{"id":4392,"date":"2024-12-23T17:00:31","date_gmt":"2024-12-23T10:00:31","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&p=4392"},"modified":"2024-12-23T17:03:58","modified_gmt":"2024-12-23T10:03:58","slug":"gay-kin-%e2%85%93-tren-xuong-chay-t-gay-mam-chay-t","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-kin-%e2%85%93-tren-xuong-chay-t-gay-mam-chay-t\/","title":{"rendered":"G\u00c3Y K\u00cdN \u2153 TR\u00caN X\u01af\u01a0NG CH\u00c0Y (T) – G\u00c3Y M\u00c2M CH\u00c0Y (T)"},"content":{"rendered":"
G\u00c3Y K\u00cdN \u2153 TR\u00caN X\u01af\u01a0NG CH\u00c0Y (T) – G\u00c3Y M\u00c2M CH\u00c0Y (T)<\/div>\n
\u00a0 L\u1edbp: Y2020 – Nh\u00f3m: 06<\/div>\n
\u00a0 Nguy\u1ec5n Th\u1ecb Kim Nhi\u00a0 \u00a0 \u00a0– 207720101060<\/div>\n
\u00a0 Hu\u1ef3nh Ki\u1ebfn Qu\u1ed1c\u00a0 \u00a0 \u00a0 \u00a0 \u00a0– 207720101063<\/div>\n
\u00a0 L\u00ea Ho\u00e0ng Kh\u00e1nh T\u00e2m\u00a0 – 207720101068<\/div>\n
\u00a0 \u0110\u1eb7ng Ho\u00e0ng Th\u00e0nh\u00a0 \u00a0 \u00a0 – 207720101073<\/div>\n
B\u1ec6NH \u00c1N KHOA NGO\u1ea0I CH\u1ea4N TH\u01af\u01a0NG CH\u1ec8NH H\u00ccNH<\/div>\n
I. H\u00e0nh ch\u00ednh:<\/strong><\/div>\n
– H\u1ecd t\u00ean: TR\u1ea6N THANH M.<\/div>\n
– Tu\u1ed5i: 1961 (63 tu\u1ed5i).<\/div>\n
– Gi\u1edbi t\u00ednh: N\u1eef.<\/div>\n
– D\u00e2n t\u1ed9c: Kinh.<\/div>\n
– \u0110\u1ecba ch\u1ec9:\u00a0 S\u1ed1 41, \u0111\u01b0\u1eddng s\u1ed1 7, ph\u01b0\u1eddng T\u00e2n Th\u00f4ng H\u1ed9i, huy\u1ec7n C\u1ee7 Chi, TP. HCM.<\/div>\n
– Ngh\u1ec1 nghi\u1ec7p: Th\u1ee3 may.<\/div>\n
– Thu\u1eadn chi: Tay ph\u1ea3i, ch\u00e2n ph\u1ea3i.<\/div>\n
– Ng\u00e0y gi\u1edd nh\u1eadp C\u1ea5p c\u1ee9u: 4 gi\u1edd 9 ph\u00fat, ng\u00e0y 4\/6\/2024.<\/div>\n
– Ng\u00e0y gi\u1edd nh\u1eadp khoa Ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh: 7 gi\u1edd 30 ph\u00fat, ng\u00e0y 4\/6\/2024.<\/div>\n
– Nga\u0300y gi\u01a1\u0300 la\u0300m b\u1ec7nh \u00e1n: 8 gi\u1edd, ng\u00e0y 4\/6\/2024.<\/div>\n
II. L\u00fd do nh\u1eadp vi\u1ec7n: \u0110au \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T).<\/strong><\/div>\n
III. B\u1ec7nh s\u1eed:<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n (BN) khai:<\/div>\n
C\u00e1ch nh\u1eadp vi\u1ec7n 7 gi\u1edd, BN ng\u00e3 t\u1eeb \u0111\u1ed9 cao #1m khi \u0111\u1ee9ng l\u00ean b\u00e0n may \u0111\u1ec3 s\u1eeda \u0111\u1ed3ng h\u1ed3, BN ng\u00e3 v\u1ec1 b\u00ean (T), va ch\u1ea1m \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T) v\u1edbi t\u1ea5m v\u00e1n c\u1ee7a m\u00e1y may r\u1ed3i va ch\u1ea1m v\u1edbi n\u1ec1n c\u1ee9ng b\u1eb1ng v\u00f9ng \u0111\u1ea7u (T) v\u00e0 to\u00e0n b\u1ed9 chi b\u00ean (T), b\u1ec7nh nh\u00e2n kh\u00f4ng ch\u1ed1ng tay xu\u1ed1ng n\u1ec1n.\u00a0<\/div>\n
Sau ng\u00e3, BN t\u1ec9nh, \u0111au nh\u00f3i v\u00f9ng \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T), k\u00e8m s\u01b0ng n\u1ec1, x\u00e2y x\u00e1t da nh\u1eb9 v\u00e0 kh\u00f4ng tr\u1ee5 \u0111\u01b0\u1ee3c b\u1eb1ng ch\u00e2n (T). Ngo\u00e0i ra, BN \u0111au \u0111\u1ea7u v\u00e0 ch\u1ea3y m\u00e1u v\u00f9ng \u0111\u1ea7u l\u01b0\u1ee3ng \u00edt #5ml k\u00e8m bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n #3 l\u1ea7n kh\u00f4ng l\u1eabn nh\u1ea7y m\u00e1u (sau u\u1ed1ng s\u1eefa). BN n\u1eb1m y\u00ean t\u1ea1i v\u1ecb tr\u00ed ng\u00e3 v\u00e0 \u0111\u01b0\u1ee3c ng\u01b0\u1eddi th\u00e2n xoa b\u00f3p v\u00f9ng ch\u00e2n (T) b\u1eb1ng d\u1ea7u n\u00f3ng kho\u1ea3ng 30 ph\u00fat v\u00e0 ch\u01b0\u1eddm l\u1ea1nh v\u00f9ng \u0111\u1ea7u. Sau \u0111\u00f3, BN \u0111\u01b0\u1ee3c ng\u01b0\u1eddi th\u00e2n c\u00f5ng tr\u00ean l\u01b0ng v\u1edbi t\u01b0 th\u1ebf ch\u00e2n (T) du\u1ed7i th\u1eb3ng, kh\u00f4ng g\u1eadp v\u00e0 \u0111\u01b0\u1ee3c x\u1eed tr\u00ed b\u1eb1ng thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 thu\u1ed1c tan m\u00e1u b\u1ea7m kh\u00f4ng r\u00f5 lo\u1ea1i \u2192 nh\u1eadp khoa c\u1ea5p c\u1ee9u b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/div>\n
Trong qua\u0301 tri\u0300nh b\u1ec7nh, BN kh\u00f4ng t\u00ea b\u00ec c\u00e1c chi, kh\u00f4ng co\u0301 ca\u0309m gia\u0301c la\u0323nh \u0111\u00e2\u0300u chi, kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng t\u1ef1 n\u1eafn \u00e9p v\u1ebft th\u01b0\u01a1ng tr\u01b0\u1edbc \u0111\u00f3. Ti\u1ec3u \u0111\u01b0\u1ee3c kh\u00f4ng g\u1eaft bu\u1ed1t.<\/div>\n
T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp khoa C\u1ea5p c\u1ee9u B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t:<\/div>\n
– B\u1ec7nh nh\u00e2n t\u1ec9nh, GCS 15\u0111.<\/div>\n
– Chi \u1ea5m, da ni\u00eam h\u1ed3ng.<\/div>\n
– Sinh hi\u1ec7u:<\/div>\n
+ M\u1ea1ch: 100 l\u1ea7n\/ph\u00fat.<\/div>\n
+ Huy\u1ebft \u00e1p: 160\/80 mmHg.<\/div>\n
\u2192 SI = 0,625 < 1.<\/div>\n
+ Nhi\u1ec7t \u0111\u1ed9: 36.3\u00a0 \u0111\u1ed9 C.<\/div>\n
+ Nh\u1ecbp th\u1edf: 20\u00a0 l\u1ea7n\/ph\u00fat.<\/div>\n
+ SpO2: 98 %\/KT<\/div>\n
+ C\u00e2n n\u1eb7ng: 65 kg, chi\u1ec1u cao: 160 cm.<\/div>\n
– Tim kh\u00f4ng \u00e2m th\u1ed5i, ph\u1ed5i kh\u00f4ng rale.<\/div>\n
– D\u1ea5u ti\u1ec3u n\u00e3o (-). S\u1ee9c c\u01a1 2 b\u00ean 5\/5, kh\u00f4ng th\u1ea5y sang th\u01b0\u01a1ng h\u1edf ch\u1ea3y m\u00e1u.<\/div>\n
X\u1eed tr\u00ed t\u1ea1i khoa C\u1ea5p c\u1ee9u B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t<\/div>\n
– \u0110eo n\u1eb9p \u0111\u00f9i (T)<\/div>\n
– Theo d\u00f5i t\u00ecnh tr\u1ea1ng s\u01b0ng n\u1ec1, m\u1ea1ch mu ch\u00e2n, t\u00ecnh tr\u1ea1ng t\u00ea ch\u00e2n.<\/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 8 n\u0103m (2016), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n H\u1edf van tim t\u1ea1i B\u1ec7nh vi\u1ec7n Nh\u00e2n D\u00e2n 115, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa t\u1ea1i \u0111\u00e2y #1 th\u00e1ng sau \u0111\u00f3 t\u1ef1 \u00fd \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c kh\u00f4ng r\u00f5 lo\u1ea1i \u1edf ph\u00f2ng kh\u00e1m t\u01b0. B\u1ec7nh nh\u00e2n kh\u00f4ng t\u00e1i kh\u00e1m l\u1ea1i sau \u0111\u00f3.<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 7 n\u0103m (2017), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n Basedow t\u1ea1i B\u1ec7nh vi\u1ec7n Ung b\u01b0\u1edbu v\u00e0 \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n ph\u1eabu thu\u1eadt nh\u01b0ng BN t\u1eeb ch\u1ed1i v\u00e0 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa li\u00ean t\u1ee5c b\u1eb1ng Thyrozol 5mg t\u1ea1i ph\u00f2ng kh\u00e1m t\u01b0.<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 5 n\u0103m (2019), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 (ESC\/ESH 2018) t\u1ea1i ph\u00f2ng kh\u00e1m t\u01b0, huy\u1ebft \u00e1p t\u00e2m thu cao nh\u1ea5t 150mmHg, BN kh\u00f4ng th\u01b0\u1eddng xuy\u00ean theo d\u00f5i huy\u1ebft \u00e1p t\u1ea1i nh\u00e0, tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Telmisartan 40mg.<\/div>\n
– C\u00e1ch nh\u1eadp vi\u1ec7n 3 n\u0103m (2021), BN \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 t\u1ea1i ph\u00f2ng kh\u00e1m t\u01b0, tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Metformin 500mg.<\/div>\n
2. Ngo\u1ea1i khoa: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n ngo\u1ea1i khoa.<\/div>\n
3. PARA: 0000, m\u00e3n kinh n\u0103m 50 tu\u1ed5i.<\/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: B\u1ec7nh nh\u00e2n kh\u00f4ng h\u00fat thu\u1ed1c, kh\u00f4ng s\u1eed d\u1ee5ng r\u01b0\u1ee3u bia.<\/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
V.\u00a0 L\u01b0\u1ee3c qua c\u00e1c c\u01a1 quan: L\u00fac 8h15 ng\u00e0y 04\/06\/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: bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, kh\u00f4ng \u0111au b\u1ee5ng.<\/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 \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T), \u0111au khi c\u1eed \u0111\u1ed9ng, \u0111au ch\u00f3i, kh\u00f4ng t\u00ea c\u1eb3ng ch\u00e2n, c\u1ed5 ch\u00e2n v\u00e0 b\u00e0n ng\u00f3n ch\u00e2n.<\/div>\n
– Th\u1ea7n kinh: c\u00f2n \u0111au \u0111\u1ea7u \u00edt.<\/div>\n
– C\u01a1 quan kh\u00e1c: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/div>\n
VI. Kh\u00e1m l\u00e2m s\u00e0ng: L\u00fac 8h20 ng\u00e0y 04\/06\/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 t\u1ed1t, GCS 15\u0111.<\/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 oC.<\/div>\n
\u25cf SpO2%: 99%\/KT.<\/div>\n
\u25cf Ch\u1ec9 s\u1ed1 cho\u00e1ng < 1.<\/div>\n
– Da, ni\u00eam m\u1ea1c h\u1ed3ng nh\u1ea1t.<\/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
– Kh\u00e1m th\u1ea5y kh\u1ed1i s\u01b0ng \u0111\u1ecf kt #1×2 cm v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T), kh\u00f4ng n\u00f3ng, kh\u00f4ng ch\u1ea3y m\u00e1u, \u1ea5n \u0111au nh\u1eb9.<\/div>\n
– Tuy\u1ebfn gi\u00e1p kh\u00f4ng to.<\/div>\n
– H\u1ea1ch th\u01b0\u1ee3ng \u0111\u00f2n, h\u1ea1ch n\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m<\/div>\n
– Th\u1ec3 tr\u1ea1ng:\u00a0<\/div>\n
\u25cf C\u00e2n n\u1eb7ng:\u00a0 65kg.<\/div>\n
\u25cf Chi\u1ec1u cao: 160cm.<\/div>\n
\u2192\u00a0 \u00a0BMI = 25.4 kg\/m2 \u2192 B\u00e9o ph\u00ec \u0111\u1ed9 I (theo IDI & WPRO).<\/div>\n
B. Kh\u00e1m c\u00e1c c\u01a1 quan:<\/div>\n
1. C\u01a1 x\u01b0\u01a1ng kh\u1edbp:\u00a0<\/div>\n
BN n\u1eb1m tr\u00ean gi\u01b0\u1eddng, ch\u00e2n du\u1ed7i, \u0111ang n\u1eb9p c\u1ed1 \u0111\u1ecbnh \u0111\u00f9i – c\u1eb3ng ch\u00e2n – b\u00e0n ch\u00e2n (T)<\/div>\n
NH\u00ccN<\/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 (T) ng\u1ea3 ngo\u00e0i<\/div>\n
\u25cf S\u01b0ng n\u1ec1, b\u1ea7m t\u00edm #3x6cm, v\u00f9ng g\u1ed1i (T) \u0111\u1ebfn v\u00f9ng \u2153 gi\u1eefa m\u1eb7t tr\u01b0\u1edbc c\u1eb3ng ch\u00e2n (T) kh\u00f4ng n\u1ed5i b\u00f3ng n\u01b0\u1edbc, kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng, kh\u00f4ng \u0111\u1eadp theo m\u1ea1ch<\/div>\n
\u25cf Chi\u1ec1u d\u00e0i ch\u00e2n (P) b\u1eb1ng ch\u00e2n (T)<\/div>\n
S\u01a0\u0300:<\/div>\n
– \u1ea4n \u0111au m\u00e2m ch\u00e0y (T) v\u00e0 \u2153 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (T)<\/div>\n
– Chi \u1ea5m, CRT < 2s<\/div>\n
– M\u1ea1ch mu ch\u00e2n, ch\u00e0y sau 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
– D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng: b\u1ec7nh nh\u00e2n \u0111au n\u00ean kh\u00f4ng th\u0103m kh\u00e1m\u00a0<\/div>\n
\u0110O:<\/div>\n
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 <\/p>\n<\/td>\n

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

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

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

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47 cm<\/p>\n<\/td>\n

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47 cm<\/p>\n<\/td>\n<\/tr>\n

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35 cm<\/p>\n<\/td>\n

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35 cm<\/p>\n<\/td>\n<\/tr>\n

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X\u01b0\u01a1ng ch\u00e0y:<\/strong><\/p>\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)<\/p>\n

Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (l\u1ed3i c\u1ee7 ch\u00e0y – m\u1eaft c\u00e1 trong)<\/p>\n<\/td>\n

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 <\/p>\n

49 cm<\/p>\n

 <\/p>\n

42 cm<\/p>\n<\/td>\n

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 <\/p>\n

49 cm<\/p>\n

 <\/p>\n

42 cm<\/p>\n<\/td>\n<\/tr>\n

\n

X\u01b0\u01a1ng m\u00e1c:<\/strong><\/p>\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)<\/p>\n

Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (ch\u1ecfm m\u00e1c- m\u1eaft c\u00e1 ngo\u00e0i)<\/p>\n<\/td>\n

\n

 <\/p>\n

42 cm<\/p>\n

 <\/p>\n

37 cm<\/p>\n<\/td>\n

\n

 <\/p>\n

42 cm<\/p>\n

 <\/p>\n

37 cm<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110o v\u00f2ng chi m\u1ed1c c\u00e1ch l\u1ed3i c\u1ee7 ch\u00e0y 15 cm<\/p>\n<\/td>\n

\n

34 cm<\/p>\n<\/td>\n

\n

38 cm<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110o v\u00f2ng chi g\u1ed1i<\/p>\n<\/td>\n

\n

37 cm<\/p>\n<\/td>\n

\n

43 cm<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
– C\u00e1c chi c\u00f2n l\u1ea1i ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/div>\n
V\u00c2N \u0110\u00d4\u0323NG:<\/div>\n
– Kh\u1edbp h\u00e1ng\u00a0<\/div>\n
+ (P): trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng\u00a0<\/div>\n
+ (T): kh\u00f4ng kh\u00e1m do b\u1ec7nh nh\u00e2n \u0111au<\/div>\n
– Kh\u1edbp g\u1ed1i:<\/div>\n
+ (P): v\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng (150\u00b0- 0\u00b0)<\/div>\n
+ (T): kh\u00f4ng kh\u00e1m do b\u1ec7nh nh\u00e2n \u0111au<\/div>\n
– Kh\u1edbp c\u1ed5 ch\u00e2n: v\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/div>\n
2. H\u1ec7 tim m\u1ea1ch<\/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
– S\u1edd: m\u1ecfm tim \u1edf khoang li\u00ean s\u01b0\u1eddn V \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i, kh\u00f4ng u c\u1ee5c, Harzer (-)<\/div>\n
– Nghe: tim \u0111\u1ec1u, T1 T2 nghe r\u00f5,\u00a0 t\u1ea7n s\u1ed1 80l\/p, kh\u00f4ng \u00e2m th\u1ed5i<\/div>\n
3. H\u1ec7 h\u00f4 h\u1ea5p<\/div>\n
– Nh\u00ecn: l\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf<\/div>\n
– S\u1edd: rung thanh \u0111\u1ec1u, r\u00f5 2 b\u00ean ph\u1ebf tr\u01b0\u1eddng<\/div>\n
– G\u00f5: trong<\/div>\n
– Nghe: r\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, kh\u00f4ng ran.<\/div>\n
4. H\u1ec7 ti\u00eau ho\u00e1<\/div>\n
– Nh\u00ecn: b\u1ee5ng c\u00e2n \u0111\u1ed1i, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng u, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169<\/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
5. Ti\u1ebft ni\u1ec7u:<\/div>\n
– Ch\u1ea1m th\u1eadn (-)<\/div>\n
– Rung th\u1eadn (-)<\/div>\n
– C\u1ea7u b\u00e0ng quang (-)<\/div>\n
6. Kh\u00e1m th\u1ea7n kinh:<\/div>\n
– C\u1ed5 m\u1ec1m.<\/div>\n
– Babinski (-)<\/div>\n
VII. T\u00f3m t\u1eaft b\u1ec7nh \u00e1n:<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n n\u1eef, 63 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T) sau TNSH gi\u1edd th\u1ee9 7. 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 \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T)<\/div>\n
\u25cf \u0110au \u0111\u1ea7u<\/div>\n
\u25cf Bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n #3 l\u1ea7n<\/div>\n
– TCTT<\/div>\n
\u25cf S\u01b0ng n\u00f3ng v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T), \u1ea5n \u0111au nh\u1eb9<\/div>\n
\u25cf B\u00e0n ch\u00e2n (T) ng\u1ea3 ngo\u00e0i<\/div>\n
\u25cf S\u01b0ng n\u1ec1, b\u1ea7m t\u00edm v\u00f9ng \u2153 gi\u1eefa m\u1eb7t tr\u01b0\u1edbc c\u1eb3ng ch\u00e2n (T)<\/div>\n
\u25cf S\u01b0ng g\u1ed1i (T)<\/div>\n
\u25cf \u1ea4n \u0111au m\u00e2m ch\u00e0y (T) v\u00e0 \u2153 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (T)<\/div>\n
\u25cf Chu vi v\u00f2ng chi m\u1ed1c c\u00e1ch l\u1ed3i c\u1ee7 ch\u00e0y #15cm: (P) < (T)<\/div>\n
\u25cf Chu vi v\u00f2ng chi g\u1ed1i: (P) < (T)<\/div>\n
\u25cf B\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch mu ch\u00e2n, ch\u00e0y sau\u00a0<\/div>\n
\u25cf 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
\u25cf Kh\u1ed1i s\u01b0ng \u0111\u1ecf kt #1×2 cm v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T), kh\u00f4ng n\u00f3ng, kh\u00f4ng ch\u1ea3y m\u00e1u, \u1ea5n \u0111au nh\u1eb9.<\/div>\n
– Ti\u1ec1n c\u0103n:<\/div>\n
\u25cf H\u1edf van tim<\/div>\n
\u25cf Basedow<\/div>\n
\u25cf T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 (ESC\/ESH 2018)<\/div>\n
\u25cf \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/div>\n
VIII. \u0110\u1eb7t v\u1ea5n \u0111\u1ec1<\/strong><\/div>\n
– \u1ea4n \u0111au ch\u00f3i \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T)<\/div>\n
– S\u01b0ng g\u1ed1i (T) \u0111\u1ebfn \u2153 gi\u1eefa c\u1eb3ng ch\u00e2n (T)<\/div>\n
– \u0110au \u0111\u1ea7u.<\/div>\n
– Kh\u1ed1i s\u01b0ng \u0111\u1ecf \u0111\u1ec9nh ch\u1ea9m (T)<\/div>\n
– N\u00f4n \u00f3i<\/div>\n
– Ti\u1ec1n c\u0103n: T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Basedow – H\u1edf van tim.<\/div>\n
IX. Ch\u1ea9n \u0111o\u00e1n s\u01a1 b\u1ed9<\/strong><\/div>\n
G\u00e3y k\u00edn \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T) gi\u1edd th\u1ee9 7 do TNSH ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng – TD m\u00e1u t\u1ee5 n\u1ed9i s\u1ecd\/T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Basedow – H\u1edf van tim<\/div>\n
X. Ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t<\/div>\n
1. G\u00e3y k\u00edn \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T) – t\u1ed5n th\u01b0\u01a1ng m\u00e2m ch\u00e0y gi\u1edd th\u1ee9 7 do TNSH ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng – TD m\u00e1u t\u1ee5 n\u1ed9i s\u1ecd\/T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Basedow – H\u1edf van tim<\/div>\n
XI. Bi\u1ec7n lu\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
B\u1ec7nh nh\u00e2n n\u1eef 63 tu\u1ed5i v\u00e0o vi\u1ec7n v\u00ec \u0111au \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T) sau tai n\u1ea1n sinh ho\u1ea1t gi\u1edd th\u1ee9 7. Ngh\u0129 b\u1ec7nh nh\u00e2n c\u00f3 g\u00e3y k\u00edn \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T), v\u00ec:<\/div>\n
– G\u00e3y k\u00edn: v\u00ec kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng th\u00f4ng \u1ed5 g\u00e3y v\u1edbi m\u00f4i tr\u01b0\u1eddng b\u00ean ngo\u00e0i<\/div>\n
– C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng: c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng r\u00f5 v\u1edbi n\u0103ng l\u01b0\u1ee3ng cao (t\u1ea5m v\u00e1n m\u00e1y may t\u00e1c \u0111\u1ed9ng tr\u1ef1c ti\u1ebfp l\u00ean \u2153 tr\u01b0\u1edbc x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T)) \u2192 Kh\u1ea3 n\u0103ng g\u00e3y \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n. Kh\u00e1m ghi nh\u1eadn c\u00e1c d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd g\u00e3y x\u01b0\u01a1ng nh\u01b0: \u1ea4n \u0111au ch\u00f3i \u2153 tr\u00ean c\u1eb3ng ch\u00e2n (T), s\u01b0ng n\u1ec1, b\u1ea7m t\u00edm v\u00f9ng g\u1ed1i (T) \u0111\u1ebfn \u2153 gi\u1eefa m\u1eb7t tr\u01b0\u1edbc x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n, v\u00f2ng chi \u2153 gi\u1eefa c\u1eb3ng ch\u00e2n (T) > (P)\u00a0<\/div>\n
\u2192 \u0110\u1ec1 ngh\u1ecb: X-quang c\u1eb3ng ch\u00e2n (T) th\u1eb3ng – nghi\u00eang\u00a0<\/div>\n
– BN l\u1edbn tu\u1ed5i > 55 tu\u1ed5i k\u00e8m c\u00f3 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 \u2192 Ngh\u0129 nhi\u1ec1u g\u00e3y x\u01b0\u01a1ng do tai n\u1ea1n sinh ho\u1ea1t.<\/div>\n
\u00a0\u2192 \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
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
– Choa\u0301ng, s\u00f4\u0301c m\u00e2\u0301t ma\u0301u: BN kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng do m\u1ea5t m\u00e1u nhi\u1ec1u, kh\u00f4ng ch\u00f3ng m\u1eb7t, b\u1ec7nh nh\u00e2n t\u1ec9nh, sinh hi\u1ec7u \u1ed5n \u2192 \u00cdt ngh\u0129<\/div>\n
– 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% \u2192 Ch\u01b0a nghi\u0303<\/div>\n
– Che\u0300n e\u0301p khoang: l\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ea7n quan t\u00e2m h\u00e0ng \u0111\u1ea7u \u0111\u1ed1i v\u1edbi g\u00e3y x\u01b0\u01a1ng v\u00f9ng c\u1eb3ng ch\u00e2n, t\u1ea1i c\u1eb3ng ch\u00e2n c\u00f3 4 khoang (tr\u01b0\u1edbc- ngo\u00e0i- sau n\u00f4ng- sau s\u00e2u, ch\u1ee7 y\u1ebfu g\u1eb7p \u1edf khoang tr\u01b0\u1edbc). Tuy nhi\u00ean b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 kh\u00f4ng c\u0103ng c\u1ee9ng khi s\u1edd tr\u00ean b\u1edd m\u1eb7t da, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng t\u00ea, kh\u00f4ng t\u00edm, m\u1ea1ch mu ch\u00e2n v\u00e0 ch\u00e0y sau b\u1eaft r\u00f5 n\u00ean kh\u00f4ng ngh\u0129 bi\u1ebfn ch\u1ee9ng ch\u00e8n \u00e9p khoang<\/div>\n
– 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 \u2192 kh\u00f4ng ngh\u0129<\/div>\n
– T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: t\u1ea1i \u2153 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n c\u1ea7n ch\u00fa \u00fd t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch ch\u00e0y tr\u01b0\u1edbc v\u00e0 ch\u00e0y sau. Kh\u00e1m chi \u1ea5m, \u0111\u1ea7u ng\u00f3n ch\u00e2n h\u1ed3ng, m\u1ea1ch ch\u00e0y, m\u1ea1ch mu ch\u00e2n (T) b\u1eaft \u0111\u01b0\u1ee3c \u0111\u1ec1u r\u00f5 n\u00ean kh\u00f4ng ngh\u0129 c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u<\/div>\n
– 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<\/div>\n
– 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 \u2192 kh\u00f4ng ngh\u0129<\/div>\n
– 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. Tuy nhi\u00ean c\u1ea7n theo d\u00f5i th\u00eam c\u00e1c tri\u1ec7u ch\u1ee9ng b\u1ec7nh n\u1ec1n c\u1ee7a b\u1ec7nh nh\u00e2n.<\/div>\n
TD m\u00e1u t\u1ee5 n\u1ed9i s\u1ecd v\u00ec b\u1ec7nh nh\u00e2n ng\u00e3 c\u00f3 \u0111\u1eadp \u0111\u1ea7u xu\u1ed1ng n\u1ec1n c\u1ee9ng, c\u00f3 ch\u1ea5n th\u01b0\u01a1ng v\u00f9ng \u0111\u1ea7u k\u00e8m \u0111au \u0111\u1ea7u v\u00e0 n\u00f4n \u00f3i sau t\u00e9, kh\u00e1m th\u1ea5y kh\u1ed1i s\u01b0ng \u0111\u1ecf kt #1×2 cm v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T), kh\u00f4ng n\u00f3ng, kh\u00f4ng ch\u1ea3y m\u00e1u, \u1ea5n \u0111au nh\u1eb9.<\/div>\n
\u2192 \u0110\u1ec1 ngh\u1ecb: CT – scan s\u1ecd n\u00e3o kh\u00f4ng c\u00f3 thu\u1ed1c c\u1ea3n quang\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 X-quang x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (T) th\u0103\u0309ng – nghi\u00eang<\/div>\n
\u25cf CT – scan s\u1ecd n\u00e3o kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n quang<\/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 TPTNT<\/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
\u25cf ECG<\/div>\n
\u25cf Xquang ng\u1ef1c th\u1eb3ng<\/div>\n
\u25cf Si\u00eau \u00e2m tim<\/div>\n
XIII. K\u1ebft qu\u1ea3 c\u1eadn l\u00e2m s\u00e0ng<\/strong><\/div>\n
1. Xquang kh\u1edbp g\u1ed1i (T) th\u1eb3ng – nghi\u00eang<\/div>\n
\n
\"1\"
1<\/figcaption><\/figure>
\"2\"
2<\/figcaption><\/figure>\n<\/div>\n
\u00a0<\/div>\n
\u0110\u1ecdc phim<\/div>\n
\u25cf H\u1ecd v\u00e0 t\u00ean BN: TR\u1ea6N THANH M.<\/div>\n
\u25cf Ng\u00e0y th\u00e1ng n\u0103m ch\u1ee5p: 4 gi\u1edd 56 ph\u00fat, ng\u00e0y 04\/06\/2024<\/div>\n
\u25cf T\u01b0 th\u1ebf phim: Xquang g\u1ed1i (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:\u00a0<\/div>\n
\u25cb G\u00e3y m\u00e2m ch\u00e0y ngo\u00e0i ph\u1ea1m 1 ph\u1ea7n kh\u1edbp g\u1ed1i<\/div>\n
\u25cf \u0110\u01b0\u1eddng g\u00e3y: ch\u00e9o<\/div>\n
\u25cf Di l\u00ea\u0323ch: sang b\u00ean ra ngo\u00e0i<\/div>\n
\u25cf Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m.<\/div>\n
K\u1ebft lu\u1eadn:<\/div>\n
– G\u00e3y \u2153 tr\u00ean x\u01b0\u01a1ng ch\u00e0y A2 theo AO<\/div>\n
– G\u00e3y m\u00e2m ch\u00e0y kh\u00f3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9. \u0110\u1ec1 ngh\u1ecb CT – scan kh\u1edbp g\u1ed1i (T) d\u1ef1ng h\u00ecnh<\/div>\n
2. CT –\u00a0 scan s\u1ecd n\u00e3o kh\u00f4ng c\u1ea3n quang<\/div>\n
M\u00f4 t\u1ea3:<\/div>\n
– Kh\u00f4ng th\u1ea5y h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng l\u00e0m thay \u0111\u1ed5i \u0111\u1eadm \u0111\u1ed9, h\u00ecnh d\u00e1ng nhu m\u00f4 n\u00e3o ph\u1ea7n tr\u00ean v\u00e0 d\u01b0\u1edbi l\u1ec1u. Kh\u00f4ng th\u1ea5y m\u00e1u t\u1ee5 n\u1ed9i s\u1ecd<\/div>\n
– H\u1ec7 th\u1ed1ng n\u00e3o th\u1ea5t, c\u00e1c b\u1ec3 n\u00e3o v\u00e0 c\u00e1c r\u00e3nh v\u1ecf n\u00e3o trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng. H\u00ecnh \u1ea3nh \u0111\u01b0\u1eddng gi\u1eefa kh\u00f4ng l\u1ec7ch<\/div>\n
– D\u1eadp xu\u1ea5t huy\u1ebft m\u00f4 m\u1ec1m d\u01b0\u1edbi da v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T)<\/div>\n
– V\u00e0i n\u1ed1t v\u00f4i m\u00e0ng m\u1ec1m r\u1ea3i r\u00e1c 2 b\u00ean v\u1ecf n\u00e3o<\/div>\n
K\u1ebft lu\u1eadn:<\/div>\n
– D\u1eadp xu\u1ea5t huy\u1ebft m\u00f4 m\u1ec1m d\u01b0\u1edbi da v\u00f9ng \u0111\u1ec9nh ch\u1ea9m (T)<\/div>\n
– V\u00e0i n\u1ed1t v\u00f4i m\u00e0ng m\u1ec1m r\u1ea3i r\u00e1c 2 b\u00ean v\u1ecf n\u00e3o<\/div>\n
3. CTM (04\/06\/2034)<\/div>\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

T\u00ean x\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

K\u1ebft qu\u1ea3<\/strong><\/p>\n<\/td>\n

\n

Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n

\n

\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

WBC<\/p>\n<\/td>\n

\n

11.8<\/strong><\/p>\n<\/td>\n

\n

4.01 – 11.42<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

NEU%<\/p>\n<\/td>\n

\n

84.93<\/strong><\/p>\n<\/td>\n

\n

40 – 74<\/p>\n<\/td>\n

\n

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

\n

LYM%<\/p>\n<\/td>\n

\n

10.76<\/strong><\/p>\n<\/td>\n

\n

19 – 48<\/p>\n<\/td>\n

\n

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

\n

MONO%<\/p>\n<\/td>\n

\n

4.25<\/p>\n<\/td>\n

\n

3.4 – 9.0<\/p>\n<\/td>\n

\n

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

\n

EOS%<\/p>\n<\/td>\n

\n

0.01<\/p>\n<\/td>\n

\n

0.0 – 7.0<\/p>\n<\/td>\n

\n

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

\n

BASO%<\/p>\n<\/td>\n

\n

0.05<\/p>\n<\/td>\n

\n

0.0 – 1.5<\/p>\n<\/td>\n

\n

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

\n

NEU#<\/p>\n<\/td>\n

\n

10.004<\/strong><\/p>\n<\/td>\n

\n

1.7 – 7.5<\/p>\n<\/td>\n

\n

k\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

LYM#<\/p>\n<\/td>\n

\n

1.267<\/p>\n<\/td>\n

\n

1.2 – 4.0<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

MONO#<\/p>\n<\/td>\n

\n

0.5<\/p>\n<\/td>\n

\n

0.2 – 2.8<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

EOS#<\/p>\n<\/td>\n

\n

0.002<\/p>\n<\/td>\n

\n

0.0 – 0.5<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

BASO#<\/p>\n<\/td>\n

\n

0.006<\/p>\n<\/td>\n

\n

0.0 – 0.1<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

RBC<\/p>\n<\/td>\n

\n

3.60<\/strong><\/p>\n<\/td>\n

\n

4.01 – 5.79<\/p>\n<\/td>\n

\n

M\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

HGB<\/p>\n<\/td>\n

\n

10.7<\/strong><\/p>\n<\/td>\n

\n

11.5 – 15.0<\/p>\n<\/td>\n

\n

g\/dL<\/p>\n<\/td>\n<\/tr>\n

\n

HCT<\/p>\n<\/td>\n

\n

31.9<\/strong><\/p>\n<\/td>\n

\n

34.4 – 48.5<\/p>\n<\/td>\n

\n

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

\n

MCV<\/p>\n<\/td>\n

\n

88.6<\/p>\n<\/td>\n

\n

80 – 99<\/p>\n<\/td>\n

\n

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

\n

MCH<\/p>\n<\/td>\n

\n

29.7<\/p>\n<\/td>\n

\n

27 – 33<\/p>\n<\/td>\n

\n

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

\n

MCHC<\/p>\n<\/td>\n

\n

33.5<\/p>\n<\/td>\n

\n

32 – 36<\/p>\n<\/td>\n

\n

g\/dL<\/p>\n<\/td>\n<\/tr>\n

\n

RDW<\/p>\n<\/td>\n

\n

11.7<\/p>\n<\/td>\n

\n

11.5 – 15.5<\/p>\n<\/td>\n

\n

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

\n

PLT<\/p>\n<\/td>\n

\n

222.0<\/p>\n<\/td>\n

\n

150 – 450<\/p>\n<\/td>\n

\n

K\/uL<\/p>\n<\/td>\n<\/tr>\n

\n

MPV<\/p>\n<\/td>\n

\n

7.5<\/p>\n<\/td>\n

\n

7.4 – 10.9<\/p>\n<\/td>\n

\n

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

\n

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

\n

AB<\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

Rh<\/p>\n<\/td>\n

\n

+<\/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
\u2192 Nh\u1eadn x\u00e9t:<\/div>\n
– B\u1ea1ch c\u1ea7u m\u00e1u t\u0103ng, Neu% \u01b0u th\u1ebf c\u00f3 th\u1ec3 do ph\u1ea3n \u1ee9ng stress do ch\u1ea5n th\u01b0\u01a1ng<\/div>\n
– Ch\u1ec9 s\u1ed1 ti\u1ec3u c\u1ea7u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/div>\n
– B\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u \u0111\u1eb3ng s\u1eafc \u0111\u1eb3ng b\u00e0o<\/div>\n
4. Sinh ho\u00e1 m\u00e1u (04\/06\/2024)<\/div>\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

T\u00ean x\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n

\n

K\u1ebft qu\u1ea3<\/strong><\/p>\n<\/td>\n

\n

Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n

\n

\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

Glucose [M\u00e1u]<\/p>\n<\/td>\n

\n

9<\/strong><\/p>\n<\/td>\n

\n

4.1 – 5.9<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Ure m\u00e1u [M\u00e1u]<\/p>\n<\/td>\n

\n

4.1<\/p>\n<\/td>\n

\n

2.8 – 7.2<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Creatinine m\u00e1u [M\u00e1u]<\/p>\n<\/td>\n

\n

53.0<\/strong><\/p>\n<\/td>\n

\n

> 50T: 72 – 127<\/p>\n<\/td>\n

\n

umol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

eGFR<\/p>\n<\/td>\n

\n

107.41<\/p>\n<\/td>\n

\n

>= 60<\/p>\n<\/td>\n

\n

ml\/ph\u00fat\/1.72m2 da<\/p>\n<\/td>\n<\/tr>\n<\/thead>\n

\n

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

\n

21<\/p>\n<\/td>\n

\n

< 50<\/p>\n<\/td>\n

\n

U\/L<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

18<\/p>\n<\/td>\n

\n

< 50<\/p>\n<\/td>\n

\n

U\/L<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

132<\/strong><\/p>\n<\/td>\n

\n

134 – 145<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

3.3<\/strong><\/p>\n<\/td>\n

\n

3.5 – 5.0<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Cl-\u00a0<\/p>\n<\/td>\n

\n

107<\/strong><\/p>\n<\/td>\n

\n

98 – 106<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Ca2+<\/p>\n<\/td>\n

\n

2.41<\/p>\n<\/td>\n

\n

2.15 – 2.6<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

\u0110\u1ecbnh l\u01b0\u1ee3ng 25OH Vitamin D (D3) [M\u00e1u]<\/p>\n<\/td>\n

\n

26.78<\/strong><\/p>\n<\/td>\n

\n

30 – 100<\/p>\n<\/td>\n

\n

ng\/mL<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

6.0<\/strong><\/p>\n<\/td>\n

\n

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

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Triglyceride [M\u00e1u]<\/p>\n<\/td>\n

\n

1.2<\/p>\n<\/td>\n

\n

< 1.7<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

HDL – cholesterol<\/p>\n<\/td>\n

\n

1.2<\/p>\n<\/td>\n

\n

> 1.03<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

non HDL cholesterol<\/p>\n<\/td>\n

\n

4.8<\/strong><\/p>\n<\/td>\n

\n

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

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

LDL – cholesterol<\/p>\n<\/td>\n

\n

4.25<\/strong><\/p>\n<\/td>\n

\n

< 2.6<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

15.92<\/strong><\/p>\n<\/td>\n

\n

<= 17<\/p>\n<\/td>\n

\n

umol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Bilirubin tr\u1ef1c ti\u1ebfp [M\u00e1u]<\/p>\n<\/td>\n

\n

2.4<\/p>\n<\/td>\n

\n

<= 4.3<\/p>\n<\/td>\n

\n

umol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

Albumin [M\u00e1u]<\/p>\n<\/td>\n

\n

35.9<\/p>\n<\/td>\n

\n

35 – 50<\/p>\n<\/td>\n

\n

g\/L<\/p>\n<\/td>\n<\/tr>\n

\n

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

\n

68.2<\/p>\n<\/td>\n

\n

65 – 82<\/p>\n<\/td>\n

\n

g\/L<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
\u2192 Nh\u1eadn x\u00e9t:<\/div>\n
– \u0110\u01b0\u1eddng huy\u1ebft b\u1ea5t k\u1ef3 cao \u2192 c\u00f3 th\u1ec3 do t\u00ecnh tr\u1ea1ng \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 ch\u01b0a \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t ho\u1eb7c do b\u1ec7nh nh\u00e2n m\u1edbi \u0103n \u2192 \u0110\u1ec1 ngh\u1ecb l\u00e0m l\u1ea1i \u0111\u01b0\u1eddng huy\u1ebft l\u00fac \u0111\u00f3i<\/div>\n
– Na+, K+ m\u00e1u gi\u1ea3m nh\u1eb9; Cl- t\u0103ng nh\u1eb9 nh\u01b0ng ch\u01b0a c\u00f3 \u00fd ngh\u0129a tr\u00ean l\u00e2m s\u00e0ng<\/div>\n
– Non HDL Cholesterol v\u00e0 LDL Cholesterol cao cho th\u1ea5y b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n lipid m\u00e1u.<\/div>\n
5. T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u (04\/06\/2024)<\/div>\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

\u00a0<\/strong><\/p>\n<\/td>\n

\n

K\u1ebft qu\u1ea3<\/strong><\/p>\n<\/td>\n

\n

CSBT <\/strong><\/p>\n<\/td>\n

\n

\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

URO<\/strong><\/p>\n<\/td>\n

\n

nom<\/p>\n<\/td>\n

\n

<<\/strong>17.1<\/p>\n<\/td>\n

\n

umol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

GLU<\/strong><\/p>\n<\/td>\n

\n

8 mmol\/l<\/strong><\/p>\n<\/td>\n

\n

<0.84<\/p>\n<\/td>\n

\n

mmol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

BIL<\/strong><\/p>\n<\/td>\n

\n

neg<\/p>\n<\/td>\n

\n

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

\n

umol\/L<\/p>\n<\/td>\n<\/tr>\n

\n

KET<\/strong><\/p>\n<\/td>\n

\n

1.5 mmol\/l<\/p>\n<\/td>\n

\n

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

\n

 <\/p>\n<\/td>\n<\/tr>\n

\n

S.G<\/strong><\/p>\n<\/td>\n

\n

1.021<\/p>\n<\/td>\n

\n

1.015 – 1.025<\/p>\n<\/td>\n

\n

\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

BLD<\/strong><\/p>\n<\/td>\n

\n

50 Ery\/ul<\/strong><\/p>\n<\/td>\n

\n

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

\n

\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

pH<\/strong><\/p>\n<\/td>\n

\n

6<\/p>\n<\/td>\n

\n

4.8 – 7.4<\/p>\n<\/td>\n

\n

\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

PRO<\/strong><\/p>\n<\/td>\n

\n

neg<\/p>\n<\/td>\n

\n

<0.1<\/p>\n<\/td>\n

\n

g\/L<\/p>\n<\/td>\n<\/tr>\n

\n

NIT<\/strong><\/p>\n<\/td>\n

\n

neg<\/p>\n<\/td>\n

\n

Negative<\/p>\n<\/td>\n

\n

\u00a0<\/strong><\/p>\n<\/td>\n<\/tr>\n

\n

LEU<\/strong><\/p>\n<\/td>\n

\n

neg<\/p>\n<\/td>\n

\n

<10<\/p>\n<\/td>\n

\n

ug\/dl<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

\u00a0<\/div>\n
\u2192 Nh\u1eadn x\u00e9t:<\/div>\n
– Glucose 8 mmol\/l: cao ph\u00f9 h\u1ee3p v\u1edbi ti\u1ec1n c\u0103n v\u00e0 glucose m\u00e1u c\u1ee7a b\u1ec7nh nh\u00e2n<\/div>\n
6. ECG<\/div>\n
\n
\"H\u00ecnh
3<\/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 94 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\u00a0<\/div>\n
\u25cf Kho\u1ea3ng PR kh\u00f4ng d\u00e3n r\u1ed9ng\u00a0<\/div>\n
\u25cf Ph\u1ee9c b\u1ed9 QRS kh\u00f4ng d\u00e3n r\u1ed9ng\u00a0<\/div>\n
\u25cf ST kh\u00f4ng ch\u00eanh<\/div>\n
\u25cf Kh\u00f4ng d\u00e0y th\u1ea5t tr\u00e1i: Ch\u1ec9 s\u1ed1 Sokolow – Lyon: S V1 + R V5 <35 mm<\/div>\n
XIV. Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/strong><\/div>\n
G\u00e3y k\u00edn \u2153 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (T) 41-A2 (theo AO) – G\u00e3y m\u00e2m ch\u00e0y (T) nh\u00f3m VI (theo Schatzker) gi\u1edd th\u1ee9 7 do TNSH ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng \/T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 (ESC 2023) – \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 – Basedow – H\u1edf van tim<\/div>\n
XV. H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb<\/strong><\/div>\n
– B\u1ea5t \u0111\u1ed9ng \u1ed5 g\u00e3y<\/div>\n
– Gi\u1ea3m \u0111au<\/div>\n
– Dinh d\u01b0\u1ee1ng<\/div>\n
– Ph\u1eabu thu\u1eadt<\/div>\n
– Theo d\u00f5i s\u00e1t, ph\u00e1t hi\u1ec7n v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi c\u00e1c bi\u1ebfn ch\u1ee9ng tr\u01b0\u1edbc v\u00e0 sau m\u1ed5<\/div>\n
XVI. Ti\u00ean l\u01b0\u1ee3ng:<\/strong><\/div>\n
– G\u1ea7n: C\u00f3 th\u1ec3 c\u00f3 bi\u1ebfn ch\u1ee9ng m\u1ea5t m\u00e1u, g\u00e3y k\u00edn chuy\u1ec3n sang g\u00e3y h\u1edf<\/div>\n
– Xa: Ch\u1eadm l\u00e0nh x\u01b0\u01a1ng, can l\u1ec7ch, kh\u1edbp gi\u1ea3,…<\/div>\n","protected":false},"featured_media":4393,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4392","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\/4392","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=4392"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4392\/revisions"}],"predecessor-version":[{"id":4399,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4392\/revisions\/4399"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4393"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4392"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4392"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4392"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}