{"id":4427,"date":"2024-12-27T12:38:22","date_gmt":"2024-12-27T05:38:22","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=bai-giang&#038;p=4427"},"modified":"2024-12-27T12:42:06","modified_gmt":"2024-12-27T05:42:06","slug":"benh-an-ngoai-khoa-tien-phau-7","status":"publish","type":"bai-giang","link":"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-an-ngoai-khoa-tien-phau-7\/","title":{"rendered":"B\u1ec6NH \u00c1N NGO\u1ea0I KHOA (Ti\u1ec1n ph\u1eabu)"},"content":{"rendered":"<p>H\u1ecd v\u00e0 t\u00ean sinh vi\u00ean:<br \/>\nT\u00f4 Ho\u00e0i N\u01b0\u01a1ng<br \/>\nPhan Th\u1ecb Thanh Th\u01b0<\/p>\n<h1>I. H\u00c0NH CH\u00cdNH:<\/h1>\n<p>&#8211; H\u1ecd v\u00e0 t\u00ean: PH\u00d9NG V\u0102N H.<\/p>\n<p>&#8211; Gi\u1edbi: Nam<\/p>\n<p>&#8211; Sinh n\u0103m: 1976 (48 tu\u1ed5i)<\/p>\n<p>&#8211; Ngh\u1ec1 nghi\u1ec7p: Nh\u00e2n vi\u00ean v\u0103n ph\u00f2ng<\/p>\n<p>&#8211; \u0110\u1ecba ch\u1ec9: T\u00e2y Th\u1ea1nh &#8211; Qu\u1eadn T\u00e2n Ph\u00fa &#8211; TP HCM<\/p>\n<p>&#8211; Ng\u00e0y, gi\u1edd nh\u1eadp C\u1ea5p c\u1ee9u: 00 gi\u1edd 07 ph\u00fat, ng\u00e0y 12 th\u00e1ng 12 n\u0103m 2024<\/p>\n<p>&#8211; Ng\u00e0y, gi\u1edd nh\u1eadp Khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh: 03 gi\u1edd 45 ph\u00fat, ng\u00e0y 12\/12\/2024<\/p>\n<p>&#8211; Ng\u00e0y, gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 6 gi\u1edd 00 ph\u00fat, ng\u00e0y 12 th\u00e1ng 12 n\u0103m 2024<\/p>\n<p>L\u00dd DO NH\u1eacP VI\u1ec6N: \u0110au v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp vai (P)<\/p>\n<h1>II. B\u1ec6NH S\u1eec:<\/h1>\n<ul>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 01 gi\u1edd, b\u1ec7nh nh\u00e2n \u0111ang l\u00e1i xe m\u00e1y t\u1ed1c \u0111\u1ed9 30km\/h c\u00f3 u\u1ed1ng r\u01b0\u1ee3u (kh\u00f4ng r\u00f5 l\u01b0\u1ee3ng), c\u00f3 \u0111\u1ed9i n\u00f3n b\u1ea3o hi\u1ec3m, m\u1ea5t l\u00e1i t\u1ef1 t\u00e9, ng\u00e3 v\u1ec1 ph\u00eda b\u00ean (P), \u0111\u1eadp th\u00e1i d\u01b0\u01a1ng (P), h\u1ea1 s\u01b0\u1eddn (P) v\u00e0 m\u1eb7t ngo\u00e0i vai (P) xu\u1ed1ng n\u1ec1n c\u1ee9ng, trong t\u01b0 th\u1ebf vai kh\u00e9p khu\u1ef7u g\u1ea5p. Sau t\u00e9 b\u1ec7nh nh\u00e2n t\u1ec9nh, th\u1ea5y \u0111au th\u00e1i d\u01b0\u01a1ng (P), h\u1ea1 s\u01b0\u1eddn (P), \u0111au nh\u00f3i vai (P), v\u1eadn \u0111\u1ed9ng n\u00e2ng tay (P) b\u1ecb h\u1ea1n ch\u1ebf, c\u1eed \u0111\u1ed9ng khu\u1ef7u tay b\u00ecnh \u00a0th\u01b0\u1eddng, b\u1ec7nh nh\u00e2n ch\u01b0a \u0111\u01b0\u1ee3c x\u1eed tr\u00ed c\u1ed1 \u0111\u1ecbnh v\u00e0 di chuy\u1ec3n b\u1eb1ng xe m\u00e1y \u0111\u1ebfn nh\u1eadp c\u1ea5p c\u1ee9u b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/li>\n<\/ul>\n<p>Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng bu\u1ed3n n\u00f4n.<\/p>\n<p>*T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp Khoa C\u1ea5p c\u1ee9u:<\/p>\n<ul>\n<li>Sinh hi\u1ec7u<\/li>\n<\/ul>\n<p>M\u1ea1ch 90 l\u1ea7n\/ph\u00fat Huy\u1ebft \u00e1p 120\/80 mmHg Nhi\u1ec7t \u0111\u1ed9 37\u00b0C<\/p>\n<p>Nh\u1ecbp th\u1edf 19 l\u1ea7n\/ph\u00fat<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 SpO2 98%\/kh\u00ed tr\u1eddi<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>\u0110au th\u00e1i d\u01b0\u01a1ng (P), \u0111au h\u1ea1 s\u01b0\u1eddn (P)<\/li>\n<li>\u0110au v\u00e0 h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng vai (P)<\/li>\n<li>M\u1ea1ch quay r\u00f5<\/li>\n<li>Kh\u00f4ng t\u00ea tay (P)<\/li>\n<li>Tim \u0111\u1ec1u, th\u1edf \u00eam, ph\u1ed5i kh\u00f4ng ran, b\u1ee5ng m\u1ec1m<\/li>\n<li>X\u1eed tr\u00ed t\u1ea1i Khoa C\u1ea5p c\u1ee9u:<\/li>\n<\/ul>\n<p>+ Fentanyl citrate 0.1mg\/2ml 01 \u1ed1ng (TB)<\/p>\n<p>+ \u0110eo \u0111ai x\u01b0\u01a1ng \u0111\u00f2n s\u1ed1 8<\/p>\n<p>+ C\u1eadn l\u00e2m s\u00e0ng: Si\u00eau \u00e2m c\u1ea5p c\u1ee9u t\u1ea1i gi\u01b0\u1eddng, CLVT s\u1ecd n\u00e3o \u2013 ng\u1ef1c \u2013 b\u1ee5ng kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n quang<\/p>\n<p><strong>*Nh\u1eadp khoa CTCH <\/strong>l\u00fac 03 gi\u1edd 45 ph\u00fat, ng\u00e0y 12\/12\/2024<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Sinh hi\u1ec7u \u1ed5n<\/li>\n<li>Vai (P) s\u01b0ng n\u1ec1 \u00edt, kh\u00f4ng b\u1ea7m t\u00edm<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng vai (P)<\/li>\n<li>M\u1ea1ch quay r\u00f5<\/li>\n<\/ul>\n<p><strong>*<\/strong><strong> Di\u1ec5n ti\u1ebfn b\u1ec7nh<\/strong> (t\u1eeb 03 gi\u1edd 45 ph\u00fat ng\u00e0y 12\/12\/2024 \u0111\u1ebfn 6 gi\u1edd ng\u00e0y 12\/12\/2024)<\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Sinh hi\u1ec7u \u1ed5n<\/li>\n<li>Vai (P) s\u01b0ng n\u1ec1 \u00edt, kh\u00f4ng b\u1ea7m t\u00edm, gi\u1ea3m \u0111au \u00edt<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng vai (P)<\/li>\n<li>M\u1ea1ch quay r\u00f5<\/li>\n<li>X\u1eed tr\u00ed:<\/li>\n<\/ul>\n<p>+ Paracetamol 1g\/100ml 01 chai (TTM) C gi\u1ecdt\/ph\u00fat<\/p>\n<p>+ C\u1eadn l\u00e2m s\u00e0ng: T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi, nh\u00f3m m\u00e1u, \u0111\u00f4ng m\u00e1u, glucose, ch\u1ee9c n\u0103ng gan, ch\u1ee9c n\u0103ng th\u1eadn, Xquang x\u01b0\u01a1ng \u0111\u00f2n th\u1eb3ng, t\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/p>\n<p>+ Ti\u1ebfp t\u1ee5c mang \u0111ai x\u01b0\u01a1ng \u0111\u00f2n<\/p>\n<h1>III. TI\u1ec0N C\u0102N:<\/h1>\n<ol>\n<li>B\u1ea3n th\u00e2n<\/li>\n<\/ol>\n<ul>\n<li>N\u1ed9i khoa:<\/li>\n<\/ul>\n<p>+ T\u0103ng huy\u1ebft \u00e1p #5 n\u0103m \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u1ea1i BV Th\u1ed1ng Nh\u1ea5t, huy\u1ebft \u00e1p t\u00e2m thu cao nh\u1ea5t 150 mmHg, huy\u1ebft \u00e1p t\u00e2m thu th\u00edch nghi 130 mmHg, hi\u1ec7n \u0111i\u1ec1u tr\u1ecb thu\u1ed1c li\u00ean t\u1ee5c (kh\u00f4ng r\u00f5 lo\u1ea1i)<\/p>\n<p>+ \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 # 2 n\u0103m \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u1ea1i BV Th\u1ed1ng Nh\u1ea5t, hi\u1ec7n \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng li\u00ean t\u1ee5c (kh\u00f4ng r\u00f5 lo\u1ea1i)<\/p>\n<p>+ R\u1ed1i lo\u1ea1n lipid m\u00e1u # 2 n\u0103m \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n t\u1ea1i BV Th\u1ed1ng Nh\u1ea5t, hi\u1ec7n \u0111i\u1ec1u tr\u1ecb thu\u1ed1c u\u1ed1ng li\u00ean t\u1ee5c (kh\u00f4ng r\u00f5 lo\u1ea1i)<\/p>\n<ul>\n<li>Ngo\u1ea1i khoa: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/li>\n<li>D\u1ecb \u1ee9ng: ch\u01b0a ghi nh\u1eadn d\u1ecb \u1ee9ng thu\u1ed1c v\u00e0 th\u1ee9c \u0103n<\/li>\n<li>Th\u00f3i quen: h\u00fat thu\u1ed1c l\u00e1 20 g\u00f3i.n\u0103m, u\u1ed1ng r\u01b0\u1ee3u 1 \u0111\u01a1n v\u1ecb c\u1ed3n\/ ng\u00e0y<\/li>\n<\/ul>\n<ol start=\"2\">\n<li>Gia \u0111\u00ecnh: ch\u01b0a ghi nh\u1eadn b\u1ec7nh l\u00fd li\u00ean quan<\/li>\n<\/ol>\n<h1>IV. KH\u00c1M L\u00c2M S\u00c0NG (6 gi\u1edd 00 ph\u00fat 12\/12\/2024):<\/h1>\n<ol>\n<li><strong>T\u1ed5ng tr\u1ea1ng:<\/strong><\/li>\n<\/ol>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Th\u1edf d\u1ec5<\/li>\n<li>Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/li>\n<li>H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/li>\n<li>Kh\u00f4ng ph\u00f9<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<\/ul>\n<p>M\u1ea1ch 80 l\u1ea7n\/ph\u00fat Huy\u1ebft \u00e1p 120\/70 mmHg Nhi\u1ec7t \u0111\u1ed9 37\u00b0C<\/p>\n<p>Nh\u1ecbp th\u1edf 20 l\u1ea7n\/ph\u00fat<\/p>\n<ul>\n<li>SpO2 99%\/kh\u00ed tr\u1eddi<\/li>\n<li>Chi\u1ec1u cao 165 cm; C\u00e2n n\u1eb7ng 70 kg -&gt;BMI 25,7 kg\/m2 -&gt; Th\u1ec3 tr\u1ea1ng b\u00e9o ph\u00ec \u0111\u1ed9 1 theo IDI&amp;WPRO<\/li>\n<\/ul>\n<p>2.\u00a0\u00a0 Tim m\u1ea1ch:<\/p>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng sao m\u1ea1ch.<\/li>\n<li>Kh\u00f4ng rung mi\u00eau, kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li>Di\u1ec7n \u0111\u1eadp m\u1ecfm tim 1&#215;1 cm, KLS 5, \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i<\/li>\n<li>T1,T2 \u0111\u1ec1u, r\u00f5, kh\u00f4ng \u00e2m th\u1ed5i<\/li>\n<\/ul>\n<p>&#8211; T\u0129nh m\u1ea1ch c\u1ed5 n\u1ed5i (-)<\/p>\n<p>\u00a0\u00a0 &#8211; M\u1ea1ch ngo\u1ea1i bi\u00ean b\u1eaft \u0111\u01b0\u1ee3c \u0111\u1ec1u r\u00f5 hai b\u00ean<\/p>\n<p>3.\u00a0\u00a0 H\u00f4 h\u1ea5p:<\/p>\n<ul>\n<li>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 g\u00f9 v\u1eb9o c\u1ed9t s\u1ed1ng.<\/li>\n<li>Rung thanh \u0111\u1ec1u hai b\u00ean, g\u00f5 trong<\/li>\n<li>R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu hai ph\u1ebf tr\u01b0\u1eddng, kh\u00f4ng ran<\/li>\n<\/ul>\n<p>4.\u00a0\u00a0 Ti\u00eau h\u00f3a<\/p>\n<ul>\n<li>B\u1ee5ng kh\u00f4ng to b\u00e8, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7.<\/li>\n<li>Nhu \u0111\u1ed9ng ru\u00f4t 8 l\u1ea7n\/ph\u00fat. Kh\u00f4ng \u00e2m th\u1ed5i \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng, \u0111\u1ed9ng m\u1ea1ch th\u1eadn<\/li>\n<li>B\u1ee5ng g\u00f5 trong<\/li>\n<li>B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au. Gan, l\u00e1ch s\u1edd kh\u00f4ng ch\u1ea1m.<\/li>\n<\/ul>\n<p>5.\u00a0\u00a0 C\u01a1 &#8211; X\u01b0\u01a1ng &#8211; Kh\u1edbp:<\/p>\n<ul>\n<li><strong>NH\u00ccN<\/strong><\/li>\n<li>B\u1ec7nh nh\u00e2n ng\u1ed3i tr\u00ean gi\u01b0\u1eddng \u0111ang \u0111eo \u0111ai vai s\u1ed1 8, th\u00e1o n\u1eb9p \u0111\u00e1nh gi\u00e1<\/li>\n<li>Kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng v\u00f9ng ng\u1ef1c v\u00e0 vai (P), kh\u00f4ng d\u1ea5u b\u1eadc thang, kh\u00f4ng u c\u1ee5c, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169<\/li>\n<li>Vai (P) th\u1ea5p h\u01a1n vai (T)<\/li>\n<li>S\u01b0ng n\u1ec1 nh\u1eb9 v\u00f9ng vai (P)<\/li>\n<li>Kh\u00f4ng m\u1ea5t r\u00e3nh delta &#8211; ng\u1ef1c<\/li>\n<\/ul>\n<p>S\u1edc<\/p>\n<ul>\n<li>Chi \u1ea5m, CRT &lt;2 gi\u00e2y<\/li>\n<li>S\u1ee9c c\u01a1 5\/5, tr\u01b0\u01a1ng l\u1ef1c c\u01a1 \u0111\u1ec1u hai b\u00ean<\/li>\n<li>C\u00e1c m\u1ed1c x\u01b0\u01a1ng: m\u1ecfm c\u00f9ng vai, m\u1ecfm qu\u1ea1, m\u1ea5u \u0111\u1ed9ng l\u1edbn x\u01b0\u01a1ng c\u00e1nh tay<\/li>\n<li>D\u1ea5u m\u1ea5t li\u00ean t\u1ee5c t\u1ea1i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) (+)<\/li>\n<li>D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng t\u1ea1i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) (+)<\/li>\n<li>\u1ea4n kh\u00f4ng \u0111au kh\u1edbp vai v\u00e0 d\u1ecdc x\u01b0\u01a1ng c\u00e1nh tay (P)<\/li>\n<li>S\u1edd 2 x\u01b0\u01a1ng b\u1ea3 vai ph\u00eda sau c\u00e2n x\u1ee9ng, kh\u00f4ng \u0111au<\/li>\n<li>D\u1ea5u ph\u00edm \u0111\u00e0n (-)<\/li>\n<li>D\u1ea5u \u1ed5 kh\u1edbp r\u1ed7ng (-)<\/li>\n<li>M\u1ea1ch quay, tr\u1ee5 (+)<\/li>\n<li>C\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u c\u00f2n t\u1ed1t<\/li>\n<\/ul>\n<p>\u00a0\u00a0 &#8211; \u1ea4n \u0111au ch\u00f3i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P)<\/p>\n<p>\u0110O<\/p>\n<ul>\n<li>Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng \u0111\u00f2n (\u0111\u1ea7u \u1ee9c &#8211; \u0111\u1ea7u c\u00f9ng vai x\u01b0\u01a1ng \u0111\u00f2n): (P): 12 cm<\/li>\n<\/ul>\n<p>(T): 14 cm<\/p>\n<ul>\n<li>Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng \u0111\u00f2n (\u0111\u1ea7u \u1ee9c &#8211; m\u1ecfm c\u00f9ng vai):<\/li>\n<\/ul>\n<p>(P): 16 cm<\/p>\n<p>(T): 16 cm<\/p>\n<p>V\u1eacN \u0110\u1ed8NG<\/p>\n<ul>\n<li>\u0110\u1ed9ng t\u00e1c tr\u01b0\u1edbc &#8211; sau, d\u1ea1ng \u2013 kh\u00e9p, xoay trong \u2013 xoay ngo\u00e0i vai (P) h\u1ea1n ch\u1ebf do b\u1ec7nh nh\u00e2n \u0111au<\/li>\n<li>V\u1eadn \u0111\u1ed9ng c\u00e1c kh\u1edbp khu\u1ef7u, c\u1ed5 tay, b\u00e0n ng\u00f3n c\u1ee7a tay (P) ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/li>\n<\/ul>\n<p>NGHI\u1ec6M PH\u00c1P<\/p>\n<p>&#8211; Drop arm test (-)<\/p>\n<p>&#8211; Apprehension test (-)<\/p>\n<p>* Kh\u00e1m tay (T) v\u00e0 hai chi d\u01b0\u1edbi ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>V.\u00a0\u00a0\u00a0\u00a0\u00a0 T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N:<\/p>\n<p>B\u1ec7nh nh\u00e2n nam, 48 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au v\u00e0 gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp vai (P) gi\u1edd \u00a0th\u1ee9 7 sau tai n\u1ea1n giao th\u00f4ng. Qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m ghi nh\u1eadn:<\/p>\n<p>Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:<\/p>\n<ul>\n<li>\u0110au, s\u01b0ng n\u1ec1 vai (P)<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp vai (P)<\/li>\n<li>\u0110au v\u00f9ng th\u00e1i d\u01b0\u01a1ng (P), h\u1ea1 s\u01b0\u1eddn (P)<\/li>\n<\/ul>\n<p>Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:<\/p>\n<ul>\n<li>\u1ea4n \u0111au ch\u00f3i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P)<\/li>\n<li>D\u1ea5u m\u1ea5t li\u00ean t\u1ee5c t\u1ea1i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) (+)<\/li>\n<li>D\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng t\u1ea1i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) (+)<\/li>\n<li>Kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng v\u00f9ng ng\u1ef1c v\u00e0 vai (P)<\/li>\n<li>V\u1eadn \u0111\u1ed9ng tr\u01b0\u1edbc \u2013 sau , d\u1ea1ng &#8211; kh\u00e9p kh\u1edbp vai (P) h\u1ea1n ch\u1ebf<\/li>\n<li>Vai (P) th\u1ea5p h\u01a1n vai (T)<\/li>\n<li>Chi\u1ec1u d\u00e0i x\u01b0\u01a1ng \u0111\u00f2n (P) ng\u1eafn h\u01a1n x\u01b0\u01a1ng \u0111\u00f2n (T)<\/li>\n<\/ul>\n<p>&#8211; Drop arm test (-)<\/p>\n<p>&#8211; Apprehension test (-)<\/p>\n<ul>\n<li>Kh\u00f4ng d\u1ea5u th\u1ea7n kinh khu tr\u00fa<\/li>\n<li>B\u1ee5ng m\u1ec1m, kh\u00f4ng \u0111\u1ec1 kh\u00e1ng<\/li>\n<\/ul>\n<h1>VI. \u0110\u1eb6T V\u0102N \u0110\u1ec0:<\/h1>\n<p>D\u1ea5u hi\u1ec7u g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n (P)<\/p>\n<p>TD ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o<\/p>\n<p>TD ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn<\/p>\n<h1>VII. CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8<\/h1>\n<p>G\u00e3y k\u00edn 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) gi\u1edd th\u1ee9 7 sau tai n\u1ea1n giao th\u00f4ng ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng &#8211; TD ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o &#8211; TD ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn\/ \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 I theo VNHA 2022 \u2013 R\u1ed1i lo\u1ea1n lipid m\u00e1u<\/p>\n<h1>VIII. BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG:<\/h1>\n<ul>\n<li>B\u1ec7nh nh\u00e2n nh\u1eadp vi\u1ec7n v\u00ec \u0111au vai (P) v\u00e0 gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp vai (P) gi\u1edd th\u1ee9 1 sau tai n\u1ea1n giao th\u00f4ng, ngh\u0129 \u0111\u1ebfn c\u00e1c nguy\u00ean nh\u00e2n sau:<\/li>\n<\/ul>\n<p>+ G\u00e3y k\u00edn 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P): ngh\u0129 nhi\u1ec1u nh\u1ea5t v\u00ec kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng v\u00f9ng ng\u1ef1c v\u00e0 vai (P), d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n (P): d\u1ea5u m\u1ea5t li\u00ean t\u1ee5c v\u00e0 d\u1ea5u l\u1ea1o x\u1ea1o x\u01b0\u01a1ng 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P), k\u00e8m c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n (P): \u1ea5n \u0111au ch\u00f3i 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P), gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp vai (P), s\u01b0ng n\u1ec1 v\u00f9ng vai (P).<\/p>\n<p>+ Tr\u1eadt kh\u1edbp vai: \u00edt ngh\u0129 v\u00ec kh\u00e1m d\u1ea5u hi\u1ec7u \u1ed5 kh\u1edbp r\u1ed7ng (-)<\/p>\n<p>+ Tr\u1eadt kh\u1edbp c\u00f9ng \u0111\u00f2n: \u00edt ngh\u0129 v\u00ec v\u00f9ng kh\u1edbp vai c\u00f9ng \u0111\u00f2n kh\u00f4ng bi\u1ebfn d\u1ea1ng, \u1ea5n t\u1ea1i kh\u1edbp vai c\u00f9ng \u0111\u00f2n b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au<\/p>\n<p>+ R\u00e1ch ch\u00f3p xoay: \u00edt ngh\u0129 v\u00ec kh\u00e1m l\u00e2m s\u00e0ng Drop arm test (-)<\/p>\n<p>+ R\u00e1ch s\u1ee5n vi\u1ec1n: \u00edt ngh\u0129 v\u00ec kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn nghi\u1ec7m ph\u00e1p Apprehension test (-)<\/p>\n<ul>\n<li>Bi\u1ec7n lu\u1eadn c\u00e1c bi\u1ebfn ch\u1ee9ng s\u1edbm c\u1ee7a g\u00e3y x\u01b0\u01a1ng \u0111\u00f2n (P):<\/li>\n<\/ul>\n<p>+ G\u00e3y k\u00edn sang g\u00e3y h\u1edf: b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 x\u00e2y x\u00e1t hay v\u1ebft th\u01b0\u01a1ng v\u00f9ng ng\u1ef1c v\u00e0 vai tr\u00e1i, kh\u00f4ng th\u1ea5y c\u0103ng ch\u1ed7 \u0111\u1ea7u x\u01b0\u01a1ng g\u00e3y n\u00ean ch\u01b0a ngh\u0129 \u0111\u1ebfn<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: b\u1ec7nh nh\u00e2n c\u00f3 c\u1ea3m gi\u00e1c n\u00f4ng v\u00e0 s\u00e2u b\u00ecnh th\u01b0\u1eddng, gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng kh\u1edbp vai do \u0111au, v\u1eadn \u0111\u1ed9ng c\u00e1c kh\u1edbp kh\u00e1c c\u1ee7a tay (P) b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng y\u1ebfu li\u1ec7t c\u01a1 v\u00f9ng c\u00e1nh v\u00e0 c\u1eb3ng tay (P) n\u00ean ch\u01b0a ngh\u0129 c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111\u00e1m r\u1ed1i th\u1ea7n kinh c\u00e1nh tay<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: b\u1ec7nh nh\u00e2n c\u00f3 sinh hi\u1ec7u \u1ed5n, chi \u1ea5m, \u0111\u1ea7u c\u00e1c ng\u00f3n h\u1ed3ng, CRT &lt;2 gi\u00e2y, m\u1ea1ch quay (+) n\u00ean ch\u01b0a ngh\u0129 t\u1ed5n th\u01b0\u01a1ng b\u00f3 m\u1ea1ch d\u01b0\u1edbi \u0111\u00f2n<\/p>\n<p>+ T\u1ed5n th\u01b0\u01a1ng \u0111\u1ec9nh ph\u1ed5i: b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au, kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng hay b\u1ea7m t\u00edm v\u00f9ng ng\u1ef1c (P), kh\u00e1m kh\u00f4ng th\u1ea5y tr\u00e0n kh\u00ed d\u01b0\u1edbi da, nghe ph\u1ed5i kh\u00f4ng ran, r\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu hai ph\u1ebf tr\u01b0\u1eddng, rung thanh \u0111\u1ec1u 2 b\u00ean, g\u00f5 trong n\u00ean ch\u01b0a ngh\u0129 c\u00f3 bi\u1ebfn ch\u1ee9ng d\u1eadp ph\u1ed5i, g\u00e3y x\u01b0\u01a1ng s\u01b0\u1eddn \u0111\u1ec9nh ph\u1ed5i hay tr\u00e0n \u00a0kh\u00ed, tr\u00e0n m\u00e1u m\u00e0ng ph\u1ed5i<\/p>\n<p>&#8211; B\u1ec7nh nh\u00e2n t\u00e9 c\u00f3 \u0111\u1eadp th\u00e1i d\u01b0\u01a1ng (P) v\u00e0 h\u1ea1 s\u01b0\u1eddn (P) xu\u1ed1ng n\u1ec1n c\u1ee9ng, sau ng\u00e3 b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u v\u00f9ng th\u00e1i d\u01b0\u01a1ng (P) v\u00e0 h\u1ea1 s\u01b0\u1eddn (P) n\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb CTSN v\u00e0 ch\u1ea5n th\u01b0\u01a1ng b\u1ee5ng k\u00edn. \u0110\u1ec1 ngh\u1ecb ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh s\u1ecd n\u00e3o \u2013 ng\u1ef1c \u2013 b\u1ee5ng kh\u00f4ng thu\u1ed1c c\u1ea3n quang \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n<\/p>\n<h1>IX. \u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG:<\/h1>\n<ol>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n:<\/strong><\/li>\n<\/ol>\n<p>\u00a0\u00a0 &#8211; X-Quang x\u01b0\u01a1ng \u0111\u00f2n (P) b\u00ecnh di\u1ec7n th\u1eb3ng<\/p>\n<p>&#8211; Ch\u1ee5p c\u1eaft l\u1edbp vi t\u00ednh s\u1ecd n\u00e3o \u2013 ng\u1ef1c \u2013 b\u1ee5ng kh\u00f4ng ti\u00eam thu\u1ed1c c\u1ea3n quang<\/p>\n<p>2.C\u1eadn l\u00e2m s\u00e0ng ti\u1ec1n ph\u1eabu:<\/p>\n<p>\u00a0\u00a0 &#8211; T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi, nh\u00f3m m\u00e1u, Rh<\/p>\n<p>\u00a0\u00a0 &#8211; \u0110\u00f4ng c\u1ea7m m\u00e1u<\/p>\n<p>\u00a0\u00a0 &#8211; Sinh ho\u00e1: ure, creatinine, eGFR, glucose, AST, ALT<\/p>\n<p>\u00a0\u00a0 &#8211; \u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/p>\n<p>\u00a0\u00a0 &#8211; T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u<\/p>\n<p>\u00a0\u00a0 &#8211; X-Quang ng\u1ef1c th\u1eb3ng<\/p>\n<p>\u00a0\u00a0 &#8211; \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/p>\n<h1>X. K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG<\/h1>\n<p>Xquang x\u01b0\u01a1ng \u0111\u00f2n th\u1eb3ng<\/p>\n<figure id=\"attachment_4431\" aria-describedby=\"caption-attachment-4431\" style=\"width: 730px\" class=\"wp-caption alignnone\"><img fetchpriority=\"high\" decoding=\"async\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/1-8.png\" height=\"393\" width=\"730\" class=\"size-full wp-image-4431\" alt=\"H\u00ecnh ch\u1ee5p X-quang ph\u1ed5i, h\u00ecnh \u1ea3nh y h\u1ecdc c\u1ee7a B\u00e1c s\u0129 V\u00f5 Th\u00e0nh To\u00e0n.\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/1-8.png 730w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/1-8-300x162.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/1-8-18x10.png 18w\" sizes=\"(max-width: 730px) 100vw, 730px\" \/><figcaption id=\"caption-attachment-4431\" class=\"wp-caption-text\">1<\/figcaption><\/figure>\n<p>&#8211; H\u00e0nh ch\u00ednh: Xquang c\u1ee7a b\u1ec7nh nh\u00e2n Ph\u00f9ng V\u0103n Hi\u1ec7u, nam, 48 tu\u1ed5i, ch\u1ee5p ng\u00e0y 12\/12\/2024<\/p>\n<p>&#8211; Ti\u00eau chu\u1ea9n phim: c\u01b0\u1eddng \u0111\u1ed9 tia \u0111\u1ee7 (ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c m\u00f4 m\u1ec1m, v\u1ecf x\u01b0\u01a1ng v\u00e0 t\u1ee7y x\u01b0\u01a1ng), phim ch\u1ee5p \u0111\u1ee7 hai kh\u1edbp qua hai \u0111\u1ea7u \u1ed5 g\u00e3y, b\u00ecnh di\u1ec7n th\u1eb3ng<\/p>\n<p>&#8211; T\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng:<\/p>\n<p>+ G\u00e3y k\u00edn 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P)<\/p>\n<p>+ \u0110\u01b0\u1eddng g\u00e3y ch\u00e9o, kh\u00f4ng m\u1ea3nh r\u1eddi<\/p>\n<p>+ Di l\u1ec7ch ch\u1ed3ng ng\u1eafn &gt;1\/2 th\u00e2n x\u01b0\u01a1ng, sang b\u00ean, xu\u1ed1ng d\u01b0\u1edbi, g\u1eadp g\u00f3c.<\/p>\n<p>&#8211; T\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m: ch\u01b0a ghi nh\u1eadn tr\u00ean xquang<\/p>\n<ul>\n<li><strong>Xquang ng\u1ef1c th\u1eb3ng<\/strong><\/li>\n<\/ul>\n<figure id=\"attachment_4432\" aria-describedby=\"caption-attachment-4432\" style=\"width: 737px\" class=\"wp-caption alignnone\"><img decoding=\"async\" class=\"size-full wp-image-4432\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/2-8.png\" alt=\"2\" width=\"737\" height=\"724\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/2-8.png 737w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/2-8-300x295.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2024\/12\/2-8-12x12.png 12w\" sizes=\"(max-width: 737px) 100vw, 737px\" \/><figcaption id=\"caption-attachment-4432\" class=\"wp-caption-text\">2<\/figcaption><\/figure>\n<p><strong>\u00a0<\/strong>-&gt; KL: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<ul>\n<li><strong>CLVT b\u1ee5ng kh\u00f4ng c\u1ea3n quang<\/strong><\/li>\n<li><strong>CLVT ng\u1ef1c kh\u00f4ng c\u1ea3n quang<\/strong><\/li>\n<\/ul>\n<p>v Si\u00eau \u00e2m c\u1ea5p c\u1ee9u t\u1ea1i gi\u01b0\u1eddng<\/p>\n<p>\u00a0-&gt; KL: ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/p>\n<ul>\n<li><strong>C\u1eadn l\u00e2m s\u00e0ng ti\u1ec1n ph\u1eabu<\/strong><\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"3\" width=\"694\">\n<p><strong>\u0110\u00f4ng c\u1ea7m m\u00e1u<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>APTT<\/p>\n<\/td>\n<td width=\"231\">\n<p>25.7<\/p>\n<\/td>\n<td width=\"231\">\n<p>Gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>TQ<\/p>\n<\/td>\n<td width=\"231\">\n<p>14<\/p>\n<\/td>\n<td width=\"231\">\n<p>Gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>TL<\/p>\n<\/td>\n<td width=\"231\">\n<p>92<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>INR<\/p>\n<\/td>\n<td width=\"231\">\n<p>1.06<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"3\" width=\"694\">\n<p><strong>T\u1ed5ng ph\u00e2n t\u00edch t\u1ebf b\u00e0o m\u00e1u ngo\u1ea1i vi<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>WBC<\/p>\n<\/td>\n<td width=\"236\">\n<p>9.31<\/p>\n<\/td>\n<td width=\"231\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>NEU#<\/p>\n<\/td>\n<td width=\"236\">\n<p>6.51<\/p>\n<\/td>\n<td width=\"231\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>NEU %<\/p>\n<\/td>\n<td width=\"236\">\n<p>69.8\u00a0\u00a0<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>LYM#<\/p>\n<\/td>\n<td width=\"236\">\n<p>2.22<\/p>\n<\/td>\n<td width=\"231\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>MONO#<\/p>\n<\/td>\n<td width=\"236\">\n<p>0.47<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>EOS#<\/p>\n<\/td>\n<td width=\"236\">\n<p>0.10<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>BASO#<\/p>\n<\/td>\n<td width=\"236\">\n<p>0.01<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>RBC<\/p>\n<\/td>\n<td width=\"236\">\n<p>4.89<\/p>\n<\/td>\n<td width=\"231\">\n<p>M\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>HGB<\/p>\n<\/td>\n<td width=\"236\">\n<p>13.7<\/p>\n<\/td>\n<td width=\"231\">\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>HCT<\/p>\n<\/td>\n<td width=\"236\">\n<p>39.0<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>PLT<\/p>\n<\/td>\n<td width=\"236\">\n<p>219<\/p>\n<\/td>\n<td width=\"231\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"227\">\n<p>Nh\u00f3m m\u00e1u<\/p>\n<\/td>\n<td width=\"236\">\n<p>O (+)<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<p>\u00a0 -&gt; KL: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"3\" width=\"694\">\n<p><strong>Sinh ho\u00e1<\/strong><strong> m\u00e1u<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>Glucose<\/p>\n<\/td>\n<td width=\"231\">\n<p><strong>9.8<\/strong><\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>Ure<\/p>\n<\/td>\n<td width=\"231\">\n<p>5.0<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>Creatinin<\/p>\n<\/td>\n<td width=\"231\">\n<p>83<\/p>\n<\/td>\n<td width=\"231\">\n<p>umol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>eGFR<\/p>\n<\/td>\n<td width=\"231\">\n<p>91.16<\/p>\n<\/td>\n<td width=\"231\">\n<p>ml\/ph\u00fat<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>AST<\/p>\n<\/td>\n<td width=\"231\">\n<p>44<\/p>\n<\/td>\n<td width=\"231\">\n<p>U\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>ALT<\/p>\n<\/td>\n<td width=\"231\">\n<p>27<\/p>\n<\/td>\n<td width=\"231\">\n<p>U\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>Na+<\/p>\n<\/td>\n<td width=\"231\">\n<p>139<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>K+<\/p>\n<\/td>\n<td width=\"231\">\n<p>3.4<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>Cl-<\/p>\n<\/td>\n<td width=\"231\">\n<p>105<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>\u0110L calci to\u00e0n ph\u1ea7n<\/p>\n<\/td>\n<td width=\"231\">\n<p>2.22<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>-&gt; \u0110\u01b0\u1eddng huy\u1ebft ghi nh\u1eadn l\u00e0 \u0111\u01b0\u1eddng huy\u1ebft b\u1ea5t k\u00ec, \u0111\u1ec1 ngh\u1ecb HbA1c \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng ki\u1ec3m so\u00e1t \u0111\u01b0\u1eddng huy\u1ebft<\/p>\n<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td colspan=\"3\" width=\"694\">\n<p><strong>T<\/strong><strong>\u1ed5ng ph\u00e2n t\u00edch<\/strong> <strong>n\u01b0\u1edbc ti\u1ec3u<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>URO<\/p>\n<\/td>\n<td width=\"231\">\n<p>nom<\/p>\n<\/td>\n<td width=\"231\">\n<p>umol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>GLU<\/p>\n<\/td>\n<td width=\"231\">\n<p>10<\/p>\n<\/td>\n<td width=\"231\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>BIL<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>umol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>KET<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>S.G<\/p>\n<\/td>\n<td width=\"231\">\n<p>1.019<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>BLD<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>pH<\/p>\n<\/td>\n<td width=\"231\">\n<p>7<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>PRO<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>g\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>NIT<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"231\">\n<p>LEU<\/p>\n<\/td>\n<td width=\"231\">\n<p>(-)<\/p>\n<\/td>\n<td width=\"231\">\n<p>ug\/dl<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>-&gt; Ghi nh\u1eadn glucose trong n\u01b0\u1edbc ti\u1ec3u ngh\u0129 do b\u1ec7nh l\u00fd n\u1ec1n \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/p>\n<p>v \u0110i\u1ec7n t\u00e2m \u0111\u1ed3:<\/p>\n<ul>\n<li>Nh\u1ecbp xoang \u0111\u1ec1u, t\u1ea7n s\u1ed1 80 chu k\u1ef3\/ph\u00fat<\/li>\n<li>Tr\u1ee5c trung gian<\/li>\n<\/ul>\n<h1>XI. CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/h1>\n<p>G\u00e3y k\u00edn 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n (P) nh\u00f3m I theo Allman gi\u1edd th\u1ee9 7 sau tai n\u1ea1n \u00a0\u00a0giao th\u00f4ng ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/ \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 I theo VNHA 2022 \u2013 R\u1ed1i lo\u1ea1n lipid m\u00e1u<\/p>\n<h1>XII. H\u01af\u1edaNG X\u1eec TR\u00cd:<\/h1>\n<ol>\n<li><strong>The principles of treatment:<\/strong><\/li>\n<\/ol>\n<ul>\n<li>N\u1eafn ch\u1ec9nh x\u01b0\u01a1ng \u0111\u00f2n v\u1ec1 v\u1ecb tr\u00ed gi\u1ea3i ph\u1eabu<\/li>\n<li>Motionless<\/li>\n<li>Pain relief<\/li>\n<li>\u1ed4n \u0111\u1ecbnh b\u1ec7nh n\u1ec1n: \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/li>\n<\/ul>\n<p style=\"padding-left: 40px;\">2. \u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3:<\/p>\n<ul>\n<li>Mixtard 30\/70 (TDD) s\u00e1ng 10UI, chi\u1ec1u 10UI<\/li>\n<li>Paracetamol 500mg 01 vi\u00ean x 3 (u\u1ed1ng)<\/li>\n<li>Meloxicam 7.5mg 02 vi\u00ean x2 (u\u1ed1ng)<\/li>\n<li>Amlodipin 5mg 01 vi\u00ean (u\u1ed1ng)<\/li>\n<li>Atorvastatin 20mg 01 vi\u00ean (u\u1ed1ng)<\/li>\n<li>Cephazolin 1g 02 l\u1ecd (TMC) tr\u01b0\u1edbc r\u1ea1ch da 30 ph\u00fat<\/li>\n<li>L\u00ean l\u1ecbch ph\u1eabu thu\u1eadt ch\u01b0\u01a1ng tr\u00ecnh: Ph\u1eabu thu\u1eadt k\u1ebft h\u1ee3p x\u01b0\u01a1ng b\u1eb1ng n\u1eb9p v\u00edt<\/li>\n<li>Trong th\u1eddi gian ch\u1edd ti\u1ebfp t\u1ee5c cho b\u1ec7nh nh\u00e2n \u0111eo \u0111ai vai s\u1ed1 8 v\u00e0 sau khi ph\u1eabu thu\u1eadt<\/li>\n<li>Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng \u2013 v\u1eadt l\u00ed tr\u1ecb li\u1ec7u cho b\u1ec7nh nh\u00e2n sau ph\u1eabu thu\u1eadt<\/li>\n<\/ul>\n<h1><strong>XIV. TI\u00caN L\u01af\u1ee2NG<\/strong><\/h1>\n<ul>\n<li>G\u1ea7n: T\u1ed1t, b\u1ec7nh nh\u00e2n g\u00e3y k\u00edn 1\/3 gi\u1eefa x\u01b0\u01a1ng \u0111\u00f2n, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng \u2192 kh\u1ea3 n\u0103ng li\u1ec1n x\u01b0\u01a1ng t\u1ed1t<\/li>\n<li>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, can l\u1ec7ch<\/li>\n<\/ul>\n<h1>XV. D\u1ef0 PH\u00d2NG<\/h1>\n<ul>\n<li>Ti\u1ebfp t\u1ee5c \u0111eo \u0111ai s\u1ed1 8 sau m\u1ed5 6 \u2013 8 tu\u1ea7n<\/li>\n<li>H\u1ea1n ch\u1ebf khu\u00e2n v\u00e1c , v\u1eadn \u0111\u1ed9ng n\u1eb7ng b\u00ean vai ch\u1ea5n ch\u01b0\u01a1ng<\/li>\n<\/ul>","protected":false},"featured_media":4256,"comment_status":"open","ping_status":"closed","template":"","tags":[],"chuyen-muc":[188],"class_list":["post-4427","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\/4427","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=4427"}],"version-history":[{"count":5,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4427\/revisions"}],"predecessor-version":[{"id":4434,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/bai-giang\/4427\/revisions\/4434"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/4256"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=4427"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=4427"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=4427"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}