{"id":2111,"date":"2023-07-21T22:26:37","date_gmt":"2023-07-21T15:26:37","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=chuyen-de&#038;p=2111"},"modified":"2024-03-20T21:47:50","modified_gmt":"2024-03-20T14:47:50","slug":"benh-an-gay-xuong-ho","status":"publish","type":"chuyen-de","link":"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/benh-an-gay-xuong-ho\/","title":{"rendered":"B\u1ec7nh \u00e1n g\u00e3y x\u01b0\u01a1ng h\u1edf"},"content":{"rendered":"<h2 style=\"text-align: justify;\"><strong><span style=\"font-size: 16px;\"><a href=\"https:\/\/vi.wikipedia.org\/wiki\/H%E1%BB%87_th%E1%BB%91ng_ph%C3%A2n_lo%E1%BA%A1i_g%C3%A3y_x%C6%B0%C6%A1ng_h%E1%BB%9F_c%E1%BB%A7a_Gustilo\" target=\"_blank\" rel=\"noopener\">G\u00e3y x\u01b0\u01a1ng h\u1edf<\/a> \u0111\u1ed9 I theo Gustilo, 1\/3 gi\u1eefa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay nh\u00f3m A3 theo AO gi\u1edd th\u1ee9 1 do tai n\u1ea1n giao th\u00f4ng, ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng\/ THA \u0111\u1ed9 I theo ESC 2018, \u0110T\u0110 type 2.<\/span><\/p>\n<p>H\u00c0NH CH\u00cdNH<\/strong><\/h2>\n<ul>\n<li>H\u1ecd v\u00e0 t\u00ean: V\u01b0\u01a1ng V\u0103n T.<\/li>\n<li>Gi\u1edbi t\u00ednh: Nam<\/li>\n<li>N\u0103m sinh: 1964 (59 tu\u1ed5i)<\/li>\n<li>Ngh\u1ec1 nghi\u1ec7p: Qu\u1ea3n l\u00fd nh\u00e0 h\u00e1t<\/li>\n<li>\u0110\u1ecba ch\u1ec9: xxxxx TP. HCM.<\/li>\n<li>Thu\u1eadn tay ph\u1ea3i<\/li>\n<li>S\u0110T: 090xxxxxx<\/li>\n<li>Ng\u00e0y gi\u1edd nh\u1eadp vi\u1ec7n: 18h40 10\/02\/2023<\/li>\n<li>Ng\u00e0y gi\u1edd l\u00e0m b\u1ec7nh \u00e1n: 8h30 11\/02\/2023<\/li>\n<\/ul>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter wp-image-2114 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/luu-y.png\" alt=\"Luu-y\" width=\"820\" height=\"462\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/luu-y.png 820w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/luu-y-300x169.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/luu-y-768x433.png 768w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/luu-y-18x10.png 18w\" sizes=\"(max-width: 820px) 100vw, 820px\" \/><\/p>\n<p><span style=\"text-decoration: underline; color: #000080;\"><strong>Tr\u01b0\u1edbc khi xem h\u00e3y \u0111\u1ecdc qua c\u00e1c b\u00e0i vi\u1ebft sau:<\/strong><\/span><\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/bai-giang\/gay-xuong-ho\/\" target=\"_blank\" rel=\"noopener\">B\u00e0i gi\u1ea3ng G\u00e3y X\u01b0\u01a1ng H\u1edf<\/a><\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/chuyen-de\/slide-bai-giang-gay-xuong-ho\/\" target=\"_blank\" rel=\"noopener\">Slide b\u00e0i gi\u1ea3ng G\u00e3y X\u01b0\u01a1ng H\u1edf<\/a><\/p>\n<h2><strong>L\u00dd DO NH\u1eacP VI\u1ec6N<\/strong><\/h2>\n<p>\u0110au + m\u1ea5t v\u1eadn \u0111\u1ed9ng c\u00e1nh tay tr\u00e1i<\/p>\n<h2><strong>B\u1ec6NH S\u1eec<\/strong><\/h2>\n<ul>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 20 ph\u00fat sau khi u\u1ed1ng r\u01b0\u1ee3u b\u1ec7nh nh\u00e2n ch\u1ea1y xe m\u00e1y v\u1ec1 nh\u00e0 v\u1edbi v\u1eadn t\u1ed1c 50 Km\/h th\u00ec va qu\u1eb9t v\u1edbi xe m\u00e1y c\u00f9ng chi\u1ec1u, b\u1ecb l\u1ec7ch tay l\u00e1i, ng\u00e3 c\u00fai ng\u01b0\u1eddi v\u1ec1 tr\u01b0\u1edbc \u0111\u1eadp m\u00f4i v\u00e0o \u0111\u1ea7u xe nh\u01b0ng kh\u00f4ng \u0111\u1eadp \u0111\u1ea7u, sau \u0111\u00f3 ng\u00e3 ng\u01b0\u1eddi nghi\u00eang sang tr\u00e1i, c\u00e1nh tay tr\u00e1i v\u00e0 g\u1ed1i tr\u00e1i \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng. Sau khi t\u00e9 b\u1ec7nh nh\u00e2n t\u1ec9nh, \u0111au nhi\u1ec1u v\u00e0 kh\u00f4ng c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c tay tr\u00e1i, c\u00f3 v\u1ebft th\u01b0\u01a1ng \u1edf 1\/3 gi\u1eefa c\u00e1nh tay tr\u00e1i, m\u00e1u ch\u1ea3y nhi\u1ec1u kh\u00f4ng c\u1ea7m \u0111\u01b0\u1ee3c, g\u1ed1i tr\u00e1i \u0111au \u00edt, c\u1eed \u0111\u1ed9ng \u0111\u01b0\u1ee3c. T\u1ea1i hi\u1ec7n tr\u01b0\u1eddng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed tr\u00ed \u2192 Nh\u1eadp vi\u1ec7n BVTN b\u1eb1ng xe \u00f4t\u00f4.<\/li>\n<li>Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng d\u1ecb c\u1ea3m \u0111\u1ea7u chi, ti\u00eau ti\u1ec3u b\u00ecnh th\u01b0\u1eddng.<\/li>\n<li>T\u00ecnh tr\u1ea1ng nh\u1eadp vi\u1ec7n t\u1ea1i khoa c\u1ea5p c\u1ee9u:<\/li>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh ti\u1ebfp x\u00fac t\u1ed1t, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>Tim \u0111\u1ec1u, ph\u1ed5i kh\u00f4ng rale, b\u1ee5ng m\u1ec1m<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">G\u00e3y h\u1edf<\/a> x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<li>M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat<\/li>\n<li>Nhi\u1ec7t \u0111\u1ed9: 37\u2103<\/li>\n<li>HA: 110\/70mmHg<\/li>\n<li>Nh\u1ecbp th\u1edf: 20 l\u1ea7n\/ph\u00fat<\/li>\n<li>SpO2: 98%<\/li>\n<li>C\u00e2n n\u1eb7ng: 70 kg, Chi\u1ec1u cao: 167 cm<\/li>\n<li>X\u1eed tr\u00ed t\u1ea1i c\u1ea5p c\u1ee9u: B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh ch\u1ee5p CT scan s\u1ecd n\u00e3o, l\u1ed3ng ng\u1ef1c, b\u1ee5ng \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n \u2192 Chuy\u1ec3n khoa Ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh.<\/li>\n<li>Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng t\u1ea1i khoa Ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh:<\/li>\n<li>21h00, ng\u00e0y 10\/02\/2023:<\/li>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, h\u01a1i th\u1edf m\u00f9i c\u1ed3n, tim \u0111\u1ec1u, ph\u1ed5i kh\u00f4ng rale, b\u1ee5ng m\u1ec1m, v\u1ebft th\u01b0\u01a1ng d#1x1cm \u1edf \u2153 gi\u1eefa c\u00e1nh tay tr\u00e1i, ch\u1ea3y m\u00e1u kh\u00f4ng t\u1ef1 c\u1ea7m. C\u00e1nh tay tr\u00e1i s\u01b0ng nh\u1eb9, \u0111au nhi\u1ec1u \u2153 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay, m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng c\u00e1nh tay, \u0111\u1ea7u c\u00e1c ng\u00f3n h\u1ed3ng, kh\u00f4ng t\u00ea.<\/li>\n<li>X\u1eed tr\u00ed: Ceftriaxone, NaCl 0,9%, Paracetamol.<\/li>\n<li>CLS: XN ti\u1ec1n ph\u1eabu<\/li>\n<li>6h30, ng\u00e0y 11\/02\/2023:<\/li>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, sinh hi\u1ec7u \u1ed5n, \u0111\u01b0\u1eddng huy\u1ebft 12,4 mmol\/L.<\/li>\n<li>X\u1eed tr\u00ed: Ceftriaxone, NaCL 0,9%, Scilin 30\/70 30 \u0111\u01a1n v\u1ecb, Paracetamol.<\/li>\n<\/ul>\n<h2><strong>TI\u1ec0N S\u1eec<\/strong><\/h2>\n<p><strong>B\u1ea3n th\u00e2n<\/strong><\/p>\n<ul>\n<li>N\u1ed9i khoa:<\/li>\n<li>T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 I theo ESC 2018 (HA t\u00e2m thu cao nh\u1ea5t 150, HA t\u00e2m thu th\u00edch nghi 110) \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n c\u00e1ch \u0111\u00e2y 2 n\u0103m t\u1ea1i BVTN. B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-ban-chan-dai-thao-duong\/\">\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/a> type II \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n c\u00e1ch \u0111\u00e2y 2 n\u0103m t\u1ea1i BVTN. B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111i\u1ec1u tr\u1ecb.<\/li>\n<li>Ngo\u1ea1i khoa: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n ph\u1eabu thu\u1eadt<\/li>\n<li>Th\u00f3i quen:<\/li>\n<li>U\u1ed1ng bia: 3-4 l\u1ea7n\/tu\u1ea7n m\u1ed7i l\u1ea7n u\u1ed1ng 5-6 lon<\/li>\n<li>Thu\u1ed1c l\u00e1: 40 g\u00f3i\/n\u0103m<\/li>\n<li>D\u1ecb \u1ee9ng: ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng<\/li>\n<\/ul>\n<h3><strong>Gia \u0111\u00ecnh<\/strong><\/h3>\n<p>Ch\u01b0a ghi nh\u1eadn b\u1ec7nh l\u00fd b\u1ea5t th\u01b0\u1eddng.<\/p>\n<h2><strong>KH\u00c1M L\u00c2M S\u00c0NG<\/strong><\/h2>\n<p>(8h30 ng\u00e0y 11\/02\/2023)<\/p>\n<p><strong>T\u1ed5ng tr\u1ea1ng<\/strong><\/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, kh\u00f4ng d\u1ea5u xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da, kh\u00f4ng ph\u00f9, kh\u00f4ng n\u1ed5i b\u00f3ng n\u01b0\u1edbc<\/li>\n<li>D\u1ea5u m\u1ea5t n\u01b0\u1edbc (-), m\u00f4i kh\u00f4ng d\u01a1, l\u01b0\u1ee1i kh\u00f4ng b\u1ea9n<\/li>\n<li>Chi \u1ea5m, CRT &lt; 2s<\/li>\n<li>M\u1ea1ch \u0111\u1ec1u r\u00f5 2 b\u00ean<\/li>\n<li>Tuy\u1ebfn gi\u00e1p kh\u00f4ng to, h\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<li>M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat<\/li>\n<li>Nhi\u1ec7t \u0111\u1ed9: 37\u2103<\/li>\n<li>HA: 120\/80 mmHg<\/li>\n<li>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/li>\n<li>SPO2: 97%<\/li>\n<li>C\u00e2n n\u1eb7ng: 70 kg, Chi\u1ec1u cao: 167 cm <br \/>\nBMI: 25 \u2192 B\u00e9o ph\u00ec \u0111\u1ed9 I (IDI &amp; WPRO)<\/li>\n<\/ul>\n<p><strong>Tim m\u1ea1ch<\/strong><\/p>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf<\/li>\n<li>Kh\u00f4ng v\u1ebft th\u01b0\u01a1ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng, kh\u00f4ng rung miu<\/li>\n<li>M\u1ecfm tim \u1edf li\u00ean s\u01b0\u1eddn 5 \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i<\/li>\n<li>Ti\u1ebfng T1, T2 \u0111\u1ec1u r\u00f5, t\u1ea7n s\u1ed1 80 l\/p kh\u00f4ng \u00e2m th\u1ed5i b\u1ea5t th\u01b0\u1eddng<\/li>\n<\/ul>\n<p><strong>H\u00f4 H\u1ea5p<\/strong><\/p>\n<ul>\n<li>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i 2 b\u00ean, kh\u00f4ng u, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169<\/li>\n<li>Rung thanh \u0111\u1ec1u 2 b\u00ean<\/li>\n<li>G\u00f5 trong<\/li>\n<li>R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, kh\u00f4ng nghe rale<\/li>\n<\/ul>\n<p><strong>Ti\u00eau h\u00f3a:<\/strong><\/p>\n<ul>\n<li>B\u1ee5ng m\u1ec1m, to b\u00e8 2 b\u00ean, c\u1eed \u0111\u1ed9ng nh\u1ecbp nh\u00e0ng theo nh\u1ecbp th\u1edf<\/li>\n<li>Kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng sao m\u1ea1ch<\/li>\n<li>Nhu \u0111\u1ed9ng ru\u1ed9t: 6 l\/p<\/li>\n<li>G\u00f5 trong<\/li>\n<li>Kh\u00f4ng \u0111i\u1ec3m \u0111au khu tr\u00fa, kh\u00f4ng s\u1edd th\u1ea5y kh\u1ed1i u b\u1ea5t th\u01b0\u1eddng<\/li>\n<li>Gan l\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m.<\/li>\n<\/ul>\n<p><strong>Ti\u1ebft ni\u1ec7u<\/strong><\/p>\n<ul>\n<li>D\u1ea5u ch\u1ea1m th\u1eadn (-)<\/li>\n<li>C\u1ea7u b\u00e0ng quang (-)<\/li>\n<li>Kh\u00f4ng \u0111i\u1ec3m \u0111au ni\u1ec7u qu\u1ea3n<\/li>\n<\/ul>\n<p><strong>Th\u1ea7n kinh<\/strong><\/p>\n<ul>\n<li>C\u1ed5 m\u1ec1m<\/li>\n<li>Kh\u00f4ng c\u00f3 d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb<\/li>\n<\/ul>\n<p><strong>C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n n\u1eb1m tr\u00ean gi\u01b0\u1eddng, n\u1eb9p c\u1ed1 \u0111\u1ecbnh tay tr\u00e1i b\u1eb1ng n\u1eb9p c\u00e1nh c\u1eb3ng b\u00e0n tay.<\/li>\n<\/ul>\n<p><strong>Chi tr\u00ean <\/strong><\/p>\n<ul>\n<li>Nh\u00ecn:<\/li>\n<li>C\u00f3 v\u1ebft th\u01b0\u01a1ng \u1edf \u2153 gi\u1eefa c\u00e1nh tay tr\u00e1i \u0111\u00e3 b\u0103ng \u00e9p<\/li>\n<li>\u0110\u1ea7u c\u00e1c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a> h\u1ed3ng<\/li>\n<li>Nhi\u1ec1u v\u1ebft th\u01b0\u01a1ng x\u00e2y x\u00e1t v\u00f9ng mu tay ph\u1ea3i d# 1&#215;0.5 cm, t\u1ef1 c\u1ea7m<\/li>\n<li>S\u1edd :<\/li>\n<li>Chi \u1ea5m 2 b\u00ean<\/li>\n<li>M\u1ea1ch quay, m\u1ea1ch tr\u1ee5 2 b\u00ean \u0111\u1ec1u r\u00f5<\/li>\n<li>C\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u t\u1ed1t, kh\u00f4ng t\u00ea, kh\u00f4ng d\u1ecb c\u1ea3m<\/li>\n<li>\u0110o: b\u1ec7nh nh\u00e2n \u0111ang n\u1eb9p c\u1ed1 \u0111\u1ecbnh v\u00e0 \u0111au n\u00ean kh\u00f4ng \u0111o<\/li>\n<\/ul>\n<p><strong>Chi d\u01b0\u1edbi<\/strong><\/p>\n<ul>\n<li>Nh\u00ecn:\n<ul>\n<li>V\u1ebft th\u01b0\u01a1ng xay x\u00e1t k\u00edch th\u01b0\u1edbc 2x1cm g\u1ed1i tr\u00e1i, t\u1ef1 c\u1ea7m m\u00e1u<\/li>\n<li>Xanh t\u00edm g\u1ed1i tr\u00e1i, kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng bi\u1ebfn d\u1ea1ng<\/li>\n<li>\u0110\u00f9i v\u00e0 c\u1eb3ng ch\u00e2n 2 b\u00ean kh\u00f4ng s\u01b0ng, kh\u00f4ng bi\u1ebfn d\u1ea1ng<\/li>\n<\/ul>\n<\/li>\n<li>S\u1edd:\n<ul>\n<li>G\u1ed1i tr\u00e1i \u1ea5n \u0111au \u00edt<\/li>\n<li>M\u1ea1ch khoeo, m\u1ea1ch ch\u00e0y sau, m\u1ea1ch mu ch\u00e2n \u0111\u1ec1u r\u00f5<\/li>\n<li>C\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u t\u1ed1t, kh\u00f4ng t\u00ea, kh\u00f4ng d\u1ecb c\u1ea3m<\/li>\n<\/ul>\n<\/li>\n<li>\u0110o:\n<ul>\n<li>Ch\u00e2n ph\u1ea3i<\/li>\n<li>Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i: 79cm<\/li>\n<li>Ch\u00e2n tr\u00e1i<\/li>\n<li>Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i: 79cm<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><strong>Kh\u00e1m v\u1eadn \u0111\u1ed9ng<\/strong><\/p>\n<ul>\n<li>Gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng v\u00f9ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>D\u1ea1ng, g\u1ea5p, du\u1ed7i, \u0111\u1ed1i ng\u00f3n I kh\u00f4ng b\u1ecb gi\u1edbi h\u1ea1n<\/li>\n<li>G\u1ea5p du\u1ed7i c\u1eb3ng ch\u00e2n kh\u00f4ng b\u1ecb gi\u1edbi h\u1ea1n, \u0111i l\u1ea1i \u0111\u01b0\u1ee3c b\u00ecnh th\u01b0\u1eddng<\/li>\n<\/ul>\n<p><strong>Kh\u00e1m c\u1ea3m gi\u00e1c<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n v\u1eabn c\u00f2n c\u1ea3m gi\u00e1c n\u00f4ng v\u00e0 c\u1ea3m gi\u00e1c s\u00e2u \u1edf l\u00f2ng b\u00e0n tay, mu b\u00e0n tay hai b\u00ean.<\/li>\n<\/ul>\n<h2><strong>T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n nam 59 tu\u1ed5i nh\u1eadp vi\u1ec7n v\u00ec \u0111au v\u00e0 m\u1ea5t v\u1eadn \u0111\u1ed9ng c\u00e1nh tay tr\u00e1i. Qua th\u0103m kh\u00e1m v\u00e0 h\u1ecfi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">b\u1ec7nh s\u1eed<\/a> ghi nh\u1eadn:<\/p>\n<ul>\n<li>TCCN: \u0110au 1\/3 gi\u1eefa c\u00e1nh tay tr\u00e1i, m\u1ea5t v\u1eadn \u0111\u1ed9ng tay tr\u00e1i.<\/li>\n<li>TCTT: C\u00e1nh tay tr\u00e1i s\u01b0ng nh\u1eb9, m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i, sinh hi\u1ec7u \u1ed5n, chi \u1ea5m, CRT &lt; 2s, b\u00e9o ph\u00ec \u0111\u1ed9 I, \u0111\u1ed9ng m\u1ea1ch quay tr\u00e1i b\u1eaft \u0111\u01b0\u1ee3c, \u0111\u1ec1u r\u00f5, g\u1ea5p, du\u1ed7i, d\u1ea1ng, \u0111\u1ed1i ng\u00f3n I b\u00ecnh th\u01b0\u1eddng, c\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u t\u1ed1t, kh\u00f4ng t\u00ea, kh\u00f4ng d\u1ecb c\u1ea3m, ch\u00e2n tr\u00e1i kh\u00f4ng gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng, \u0111i l\u1ea1i b\u00ecnh th\u01b0\u1eddng.<\/li>\n<li>Ti\u1ec1n c\u0103n:\n<ul>\n<li>T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 I theo ESC 2018<\/li>\n<li>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2<\/li>\n<li>S\u1eed d\u1ee5ng r\u01b0\u1ee3u bia, thu\u1ed1c l\u00e1<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><strong>\u0110\u1eb6T V\u1ea4N \u0110\u1ec0<\/strong><\/h2>\n<ul>\n<li>C\u00f3 d\u1ea5u hi\u1ec7u <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">g\u00e3y x\u01b0\u01a1ng<\/a> c\u00e1nh tay tr\u00e1i<\/li>\n<li>Ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh, m\u1ea1ch m\u00e1u c\u1ee7a g\u00e3y x\u01b0\u01a1ng<\/li>\n<\/ul>\n<h2><strong>CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8<\/strong><\/h2>\n<p>G\u00e3y h\u1edf 1\/3 gi\u1eefa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay \u0111\u1ed9 I theo <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">Gustilo<\/a> gi\u1edd th\u1ee9 1 do TNGT ch\u01b0a bi\u1ebfn ch\u1ee9ng kh\u00f4ng t\u1ed5n th\u01b0\u01a1ng k\u00e8m theo \/ T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 I theo ESC 2018 &#8211; \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2.<\/p>\n<h2><strong> BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG<\/strong><\/h2>\n<p><strong>Bi\u1ec7n lu\u1eadn g\u00e3y x\u01b0\u01a1ng:<\/strong><\/p>\n<ul>\n<li>BN c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u g\u00e3y x\u01b0\u01a1ng kh\u00f4ng ch\u1eafc ch\u1eafn \u1edf x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i nh\u01b0: \u0111au 1\/3 gi\u1eefa c\u00e1nh tay tr\u00e1i, s\u01b0ng nh\u1eb9 v\u00e0 m\u1ea5t v\u1eadn \u0111\u1ed9ng v\u00f9ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>D\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-chi-tren\/\">g\u00e3y x\u01b0\u01a1ng c\u00e1nh tay<\/a> tr\u00e1i: m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>BN c\u00f3 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng cao &#8211; t\u00e9 ng\u00e3 trong tai n\u1ea1n giao th\u00f4ng.<\/li>\n<li>V\u1ecb tr\u00ed g\u00e3y x\u01b0\u01a1ng:\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u00e9 sang tr\u00e1i v\u00e0 ti\u1ebfp \u0111\u1ea5t b\u1eb1ng c\u00e1nh tay tr\u00e1i, c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn v\u00e0 kh\u00f4ng ch\u1eafc ch\u1eafn c\u1ee7a g\u00e3y x\u01b0\u01a1ng \u1edf v\u1ecb tr\u00ed 1\/3 gi\u1eefa c\u00e1nh tay tr\u00e1i \u2192 Ngh\u0129 g\u00e3y \u1edf 1\/3 gi\u1eefa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i do tai n\u1ea1n giao th\u00f4ng \u2192 \u0110\u1ec1 ngh\u1ecb: X quang c\u00e1nh tay tr\u00e1i th\u1eb3ng &#8211; nghi\u00eang \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh<\/li>\n<li>B\u1ec7nh nh\u00e2n c\u0169ng c\u00f3 ti\u1ebfp \u0111\u1ea5t b\u1eb1ng g\u1ed1i tr\u00e1i,c\u00f3 v\u1ebft x\u00e2y x\u00e1t v\u00e0 ch\u1ea5n th\u01b0\u01a1ng g\u1ed1i, tuy nhi\u00ean g\u1ed1i v\u1eabn v\u1eadn \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng \u2192 Kh\u00f4ng ngh\u0129 nhi\u1ec1u c\u00f3 g\u00e3y x\u01b0\u01a1ng v\u00f9ng g\u1ed1i \u2192 \u0110\u1ec1 ngh\u1ecb X quang v\u00f9ng g\u1ed1i tr\u00e1i \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb<\/li>\n<\/ul>\n<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">G\u00e3y x\u01b0\u01a1ng h\u1edf<\/a>:<\/li>\n<li>C\u00f3 v\u1ebft th\u01b0\u01a1ng \u1edf 1\/3 gi\u1eefa v\u00f9ng c\u00e1nh tay tr\u00e1i, g\u1ea7n v\u1ecb tr\u00ed \u1ed5 g\u00e3y \u2192 Ngh\u0129 g\u00e3y x\u01b0\u01a1ng h\u1edf 1\/3 gi\u1eefa c\u00e1nh tay tr\u00e1i<\/li>\n<li>V\u1ebft th\u01b0\u01a1ng d#1x1cm \u2192 G\u00e3y h\u1edf 1\/3 gi\u1eefa x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i \u0111\u1ed9 I theo Gustilo<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng c\u01a1 quan k\u00e8m theo: qua h\u1ecfi b\u1ec7nh s\u1eed BN kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng \u0111au h\u00f4ng l\u01b0ng, kh\u00f4ng \u0111au \u0111\u1ea7u, th\u0103m kh\u00e1m l\u00e2m s\u00e0ng cho th\u1ea5y, b\u1ee5ng m\u1ec1m kh\u00f4ng \u0111i\u1ec3m \u0111au khu tr\u00fa, ch\u1ea1m th\u1eadn (-), gan l\u00e1ch kh\u00f4ng s\u1edd ch\u1ea1m, c\u1ea7u b\u00e0ng quang (-), ti\u1ec3u \u0111\u01b0\u1ee3c, kh\u00f4ng \u1ea5n \u0111au g\u00f3c s\u01b0\u1eddn \u2013 s\u1ed1ng \u2192 \u00edt ngh\u0129 t\u1ed5n th\u01b0\u01a1ng t\u1ea1ng \u1ed5 b\u1ee5ng (t\u1ea1ng \u0111\u1eb7c, b\u00e0ng quang).<\/li>\n<\/ul>\n<p><strong>Bi\u1ec7n lu\u1eadn bi\u1ebfn ch\u1ee9ng g\u00e3y x\u01b0\u01a1ng<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n \u0111ang \u1edf ng\u00e0y 1 c\u1ee7a b\u1ec7nh (ho\u00e3n ph\u1eabu thu\u1eadt do \u0111\u01b0\u1eddng huy\u1ebft cao) \u2192 bi\u1ec7n lu\u1eadn bi\u1ebfn ch\u1ee9ng<\/li>\n<li>Bi\u1ebfn ch\u1ee9ng s\u1edbm<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: \u00edt ngh\u0129 do da v\u00f9ng b\u00e0n tay v\u00e0 c\u1eb3ng v\u1eabn h\u1ed3ng v\u00e0 s\u1edd \u1ea5m \u2013 \u0111\u01b0\u1ee3c t\u01b0\u1edbi m\u00e1u t\u1ed1t, b\u1eaft \u0111\u01b0\u1ee3c m\u1ea1ch quay \u0111\u1ec1u r\u00f5 2 b\u00ean<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: \u00edt ngh\u0129 do b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c t\u00ea \u1edf gan tay, v\u1eadn \u0111\u1ed9ng du\u1ed7i, d\u1ea1ng c\u00e1c ng\u00f3n tay tr\u00e1i b\u00ecnh th\u01b0\u1eddng, c\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u v\u1eabn c\u00f2n \u1edf c\u1eb3ng tay v\u00e0 b\u00e0n tay.<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">Ch\u00e8n \u00e9p khoang<\/a>: kh\u00f4ng ngh\u0129 v\u00ec b\u1ec7nh nh\u00e2n c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u1ea3m \u0111au, m\u1ea1ch quay \u0111\u1ec1u, r\u00f5 2 b\u00ean, \u0111\u1ea7u ng\u00f3n tay h\u1ed3ng, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng t\u00ea li\u1ec7t chi.<\/li>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">Cho\u00e1ng ch\u1ea5n th\u01b0\u01a1ng<\/a>: kh\u00f4ng ngh\u0129 v\u00ec kh\u00e1m th\u1ea5y sinh hi\u1ec7u b\u1ec7nh nh\u00e2n \u1ed5n, kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng co gi\u1eadt.<\/li>\n<li>T\u1eafc m\u1ea1ch m\u00e1u do m\u1ee1: \u00edt ngh\u0129 do b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng suy h\u00f4 h\u1ea5p, l\u01a1 m\u01a1 h\u00f4n m\u00ea hay ph\u00e1t ban d\u01b0\u1edbi da, tuy nhi\u00ean c\u1ea7n ph\u1ea3i theo d\u00f5i t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n th\u00eam v\u00ec bi\u1ebfn ch\u1ee9ng n\u00e0y c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u t\u1eeb 12 gi\u1edd &#8211; 3 ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng: b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 s\u1ed1t, m\u00f4i kh\u00f4ng kh\u00f4, l\u01b0\u1ee1i kh\u00f4ng d\u01a1.<\/li>\n<li>R\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng: c\u00e1nh tay tr\u00e1i kh\u00f4ng s\u01b0ng n\u1ec1, kh\u00f4ng c\u0103ng c\u1ee9ng, kh\u00f4ng n\u1ed5i b\u00f3ng n\u01b0\u1edbc, kh\u00f4ng r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng c\u1ea3m gi\u00e1c c\u1eb3ng v\u00e0 b\u00e0n tay tr\u00e1i, chi \u1ea5m, m\u1ea1ch quay \u0111\u1ec1u r\u00f5 2 b\u00ean, CRT&lt;2s.<\/li>\n<li>Bi\u1ebfn ch\u1ee9ng trong qu\u00e1 tr\u00ecnh ch\u1edd m\u1ed5: <br \/>\nBN \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh m\u1ed5 c\u1ea5p c\u1ee9u v\u00e0o ng\u00e0y 10\/02 tuy nhi\u00ean do \u0111\u01b0\u1eddng huy\u1ebft BN cao (11.4 mmol\/dL) trong n\u00ean ph\u1ea3i tr\u00ec ho\u00e3n ph\u1eabu thu\u1eadt cho \u0111\u1ebfn khi \u0111\u01b0\u1eddng huy\u1ebft &lt; 8 mmol\/dL. Theo d\u00f5i s\u00e1t c\u00e1c bi\u1ebfn ch\u1ee9ng do n\u1eb1m <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">b\u1ea5t \u0111\u1ed9ng<\/a> chi.<\/li>\n<li>Thuy\u00ean t\u1eafc huy\u1ebft kh\u1ed1i: \u00cdt ngh\u0129 do chi \u1ea5m, kh\u00f4ng \u0111au d\u1ecdc \u0111\u01b0\u1eddng \u0111i t\u0129nh m\u1ea1ch, kh\u00f4ng c\u00f3 ti\u1ec1n c\u0103n r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/li>\n<li>Vi\u00eam ph\u1ed5i: \u00cdt ngh\u0129 do b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111au ng\u1ef1c, kh\u00f4ng ho, kh\u00f4ng s\u1ed1t, SpO2 97%, kh\u00e1m ph\u1ed5i: r\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, g\u00f5 trong, kh\u00f4ng nghe ti\u1ebfng rale b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li>Nhi\u1ec5m tr\u00f9ng ti\u1ec3u: \u00cdt ngh\u0129 BN ti\u1ec3u kh\u00f4ng g\u1eaft bu\u1ed1t, n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong, l\u01b0\u1ee3ng n\u01b0\u1edbc ti\u1ec3u b\u00ecnh th\u01b0\u1eddng.<\/li>\n<\/ul>\n<h2><strong>\u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/h2>\n<ul>\n<li>C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n:<\/li>\n<li>X quang c\u00e1nh tay tr\u00e1i th\u1eb3ng &#8211; nghi\u00eang<\/li>\n<li>X quang g\u1ed1i tr\u00e1i th\u1eb3ng &#8211; nghi\u00eang<\/li>\n<li>C\u1eadn l\u00e2m s\u00e0ng ti\u1ec1n ph\u1eabu<\/li>\n<li>C\u00f4ng th\u1ee9c m\u00e1u<\/li>\n<li>\u0110\u1ecbnh nh\u00f3m m\u00e1u ABO Rh<\/li>\n<li>\u0110\u00f4ng c\u1ea7m m\u00e1u<\/li>\n<li>Sinh h\u00f3a m\u00e1u: Glucose m\u00e1u, Ure m\u00e1u, Creatinin m\u00e1u, AST, ALT, ion \u0111\u1ed3 (Na+, K+, Cl-)<\/li>\n<li>C\u1eadn l\u00e2m s\u00e0ng h\u1ed7 tr\u1ee3: CT-scan \u0111\u1ea7u<\/li>\n<\/ul>\n<h2><strong>K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG<\/strong><\/h2>\n<p><strong><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-quang<\/a>:<\/strong><\/p>\n<p><img decoding=\"async\" width=\"344\" height=\"455\" class=\"wp-image-2113 aligncenter\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/x-ray-of-a-shoulder-bone-description-automaticall.png\" alt=\"X-ray of a shoulder bone\n\nDescription automatically generated\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/x-ray-of-a-shoulder-bone-description-automaticall.png 344w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/x-ray-of-a-shoulder-bone-description-automaticall-227x300.png 227w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/x-ray-of-a-shoulder-bone-description-automaticall-9x12.png 9w\" sizes=\"(max-width: 344px) 100vw, 344px\" \/><\/p>\n<p>H\u00e0nh ch\u00ednh:<\/p>\n<ul>\n<li>H\u1ecd v\u00e0 t\u00ean: V\u01b0\u01a1ng V\u0103n T. , nam, 1964 (59 tu\u1ed5i)<\/li>\n<li>X-quang c\u00e1nh tay tr\u00e1i (7h26, 10\/02\/2023)<\/li>\n<li>1 phim ch\u1ee5p th\u1eb3ng (thi\u1ebfu phim nghi\u00eang), tia chu\u1ea9n, t\u1ef7 l\u1ec7 20%, l\u1ea5y \u0111\u1ee7 2 \u0111\u1ea7u c\u00e1nh tay tr\u00e1i.<\/li>\n<\/ul>\n<p>\u0110\u1ecdc phim:<\/p>\n<ul>\n<li>Kh\u00f4ng th\u1ea5y ph\u00f9 n\u1ec1 m\u00f4 m\u1ec1m<\/li>\n<li>G\u00e3y x\u01b0\u01a1ng<\/li>\n<li>V\u1ecb tr\u00ed: 1\/3 gi\u1eefa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay<\/li>\n<li>\u0110\u01b0\u1eddng g\u00e3y ngang<\/li>\n<li>D\u1ecb l\u1ec7ch:\n<ul>\n<li>Ch\u1ed3ng ng\u1eafn 2cm<\/li>\n<li>Sang b\u00ean 1 th\u00e2n x\u01b0\u01a1ng<\/li>\n<\/ul>\n<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng k\u00e8m: ch\u01b0a ph\u00e1t hi\u1ec7n<\/li>\n<\/ul>\n<p><strong>X\u00e9t nghi\u1ec7m m\u00e1u<\/strong> (20h15 ng\u00e0y 10\/02\/2023)<\/p>\n<table>\n<tbody>\n<tr>\n<td>&nbsp;<\/td>\n<td>\n<p>K\u1ebft qu\u1ea3<\/p>\n<\/td>\n<td>\n<p>Kho\u1ea3ng tham chi\u1ebfu<\/p>\n<\/td>\n<td>\n<p>\u0110\u01a1n v\u1ecb<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>WBC<\/p>\n<\/td>\n<td>\n<p>8.19<\/p>\n<\/td>\n<td>\n<p>4.01 &#8211; 11.42<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>NEU%<\/p>\n<\/td>\n<td>\n<p><strong>30.7<\/strong><\/p>\n<\/td>\n<td>\n<p>40 &#8211; 74<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>LYM%<\/p>\n<\/td>\n<td>\n<p><strong>53.7<\/strong><\/p>\n<\/td>\n<td>\n<p>19 &#8211; 48<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MONO%<\/p>\n<\/td>\n<td>\n<p><strong>10.94<\/strong><\/p>\n<\/td>\n<td>\n<p>3.4 &#8211; 9.0<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>EOS%<\/p>\n<\/td>\n<td>\n<p>3.714<\/p>\n<\/td>\n<td>\n<p>0.0 &#8211; 7.0<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>BASO%<\/p>\n<\/td>\n<td>\n<p>0.928<\/p>\n<\/td>\n<td>\n<p>0.0 &#8211; 1.5<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>NEU#<\/p>\n<\/td>\n<td>\n<p>2.52<\/p>\n<\/td>\n<td>\n<p>1.7 &#8211; 7.5<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>LYM#<\/p>\n<\/td>\n<td>\n<p><strong>4.40<\/strong><\/p>\n<\/td>\n<td>\n<p>1.2 &#8211; 4.0<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MONO#<\/p>\n<\/td>\n<td>\n<p><strong>0.896<\/strong><\/p>\n<\/td>\n<td>\n<p>0.2 &#8211; 0.8<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>EOS#<\/p>\n<\/td>\n<td>\n<p>0.304<\/p>\n<\/td>\n<td>\n<p>0.0 &#8211; 0.6<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>BASO#<\/p>\n<\/td>\n<td>\n<p>0.076<\/p>\n<\/td>\n<td>\n<p>0.0 &#8211; 0.1<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>RBC<\/p>\n<\/td>\n<td>\n<p>4.92<\/p>\n<\/td>\n<td>\n<p>4.01 &#8211; 5.79<\/p>\n<\/td>\n<td>\n<p>M\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>HGB<\/p>\n<\/td>\n<td>\n<p><strong>15.3<\/strong><\/p>\n<\/td>\n<td>\n<p>11.5 &#8211; 15.0<\/p>\n<\/td>\n<td>\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>HCT<\/p>\n<\/td>\n<td>\n<p>47.1<\/p>\n<\/td>\n<td>\n<p>34.4 &#8211; 48.6<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MCV<\/p>\n<\/td>\n<td>\n<p>95.7<\/p>\n<\/td>\n<td>\n<p>80 &#8211; 99<\/p>\n<\/td>\n<td>\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MCH<\/p>\n<\/td>\n<td>\n<p>31.1<\/p>\n<\/td>\n<td>\n<p>27 &#8211; 33<\/p>\n<\/td>\n<td>\n<p>Pg<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MCHC<\/p>\n<\/td>\n<td>\n<p>32.5<\/p>\n<\/td>\n<td>\n<p>32 &#8211; 36<\/p>\n<\/td>\n<td>\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>RDW<\/p>\n<\/td>\n<td>\n<p>12.2<\/p>\n<\/td>\n<td>\n<p>11.5 &#8211; 15.5<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>PLT<\/p>\n<\/td>\n<td>\n<p><strong>122<\/strong><\/p>\n<\/td>\n<td>\n<p>150 &#8211; 450<\/p>\n<\/td>\n<td>\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>MPV<\/p>\n<\/td>\n<td>\n<p>9.23<\/p>\n<\/td>\n<td>\n<p>7.4 &#8211; 10.9<\/p>\n<\/td>\n<td>\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>Bi\u1ec7n lu\u1eadn:<\/li>\n<li>H\u1ed3ng c\u1ea7u, b\u1ea1ch c\u1ea7u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng \u2192 ch\u01b0a ghi nh\u1eadn thi\u1ebfu m\u00e1u<\/li>\n<li>Ti\u1ec3u c\u1ea7u gi\u1ea3m \u2192 b\u1ec7nh nh\u00e2n c\u00f3 r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td colspan=\"4\">\n<p>Nh\u00f3m m\u00e1u: B+<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>APTT<\/p>\n<\/td>\n<td>\n<p><strong>39.7<\/strong><\/p>\n<\/td>\n<td>\n<p>25 &#8211; 37<\/p>\n<\/td>\n<td>\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>TQ<\/p>\n<\/td>\n<td>\n<p><strong>32.4<\/strong><\/p>\n<\/td>\n<td>\n<p>9.3 &#8211; 14.3<\/p>\n<\/td>\n<td>\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Prothrombine<\/p>\n<\/td>\n<td>\n<p><strong>30<\/strong><\/p>\n<\/td>\n<td>\n<p>&gt; 70<\/p>\n<\/td>\n<td>\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>INR<\/p>\n<\/td>\n<td>\n<p><strong>2.53<\/strong><\/p>\n<\/td>\n<td>\n<p>0.84 &#8211; 1.29<\/p>\n<\/td>\n<td>&nbsp;<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>K\u1ebft qu\u1ea3:<\/li>\n<li>APTT, TQ, INR t\u0103ng, PT gi\u1ea3m \u2192 t\u1ec9 l\u1ec7 prothrombin gi\u1ea3m, th\u1eddi gian \u0111\u00f4ng m\u00e1u n\u1ed9i sinh k\u00e9o d\u00e0i, b\u1ec7nh nh\u00e2n c\u00f3 t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td>\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Glucose [m\u00e1u]<\/p>\n<\/td>\n<td>\n<p><strong>11.4<\/strong><\/p>\n<\/td>\n<td>\n<p>4.1 &#8211; 5.9<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Ure [ma\u0301u]<\/p>\n<\/td>\n<td>\n<p>3.1<\/p>\n<\/td>\n<td>\n<p>2.8 &#8211; 7.2<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Creatinin [m\u00e1u]<\/p>\n<\/td>\n<td>\n<p>87<\/p>\n<\/td>\n<td>\n<p>53 &#8211; 120<\/p>\n<\/td>\n<td>\n<p>umol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>eGFR<\/p>\n<\/td>\n<td>\n<p>82.8<\/p>\n<\/td>\n<td>\n<p>\u2265 60<\/p>\n<\/td>\n<td>\n<p>U\/L &#8211; 37\u2103<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u0110o ho\u1ea1t \u0111\u1ed9 AST (GOT) [m\u00e1u]<\/p>\n<\/td>\n<td>\n<p><strong>78<\/strong><\/p>\n<\/td>\n<td>\n<p>&lt; 50<\/p>\n<\/td>\n<td>\n<p>U\/L &#8211; 37\u2103<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u0110o ho\u1ea1t \u0111\u1ed9 ALT (GPT) [m\u00e1u]<\/p>\n<\/td>\n<td>\n<p><strong>56<\/strong><\/p>\n<\/td>\n<td>\n<p>&lt; 50<\/p>\n<\/td>\n<td>\n<p>U\/L &#8211; 37\u2103<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Na+<\/p>\n<\/td>\n<td>\n<p>137<\/p>\n<\/td>\n<td>\n<p>135-145<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>K+<\/p>\n<\/td>\n<td>\n<p>3.5<\/p>\n<\/td>\n<td>\n<p>3.5 -5.0<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>Cl-<\/p>\n<\/td>\n<td>\n<p>100<\/p>\n<\/td>\n<td>\n<p>98 &#8211; 106<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td>\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Calci to\u00e0n ph\u1ea7n<\/p>\n<\/td>\n<td>\n<p>2.2<\/p>\n<\/td>\n<td>\n<p>2.15-2.6<\/p>\n<\/td>\n<td>\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>Bi\u1ec7n lu\u1eadn:<\/li>\n<li>Glucose m\u00e1u b\u1ea5t k\u00ec t\u0103ng 11,4 mmol\/L \u2192 l\u1ea5y m\u00e1u sau b\u1eefa \u0103n kho\u1ea3ng 1 ti\u1ebfng, b\u1ec7nh nh\u00e2n m\u1eafc \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng type 2 v\u00e0 b\u1ecb stress do ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>Men gan AST, ALT t\u0103ng \u2192 b\u1ec7nh nh\u00e2n u\u1ed1ng r\u01b0\u1ee3u<\/li>\n<li>Ch\u1ee9c n\u0103ng th\u1eadn b\u00ecnh th\u01b0\u1eddng<\/li>\n<\/ul>\n<p><strong>CT-scan s\u1ecd n\u00e3o<\/strong><\/p>\n<p>Ch\u01b0a th\u1ea5y b\u1ea5t th\u01b0\u1eddng n\u1ed9i s\u1ecd tr\u00ean CT-scan s\u1ecd n\u00e3o<\/p>\n<h2><strong>CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong><\/h2>\n<p>G\u00e3y h\u1edf \u0111\u1ed9 I theo Gustilo, 1\/3 gi\u1eefa th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay nh\u00f3m A3 theo AO gi\u1edd th\u1ee9 1 do tai n\u1ea1n giao th\u00f4ng, ch\u01b0a c\u00f3 bi\u1ebfn ch\u1ee9ng\/ THA \u0111\u1ed9 I theo ESC 2018, \u0110T\u0110 type 2.<\/p>\n<h2><strong>\u0110I\u1ec0U TR\u1eca:<\/strong><\/h2>\n<p>\u01afu ti\u00ean l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p bao g\u1ed3m:<\/p>\n<ul>\n<li>K\u1ebft h\u1ee3p x\u01b0\u01a1ng b\u1eb1ng n\u1eb9p<\/li>\n<li>K\u1ebft h\u1ee3p x\u01b0\u01a1ng b\u1eb1ng \u0111inh n\u1ed9i t\u1ee7y<\/li>\n<li>K\u1ebft h\u1ee3p x\u01b0\u01a1ng b\u1eb1ng c\u1ed1 \u0111\u1ecbnh ngo\u00e0i<\/li>\n<\/ul>\n<p>Trong th\u1eddi gian ch\u1edd ph\u1eabu thu\u1eadt:<\/p>\n<ul>\n<li>B\u1ea5t \u0111\u1ed9ng<\/li>\n<li>Gi\u1ea3m \u0111au, kh\u00e1ng vi\u00eam<\/li>\n<li>Kh\u00e1ng sinh d\u1ef1 ph\u00f2ng<\/li>\n<\/ul>\n","protected":false},"featured_media":708,"comment_status":"open","ping_status":"open","template":"","tags":[189,44,54],"chuyen-muc":[188],"class_list":["post-2111","chuyen-de","type-chuyen-de","status-publish","has-post-thumbnail","hentry","tag-benh-an-chan-thuong-chinh-hinh","tag-gay-xuong","tag-gay-xuong-canh-tay","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de"}],"about":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/types\/chuyen-de"}],"replies":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/comments?post=2111"}],"version-history":[{"count":2,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2111\/revisions"}],"predecessor-version":[{"id":2698,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2111\/revisions\/2698"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/708"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=2111"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=2111"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=2111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}