{"id":4383,"date":"2024-12-23T16:34:08","date_gmt":"2024-12-23T09:34:08","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=4383"},"modified":"2024-12-23T16:34:08","modified_gmt":"2024-12-23T09:34:08","slug":"lam-sang-chan-thuong-chinh-hinh","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/lam-sang-chan-thuong-chinh-hinh\/","title":{"rendered":"L\u00c2M S\u00c0NG CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH"},"content":{"rendered":"
L\u00c2M S\u00c0NG CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/div>\n
B\u1ec6NH \u00c1N NH\u00d3M<\/div>\n
Nh\u00f3m sinh vi\u00ean<\/div>\n
– Tr\u1ea7n Th\u1ecb Thanh Tr\u00fac – 207720101087<\/div>\n
– Ng\u00f4 Thanh V\u00e2n – 207720101094<\/div>\n
– Nguy\u1ec5n Tr\u01b0\u01a1ng H\u00f9ng V\u0129 – 207720101096<\/div>\n
L\u1edbp Y2020<\/div>\n
Nh\u00f3m 8<\/div>\n
Module: Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh<\/div>\n
I. H\u00c0NH CH\u00cdNH<\/strong><\/div>\n
1. H\u1ecd v\u00e0 t\u00ean b\u1ec7nh nh\u00e2n: Ng\u00f4 Th\u1ecb T.<\/div>\n
2. Gi\u1edbi t\u00ednh: N\u1eef<\/div>\n
3. N\u0103m sinh: 1973 (51 tu\u1ed5i)<\/div>\n
4. D\u00e2n t\u1ed9c: Kinh<\/div>\n
5. Ngh\u1ec1 nghi\u1ec7p: C\u00f4ng nh\u00e2n<\/div>\n
6. \u0110\u1ecba ch\u1ec9: e8\/2, x\u00e3 V\u0129nh L\u1ed9c A, huy\u1ec7n B\u00ecnh Ch\u00e1nh, TPHCM<\/div>\n
7. Ng\u00e0y, gi\u1edd nh\u1eadp vi\u1ec7n: 16 gi\u1edd 02 ng\u00e0y 07\/07\/2024<\/div>\n
8. Ng\u00e0y, gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 19 gi\u1edd ng\u00e0y 07\/07\/2024<\/div>\n
I. L\u00dd DO NH\u1eacP VI\u1ec6N:<\/strong><\/div>\n
\u0110au \u2153 d\u01b0\u1edbi c\u1eb3ng tay (T) k\u00e8m h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay (T)<\/div>\n
II. B\u1ec6NH S\u1eec<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n tr\u1ef1c ti\u1ebfp khai b\u1ec7nh:<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n (CNV) 2 gi\u1edd, b\u1ec7nh nh\u00e2n \u0111ang ch\u1ea1y xe \u0111\u1ea1p v\u1edbi v\u1eadn t\u1ed1c kho\u1ea3ng 15km\/h b\u1ecb xe m\u00e1y (kh\u00f4ng r\u00f5 v\u1eadn t\u1ed1c) t\u00f4ng theo h\u01b0\u1edbng vu\u00f4ng g\u00f3c va ch\u1ea1m v\u00e0o ph\u00eda b\u00ean (P) c\u1ee7a BN. BN ng\u00e3 v\u1edbi t\u01b0 th\u1ebf c\u1eb3ng tay (T) ng\u1eeda v\u00e0 khu\u1ef7u g\u1ea5p 90 \u0111\u1ed9 \u0111\u1eadp xu\u1ed1ng m\u1eb7t \u0111\u01b0\u1eddng b\u00ea t\u00f4ng, kh\u00f4ng va \u0111\u1eadp v\u00f9ng \u0111\u1ea7u, kh\u00f4ng va \u0111\u1eadp v\u00f9ng l\u01b0ng – ng\u1ef1c – b\u1ee5ng, BN ng\u00e3 t\u1ea1i ch\u1ed7, xe \u0111\u1ea1p c\u00e1ch ng\u01b0\u1eddi BN 0.5m. Sau va ch\u1ea1m, BN t\u1ec9nh, nh\u1eadn th\u1ee9c \u0111\u01b0\u1ee3c xung quanh, \u0111au ch\u00f3i v\u00e0 bi\u1ebfn d\u1ea1ng v\u00f9ng \u2153 d\u01b0\u1edbi c\u1eb3ng tay (T), c\u01b0\u1eddng \u0111\u1ed9 \u0111au 8\/10, kh\u00f4ng lan, kh\u00f4ng t\u01b0 th\u1ebf gi\u1ea3m \u0111au, kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u1ed9ng t\u00e1c s\u1ea5p – ng\u1eeda c\u1eb3ng tay (T), h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng g\u1ea5p – du\u1ed7i c\u1ed5 tay (T). BN \u0111\u01b0\u1ee3c \u0111\u01b0a \u0111i kh\u00e1m t\u1ea1i Ph\u00f2ng kh\u00e1m \u0111a khoa B\u00e0 \u0110i\u1ec3m. T\u1ea1i Ph\u00f2ng kh\u00e1m, BN b\u1eaft \u0111\u1ea7u th\u1ea5y s\u01b0ng v\u00f9ng \u2153 d\u01b0\u1edbi c\u1eb3ng tay (T), \u1ea5n \u0111au v\u00e0 s\u01b0ng m\u00f4 ng\u00f3n c\u00e1i (T) v\u00e0 t\u00ea li\u00ean t\u1ee5c t\u1eeb c\u1ed5 tay lan t\u1edbi \u0111\u1ea7u 5 ng\u00f3n tay (T) v\u1ec1 ph\u00eda m\u1eb7t l\u00f2ng b\u00e0n tay, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ee5p XQ th\u1eb3ng v\u00f9ng c\u1eb3ng tay (T) (t\u1eeb \u00bd gi\u1eefa x\u01b0\u01a1ng c\u1eb3ng tay \u0111\u1ebfn \u0111\u1ed1t b\u00e0n (T)) v\u00e0 n\u1eb9p c\u1eb3ng tay (T) v\u00e0 t\u1ef1 xin chuy\u1ec3n vi\u1ec7n v\u00e0 nh\u1eadp c\u1ea5p c\u1ee9u BVTN.<\/div>\n
– Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng, ti\u00eau ti\u1ec3u b\u00ecnh th\u01b0\u1eddng.<\/div>\n
C\u1eadn l\u00e2m s\u00e0ng tuy\u1ebfn tr\u01b0\u1edbc:<\/div>\n
\n
\"H\u00ecnh
1<\/figcaption><\/figure>\n<\/div>\n
\u25cf H\u00e0nh ch\u00ednh:<\/div>\n
+H\u1ecd v\u00e0 t\u00ean: Ng\u00f4 Th\u1ecb T.<\/div>\n
+Gi\u1edbi t\u00ednh N\u1eef<\/div>\n
+Tu\u1ed5i: 51 tu\u1ed5i<\/div>\n
+Ng\u00e0y gi\u1edd ch\u1ee5p: 07\/07\/2024<\/div>\n
\u25cf Ti\u00eau chu\u1ea9n phim:<\/div>\n
+C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng, tu\u1ef7 x\u01b0\u01a1ng),<\/div>\n
+Phim ch\u1ee5p qua kh\u1edbp c\u1ed5 tay v\u00e0 kh\u1edbp b\u00e0n ng\u00f3n tay, b\u00ecnh di\u1ec7n th\u1eb3ng.<\/div>\n
\u25cf T\u1ed5n th\u01b0\u01a1ng g\u00e3y x\u01b0\u01a1ng quay v\u1ecb tr\u00ed \u2153 d\u01b0\u1edbi, g\u00e3y nhi\u1ec1u m\u1ea3nh kh\u00f4ng di l\u1ec7ch k\u00e8m g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5.<\/div>\n
\u25cf S\u01b0ng m\u00f4 m\u1ec1m v\u00f9ng m\u00f4 ng\u00f3n tay c\u00e1i<\/div>\n
\u25cf Kh\u00f4ng c\u00f3 h\u00ecnh \u1ea3nh v\u00f4i h\u00f3a g\u00e2n<\/div>\n
\u25cf T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n<\/div>\n
– B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/div>\n
– Da, ni\u00eam m\u1ea1c m\u1eaft h\u1ed3ng<\/div>\n
– Sinh hi\u1ec7u<\/div>\n
+ M\u1ea1ch: 79 l\u1ea7n\/ph\u00fat<\/div>\n
+ Huy\u1ebft \u00e1p: 210\/125 mmHg<\/div>\n
+ Nhi\u1ec7t \u0111\u1ed9: 37 \u0111\u1ed9 C<\/div>\n
+ Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ph\u00fat<\/div>\n
+ SpO2 97% (kh\u00ed tr\u1eddi)<\/div>\n
– H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/div>\n
– Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/div>\n
– Kh\u00f4ng ph\u00f9, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da<\/div>\n
– Kh\u00e1m c\u01a1 quan<\/div>\n
+ Tim \u0111\u1ec1u, ph\u1ed5i kh\u00f4ng ran, b\u1ee5ng m\u1ec1m<\/div>\n
+\u1ea4n \u0111au ch\u00f3i c\u1eb3ng tay (T)<\/div>\n
\u25cf X\u1eed tr\u00ed t\u1ea1i c\u1ea5p c\u1ee9u<\/div>\n
– Nicardipine<\/div>\n
– X\u00e9t nghi\u1ec7m Ethanol m\u00e1u<\/div>\n
– CS II<\/div>\n
III. TI\u1ec0N S\u1eec<\/strong><\/div>\n
1. B\u1ea3n th\u00e2n<\/div>\n
1.1.N\u1ed9i khoa<\/div>\n
-Ch\u01b0a ghi nh\u1eadn<\/div>\n
1.2.Ngo\u1ea1i khoa<\/div>\n
-Ch\u01b0a ghi nh\u1eadn<\/div>\n
1.3. Th\u00f3i quen: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
1.4. D\u1ecb \u1ee9ng<\/div>\n
-Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng.<\/div>\n
1.5. Ti\u00eam ch\u1ee7ng: ti\u00eam 3 m\u0169i v\u1eafc xin COVID 19<\/div>\n
1.6. S\u1ea3n – ph\u1ee5 khoa: PARA 2002, ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh ph\u1ee5<\/div>\n
khoa<\/div>\n
2. Gia \u0111\u00ecnh: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n b\u1ec7nh l\u00fd li\u00ean quan<\/div>\n
IV. L\u01af\u1ee2C QUA C\u00c1C C\u01a0 QUAN (19 gi\u1edd ng\u00e0y 07\/07\/2024)<\/strong><\/div>\n
1. Tim m\u1ea1ch: kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.<\/div>\n
2. H\u00f4 h\u1ea5p: kh\u00f4ng ho, kh\u00f4ng kh\u00f3 th\u1edf.<\/div>\n
3. Ti\u00eau h\u00f3a: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, ti\u00eau ph\u00e2n v\u00e0ng \u0111\u00f3ng khu\u00f4n.<\/div>\n
4. Th\u1eadn ni\u1ec7u: kh\u00f4ng ti\u1ec3u g\u1eaft\/ti\u1ec3u bu\u1ed1t, n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong<\/div>\n
5. Th\u1ea7n kinh: kh\u00f4ng y\u1ebfu li\u1ec7t, kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, t\u00ea li\u00ean t\u1ee5c c\u1ed5 tay lan xu\u1ed1ng c\u00e1c ng\u00f3n tay (T)<\/div>\n
6. C\u01a1 x\u01b0\u01a1ng kh\u1edbp: \u0111au ch\u00f3i + s\u01b0ng \u2153 d\u01b0\u1edbi c\u1eb3ng tay (T), h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng s\u1ea5p ng\u1eeda c\u1eb3ng tay (T), h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng g\u1ea5p du\u1ed7i c\u1ed5 tay (T)<\/div>\n
7. Kh\u00e1c: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
V. KH\u00c1M (19 gi\u1edd ng\u00e0y 07\/07\/2024)<\/strong><\/div>\n
1. T\u1ed5ng tr\u1ea1ng<\/div>\n
– B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/div>\n
– Da ni\u00eam m\u1ea1c m\u1eaft h\u1ed3ng<\/div>\n
– H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/div>\n
– Tuy\u1ebfn gi\u00e1p kh\u00f4ng to – Sinh hi\u1ec7u:<\/div>\n
+M\u1ea1ch: 92 l\u1ea7n\/ph\u00fat<\/div>\n
+Huy\u1ebft \u00e1p tay (P): 160\/80 mmHg<\/div>\n
+Huy\u1ebft \u00e1p tay (T): 165\/80 mmHg<\/div>\n
+Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/div>\n
+Nhi\u1ec7t \u0111\u1ed9: 36.8 \u0111\u1ed9 C<\/div>\n
+SpO2: 99%<\/div>\n
– C\u00e2n n\u1eb7ng: 52kg, chi\u1ec1u cao 150 cm => BMI 23.11 kg\/m2 (th\u1ec3 tr\u1ea1ng ti\u1ec1n b\u00e9o ph\u00ec theo IDI&WPRO)<\/div>\n
– Kh\u00f4ng ph\u00f9, kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da<\/div>\n
– M\u1ea1ch quay b\u1eaft nh\u1eb9, kh\u00f4ng \u0111\u1ec1u, m\u1ea1ch b\u1eb9n, m\u1ea1ch \u0111\u00f9i d\u1ec5 b\u1eaft.<\/div>\n
2. Tim m\u1ea1ch<\/div>\n
– L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, kh\u00f4ng u, kh\u00f4ng v\u1ebft 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
– Di\u1ec7n \u0111\u1eadp m\u1ecfm tim 1 cm x 2 cm \u1edf li\u00ean s\u01b0\u1eddn V \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i.<\/div>\n
– Tim \u0111\u1ec1u, t\u1ea7n s\u1ed1 l\u1ea7n\/ph\u00fat, 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, kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5, kh\u00f4ng u s\u1eb9o.<\/div>\n
– Rung th\u00e0nh \u0111\u1ec1u 2 b\u00ean.<\/div>\n
– G\u00f5 trong 2 ph\u1ed5i.<\/div>\n
– R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu 2 ph\u1ebf tr\u01b0\u1eddng, kh\u00f4ng rale.<\/div>\n
4. Ti\u00eau h\u00f3a<\/div>\n
– B\u1ee5ng c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169<\/div>\n
– Nhu \u0111\u1ed9ng ru\u1ed9t 5 l\u1ea7n\/ph\u00fat<\/div>\n
– G\u00f5 trong<\/div>\n
– B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au, kh\u00f4ng s\u1edd th\u1ea5y kh\u1ed1i u v\u00f9ng b\u1ee5ng, gan l\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m<\/div>\n
5. Th\u1eadn ni\u1ec7u<\/div>\n
– C\u1ea7u b\u00e0ng quang (-)<\/div>\n
– Ch\u1ea1m th\u1eadn (-)<\/div>\n
6. Th\u1ea7n kinh:<\/div>\n
– Ch\u1ee9c n\u0103ng th\u1ea7n kinh cao c\u1ea5p v\u1ecf n\u00e3o<\/div>\n
+\u0110\u1ecbnh h\u01b0\u1edbng v\u1ec1 b\u1ea3n th\u00e2n, kh\u00f4ng gian v\u00e0 th\u1eddi gian: t\u1ed1t, ch\u00ednh x\u00e1c<\/div>\n
+Tr\u00ed nh\u1edb t\u1ee9c th\u00ec, g\u1ea7n, xa: b\u00ecnh th\u01b0\u1eddng<\/div>\n
+Kh\u1ea3 n\u0103ng ng\u00f4n ng\u1eef, vi\u1ebft, hi\u1ec3u: b\u00ecnh th\u01b0\u1eddng<\/div>\n
– T\u01b0 th\u1ebf d\u00e1ng b\u1ed9: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
– C\u1ea3m gi\u00e1c<\/div>\n
+C\u1ea3m gi\u00e1c n\u00f4ng nguy\u00ean ph\u00e1t:<\/div>\n
\u25cf S\u1edd, \u0111au: gi\u1ea3m c\u1ea3m gi\u00e1c b\u00e0n tay (T); tay (P) v\u00e0 chi d\u01b0\u1edbi b\u00ecnh th\u01b0\u1eddng + C\u1ea3m gi\u00e1c s\u00e2u nguy\u00ean ph\u00e1t: \u25cf V\u1ecb th\u1ebf kh\u1edbp: b\u00ecnh th\u01b0\u1eddng \u25cf C\u1ea3m gi\u00e1c v\u1ecf n\u00e3o:<\/div>\n
\u25a0 Kh\u1ed1i h\u00ecnh: ch\u00ednh x\u00e1c \u25a0 H\u00ecnh v\u1ebd tr\u00ean da: ch\u00ednh x\u00e1c – Ph\u1ea3n x\u1ea1: (P)(T)<\/div>\n
\n

H\u00ecnh v\u1ebd tr\u00ean da: ch\u00ednh x\u00e1c –\u00a0\u00a0\u00a0 Ph\u1ea3n x\u1ea1:<\/p>\n\n\n\n\n\n\n\n\n
\n

 <\/p>\n<\/td>\n

\n

(P)<\/strong><\/p>\n<\/td>\n

\n

(T)<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Ph\u1ea3n x\u1ea1 g\u00e2n c\u01a1 nh\u1ecb \u0111\u1ea7u<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n

\n

Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c<\/p>\n<\/td>\n<\/tr>\n

\n

Ph\u1ea3n x\u1ea1 g\u00e2n c\u01a1 tam \u0111\u1ea7u<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n

\n

Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c<\/p>\n<\/td>\n<\/tr>\n

\n

Ph\u1ea3n x\u1ea1 g\u00e2n c\u01a1 c\u00e1nh tay quay<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n

\n

Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c<\/p>\n<\/td>\n<\/tr>\n

\n

Ph\u1ea3n x\u1ea1 g\u1ed1i<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n<\/tr>\n

\n

Ph\u1ea3n x\u1ea1 g\u00f3t<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n

\n

++<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
7. C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/div>\n
Nh\u00ecn:<\/div>\n
-BN n\u1eb1m ng\u1eeda, 2 tay du\u1ed7i th\u1eb3ng:<\/div>\n
+ Tr\u1ee5c chi th\u1eb3ng<\/div>\n
+ S\u01b0ng n\u1ec1 1\u20443 d\u01b0\u1edbi – m\u1eb7t ngo\u00e0i c\u1eb3ng tay tr\u00e1i<\/div>\n
+ Kh\u00f4ng ghi nh\u1eadn c\u00f3 v\u1ebft th\u01b0\u01a1ng, b\u00f3ng n\u01b0\u1edbc, x\u00e2y x\u00e1t da \u1edf hai chi tr\u00ean, da chi tr\u00ean kh\u00f4ng c\u0103ng b\u00f3ng<\/div>\n
+ \u0110\u1ea7u ng\u00f3n tay hai b\u00ean h\u1ed3ng<\/div>\n
S\u1edd:<\/div>\n
+ \u1ea4n \u0111au ch\u00f3i \u2153 d\u01b0\u1edbi-m\u1eb7t ngo\u00e0i c\u1eb3ng tay (T).<\/div>\n
+ \u1ea4n \u0111au kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi, \u1ea5n \u0111au m\u1ecfm tr\u00e2m quay v\u00e0 m\u1ecfm tr\u00e2m<\/div>\n
tr\u1ee5, \u1ea5n \u0111au h\u1ed1 l\u00e0o.<\/div>\n
+ S\u01b0ng v\u00f9ng c\u1eb3ng tay (T) c\u00e1ch m\u1ecfm tr\u00e2m quay 2cm, k\u00edch th\u01b0\u1edbc v\u00f9ng s\u01b0ng n\u00f3ng \u0111\u1ecf kho\u1ea3ng 3x3cm, \u1ea5n \u0111au, v\u00f9ng da b\u1ecb \u1ea5n chuy\u1ec3n sang m\u00e0u tr\u1eafng, sau khi bu\u00f4ng ra chuy\u1ec3n th\u00e0nh m\u00e0u \u0111\u1ecf.<\/div>\n
+ V\u1ebft b\u1ea7m t\u00edm v\u00f9ng mu b\u00e0n tay (T), c\u00e1ch m\u1ecfm tr\u00e2m quay 1cm, \u1ea5n \u0111au, v\u00f9ng da kh\u00f4ng chuy\u1ec3n m\u00e0u.<\/div>\n
+ Tay \u1ea5m, m\u1ea1ch quay b\u00ean T b\u1eaft nh\u1eb9, kh\u00f4ng \u0111\u1ec1u so v\u1edbi b\u00ean P<\/div>\n
+ D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng: d\u01b0\u01a1ng t\u00ednh<\/div>\n
+ D\u1ea5u \u1ed5 kh\u1edbp r\u1ed7ng: kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au G\u00f5: nghi\u1ec7m ph\u00e1p g\u00f5 d\u1ed3n chi tr\u00ean (kh\u00f4ng g\u00f5 \u0111\u01b0\u1ee3c do BN \u0111au) \u0110o:<\/div>\n
+Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u – m\u1ecfm tr\u00e2m quay)<\/div>\n
\u25cf Tay ph\u1ea3i: 23 cm<\/div>\n
\u25cf Tay tr\u00e1i: 23 cm<\/div>\n
+Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (ch\u1ecfm quay – m\u1ecfm tr\u00e2m quay )<\/div>\n
\u25cf Tay ph\u1ea3i: 21 cm<\/div>\n
\u25cf Tay tr\u00e1i: 21 cm<\/div>\n
+ Chu vi v\u00f2ng chi (c\u00e1ch m\u1ecfm tr\u00e2m quay 3cm v\u1ec1 ph\u00eda \u0111\u1ea7u g\u1ea7n x\u01b0\u01a1ng quay)<\/div>\n
\u25cf Tay ph\u1ea3i: 5 cm \u25cf Tay tr\u00e1i: 5.5 cm<\/div>\n
-Kh\u00e1m v\u1eadn \u0111\u1ed9ng:<\/div>\n
+ Kh\u1edbp vai v\u1eadn \u0111\u1ed9ng kh\u00f4ng h\u1ea1n ch\u1ebf: g\u1ea5p – du\u1ed7i, d\u1ea1ng – kh\u00e9p, xoay trong – xoay ngo\u00e0i c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n b\u00ecnh th\u01b0\u1eddng<\/div>\n
+ Kh\u1edbp khu\u1ef7u v\u1eadn \u0111\u1ed9ng kh\u00f4ng h\u1ea1n ch\u1ebf: g\u1ea5p – du\u1ed7i th\u1ef1c hi\u1ec7n b\u00ecnh th\u01b0\u1eddng<\/div>\n
+S\u1ea5p – ng\u1eeda c\u1eb3ng tay tr\u00e1i kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c<\/div>\n
+ H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 tay tr\u00e1i: g\u1ea5p m\u1eb7t l\u01b0ng, g\u1ea5p m\u1eb7t l\u00f2ng, nghi\u00eang quay, nghi\u00eang tr\u1ee5 kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c.<\/div>\n
+S\u1ee9c c\u01a1:<\/div>\n
\u00a0<\/div>\n
\n\n\n\n\n\n\n\n
\n

 <\/p>\n<\/td>\n

\n

G\u1ed1c chi<\/strong><\/p>\n<\/td>\n

\n

Ng\u1ecdn chi<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Tay (T)<\/strong><\/p>\n<\/td>\n

\n

Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c<\/p>\n<\/td>\n

\n

Kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c<\/p>\n<\/td>\n<\/tr>\n

\n

Ch\u00e2n (T)<\/strong><\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n<\/tr>\n

\n

Tay (P)<\/strong><\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n<\/tr>\n

\n

Ch\u00e2n (P)<\/strong><\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n

\n

5\/5<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

8. C\u00e1c c\u01a1 quan kh\u00e1c:<\/div>\n
-Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
VI. T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n 51, tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au \u2153 d\u01b0\u1edbi c\u1eb3ng tay T v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay T. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:<\/div>\n
1. Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng<\/div>\n
– \u0110au v\u00e0 s\u01b0ng v\u00e0 bi\u1ebfn d\u1ea1ng \u2153 d\u01b0\u1edbi m\u1eb7t ngo\u00e0i c\u1eb3ng tay T<\/div>\n
– T\u00ea li\u00ean t\u1ee5c c\u1ed5 tay T lan xu\u1ed1ng c\u00e1c ng\u00f3n tay T<\/div>\n
– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng s\u1ea5p ng\u1eeda c\u1eb3ng tay T<\/div>\n
– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1ed5 tay T<\/div>\n
2. Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3<\/div>\n
– S\u01b0ng n\u1ec1 1\u20443 d\u01b0\u1edbi – m\u1eb7t ngo\u00e0i c\u1eb3ng tay tr\u00e1i<\/div>\n
– \u1ea4n \u0111au ch\u00f3i \u2153 d\u01b0\u1edbi m\u1eb7t ngo\u00e0i c\u1eb3ng tay (T).<\/div>\n
– \u1ea4n \u0111au kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi, \u1ea5n \u0111au m\u1ecfm tr\u00e2m quay v\u00e0 m\u1ecfm tr\u00e2m tr\u1ee5, \u1ea5n \u0111au h\u1ed1 l\u00e0o.<\/div>\n
– D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng (+)<\/div>\n
– S\u1ea5p – ng\u1eeda c\u1eb3ng tay tr\u00e1i kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c<\/div>\n
– H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp c\u1ed5 tay tr\u00e1i: g\u1ea5p m\u1eb7t l\u01b0ng, g\u1ea5p m\u1eb7t l\u00f2ng, nghi\u00eang quay, nghi\u00eang tr\u1ee5 kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c.<\/div>\n
– Gi\u1ea3m c\u1ea3m gi\u00e1c b\u00e0n tay T<\/div>\n
VII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0<\/strong><\/div>\n
1. C\u01a1n t\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p<\/div>\n
2. D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y \u2153 d\u01b0\u1edbi x\u01b0\u01a1ng quay T (d\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng, bi\u1ebfn d\u1ea1ng, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay T)<\/div>\n
3. G\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 T<\/div>\n
4. T\u00ea v\u00e0 gi\u1ea3m c\u1ea3m gi\u00e1c t\u1eeb c\u1ed5 tay \u0111\u1ebfn \u0111\u1ea7u ng\u00f3n tay T<\/div>\n
VIII.CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8:<\/strong><\/div>\n
– T\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p – G\u00e3y k\u00edn \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay (T) k\u00e8m g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 ph\u00e2n \u0111\u1ed9 A3 theo AO do tai n\u1ea1n giao th\u00f4ng gi\u1edd th\u1ee9 4, bi\u1ebfn ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u1ee5 v\u00e0 th\u1ea7n kinh quay,<\/div>\n
IX. CH\u1ea8N \u0110O\u00c1N PH\u00c2N BI\u1ec6T<\/div>\n
– G\u00e3y k\u00edn \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay (T) k\u00e8m g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 ph\u00e2n \u0111\u1ed9 A3 theo AO do tai n\u1ea1n giao th\u00f4ng gi\u1edd th\u1ee9 4, bi\u1ebfn ch\u1ee9ng tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi, t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u1ee5 v\u00e0 th\u1ea7n kinh quay<\/div>\n
X. BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n n\u1eef, 51 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au k\u00e8m h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay v\u00e0 c\u1ed5 tay (T). Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng, ngh\u0129 nhi\u1ec1u:<\/div>\n
1. Ngh\u0129 \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p<\/div>\n
– B\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u1edbi huy\u1ebft \u00e1p 210\/125 mmHg, x\u1eed tr\u00ed c\u1ea5p c\u1ee9u Nicardipine, HA t\u1ea1i Khoa CTCH (sau \u0111\u00f3 2h) 160\/100 mmHg \u2192 c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c h\u1ea1 HA.<\/div>\n
– B\u1ec7nh nh\u00e2n kh\u00f4ng bu\u1ed3n n\u00f4n-n\u00f4n, kh\u00f4ng y\u1ebfu li\u1ec7t chi, kh\u00f4ng n\u00f3i \u0111\u1edb, th\u0103m kh\u00e1m th\u1ea5y ph\u1ea3n x\u1ea1 \u0111\u1ed3ng t\u1eed v\u00e0 v\u1eadn \u0111\u1ed9ng nh\u00e3n c\u1ea7u b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng thay \u0111\u1ed5i th\u1ecb gi\u00e1c, \u0111i ti\u1ec3u b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng ph\u00f9 \u2192 ngh\u0129 nhi\u1ec1u l\u00e0 t\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p v\u00ec ch\u01b0a th\u1ea5y t\u1ed5n th\u01b0\u01a1ng c\u01a1 quan \u0111\u00edch + Th\u1ea7n kinh:<\/div>\n
\u25cf B\u1ec7nh n\u00e3o THA: kh\u00f4ng ngh\u0129 do BN t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/div>\n
\u25cf Nh\u1ed3i m\u00e1u n\u00e3o: kh\u00f4ng ngh\u0129 do BN kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb<\/div>\n
\u25cf Xu\u1ea5t huy\u1ebft n\u00e3o: \u00edt ngh\u0129 do xu\u1ea5t huy\u1ebft n\u00e3o th\u01b0\u1eddng \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, k\u00e8m n\u00f4n \u00f3i, d\u1ea5u m\u00e0ng n\u00e3o, d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb, BN n\u00e0y kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u tr\u00ean tuy nhi\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb Xu\u1ea5t huy\u1ebft n\u00e3o nh\u1ecf (m\u00e1u t\u1ee5 ngo\u00e0i m\u00e0ng c\u1ee9ng) do BN c\u00f3 ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao \u2192 \u0111\u1ec1 ngh\u1ecb CT-scan s\u1ecd n\u00e3o kh\u00f4ng c\u1ea3n quang.<\/div>\n
+ M\u1eaft: b\u1ec7nh v\u00f5ng m\u1ea1c THA: kh\u00f4ng ngh\u0129 do BN kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng m\u1eaft m\u1edd \u0111\u1ed9t ng\u1ed9t, nh\u00ecn l\u00f3a + Tim:<\/div>\n
\u25cf Suy tim c\u1ea5p: kh\u00f4ng ngh\u0129 do BN kh\u00f4ng kh\u00f3 th\u1edf, kh\u00e1m ph\u1ed5i kh\u00f4ng ran, kh\u00f4ng gallop T3<\/div>\n
\u25cf NMCT c\u1ea5p: kh\u00f4ng ngh\u0129 do BN kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng h\u1ed3i h\u1ed9p \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.<\/div>\n
+Th\u1eadn:T\u1ed5nth\u01b0\u01a1ngth\u1eadnc\u1ea5p,kh\u00f4ngth\u1ec3lo\u1ea1itr\u1eeb\u2192\u0111\u1ec1ngh\u1ecbBUN,<\/div>\n
Creatinin m\u00e1u<\/div>\n
+ M\u1ea1ch m\u00e1u: ph\u00ecnh b\u00f3c t\u00e1ch \u0110M ch\u1ee7 : kh\u00f4ng ngh\u0129 do BN kh\u00f4ng \u0111au ng\u1ef1c. – THA th\u1ee9 ph\u00e1t c\u00f3 5 nh\u00f3m nguy\u00ean nh\u00e2n:<\/div>\n
+ Thu\u1ed1c: kh\u00f4ng ngh\u0129 do BN ch\u01b0a t\u1eebng s\u1eed d\u1ee5ng Cam th\u1ea3o (\u0111i\u1ec1u tr\u1ecb ho, b\u1ec7nh d\u1ea1 d\u00e0y), corticoid (g\u00e2y \u1ee9c mu\u1ed1i, n\u01b0\u1edbc), thu\u1ed1c ng\u1eeba thai (gi\u1eef mu\u1ed1i-n\u01b0\u1edbc do Progesteron, t\u0103ng chuy\u1ec3n Renin th\u00e0nh Angiotensin do Estrogen)<\/div>\n
+ H\u1eb9p eo \u0110MC: BN tr\u1ebb, kh\u00f4ng ch\u00eanh \u00e1p hai tay \u2265 10mmHg, m\u1ea1ch b\u1eb9n\/\u0111\u00f9i d\u1ec5 b\u1eaft, kh\u00f4ng teo chi d\u01b0\u1edbi, T1, T2 \u0111\u1ec1u r\u00f5, kh\u00f4ng c\u00f3 \u00e2m th\u1ed5i.<\/div>\n
+ B\u1ec7nh th\u1eadn-ni\u1ec7u: BN kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng g\u1ee3i \u00fd b\u1ec7nh th\u1eadn nh\u01b0 ph\u00f9 t\u00e1i \u0111i t\u00e1i l\u1ea1i, ti\u1ec3u \u0111\u00eam, tuy nhi\u00ean kh\u00f4ng lo\u1ea1i tr\u1eeb \u0111\u01b0\u1ee3c \u2192 TPTNT, SA b\u1ee5ng, BUN, Creatinin<\/div>\n
+ N\u1ed9i ti\u1ebft: kh\u00f4ng ngh\u0129 do BN kh\u00f4ng s\u1ee5t c\u00e2n, kh\u00f4ng run tay, kh\u00f4ng v\u00e3 m\u1ed3 h\u00f4i, kh\u00f4ng r\u1ee5ng l\u00f4ng, t\u00f3c, kh\u00f4ng t\u00e1o b\u00f3n, kh\u00f4ng y\u1ebfu c\u01a1, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng v\u1ebb m\u1eb7t Cushing (tr\u00f2n nh\u01b0 m\u1eb7t tr\u0103ng), kh\u00f4ng b\u00e9o ph\u1ea7n th\u00e2n hay ch\u00e2n tay nh\u1ecf, m\u1edf \u1edf g\u00e1y, da m\u1ecfng<\/div>\n
+Kh\u00e1c<\/div>\n
\u25cf Thai k\u1ef3 (5%): kh\u00f4ng ngh\u0129 do BN kh\u00f4ng mang thai<\/div>\n
\u25cf B\u1ecfng: kh\u00f4ng ngh\u0129<\/div>\n
\u25cf \u0110a h\u1ed3ng c\u1ea7u: ch\u01b0a lo\u1ea1i tr\u1eeb, \u0111\u1ec1 ngh\u1ecb T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi.<\/div>\n
\u25cf Stress (g\u00e3y x\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao): ngh\u0129<\/div>\n
nhi\u1ec1u<\/div>\n
2. Ngh\u0129 nhi\u1ec1u \u0111\u1ebfn g\u00e3y k\u00edn \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay tr\u00e1i do ch\u1ea5n th\u01b0\u01a1ng v\u00ec:<\/div>\n
– B\u1ec7nh nh\u00e2n b\u1ecb ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao (tai n\u1ea1n giao th\u00f4ng), ng\u00e3 xu\u1ed1ng \u0111\u01b0\u1eddng v\u1edbi t\u01b0 th\u1ebf \u0111\u1eadp c\u1ed5 tay xu\u1ed1ng n\u1ec1n c\u1ee9ng, khu\u1ef7u tay g\u1eadp.<\/div>\n
– Sau ng\u00e3 b\u1ec7nh nh\u00e2n \u0111au ch\u00f3i, m\u1ea5t v\u1eadn \u0111\u1ed9ng c\u01a1 n\u0103ng v\u00f9ng c\u1ed5 tay \u21d2 C\u01a1 ch\u1ebf ng\u00e3 v\u00e0 v\u1ecb tr\u00ed \u0111au sau ng\u00e3 g\u1ee3i \u00fd c\u00f3 th\u1ec3 c\u00f3 t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng kh\u1edbp v\u00f9ng c\u1ed5 tay<\/div>\n
– Kh\u00e1m th\u1ea5y s\u01b0ng, \u0111au, d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y \u2153 d\u01b0\u1edbi x\u01b0\u01a1ng quay T (d\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng, bi\u1ebfn d\u1ea1ng, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1eb3ng tay T) k\u00e8m h\u00ecnh \u1ea3nh g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng \u21d2 Kh\u1eb3ng \u0111\u1ecbnh g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay<\/div>\n
– Kh\u00f4ng ngh\u0129 b\u1ec7nh nh\u00e2n g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng \u0111au x\u01b0\u01a1ng tr\u01b0\u1edbc \u0111\u00f3<\/div>\n
– B\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng v\u00f9ng g\u1ea7n \u1ed5 g\u00e3y, kh\u00f4ng l\u1ed9 \u0111\u1ea7u x\u01b0\u01a1ng, kh\u00f4ng ch\u1ea3y m\u00e1u v\u00e1ng m\u1ee1 \u21d2 G\u00e3y k\u00edn<\/div>\n
– \u1ea4n \u0111au kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi, m\u1ecfm tr\u00e2m tr\u1ee5, h\u1ed1 l\u00e0o, k\u00e8m tr\u00ean phim X quang tuy\u1ebfn tr\u01b0\u1edbc c\u00f3 h\u00ecnh \u1ea3nh G\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 \u21d2 C\u00f3 g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5 k\u00e8m theo<\/div>\n
v\u00e0 ngh\u0129 c\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng t\u1ea1i kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi ho\u1eb7c x\u01b0\u01a1ng kh\u1edbp b\u00e0n tay<\/div>\n
(thuy\u1ec1n, nguy\u1ec7t, th\u00e1p, \u0111\u1eadu)<\/div>\n
\u21d2 \u0110\u1ec1 ngh\u1ecb ch\u1ee5p X Quang c\u1eb3ng tay tr\u00e1i t\u01b0 th\u1ebf th\u1eb3ng, nghi\u00eang; X Quang x\u01b0\u01a1ng c\u1ed5 tay th\u1eb3ng, nghi\u00eang v\u00e0 ch\u1ebfch \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n; CT scan v\u00f9ng c\u1ed5 tay \u0111\u1ec3 ki\u1ec3m tra v\u00e0 \u0111\u00e1nh gi\u00e1 g\u00e3y ph\u1ea1m kh\u1edbp.<\/div>\n
Bi\u1ebfn ch\u1ee9ng:<\/div>\n
– \u0110e d\u1ecda t\u00ednh m\u1ea1ng:<\/div>\n
+ S\u1ed1c do m\u1ea5t m\u00e1u: b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng h\u1edf, kh\u00f4ng ch\u1ea3y m\u00e1u, m\u1ea1ch v\u00e0 huy\u1ebft \u00e1p b\u00ecnh th\u01b0\u1eddng \u21d2 kh\u00f4ng ngh\u0129<\/div>\n
+ S\u1ed1c do \u0111au: S\u1ed1c do \u0111au: b\u1ec7nh nh\u00e2n t\u1ec9nh, sinh hi\u1ec7u nh\u1eadp khoa C\u1ea5p c\u1ee9u hi\u1ec7n \u1ed5n, kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng \u0111au d\u1eef d\u1ed9i \u21d2 kh\u00f4ng ngh\u0129<\/div>\n
– S\u1edbm:<\/div>\n
+ Ch\u00e8n \u00e9p khoang: B\u1ec7nh nh\u00e2n \u0111au nh\u01b0ng m\u1ee9c \u0111\u1ed9 \u0111au kh\u00f4ng t\u0103ng, da v\u00f9ng c\u1eb3ng tay kh\u00f4ng c\u1ee9ng, c\u0103ng b\u00f3ng, chi \u1ea5m, m\u1ea1ch quay b\u1eaft \u0111\u1ec1u r\u00f5, kh\u00f4ng t\u00edm \u0111\u1ea7u chi \u21d2 \u00edt ngh\u0129<\/div>\n
+ T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: Kh\u00e1m chi \u1ea5m, CRT< 2s, \u0111\u1ea7u chi h\u1ed3ng, \u0111\u1ed9ng m\u1ea1ch quay tr\u00e1i b\u1eaft nh\u1eb9, kh\u00f4ng \u0111\u1ec1u. HA nh\u1eadp C\u1ea5p c\u1ee9u 210\/125 mmHg.<\/div>\n
\u25cf Xu\u1ea5t huy\u1ebft n\u00e3o: \u00edt ngh\u0129 do xu\u1ea5t huy\u1ebft n\u00e3o th\u01b0\u1eddng \u0111au \u0111\u1ea7u d\u1eef d\u1ed9i, k\u00e8m n\u00f4n \u00f3i, d\u1ea5u m\u00e0ng n\u00e3o, d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb, BN n\u00e0y kh\u00f4ng c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u tr\u00ean tuy nhi\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb Xu\u1ea5t huy\u1ebft n\u00e3o nh\u1ecf (m\u00e1u t\u1ee5 ngo\u00e0i m\u00e0ng c\u1ee9ng) do BN c\u00f3 ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao \u2192 \u0111\u1ec1 ngh\u1ecb CT-scan s\u1ecd n\u00e3o kh\u00f4ng c\u1ea3n quang.<\/div>\n
+ T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: B\u1ec7nh nh\u00e2n t\u00ea tay, c\u1ea3m gi\u00e1c chi ph\u1ed1i th\u1ea7n kinh t\u1ea1i ch\u1ed7 gi\u1ea3m, c\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u b\u00ecnh th\u01b0\u1eddng. BN c\u00f3 g\u00e3y \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay k\u00e8m g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5, ngh\u0129 c\u00f3 th\u1ec3 t\u1ed5n th\u01b0\u01a1ng:<\/div>\n
\u25cf Th\u1ea7n kinh gi\u1eefa<\/div>\n
\u25cf Th\u1ea7n kinh tr\u1ee5<\/div>\n
\n
\"ALT:
2<\/figcaption><\/figure>\n<\/div>\n
XI.\u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/div>\n
1. CLS ch\u1ea9n \u0111o\u00e1n<\/div>\n
– XQ c\u1eb3ng tay T th\u1eb3ng – nghi\u00eang<\/div>\n
– CT scan s\u1ecd n\u00e3o kh\u00f4ng c\u1ea3n quang<\/div>\n
2. CLS theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb – C\u00f4ng th\u1ee9c m\u00e1u<\/div>\n
– \u0110\u00f4ng c\u1ea7m m\u00e1u<\/div>\n
– Sinh ho\u00e1 m\u00e1u (AST, ALT, ure, creatinine, glucose)<\/div>\n
– \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/div>\n
– T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u 10 th\u00f4ng s\u1ed1<\/div>\n
– X-quang ng\u1ef1c th\u1eb3ng<\/div>\n
XII. K\u1ebeT QU\u1ea2 & BI\u1ec6N LU\u1eacN C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/div>\n
1. X-quang c\u1eb3ng tay (T) th\u1eb3ng – nghi\u00eang:<\/div>\n
\n
\"X
3<\/figcaption><\/figure>\n<\/div>\n
\u25cf H\u00e0nh ch\u00ednh:<\/div>\n
+H\u1ecd v\u00e0 t\u00ean: Ng\u00f4 Th\u1ecb T.<\/div>\n
+Gi\u1edbi t\u00ednh N\u1eef<\/div>\n
+Tu\u1ed5i: 51 tu\u1ed5i<\/div>\n
+Ng\u00e0y gi\u1edd ch\u1ee5p: 07\/07\/2024<\/div>\n
\u25cf Ti\u00eau chu\u1ea9n phim:<\/div>\n
+C\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng, tu\u1ef7 x\u01b0\u01a1ng)<\/div>\n
+Phim ch\u1ee5p qua kh\u1edbp c\u1ed5 tay v\u00e0 kh\u1edbp b\u00e0n ng\u00f3n tay, b\u00ecnh di\u1ec7n th\u1eb3ng.<\/div>\n
+ T\u1ed5n th\u01b0\u01a1ng g\u00e3y x\u01b0\u01a1ng v\u1ecb tr\u00ed \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay, g\u00e3y nhi\u1ec1u m\u1ea3nh kh\u00f4ng di l\u1ec7ch k\u00e8m g\u00e3y m\u1ecfm tr\u00e2m tr\u1ee5.<\/div>\n
+Ch\u01b0a ghi nh\u1eadn tr\u1eadt kh\u1edbp quay tr\u1ee5 d\u01b0\u1edbi<\/div>\n
+S\u01b0ng m\u00f4 m\u1ec1m v\u00f9ng m\u00f4 ng\u00f3n tay c\u00e1i<\/div>\n
+Kh\u00f4ng c\u00f3 h\u00ecnh \u1ea3nh v\u00f4i h\u00f3a g\u00e2n<\/div>\n
2. C\u00f4ng th\u1ee9c m\u00e1u<\/div>\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

X\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

20:32, 07\/07\/2024<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

WBC (4.01 – 11.42 K\/uL)<\/p>\n<\/td>\n

\n

9.2<\/p>\n<\/td>\n<\/tr>\n

\n

NEU% (40 – 74%)<\/p>\n<\/td>\n

\n

75.63<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

LYM% (19 – 48%)<\/p>\n<\/td>\n

\n

17.96<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

MONO% (3.4 – 9.0%)<\/p>\n<\/td>\n

\n

5.42<\/p>\n<\/td>\n<\/tr>\n

\n

EOS% (0.0 – 7.0%)<\/p>\n<\/td>\n

\n

0.71<\/p>\n<\/td>\n<\/tr>\n

\n

BASO% (0.0 – 1.5%)<\/p>\n<\/td>\n

\n

0.28<\/p>\n<\/td>\n<\/tr>\n

\n

NEU# (1.7 – 7.5 K\/uL)<\/p>\n<\/td>\n

\n

6.988<\/p>\n<\/td>\n<\/tr>\n

\n

LYM# (1.2 – 4.0 K\/uL)<\/p>\n<\/td>\n

\n

1.659<\/p>\n<\/td>\n<\/tr>\n

\n

MONO# (0.2 – 0.8 K\/uL)<\/p>\n<\/td>\n

\n

0.501<\/p>\n<\/td>\n<\/tr>\n

\n

EOS# (0.0 – 0.6 K\/uL)<\/p>\n<\/td>\n

\n

0.065<\/p>\n<\/td>\n<\/tr>\n

\n

BASO# (0.0 – 0.1 K\/uL)<\/p>\n<\/td>\n

\n

0.026<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

RBC (4.01 – 5.79 M\/uL)<\/p>\n<\/td>\n

\n

4.47<\/p>\n<\/td>\n<\/tr>\n

\n

HGB (11.5 – 15.0 g\/dL)<\/p>\n<\/td>\n

\n

12.7<\/p>\n<\/td>\n<\/tr>\n

\n

HCT (34.4 – 48.6 %)<\/p>\n<\/td>\n

\n

37.9<\/p>\n<\/td>\n<\/tr>\n

\n

MCV (80 – 99 fL)<\/p>\n<\/td>\n

\n

84.6<\/p>\n<\/td>\n<\/tr>\n

\n

MCH (27 – 33 Pg)<\/p>\n<\/td>\n

\n

28.4<\/p>\n<\/td>\n<\/tr>\n

\n

MCHC (32 – 36 g\/dL)<\/p>\n<\/td>\n

\n

33.6<\/p>\n<\/td>\n<\/tr>\n

\n

RDW (11.5 – 15.5 %)<\/p>\n<\/td>\n

\n

14.4<\/p>\n<\/td>\n<\/tr>\n

\n

PLT (150 – 450 K\/uL)<\/p>\n<\/td>\n

\n

360.0<\/p>\n<\/td>\n<\/tr>\n

\n

MPV (7.4 – 10.9 fL)<\/p>\n<\/td>\n

\n

6.8<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh nh\u00f3m m\u00e1u h\u1ec7 Rh(D)<\/p>\n<\/td>\n

\n

+<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh nh\u00f3m m\u00e1u h\u1ec7 ABO<\/p>\n<\/td>\n

\n

O<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
– K\u1ebft lu\u1eadn: H\u1ed3ng c\u1ea7u, b\u1ea1ch c\u1ea7u, ti\u1ec3u c\u1ea7u ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
3. \u0110\u00f4ng c\u1ea7m m\u00e1u<\/div>\n
\n\n\n\n\n\n\n\n\n\n
\n

X\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

20:32, 07\/07\/2024<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

aPTT<\/p>\n<\/td>\n

\n

28.1<\/p>\n<\/td>\n<\/tr>\n

\n

PT<\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

TQ<\/p>\n<\/td>\n

\n

12.4<\/p>\n<\/td>\n<\/tr>\n

\n

TL<\/p>\n<\/td>\n

\n

100<\/p>\n<\/td>\n<\/tr>\n

\n

INR<\/p>\n<\/td>\n

\n

1.00<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Fibrinogen<\/p>\n<\/td>\n

\n

395.0<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
– K\u1ebft lu\u1eadn: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
4. Sinh h\u00f3a m\u00e1u<\/div>\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

X\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

20:32, 07\/07\/2024<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng 25OH Vitamin<\/p>\n

D (D3) [M\u00e1u] (30-100)<\/p>\n<\/td>\n

\n

27.76<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Glucose [M\u00e1u]<\/p>\n

(4,1-5,9 mmol\/L)<\/p>\n<\/td>\n

\n

8.69<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Ure [M\u00e1u]<\/p>\n

(2,8-7,2 mmol\/L)<\/p>\n<\/td>\n

\n

3.49<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Creatinin [M\u00e1u]<\/p>\n

(58-96 umol\/L)<\/p>\n<\/td>\n

\n

53.1<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

eGFR ( >= 60 ml\/p)<\/p>\n<\/td>\n

\n

150.77<\/p>\n<\/td>\n<\/tr>\n

\n

AST ( <35 U\/L)<\/p>\n<\/td>\n

\n

18.3<\/p>\n<\/td>\n<\/tr>\n

\n

ALT (<35 U\/L)<\/p>\n<\/td>\n

\n

10.4<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Cholesterol to\u00e0n ph\u1ea7n [M\u00e1u]<\/p>\n

(<5.2)<\/p>\n<\/td>\n

\n

4.77<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Triglyceride<\/p>\n

[M\u00e1u] (<1.7)<\/p>\n<\/td>\n

\n

0.676<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng HDL-C<\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

HDL – Cholesterol (>1.03)<\/p>\n<\/td>\n

\n

1.3<\/p>\n<\/td>\n<\/tr>\n

\n

Non – HDL – Cholesterol<\/p>\n

(<3.4)<\/p>\n<\/td>\n

\n

3.47<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng LDL – C [M\u00e1u]<\/p>\n<\/td>\n

\n

3.16<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Bilirubin to\u00e0n ph\u1ea7n [M\u00e1u] (<=17)<\/p>\n<\/td>\n

\n

4.44<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Bilirubin tr\u1ef1c ti\u1ebfp [M\u00e1u] (<=4.3)<\/p>\n<\/td>\n

\n

1.75<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng Protein to\u00e0n ph\u1ea7n [M\u00e1u] (65-82)<\/p>\n<\/td>\n

\n

73.6<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
– K\u1ebft lu\u1eadn:<\/div>\n
+Glucose m\u00e1u t\u0103ng, \u0111\u1ec1 ngh\u1ecb l\u00e0m l\u1ea1i \u0111\u01b0\u1eddng huy\u1ebft \u0111\u00f3i v\u00e0 HbA1c.<\/div>\n
+LDL – C, Non-HDL-Cholesterol t\u0103ng nh\u1eb9.\u2003<\/div>\n
5. \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/div>\n
\n\n\n\n\n\n\n\n
\n

X\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

20:32, 07\/07\/2024<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Na (135-145 mmol\/L)<\/p>\n<\/td>\n

\n

137.1<\/p>\n<\/td>\n<\/tr>\n

\n

K (3,5-5,0 mmol\/L)<\/p>\n<\/td>\n

\n

3.07<\/p>\n<\/td>\n<\/tr>\n

\n

Cl (98-106 mmol\/L)<\/p>\n<\/td>\n

\n

103.7<\/p>\n<\/td>\n<\/tr>\n

\n

Calci to\u00e0n ph\u1ea7n [M\u00e1u]<\/p>\n

(2,15-2,6 mmol\/L)<\/p>\n<\/td>\n

\n

2.18<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
– K\u1ebft lu\u1eadn: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
XIII.CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong><\/div>\n
T\u0103ng huy\u1ebft \u00e1p kh\u1ea9n c\u1ea5p – G\u00e3y k\u00edn \u0111\u1ea7u d\u01b0\u1edbi x\u01b0\u01a1ng quay ph\u00e2n \u0111\u1ed9 A3 theo AO do tai n\u1ea1n giao th\u00f4ng gi\u1edd th\u1ee9 4, bi\u1ebfn ch\u1ee9ng t\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh tr\u1ee5 v\u00e0 th\u1ea7n kinh quay<\/div>\n
XIV. H\u01af\u1edaNG \u0110I\u1ec0U TR\u1eca<\/strong><\/div>\n
– \u0110i\u1ec1u tr\u1ecb ban \u0111\u1ea7u:<\/div>\n
+\u0110i\u1ec1u tr\u1ecb \u1ed5n \u0111\u1ecbnh huy\u1ebft \u00e1p<\/div>\n
+Gi\u1ea3m \u0111au<\/div>\n
+N\u1eb9p c\u1ed1 \u0111\u1ecbnh c\u1eb3ng – b\u00e0n tay (T)<\/div>\n
– \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/div>\n
+B\u1ea3o t\u1ed3n: b\u00f3 b\u1ed9t c\u00e1nh – c\u1eb3ng – b\u00e0n tay<\/div>\n
+Ph\u1eabu thu\u1eadt: ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng<\/div>\n
XV. TI\u00caN L\u01af\u1ee2NG<\/strong><\/div>\n
– G\u1ea7n: ti\u00ean l\u01b0\u1ee3ng to\u00e0n th\u00e2n t\u1ed1t, ti\u00ean l\u01b0\u1ee3ng t\u1ea1i ch\u1ed7 t\u1ed1t.<\/div>\n
– Xa: t\u1ed1t, ti\u1ebfp t\u1ee5c theo d\u00f5i di\u1ec5n ti\u1ebfn l\u00e2m s\u00e0ng v\u00ec v\u1eabn c\u00f2n nguy c\u01a1 bi\u1ebfn ch\u1ee9ng xa.<\/div>\n
XV. D\u1ef0 PH\u00d2NG:<\/strong><\/div>\n
– Dinh d\u01b0\u1ee1ng h\u1ee3p l\u00fd<\/div>\n
– Tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb<\/div>\n
– T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm.<\/div>\n","protected":false},"featured_media":4390,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4383","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\/4383","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=4383"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4383\/revisions"}],"predecessor-version":[{"id":4391,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4383\/revisions\/4391"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4390"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4383"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4383"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4383"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}