{"id":2163,"date":"2023-07-31T19:00:56","date_gmt":"2023-07-31T12:00:56","guid":{"rendered":"https:\/\/bsvothanhtoan.com\/?post_type=chuyen-de&#038;p=2163"},"modified":"2024-03-20T16:33:40","modified_gmt":"2024-03-20T09:33:40","slug":"benh-an-gay-mam-chay","status":"publish","type":"chuyen-de","link":"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/benh-an-gay-mam-chay\/","title":{"rendered":"B\u1ec7nh \u00e1n g\u00e3y m\u00e2m ch\u00e0y"},"content":{"rendered":"<h2><em><span style=\"font-size: 16px;\">G\u00e3y m\u00e2m ch\u00e0y (<\/span><\/em><em><span style=\"font-size: 16px;\">k\u00edn 1\/3) <\/span><\/em><em><span style=\"font-size: 16px;\">(P) 41-A2 theo AO &#8211; G\u00e3y k\u00edn \u0111\u1ea7u tr\u00ean m\u00e2m ch\u00e0y (P) lo\u1ea1i VI theo Schatzker &#8211; do TNGT, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/ Hen PQ ki\u1ec3m so\u00e1t t\u1ed1t- Th\u1eadn \u0111a nang- s\u1ecfi 2 th\u1eadn<\/span><\/em><\/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 N.<\/li>\n<li>N\u0103m sinh: 1987 (36 tu\u1ed5i)<\/li>\n<li>Gi\u1edbi: N\u1eef<\/li>\n<li>Ngh\u1ec1 nghi\u1ec7p: N\u1ed9i tr\u1ee3.<\/li>\n<li>D\u00e2n t\u1ed9c: Kinh<\/li>\n<li>\u0110\u1ecba ch\u1ec9: th\u00e0nh ph\u1ed1 H\u1ed3 Ch\u00ed Minh.<\/li>\n<li>Ng\u00e0y gi\u1edd nh\u1eadp vi\u1ec7n : 12 gi\u1edd 30 ph\u00fat 18\/04\/2023<\/li>\n<li>Ng\u00e0y v\u00e0o khoa CTCH: 13 gi\u1edd 30 ph\u00fat 18\/04\/2023<\/li>\n<li>Ng\u00e0y l\u00e0m b\u1ec7nh \u00e1n: 17 gi\u1edd 19\/04\/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>&nbsp;<\/p>\n<h2><strong>II. L\u00dd DO NH\u1eacP VI\u1ec6N: <\/strong>\u0110au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P)<\/h2>\n<h2><strong>III. B\u1ec6NH S\u1eec:<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n (BN) khai :<\/p>\n<ul>\n<li>C\u00e1ch nh\u1eadp vi\u1ec7n 3 gi\u1edd, b\u1ec7nh nh\u00e2n ch\u1ea1y xe m\u00e1y v\u1edbi t\u1ed1c \u0111\u1ed9 30km\/gi\u1edd th\u00ec \u0111\u1ed9t ng\u1ed9t phanh g\u1ea5p khi r\u1ebd ph\u1ea3i \u0111\u1ec3 tr\u00e1nh va ch\u1ea1m v\u1edbi xe ch\u1ea1y ng\u01b0\u1ee3c chi\u1ec1u. B\u1edd ngo\u00e0i b\u00e0n ch\u00e2n (P) ch\u1ed1ng xu\u1ed1ng m\u1eb7t \u0111\u01b0\u1eddng, xe v\u00e0 ng\u01b0\u1eddi ng\u00e3 sang ph\u1ea3i, m\u1eb7t ngo\u00e0i c\u1eb3ng ch\u00e2n, g\u1ed1i (P) \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng, h\u00e1ng \u1edf t\u01b0 th\u1ebf d\u1ea1ng, g\u1ed1i g\u1ea5p, sau \u0111\u00f3 xe \u0111\u00e8 l\u00ean 1\/3 tr\u00ean m\u1eb7t trong c\u1eb3ng ch\u00e2n (P) (kh\u1ed1i l\u01b0\u1ee3ng xe 97kg), kh\u00f4ng va ch\u1ea1m v\u00f9ng \u0111\u1ea7u, ng\u1ef1c, b\u1ee5ng.<\/li>\n<li>Sau t\u00e9, BN t\u1ec9nh, \u0111au ch\u00f3i v\u00f9ng 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P), \u0111\u1ea7u tr\u00ean, k\u00e8m s\u01b0ng n\u1ec1, kh\u00f4ng x\u00e2y x\u00e1t da. BN kh\u00f4ng ch\u1ecbu l\u1ef1c \u0111\u01b0\u1ee3c ch\u00e2n b\u00ean ph\u1ea3i, sau \u0111\u00f3 BN \u0111\u01b0\u1ee3c ng\u01b0\u1eddi d\u00e2n ch\u1edf b\u1eb1ng xe m\u00e1y \u0111\u1ebfn Ph\u00f2ng kh\u00e1m H\u00f3c M\u00f4n. T\u1ea1i \u0111\u00e2y BN \u0111\u01b0\u1ee3c \u0111eo n\u1eb9p c\u1eb3ng b\u00e0n ch\u00e2n v\u00e0 ti\u00eam thu\u1ed1c gi\u1ea3m \u0111au kh\u00f4ng r\u00f5 lo\u1ea1i r\u1ed3i chuy\u1ec3n \u0111\u1ebfn<a href=\"https:\/\/bsvothanhtoan.com\/en\/\"> BV Th\u1ed1ng Nh\u1ea5t<\/a> b\u1eb1ng xe c\u1ea5p c\u1ee9u.<\/li>\n<li>Trong qu\u00e1 tr\u00ecnh b\u1ec7nh, BN kh\u00f4ng \u0111au \u0111\u1ea7u, kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng n\u00f4n, kh\u00f4ng c\u00f3 c\u1ea3m gi\u00e1c l\u1ea1nh \u0111\u1ea7u chi.<\/li>\n<\/ul>\n<p><strong>T\u00ecnh tr\u1ea1ng l\u00fac nh\u1eadp vi\u1ec7n BV Th\u1ed1ng Nh\u1ea5t: <\/strong><\/p>\n<p>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c.<\/p>\n<p>+ DHST:<\/p>\n<p>M\u1ea1ch : 92 l\u1ea7n\/ph\u00fat<\/p>\n<p><a href=\"https:\/\/vi.wikipedia.org\/wiki\/Huy%E1%BA%BFt_%C3%A1p\" target=\"_blank\" rel=\"noopener\">Huy\u1ebft \u00e1p<\/a> : 120\/80 mmHg<\/p>\n<p>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat<\/p>\n<p>Nhi\u1ec7t \u0111\u1ed9 : 37\u00b0 C<\/p>\n<p>SpO2;98% (kh\u00ed tr\u1eddi)<\/p>\n<p>+ BN than \u0111au v\u00f9ng 1\/3 tr\u00ean v\u00e0 v\u00f9ng \u0111\u1ea7u tr\u00ean c\u1eb3ng ch\u00e2n (P), m\u1ea1ch mu ch\u00e2n (P) r\u00f5, \u0111\u1ea7u ng\u00f3n ch\u00e2n h\u1ed3ng, kh\u00f4ng t\u00ea b\u00ec ch\u00e2n (P).<\/p>\n<pre><strong> X\u1eed tr\u00ed:<\/strong><\/pre>\n<p>\u0110\u00e3 \u0111eo n\u1eb9p \u0111\u00f9i \u2013 c\u1eb3ng ch\u00e2n \u2013 b\u00e0n ch\u00e2n<\/p>\n<p>CLS \u0111\u01b0\u1ee3c l\u00e0m: \u0111\u1ecbnh l\u01b0\u1ee3ng ethanol (c\u1ed3n) trong m\u00e1u, ch\u1ee5p Xquang x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n th\u1eb3ng nghi\u00eang, ch\u1ee5p Xquang ng\u1ef1c th\u1eb3ng, ch\u1ee5p Xquang <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/khai-thac-benh-su-va-tien-can-benh-ly-ngoai-chan-thuong\/\">knee joint<\/a> th\u1eb3ng, nghi\u00eang ho\u1eb7c ch\u1ebfch.<\/p>\n<p><strong>T\u00ecnh tr\u1ea1ng t\u1ea1i khoa CTCH (13g30p, ng\u00e0y 18\/04\/2023)<\/strong><\/p>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>\u0110au h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng c\u1eb3ng ch\u00e2n (P), s\u01b0ng n\u1ec1 b\u1ea7m t\u00edm, m\u1ea1ch mu ch\u00e2n r\u00f5.<\/li>\n<li>X\u1eed tr\u00ed: Tatanol 0.5g 01v (u) 14h<\/li>\n<li>Brexin 20mg 01v 18g<\/li>\n<li>Savi pantoprazol 20mg 01v (u) 18h<\/li>\n<li>CLS: ch\u1ee5p CT- Scanner kh\u1edbp g\u1ed1i (P), si\u00eau \u00e2m b\u1ee5ng, x\u00e9t nghi\u1ec7m ti\u1ec1n ph\u1eabu<\/li>\n<\/ul>\n<pre><strong>Di\u1ec5n ti\u1ebfn b\u1ec7nh ph\u00f2ng (19\/04\/2023)<\/strong><\/pre>\n<ul>\n<li>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t<\/li>\n<li>Gi\u1ea3m \u0111au c\u1eb3ng ch\u00e2n (P) + h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng ch\u00e2n (P)<\/li>\n<li>\u0110au g\u1ed1i (P)<\/li>\n<li>C\u1eb3ng ch\u00e2n (P) s\u01b0ng n\u1ec1, b\u1ea7m t\u00edm<\/li>\n<li>M\u1ea1ch mu ch\u00e2n (P) r\u00f5<\/li>\n<li>M\u1ec7t do nh\u1ecbn \u0103n<\/li>\n<\/ul>\n<p><strong>X\u1eed tr\u00ed:<\/strong><\/p>\n<ul>\n<li>500mg 01 vi\u00ean (u)<\/li>\n<li>Brexin 20 mg 01 vi\u00ean (u)<\/li>\n<li>Savipantoprazol 20mg 01 vi\u00ean (u)<\/li>\n<li>Natri Clorid 0,9% 500ml<\/li>\n<li>Kali Clorid 10% 2A<\/li>\n<li>Magie Sulfat 15% 2A TTM XXX g\/p<\/li>\n<li>Glucose 5% 500ml 01 chai (TTM) XXX g\/p<\/li>\n<\/ul>\n<pre><strong> T\u00ecnh tr\u1ea1ng hi\u1ec7n t\u1ea1i:<\/strong><\/pre>\n<pre>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c, gi\u1ea3m \u0111au c\u1eb3ng ch\u00e2n, g\u1ed1i (P)\r\n\r\nS\u01b0ng n\u1ec1 g\u1ed1i, c\u1eb3ng ch\u00e2n (P), b\u1ea7m t\u00edm 1\/3 gi\u1eefa c\u1eb3ng ch\u00e2n (P)<\/pre>\n<h2><strong>IV. TI\u1ec0N S\u1eec:<\/strong><\/h2>\n<h3><strong>1. Ti\u1ec1n c\u0103n b\u1ea3n th\u00e2n:<\/strong><\/h3>\n<p><strong>N\u1ed9i khoa:<\/strong><\/p>\n<ul>\n<li>Hen ph\u1ebf qu\u1ea3n ch\u1ea9n \u0111o\u00e1n t\u1ea1i b\u1ec7nh vi\u1ec7n Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch c\u00e1ch \u0111\u00e2y 7 n\u0103m tr\u01b0\u1edbc \u0111\u00e3 \u0111o h\u00f4 h\u1ea5p k\u00fd, \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Symbicort x\u1ecbt 2 nh\u00e1t\/1 l\u1ea7n\/ng\u00e0y. Trong 4 tu\u1ea7n g\u1ea7n \u0111\u00e2y, BN kh\u00f4ng xu\u1ea5t hi\u1ec7n c\u01a1n hen v\u00e0o ban ng\u00e0y, ban \u0111\u00eam, kh\u00f4ng t\u0103ng nhu c\u1ea7u s\u1eed d\u1ee5ng thu\u1ed1c c\u1eaft c\u01a1n, kh\u00f4ng \u1ea3nh h\u01b0\u1edfng ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng. B\u1ec7nh hen ph\u1ebf qu\u1ea3n ki\u1ec3m so\u00e1t t\u1ed1t.<\/li>\n<li>Th\u1eadn \u0111a nang &#8211; s\u1ecfi th\u1eadn hai b\u00ean ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd khi \u0111i kh\u00e1m t\u1ed5ng qu\u00e1t t\u1ea1i bv Ph\u1ea1m Ng\u1ecdc Th\u1ea1ch c\u00e1ch \u0111\u00e2y 1 n\u0103m, kh\u00f4ng tri\u1ec7u ch\u1ee9ng, kh\u00f4ng \u0111i\u1ec1u tr\u1ecb.<\/li>\n<\/ul>\n<p><strong>Ngo\u1ea1i khoa: <\/strong>\u0111\u00e3 m\u1ed5 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-kin\/\">fracture<\/a> h\u00e0m (P) do tai n\u1ea1n giao th\u00f4ng c\u00e1ch \u0111\u00e2y 20 n\u0103m t\u1ea1i bv Th\u1ed1ng Nh\u1ea5t.<\/p>\n<p><strong>S\u1ea3n khoa: <\/strong>PARA 2032, sinh th\u01b0\u1eddng, c\u00f3 kinh n\u0103m 14 tu\u1ed5i, chu k\u00ec kinh \u0111\u1ec1u, s\u1ed1 ng\u00e0y h\u00e0nh kinh: 5 &#8211; 7 ng\u00e0y, s\u1ed1 l\u01b0\u1ee3ng: 3 &#8211; 4 BVS\/ng\u00e0y k\u00e8m m\u00e1u b\u1ea7m, kh\u00f4ng \u0111au b\u1ee5ng.<\/p>\n<p><strong>Th\u00f3i quen: <\/strong>kh\u00f4ng h\u00fat thu\u1ed1c, kh\u00f4ng u\u1ed1ng r\u01b0\u1ee3u bia.<\/p>\n<p><strong>D\u1ecb \u1ee9ng: <\/strong>ch\u01b0a ghi nh\u1eadn ti\u1ec1n c\u0103n d\u1ecb \u1ee9ng thu\u1ed1c, th\u1ee9c \u0103n<\/p>\n<h3><strong>2. Gia \u0111\u00ecnh<\/strong>:<\/h3>\n<pre>Cha v\u00e0 em trai \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n th\u1eadn \u0111a nang.<\/pre>\n<h2><strong>V. L\u01af\u1ee2C QUA C\u00c1C C\u01a0 QUAN<\/strong>:<\/h2>\n<ul>\n<li>Tim m\u1ea1ch: Kh\u00f4ng h\u1ed3i h\u1ed9p, kh\u00f4ng \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, kh\u00f4ng \u0111au ng\u1ef1c<\/li>\n<li>H\u00f4 h\u1ea5p: Kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng ho, kh\u00f4ng kh\u00f2 kh\u00e8<\/li>\n<li>Ti\u00eau ho\u00e1: Kh\u00f4ng \u0111au b\u1ee5ng, kh\u00f4ng n\u00f4n \u00f3i<\/li>\n<li>Ti\u1ebft ni\u1ec7u: Kh\u00f4ng ti\u1ec3u g\u1eaft bu\u1ed1t, n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong<\/li>\n<li>C\u01a1 x\u01b0\u01a1ng kh\u1edbp: S\u01b0ng \u0111au v\u00f9ng c\u1eb3ng ch\u00e2n, g\u1ed1i (P)<\/li>\n<li>Th\u1ea7n kinh: kh\u00f4ng ch\u00f3ng m\u1eb7t, kh\u00f4ng \u0111au \u0111\u1ea7u<\/li>\n<\/ul>\n<h2><strong>VI. KH\u00c1M B\u1ec6NH: <\/strong>17 gi\u1edd, ng\u00e0y 19\/04\/2023<\/h2>\n<h3><strong>1. T\u1ed5ng tr\u1ea1ng<\/strong><\/h3>\n<p><strong>&#8211; <\/strong>B\u1ec7nh nh\u00e2n t\u1ec9nh, ti\u1ebfp x\u00fac \u0111\u01b0\u1ee3c.<\/p>\n<p>&#8211; Da ni\u00eam h\u1ed3ng, chi \u1ea5m<\/p>\n<p>&#8211; Tuy\u1ebfn gi\u00e1p kh\u00f4ng to<\/p>\n<p>&#8211; H\u1ea1ch ngo\u1ea1i vi kh\u00f4ng s\u1edd ch\u1ea1m<\/p>\n<p>&#8211; Sinh hi\u1ec7u:<\/p>\n<p>M\u1ea1ch: 80 l\u1ea7n\/ph\u00fat\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n<p>Huy\u1ebft \u00e1p: 120\/85 mmHg<\/p>\n<p>Nh\u1ecbp th\u1edf: 18 l\u1ea7n\/ph\u00fat\u00a0\u00a0\u00a0<\/p>\n<p>Nhi\u1ec7t \u0111\u1ed9: 37<sup>o<\/sup>OLD<\/p>\n<p>Ch\u1ec9 s\u1ed1 s\u1ed1c 0,67 (&lt;1)<\/p>\n<p>C\u00e2n n\u1eb7ng = 56 kg, Chi\u1ec1u cao = 158 cm -&gt; BMI=22,43 kg\/m2 =&gt; Th\u1ec3 tr\u1ea1ng c\u00e2n \u0111\u1ed1i theo IDI &amp; WPRO<\/p>\n<h3><strong>2. Kh\u00e1m tim<\/strong><\/h3>\n<p><strong>&#8211; <\/strong>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng theo nh\u1ecbp th\u1edf, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng \u1ed5 \u0111\u1eadp b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p>&#8211; Nh\u1ecbp tim \u0111\u1ec1u, T1 v\u00e0 T2 r\u00f5, t\u1ea7n s\u1ed1 80 l\u1ea7n\/ph\u00fat<\/p>\n<p>&#8211; Kh\u00f4ng \u00e2m th\u1ed5i.<\/p>\n<h3><strong>3. Kh\u00e1m ph\u1ed5i:<\/strong><\/h3>\n<p><strong>&#8211; <\/strong>L\u1ed3ng ng\u1ef1c c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng co k\u00e9o c\u01a1 h\u00f4 h\u1ea5p ph\u1ee5<\/p>\n<p>&#8211; Rung thanh \u0111\u1ec1u 2 b\u00ean<\/p>\n<p>&#8211; Ph\u1ed5i kh\u00f4ng ran<\/p>\n<p>&#8211; R\u00ec r\u00e0o ph\u1ebf nang \u00eam d\u1ecbu 2 ph\u1ebf tr\u01b0\u1eddng<\/p>\n<h3><strong>4. Kh\u00e1m c\u01a1 x\u01b0\u01a1ng kh\u1edbp:<\/strong><\/h3>\n<p>BN n\u1eb1m tr\u00ean gi\u01b0\u1eddng, \u0111ang n\u1eb9p c\u1ed1 \u0111\u1ecbnh \u0111\u00f9i &#8211; c\u1eb3ng ch\u00e2n &#8211; b\u00e0n ch\u00e2n (P) =&gt; Th\u00e1o n\u1eb9p:<\/p>\n<ul>\n<li><strong>NH\u00ccN:<\/strong><\/li>\n<\/ul>\n<p>+ B\u00e0n ch\u00e2n (P) ng\u1ea3 ngo\u00e0i 30\u00b0<\/p>\n<p>+ S\u01b0ng n\u1ec1 v\u00f9ng g\u1ed1i (P) \u0111\u1ebfn 1\/3 gi\u1eefa c\u1eb3ng ch\u00e2n (P), kh\u00f4ng b\u00f3ng n\u01b0\u1edbc, kh\u00f4ng v\u1ebft th\u01b0\u01a1ng v\u00f9ng g\u1ed1i, c\u1eb3ng ch\u00e2n, b\u00e0n ch\u00e2n (P)<\/p>\n<p>+ B\u1ea7m t\u00edm #3x5cm v\u00f9ng 1\/3 gi\u1eefa m\u1eb7t tr\u01b0\u1edbc c\u1eb3ng ch\u00e2n (P), kh\u00f4ng \u0111\u1eadp theo m\u1ea1ch<\/p>\n<p>+ Chi\u1ec1u d\u00e0i ch\u00e2n (P) b\u1eb1ng ch\u00e2n (T)<\/p>\n<p>+ Ch\u00e2n tr\u00e1i kh\u00f4ng ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<ul>\n<li><strong>S\u1edc:<\/strong><\/li>\n<\/ul>\n<p>+ \u1ea4n \u0111au m\u00e2m ch\u00e0y (P) v\u00e0 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P)<\/p>\n<p>+ Chi \u1ea5m, CRT&lt; 2s<\/p>\n<p>+ M\u1ea1ch ch\u00e0y sau, m\u1ea1ch mu ch\u00e2n b\u1eaft r\u00f5, \u0111\u1ec1u 2 b\u00ean<\/p>\n<p>+ C\u1ea3m gi\u00e1c n\u00f4ng, s\u00e2u 2 ch\u00e2n b\u00ecnh th\u01b0\u1eddng, kh\u00f4ng t\u00ea, kh\u00f4ng d\u1ecb c\u1ea3m<\/p>\n<p>+ Kh\u00f3 s\u1edd m\u1ea5t li\u00ean t\u1ee5c x\u01b0\u01a1ng, kh\u00f3 kh\u00e1m l\u1ea1o x\u1ea1o x\u01b0\u01a1ng, b\u1eadp b\u1ec1nh <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-xuong-banh-che\/\">x\u01b0\u01a1ng b\u00e1nh ch\u00e8<\/a> (-)<\/p>\n<ul>\n<li><strong>\u0110O: <\/strong><\/li>\n<\/ul>\n<table width=\"654\">\n<tbody>\n<tr>\n<td width=\"508\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"70\">\n<p><strong>Ch\u00e2n (P)<\/strong><\/p>\n<\/td>\n<td width=\"76\">\n<p><strong>Ch\u00e2n (T)<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"508\">\n<p>X\u01b0\u01a1ng ch\u00e0y:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (l\u1ed3i c\u1ee7 ch\u00e0y &#8211; m\u1eaft c\u00e1 trong)<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (l\u1ed3i c\u1ea7u trong x\u01b0\u01a1ng \u0111\u00f9i &#8211; m\u1eaft c\u00e1 trong)<\/p>\n<\/td>\n<td width=\"70\">\n<p><strong>\u00a0<\/strong><\/p>\n<p>39cm<\/p>\n<p>46cm<\/p>\n<\/td>\n<td width=\"76\">\n<p><strong>\u00a0<\/strong><\/p>\n<p>39cm<\/p>\n<p>46cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"508\">\n<p>X\u01b0\u01a1ng m\u00e1c:<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 Chi\u1ec1u d\u00e0i tuy\u1ec7t \u0111\u1ed1i (ch\u1ecfm m\u00e1c &#8211; m\u1eaft c\u00e1 ngo\u00e0i)<\/p>\n<p>&#8211;\u00a0\u00a0\u00a0\u00a0 Chi\u1ec1u d\u00e0i t\u01b0\u01a1ng \u0111\u1ed1i (l\u1ed3i c\u1ea7u ngo\u00e0i x\u01b0\u01a1ng \u0111\u00f9i &#8211; m\u1eaft c\u00e1 ngo\u00e0i)<\/p>\n<\/td>\n<td width=\"70\">\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>34cm<\/p>\n<p>39cm<\/p>\n<\/td>\n<td width=\"76\">\n<p><strong>\u00a0<\/strong><\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>34cm<\/p>\n<p>39cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"508\">\n<p>Chu vi g\u1ed1i<\/p>\n<\/td>\n<td width=\"70\">\n<p>40cm<\/p>\n<\/td>\n<td width=\"76\">\n<p>34cm<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"508\">\n<p>Chu vi v\u00f2ng chi m\u1ed1c c\u00e1ch l\u1ed3i c\u1ee7 ch\u00e0y xu\u1ed1ng d\u01b0\u1edbi 14cm<\/p>\n<\/td>\n<td width=\"70\">\n<p>37cm<\/p>\n<\/td>\n<td width=\"76\">\n<p>32cm<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>+ C\u00e1c chi c\u00f2n l\u1ea1i ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/p>\n<ul>\n<li><strong>V\u1eacN \u0110\u1ed8NG:<\/strong><\/li>\n<\/ul>\n<p><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/trat-khop-vai-khuyu-hang\/\">Hip joint<\/a> 2 b\u00ean: v\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng (g\u1ea5p &#8211; du\u1ed7i, d\u1ea1ng &#8211; kh\u00e9p, xoay trong &#8211; xoay ngo\u00e0i)<\/p>\n<p>+ Kh\u1edbp g\u1ed1i:<\/p>\n<ul>\n<li>G\u1ed1i (P): H\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng (g\u1ea5p &#8211; du\u1ed7i)<\/li>\n<li>G\u1ed1i (T): V\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng 150-0<\/li>\n<\/ul>\n<p>+ Kh\u1edbp c\u1ed5 ch\u00e2n 2 b\u00ean: V\u1eadn \u0111\u1ed9ng trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng<\/p>\n<ol>\n<li><strong>Kh\u00e1m b\u1ee5ng:<\/strong><\/li>\n<\/ol>\n<p><strong>&#8211; <\/strong>Th\u00e0nh b\u1ee5ng c\u00e2n \u0111\u1ed1i, di \u0111\u1ed9ng \u0111\u1ec1u theo nh\u1ecbp th\u1edf, kh\u00f4ng s\u1eb9o m\u1ed5 c\u0169, kh\u00f4ng tu\u1ea7n ho\u00e0n b\u00e0ng h\u1ec7, kh\u00f4ng u c\u1ee5c b\u1ea5t th\u01b0\u1eddng<\/p>\n<p>&#8211; B\u1ee5ng m\u1ec1m, \u1ea5n kh\u00f4ng \u0111au khu tr\u00fa<\/p>\n<p>&#8211; Gan l\u00e1ch s\u1edd kh\u00f4ng ch\u1ea1m<\/p>\n<ol start=\"2\">\n<li><strong>Th\u1eadn &#8211; Ti\u1ebft ni\u1ec7u:<\/strong><\/li>\n<\/ol>\n<p><strong>&#8211; <\/strong>Ch\u1ea1m th\u1eadn (-)<\/p>\n<p>&#8211; C\u1ea7u b\u00e0ng quang (-)<\/p>\n<p>&#8211; \u1ea4n \u0111i\u1ec3m \u0111au ni\u1ec7u qu\u1ea3n tr\u00ean v\u00e0 gi\u1eefa kh\u00f4ng \u0111au<\/p>\n<ol start=\"3\">\n<li><strong>Kh\u00e1m th\u1ea7n kinh:<\/strong><\/li>\n<\/ol>\n<p><strong>&#8211; <\/strong>C\u1ed5 m\u1ec1m<\/p>\n<p>&#8211; Kh\u00f4ng d\u1ea5u th\u1ea7n kinh \u0111\u1ecbnh v\u1ecb<\/p>\n<ol start=\"4\">\n<li><strong>C\u00e1c c\u01a1 quan kh\u00e1c: <\/strong>Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng<\/li>\n<\/ol>\n<h2><strong>VII. T\u00d3M T\u1eaeT B\u1ec6NH \u00c1N<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n n\u1eef, 36 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec l\u00fd do \u0111au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P) sau TNGT, qua h\u1ecfi b\u1ec7nh v\u00e0 th\u0103m kh\u00e1m l\u00e2m s\u00e0ng ghi nh\u1eadn.<\/p>\n<h3>D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng:<\/h3>\n<p>\u1ea4n \u0111au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P).<\/p>\n<p>S\u01b0ng n\u1ec1 v\u00f9ng g\u1ed1i (P) \u0111\u1ebfn 1\/3 gi\u1eefa c\u1eb3ng ch\u00e2n (P).<\/p>\n<p>B\u1ea7m t\u00edm #3x5cm v\u00f9ng 1\/3 gi\u1eefa m\u1eb7t tr\u01b0\u1edbc c\u1eb3ng ch\u00e2n (P).<\/p>\n<pre><strong>Ch\u1ec9 s\u1ed1 s\u1ed1c 0,67 (&lt;1) <\/strong><\/pre>\n<pre><strong>Ti\u1ec1n c\u0103n:<\/strong><\/pre>\n<p>Hen suy\u1ec5n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n 7 n\u0103m tr\u01b0\u1edbc.<\/p>\n<p>Th\u1eadn \u0111a nang &#8211; s\u1ecfi th\u1eadn hai b\u00ean \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n 1 n\u0103m tr\u01b0\u1edbc.<\/p>\n<p>\u0110\u00e3 m\u1ed5 g\u00e3y x\u01b0\u01a1ng h\u00e0m c\u00e1ch \u0111\u00e2y 20 n\u0103m.<\/p>\n<h2><strong>VIII. \u0110\u1eb6T V\u1ea4N \u0110\u1ec0:<\/strong><\/h2>\n<ul>\n<li>\u1ea4n \u0111au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P).<\/li>\n<li>S\u01b0ng n\u1ec1 g\u1ed1i (P)<\/li>\n<li>D\u1ea5u hi\u1ec7u kh\u00f4ng ch\u1eafc ch\u1eafn g\u00e3y x\u01b0\u01a1ng<\/li>\n<li>Ti\u1ec1n c\u0103n: Hen suy\u1ec5n, th\u1eadn \u0111a nang<\/li>\n<\/ul>\n<h2><strong>IX. 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> 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P) gi\u1edd th\u1ee9 36 do TNGT ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/ Hen ph\u1ebf qu\u1ea3n ki\u1ec3m so\u00e1t t\u1ed1t &#8211; Th\u1eadn \u0111a nang<\/p>\n<h2><strong>X. CH\u1ea8N \u0110O\u00c1N PH\u00c2N BI\u1ec6T<\/strong><\/h2>\n<ol>\n<li>G\u00e3y k\u00edn 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P) &#8211; T\u1ed5n th\u01b0\u01a1ng m\u00e2m ch\u00e0y gi\u1edd th\u1ee9 36 do TNGT ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/ Hen ph\u1ebf qu\u1ea3n ki\u1ec3m so\u00e1t t\u1ed1t- Th\u1eadn \u0111a nang<\/li>\n<li>G\u00e3y k\u00edn 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P) &#8211; t\u1ed5n th\u01b0\u01a1ng d\u00e2y ch\u1eb1ng v\u00f9ng g\u1ed1i + <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/ton-thuong-day-chang-cheo\/\">meniscus<\/a> g\u1ed1i (P) gi\u1edd th\u1ee9 36\/ Hen ph\u1ebf qu\u1ea3n ki\u1ec3m so\u00e1t t\u1ed1t- Th\u1eadn \u0111a nang<\/li>\n<\/ol>\n<h2><strong>XI. BI\u1ec6N LU\u1eacN:<\/strong><\/h2>\n<p>B\u1ec7nh nh\u00e2n n\u1eef, 36 tu\u1ed5i, nh\u1eadp vi\u1ec7n v\u00ec \u0111au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P) do tai n\u1ea1n giao th\u00f4ng. Ngh\u0129 b\u1ec7nh nh\u00e2n c\u00f3 g\u00e3y k\u00edn 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P), v\u00ec:<\/p>\n<p>+ Ngh\u0129 g\u00e3y k\u00edn: v\u00ec kh\u00f4ng c\u00f3 v\u1ebft th\u01b0\u01a1ng th\u00f4ng \u1ed5 g\u00e3y v\u1edbi m\u00f4i tr\u01b0\u1eddng b\u00ean ngo\u00e0i.<\/p>\n<p>+ C\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng r\u00f5 v\u1edbi n\u0103ng l\u01b0\u1ee3ng cao (xe m\u00e1y \u0111\u00e8 tr\u1ef1c ti\u1ebfp l\u00ean 1\/3 tr\u00ean m\u1eb7t trong x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P)), -&gt; kh\u1ea3 n\u0103ng g\u00e3y 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n. Kh\u00e1m ghi nh\u1eadn c\u00e1c d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd g\u00e3y x\u01b0\u01a1ng nh\u01b0: \u1ea4n \u0111au ch\u00f3i 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P), s\u01b0ng n\u1ec1 v\u00f9ng g\u1ed1i (P) \u0111\u1ebfn 1\/3 gi\u1eefa c\u1eb3ng ch\u00e2n (P), v\u00f2ng chi g\u1ed1i (P) &gt; (T), v\u00f2ng chi 1\/3 tr\u00ean c\u1eb3ng ch\u00e2n (P)&gt;(T) -&gt; \u0110\u1ec1 ngh\u1ecb: <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/x-quang-trong-chan-thuong-chinh-hinh\/\">X-ray<\/a> c\u1eb3ng ch\u00e2n th\u1eb3ng &#8211; nghi\u00eang.<\/p>\n<p>+ Bi\u1ebfn ch\u1ee9ng \u0111e d\u1ecda t\u00ednh m\u1ea1ng:<\/p>\n<ul>\n<li><a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">Injury shock<\/a>: l\u00e2m s\u00e0ng ghi nh\u1eadn b\u1ec7nh t\u1ec9nh, ti\u1ebfp x\u00fac t\u1ed1t, sinh hi\u1ec7u \u1ed5n, chi \u1ea5m, CRT &lt;2s, m\u1ee9c \u0111\u1ed9 \u0111au gi\u1ea3m d\u1ea7n, ch\u1ecbu \u0111\u1ef1ng \u0111\u01b0\u1ee3c, ch\u1ec9 s\u1ed1 s\u1ed1c 0,67 (&lt;1). Ngh\u0129 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/da-chan-thuong-choang-chan-thuong\/\">stunned<\/a> ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n<\/ul>\n<p>&#8211; T\u1eafc m\u1ea1ch m\u00e1u do m\u1ee1: \u00edt ngh\u0129 v\u00ec l\u00e2m s\u00e0ng b\u1ec7nh nh\u00e2n t\u1ec9nh, kh\u00f4ng kh\u00f3 th\u1edf, kh\u00f4ng<\/p>\n<p>\u0111\u1ed1m xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da, sinh hi\u1ec7u \u1ed5n.<\/p>\n<p>&#8211; T\u0103ng n\u1eb7ng b\u1ec7nh n\u1ec1n: b\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n c\u0103n hen ph\u1ebf qu\u1ea3n nh\u01b0ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t t\u1ed1t, l\u00e2m s\u00e0ng kh\u00f4ng kh\u00f2 kh\u00e8, kh\u00f4ng kh\u00f3 th\u1edf, nghe ph\u1ed5i kh\u00f4ng rale t\u1eafc ngh\u1ebdn. Tuy nhi\u00ean, g\u00e3y x\u01b0\u01a1ng l\u00e0 1 stress n\u1eb7ng, y\u1ebfu t\u1ed1 th\u00fac \u0111\u1ea9y c\u01a1n hen ph\u1ebf qu\u1ea3n, v\u00ec v\u1eady c\u1ea7n theo d\u00f5i s\u00e1t.<\/p>\n<p>+ Bi\u1ebfn ch\u1ee9ng c\u1ea5p:<\/p>\n<p>&#8211; Bi\u1ebfn ch\u1ee9ng <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/hoi-chung-chen-ep-khoang\/\">cavity compression<\/a> c\u1ea5p l\u00e0 bi\u1ebfn ch\u1ee9ng c\u1ea7n quan t\u00e2m h\u00e0ng \u0111\u1ea7u \u0111\u1ed1i v\u1edbi g\u00e3y x\u01b0\u01a1ng v\u00f9ng c\u1eb3ng ch\u00e2n, t\u1ea1i c\u1eb3ng ch\u00e2n c\u00f3 4 khoang (tr\u01b0\u1edbc &#8211; ngo\u00e0i &#8211; sau n\u00f4ng &#8211; sau s\u00e2u, ch\u1ee7 y\u1ebfu g\u1eb7p \u1edf khoang tr\u01b0\u1edbc). Tuy nhi\u00ean, BN c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c gi\u1ea3m \u0111au v\u00e0 kh\u00f4ng c\u0103ng c\u1ee9ng khi s\u1edd tr\u00ean b\u1ec1 m\u1eb7t da, kh\u00f4ng d\u1ecb c\u1ea3m, kh\u00f4ng t\u00ea, kh\u00f4ng t\u00edm, m\u1ea1ch mu ch\u00e2n v\u00e0 ch\u00e0y sau b\u1eaft r\u00f5 n\u00ean kh\u00f4ng ngh\u0129 bi\u1ebfn ch\u1ee9ng ch\u00e8n \u00e9p khoang.<\/p>\n<p>&#8211; T\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u: t\u1ea1i 1\/3 tr\u00ean x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n c\u1ea7n ch\u00fa \u00fd t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch ch\u00e0y tr\u01b0\u1edbc v\u00e0 ch\u00e0y sau. Kh\u00e1m chi \u1ea5m, \u0111\u1ea7u ng\u00f3n ch\u00e2n h\u1ed3ng, m\u1ea1ch ch\u00e0y, m\u1ea1ch mu ch\u00e2n (P) b\u1eaft \u0111\u01b0\u1ee3c \u0111\u1ec1u r\u00f5 n\u00ean kh\u00f4ng ngh\u0129 c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u1ea1ch m\u00e1u.<\/p>\n<p>&#8211; T\u1ed5n th\u01b0\u01a1ng th\u1ea7n kinh: c\u1ea7n ch\u00fa \u00fd th\u1ea7n kinh ch\u00e0y v\u00e0 m\u00e1c chung. B\u1ec7nh nh\u00e2n th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c g\u1ea5p b\u00e0n ch\u00e2n, kh\u00f4ng t\u00ea b\u00ec, d\u1ecb c\u1ea3m, c\u1ea3m gi\u00e1c n\u00f4ng s\u00e2u v\u00f9ng gan ch\u00e2n trong gi\u1edbi h\u1ea1n b\u00ecnh th\u01b0\u1eddng n\u00ean \u00edt ngh\u0129 c\u00f3 t\u1ed5n th\u01b0\u01a1ng TK ch\u00e0y. B\u1ec7nh nh\u00e2n du\u1ed7i \u0111\u01b0\u1ee3c b\u00e0n ch\u00e2n, kh\u00f4ng r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c mu ch\u00e2n n\u00ean ngh\u0129 kh\u00f4ng t\u1ed5n th\u01b0\u01a1ng TK m\u00e1c chung.<\/p>\n<p>&#8211; G\u00e3y k\u00edn chuy\u1ec3n sang <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/gay-xuong-ho\/\">broken open<\/a>: Kh\u00f4ng s\u1edd \u0111\u01b0\u1ee3c \u0111\u1ea7u x\u01b0\u01a1ng g\u00e3y d\u01b0\u1edbi da, kh\u00f4ng th\u1ea5y v\u1ebft th\u01b0\u01a1ng \u1edf khu v\u1ef1c t\u1ed5n th\u01b0\u01a1ng, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/so-cuu-bat-dong-gay-xuong\/\">motionless<\/a> tr\u01b0\u1edbc khi nh\u1eadp vi\u1ec7n b\u1eb1ng n\u1eb9p \u0111\u00f9i &#8211; c\u1eb3ng ch\u00e2n &#8211; b\u00e0n ch\u00e2n, n\u00ean \u00edt ngh\u0129<\/p>\n<p>+ V\u1ec1 c\u01a1 ch\u1ebf ch\u1ea5n th\u01b0\u01a1ng, ghi nh\u1eadn xe v\u00e0 ng\u01b0\u1eddi ng\u00e3 sang ph\u1ea3i, m\u1eb7t ngo\u00e0i c\u1eb3ng ch\u00e2n (P), g\u1ed1i (P) \u0111\u1eadp xu\u1ed1ng n\u1ec1n c\u1ee9ng, h\u00e1ng \u1edf t\u01b0 th\u1ebf d\u1ea1ng, g\u1ed1i g\u1ea5p. Kh\u00e1m l\u00e2m s\u00e0ng c\u00f3 s\u01b0ng n\u1ec1 nhi\u1ec1u v\u00f9ng g\u1ed1i (P), \u1ea5n \u0111au v\u00f9ng m\u00e2m ch\u00e0y, c\u00e1c th\u0103m kh\u00e1m \u0111\u1ee9t d\u00e2y ch\u1eb1ng t\u1ea1i v\u00f9ng g\u1ed1i kh\u00f4ng th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c do b\u1ec7nh nh\u00e2n \u0111au nhi\u1ec1u v\u00f9ng g\u1ed1i. Nh\u01b0ng v\u1edbi t\u00e1c \u0111\u1ed9ng l\u1ef1c tr\u1ef1c ti\u1ebfp nh\u01b0 v\u1eady, kh\u00f4ng th\u1ec3 lo\u1ea1i tr\u1eeb c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u00e2m ch\u00e0y, \u0111\u1ee9t d\u00e2y ch\u1eb1ng v\u00f9ng g\u1ed1i, <a href=\"https:\/\/bsvothanhtoan.com\/en\/chuyen-de\/lam-sang-rach-sun-chem\/\">meniscus tear<\/a> k\u00e8m theo. \u0110\u1ec1 ngh\u1ecb ch\u1ee5p CT- Scanner kh\u1edbp g\u1ed1i (P), ch\u1ee5p MRI kh\u1edbp g\u1ed1i (P) \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n.<\/p>\n<h2><strong>XII. NGH\u1eca C\u1eacN L\u00c2M S\u00c0NG:<\/strong><\/h2>\n<ul>\n<li>Ch\u1ee5p MRI kh\u1edbp g\u1ed1i (P) \u0111\u1ec3 ch\u1ea9n \u0111o\u00e1n<\/li>\n<li>Xem k\u1ebft qu\u1ea3 phim<\/li>\n<li>CT-Scanner kh\u1edbp g\u1ed1i (P) d\u1ef1ng h\u00ecnh<\/li>\n<li>Xem k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m ti\u1ec1n ph\u1eabu<\/li>\n<\/ul>\n<h2><strong>XIII. K\u1ebeT QU\u1ea2 C\u1eacN L\u00c2M S\u00c0NG:<\/strong><\/h2>\n<p><strong>1. C\u00f4ng th\u1ee9c m\u00e1u<\/strong><\/p>\n<table width=\"553\">\n<thead>\n<tr>\n<td width=\"82\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>Results <\/strong><\/p>\n<p><strong>18\/04\/2023<\/strong><\/p>\n<\/td>\n<td width=\"105\">\n<p><strong>Results <\/strong><\/p>\n<p><strong>19\/04\/2023<\/strong><\/p>\n<\/td>\n<td width=\"139\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu <\/strong><\/p>\n<\/td>\n<td width=\"125\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td width=\"82\">\n<p><strong>WBC <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>15.73<\/strong><\/p>\n<\/td>\n<td width=\"105\">\n<p>9.6<\/p>\n<\/td>\n<td width=\"139\">\n<p>4.01 &#8211; 11.42<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>NEU% <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>88.4<\/strong><\/p>\n<\/td>\n<td width=\"105\">\n<p><strong>19.81<\/strong><\/p>\n<\/td>\n<td width=\"139\">\n<p>40 &#8211; 74<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>LYM% <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>6.4<\/strong><\/p>\n<\/td>\n<td width=\"105\">\n<p><strong>12.88<\/strong><\/p>\n<\/td>\n<td width=\"139\">\n<p>19 &#8211; 48<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MONO% <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>3.869<\/p>\n<\/td>\n<td width=\"105\">\n<p>5.4<\/p>\n<\/td>\n<td width=\"139\">\n<p>3.4 &#8211; 9.0<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>EOS% <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>0.862<\/p>\n<\/td>\n<td width=\"105\">\n<p>1.46<\/p>\n<\/td>\n<td width=\"139\">\n<p>0.0 &#8211; 7.0<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>BASO% <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>0.481<\/p>\n<\/td>\n<td width=\"105\">\n<p>0.35<\/p>\n<\/td>\n<td width=\"139\">\n<p>0.0 &#8211; 1.5<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>NEU# <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p><strong>13.91<\/strong><\/p>\n<\/td>\n<td width=\"105\">\n<p><strong>7.647<\/strong><\/p>\n<\/td>\n<td width=\"139\">\n<p>1.7 &#8211; 7.5<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>LYM# <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>1.00<\/p>\n<\/td>\n<td width=\"105\">\n<p>1.233<\/p>\n<\/td>\n<td width=\"139\">\n<p>1.2 &#8211; 4.0<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MONO# <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>0.609<\/p>\n<\/td>\n<td width=\"105\">\n<p>0.516<\/p>\n<\/td>\n<td width=\"139\">\n<p>0.2 &#8211; 0.8<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>EOS# <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>0.136<\/p>\n<\/td>\n<td width=\"105\">\n<p>0.139<\/p>\n<\/td>\n<td width=\"139\">\n<p>0.0 &#8211; 0.6<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>BASO# <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>0.076<\/p>\n<\/td>\n<td width=\"105\">\n<p>0.034<\/p>\n<\/td>\n<td width=\"139\">\n<p>0.0 &#8211; 0.1<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>RBC <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>4.61<\/p>\n<\/td>\n<td width=\"105\">\n<p>4.18<\/p>\n<\/td>\n<td width=\"139\">\n<p>4.01 &#8211; 5.79<\/p>\n<\/td>\n<td width=\"125\">\n<p>M\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>HGB <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>13.5<\/p>\n<\/td>\n<td width=\"105\">\n<p>12.5<\/p>\n<\/td>\n<td width=\"139\">\n<p>11.5 &#8211; 15.0<\/p>\n<\/td>\n<td width=\"125\">\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>HCT <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>41.3<\/p>\n<\/td>\n<td width=\"105\">\n<p>35.7<\/p>\n<\/td>\n<td width=\"139\">\n<p>34.4 &#8211; 48.6<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MCV <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>89.6<\/p>\n<\/td>\n<td width=\"105\">\n<p>85.4<\/p>\n<\/td>\n<td width=\"139\">\n<p>80 &#8211; 99<\/p>\n<\/td>\n<td width=\"125\">\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MCH <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>29.4<\/p>\n<\/td>\n<td width=\"105\">\n<p>29.9<\/p>\n<\/td>\n<td width=\"139\">\n<p>27 &#8211; 33<\/p>\n<\/td>\n<td width=\"125\">\n<p>Pg<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MCHC <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>32.8<\/p>\n<\/td>\n<td width=\"105\">\n<p>35.0<\/p>\n<\/td>\n<td width=\"139\">\n<p>32 &#8211; 36<\/p>\n<\/td>\n<td width=\"125\">\n<p>g\/dL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>RDW <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>10.9<\/p>\n<\/td>\n<td width=\"105\">\n<p>12.6<\/p>\n<\/td>\n<td width=\"139\">\n<p>11.5 &#8211; 15.5<\/p>\n<\/td>\n<td width=\"125\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>PLT <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>239<\/p>\n<\/td>\n<td width=\"105\">\n<p>230<\/p>\n<\/td>\n<td width=\"139\">\n<p>150 &#8211; 450<\/p>\n<\/td>\n<td width=\"125\">\n<p>K\/uL<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"82\">\n<p><strong>MPV <\/strong><\/p>\n<\/td>\n<td width=\"101\">\n<p>7.70<\/p>\n<\/td>\n<td width=\"105\">\n<p>8.5<\/p>\n<\/td>\n<td width=\"139\">\n<p>7.4 &#8211; 10.9<\/p>\n<\/td>\n<td width=\"125\">\n<p>fL<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li><strong>B\u1ea1ch c\u1ea7u<\/strong>: WBC t\u0103ng, NEU% \u01b0u th\u1ebf tuy nhi\u00ean tr\u00ean l\u00e2m s\u00e0ng kh\u00e1m b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 h\u1ed9i ch\u1ee9ng nhi\u1ec5m tr\u00f9ng ngh\u0129 nhi\u1ec1u t\u0103ng b\u1ea1ch c\u1ea7u ph\u1ea3n \u1ee9ng.<\/li>\n<li><strong>H\u1ed3ng c\u1ea7u: <\/strong>Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<li><strong>Ti\u1ec3u c\u1ea7u: <\/strong>Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<\/ul>\n<p><strong>2. Sinh h\u00f3a m\u00e1u<\/strong><\/p>\n<table width=\"602\">\n<tbody>\n<tr>\n<td width=\"225\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>18\/04\/2023<\/strong><\/p>\n<\/td>\n<td width=\"167\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"77\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110\u1ecbnh l\u01b0\u1ee3ng Glucose ( M\u00e1u )<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>5.7<\/p>\n<\/td>\n<td width=\"167\">\n<p>4.1-5.9<\/p>\n<\/td>\n<td width=\"77\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110\u1ecbnh l\u01b0\u1ee3ng Ure (M\u00e1u )<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>5.9<\/p>\n<\/td>\n<td width=\"167\">\n<p>2.8-7.2<\/p>\n<\/td>\n<td width=\"77\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110\u1ecbnh l\u01b0\u1ee3ng Creatinin ( M\u00e1u )<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>75<\/p>\n<\/td>\n<td width=\"167\">\n<p>43-120<\/p>\n<\/td>\n<td width=\"77\">\n<p>umol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>eGFR<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>80.61<\/p>\n<\/td>\n<td width=\"167\">\n<p>&gt;=60<\/p>\n<\/td>\n<td width=\"77\">\n<p>mL\/ph\u00fat<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110o ho\u1ea1t \u0111\u1ed9ng AST GOT m\u00e1u<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>25<\/p>\n<\/td>\n<td width=\"167\">\n<p>&lt;35<\/p>\n<\/td>\n<td width=\"77\">\n<p>U\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110o ho\u1ea1t \u0111\u1ed9ng ALT GOT m\u00e1u<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>38<\/p>\n<\/td>\n<td width=\"167\">\n<p>&lt;35<\/p>\n<\/td>\n<td width=\"77\">\n<p>U\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>\u0110i\u1ec7n gi\u1ea3i \u0111\u1ed3<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"167\">\n<p>&nbsp;<\/p>\n<\/td>\n<td width=\"77\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>Na +<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p>141<\/p>\n<\/td>\n<td width=\"167\">\n<p>135-145<\/p>\n<\/td>\n<td width=\"77\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>K+<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>3.1<\/strong><\/p>\n<\/td>\n<td width=\"167\">\n<p>3.5-5.0<\/p>\n<\/td>\n<td width=\"77\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"225\">\n<p><strong>Cl-<\/strong><\/p>\n<\/td>\n<td width=\"134\">\n<p><strong>108<\/strong><\/p>\n<\/td>\n<td width=\"167\">\n<p>98-106<\/p>\n<\/td>\n<td width=\"77\">\n<p>mmol\/L<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<ul>\n<li>B\u1ec7nh nh\u00e2n h\u1ea1 Kali m\u00e1u nh\u1eb9 (3.5-3.0mmol\/L) nghi do t\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c Symbicort (g\u1ed3m ICS + \u0110\u1ed3ng v\u1eadn Beta2). Thu\u1ed1c \u0111\u1ed3ng v\u1eadn Beta 2 c\u00f3 th\u1ec3 g\u00e2y h\u1ea1 Kali m\u00e1u do c\u01a1 ch\u1ebf t\u0103ng \u0111\u01b0a K+ v\u00e0o trong t\u1ebf b\u00e0o.<\/li>\n<li>Sinh ho\u00e1 m\u00e1u: Ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/li>\n<\/ul>\n<p><strong>3. \u0110\u00f4ng c\u1ea7m m\u00e1u<\/strong><\/p>\n<table width=\"554\">\n<tbody>\n<tr>\n<td width=\"101\">\n<p><strong>\u00a0<\/strong><\/p>\n<\/td>\n<td width=\"142\">\n<p><strong>Results<\/strong><\/p>\n<\/td>\n<td width=\"193\">\n<p><strong>Kho\u1ea3ng tham chi\u1ebfu<\/strong><\/p>\n<\/td>\n<td width=\"118\">\n<p><strong>\u0110\u01a1n v\u1ecb<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"101\">\n<p><strong>APTT<\/strong><\/p>\n<\/td>\n<td width=\"142\">\n<p>24.3<\/p>\n<\/td>\n<td width=\"193\">\n<p>25 &#8211; 37<\/p>\n<\/td>\n<td width=\"118\">\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"101\">\n<p><strong>TQ<\/strong><\/p>\n<\/td>\n<td width=\"142\">\n<p>11.0<\/p>\n<\/td>\n<td width=\"193\">\n<p>9.3 -12<\/p>\n<\/td>\n<td width=\"118\">\n<p>gi\u00e2y<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"101\">\n<p><strong>TL<\/strong><\/p>\n<\/td>\n<td width=\"142\">\n<p>100<\/p>\n<\/td>\n<td width=\"193\">\n<p>&gt; 70<\/p>\n<\/td>\n<td width=\"118\">\n<p>%<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td width=\"101\">\n<p><strong>INR<\/strong><\/p>\n<\/td>\n<td width=\"142\">\n<p>1.00<\/p>\n<\/td>\n<td width=\"193\">\n<p>0.84 &#8211; 1.29<\/p>\n<\/td>\n<td width=\"118\">\n<p>&nbsp;<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>K\u1ebft lu\u1eadn:<\/strong> k\u1ebft qu\u1ea3 \u1edf trong ng\u01b0\u1ee1ng b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p>Nh\u00f3m m\u00e1u: A+<\/p>\n<p><strong>4. \u0110i\u1ec7n t\u00e2m \u0111\u1ed3<\/strong><\/p>\n<figure id=\"attachment_2164\" aria-describedby=\"caption-attachment-2164\" style=\"width: 602px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"wp-image-2164 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-1.jpg\" alt=\"B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 1\" width=\"602\" height=\"171\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-1.jpg 602w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-1-300x85.jpg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-1-18x5.jpg 18w\" sizes=\"(max-width: 602px) 100vw, 602px\" \/><figcaption id=\"caption-attachment-2164\" class=\"wp-caption-text\">B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 1<\/figcaption><\/figure>\n<p><strong>H\u00e0nh ch\u00ednh:<\/strong><\/p>\n<p>H\u1ecd v\u00e0 t\u00ean: NGUY\u1ec4N TH\u1eca N.<\/p>\n<p>Gi\u1edbi: N\u1eef<\/p>\n<p>N\u0103m sinh: 1987<\/p>\n<p>Ng\u00e0y \u0111o: 18\/04\/2023<\/p>\n<p>T\u1ed1c \u0111\u1ed9 k\u00e9o gi\u1ea5y: 25mm\/s<\/p>\n<p>Test Millivolt: 10mm\/mV<\/p>\n<p>Nh\u1ecbp xoang \u0111\u1ec1u, t\u1ea7n s\u1ed1 94 l\u1ea7n\/ph\u00fat<\/p>\n<p>Tr\u1ee5c QRS trung gian<\/p>\n<p><strong>K\u1ebft lu\u1eadn: <\/strong>\u0110i\u1ec7n t\u00e2m \u0111\u1ed3 ch\u01b0a ghi nh\u1eadn b\u1ea5t th\u01b0\u1eddng.<\/p>\n<p><strong>5. X Quang kh\u1edbp g\u1ed1i (P) th\u1eb3ng, nghi\u00eang<\/strong><\/p>\n<p><figure id=\"attachment_2165\" aria-describedby=\"caption-attachment-2165\" style=\"width: 384px\" class=\"wp-caption aligncenter\"><img decoding=\"async\" class=\"wp-image-2165 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-2.png\" alt=\"B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 2\" width=\"384\" height=\"558\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-2.png 384w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-2-206x300.png 206w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-2-8x12.png 8w\" sizes=\"(max-width: 384px) 100vw, 384px\" \/><figcaption id=\"caption-attachment-2165\" class=\"wp-caption-text\">B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 2<\/figcaption><\/figure> <figure id=\"attachment_2166\" aria-describedby=\"caption-attachment-2166\" style=\"width: 372px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2166 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-3.png\" alt=\"B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 3\" width=\"372\" height=\"526\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-3.png 372w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-3-212x300.png 212w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-3-8x12.png 8w\" sizes=\"(max-width: 372px) 100vw, 372px\" \/><figcaption id=\"caption-attachment-2166\" class=\"wp-caption-text\">B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 3<\/figcaption><\/figure><\/p>\n<p>BN NGUY\u1ec4N TH\u1eca N., n\u1eef, 36 tu\u1ed5i<\/p>\n<p>Phim ch\u1ee5p ng\u00e0y 18\/04\/2023, ch\u1ee5p kh\u1edbp g\u1ed1i (P) + 1\/3 tr\u00ean v\u00e0 1\/3 gi\u1eefa 2 x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P)<\/p>\n<p>Phim \u0111\u1ee7 ti\u00eau chu\u1ea9n: ch\u1ee5p \u0111\u1ee7 qua 2 kh\u1edbp, ch\u1ee5p \u0111\u1ee7 2 b\u00ecnh di\u1ec7n th\u1eb3ng, nghi\u00eang, qua kh\u1edbp g\u1ed1i v\u00e0 qua kh\u1edbp c\u1ed5 ch\u00e2n<\/p>\n<p>Tia v\u1eeba<\/p>\n<pre><strong>T\u1ed5n th\u01b0\u01a1ng:<\/strong><\/pre>\n<ul>\n<li>M\u00f4 m\u1ec1m: s\u01b0ng n\u1ec1, kh\u00f4ng b\u00f3ng kh\u00ed<\/li>\n<li>X\u01b0\u01a1ng g\u00e3y: x\u01b0\u01a1ng ch\u00e0y<\/li>\n<li>V\u1ecb tr\u00ed: : M\u00e2m ch\u00e0y ngo\u00e0i + 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P)<\/li>\n<li>\u0110\u01b0\u1eddng g\u00e3y: ch\u00e9o k\u00e9o d\u00e0i t\u1eeb m\u00e2m ch\u00e0y ngo\u00e0i xu\u1ed1ng d\u01b0\u1edbi v\u00e0o trong 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P)<\/li>\n<li>Ki\u1ec3u di l\u1ec7ch: ch\u1ed3ng ng\u1eafn (4mm), sang b\u00ean ra ngo\u00e0i 1 v\u1ecf x\u01b0\u01a1ng<\/li>\n<\/ul>\n<pre><strong>K\u1ebft lu\u1eadn:<\/strong><\/pre>\n<p>G\u00e3y 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y <strong>A2 theo AO<\/strong><\/p>\n<p>G\u00e3y m\u00e2m ch\u00e0y kh\u00f3 x\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9. \u0110\u1ec1 ngh\u1ecb CT- Scan kh\u1edbp g\u1ed1i (P) d\u1ef1ng h\u00ecnh<\/p>\n<p><strong>6. CT &#8211; scan kh\u1edbp g\u1ed1i c\u00f3 d\u1ef1ng h\u00ecnh<\/strong><\/p>\n<p><figure id=\"attachment_2167\" aria-describedby=\"caption-attachment-2167\" style=\"width: 602px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2167 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-4.jpg\" alt=\"B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 4\" width=\"602\" height=\"368\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-4.jpg 602w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-4-300x183.jpg 300w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-4-18x12.jpg 18w\" sizes=\"(max-width: 602px) 100vw, 602px\" \/><figcaption id=\"caption-attachment-2167\" class=\"wp-caption-text\">B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 4<\/figcaption><\/figure> <figure id=\"attachment_2169\" aria-describedby=\"caption-attachment-2169\" style=\"width: 299px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2169 size-full\" src=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-5.jpg\" alt=\"B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 5\" width=\"299\" height=\"480\" title=\"\" srcset=\"https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-5.jpg 299w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-5-187x300.jpg 187w, https:\/\/bsvothanhtoan.com\/wp-content\/uploads\/2023\/07\/gay-mam-chay-5-7x12.jpg 7w\" sizes=\"(max-width: 299px) 100vw, 299px\" \/><figcaption id=\"caption-attachment-2169\" class=\"wp-caption-text\">B\u1ec7nh \u00e1n g\u00e3y m\u1ea7m ch\u00e0y 5<\/figcaption><\/figure><\/p>\n<p>BN NGUY\u1ec4N TH\u1eca N., n\u1eef, 36 tu\u1ed5i<\/p>\n<p>Phim ch\u1ee5p ng\u00e0y 18\/04\/2023, ch\u1ee5p kh\u1edbp g\u1ed1i (P) + 1\/3 tr\u00ean v\u00e0 1\/3 gi\u1eefa 2 x\u01b0\u01a1ng c\u1eb3ng ch\u00e2n (P) Phim \u0111\u1ee7 ti\u00eau chu\u1ea9n: ch\u1ee5p \u0111\u1ee7 qua 2 kh\u1edbp, ch\u1ee5p \u0111\u1ee7 2 b\u00ecnh di\u1ec7n th\u1eb3ng, nghi\u00eang, qua kh\u1edbp g\u1ed1i v\u00e0 qua kh\u1edbp c\u1ed5 ch\u00e2n<\/p>\n<pre><strong>T\u1ed5n th\u01b0\u01a1ng:<\/strong><\/pre>\n<ul>\n<li>X\u01b0\u01a1ng g\u00e3y: x\u01b0\u01a1ng ch\u00e0y<\/li>\n<li>V\u1ecb tr\u00ed: : M\u00e2m ch\u00e0y ngo\u00e0i + 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P).<\/li>\n<li>\u0110\u01b0\u1eddng g\u00e3y: G\u00e3y l\u00fan m\u00e2m ch\u00e0y ngo\u00e0i, \u0111\u01b0\u1eddng g\u00e3y ch\u00e9o t\u1eeb m\u00e2m ch\u00e0y ngo\u00e0i xu\u1ed1ng d\u01b0\u1edbi v\u00e0o trong 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P). M\u00e2m ch\u00e0y c\u00f3 s\u1ef1 m\u1ea5t li\u00ean t\u1ee5c, gi\u1eefa th\u00e2n v\u00e0 h\u00e0nh x\u01b0\u01a1ng, g\u00e3y c\u00f3 m\u1ea3nh th\u1ee9 ba.<\/li>\n<li>Ki\u1ec3u di l\u1ec7ch: ch\u1ed3ng ng\u1eafn (4mm), sang b\u00ean ra ngo\u00e0i 1 v\u1ecf x\u01b0\u01a1ng<\/li>\n<\/ul>\n<pre><strong>K\u1ebft lu\u1eadn:<\/strong><\/pre>\n<p>G\u00e3y 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P)A2 theo AO G\u00e3y m\u00e2m ch\u00e0y (P) nh\u00f3m VI theo Schatzker<\/p>\n<p><strong>7. <\/strong><strong>Si\u00eau \u00e2m b\u1ee5ng<\/strong><\/p>\n<p>Gan:\u00a0\u00a0\u00a0\u00a0 &#8211; K\u00edch th\u01b0\u1edbc. Kh\u00f4ng to<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; Nhu m\u00f4: S\u00e1ng, gi\u1ea3m \u00e2m v\u00f9ng s\u00e2u<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; M\u1ea1ch m\u00e1u. T\u0129nh m\u1ea1ch c\u1eeda v\u00e0 t\u0129nh m\u1ea1ch gan kh\u00f4ng d\u00e3n.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; T\u00fai m\u1eadt: K\u00edch th\u01b0\u1edbc kh\u00f4ng to, th\u00e0nh: kh\u00f4ng d\u00e0y, kh\u00f4ng th\u1ea5y s\u1ecfi.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; \u0110\u01b0\u1eddng m\u1eadt: \u1ed1ng m\u1eadt ch\u1ee7 v\u00e0 \u0111\u01b0\u1eddng m\u1eadt trong gan kh\u00f4ng d\u00e3n, kh\u00f4ng s\u1ecfi<\/p>\n<p>T\u1ee5y:\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; K\u00edch th\u01b0\u1edbc: Kh\u00f4ng to<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; Nhu m\u00f4 : \u0110\u1ed3ng nh\u1ea5t, kh\u00f4ng sang th\u01b0\u01a1ng khu tr\u00fa<\/p>\n<p>L\u00e1ch:\u00a0\u00a0\u00a0 &#8211; K\u00edch th\u01b0\u1edbc. Kh\u00f4ng to.<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; Nhu m\u00f4: \u0110\u1ed3ng nh\u1ea5t, kh\u00f4ng sang th\u01b0\u01a1ng khu tr\u00fa<\/p>\n<p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 &#8211; M\u1ea1ch m\u00e1u. T\u0129nh m\u1ea1ch l\u00e1ch kh\u00f4ng d\u00e3n<\/p>\n<p>Th\u1eadn:\u00a0\u00a0\u00a0<\/p>\n<p>&#8211; 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, c\u00f3 nhi\u1ec1u b\u00f3ng c\u1ea3n \u00e2m d# 3-4mm, kh\u00f4ng \u1ee9 n\u01b0\u1edbc, c\u00f3 nhi\u1ec1u kh\u1ed1i echo tr\u1ed1ng d# 15- 20mm.<\/p>\n<p>\u00a0&#8211; 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, c\u00f3 nhi\u1ec1u b\u00f3ng c\u1ea3n \u00e2m d#\u00a0 3-4mm, kh\u00f4ng \u1ee9 n\u01b0\u1edbc, c\u00f3 nhi\u1ec1u kh\u1ed1i echo tr\u1ed1ng d# 15 &#8211; 20mm.<\/p>\n<p>B\u00e0ng quang: \u00edt n\u01b0\u1edbc ti\u1ec3u, kh\u00f3 kh\u1ea3o s\u00e1t<\/p>\n<p>T\u1eed cung: Trong l\u00f2ng t\u1eed cung c\u00f3 v\u00f2ng tr\u00e1nh thai \u0111\u00fang v\u1ecb tr\u00ed<\/p>\n<p>Ph\u1ea7n ph\u1ee5: kh\u00f3 kh\u1ea3o s\u00e1t.<\/p>\n<p>\u0110\u1ed9ng m\u1ea1ch ch\u1ee7 b\u1ee5ng: Kh\u00f4ng ph\u00ecnh<\/p>\n<p>D\u1ecbch \u1ed5 b\u1ee5ng: Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau \u00e2m<\/p>\n<p>D\u1ecbch m\u00e0ng ph\u1ed5i: B\u1ec1n (P): Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau \u00e2m; B\u00ean (T): Kh\u00f4ng th\u1ea5y tr\u00ean si\u00eau<\/p>\n<p>\u00e2m.<\/p>\n<p><strong>Conclusion<\/strong>: Gan nhi\u1ec5m m\u1ee1<\/p>\n<p>\u0110a nang hai th\u1eadn + S\u1ecfi hai th\u1eadn<\/p>\n<h2><strong>XIV. CH\u1ea8N \u0110O\u00c1N X\u00c1C \u0110\u1ecaNH:<\/strong><\/h2>\n<p>G\u00e3y k\u00edn 1\/3 tr\u00ean x\u01b0\u01a1ng ch\u00e0y (P) 41-A2 theo AO &#8211; G\u00e3y k\u00edn \u0111\u1ea7u tr\u00ean m\u00e2m ch\u00e0y (P) lo\u1ea1i VI theo Schatzker &#8211; do TNGT, ch\u01b0a ghi nh\u1eadn bi\u1ebfn ch\u1ee9ng\/ Hen PQ ki\u1ec3m so\u00e1t t\u1ed1t- Th\u1eadn \u0111a nang- s\u1ecfi 2 th\u1eadn<\/p>\n<h2><strong>XV. \u0110I\u1ec0U TR\u1eca:<\/strong><\/h2>\n<p><strong>The principles of treatment:<\/strong><\/p>\n<ul>\n<li>B\u1ea5t \u0111\u1ed9ng \u1ed5 g\u00e3y<\/li>\n<li>Pain relief<\/li>\n<li>Dinh d\u01b0\u1ee1ng<\/li>\n<li>Ph\u1eabu thu\u1eadt: v\u00ec g\u00e3y m\u1ea5t v\u1eefng, ph\u1ea1m kh\u1edbp, g\u00e3y l\u00fan. G\u00e3y m\u00e2m ch\u00e0y (P) nh\u00f3m VI theo Schatzker<\/li>\n<li>Theo d\u00f5i s\u00e1t, ph\u00e1t hi\u1ec7n v\u00e0 x\u1eed tr\u00ed k\u1ecbp th\u1eddi c\u00e1c bi\u1ebfn ch\u1ee9ng tr\u01b0\u1edbc m\u1ed5 v\u00e0 sau m\u1ed5<\/li>\n<\/ul>\n<pre><strong>\u0110i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3:<\/strong><\/pre>\n<ul>\n<li>N\u1eb9p \u0111\u00f9i- c\u1eb3ng- b\u00e0n ch\u00e2n<\/li>\n<li>Tatanol 500mg 01 vi\u00ean (u)<\/li>\n<li>Brexin 20 mg 01 vi\u00ean (u)<\/li>\n<li>Savi Pantoprazol 20mg 01 vi\u00ean (u)<\/li>\n<li>Ph\u1eabu thu\u1eadt KHX ch\u00e0y b\u1eb1ng n\u1eb9p v\u00edt<\/li>\n<li>Ch\u0103m s\u00f3c c\u1ea5p II- BT01- C\u01a1m<\/li>\n<li>Theo d\u00f5i tri gi\u00e1c, sinh hi\u1ec7u, \u0111au m\u1ed7i 4 gi\u1edd.<\/li>\n<\/ul>\n<h2><strong>XVI. TI\u00caN L\u01af\u1ee2NG:<\/strong><\/h2>\n<ul>\n<li><strong>G\u1ea6N: <\/strong>C\u00f3 th\u1ec3 c\u00f3 bi\u1ebfn ch\u1ee9ng m\u1ea5t m\u00e1u, g\u00e3y k\u00edn chuy\u1ec3n sang g\u00e3y h\u1edf,&#8230;<\/li>\n<li><strong>XA: <\/strong>Slow <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/cham-lanh-xuong-va-khong-lanh-xuong\/\">heal bones<\/a>, can l\u1ec7ch, kh\u1edbp gi\u1ea3 do g\u00e3y nhi\u1ec1u m\u1ea3nh, <a href=\"https:\/\/bsvothanhtoan.com\/en\/bai-giang\/thoai-hoa-khop\/\">osteoarthritis<\/a> g\u1ed1i\u2026<\/li>\n<\/ul>\n<h2><strong>XVII. D\u1ef0 PH\u00d2NG:<\/strong><\/h2>\n<ul>\n<li>Gi\u1ea3m \u0111au sau ph\u1eabu thu\u1eadt<\/li>\n<li>Kh\u00e1ng sinh sau ph\u1eabu thu\u1eadt<\/li>\n<li>B\u1ea5t \u0111\u1ed9ng kh\u1edbp g\u1ed1i<\/li>\n<li>Ph\u00f2ng ng\u1eeba di ch\u1ee9ng bi\u1ebfn d\u1ea1ng tr\u1ee5c chi, h\u00ecnh th\u00e0nh can x\u01b0\u01a1ng x\u1ea5u \u1edf b\u1ec7nh nh\u00e2n<\/li>\n<li>T\u1eadp v\u1eadn \u0111\u1ed9ng s\u1edbm cho b\u1ec7nh sau ph\u1eabu thu\u1eadt.<\/li>\n<\/ul>","protected":false},"featured_media":1762,"comment_status":"open","ping_status":"open","template":"","tags":[200,204],"chuyen-muc":[188],"class_list":["post-2163","chuyen-de","type-chuyen-de","status-publish","has-post-thumbnail","hentry","tag-benh-an-gay-mam-chay","tag-gay-mam-chay","chuyen-muc-benh-an-mau"],"_links":{"self":[{"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2163","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=2163"}],"version-history":[{"count":2,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2163\/revisions"}],"predecessor-version":[{"id":2683,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-de\/2163\/revisions\/2683"}],"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=2163"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/tags?post=2163"},{"taxonomy":"chuyen-muc","embeddable":true,"href":"https:\/\/bsvothanhtoan.com\/en\/wp-json\/wp\/v2\/chuyen-muc?post=2163"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}