01a1ng BN xoay trong b\u00e0n ch\u00e2n khi t\u00e9, g\u00e2y d\u00e3n d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i, th\u01b0\u1eddng d\u1ec5 t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng m\u00e1c – s\u00ean tr\u01b0\u1edbc. Test nghi\u1ec7m ph\u00e1p ng\u0103n k\u00e9o tr\u01b0\u1edbc \u00e2m t\u00ednh n\u00ean \u00edt ngh\u0129.<\/div>\n
\u00a0<\/div>\n
X. \u0110\u1ec1 ngh\u1ecb CLS<\/strong><\/div>\n
CLS ch\u1ea9n \u0111o\u00e1n:<\/div>\n
– X quang x\u01b0\u01a1ng c\u1ed5 ch\u00e2n th\u1eb3ng, nghi\u00eang ho\u1eb7c ch\u1ebfch.<\/div>\n
\u00a0<\/div>\n
CLS th\u01b0\u1eddng quy:\u00a0<\/div>\n
– C\u00f4ng th\u1ee9c m\u00e1u.<\/div>\n
– Nh\u00f3m m\u00e1u.<\/div>\n
– \u0110\u00f4ng c\u1ea7m m\u00e1u.<\/div>\n
– Sinh h\u00f3a m\u00e1u.<\/div>\n
– Ion \u0111\u1ed3.<\/div>\n
– T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u.<\/div>\n
– ECG.<\/div>\n
– Xquang ng\u1ef1c th\u1eb3ng.<\/div>\n
\u00a0<\/div>\n
XI. K\u1ebft qu\u1ea3 CLS<\/strong><\/div>\n
1. X-quang x\u01b0\u01a1ng c\u1ed5 ch\u00e2n th\u1eb3ng, nghi\u00eang ho\u1eb7c ch\u1ebfch<\/div>\n
\n
\"X
1<\/figcaption><\/figure>\n<\/div>\n
H\u00e0nh ch\u00ednh: b\u1ec7nh nh\u00e2n L\u00c2M NG\u1eccC K, nam, 25 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 26\/03\/2024<\/div>\n
T\u01b0 th\u1ebf ch\u1ee5p: th\u1eb3ng, nghi\u00eang c\u1ed5 ch\u00e2n ph\u1ea3i<\/div>\n
Ch\u1ea5t l\u01b0\u1ee3ng tia: chu\u1ea9n<\/div>\n
Phim th\u1eb3ng.<\/div>\n
M\u00f4 m\u1ec1m: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
X\u01b0\u01a1ng: g\u00e3y m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n ph\u1ea3i, \u0111\u01b0\u1eddng g\u00e3y ch\u00e9o, kh\u00f4ng di l\u1ec7ch<\/div>\n
\n
\"X
2<\/figcaption><\/figure>\n<\/div>\n
\u00a0<\/div>\n
H\u00e0nh ch\u00ednh: b\u1ec7nh nh\u00e2n L\u00c2M NG\u1eccC K, nam, 25 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 26\/03\/2024<\/div>\n
T\u01b0 th\u1ebf ch\u1ee5p: th\u1eb3ng, nghi\u00eang c\u1ed5 ch\u00e2n ph\u1ea3i<\/div>\n
Ch\u1ea5t l\u01b0\u1ee3ng tia: chu\u1ea9n<\/div>\n
Phim nghi\u00eang<\/div>\n
M\u00f4 m\u1ec1m: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
X\u01b0\u01a1ng: g\u00e3y m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n ph\u1ea3i, \u0111\u01b0\u1eddng g\u00e3y ch\u00e9o, kh\u00f4ng di l\u1ec7ch.<\/div>\n
K\u1ebft lu\u1eadn: g\u00e3y m\u1eaft c\u00e1 ngo\u00e0i x\u01b0\u01a1ng ph\u1ea3i, \u0111\u01b0\u1eddng g\u00e3y ch\u00e9o, kh\u00f4ng di l\u1ec7ch.<\/div>\n
\u00a0<\/div>\n
2. \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/div>\n
\n
\"H\u00ecnh
3<\/figcaption><\/figure>\n<\/div>\n
T\u1ed1c \u0111\u1ed9 m\u00e1y: 25mm\/s<\/div>\n
Nh\u1ecbp xoang, \u0111\u1ec1u, t\u1ea7n s\u1ed1 87 l\u1ea7n\/ph\u00fat, t\u1ec9 l\u1ec7 P:QRS = 1:1<\/div>\n
Tr\u1ee5c \u0111i\u1ec7n tim trung gian<\/div>\n
S\u00f3ng P (+) \u1edf DI, DII, (-) \u1edf aVR bi\u00ean \u0111\u1ed9 1mm, th\u1eddi gian 0.08s -> s\u00f3ng P b\u00ecnh th\u01b0\u1eddng<\/div>\n
Kho\u1ea3ng PR th\u1eddi gian 0.16s -> kh\u00f4ng d\u00e3n r\u1ed9ng<\/div>\n
Ph\u1ee9c b\u1ed9 QRS th\u1eddi gian 0.05s -> kh\u00f4ng d\u00e3n r\u1ed9ng<\/div>\n
RV1 + SV5\/V6 <11mm -> kh\u00f4ng c\u00f3 l\u1edbn th\u1ea5t ph\u1ea3i\u00a0<\/div>\n
SV1 + RV5\/V6 <35mm -> kh\u00f4ng c\u00f3 l\u1edbn th\u1ea5t tr\u00e1i<\/div>\n
Kho\u1ea3ng QT < 50%\u00a0 RR t\u01b0\u01a1ng \u1ee9ng -> kh\u00f4ng d\u00e0i<\/div>\n
\u0110o\u1ea1n ST kh\u00f4ng ch\u00eanh\u00a0<\/div>\n
K\u1ebft lu\u1eadn: Nh\u1ecbp xoang \u0111\u1ec1u, t\u1ea7n s\u1ed1 87 l\u1ea7n\/ph\u00fat, tr\u1ee5c \u0111i\u1ec7n tim trung gian<\/div>\n
\u00a0<\/div>\n
3. C\u00f4ng th\u1ee9c m\u00e1u:\u00a0<\/div>\n
Ch\u1ec9 s\u1ed1 20h40 ng\u00e0y 25\/03\/2024 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
WBC 8.19 4.01 – 11.42 %<\/div>\n
\u00a0 \u00a0NEU% 58.6 40 – 74 %<\/div>\n
\u00a0 \u00a0LYM% 33.9 19 – 48 %<\/div>\n
\u00a0 \u00a0MONO% 4.8 3.4 – 9.0 %<\/div>\n
\u00a0 \u00a0EOS% 2.4 0.0 – 7.0 %<\/div>\n
\u00a0 \u00a0BASO% 0.3 0.0 – 0.15 %<\/div>\n
\u00a0 \u00a0NEU# 4.81 1.7 – 7.5 K\/uL<\/div>\n
\u00a0 \u00a0LYM# 2.78 1.2 – 4.0 K\/uL<\/div>\n
\u00a0 \u00a0MONO# 0.39 0.2 – 0.8 K\/uL<\/div>\n
\u00a0 \u00a0EOS# 0.19 0.0 – 0.6 K\/uL<\/div>\n
\u00a0 \u00a0BASO# 0.02 0.0 – 0.1 K\/uL<\/div>\n
RBC 5.97 4.01 – 5.79 M\/uL<\/div>\n
\u00a0 \u00a0HGB 16.6 11.5 – 15.0 g\/dL<\/div>\n
\u00a0 \u00a0HCT 49.2 34.4 – 48.6 %<\/div>\n
\u00a0 \u00a0MCV 82.6 80 – 99 fL<\/div>\n
\u00a0 \u00a0MCH 27.8 27 – 33 Pg<\/div>\n
\u00a0 \u00a0MCHC 33.7 32 – 36 g\/dL<\/div>\n
\u00a0 \u00a0RDW 12.8 11.5 – 15.5 %<\/div>\n
PLT 295.0 150 – 450 K\/uL<\/div>\n
\u00a0 \u00a0MPV 10.4 7.4 – 10.9 fL\u00a0<\/div>\n
Nh\u1eadn x\u00e9t: C\u00e1c ch\u1ec9 s\u1ed1 n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
\u00a0<\/div>\n
4. Sinh h\u00f3a m\u00e1u:<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m 08h46 ng\u00e0y 15\/01\/2024 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
\u0110\u1ecbnh l\u01b0\u1ee3ng Glucose (m\u00e1u) 4.08 4.1 – 5.9 mmol\/L<\/div>\n
\u0110\u1ecbnh l\u01b0\u1ee3ng Ure (m\u00e1u) 4.5 2.8 – 7.2 mmol\/L<\/div>\n
\u0110\u1ecbnh l\u01b0\u1ee3ng Creatinin (m\u00e1u) 95.9 53 – 120 umol\/L\u00a0<\/div>\n
eGFR 88.09 >= 60 mL\/ph\u00fat<\/div>\n
\u0110o ho\u1ea1t \u0111\u1ed9 AST (GOT) (m\u00e1u) 22.1 < 35 U\/L – 37oC<\/div>\n
\u0110o ho\u1ea1t \u0111\u1ed9 ALT (GPT) (m\u00e1u) 17.5 < 35 U\/L – 37oC<\/div>\n
\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3\u00a0<\/div>\n
Na+ 141.4 135 – 145 mmol\/L<\/div>\n
K+ 3.56 3.5 – 5.0 mmol\/L<\/div>\n
Cl- 100.9 98 – 106 mmol\/L<\/div>\n
Calci 2.51 2.15-2.6 mmol\/L<\/div>\n
Nh\u1eadn x\u00e9t: C\u00e1c ch\u1ec9 s\u1ed1 n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
\u00a0<\/div>\n
5. \u0110\u1ecbnh l\u01b0\u1ee3ng nh\u00f3m m\u00e1u<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m 08h56 15\/01\/2024<\/div>\n
Nh\u00f3m m\u00e1u h\u1ec7 Rh(D) D\u01b0\u01a1ng t\u00ednh<\/div>\n
\u0110\u1ecbnh nh\u00f3m m\u00e1u h\u1ec7 ABO B<\/div>\n
\u00a0<\/div>\n
6. Th\u1eddi gian \u0111\u00f4ng m\u00e1u\u00a0<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m K\u1ebft qu\u1ea3 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
APTT 31.9 25-37 Gi\u00e2y<\/div>\n
TQ 13 9.3-14.3 Gi\u00e2y<\/div>\n
TL 100 >70 %<\/div>\n
INR1.000.84 – 1.29<\/div>\n
Nh\u1eadn x\u00e9t: C\u00e1c ch\u1ec9 s\u1ed1 n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
\u00a0<\/div>\n
7. T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u\u00a0<\/div>\n
T\u00ean x\u00e9t nghi\u1ec7m K\u1ebft qu\u1ea3 Kho\u1ea3ng tham chi\u1ebfu \u0110\u01a1n v\u1ecb<\/div>\n
URO nom < 17.1 umol\/L<\/div>\n
GLU nom < 0.84 mmol\/L<\/div>\n
BIL neg < 3.4 umol\/L<\/div>\n
KETneg< 5<\/div>\n
S.G1.0231.015 – 1.025<\/div>\n
BLDneg < 5<\/div>\n
pH5.04.8 – 7.4<\/div>\n
PRO neg < 0.1 g\/L<\/div>\n
NITnegNegative<\/div>\n
LEU neg < 10 ug\/dl<\/div>\n
Nh\u1eadn x\u00e9t: C\u00e1c ch\u1ec9 s\u1ed1 n\u1eb1m trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
\u00a0<\/div>\n
8. X-quang ng\u1ef1c th\u1eb3ng<\/div>\n
\n
\"X
4<\/figcaption><\/figure>\n<\/div>\n
Phim t\u01b0 th\u1ebf sau tr\u01b0\u1edbc, tia v\u1eeba, 2 x\u01b0\u01a1ng \u0111\u00f2n \u0111\u1ed1i x\u1ee9ng qua c\u1ed9t s\u1ed1ng,\u00a0<\/div>\n
Kh\u00ed qu\u1ea3n kh\u00f4ng l\u1ec7ch. G\u00f3c carina nh\u1ecdn < 90 \u0111\u1ed9<\/div>\n
G\u00f3c s\u01b0\u1eddn ho\u00e0nh nh\u1ecdn<\/div>\n
Li\u00ean s\u01b0\u1eddn kh\u00f4ng gi\u00e3n r\u1ed9ng, x\u01b0\u01a1ng s\u01b0\u1eddn kh\u00f4ng t\u1ed5n th\u01b0\u01a1ng<\/div>\n
B\u00f3ng tim kh\u00f4ng l\u1edbn<\/div>\n
Kh\u00f4ng th\u1ea5y t\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 ph\u1ed5i, m\u00e0ng ph\u1ed5i tr\u00ean phim<\/div>\n
X\u01b0\u01a1ng l\u1ed3ng ng\u1ef1c b\u00ecnh th\u01b0\u1eddng<\/div>\n
Nh\u1eadn x\u00e9t: Ch\u01b0a th\u1ea5y t\u1ed5n th\u01b0\u01a1ng b\u1ea5t th\u01b0\u1eddng<\/div>\n
\u00a0<\/div>\n
XII. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/div>\n
G\u00e3y k\u00edn x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i ch\u00e2n (P) ph\u00e2n \u0111\u1ed9 44-B1 theo AO, ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng.<\/div>\n
\u00a0<\/div>\n
XIII. H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/strong><\/div>\n
1. Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb<\/div>\n
– N\u1eafn ch\u1ec9nh x\u01b0\u01a1ng m\u1eaft c\u00e1 ngo\u00e0i v\u1ec1 v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu.<\/div>\n
– B\u1ea5t \u0111\u1ed9ng t\u1ed1t.<\/div>\n
– Gi\u1ea3m \u0111au.<\/div>\n
– T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm.<\/div>\n
2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/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 theo mong mu\u1ed1n c\u1ee7a BN.<\/div>\n
– Trong th\u1eddi gian ch\u1edd ti\u1ebfp t\u1ee5c cho BN \u0111eo n\u1eb9p c\u1eb3ng b\u00e0n ch\u00e2n.<\/div>\n
– Sau ph\u1eabu thu\u1eadt, cho BN ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng – v\u1eadt l\u00ed tr\u1ecb li\u1ec7u.<\/div>\n
\u00a0<\/div>\n
XIV. Ti\u00ean l\u01b0\u1ee3ng<\/strong><\/div>\n
– G\u1ea7n: T\u1ed1t – BN tr\u1ebb, kh\u00f4ng b\u1ec7nh n\u1ec1n, g\u00e3y k\u00edn m\u1eaft c\u00e1 ngo\u00e0i \u2014> kh\u1ea3 n\u0103ng li\u1ec1n x\u01b0\u01a1ng t\u1ed1t.<\/div>\n
– Xa: Kh\u00e1 – c\u00f3 th\u1ec3 b\u1ecb nh\u1eefng bi\u1ebfn ch\u1ee9ng ph\u1eabu thu\u1eadt (bi\u1ebfn ch\u1ee9ng v\u00f4 c\u1ea3m, t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh v\u00e0 m\u1ea1ch m\u00e1u trong qu\u00e1 tr\u00ecnh k\u1ebft h\u1ee3p x\u01b0\u01a1ng, nhi\u1ec5m tr\u00f9ng v\u00e0 ch\u1ea3y m\u00e1u v\u1ebft m\u1ed5), ch\u1eadm li\u1ec1n x\u01b0\u01a1ng.<\/div>","protected":false},"featured_media":4367,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4366","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\/4366","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=4366"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4366\/revisions"}],"predecessor-version":[{"id":4374,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4366\/revisions\/4374"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4367"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4366"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4366"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4366"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}