{"id":2130,"date":"2023-07-29T16:00:40","date_gmt":"2023-07-29T09:00:40","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=chuyen-de&#038;p=2130"},"modified":"2024-03-20T21:45:08","modified_gmt":"2024-03-20T14:45:08","slug":"benh-an-da-chan-thuong","status":"publish","type":"chuyen-de","link":"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/benh-an-da-chan-thuong\/","title":{"rendered":"B\u1ec7nh \u00e1n \u0111a ch\u1ea5n th\u01b0\u01a1ng"},"content":{"rendered":"<h2><span style=\"font-size: 16px;\">G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i k\u00e8m g\u00e3y k\u00edn \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i ng\u00e0y th\u1ee9 4 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean. Tr\u01b0\u1eddng h\u1ee3p b\u1ecb \u0111a ch\u1ea5n th\u01b0\u01a1ng.<\/span><\/h2>\n<h2><strong>I. H\u00c0NH CH\u00cdNH:<\/strong><\/h2>\n<ol>\n<li>H\u1ecd v\u00e0 t\u00ean: NGUY\u1ec4N TH\u1eca T.<\/li>\n<li>Gi\u1edbi t\u00ednh: N\u1eef<\/li>\n<li>N\u0103m sinh: 1959 (64 tu\u1ed5i) \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/li>\n<li>Ngh\u1ec1 nghi\u1ec7p: N\u1ed9i tr\u1ee3 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/li>\n<li>D\u00e2n t\u1ed9c: Kinh<\/li>\n<li>\u0110\u1ecba ch\u1ec9: TP HCM<\/li>\n<li>Chi thu\u1eadn: Tay ph\u1ea3i &#8211; Ch\u00e2n ph\u1ea3i.<\/li>\n<li>Ng\u00e0y gi\u1edd nh\u1eadp vi\u1ec7n: 10 gi\u1edd 08 ph\u00fat ng\u00e0y 16\/5\/2023<\/li>\n<li>Ng\u00e0y gi\u1edd nh\u1eadp khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh: 11 gi\u1edd 30 ph\u00fat ng\u00e0y 16\/05\/2023.<\/li>\n<\/ol>\n<p><img fetchpriority=\"high\" decoding=\"async\" class=\"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><strong><span style=\"text-decoration: underline;\">Tr\u01b0\u1edbc khi xem h\u00e3y \u0111\u1ecdc qua c\u00e1c b\u00e0i vi\u1ebft sau<\/span><\/strong><\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">B\u00e0i gi\u1ea3ng \u0110a ch\u1ea5n th\u01b0\u01a1ng &#8211; Cho\u00e1ng ch\u1ea5n th\u01b0\u01a1ng<\/a><\/p>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/slide-bai-giang-da-chan-thuong-va-choang-chan-thuong\/\">Slide b\u00e0i gi\u1ea3ng \u0110a ch\u1ea5n th\u01b0\u01a1ng &#8211; Cho\u00e1ng ch\u1ea5n th\u01b0\u01a1ng\u00a0<\/a><\/p>\n<h2><strong>II. <\/strong><strong>L\u00dd DO V\u00c0O VI\u1ec6N<\/strong>: \u0110au h\u00e1ng tr\u00e1i<\/h2>\n<h2><strong>III. B\u1ec6NH S\u1eec:<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n tr\u1ef1c ti\u1ebfp khai b\u1ec7nh:<\/p>\n<p>C\u00e1ch nh\u1eadp vi\u1ec7n 4 ng\u00e0y, b\u1ec7nh nh\u00e2n \u0111ang \u0111i l\u1ea1i trong nh\u00e0 th\u00ec \u0111\u1ed9t ng\u1ed9t ng\u00e3 ng\u01b0\u1eddi nghi\u00eang v\u1ec1 b\u00ean tr\u00e1i v\u1edbi t\u01b0 th\u1ebf ch\u00e2n tr\u00e1i du\u1ed7i, m\u00f4ng tr\u00e1i v\u00e0 vai tr\u00e1i \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng, kh\u00f4ng va \u0111\u1eadp \u0111\u1ea7u v\u00e0 c\u00e1c b\u1ed9 ph\u1eadn kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3. Sau t\u00e9, b\u1ec7nh nh\u00e2n t\u1ec9nh, ch\u00e2n tr\u00e1i kh\u00f4ng ch\u1ecbu l\u1ef1c \u0111\u01b0\u1ee3c, \u0111au k\u00e8m gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng h\u00e1ng tr\u00e1i v\u00e0 vai tr\u00e1i. Ng\u01b0\u1eddi nh\u00e0 khuy\u00ean nh\u1eadp vi\u1ec7n nh\u01b0ng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u1ed3ng \u00fd.<\/p>\n<p>C\u00e1ch nh\u1eadp vi\u1ec7n 3 ng\u00e0y, \u0111au t\u0103ng v\u00f9ng h\u00e1ng tr\u00e1i, b\u1ec7nh nh\u00e2n t\u1ef1 mua<a href=\"https:\/\/vi.wikipedia.org\/wiki\/Paracetamol\" target=\"_blank\" rel=\"noopener\"> Paracetamol<\/a> 500mg u\u1ed1ng th\u1ea5y gi\u1ea3m \u0111au \u00edt.<\/p>\n<p>C\u00e1ch nh\u1eadp vi\u1ec7n 1 ng\u00e0y, ng\u01b0\u1eddi nh\u00e0 ph\u00e1t hi\u1ec7n m\u1ea3ng b\u1ea7m t\u00edm v\u00f9ng m\u1eb7t trong c\u00e1nh tay tr\u00e1i v\u00e0 m\u1eb7t ngo\u00e0i \u0111\u00f9i tr\u00e1i, b\u1ec7nh nh\u00e2n ti\u1ebfp t\u1ee5c u\u1ed1ng thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 kh\u00f4ng x\u1eed tr\u00ed g\u00ec th\u00eam.<\/p>\n<p>Ng\u00e0y <a href=\"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/\">nh\u1eadp vi\u1ec7n<\/a>, b\u1ec7nh nh\u00e2n th\u1ea5y \u0111au t\u0103ng nhi\u1ec1u \u0111\u01b0\u1ee3c ng\u01b0\u1eddi nh\u00e0 \u0111\u01b0a \u0111i t\u00e1i kh\u00e1m (khoa N\u1ed9i Th\u1ea7n kinh) t\u1ea1i b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, \u0111\u01b0\u1ee3c ch\u1ee5p X quang v\u00e0 chuy\u1ec3n ngo\u1ea1i Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh.<\/p>\n<p>Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, b\u1ec7nh nh\u00e2n kh\u00f4ng s\u1ed1t, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng \u0111i l\u1ea1i \u0111\u01b0\u1ee3c, \u0103n u\u1ed1ng \u0111\u01b0\u1ee3c, u\u1ed1ng n\u01b0\u1edbc 1,5 l\/ng\u00e0y, ti\u1ec3u 800ml\/ng\u00e0y n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong, ti\u00eau ph\u00e2n v\u00e0ng, s\u1ec7t 2 l\u1ea7n\/ng\u00e0y.<\/p>\n<h4><strong><em>T\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n l\u00fac nh\u1eadp khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t (11h30 ng\u00e0y 16\/5\/2023):<\/em><\/strong><\/h4>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, Glasgow 15 \u0111i\u1ec3m (E4V5M6)<\/li>\n<li>Sinh hi\u1ec7u:<\/li>\n<\/ul>\n<p>M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>Huy\u1ebft \u00e1p: 100\/60 mmHg<\/p>\n<p>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat\u00a0\u00a0<\/p>\n<p>Nhi\u1ec7t \u0111\u1ed9: 36.6\u00b0 C<\/p>\n<p>SpO2: 99% (KT)<\/p>\n<ul>\n<li>Tim \u0111\u1ec1u, ph\u1ed5i kh\u00f4ng ran, b\u1ee5ng m\u1ec1m.<\/li>\n<li>Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>\u0110au, m\u1ea5t v\u1eadn \u0111\u1ed9ng h\u00e1ng tr\u00e1i<\/li>\n<li>Ch\u00e2n tr\u00e1i xoay ngo\u00e0i<\/li>\n<li>Ng\u1eafn chi: ch\u00e2n tr\u00e1i &lt; ch\u00e2n ph\u1ea3i #1cm<\/li>\n<li>\u0110\u1ea7u ng\u00f3n ch\u00e2n h\u1ed3ng, chi \u1ea5m, kh\u00f4ng t\u00ea b\u00ec ch\u00e2n tr\u00e1i<\/li>\n<\/ul>\n<h4><em><strong>X\u1eed tr\u00ed: <\/strong><\/em><\/h4>\n<p>+ Gi\u1ea3m \u0111au<\/p>\n<p>+ H\u1ea1 huy\u1ebft \u00e1p<\/p>\n<p>+ H\u1ea1 \u0111\u01b0\u1eddng huy\u1ebft<\/p>\n<p>+ N\u1eb9p ch\u1ed1ng xoay \u0111\u00f9i &#8211; c\u1eb3ng ch\u00e2n tr\u00e1i<\/p>\n<p>+ \u0110ai vai Desault<\/p>\n<h4><em><strong>C\u1eadn l\u00e2m s\u00e0ng \u0111\u01b0\u1ee3c l\u00e0m t\u1ea1i khoa Ch\u1ea5n th\u01b0\u01a1ng ch\u1ec9nh h\u00ecnh:<\/strong> <\/em><\/h4>\n<ul>\n<li>X\u00e9t nghi\u1ec7m ti\u1ec1n ph\u1eabu, Si\u00eau \u00e2m tim, Si\u00eau \u00e2m b\u1ee5ng.<\/li>\n<\/ul>\n<h2><strong>IV. TI\u1ec0N S\u1eec:<\/strong><\/h2>\n<h3><strong style=\"font-size: 16px;\">a. B\u1ea3n th\u00e2n<\/strong><\/h3>\n<h3><strong>N\u1ed9i khoa:<\/strong><\/h3>\n<ul>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 20 n\u0103m, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n Tho\u00e1i ho\u00e1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">knee joint<\/a> 2 b\u00ean t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa b\u1eb1ng Glucosamine (li\u1ec1u kh\u00f4ng r\u00f5) \u0111\u1ebfn nay.<\/li>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 17 n\u0103m, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/benh-ly-ban-chan-dai-thao-duong\/\">\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/a> tu\u00fdp 2 t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t. Hi\u1ec7n \u0111ang \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Mixtard 30\/70, ch\u00edch 2 l\u1ea7n\/ng\u00e0y (s\u00e1ng 20 IU, chi\u1ec1u 16 IU). B\u1ec7nh nh\u00e2n th\u01b0\u1eddng xuy\u00ean ki\u1ec3m tra \u0111\u01b0\u1eddng huy\u1ebft t\u1ea1i nh\u00e0, \u0111\u01b0\u1eddng huy\u1ebft cao nh\u1ea5t l\u00e0 220 mg\/dl, \u0111\u01b0\u1eddng huy\u1ebft th\u00edch nghi l\u00e0 150-170 mg\/dl.<\/li>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 17 n\u0103m, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n H\u1eb9p van 3 l\u00e1 &#8211; T\u0103ng huy\u1ebft \u00e1p t\u1ea1i B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa theo toa (kh\u00f4ng r\u00f5 do ng\u01b0\u1eddi nh\u00e0 kh\u00f4ng mang theo v\u00e0 c\u0169ng kh\u00f4ng nh\u1edb t\u00ean hay m\u00e0u s\u1eafc c\u1ee7a vi\u00ean thu\u1ed1c). B\u1ec7nh nh\u00e2n th\u01b0\u1eddng xuy\u00ean \u0111o huy\u1ebft \u00e1p t\u1ea1i nh\u00e0, huy\u1ebft \u00e1p t\u00e2m thu cao nh\u1ea5t kh\u00f4ng ghi nh\u1eadn \u0111\u01b0\u1ee3c, huy\u1ebft \u00e1p th\u00edch nghi l\u00e0 120\/80 mmHg.<\/li>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 4 th\u00e1ng, \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n Nh\u1ed3i m\u00e1u n\u00e3o t\u1ea1i b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t, \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa 3 tu\u1ea7n, di ch\u1ee9ng li\u1ec7t n\u1eeda ng\u01b0\u1eddi tr\u00e1i k\u00e8m co c\u1ee9ng c\u01a1 sau \u0111\u1ed9t qu\u1ef5. B\u1ec7nh nh\u00e2n t\u1eadp v\u1eadt l\u00fd tr\u1ecb li\u1ec7u 3 th\u00e1ng, ch\u00e2n tr\u00e1i \u0111i l\u1ea1i \u0111\u01b0\u1ee3c nh\u01b0ng ch\u01b0a v\u1eefng (ph\u1ea3i d\u00f9ng g\u1eady), tay tr\u00e1i ch\u01b0a ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c ch\u1ee9c n\u0103ng.<\/li>\n<\/ul>\n<h3><strong>Ngo\u1ea1i khoa:<\/strong><\/h3>\n<ul>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 19 n\u0103m, ph\u1eabu thu\u1eadt c\u1eaft t\u1eed cung t\u1ea1i b\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t.<\/li>\n<\/ul>\n<h3><strong>S\u1ea3n khoa:<\/strong><\/h3>\n<ul>\n<li>PARA 4004, m\u00e3n kinh n\u0103m 40 tu\u1ed5i.<\/li>\n<\/ul>\n<h3><strong>Th\u00f3i quen:<\/strong><\/h3>\n<ul>\n<li>Kh\u00f4ng h\u00fat thu\u1ed1c, kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u bia.<\/li>\n<\/ul>\n<h3><strong>D\u1ecb \u1ee9ng:<\/strong><\/h3>\n<ul>\n<li>Ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng thu\u1ed1c.<\/li>\n<\/ul>\n<p><strong>b. Gia \u0111\u00ecnh<\/strong>: ch\u01b0a ghi nh\u1eadn b\u1ec7nh l\u00fd li\u00ean quan.<\/p>\n<p><strong>c. V\u1eadt ch\u1ea5t \u2013 Tinh th\u1ea7n<\/strong>:<\/p>\n<ul>\n<li><strong>V\u1eadt ch\u1ea5t:<\/strong> \u0111\u1ea7y \u0111\u1ee7.<\/li>\n<li><strong>Tinh th\u1ea7n:<\/strong> tho\u1ea3i m\u00e1i.<\/li>\n<li><strong>H\u00f4n nh\u00e2n:<\/strong> hi\u1ec7n \u0111ang s\u1ed1ng v\u1edbi ch\u1ed3ng v\u00e0 con.<\/li>\n<\/ul>\n<p><strong>d. D\u1ecbch t\u1ec5<\/strong>: \u0110\u00e3 ti\u00eam 3 m\u0169i Vaccine COVID-19.<\/p>\n<h2><strong>V. L\u01af\u1ee2C QUA C\u00c1C C\u01a0 QUAN<\/strong><\/h2>\n<p>(kh\u00e1m l\u00fac 19h00 ng\u00e0y 16\/05\/2023 \u2013 Ng\u00e0y th\u1ee9 4 c\u1ee7a b\u1ec7nh)<\/p>\n<ul>\n<li><strong>Tim m\u1ea1ch:<\/strong> kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, kh\u00f4ng \u0111au ng\u1ef1c.<\/li>\n<li><strong>H\u00f4 h\u1ea5p:<\/strong> kh\u00f4ng ho khan, kh\u00f4ng kh\u00f3 th\u1edf.<\/li>\n<li><strong>Ti\u00eau ho\u00e1<\/strong>: kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng bu\u1ed3n n\u00f4n, kh\u00f4ng n\u00f4n, ti\u00eau ph\u00e2n v\u00e0ng s\u1ec7t.<\/li>\n<li><strong>Ti\u1ebft ni\u1ec7u:<\/strong> n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong, kh\u00f4ng g\u1eaft bu\u1ed1t.<\/li>\n<li><strong>Th\u1ea7n kinh:<\/strong> kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, li\u1ec7t tay tr\u00e1i.<\/li>\n<li><strong>C\u01a1 &#8211; x\u01b0\u01a1ng &#8211; kh\u1edbp: <\/strong>\u0111au v\u00f9ng h\u00e1ng tr\u00e1i v\u00e0 vai tr\u00e1i, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00f9ng h\u00e1ng tr\u00e1i v\u00e0 vai tr\u00e1i.<\/li>\n<\/ul>\n<h2><strong>VI. KH\u00c1M L\u00c2M S\u00c0NG<\/strong><\/h2>\n<p>(kh\u00e1m l\u00fac 19h00 ng\u00e0y 16\/05\/2023 \u2013 Ng\u00e0y th\u1ee9 4 c\u1ee7a b\u1ec7nh):<\/p>\n<p><strong>1. T\u1ed5ng tr\u1ea1ng<\/strong>:<\/p>\n<ul>\n<li>B\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c, Glasgow 15 \u0111i\u1ec3m<\/li>\n<li>BMI: 65 kg\/m<sup>2<\/sup> (1m60, 58kg) =&gt; th\u1ec3 tr\u1ea1ng trung b\u00ecnh theo IDI&amp;WPRO<\/li>\n<li>Da, ni\u00eam m\u1ea1c h\u1ed3ng<\/li>\n<li>M\u00f4i kh\u00f4ng kh\u00f4, l\u01b0\u1ee1i kh\u00f4ng d\u01a1.<\/li>\n<li>Kh\u00f4ng d\u1ea5u xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da, kh\u00f4ng ph\u00f9.<\/li>\n<li>Chi \u1ea5m, CRT&lt;2s<\/li>\n<li>H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/li>\n<li>Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/li>\n<li>Sinh hi\u1ec7u:\n<ul>\n<li>M\u1ea1ch: 78 l\u1ea7n\/ph\u00fat<\/li>\n<li>Huy\u1ebft \u00e1p: 120\/60 mmHg<\/li>\n<li>Nh\u1ecbp th\u1edf: 16 l\u1ea7n\/ph\u00fat<\/li>\n<li>Nhi\u1ec7t \u0111\u1ed9: 37\u00b0C<\/li>\n<li>SpO2: 98% (KT)<\/li>\n<\/ul>\n<\/li>\n<li>Ch\u1ec9 s\u1ed1 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">stunned<\/a> (CSC): 0.66 (&lt;1)<\/li>\n<\/ul>\n<p><strong>2.C\u01a1 x\u01b0\u01a1ng kh\u1edbp<\/strong><\/p>\n<h3><strong>\u00a0<\/strong><strong><u>Kh\u00e1m chi tr\u00ean<\/u><\/strong><\/h3>\n<p><strong>A. NH\u00ccN: <\/strong>B\u1ec7nh n\u1eb1m ng\u1eeda tr\u00ean gi\u01b0\u1eddng, vai tr\u00e1i \u0111eo \u0111ai Desault, tay tr\u00e1i kh\u00e9p s\u00e1t th\u00e2n ng\u01b0\u1eddi, g\u1eadp khu\u1ef7u, xoay trong, tay ph\u1ea3i du\u1ed7i t\u1ef1 nhi\u00ean:<\/p>\n<ul>\n<li>Tr\u1ee5c c\u00e1nh tay &#8211; c\u1eb3ng tay &#8211; b\u00e0n tay 2 b\u00ean b\u00ecnh th\u01b0\u1eddng<\/li>\n<li>Kh\u1edbp c\u00f9ng &#8211; \u0111\u00f2n kh\u00f4ng nh\u00f4 cao, d\u1ea5u ph\u00edm \u0111\u00e0n d\u01b0\u01a1ng c\u1ea7m \u00e2m t\u00ednh<\/li>\n<li>M\u1ea3ng b\u1ea7m t\u00edm m\u1eb7t trong 1\/3 tr\u00ean c\u00e1nh tay tr\u00e1i k\u00edch th\u01b0\u1edbc 5&#215;3 cm.<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn v\u1ebft th\u01b0\u01a1ng, b\u00f3ng n\u01b0\u1edbc, x\u00e2y x\u00e1t da t\u1ea1i tay tr\u00e1i<\/li>\n<li>\u0110\u1ea7u <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ban-ngon-tay-gay-xuong-ban-tay\/\">ng\u00f3n tay<\/a>, l\u00f2ng b\u00e0n tay 2 b\u00ean h\u1ed3ng<\/li>\n<\/ul>\n<p><strong>B. S\u1edc:<\/strong><\/p>\n<ul>\n<li>C\u00e1c c\u01a1 v\u00e0 g\u00e2n c\u01a1 b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng \u0111au.<\/li>\n<li>Kh\u00f4ng m\u1ea5t li\u00ean t\u1ee5c v\u00f9ng x\u01b0\u01a1ng d\u1ecdc c\u00e1nh tay, c\u1eb3ng tay, c\u1ed5 tay tr\u00e1i<\/li>\n<li>\u1ea4n \u0111au nh\u1eb9 1\/3 tr\u00ean c\u00e1nh tay tr\u00e1i<\/li>\n<li>2 tay \u1ea5m, m\u1ea1ch c\u00e1nh tay, m\u1ea1ch quay, m\u1ea1ch tr\u1ee5 2 b\u00ean \u0111\u1ec1u r\u00f5.<\/li>\n<li>Kh\u00f4ng c\u00f3 ti\u1ebfng l\u1ea1o x\u1ea1o x\u01b0\u01a1ng v\u00f9ng vai tr\u00e1i.<\/li>\n<\/ul>\n<p><strong>C. G\u00d5: <\/strong>Nghi\u1ec7m ph\u00e1p g\u00f5 d\u1ed3n kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au.<\/p>\n<p><strong>D. \u0110O:<\/strong><\/p>\n<table width=\"601\">\n<tbody>\n<tr>\n<td width=\"415\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"95\">\n<p><strong>Tay ph\u1ea3i<\/strong><\/p>\n<\/td>\n<td width=\"91\">\n<p><strong>Tay tr\u00e1i<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"415\">\n<p>\u0110o chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (\u0111o t\u1eeb m\u1ecfm c\u00f9ng vai \u0111\u1ebfn m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i)<\/p>\n<\/td>\n<td width=\"95\">\n<p>25cm<\/p>\n<\/td>\n<td width=\"91\">\n<p>25cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"415\">\n<p>\u0110o chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng c\u00e1nh tay (\u0111o t\u1eeb m\u1ea5u \u0111\u1ed9ng l\u1edbn \u0111\u1ebfn m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i)<\/p>\n<\/td>\n<td width=\"95\">\n<p>23cm<\/p>\n<\/td>\n<td width=\"91\">\n<p>23cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"415\">\n<p>V\u00f2ng chi (\u0111o tr\u00ean m\u1ecfm tr\u00ean l\u1ed3i c\u1ea7u ngo\u00e0i 15 cm)<\/p>\n<\/td>\n<td width=\"95\">\n<p>28cm<\/p>\n<\/td>\n<td width=\"91\">\n<p>28cm<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong><em>K\u1ebft lu\u1eadn:<\/em><\/strong><\/p>\n<p>&#8211; Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i, chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i 2 b\u00ean b\u1eb1ng nhau<\/p>\n<p>&#8211; V\u00f2ng chi 2 b\u00ean tay b\u1eb1ng nhau.<\/p>\n<p><strong>5. KH\u00c1M C\u1ea2M GI\u00c1C:<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c n\u00f4ng (c\u1ea3m gi\u00e1c s\u1edd ch\u1ea1m, \u0111au, nhi\u1ec7t) \u1edf mu tay, l\u00f2ng b\u00e0n tay, m\u1eb7t tr\u01b0\u1edbc v\u00e0 sau c\u1eb3ng tay hai b\u00ean, m\u1eb7t trong v\u00e0 m\u1eb7t tr\u01b0\u1edbc c\u00e1nh tay hai b\u00ean.<\/li>\n<li>B\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c s\u00e2u 2 b\u00ean tay.<\/li>\n<\/ul>\n<p><strong>6. KH\u00c1M V\u1eacN \u0110\u1ed8NG:<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n m\u1ea5t v\u1eadn \u0111\u1ed9ng ch\u1ee7 \u0111\u1ed9ng tay tr\u00e1i<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng vai tr\u00e1i: B\u1ec7nh nh\u00e2n du\u1ed7i \u0111\u01b0\u1ee3c, kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c \u0111\u1ed9ng t\u00e1c: g\u1ea5p, dang &#8211; kh\u00e9p, xoay trong &#8211; xoay ngo\u00e0i do \u0111au.<\/li>\n<li>Kh\u00f4ng gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/\">elbow joint<\/a> v\u00e0 kh\u1edbp c\u1ed5 tay tr\u00e1i<\/li>\n<li>S\u1ee9c c\u01a1 tay ph\u1ea3i: 5\/5<\/li>\n<li>S\u1ee9c c\u01a1 tay tr\u00e1i: 0\/5.<\/li>\n<\/ul>\n<h3><strong><u>Kh\u00e1m chi d\u01b0\u1edbi<\/u><\/strong><\/h3>\n<p><strong>A. NH\u00ccN: <\/strong>B\u1ec7nh n\u1eb1m ng\u1eeda tr\u00ean gi\u01b0\u1eddng, \u0111ang \u0111eo n\u1eb9p ch\u1ed1ng xoay \u0111\u00f9i &#8211; c\u1eb3ng b\u00e0n ch\u00e2n tr\u00e1i, th\u00e1o n\u1eb9p \u0111\u00e1nh gi\u00e1:<\/p>\n<ul>\n<li>B\u00e0n ch\u00e2n tr\u00e1i xoay ngo\u00e0i<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn v\u1ebft th\u01b0\u01a1ng, b\u00f3ng n\u01b0\u1edbc, d\u1ea5u hi\u1ec7u x\u00e2y x\u00e1t da t\u1ea1i v\u00f9ng \u0111\u00f9i tr\u00e1i<\/li>\n<li>M\u1ea3ng b\u1ea7m t\u00edm v\u00f9ng tam gi\u00e1c Scarpa k\u00edch th\u01b0\u1edbc #7&#215;4 cm, m\u1ea3ng b\u1ea7m t\u00edm v\u00f9ng m\u1ea5u chuy\u1ec3n l\u1edbn k\u00edch th\u01b0\u1edbc #1x2cm<\/li>\n<li>\u0110\u1ea7u ng\u00f3n ch\u00e2n, b\u00e0n ch\u00e2n 2 b\u00ean h\u1ed3ng.<\/li>\n<\/ul>\n<p><strong>B. S\u1edc:<\/strong><\/p>\n<ul>\n<li>Kh\u00f4ng th\u1ea5y m\u1ea5t li\u00ean t\u1ee5c v\u00f9ng \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng nghi ng\u1edd d\u1ecdc <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-chi-duoi\/\">femur body<\/a> 2 b\u00ean.<\/li>\n<li>Tam gi\u00e1c Bryant (\u0111\u01b0\u1ee3c t\u1ea1o b\u1edfi \u0111\u01b0\u1eddng n\u1ed1i Gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean \u2013 M\u1ea5u chuy\u1ec3n l\u1edbn, \u0111\u01b0\u1eddng k\u1ebb ngang v\u00f9ng M\u1ea5u chuy\u1ec3n l\u1edbn v\u00e0 \u0111\u01b0\u1eddng chi\u1ebfu vu\u00f4ng g\u00f3c c\u1ee7a Gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean) vu\u00f4ng c\u00e2n.<\/li>\n<li>\u0110\u01b0\u1eddng Nelaton Roser thay \u0111\u1ed5i: M\u1ea5u chuy\u1ec3n l\u1edbn l\u1ec7ch l\u00ean tr\u00ean so v\u1edbi Gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean v\u00e0 \u1ee4 ng\u1ed3i.<\/li>\n<li>\u1ea4n \u0111au ch\u00f3i v\u00f9ng Tam gi\u00e1c Scarpa tr\u00e1i v\u00e0 n\u1ebfp l\u1eb1n b\u1eb9n tr\u00e1i<\/li>\n<li>\u1ea4n kh\u00f4ng \u0111au v\u00f9ng m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i<\/li>\n<li>Ch\u00e2n \u1ea5m, m\u1ea1ch b\u1eb9n, m\u1ea1ch khoeo, m\u1ea1ch mu ch\u00e2n, m\u1ea1ch ch\u00e0y sau 2 b\u00ean \u0111\u1ec1u r\u00f5.<\/li>\n<li>Kh\u00f4ng t\u00ecm d\u1ea5u l\u1ea1o x\u1ea1o do b\u1ec7nh nh\u00e2n \u0111\u00e3 c\u00f3 1 trong 3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">fracture<\/a>.<\/li>\n<\/ul>\n<p><strong>C. G\u00d5:<\/strong><\/p>\n<ul>\n<li>Nghi\u1ec7m ph\u00e1p g\u00f5 d\u1ed3n kh\u00f4ng kh\u00e1m \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u.<\/li>\n<\/ul>\n<p><strong>D. \u0110O:<\/strong><\/p>\n<table width=\"608\">\n<tbody>\n<tr>\n<td width=\"409\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>Ch\u00e2n <\/strong><strong>ph\u1ea3i<\/strong><\/p>\n<\/td>\n<td width=\"98\">\n<p><strong>Ch\u00e2n <\/strong><strong>tr\u00e1i<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"409\">\n<p>\u0110o chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i x\u01b0\u01a1ng \u0111\u00f9i (\u0111o t\u1eeb Gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean \u0111\u1ebfn l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i)<\/p>\n<\/td>\n<td width=\"101\">\n<p>48 cm<\/p>\n<\/td>\n<td width=\"98\">\n<p>47 cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"409\">\n<p>\u0110o chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i x\u01b0\u01a1ng \u0111\u00f9i (\u0111o t\u1eeb m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i \u0111\u1ebfn l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i)<\/p>\n<\/td>\n<td width=\"101\">\n<p>37 cm<\/p>\n<\/td>\n<td width=\"98\">\n<p>37 cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"409\">\n<p>V\u00f2ng chi (\u0111o d\u01b0\u1edbi gai ch\u1eadu tr\u01b0\u1edbc tr\u00ean 15 cm)<\/p>\n<\/td>\n<td width=\"101\">\n<p>40 cm<\/p>\n<\/td>\n<td width=\"98\">\n<p>41 cm<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong><em>Nh\u1eadn x\u00e9t:<\/em><\/strong><\/p>\n<p>&#8211; Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i thay \u0111\u1ed5i, ch\u00e2n tr\u00e1i &lt; ch\u00e2n ph\u1ea3i #1cm.<\/p>\n<p>&#8211; Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i ch\u00e2n tr\u00e1i b\u1eb1ng ch\u00e2n ph\u1ea3i.<\/p>\n<p>&#8211; V\u00f2ng chi ch\u00e2n tr\u00e1i &gt; ch\u00e2n ph\u1ea3i #1cm<\/p>\n<p><span style=\"text-decoration: underline;\"><strong>KH\u00c1M C\u1ea2M GI\u00c1C:<\/strong><\/span><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c n\u00f4ng (c\u1ea3m gi\u00e1c s\u1edd ch\u1ea1m, \u0111au, nhi\u1ec7t) \u1edf mu ch\u00e2n, l\u00f2ng b\u00e0n ch\u00e2n, m\u1eb7t tr\u01b0\u1edbc v\u00e0 sau c\u1eb3ng ch\u00e2n hai b\u00ean, m\u1eb7t trong v\u00e0 m\u1eb7t tr\u01b0\u1edbc \u0111\u00f9i hai b\u00ean.<\/li>\n<li>B\u1ec7nh nh\u00e2n c\u00f2n c\u1ea3m gi\u00e1c s\u00e2u 2 b\u00ean ch\u00e2n.<\/li>\n<\/ul>\n<p><strong><span style=\"text-decoration: underline;\">KH\u00c1M V\u1eacN \u0110\u1ed8NG<\/span>:<\/strong><\/p>\n<ul>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/\">hip joint<\/a> tr\u00e1i: B\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u1ed9ng t\u00e1c g\u1ea5p \u2013 du\u1ed7i, d\u1ea1ng \u2013 kh\u00e9p, xoay trong \u2013 xoay ngo\u00e0i do \u0111au.<\/li>\n<li>Bi\u00ean \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng tr\u00e1i kh\u00f4ng ghi nh\u1eadn \u0111\u01b0\u1ee3c.<\/li>\n<li>S\u1ee9c c\u01a1 ch\u00e2n tr\u00e1i kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n kh\u00f4ng th\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c \u0111\u1ed9ng t\u00e1c.<\/li>\n<li>S\u1ee9c c\u01a1 ch\u00e2n ph\u1ea3i: 5\/5.<\/li>\n<\/ul>\n<p><strong>3. H\u1ec7 tim m\u1ea1ch:<\/strong><\/p>\n<ul>\n<li>M\u1ecfm tim n\u1eb1m \u1edf \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i, kho\u1ea3ng li\u00ean s\u01b0\u1eddn V.<\/li>\n<li>L\u1ed3ng ng\u1ef1c kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf \u0111\u1ec1u 2 b\u00ean.<\/li>\n<li>Ti\u1ebfng tim: T1, T2 \u0111\u1ec1u r\u00f5, kh\u00f4ng nghe \u00e2m th\u1ed5i b\u1ec7nh l\u00fd.<\/li>\n<li>D\u1ea5u Harzer (-), Rung miu (-).<\/li>\n<\/ul>\n<p><strong>4. H\u1ec7 h\u00f4 h\u1ea5p:<\/strong><\/p>\n<ul>\n<li>R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu, kh\u00f4ng ran<\/li>\n<li>G\u00f5 trong<\/li>\n<li>Rung thanh \u0111\u1ec1u 2 b\u00ean ph\u1ebf tr\u01b0\u1eddng<\/li>\n<\/ul>\n<p><strong>5. H\u1ec7 ti\u00eau h\u00f3a:<\/strong><\/p>\n<ul>\n<li>Th\u00e0nh b\u1ee5ng kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng d\u1ea5u sao m\u1ea1ch, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf.<\/li>\n<li>Nhu \u0111\u1ed9ng ru\u1ed9t: 6 l\u1ea7n\/ph\u00fat<\/li>\n<li>G\u00f5 trong<\/li>\n<li>S\u1edd b\u1ee5ng m\u1ec1m, 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>6. H\u1ec7 th\u1eadn &#8211; ti\u1ebft ni\u1ec7u &#8211; sinh d\u1ee5c:<\/strong><\/p>\n<ul>\n<li>C\u1ea7u b\u00e0ng quang (-)<\/li>\n<li>Ch\u1ea1m th\u1eadn (-)<\/li>\n<li>Rung th\u1eadn (-)<\/li>\n<\/ul>\n<p><strong>7. H\u1ec7 th\u1ea7n kinh:<\/strong><\/p>\n<ul>\n<li>C\u1ed5 m\u1ec1m, kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb<\/li>\n<li>S\u1ee9c c\u01a1 tay ph\u1ea3i 4\/5, s\u1ee9c c\u01a1 tay tr\u00e1i 5\/5<\/li>\n<li>S\u1ee9c c\u01a1 ch\u00e2n ph\u1ea3i kh\u00f4ng \u0111\u00e1nh gi\u00e1 \u0111\u01b0\u1ee3c, s\u1ee9c c\u01a1 ch\u00e2n tr\u00e1i 5\/5.<\/li>\n<\/ul>\n<p><strong>8<\/strong>. <strong>C\u00e1c c\u01a1 quan kh\u00e1c:<\/strong> Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/p>\n<h2><strong>VI. <\/strong><strong>T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N:<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n n\u1eef 64 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au h\u00e1ng tr\u00e1i sau tai n\u1ea1n sinh ho\u1ea1t, qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn:<\/p>\n<p><strong>&#8211; Tri\u1ec7u ch\u1ee9ng c\u01a1 n\u0103ng:<\/strong><\/p>\n<ul>\n<li>\u0110au h\u00e1ng tr\u00e1i, vai tr\u00e1i<\/li>\n<li>Kh\u00f4ng th\u1ec3 \u0111i l\u1ea1i sau ch\u1ea5n th\u01b0\u01a1ng<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng tr\u00e1i<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/\">shoulder<\/a> tr\u00e1i<\/li>\n<li>B\u1ea7m t\u00edm h\u00e1ng tr\u00e1i, vai tr\u00e1i<\/li>\n<\/ul>\n<p><strong>&#8211; Tri\u1ec7u ch\u1ee9ng th\u1ef1c th\u1ec3:<\/strong><\/p>\n<ul>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng v\u00f9ng kh\u1edbp vai tr\u00e1i<\/li>\n<li>B\u00e0n ch\u00e2n tr\u00e1i xoay ngo\u00e0i<\/li>\n<li>\u1ea4n \u0111au ch\u00f3i v\u00f9ng tam gi\u00e1c Scarpa v\u00e0 n\u1ebfp l\u1eb1n b\u1eb9n tr\u00e1i<\/li>\n<li>\u0110\u01b0\u1eddng N\u00e9laton Roser v\u00f9ng h\u00e1ng tr\u00e1i thay \u0111\u1ed5i<\/li>\n<li>H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng kh\u1edbp h\u00e1ng tr\u00e1i<\/li>\n<li>V\u1ebft b\u1ea7m t\u00edm v\u00f9ng tam gi\u00e1c Scarpa v\u00e0 m\u1ea5u chuy\u1ec3n l\u1edbn x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i<\/li>\n<li>Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i ch\u00e2n tr\u00e1i &lt; ch\u00e2n ph\u1ea3i #1cm<\/li>\n<li>2 chi d\u01b0\u1edbi \u1ea5m, m\u1ea1ch khoeo, mu ch\u00e2n, ch\u00e0y sau \u0111\u1ec1u, r\u00f5<\/li>\n<li>C\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u ch\u00e2n tr\u00e1i, tay tr\u00e1i c\u00f2n.<\/li>\n<li>M\u1ea3ng b\u1ea7m t\u00edm t\u1ea1i m\u1eb7t trong 1\/3 tr\u00ean c\u00e1nh tay tr\u00e1i k\u00edch th\u01b0\u1edbc #5&#215;3 cm.<\/li>\n<li>\u1ea4n \u0111au nh\u1eb9 1\/3 tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>S\u1ee9c c\u01a1 tay ph\u1ea3i 5\/5, s\u1ee9c c\u01a1 tay tr\u00e1i 0\/5<\/li>\n<\/ul>\n<p><strong>&#8211; Ti\u1ec1n c\u0103n:<\/strong><\/p>\n<ul>\n<li>Nh\u1ed3i m\u00e1u n\u00e3o di ch\u1ee9ng li\u1ec7t n\u1eeda ng\u01b0\u1eddi b\u00ean tr\u00e1i &#8211; co c\u1ee9ng c\u01a1 sau \u0111\u1ed9t qu\u1ef5 (4 th\u00e1ng)<\/li>\n<li>\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 (17 n\u0103m)<\/li>\n<li>T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 (17 n\u0103m)<\/li>\n<li>H\u1eb9p van 3 l\u00e1 (17 n\u0103m)<\/li>\n<li>Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean (20 n\u0103m)<\/li>\n<\/ul>\n<h2><strong>VII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0:<\/strong><\/h2>\n<ul>\n<li>D\u1ea5u hi\u1ec7u <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-chi-duoi\/\">femoral neck fracture<\/a> tr\u00e1i<\/li>\n<li>D\u1ea5u hi\u1ec7u g\u1ee3i \u00fd g\u00e3y \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i<\/li>\n<li>Ti\u1ec1n c\u0103n: Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o, \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2, T\u0103ng huy\u1ebft \u00e1p, H\u1eb9p van 3 l\u00e1, Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/li>\n<\/ul>\n<h2><strong>VIII. CH\u1ea8N \u0110O\u00c1N S\u01a0 B\u1ed8<\/strong>:<\/h2>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">Closed fracture<\/a> c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i k\u00e8m g\u00e3y k\u00edn \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i ng\u00e0y th\u1ee9 4 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/p>\n<h2><strong>IX. CH\u1ea8N \u0110O\u00c1N PH\u00c2N BI\u1ec6T:<\/strong><\/h2>\n<ul>\n<li>G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i k\u00e8m tr\u1eadt kh\u1edbp vai tr\u00e1i ng\u00e0y th\u1ee9 4 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/li>\n<li>G\u00e3y k\u00edn li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i k\u00e8m g\u00e3y k\u00edn \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i ng\u00e0y th\u1ee9 4 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/li>\n<li>G\u00e3y k\u00edn li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i k\u00e8m tr\u1eadt kh\u1edbp vai tr\u00e1i ng\u00e0y th\u1ee9 4 do tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/li>\n<\/ul>\n<h2><strong>X. BI\u1ec6N LU\u1eacN L\u00c2M S\u00c0NG: <\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n n\u1eef, 64 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au h\u00e1ng tr\u00e1i sau tai n\u1ea1n sinh ho\u1ea1t. B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c v\u1ea5n \u0111\u1ec1 sau:<\/p>\n<ol>\n<li><strong>D\u1ea5u hi\u1ec7u g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i<\/strong><\/li>\n<\/ol>\n<ul>\n<li>C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng: tr\u1ef1c ti\u1ebfp (t\u00e9 \u0111\u1eadp v\u00f9ng h\u00f4ng tr\u00e1i xu\u1ed1ng n\u1ec1n c\u1ee9ng, t\u01b0 th\u1ebf n\u1eb1m nghi\u00eang v\u1ec1 b\u00ean tr\u00e1i) v\u00e0 l\u00e0 ch\u1ea5n th\u01b0\u01a1ng n\u0103ng l\u01b0\u1ee3ng th\u1ea5p (t\u00e9 ng\u00e3 t\u1eeb \u0111\u1ed9 cao &lt; chi\u1ec1u cao c\u01a1 th\u1ec3). V\u1edbi \u0111\u1ed9 tu\u1ed5i 64 tu\u1ed5i, ti\u1ec1n s\u1eed m\u00e3n kinh s\u1edbm n\u0103m 40 tu\u1ed5i, b\u1ec7nh nh\u00e2n c\u00f3 y\u1ebfu t\u1ed1 nguy c\u01a1 m\u1eafc lo\u00e3ng x\u01b0\u01a1ng \u2192 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 g\u00e3y x\u01b0\u01a1ng v\u1edbi c\u01a1 ch\u1ebf n\u00e0y l\u00e0 ph\u00f9 h\u1ee3p \u2192 Lo\u1ea1i tr\u1eeb g\u00e3y x\u01b0\u01a1ng b\u1ec7nh l\u00fd.<\/li>\n<li>B\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng nh\u01b0 \u1ea5n \u0111au v\u00f9ng tam gi\u00e1c Scarpa v\u00e0 n\u1ebfp l\u1eb1n b\u1eb9n tr\u00e1i, m\u1ea5t v\u1eadn \u0111\u1ed9ng c\u01a1 n\u0103ng ch\u00e2n tr\u00e1i, b\u1ea7m t\u00edm v\u00f9ng \u0111\u00f9i tr\u00e1i. B\u00ean c\u1ea1nh \u0111\u00f3, \u0111\u01b0\u1eddng N\u00e9laton Roser thay \u0111\u1ed5i l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd g\u00e3y x\u01b0\u01a1ng kh\u1edbp h\u00e1ng tr\u00ean b\u1ec7nh nh\u00e2n n\u00e0y. Ghi nh\u1eadn \u0111\u01b0\u1ee3c 1\/3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng \u1edf b\u1ec7nh nh\u00e2n l\u00e0 bi\u1ebfn d\u1ea1ng chi: Ch\u00e2n tr\u00e1i xoay ngo\u00e0i v\u00e0 Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i ch\u00e2n tr\u00e1i &lt; ch\u00e2n ph\u1ea3i #1cm =&gt; B\u1ec7nh nh\u00e2n c\u00f3 g\u00e3y x\u01b0\u01a1ng th\u1ef1c s\u1ef1.<\/li>\n<li>Ngh\u0129 nhi\u1ec1u b\u1ec7nh nh\u00e2n g\u00e3y k\u00edn v\u00ec: b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng g\u1ea7n \u1ed5 g\u00e3y, kh\u00f4ng ch\u1ea3y m\u00e1u v\u00e1ng m\u1ee1.<\/li>\n<li>Ngh\u0129 nhi\u1ec1u g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i v\u00ec b\u1ec7nh nh\u00e2n c\u00f3 c\u00e1c \u0111\u1eb7c \u0111i\u1ec3m sau:<\/li>\n<\/ul>\n<p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 + B\u00e0n ch\u00e2n xoay ngo\u00e0i<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 + \u1ea4n \u0111au v\u00f9ng tam gi\u00e1c Scarpa v\u00e0 n\u1ebfp l\u1eb1n b\u1eb9n tr\u00e1i, kh\u00f4ng \u1ea5n \u0111au v\u00f9ng m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i<\/p>\n<p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0 + Xu\u1ea5t hi\u1ec7n d\u1ea5u b\u1ea7m t\u00edm 3 ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng =&gt; Ph\u00f9 h\u1ee3p v\u1edbi t\u00ednh ch\u1ea5t g\u00e3y bao kh\u1edbp c\u1ee7a g\u00e3y c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i.\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>\u00a0 \u00a0 \u00a0 \u00a0 \u00a0+ Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i ch\u00e2n tr\u00e1i &lt; ch\u00e2n ph\u1ea3i, chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i 2 ch\u00e2n b\u1eb1ng nhau.<\/p>\n<p>Tuy nhi\u00ean, c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi G\u00e3y li\u00ean m\u1ea5u chuy\u1ec3n x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i do c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng c\u1ee7a 2 b\u1ec7nh c\u1ea3nh n\u00e0y gi\u1ed1ng nhau, sau ch\u1ea5n th\u01b0\u01a1ng kh\u00f4ng \u0111i l\u1ea1i \u0111\u01b0\u1ee3c ngay.<\/p>\n<p><strong>2. T\u1ed5n th\u01b0\u01a1ng k\u00e8m theo: <\/strong><\/p>\n<p>+ B\u1ec7nh nh\u00e2n t\u00e9 ng\u00e3 c\u00f3 va \u0111\u1eadp v\u00f9ng vai tr\u00e1i xu\u1ed1ng n\u1ec1n c\u1ee9ng, ghi nh\u1eadn \u0111\u01b0\u1ee3c c\u00e1c d\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng v\u00f9ng c\u00e1nh tay tr\u00e1i g\u1ed3m: \u0110au, b\u1ea7m t\u00edm m\u1eb7t trong \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i (d\u1ea5u Hennequin trong g\u00e3y \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay), gi\u1edbi h\u1ea1n v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng kh\u1edbp vai tr\u00e1i. Kh\u00e1m th\u1ea5y kh\u1edbp c\u00f9ng &#8211; \u0111\u00f2n kh\u00f4ng nh\u00f4 cao, d\u1ea5u \u1ed5 kh\u1edbp r\u1ed7ng \u00e2m t\u00ednh, d\u1ea5u ph\u00edm \u0111\u00e0n d\u01b0\u01a1ng c\u1ea7m \u00e2m t\u00ednh =&gt; Ngh\u0129 nhi\u1ec1u b\u1ec7nh nh\u00e2n g\u00e3y \u2153 tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay tr\u00e1i k\u00e8m theo. Tuy nhi\u00ean, c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi tr\u1eadt kh\u1edbp vai tr\u00e1i v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u ch\u1eafc ch\u1eafn c\u1ee7a g\u00e3y x\u01b0\u01a1ng n\u00ean kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb tr\u01b0\u1eddng h\u1ee3p n\u00e0y.<\/p>\n<p>+ V\u1ec1 t\u1ea1ng \u0111\u1eb7c, qua th\u0103m h\u1ecfi <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">medical history<\/a>, b\u1ec7nh nh\u00e2n kh\u00f4ng va \u0111\u1eadp \u0111\u1ea7u hay c\u00e1c v\u00f9ng kh\u00e1c c\u1ee7a c\u01a1 th\u1ec3, l\u00e2m s\u00e0ng 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 =&gt; Kh\u00f4ng ngh\u0129 b\u1ec7nh nh\u00e2n c\u00f3 t\u1ed5n th\u01b0\u01a1ng t\u1ea1ng \u0111\u1eb7c.<\/p>\n<p><strong>3. Bi\u1ec7n lu\u1eadn bi\u1ebfn ch\u1ee9ng: <\/strong><\/p>\n<p>Hi\u1ec7n t\u1ea1i l\u00e0 ng\u00e0y th\u1ee9 4, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 c\u00e1c bi\u1ebfn ch\u1ee9ng do g\u00e3y x\u01b0\u01a1ng nh\u01b0 sau:<\/p>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">Cavity compression<\/a>: Kh\u00f4ng ngh\u0129 v\u00ec b\u1ec7nh nh\u00e2n \u0111au kh\u00f4ng k\u00e8m t\u00ea b\u00ec, chi tr\u00ean, chi d\u01b0\u1edbi \u1ea5m, m\u1ea1ch ngo\u1ea1i bi\u00ean \u0111\u1ec1u, r\u00f5.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: Kh\u00f4ng ngh\u0129 v\u00ec chi tr\u00ean, chi d\u01b0\u1edbi b\u1ec7nh nh\u00e2n \u1ea5m, da, ni\u00eam m\u1ea1c h\u1ed3ng, \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean b\u1eaft \u0111\u01b0\u1ee3c r\u00f5.<\/li>\n<li>T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: Kh\u00f4ng ngh\u0129 v\u00ec b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c t\u00ea b\u00ec, kh\u00e1m c\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u c\u00f2n.<\/li>\n<li>R\u1ed1i lo\u1ea1n dinh d\u01b0\u1ee1ng c\u1ea5p t\u00ednh: Kh\u00f4ng ngh\u0129 do kh\u00e1m l\u00e2m s\u00e0ng kh\u00f4ng ghi nh\u1eadn b\u00f3ng n\u01b0\u1edbc tr\u00ean v\u00f9ng da ch\u00e2n tr\u00e1i.<\/li>\n<\/ul>\n<h2><strong>XI. \u0110\u1ec0 NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG:<\/strong><\/h2>\n<p><strong>\u00a01. <\/strong><strong>C\u1eadn l\u00e2m s\u00e0ng ch\u1ea9n \u0111o\u00e1n: <\/strong><\/p>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-ray<\/a> kh\u1edbp h\u00e1ng tr\u00e1i th\u1eb3ng-nghi\u00eang<\/li>\n<li>X-quang khung ch\u1eadu th\u1eb3ng<\/li>\n<\/ul>\n<p><strong>2. C\u1eadn l\u00e2m s\u00e0ng th\u01b0\u1eddng qui: <\/strong>C\u00f4ng th\u1ee9c m\u00e1u, \u0110\u00f4ng c\u1ea7m m\u00e1u, Nh\u00f3m m\u00e1u, Sinh h\u00f3a m\u00e1u, X-quang ng\u1ef1c th\u1eb3ng, ECG, T\u1ed5ng ph\u00e2n t\u00edch n\u01b0\u1edbc ti\u1ec3u, Ion \u0111\u1ed3.<\/p>\n<p><strong>3. C\u1eadn l\u00e2m s\u00e0ng h\u1ed7 tr\u1ee3 \u0111i\u1ec1u tr\u1ecb:<\/strong><\/p>\n<ul>\n<li>\u0110o \u0111\u1ed9 lo\u00e3ng x\u01b0\u01a1ng DEXA.<\/li>\n<li>Si\u00eau \u00e2m tim<\/li>\n<\/ul>\n<h2><strong>\u00a0<\/strong><strong>XII. K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG:<\/strong><\/h2>\n<p><strong>\u00a01. <\/strong><strong>X-quang (ch\u1ee5p ng\u00e0y <\/strong><strong>16\/05\/2023):<\/strong><\/p>\n<p><em><u>X-quang khung ch\u1eadu th\u1eb3ng:<\/u><\/em><\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-2131 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture1-4.png\" alt=\"\u0110a ch\u1ea5n th\u01b0\u01a1ng\" width=\"456\" height=\"567\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture1-4.png 456w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture1-4-241x300.png 241w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture1-4-10x12.png 10w\" sizes=\"(max-width: 456px) 100vw, 456px\" \/><\/p>\n<p><strong><em>H\u00e0nh ch\u00ednh:<\/em><\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n NGUY\u1ec4N TH\u1eca T., gi\u1edbi t\u00ednh n\u1eef, 64 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 16\/05\/2023<\/li>\n<li>T\u1ec9 l\u1ec7 ch\u1ee5p: 100%<\/li>\n<li>T\u01b0 th\u1ebf ch\u1ee5p: Tr\u01b0\u1edbc &#8211; sau<\/li>\n<\/ul>\n<p><strong><em>Ti\u00eau chu\u1ea9n phim:<\/em><\/strong><\/p>\n<ul>\n<li>Tia chu\u1ea9n<\/li>\n<li>Phim kh\u00f4ng ch\u1ee5p \u0111\u1ee7 qua hai kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi \u1ed5 g\u00e3y<\/li>\n<li>Ch\u1ee5p kh\u00f4ng \u0111\u1ee7 2 b\u00ecnh di\u1ec7n (thi\u1ebfu b\u00ecnh di\u1ec7n nghi\u00eang)<\/li>\n<\/ul>\n<p><strong><em>T\u1ed5n th\u01b0\u01a1ng:<\/em><\/strong><\/p>\n<ul>\n<li>Kh\u00f4ng ghi nh\u1eadn <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-kin-mo-mem\/\">t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m<\/a><\/li>\n<li>G\u00e3y ngang c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i di l\u1ec7ch ra ngo\u00e0i v\u00e0 l\u00ean tr\u00ean, hai m\u1eb7t g\u00e3y c\u00f2n \u00e1p s\u00e1t v\u00e0o nhau<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng kh\u1edbp k\u00e8m theo<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><strong>\u2192 K\u1ebft lu\u1eadn:<\/strong> G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i \u0111\u1ed9 III theo ph\u00e2n lo\u1ea1i Garden.<\/p>\n<p><em><u>X-quang kh\u1edbp vai t\u01b0 th\u1ebf tr\u01b0\u1edbc &#8211; sau<\/u><\/em><\/p>\n<p><img decoding=\"async\" class=\"aligncenter wp-image-2133 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture2-2.png\" alt=\"Picture2\" width=\"525\" height=\"437\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture2-2.png 525w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture2-2-300x250.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/Picture2-2-14x12.png 14w\" sizes=\"(max-width: 525px) 100vw, 525px\" \/><\/p>\n<p><strong><em>H\u00e0nh ch\u00ednh:<\/em><\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n NGUY\u1ec4N TH\u1eca T., gi\u1edbi t\u00ednh n\u1eef, 64 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 16\/05\/2023<\/li>\n<li>T\u1ec9 l\u1ec7 ch\u1ee5p: 100%<\/li>\n<li>T\u01b0 th\u1ebf ch\u1ee5p: Tr\u01b0\u1edbc &#8211; sau<\/li>\n<\/ul>\n<p><strong><em>Ti\u00eau chu\u1ea9n phim:<\/em><\/strong><\/p>\n<ul>\n<li>Tia chu\u1ea9n<\/li>\n<li>Phim kh\u00f4ng ch\u1ee5p \u0111\u1ee7 qua hai kh\u1edbp tr\u00ean v\u00e0 d\u01b0\u1edbi \u1ed5 g\u00e3y<\/li>\n<li>Ch\u1ee5p kh\u00f4ng \u0111\u1ee7 2 b\u00ecnh di\u1ec7n (thi\u1ebfu b\u00ecnh di\u1ec7n nghi\u00eang)<\/li>\n<\/ul>\n<p><strong><em>T\u1ed5n th\u01b0\u01a1ng:<\/em><\/strong><\/p>\n<ul>\n<li>\u0110\u01b0\u1eddng g\u00e3y ngang 1\/3 ngo\u00e0i \u0111\u1ea7u tr\u00ean th\u00e2n x\u01b0\u01a1ng c\u00e1nh tay<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng kh\u1edbp k\u00e8m theo<\/li>\n<\/ul>\n<p><strong>\u2192 K\u1ebft lu\u1eadn:<\/strong> G\u00e3y k\u00edn \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay lo\u1ea1i I theo ph\u00e2n lo\u1ea1i NEER.<\/p>\n<p><strong>2. C\u00f4ng th\u1ee9c m\u00e1u (k\u1ebft qu\u1ea3 ng\u00e0y 1<\/strong><strong>6\/05\/2023):<\/strong><\/p>\n<table width=\"632\">\n<tbody>\n<tr>\n<td width=\"128\">\n<p><strong>T\u00ean<\/strong><\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>Results <\/strong><\/p>\n<p><strong>(11h42 &#8211; 16\/05\/2023)<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>WBC<\/strong><\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>14.95 H<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p>4.01-11.42<\/p>\n<\/td>\n<td width=\"134\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>NEU%<\/p>\n<\/td>\n<td width=\"208\">\n<p>73.8<\/p>\n<\/td>\n<td width=\"162\">\n<p>40-74<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>LYM%<\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>17.5 L<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p>19-48<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MONO%<\/p>\n<\/td>\n<td width=\"208\">\n<p>7.05<\/p>\n<\/td>\n<td width=\"162\">\n<p>3.4-9.0<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>EOS%<\/p>\n<\/td>\n<td width=\"208\">\n<p>1.03<\/p>\n<\/td>\n<td width=\"162\">\n<p>0.0-7.0<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>BASO%<\/p>\n<\/td>\n<td width=\"208\">\n<p>0.61<\/p>\n<\/td>\n<td width=\"162\">\n<p>0.0-1.5<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>NEU#<\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>11.03 H<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p>1.7-7.5<\/p>\n<\/td>\n<td width=\"134\">\n<p>k\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>LYM#<\/p>\n<\/td>\n<td width=\"208\">\n<p>2.62<\/p>\n<\/td>\n<td width=\"162\">\n<p>1.2-4.0<\/p>\n<\/td>\n<td width=\"134\">\n<p>k\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MONO#<\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>1.05 H<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p>0.2-0.8<\/p>\n<\/td>\n<td width=\"134\">\n<p>k\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>EOS#<\/p>\n<\/td>\n<td width=\"208\">\n<p>0.15<\/p>\n<\/td>\n<td width=\"162\">\n<p>0.0-0.6<\/p>\n<\/td>\n<td width=\"134\">\n<p>k\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>BASO#<\/p>\n<\/td>\n<td width=\"208\">\n<p>0.09<\/p>\n<\/td>\n<td width=\"162\">\n<p>0.0-0.1<\/p>\n<\/td>\n<td width=\"134\">\n<p>k\/uL<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<table width=\"632\">\n<tbody>\n<tr>\n<td width=\"128\">\n<p><strong>RBC<\/strong><\/p>\n<\/td>\n<td width=\"208\">\n<p>4.89<\/p>\n<\/td>\n<td width=\"162\">\n<p>4.01-5.79<\/p>\n<\/td>\n<td width=\"134\">\n<p>M\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>HGB<\/p>\n<\/td>\n<td width=\"208\">\n<p>13.6<\/p>\n<\/td>\n<td width=\"162\">\n<p>11.5-15.0<\/p>\n<\/td>\n<td width=\"134\">\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>HCT<\/p>\n<\/td>\n<td width=\"208\">\n<p>43.6<\/p>\n<\/td>\n<td width=\"162\">\n<p>34.4-48.6<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MCV<\/p>\n<\/td>\n<td width=\"208\">\n<p>89.1<\/p>\n<\/td>\n<td width=\"162\">\n<p>80-99<\/p>\n<\/td>\n<td width=\"134\">\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MCH<\/p>\n<\/td>\n<td width=\"208\">\n<p>27.8<\/p>\n<\/td>\n<td width=\"162\">\n<p>27-33<\/p>\n<\/td>\n<td width=\"134\">\n<p>Pg<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MCHC<\/p>\n<\/td>\n<td width=\"208\">\n<p><strong>31.2 L<\/strong><\/p>\n<\/td>\n<td width=\"162\">\n<p>32-36<\/p>\n<\/td>\n<td width=\"134\">\n<p>g\/dl<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>RDW<\/p>\n<\/td>\n<td width=\"208\">\n<p>11.7<\/p>\n<\/td>\n<td width=\"162\">\n<p>11.5-15.5<\/p>\n<\/td>\n<td width=\"134\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p><strong>PLT<\/strong><\/p>\n<\/td>\n<td width=\"208\">\n<p>339<\/p>\n<\/td>\n<td width=\"162\">\n<p>150-450<\/p>\n<\/td>\n<td width=\"134\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"128\">\n<p>MPV<\/p>\n<\/td>\n<td width=\"208\">\n<p>8.3<\/p>\n<\/td>\n<td width=\"162\">\n<p>7.4-10.9<\/p>\n<\/td>\n<td width=\"134\">\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong><\/p>\n<p>&#8211; B\u1ea1ch c\u1ea7u t\u0103ng cao ngh\u0129 do ph\u1ea3n \u1ee9ng v\u00ec tr\u00ean l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 d\u1ea5u hi\u1ec7u nhi\u1ec5m tr\u00f9ng.<\/p>\n<p>&#8211; Ch\u1ec9 s\u1ed1 h\u1ed3ng c\u1ea7u, MCV, MCH trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, MCHC gi\u1ea3m kh\u00f4ng \u0111\u00e1ng k\u1ec3 \u2192 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u.<\/p>\n<p>&#8211; Ch\u1ec9 s\u1ed1 ti\u1ec3u c\u1ea7u trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p><strong>\u00a03. <\/strong><strong>Sinh ho\u00e1 m\u00e1u <\/strong><strong>(k\u1ebft qu\u1ea3 ng\u00e0y 16\/05\/2023)<\/strong><\/p>\n<table width=\"706\">\n<tbody>\n<tr>\n<td width=\"264\">\n<p><strong>T\u00ean x\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n<td width=\"152\">\n<p><strong>11h33<\/strong><\/p>\n<p><strong>16\/05\/2023<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>CSBT N\u1eef<\/strong><\/p>\n<\/td>\n<td width=\"156\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"264\">\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Glucose (M\u00e1u)<\/p>\n<\/td>\n<td width=\"152\">\n<p><strong>12.2 H<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>4.1 &#8211; 5.9<\/p>\n<\/td>\n<td width=\"156\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"264\">\n<p>\u0110\u1ecbnh l\u01b0\u1ee3ng Ure (M\u00e1u)<\/p>\n<\/td>\n<td width=\"152\">\n<p>8.1<\/p>\n<\/td>\n<td width=\"134\">\n<p>2.8 &#8211; 7.2<\/p>\n<\/td>\n<td width=\"156\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"264\">\n<p>\u0110o ho\u1ea1t \u0111\u1ed9 AST (M\u00e1u)<\/p>\n<\/td>\n<td width=\"152\">\n<p>12<\/p>\n<\/td>\n<td width=\"134\">\n<p>&lt; 35<\/p>\n<\/td>\n<td width=\"156\">\n<p>U\/L &#8211; 37 \u0111\u1ed9 C<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"264\">\n<p>\u0110o ho\u1ea1t \u0111\u1ed9 ALT (M\u00e1u)<\/p>\n<\/td>\n<td width=\"152\">\n<p>18<\/p>\n<\/td>\n<td width=\"134\">\n<p>&lt; 35<\/p>\n<\/td>\n<td width=\"156\">\n<p>U\/L &#8211; 37 \u0111\u1ed9 C<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong><\/p>\n<p>&#8211; \u0110\u01b0\u1eddng huy\u1ebft b\u1ea5t k\u1ef3 = 12.2 mmol\/L, b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n c\u0103n \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 hi\u1ec7n \u0111ang \u0111i\u1ec1u tr\u1ecb =&gt; \u0110\u1ec1 ngh\u1ecb l\u00e0m th\u00eam HbA1c v\u00e0 \u0111\u01b0\u1eddng huy\u1ebft mao m\u1ea1ch t\u1ea1i gi\u01b0\u1eddng \u0111\u1ec3 theo d\u00f5i.<\/p>\n<p>&#8211; C\u00e1c ch\u1ec9 s\u1ed1 kh\u00e1c trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p><strong>4. \u0110\u00f4ng c\u1ea7m m\u00e1u (k\u1ebft qu\u1ea3 ng\u00e0y 16\/05\/2023)<\/strong><\/p>\n<table width=\"636\">\n<tbody>\n<tr>\n<td width=\"159\">\n<p><strong>T\u00ean x\u00e9t nghi\u1ec7m<\/strong><\/p>\n<\/td>\n<td width=\"159\">\n<p><strong>Results<\/strong><\/p>\n<\/td>\n<td width=\"199\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"119\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"159\">\n<p>APTT (TCK)<\/p>\n<\/td>\n<td width=\"159\">\n<p>33<\/p>\n<\/td>\n<td width=\"199\">\n<p>25 &#8211; 37<\/p>\n<\/td>\n<td width=\"119\">\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td colspan=\"4\" width=\"636\">\n<p>Th\u1eddi gian prothrombin (PT: Prothrombin Time), (C\u00e1c t\u00ean kh\u00e1c: TQ; T\u1ef7 l\u1ec7 Prothrombin) b\u1eb1ng m\u00e1y t\u1ef1 \u0111\u1ed9ng<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"159\">\n<p>TQ (Th\u1eddi gian Quick)<\/p>\n<\/td>\n<td width=\"159\">\n<p>12.4<\/p>\n<\/td>\n<td width=\"199\">\n<p>9.3 &#8211; 12.0<\/p>\n<\/td>\n<td width=\"119\">\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"159\">\n<p>TL. Prothrombine<\/p>\n<\/td>\n<td width=\"159\">\n<p>85<\/p>\n<\/td>\n<td width=\"199\">\n<p>&gt; 70<\/p>\n<\/td>\n<td width=\"119\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"159\">\n<p>INR<\/p>\n<\/td>\n<td width=\"159\">\n<p>1.13<\/p>\n<\/td>\n<td width=\"199\">\n<p>0.84 &#8211; 1.29<\/p>\n<\/td>\n<td width=\"119\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>\u00a0<\/strong><strong>K\u1ebft lu\u1eadn: <\/strong>C\u00e1c ch\u1ec9 s\u1ed1 trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/p>\n<p><strong>\u00a05. <\/strong><strong>\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 (k\u1ebft qu\u1ea3 ng\u00e0y <\/strong><strong>16\/05\/2023):<\/strong><\/p>\n<table width=\"640\">\n<tbody>\n<tr>\n<td colspan=\"4\" width=\"640\">\n<p>\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3 (Na, K, Cl) (M\u00e1u)<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"160\">\n<p>Na+<\/p>\n<\/td>\n<td width=\"160\">\n<p>142<\/p>\n<\/td>\n<td width=\"160\">\n<p>135 &#8211; 145<\/p>\n<\/td>\n<td width=\"160\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"160\">\n<p>K+<\/p>\n<\/td>\n<td width=\"160\">\n<p>3.6<\/p>\n<\/td>\n<td width=\"160\">\n<p>3.5 &#8211; 5.0<\/p>\n<\/td>\n<td width=\"160\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"160\">\n<p>Cl-<\/p>\n<\/td>\n<td width=\"160\">\n<p>103<\/p>\n<\/td>\n<td width=\"160\">\n<p>98 &#8211; 106<\/p>\n<\/td>\n<td width=\"160\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"160\">\n<p>Calci<\/p>\n<\/td>\n<td width=\"160\">\n<p>2.3<\/p>\n<\/td>\n<td width=\"160\">\n<p>2.15 &#8211; 2.6<\/p>\n<\/td>\n<td width=\"160\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>K\u1ebft lu\u1eadn: <\/strong>C\u00e1c ch\u1ec9 s\u1ed1 trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng, b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 r\u1ed1i lo\u1ea1n \u0111i\u1ec7n gi\u1ea3i.<\/p>\n<p><strong>6. Si\u00eau \u00e2m tim<\/strong><strong> (k\u1ebft qu\u1ea3 ng\u00e0y 16\/05\/2023)<\/strong><\/p>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong><\/p>\n<ul>\n<li>Ch\u1ee9c n\u0103ng t\u00e2m thu th\u1ea5t tr\u00e1i b\u1ea3o t\u1ed3n EF 66%<\/li>\n<li>C\u00e1c bu\u1ed3ng tim kh\u00f4ng d\u00e3n<\/li>\n<li>Kh\u00f4ng r\u1ed1i lo\u1ea1n v\u1eadn \u0111\u1ed9ng v\u00f9ng<\/li>\n<li>PAPs = 25 mmHg, kh\u00f4ng t\u0103ng \u00e1p l\u1ef1c \u0111\u1ed9ng m\u1ea1ch ph\u1ed5i<\/li>\n<li>D\u1ecbch m\u00e0ng tim (-), kh\u00f4ng huy\u1ebft kh\u1ed1i trong bu\u1ed3ng tim<\/li>\n<\/ul>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-2134 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh-an3.png\" alt=\"Benh An3\" width=\"602\" height=\"284\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh-an3.png 602w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh-an3-300x142.png 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh-an3-18x8.png 18w\" sizes=\"(max-width: 602px) 100vw, 602px\" \/><\/p>\n<p><strong>7. Si\u00eau \u00e2m b\u1ee5ng (k\u1ebft qu\u1ea3 ng\u00e0y 16\/05\/2023): <\/strong><\/p>\n<p><strong>Gan:<\/strong><\/p>\n<ul>\n<li>K\u00edch th\u01b0\u1edbc: Kh\u00f4ng to.<\/li>\n<li>Nhu m\u00f4: S\u00e1ng, gi\u1ea3m \u00e2m v\u00f9ng s\u00e2u.<\/li>\n<li>M\u1ea1ch m\u00e1u: T\u0129nh m\u1ea1ch c\u1eeda v\u00e0 t\u0129nh m\u1ea1ch gan kh\u00f4ng d\u00e3n.<\/li>\n<\/ul>\n<p><strong>M\u1eadt:<\/strong><\/p>\n<ul>\n<li>T\u00fai m\u1eadt: K\u00edch th\u01b0\u1edbc: kh\u00f4ng to; th\u00e0nh: kh\u00f4ng d\u00e0y, kh\u00f4ng th\u1ea5y s\u1ecfi, c\u00f3 kh\u1ed1i echo d\u00e0y d # 7 mm.<\/li>\n<li>\u0110\u01b0\u1eddng m\u1eadt: \u1ed0ng m\u1eadt ch\u1ee7 v\u00e0 \u0111\u01b0\u1eddng m\u1eadt trong gan kh\u00f4ng d\u1eabn, kh\u00f4ng s\u1ecfi.<\/li>\n<\/ul>\n<p><strong>T\u1ee5y:<\/strong><\/p>\n<ul>\n<li>K\u00edch th\u01b0\u1edbc: Kh\u00f4ng to<\/li>\n<li>Nhu m\u00f4: \u0110\u1ed3ng nh\u1ea5t, kh\u00f4ng sang th\u01b0\u01a1ng khu tr\u00fa.<\/li>\n<\/ul>\n<p><strong>L\u00e1ch:<\/strong><\/p>\n<ul>\n<li>K\u00edch th\u01b0\u1edbc: Kh\u00f4ng to.<\/li>\n<li>Nhu m\u00f4: \u0110\u1ed3ng nh\u1ea5t, kh\u00f4ng sang th\u01b0\u01a1ng khu tr\u00fa.<\/li>\n<li>M\u1ea1ch m\u00e1u: T\u0129nh m\u1ea1ch l\u00e1ch kh\u00f4ng d\u00e3n.<\/li>\n<\/ul>\n<p><strong>Th\u1eadn:<\/strong><\/p>\n<ul>\n<li>Th\u1eadn ph\u1ea3i: K\u00edch th\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng, gi\u1edbi h\u1ea1n v\u1ecf &#8211; t\u1ee7y r\u00f5, kh\u00f4ng s\u1ecfi, kh\u00f4ng \u1ee9 n\u01b0\u1edbc.<\/li>\n<li>Th\u1eadn tr\u00e1i: K\u00edch th\u01b0\u1edbc b\u00ecnh th\u01b0\u1eddng, gi\u1edbi h\u1ea1n v\u1ecf &#8211; t\u1ee7y r\u00f5, kh\u00f4ng s\u1ecfi, kh\u00f4ng \u1ee9 n\u01b0\u1edbc.<\/li>\n<\/ul>\n<p><strong>B\u00e0ng quang: <\/strong>Th\u00e0nh kh\u00f4ng d\u00e0y, kh\u00f4ng s\u1ecfi.<\/p>\n<p><strong>T\u1eed cung: <\/strong>Kh\u00f4ng u.<\/p>\n<p><strong>Ph\u1ea7n ph\u1ee5:<\/strong> Kh\u00f4ng u.<\/p>\n<p><strong>\u0110\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng:<\/strong> Kh\u00f4ng ph\u1ec9nh.<\/p>\n<p><strong>D\u1ecbch \u1ed5 b\u1ee5ng:<\/strong> Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau \u00e2m<\/p>\n<p><strong>D\u1ecbch m\u00e0ng ph\u1ed5i: <\/strong>B\u00ean (P): Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau \u00e2m; B\u00ean (T): Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau \u00e2m;<\/p>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong> Gan nhi\u1ec5m m\u1ee1, Polyp t\u00fai m\u1eadt.<\/p>\n<p><strong>8. X-quang ng\u1ef1c th\u1eb3ng (k\u1ebft qu\u1ea3 ng\u00e0y 16\/05\/2023):<\/strong><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-2135 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh4.png\" alt=\"Benh4\" width=\"478\" height=\"524\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh4.png 478w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh4-274x300.png 274w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/benh4-11x12.png 11w\" sizes=\"(max-width: 478px) 100vw, 478px\" \/><\/p>\n<p><strong><em>H\u00e0nh ch\u00ednh:<\/em><\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n NGUY\u1ec4N TH\u1eca T., gi\u1edbi t\u00ednh n\u1eef, 64 tu\u1ed5i, phim ch\u1ee5p ng\u00e0y 16\/05\/2023<\/li>\n<li>T\u1ec9 l\u1ec7 ch\u1ee5p: 100%<\/li>\n<li>T\u01b0 th\u1ebf n\u1eb1m, phim ch\u1ee5p tr\u01b0\u1edbc &#8211; sau<\/li>\n<\/ul>\n<p><strong><em>Ti\u00eau chu\u1ea9n phim:<\/em><\/strong><\/p>\n<ul>\n<li>Tia chu\u1ea9n<\/li>\n<li>B\u1ec7nh nh\u00e2n kh\u00f4ng xoay, h\u00edt v\u00e0o \u0111\u1ee7 s\u00e2u<\/li>\n<\/ul>\n<p><strong><em>T\u1ed5n th\u01b0\u01a1ng:<\/em><\/strong><\/p>\n<ul>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng m\u00f4 m\u1ec1m<\/li>\n<li>Kh\u00f4ng ghi nh\u1eadn t\u1ed5n th\u01b0\u01a1ng x\u01b0\u01a1ng, kh\u1edbp<\/li>\n<li>M\u1edd kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t 2 b\u00ean \u0111\u1ec9nh ph\u1ed5i<\/li>\n<li>B\u00f3ng tim kh\u00f4ng l\u1edbn<\/li>\n<\/ul>\n<h2><strong>XIII. CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong><\/h2>\n<p>G\u00e3y k\u00edn c\u1ed5 x\u01b0\u01a1ng \u0111\u00f9i tr\u00e1i \u0111\u1ed9 III theo Garden k\u00e8m g\u00e3y \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng c\u00e1nh tay lo\u1ea1i I theo NEER ng\u00e0y th\u1ee9 4 do Tai n\u1ea1n sinh ho\u1ea1t ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/Di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o \u2013 \u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2 \u2013 T\u0103ng huy\u1ebft \u00e1p \u0111\u1ed9 1 theo ESC 2018 \u2013 H\u1eb9p van 3 l\u00e1 \u2013 Tho\u00e1i ho\u00e1 kh\u1edbp g\u1ed1i 2 b\u00ean.<\/p>\n<h2><strong>XIV. \u0110I\u1ec0U TR\u1eca: <\/strong><\/h2>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb n\u1ed9i:\u00a0\n<ul>\n<li>Pain relief<\/li>\n<li>Ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p v\u00e0 \u0111\u01b0\u1eddng huy\u1ebft<\/li>\n<\/ul>\n<\/li>\n<li>\u0110i\u1ec1u tr\u1ecb ngo\u1ea1i:\u00a0\n<ul>\n<li>Chi tr\u00ean: \u0110i\u1ec1u tr\u1ecb b\u1ea3o t\u1ed3n b\u1eb1ng mang \u0111ai Desault, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">motionless<\/a> c\u00e1nh tay &#8211; c\u1eb3ng tay b\u1eb1ng n\u1eb9p<\/li>\n<li>Chi d\u01b0\u1edbi:\n<ul>\n<li>N\u1eb9p \u0111\u00f9i \u2013 c\u1eb3ng \u2013 b\u00e0n ch\u00e2n tr\u00e1i ch\u1ed1ng xoay<\/li>\n<li>Ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng b\u00e1n ph\u1ea7n.<\/li>\n<\/ul>\n<\/li>\n<li>Theo d\u00f5i sinh hi\u1ec7u, bi\u1ebfn ch\u1ee9ng g\u00e3y x\u01b0\u01a1ng<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><strong>XV. TI\u00caN L\u01af\u1ee2NG<\/strong><\/h2>\n<ol>\n<li><strong>G\u1ea6N: <\/strong>Trung b\u00ecnh, v\u00ec b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, hi\u1ec7n t\u1ea1i b\u1ec7nh nh\u00e2n t\u1ec9nh, sinh hi\u1ec7u \u1ed5n, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng. Tuy nhi\u00ean, b\u1ec7nh nh\u00e2n c\u00f3 s\u1eed d\u1ee5ng thu\u1ed1c ch\u1ed1ng \u0111\u00f4ng n\u00ean v\u1eabn c\u00f3 nguy c\u01a1 m\u1ea5t\u00a0 m\u00e1u cao khi th\u1ef1c hi\u1ec7n ph\u1eabu thu\u1eadt.<\/li>\n<li><strong>XA:<\/strong> Trung b\u00ecnh, v\u00ec b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, b\u1ec7nh n\u1ec1n t\u0103ng huy\u1ebft \u00e1p v\u00e0 \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tu\u00fdp 2, di ch\u1ee9ng nh\u1ed3i m\u00e1u n\u00e3o, kh\u00f4ng tr\u00e1nh kh\u1ecfi nguy c\u01a1 t\u00e9 ng\u00e3 trong t\u01b0\u01a1ng lai.<\/li>\n<\/ol>\n<h2><strong>XVI. D\u1ef0 PH\u00d2NG:<\/strong><\/h2>\n<ul>\n<li>D\u1ef1 ph\u00f2ng bi\u1ebfn ch\u1ee9ng n\u1eb1m l\u00e2u: Lo\u00e9t t\u1ef3 \u0111\u00e8, vi\u00eam ph\u1ed5i, nhi\u1ec5m tr\u00f9ng ti\u1ec3u, huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u chi d\u01b0\u1edbi.<\/li>\n<li>Dinh d\u01b0\u1ee1ng \u0111\u1ea7y \u0111\u1ee7 h\u1ee3p l\u00fd.\u00a0<\/li>\n<li>Tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb\u00a0<\/li>\n<li>T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm: v\u1eadn \u0111\u1ed9ng th\u1ee5 \u0111\u1ed9ng, sau \u0111\u00f3 ch\u1ee7 \u0111\u1ed9ng, t\u1eadp v\u1eadn \u0111\u1ed9ng t\u1ea1i gi\u01b0\u1eddng.<\/li>\n<li>D\u1ef1 ph\u00f2ng t\u00e9 ng\u00e3.<\/li>\n<\/ul>\n<p><strong>\u00a0<\/strong><\/p>","protected":false},"featured_media":1762,"comment_status":"open","ping_status":"open","template":"","tags":[71,190,38],"chuyen-muc":[188],"class_list":["post-2130","chuyen-de","type-chuyen-de","status-publish","has-post-thumbnail","hentry","tag-benh-an","tag-benh-an-da-chan-thuong","tag-da-chan-thuong","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2130","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=2130"}],"version-history":[{"count":3,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2130\/revisions"}],"predecessor-version":[{"id":2697,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2130\/revisions\/2697"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media\/1762"}],"wp:attachment":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/media?parent=2130"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=2130"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=2130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}