{"id":3193,"date":"2023-08-25T08:29:56","date_gmt":"2023-08-25T01:29:56","guid":{"rendered":"http:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/"},"modified":"2023-08-25T08:29:56","modified_gmt":"2023-08-25T01:29:56","slug":"xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai","status":"publish","type":"post","link":"https:\/\/bvnguyentrai.org.vn\/en\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/","title":{"rendered":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"

Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i<\/h1>\n

Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21; C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i; Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i c\u00f9ng h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng, can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh\u2026 l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c c\u00e1c chuy\u00ean gia b\u00e0n lu\u1eadn trong Phi\u00ean to\u00e0n th\u1ec3 c\u1ee7a H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt 2023 do B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i t\u1ed5 ch\u1ee9c.<\/p>\n

\n

H\u1ed9i ngh\u1ecb \u0111\u01b0\u1ee3c t\u1ed5 ch\u1ee9c v\u00e0o ng\u00e0y 24\/8\/2023<\/a>\u00a0v\u1eeba qua \u0111\u00e1nh d\u1ea5u c\u1ed9t m\u1ed1c l\u1ea7n \u0111\u1ea7u ti\u00ean B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i ghi nh\u1eadn ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 1.000. Trong 40 b\u00e0i b\u00e1o c\u00e1o ch\u1ea5t l\u01b0\u1ee3ng t\u1eeb c\u00e1c chuy\u00ean gia, gi\u1ea3ng vi\u00ean xuy\u00ean su\u1ed1t tr\u00ean 5 phi\u00ean (t\u1eeb N\u1ed9i khoa, Ngo\u1ea1i Khoa, \u0110i\u1ec1u d\u01b0\u1ee1ng), phi\u00ean To\u00e0n th\u1ec3 v\u1edbi 8 b\u00e0i b\u00e1o c\u00e1o \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe n\u1ed5i tr\u1ed9i c\u0169ng nh\u01b0 l\u00e0 th\u1ebf m\u1ea1nh, m\u0169i nh\u1ecdn m\u00e0 b\u1ec7nh vi\u1ec7n h\u01b0\u1edbng \u0111\u1ebfn trong n\u0103m 2023.\u00a0<\/p>\n

<\/div>\n

H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i thu h\u00fat h\u01a1n 1.000 ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 5 phi\u00ean<\/span><\/div>\n
<\/div>\n
Ch\u1ee7 t\u1ecda \u0111o\u00e0n phi\u00ean To\u00e0n th\u1ec3<\/p>\n

Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21\u00a0<\/h2>\n

Trong b\u00e0i b\u00e1o c\u00e1o \u201cCh\u1ee7ng ng\u1eeba cho c\u1ea3 gia \u0111\u00ecnh<\/strong>\u201d – PGS.TS.BS Ph\u1ea1m L\u00ea An – Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM, Tr\u01b0\u1edfng Trung t\u00e2m B\u00e1c s\u0129 gia \u0111\u00ecnh – Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM nh\u1ea5n m\u1ea1nh, vi\u1ec7c ch\u1ee7ng ng\u1eeba cho tr\u1ebb em \u0111\u00e3 mang l\u1ea1i nh\u1eefng gi\u00e1 tr\u1ecb ngo\u1ea1n m\u1ee5c, h\u1eb1ng n\u0103m gi\u00fap d\u1ef1 ph\u00f2ng 3 tri\u1ec7u ca t\u1eed vong v\u00e0 750.000 tr\u1ebb kh\u00f4ng b\u1ecb t\u00e0n ph\u1ebf. Cho \u0111\u1ebfn nay \u0111\u00e3 c\u00f3 26 b\u1ec7nh \u0111\u01b0\u1ee3c d\u1ef1 ph\u00f2ng b\u1edfi thu\u1ed1c ti\u00eam ch\u1ee7ng.\u00a0<\/p>\n

Tuy v\u1eady, chuy\u00ean gia n\u00eau l\u00ean th\u1ef1c t\u1ebf, ch\u1ee7ng ng\u1eeba tr\u00ean to\u00e0n th\u1ebf gi\u1edbi nh\u1eb1m v\u00e0o tr\u1ebb em, song \u0111i\u1ec1u n\u00e0y ch\u01b0a ho\u00e0n to\u00e0n ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u00e1c b\u1ec7nh ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng v\u1eafc xin \u1edf v\u1ecb th\u00e0nh ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn ngay c\u1ea3 khi \u0111\u1ea1t t\u1ef7 l\u1ec7 bao ph\u1ee7 cao \u1edf tr\u1ebb em. Do v\u1eady, trong th\u1ebf k\u1ef7 21, khuynh h\u01b0\u1edbng ch\u1ee7ng ng\u1eeba c\u1ed5 \u0111i\u1ec3n ch\u1ec9 \u1edf tr\u1ebb em \u0111\u00e3 ph\u00e1t tri\u1ec3n r\u1ed9ng th\u00e0nh ch\u1ee7ng ng\u1eeba cho m\u1ecdi l\u1ee9a tu\u1ed5i nh\u01b0 v\u1ecb th\u00e0nh ni\u00ean, thai k\u1ef3, ng\u01b0\u1eddi cao tu\u1ed5i, nh\u00f3m b\u1ec7nh m\u00e3n t\u00ednh\u2026<\/p>\n

<\/div>\n

PGS.TS.BS Ph\u1ea1m L\u00ea An – Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM<\/p>\n

Xu h\u01b0\u1edbng m\u1edbi trong ti\u00eam ng\u1eeba c\u0169ng \u0111\u01b0\u1ee3c PGS.TS.BS Ph\u1ea1m L\u00ea An \u0111\u1ec1 c\u1eadp. Hi\u1ec7n nay v\u1eafc xin \u0111\u00e3 g\u1ed9p nhi\u1ec1u th\u00e0nh ph\u1ea7n trong 1 s\u1ea3n ph\u1ea9m \u0111\u1ec3 b\u1ea3o v\u1ec7 \u0111\u01b0\u1ee3c nhi\u1ec1u b\u1ec7nh ho\u1eb7c nhi\u1ec1u ch\u1ee7ng vi sinh v\u1eadt c\u1ee7a m\u1ed9t b\u1ec7nh, gi\u00fap gi\u1ea3m s\u1ed1 m\u0169i ti\u00eam v\u1eafc xin v\u00e0 b\u1ed5 sung nhanh s\u1ed1 m\u0169i v\u1eafc xin \u0111\u1ed1i v\u1edbi nh\u1eefng tr\u1ebb ch\u1ee7ng ng\u1eeba mu\u1ed9n.\u00a0<\/p>\n

Trong khi \u0111\u00f3, ch\u1ee7ng ng\u1eeba \u1edf tr\u1ebb em \u0111\u00e3 c\u00f3 s\u1ef1 kh\u1edfi \u0111\u1ea7u c\u1ee7a v\u1eafc xin vi\u00eam gan si\u00eau vi A, B; v\u1eafc xin Hib; v\u1eafc xin b\u1ea1i li\u1ec7t chuy\u1ec3n t\u1eeb d\u1ea1ng u\u1ed1ng (OPV) sang d\u1ea1ng ti\u00eam (IPV); c\u00e1c d\u1ea1ng v\u1eafc xin li\u00ean h\u1ee3p m\u1edbi (vi\u00eam m\u00e0ng n\u00e3o pneumococcal v\u00e0 group C), \u0111\u1ed3ng th\u1eddi c\u00e1c nh\u00e0 s\u1ea3n s\u1ea3n xu\u1ea5t l\u1edbn \u0111\u00e3 ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i v\u1eafc xin \u0111a gi\u00e1 5 trong 1 \u0111\u1ebfn 6 trong 1. Ngo\u00e0i ra, theo khuy\u1ebfn c\u00e1o c\u1ee7a WHO (2019) c\u0169ng cho th\u1ea5y, c\u1ea7n ti\u00eam b\u1ed5 sung DTwP\/DtaP & Tdap\/Td trong tr\u01b0\u1eddng h\u1ee3p b\u1ecb tr\u00ec ho\u00e3n.\u00a0<\/p>\n

Vi\u1ec7c thay th\u1ebf v\u1eafc xin (v\u00e0i thu\u1ed1c ch\u1ee7ng ng\u1eeba t\u1eeb c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t kh\u00e1c nhau nh\u1eb1m b\u1ea3o v\u1ec7 c\u00f9ng m\u1ed9t t\u00e1c nh\u00e2n) c\u0169ng r\u1ea5t c\u1ea7n thi\u1ebft khi c\u00f3 s\u1ef1 thi\u1ebfu h\u1ee5t (nh\u01b0 HepB v\u00e0 Hib). Chuy\u00ean gia l\u1ea5y v\u00ed d\u1ee5 th\u1ef1c t\u1ebf nh\u01b0 thu\u1ed1c ch\u1ee7ng k\u1ebft h\u1ee3p v\u1edbi th\u00e0nh ph\u1ea7n kh\u00e1ng nguy\u00ean c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t (nh\u01b0 DTaP, DtaP-Hib, hay c\u00e1c DtaP kh\u00e1c trong c\u00e1c v\u1eafc xin k\u1ebft h\u1ee3p c\u00f3 ch\u1ee9a c\u00f9ng kh\u00e1ng nguy\u00ean v\u00f4 b\u00e0o ho g\u00e0 t\u1eeb c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thay th\u1ebf cho nhau.<\/p>\n

Cu\u1ed1i c\u00f9ng PGS.TS.BS Ph\u1ea1m L\u00ea An l\u01b0u \u00fd, kh\u00f4ng s\u1eed d\u1ee5ng v\u1eafc xin v\u1edbi kho\u1ea3ng c\u00e1ch \u00edt h\u01a1n th\u1eddi gian t\u1ed1i thi\u1ec3u quy \u0111\u1ecbnh hay s\u1eed d\u1ee5ng s\u1edbm h\u01a1n tu\u1ed5i \u0111\u1ec1 ngh\u1ecb. Li\u1ec1u v\u1eafc xin \u0111\u01b0\u1ee3c cho s\u1edbm \u2264 4 ng\u00e0y so v\u1edbi kho\u1ea3ng c\u00e1ch t\u1ed1i thi\u1ec3u hay v\u1edbi tu\u1ed5i quy \u0111\u1ecbnh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ednh l\u00e0 li\u1ec1u h\u1ee3p l\u1ec7, nh\u01b0ng nguy\u00ean t\u1eafc n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho v\u1eafc xin s\u1ed1ng. T\u0103ng kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c li\u1ec1u v\u1edbi v\u1eafc xin c\u1ea7n nhi\u1ec1u li\u1ec1u ti\u00eam kh\u00f4ng l\u00e0m gi\u1ea3m t\u00ednh hi\u1ec7u qu\u1ea3 c\u1ee7a v\u1eafc xin v\u00e0 kh\u00f4ng ti\u00eam l\u1ea1i t\u1eeb \u0111\u1ea7u n\u1ebfu b\u1ecf s\u00f3t.\u00a0<\/p>\n

Ti\u1ebfp c\u1eadn v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i, \u0111\u00e2u l\u00e0 th\u00e1ch th\u1ee9c?<\/h2>\n

<\/div>\n

PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n chia s\u1ebb v\u1ec1 C\u1eadp nh\u1eadt tron ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i<\/p>\n

PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n – Tr\u01b0\u1edfng B\u1ed9 m\u00f4n L\u00e3o khoa, khoa Y Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM, Tr\u01b0\u1edfng khoa Tim m\u1ea1ch C\u1ea5p c\u1ee9u v\u00e0 Can thi\u1ec7p B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t TPHCM cho r\u1eb1ng, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p tr\u00ean ng\u01b0\u1eddi cao tu\u1ed5i g\u1eb7p r\u1ea5t nhi\u1ec1u th\u00e1ch th\u1ee9c, b\u1edfi s\u1ef1 l\u00e3o h\u00f3a c\u1ee7a h\u1ec7 th\u1ed1ng tim m\u1ea1ch, \u0111\u1ed1i di\u1ec7n v\u1edbi h\u1ed9i ch\u1ee9ng l\u00e3o khoa, t\u00ecnh tr\u1ea1ng suy y\u1ebfu, g\u00e1nh n\u1eb7ng b\u1ec7nh \u0111\u1ed3ng m\u1eafc. Khi \u0111\u00f3, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb s\u1ebd c\u00e2n nh\u1eafc d\u1ef1a tr\u00ean l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, trong \u0111\u00f3 nguy c\u01a1 c\u1ee7a ng\u01b0\u1eddi cao tu\u1ed5i l\u00e0 huy\u1ebft kh\u1ed1i v\u00e0 ch\u1ea3y m\u00e1u.\u00a0<\/p>\n

Do v\u1eady, chuy\u00ean gia \u0111\u00e1nh gi\u00e1 ph\u00e1c \u0111\u1ed3 t\u1ed1i \u01b0u cho b\u1ec7nh nh\u00e2n \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng. Theo \u0111\u00f3, ti\u1ebfp c\u1eadn ban \u0111\u1ea7u trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u1ea7n d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng, ECG, men tim (hs-cTn) v\u00e0 ph\u00e2n t\u1ea7ng nguy c\u01a1, t\u1eeb \u0111\u00f3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd.\u00a0<\/p>\n

V\u1ec1 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb, c\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n nay \u0111\u1ec1u cho th\u1ea5y, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean, kh\u00f4ng d\u1ef1a v\u00e0o tu\u1ed5i m\u00e0 h\u1ea1n ch\u1ebf v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u cho b\u1ec7nh nh\u00e2n, thay v\u00e0o \u0111\u00f3 s\u1ebd \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ST ch\u00eanh l\u00ean. Tuy nhi\u00ean, ph\u1ea3i xem x\u00e9t c\u00e1c kh\u00eda c\u1ea1nh \u0111\u1ec3 ng\u0103n ng\u1eeba d\u1ef1 ph\u00f2ng nguy c\u01a1 c\u00f3 th\u1ec3 g\u1eb7p.\u00a0<\/p>\n

Trong khi \u0111\u00f3, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p kh\u00f4ng ST ch\u00eanh l\u00ean \u00e1p d\u1ee5ng chi\u1ebfn l\u01b0\u1ee3c ti\u1ebfp c\u1eadn ng\u01b0\u1eddi cao tu\u1ed5i t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng cao tu\u1ed5i. Song, tu\u1ed5i c\u00e0ng cao c\u00e0ng l\u00e0m gia t\u0103ng nguy c\u01a1 t\u1eed vong, do \u0111\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u s\u1edbm cho b\u1ec7nh nh\u00e2n hay tr\u00ec ho\u00e3n ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c ph\u00e2n t\u1ea7ng nguy c\u01a1. N\u1ebfu nguy c\u01a1 r\u1ea5t cao, c\u1ea7n t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 2 gi\u1edd. Nguy c\u01a1 cao trung b\u00ecnh t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 24 gi\u1edd. Nguy c\u01a1 th\u1ea5p h\u01a1n, tr\u00ec ho\u00e3n.\u00a0<\/p>\n

Chuy\u00ean gia c\u0169ng luu \u00fd, c\u1ea7n xem x\u00e9t t\u00ecnh tr\u1ea1ng suy y\u1ebfu c\u1ee7a b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, n\u1ebfu c\u00f3 c\u1ea7n ph\u1ea3i \u0111\u1eb7t l\u00ean b\u00e0n c\u00e2n gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, \u0111\u1ec3 \u0111\u01b0a ra chi\u1ebfn l\u01b0\u1ee3c ph\u00f9 h\u1ee3p. Hi\u1ec7n c\u00f3 r\u1ea5t nhi\u1ec1u thang \u0111i\u1ec3m \u0111\u1ec3 ph\u00e2n t\u1ea7ng nguy c\u01a1 ch\u1ea3y m\u00e1u tr\u00ean ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, nh\u01b0ng g\u1ea7n \u0111\u00e2y ARC – HBR (2019) \u0111\u01b0\u1ee3c \u0111\u1ed3ng thu\u1eadn nh\u1ea5t.<\/p>\n

<\/p>\n

PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n \u0111\u1ec1 c\u1eadp th\u00eam, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u b\u1eb1ng can thi\u1ec7p hay ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh nh\u00e2n, gi\u1ea3i ph\u1eabu m\u1ea1ch v\u00e0nh, nguy\u1ec7n v\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n. N\u1ebfu ch\u1ecdn l\u1ef1a chi\u1ebfn l\u01b0\u1ee3c can thi\u1ec7p, khuy\u1ebfn c\u00e1o l\u00e0 ph\u1ee5 thu\u1ed9c b\u1ed1i c\u1ea3nh l\u00e2m s\u00e0ng, lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng, tuy nhi\u00ean \u0111a s\u1ed1 \u0111\u1ec1u l\u00e0 stent ph\u1ee7 thu\u1ed1c.<\/p>\n

Chuy\u00ean gia n\u00f3i th\u00eam, \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng huy\u1ebft kh\u1ed1i (kh\u00e1ng \u0111\u00f4ng v\u00e0 kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u) ch\u00fa \u00fd thay \u0111\u1ed5i ph\u00e1c \u0111\u1ed3 tr\u00ean t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 (n\u1ed9i khoa, x\u00e2m l\u1ea5n v\u00e0\/ ho\u1eb7c c\u00f3 rung nh\u0129 hay kh\u00f4ng). V\u1ea5n \u0111\u1ec1 quan tr\u1ecdng h\u01a1n l\u00e0, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i ph\u1ea3i c\u00e2n nh\u1eafc nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 nguy c\u01a1 xu\u1ea5t huy\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i s\u1ebd \u01b0u ti\u00ean nguy c\u01a1 xu\u1ea5t huy\u1ebft h\u01a1n nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, b\u1edfi v\u00ec n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 xu\u1ea5t huy\u1ebft th\u00ec kh\u00f4ng th\u1ec3 d\u00f9ng t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c kh\u00e1c.\u00a0<\/p>\n

Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i, chi\u1ebfn l\u01b0\u1ee3c n\u00e0o t\u1ed1i \u01b0u?<\/h2>\n

<\/div>\n

BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean<\/p>\n

V\u1edbi b\u00e0i b\u00e1o c\u00e1o \u201cCan thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i: T\u1eeb l\u00fd thuy\u1ebft \u0111\u1ebfn th\u1ef1c ti\u1ec5n l\u00e2m s\u00e0ng<\/strong>\u201d – BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean – Ph\u00f3 khoa Tim m\u1ea1ch Can thi\u1ec7p – B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft, th\u00e2n chung v\u00e0nh tr\u00e1i cung c\u1ea5p m\u00e1u cho ph\u1ea7n l\u1edbn c\u01a1 tim th\u1ea5t tr\u00e1i (75-100%), do v\u1eady h\u1eb9p n\u1eb7ng th\u00e2n chung s\u1ebd \u0111\u1eb7t th\u1ea5t tr\u00e1i v\u00e0o nguy c\u01a1 cao.\u00a0<\/p>\n

H\u1eb9p th\u00e2n chung th\u01b0\u1eddng c\u00f3 k\u00e8m theo h\u1eb9p nhi\u1ec1u nh\u00e1nh m\u1ea1ch v\u00e0nh v\u00e0 h\u1eb9p th\u00e2n chung \u0111\u01a1n \u0111\u1ed9c ch\u1ec9 x\u1ea3y ra \u1edf 4-6%. H\u1eb9p th\u00e2n chung c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf l\u1ed7 (23%), \u0111o\u1ea1n gi\u1eefa (15%) v\u00e0 \u0111i\u1ec1u kh\u00f4ng may l\u00e0 v\u1ecb tr\u00ed kh\u00f3 nh\u1ea5t l\u1ea1i chi\u1ebfm t\u1ef7 l\u1ec7 h\u1eb9p nhi\u1ec1u nh\u1ea5t, \u0111\u00f3 l\u00e0 \u0111o\u1ea1n xa (61%). T\u00f9y thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1eb9p, c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 kh\u00e1c nhau.\u00a0<\/p>\n

BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean khuy\u1ebfn ngh\u1ecb, \u0111\u1ed1i v\u1edbi sang th\u01b0\u01a1ng th\u00e2n chung, khi c\u00f3 m\u1ed9t h\u1eb9p th\u00e2n chung \u1edf c\u1ea3 3 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng c\u00f3 khuynh h\u01b0\u1edbng ch\u1ecdn l\u1ef1a ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u n\u1ed1i \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, trong khi n\u1ebfu ch\u1ec9 h\u1eb9p \u0111\u01a1n gi\u1ea3n \u1edf l\u1ed7, \u1edf th\u00e2n ho\u1eb7c h\u1eb9p 1 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng s\u1ebd ch\u1ecdn l\u1ef1a can thi\u1ec7p m\u1ea1ch v\u00e0nh qua da.\u00a0<\/p>\n

\u0110\u1ec3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n, H\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3, H\u1ed9i Tim m\u1ea1ch ch\u00e2u \u00c2u \u0111\u1ec1u nh\u1eadn \u0111\u1ecbnh vai tr\u00f2 quan tr\u1ecdng c\u1ee7a si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Qua k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i, \u0111\u01b0\u1eddng k\u00ednh v\u00e0 v\u1ecb tr\u00ed, t\u00ednh ch\u1ea5t c\u1ee7a sang th\u01b0\u01a1ng th\u00e2n chung c\u0169ng nh\u01b0 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, t\u1ed1i \u01b0u h\u00f3a k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb sau \u0111\u00f3.\u00a0<\/p>\n

Tuy nhi\u00ean, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean c\u0169ng \u0111\u1ec1 c\u1eadp, kh\u00f4ng ph\u1ea3i trung t\u00e2m n\u00e0o c\u0169ng \u0111\u01b0\u1ee3c trang b\u1ecb si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Do v\u1eady, m\u1eb7c d\u00f9 kh\u00f4ng th\u1ec3 thay th\u1ebf cho h\u00ecnh \u1ea3nh si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch, song chuy\u00ean gia \u0111\u01b0a ra g\u1ee3i \u00fd c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng d\u1ea5u hi\u1ec7u POT – PUFF \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u00ecnh tr\u1ea1ng stent kh\u00f4ng \u00e1p s\u00e1t, v\u1edbi t\u00ednh \u0111\u1eb7c hi\u1ec7u v\u00e0 gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n \u00e2m t\u00ednh tr\u00ean 90%.<\/p>\n

Qua c\u00e1c nghi\u00ean c\u1ee9u, chuy\u00ean gia cho bi\u1ebft th\u00eam, n\u1ebfu v\u1ecb tr\u00ed h\u1eb9p th\u00e2n chung \u1edf \u0111o\u1ea1n sau, c\u00f3 li\u00ean quan \u0111\u1ebfn nh\u00e1nh chia, trong tr\u01b0\u1eddng h\u1ee3p \u0111\u01a1n gi\u1ea3n s\u1ebd s\u1eed d\u1ee5ng 1 stent ch\u1edd (\u0111\u1eb7t 1 stent b\u0103ng qua sang th\u01b0\u01a1ng v\u00e0 ki\u1ec3m tra t\u00ecnh tr\u1ea1ng ch\u1eb9n g\u00e2y m\u1ea5t d\u00f2ng c\u1ee7a nh\u00e1nh b\u00ean, n\u1ebfu c\u00f3 th\u00ec \u0111\u1eb7t stent th\u1ee9 2). Trong tr\u01b0\u1eddng h\u1ee3p sang th\u01b0\u01a1ng chia \u0111\u00f4i ph\u1ee9c t\u1ea1p, n\u00ean l\u1ef1a ch\u1ecdn chi\u1ebfn l\u01b0\u1ee3c \u0111\u1eb7t 2 stent ngay t\u1eeb \u0111\u1ea7u v\u00e0 \u01b0u ti\u00ean k\u1ef9 thu\u1eadt DK-Crush (\u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt t\u1ea1p b\u1eadc nh\u1ea5t trong tim m\u1ea1ch can thi\u1ec7p, \u0111\u00f2i h\u1ecfi r\u1ea5t nhi\u1ec1u kinh nghi\u1ec7m) ho\u1eb7c 2 k\u1ef9 thu\u1eadt \u0111\u01a1n gi\u1ea3n h\u01a1n, bao g\u1ed3m Culotte v\u00e0 TAP (T and Protrusion).<\/p>\n

Cu\u1ed1i c\u00f9ng, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean nh\u1ea5n m\u1ea1nh, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1eb9p th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i ph\u1ea3i \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi m\u1ed9t h\u1ed9i \u0111\u1ed3ng chuy\u00ean gia g\u1ed3m c\u00f3 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt tim, n\u1ed9i tim m\u1ea1ch v\u00e0 tim m\u1ea1ch can thi\u1ec7p. Qua \u0111\u00f3 \u0111\u00e1nh gi\u00e1 c\u1ea9n tr\u1ecdng d\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ea3 n\u0103ng t\u00e1i th\u00f4ng ho\u00e0n to\u00e0n, t\u1ef7 l\u1ec7 t\u1eed vong, nguy\u1ec7n v\u1ecdng c\u1ee7a gia \u0111\u00ecnh\u2026<\/p>\n

<\/div>\n

BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng<\/p>\n

H\u1ed9i ngh\u1ecb Khoa h\u1ecdc th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i n\u0103m 2023 kh\u00f4ng ch\u1ec9 cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c c\u1eadp nh\u1eadt m\u00e0 c\u00f2n l\u00e0 di\u1ec5n \u0111\u00e0n uy t\u00edn \u0111\u1ec3 trao \u0111\u1ed5i v\u1ec1 h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ngay t\u1ea1i b\u1ec7nh vi\u1ec7n. \u00a0<\/p>\n

Trong phi\u00ean to\u00e0n th\u1ec3, 3 nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y v\u1edbi nhi\u1ec1u th\u00f4ng tin th\u00fa v\u1ecb. BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng – Tr\u01b0\u1edfng \u0110\u01a1n v\u1ecb Ch\u1ea5n th\u01b0\u01a1ng Ch\u1ec9nh h\u00ecnh – Khoa Ngo\u1ea1i t\u1ed5ng h\u1ee3p – B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i v\u1edbi nghi\u00ean c\u1ee9u\u00a0B\u01b0\u1edbc \u0111\u1ea7u \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng<\/strong>\u00a0th\u1ef1c hi\u1ec7n tr\u00ean 34 b\u1ec7nh nh\u00e2n, tu\u1ed5i nh\u1ecf nh\u1ea5t 44 tu\u1ed5i, l\u1edbn nh\u1ea5t 86 tu\u1ed5i.\u00a0<\/p>\n

Qua nghi\u00ean c\u1ee9u, chuy\u00ean gia cho r\u1eb1ng, m\u1eb7c d\u00f9 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng to\u00e0n ph\u1ea7n v\u00e0 b\u00e1n ph\u1ea7n kh\u00f4ng xi m\u0103ng t\u1ea1i b\u1ec7nh vi\u1ec7n mang l\u1ea1i k\u1ebft qu\u1ea3 ban \u0111\u1ea7u t\u1ed1t cho b\u1ec7nh nh\u00e2n, tuy nhi\u00ean c\u1ea7n ti\u1ebfp t\u1ee5c theo d\u00f5i trong th\u1eddi gian d\u00e0i h\u01a1n nh\u1eb1m ph\u00e1t hi\u1ec7n nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra mu\u1ed9n nhi\u1ec1u n\u0103m sau ph\u1eabu thu\u1eadt.<\/p>\n

<\/div>\n

BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n<\/p>\n

V\u1edbi nghi\u00ean c\u1ee9u \u201cK\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh \u1edf B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i<\/strong>\u201d – BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n – Ph\u00f3 Tr\u01b0\u1edfng khoa Tim m\u1ea1ch 1 c\u1ee7a b\u1ec7nh vi\u1ec7n \u0111\u1eb7t v\u1ea5n \u0111\u1ec1 cho th\u1ea5y, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh g\u1ea7n \u0111\u00e2y c\u00f3 xu h\u01b0\u1edbng t\u0103ng v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u1ee9c t\u1ea1p c\u1ee7a b\u1ec7nh, \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 n\u1eb7ng. Can thi\u1ec7p n\u1ed9i m\u1ea1ch l\u00e0 h\u01b0\u1edbng ti\u1ebfp c\u1eadn m\u1edbi \u00edt x\u00e2m l\u1ea5n, hi\u1ec7u qu\u1ea3 cao, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ng\u1eafn, h\u1ed3i ph\u1ee5c s\u1edbm.\u00a0<\/p>\n

Nghi\u00ean c\u1ee9u th\u1ef1c hi\u1ec7n tr\u00ean 22 tr\u01b0\u1eddng h\u1ee3p, trong \u0111\u00f3 c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, 91% t\u0103ng huy\u1ebft \u00e1p, 82% \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, 73% r\u1ed1i lo\u1ea1n lipid m\u00e1u, 73% h\u00fat thu\u1ed1c l\u00e1. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a th\u1ee7 thu\u1eadt l\u00e0 91% (20\/11), trong \u0111\u00f3 can thi\u1ec7p \u0111\u1eb7t stent 82% (18\/22), nong b\u00f3ng \u0111\u01a1n thu\u1ea7n 9% (2\/22).\u00a0<\/p>\n

Qua nghi\u00ean c\u1ee9u ghi nh\u1eadn k\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u cho th\u1ea5y ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p n\u1ed9i m\u1ea1ch an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 cao trong \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh, ch\u01b0a ghi nh\u1eadn c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng nh\u01b0 t\u1eed vong, nh\u1ed3i m\u00e1u c\u01a1 tim, tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, ch\u1ea3y m\u00e1u n\u1eb7ng ph\u1ea3i truy\u1ec1n m\u00e1u.\u00a0<\/p>\n

<\/div>\n

BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng\u00a0<\/p>\n

\u201cNghi\u00ean c\u1ee9u hi\u1ec7u qu\u1ea3 c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi k\u1ebft h\u1ee3p nong nh\u00fa vater b\u1eb1ng b\u00f3ng trong \u0111i\u1ec1u tr\u1ecb s\u1ecfi m\u1eadt t\u1ea1i B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i<\/strong>\u201d t\u1eeb BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng – Tr\u01b0\u1edfng khoa N\u1ed9i soi c\u1ee7a b\u1ec7nh vi\u1ec7n c\u0169ng cung c\u1ea5p g\u00f3c nh\u00ecn khoa h\u1ecdc h\u1ea5p d\u1eabn.\u00a0<\/p>\n

Nghi\u00ean c\u1ee9u m\u00f4 t\u1ea3 c\u1eaft ngang 38 b\u1ec7nh nh\u00e2n, ng\u01b0\u1eddi c\u00f3 tr\u00ean 2 vi\u00ean s\u1ecfi chi\u1ebfm 35,2%, k\u00edch th\u01b0\u1edbc s\u1ecfi trung b\u00ecnh 13,39 \u00b1 2,86mm, \u0111\u01b0\u1eddng k\u00ednh s\u1ecfi \u1ed1ng m\u1eadt ch\u1ee7 (OMC) trung b\u00ecnh 16,53 \u00b1 3,51mm, can thi\u1ec7p th\u00e0nh c\u00f4ng l\u1ea7n 1 l\u00e0 89,5%, t\u00e1n s\u1ecfi c\u01a1 h\u1ecdc 10,5% v\u00e0 can thi\u1ec7p l\u1ea7n 2 l\u00e0 5,2%. Bi\u1ebfn ch\u1ee9ng vi\u00eam t\u1ee5y c\u1ea5p 5,2%. \u00a0<\/p>\n

BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng cho r\u1eb1ng, n\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng k\u1ebft h\u1ee3p c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi v\u00e0 nong nh\u00fa Vater \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 s\u1ecfi OMC l\u1edbn v\u1edbi t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng cao, bi\u1ebfn ch\u1ee9ng th\u1ea5p.\u00a0<\/p>\n

Ngu\u1ed3n t\u1eeb : AloBacsi<\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8,7],"tags":[],"class_list":["post-3193","post","type-post","status-publish","format-standard","hentry","category-hoat-dong-benh-vien","category-tin-tuc"],"blocksy_meta":[],"acf":[],"yoast_head":"\nXu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bvnguyentrai.org.vn\/en\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i\" \/>\n<meta property=\"og:description\" content=\"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21; C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i; Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i c\u00f9ng h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng, can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh\u2026 l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c c\u00e1c chuy\u00ean gia b\u00e0n lu\u1eadn trong Phi\u00ean to\u00e0n th\u1ec3 c\u1ee7a H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt 2023 do B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i t\u1ed5 ch\u1ee9c. H\u1ed9i ngh\u1ecb \u0111\u01b0\u1ee3c t\u1ed5 ch\u1ee9c v\u00e0o ng\u00e0y 24\/8\/2023\u00a0v\u1eeba qua \u0111\u00e1nh d\u1ea5u c\u1ed9t m\u1ed1c l\u1ea7n \u0111\u1ea7u ti\u00ean B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i ghi nh\u1eadn ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 1.000. Trong 40 b\u00e0i b\u00e1o c\u00e1o ch\u1ea5t l\u01b0\u1ee3ng t\u1eeb c\u00e1c chuy\u00ean gia, gi\u1ea3ng vi\u00ean xuy\u00ean su\u1ed1t tr\u00ean 5 phi\u00ean (t\u1eeb N\u1ed9i khoa, Ngo\u1ea1i Khoa, \u0110i\u1ec1u d\u01b0\u1ee1ng), phi\u00ean To\u00e0n th\u1ec3 v\u1edbi 8 b\u00e0i b\u00e1o c\u00e1o \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe n\u1ed5i tr\u1ed9i c\u0169ng nh\u01b0 l\u00e0 th\u1ebf m\u1ea1nh, m\u0169i nh\u1ecdn m\u00e0 b\u1ec7nh vi\u1ec7n h\u01b0\u1edbng \u0111\u1ebfn trong n\u0103m 2023.\u00a0 H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i thu h\u00fat h\u01a1n 1.000 ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 5 phi\u00ean Ch\u1ee7 t\u1ecda \u0111o\u00e0n phi\u00ean To\u00e0n th\u1ec3 Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21\u00a0 Trong b\u00e0i b\u00e1o c\u00e1o \u201cCh\u1ee7ng ng\u1eeba cho c\u1ea3 gia \u0111\u00ecnh\u201d - PGS.TS.BS Ph\u1ea1m L\u00ea An - Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM, Tr\u01b0\u1edfng Trung t\u00e2m B\u00e1c s\u0129 gia \u0111\u00ecnh - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM nh\u1ea5n m\u1ea1nh, vi\u1ec7c ch\u1ee7ng ng\u1eeba cho tr\u1ebb em \u0111\u00e3 mang l\u1ea1i nh\u1eefng gi\u00e1 tr\u1ecb ngo\u1ea1n m\u1ee5c, h\u1eb1ng n\u0103m gi\u00fap d\u1ef1 ph\u00f2ng 3 tri\u1ec7u ca t\u1eed vong v\u00e0 750.000 tr\u1ebb kh\u00f4ng b\u1ecb t\u00e0n ph\u1ebf. Cho \u0111\u1ebfn nay \u0111\u00e3 c\u00f3 26 b\u1ec7nh \u0111\u01b0\u1ee3c d\u1ef1 ph\u00f2ng b\u1edfi thu\u1ed1c ti\u00eam ch\u1ee7ng.\u00a0 Tuy v\u1eady, chuy\u00ean gia n\u00eau l\u00ean th\u1ef1c t\u1ebf, ch\u1ee7ng ng\u1eeba tr\u00ean to\u00e0n th\u1ebf gi\u1edbi nh\u1eb1m v\u00e0o tr\u1ebb em, song \u0111i\u1ec1u n\u00e0y ch\u01b0a ho\u00e0n to\u00e0n ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u00e1c b\u1ec7nh ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng v\u1eafc xin \u1edf v\u1ecb th\u00e0nh ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn ngay c\u1ea3 khi \u0111\u1ea1t t\u1ef7 l\u1ec7 bao ph\u1ee7 cao \u1edf tr\u1ebb em. Do v\u1eady, trong th\u1ebf k\u1ef7 21, khuynh h\u01b0\u1edbng ch\u1ee7ng ng\u1eeba c\u1ed5 \u0111i\u1ec3n ch\u1ec9 \u1edf tr\u1ebb em \u0111\u00e3 ph\u00e1t tri\u1ec3n r\u1ed9ng th\u00e0nh ch\u1ee7ng ng\u1eeba cho m\u1ecdi l\u1ee9a tu\u1ed5i nh\u01b0 v\u1ecb th\u00e0nh ni\u00ean, thai k\u1ef3, ng\u01b0\u1eddi cao tu\u1ed5i, nh\u00f3m b\u1ec7nh m\u00e3n t\u00ednh\u2026 PGS.TS.BS Ph\u1ea1m L\u00ea An - Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM Xu h\u01b0\u1edbng m\u1edbi trong ti\u00eam ng\u1eeba c\u0169ng \u0111\u01b0\u1ee3c PGS.TS.BS Ph\u1ea1m L\u00ea An \u0111\u1ec1 c\u1eadp. Hi\u1ec7n nay v\u1eafc xin \u0111\u00e3 g\u1ed9p nhi\u1ec1u th\u00e0nh ph\u1ea7n trong 1 s\u1ea3n ph\u1ea9m \u0111\u1ec3 b\u1ea3o v\u1ec7 \u0111\u01b0\u1ee3c nhi\u1ec1u b\u1ec7nh ho\u1eb7c nhi\u1ec1u ch\u1ee7ng vi sinh v\u1eadt c\u1ee7a m\u1ed9t b\u1ec7nh, gi\u00fap gi\u1ea3m s\u1ed1 m\u0169i ti\u00eam v\u1eafc xin v\u00e0 b\u1ed5 sung nhanh s\u1ed1 m\u0169i v\u1eafc xin \u0111\u1ed1i v\u1edbi nh\u1eefng tr\u1ebb ch\u1ee7ng ng\u1eeba mu\u1ed9n.\u00a0 Trong khi \u0111\u00f3, ch\u1ee7ng ng\u1eeba \u1edf tr\u1ebb em \u0111\u00e3 c\u00f3 s\u1ef1 kh\u1edfi \u0111\u1ea7u c\u1ee7a v\u1eafc xin vi\u00eam gan si\u00eau vi A, B; v\u1eafc xin Hib; v\u1eafc xin b\u1ea1i li\u1ec7t chuy\u1ec3n t\u1eeb d\u1ea1ng u\u1ed1ng (OPV) sang d\u1ea1ng ti\u00eam (IPV); c\u00e1c d\u1ea1ng v\u1eafc xin li\u00ean h\u1ee3p m\u1edbi (vi\u00eam m\u00e0ng n\u00e3o pneumococcal v\u00e0 group C), \u0111\u1ed3ng th\u1eddi c\u00e1c nh\u00e0 s\u1ea3n s\u1ea3n xu\u1ea5t l\u1edbn \u0111\u00e3 ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i v\u1eafc xin \u0111a gi\u00e1 5 trong 1 \u0111\u1ebfn 6 trong 1. Ngo\u00e0i ra, theo khuy\u1ebfn c\u00e1o c\u1ee7a WHO (2019) c\u0169ng cho th\u1ea5y, c\u1ea7n ti\u00eam b\u1ed5 sung DTwP\/DtaP & Tdap\/Td trong tr\u01b0\u1eddng h\u1ee3p b\u1ecb tr\u00ec ho\u00e3n.\u00a0 Vi\u1ec7c thay th\u1ebf v\u1eafc xin (v\u00e0i thu\u1ed1c ch\u1ee7ng ng\u1eeba t\u1eeb c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t kh\u00e1c nhau nh\u1eb1m b\u1ea3o v\u1ec7 c\u00f9ng m\u1ed9t t\u00e1c nh\u00e2n) c\u0169ng r\u1ea5t c\u1ea7n thi\u1ebft khi c\u00f3 s\u1ef1 thi\u1ebfu h\u1ee5t (nh\u01b0 HepB v\u00e0 Hib). Chuy\u00ean gia l\u1ea5y v\u00ed d\u1ee5 th\u1ef1c t\u1ebf nh\u01b0 thu\u1ed1c ch\u1ee7ng k\u1ebft h\u1ee3p v\u1edbi th\u00e0nh ph\u1ea7n kh\u00e1ng nguy\u00ean c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t (nh\u01b0 DTaP, DtaP-Hib, hay c\u00e1c DtaP kh\u00e1c trong c\u00e1c v\u1eafc xin k\u1ebft h\u1ee3p c\u00f3 ch\u1ee9a c\u00f9ng kh\u00e1ng nguy\u00ean v\u00f4 b\u00e0o ho g\u00e0 t\u1eeb c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thay th\u1ebf cho nhau. Cu\u1ed1i c\u00f9ng PGS.TS.BS Ph\u1ea1m L\u00ea An l\u01b0u \u00fd, kh\u00f4ng s\u1eed d\u1ee5ng v\u1eafc xin v\u1edbi kho\u1ea3ng c\u00e1ch \u00edt h\u01a1n th\u1eddi gian t\u1ed1i thi\u1ec3u quy \u0111\u1ecbnh hay s\u1eed d\u1ee5ng s\u1edbm h\u01a1n tu\u1ed5i \u0111\u1ec1 ngh\u1ecb. Li\u1ec1u v\u1eafc xin \u0111\u01b0\u1ee3c cho s\u1edbm \u2264 4 ng\u00e0y so v\u1edbi kho\u1ea3ng c\u00e1ch t\u1ed1i thi\u1ec3u hay v\u1edbi tu\u1ed5i quy \u0111\u1ecbnh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ednh l\u00e0 li\u1ec1u h\u1ee3p l\u1ec7, nh\u01b0ng nguy\u00ean t\u1eafc n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho v\u1eafc xin s\u1ed1ng. T\u0103ng kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c li\u1ec1u v\u1edbi v\u1eafc xin c\u1ea7n nhi\u1ec1u li\u1ec1u ti\u00eam kh\u00f4ng l\u00e0m gi\u1ea3m t\u00ednh hi\u1ec7u qu\u1ea3 c\u1ee7a v\u1eafc xin v\u00e0 kh\u00f4ng ti\u00eam l\u1ea1i t\u1eeb \u0111\u1ea7u n\u1ebfu b\u1ecf s\u00f3t.\u00a0 Ti\u1ebfp c\u1eadn v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i, \u0111\u00e2u l\u00e0 th\u00e1ch th\u1ee9c? PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n chia s\u1ebb v\u1ec1 C\u1eadp nh\u1eadt tron ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n - Tr\u01b0\u1edfng B\u1ed9 m\u00f4n L\u00e3o khoa, khoa Y Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM, Tr\u01b0\u1edfng khoa Tim m\u1ea1ch C\u1ea5p c\u1ee9u v\u00e0 Can thi\u1ec7p B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t TPHCM cho r\u1eb1ng, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p tr\u00ean ng\u01b0\u1eddi cao tu\u1ed5i g\u1eb7p r\u1ea5t nhi\u1ec1u th\u00e1ch th\u1ee9c, b\u1edfi s\u1ef1 l\u00e3o h\u00f3a c\u1ee7a h\u1ec7 th\u1ed1ng tim m\u1ea1ch, \u0111\u1ed1i di\u1ec7n v\u1edbi h\u1ed9i ch\u1ee9ng l\u00e3o khoa, t\u00ecnh tr\u1ea1ng suy y\u1ebfu, g\u00e1nh n\u1eb7ng b\u1ec7nh \u0111\u1ed3ng m\u1eafc. Khi \u0111\u00f3, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb s\u1ebd c\u00e2n nh\u1eafc d\u1ef1a tr\u00ean l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, trong \u0111\u00f3 nguy c\u01a1 c\u1ee7a ng\u01b0\u1eddi cao tu\u1ed5i l\u00e0 huy\u1ebft kh\u1ed1i v\u00e0 ch\u1ea3y m\u00e1u.\u00a0 Do v\u1eady, chuy\u00ean gia \u0111\u00e1nh gi\u00e1 ph\u00e1c \u0111\u1ed3 t\u1ed1i \u01b0u cho b\u1ec7nh nh\u00e2n \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng. Theo \u0111\u00f3, ti\u1ebfp c\u1eadn ban \u0111\u1ea7u trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u1ea7n d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng, ECG, men tim (hs-cTn) v\u00e0 ph\u00e2n t\u1ea7ng nguy c\u01a1, t\u1eeb \u0111\u00f3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd.\u00a0 V\u1ec1 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb, c\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n nay \u0111\u1ec1u cho th\u1ea5y, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean, kh\u00f4ng d\u1ef1a v\u00e0o tu\u1ed5i m\u00e0 h\u1ea1n ch\u1ebf v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u cho b\u1ec7nh nh\u00e2n, thay v\u00e0o \u0111\u00f3 s\u1ebd \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ST ch\u00eanh l\u00ean. Tuy nhi\u00ean, ph\u1ea3i xem x\u00e9t c\u00e1c kh\u00eda c\u1ea1nh \u0111\u1ec3 ng\u0103n ng\u1eeba d\u1ef1 ph\u00f2ng nguy c\u01a1 c\u00f3 th\u1ec3 g\u1eb7p.\u00a0 Trong khi \u0111\u00f3, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p kh\u00f4ng ST ch\u00eanh l\u00ean \u00e1p d\u1ee5ng chi\u1ebfn l\u01b0\u1ee3c ti\u1ebfp c\u1eadn ng\u01b0\u1eddi cao tu\u1ed5i t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng cao tu\u1ed5i. Song, tu\u1ed5i c\u00e0ng cao c\u00e0ng l\u00e0m gia t\u0103ng nguy c\u01a1 t\u1eed vong, do \u0111\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u s\u1edbm cho b\u1ec7nh nh\u00e2n hay tr\u00ec ho\u00e3n ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c ph\u00e2n t\u1ea7ng nguy c\u01a1. N\u1ebfu nguy c\u01a1 r\u1ea5t cao, c\u1ea7n t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 2 gi\u1edd. Nguy c\u01a1 cao trung b\u00ecnh t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 24 gi\u1edd. Nguy c\u01a1 th\u1ea5p h\u01a1n, tr\u00ec ho\u00e3n.\u00a0 Chuy\u00ean gia c\u0169ng luu \u00fd, c\u1ea7n xem x\u00e9t t\u00ecnh tr\u1ea1ng suy y\u1ebfu c\u1ee7a b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, n\u1ebfu c\u00f3 c\u1ea7n ph\u1ea3i \u0111\u1eb7t l\u00ean b\u00e0n c\u00e2n gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, \u0111\u1ec3 \u0111\u01b0a ra chi\u1ebfn l\u01b0\u1ee3c ph\u00f9 h\u1ee3p. Hi\u1ec7n c\u00f3 r\u1ea5t nhi\u1ec1u thang \u0111i\u1ec3m \u0111\u1ec3 ph\u00e2n t\u1ea7ng nguy c\u01a1 ch\u1ea3y m\u00e1u tr\u00ean ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, nh\u01b0ng g\u1ea7n \u0111\u00e2y ARC - HBR (2019) \u0111\u01b0\u1ee3c \u0111\u1ed3ng thu\u1eadn nh\u1ea5t. PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n \u0111\u1ec1 c\u1eadp th\u00eam, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u b\u1eb1ng can thi\u1ec7p hay ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh nh\u00e2n, gi\u1ea3i ph\u1eabu m\u1ea1ch v\u00e0nh, nguy\u1ec7n v\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n. N\u1ebfu ch\u1ecdn l\u1ef1a chi\u1ebfn l\u01b0\u1ee3c can thi\u1ec7p, khuy\u1ebfn c\u00e1o l\u00e0 ph\u1ee5 thu\u1ed9c b\u1ed1i c\u1ea3nh l\u00e2m s\u00e0ng, lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng, tuy nhi\u00ean \u0111a s\u1ed1 \u0111\u1ec1u l\u00e0 stent ph\u1ee7 thu\u1ed1c. Chuy\u00ean gia n\u00f3i th\u00eam, \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng huy\u1ebft kh\u1ed1i (kh\u00e1ng \u0111\u00f4ng v\u00e0 kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u) ch\u00fa \u00fd thay \u0111\u1ed5i ph\u00e1c \u0111\u1ed3 tr\u00ean t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 (n\u1ed9i khoa, x\u00e2m l\u1ea5n v\u00e0\/ ho\u1eb7c c\u00f3 rung nh\u0129 hay kh\u00f4ng). V\u1ea5n \u0111\u1ec1 quan tr\u1ecdng h\u01a1n l\u00e0, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i ph\u1ea3i c\u00e2n nh\u1eafc nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 nguy c\u01a1 xu\u1ea5t huy\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i s\u1ebd \u01b0u ti\u00ean nguy c\u01a1 xu\u1ea5t huy\u1ebft h\u01a1n nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, b\u1edfi v\u00ec n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 xu\u1ea5t huy\u1ebft th\u00ec kh\u00f4ng th\u1ec3 d\u00f9ng t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c kh\u00e1c.\u00a0 Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i, chi\u1ebfn l\u01b0\u1ee3c n\u00e0o t\u1ed1i \u01b0u? BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean V\u1edbi b\u00e0i b\u00e1o c\u00e1o \u201cCan thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i: T\u1eeb l\u00fd thuy\u1ebft \u0111\u1ebfn th\u1ef1c ti\u1ec5n l\u00e2m s\u00e0ng\u201d - BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean - Ph\u00f3 khoa Tim m\u1ea1ch Can thi\u1ec7p - B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft, th\u00e2n chung v\u00e0nh tr\u00e1i cung c\u1ea5p m\u00e1u cho ph\u1ea7n l\u1edbn c\u01a1 tim th\u1ea5t tr\u00e1i (75-100%), do v\u1eady h\u1eb9p n\u1eb7ng th\u00e2n chung s\u1ebd \u0111\u1eb7t th\u1ea5t tr\u00e1i v\u00e0o nguy c\u01a1 cao.\u00a0 H\u1eb9p th\u00e2n chung th\u01b0\u1eddng c\u00f3 k\u00e8m theo h\u1eb9p nhi\u1ec1u nh\u00e1nh m\u1ea1ch v\u00e0nh v\u00e0 h\u1eb9p th\u00e2n chung \u0111\u01a1n \u0111\u1ed9c ch\u1ec9 x\u1ea3y ra \u1edf 4-6%. H\u1eb9p th\u00e2n chung c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf l\u1ed7 (23%), \u0111o\u1ea1n gi\u1eefa (15%) v\u00e0 \u0111i\u1ec1u kh\u00f4ng may l\u00e0 v\u1ecb tr\u00ed kh\u00f3 nh\u1ea5t l\u1ea1i chi\u1ebfm t\u1ef7 l\u1ec7 h\u1eb9p nhi\u1ec1u nh\u1ea5t, \u0111\u00f3 l\u00e0 \u0111o\u1ea1n xa (61%). T\u00f9y thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1eb9p, c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 kh\u00e1c nhau.\u00a0 BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean khuy\u1ebfn ngh\u1ecb, \u0111\u1ed1i v\u1edbi sang th\u01b0\u01a1ng th\u00e2n chung, khi c\u00f3 m\u1ed9t h\u1eb9p th\u00e2n chung \u1edf c\u1ea3 3 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng c\u00f3 khuynh h\u01b0\u1edbng ch\u1ecdn l\u1ef1a ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u n\u1ed1i \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, trong khi n\u1ebfu ch\u1ec9 h\u1eb9p \u0111\u01a1n gi\u1ea3n \u1edf l\u1ed7, \u1edf th\u00e2n ho\u1eb7c h\u1eb9p 1 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng s\u1ebd ch\u1ecdn l\u1ef1a can thi\u1ec7p m\u1ea1ch v\u00e0nh qua da.\u00a0 \u0110\u1ec3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n, H\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3, H\u1ed9i Tim m\u1ea1ch ch\u00e2u \u00c2u \u0111\u1ec1u nh\u1eadn \u0111\u1ecbnh vai tr\u00f2 quan tr\u1ecdng c\u1ee7a si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Qua k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i, \u0111\u01b0\u1eddng k\u00ednh v\u00e0 v\u1ecb tr\u00ed, t\u00ednh ch\u1ea5t c\u1ee7a sang th\u01b0\u01a1ng th\u00e2n chung c\u0169ng nh\u01b0 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, t\u1ed1i \u01b0u h\u00f3a k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb sau \u0111\u00f3.\u00a0 Tuy nhi\u00ean, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean c\u0169ng \u0111\u1ec1 c\u1eadp, kh\u00f4ng ph\u1ea3i trung t\u00e2m n\u00e0o c\u0169ng \u0111\u01b0\u1ee3c trang b\u1ecb si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Do v\u1eady, m\u1eb7c d\u00f9 kh\u00f4ng th\u1ec3 thay th\u1ebf cho h\u00ecnh \u1ea3nh si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch, song chuy\u00ean gia \u0111\u01b0a ra g\u1ee3i \u00fd c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng d\u1ea5u hi\u1ec7u POT - PUFF \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u00ecnh tr\u1ea1ng stent kh\u00f4ng \u00e1p s\u00e1t, v\u1edbi t\u00ednh \u0111\u1eb7c hi\u1ec7u v\u00e0 gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n \u00e2m t\u00ednh tr\u00ean 90%. Qua c\u00e1c nghi\u00ean c\u1ee9u, chuy\u00ean gia cho bi\u1ebft th\u00eam, n\u1ebfu v\u1ecb tr\u00ed h\u1eb9p th\u00e2n chung \u1edf \u0111o\u1ea1n sau, c\u00f3 li\u00ean quan \u0111\u1ebfn nh\u00e1nh chia, trong tr\u01b0\u1eddng h\u1ee3p \u0111\u01a1n gi\u1ea3n s\u1ebd s\u1eed d\u1ee5ng 1 stent ch\u1edd (\u0111\u1eb7t 1 stent b\u0103ng qua sang th\u01b0\u01a1ng v\u00e0 ki\u1ec3m tra t\u00ecnh tr\u1ea1ng ch\u1eb9n g\u00e2y m\u1ea5t d\u00f2ng c\u1ee7a nh\u00e1nh b\u00ean, n\u1ebfu c\u00f3 th\u00ec \u0111\u1eb7t stent th\u1ee9 2). Trong tr\u01b0\u1eddng h\u1ee3p sang th\u01b0\u01a1ng chia \u0111\u00f4i ph\u1ee9c t\u1ea1p, n\u00ean l\u1ef1a ch\u1ecdn chi\u1ebfn l\u01b0\u1ee3c \u0111\u1eb7t 2 stent ngay t\u1eeb \u0111\u1ea7u v\u00e0 \u01b0u ti\u00ean k\u1ef9 thu\u1eadt DK-Crush (\u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt t\u1ea1p b\u1eadc nh\u1ea5t trong tim m\u1ea1ch can thi\u1ec7p, \u0111\u00f2i h\u1ecfi r\u1ea5t nhi\u1ec1u kinh nghi\u1ec7m) ho\u1eb7c 2 k\u1ef9 thu\u1eadt \u0111\u01a1n gi\u1ea3n h\u01a1n, bao g\u1ed3m Culotte v\u00e0 TAP (T and Protrusion). Cu\u1ed1i c\u00f9ng, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean nh\u1ea5n m\u1ea1nh, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1eb9p th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i ph\u1ea3i \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi m\u1ed9t h\u1ed9i \u0111\u1ed3ng chuy\u00ean gia g\u1ed3m c\u00f3 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt tim, n\u1ed9i tim m\u1ea1ch v\u00e0 tim m\u1ea1ch can thi\u1ec7p. Qua \u0111\u00f3 \u0111\u00e1nh gi\u00e1 c\u1ea9n tr\u1ecdng d\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ea3 n\u0103ng t\u00e1i th\u00f4ng ho\u00e0n to\u00e0n, t\u1ef7 l\u1ec7 t\u1eed vong, nguy\u1ec7n v\u1ecdng c\u1ee7a gia \u0111\u00ecnh\u2026 BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng H\u1ed9i ngh\u1ecb Khoa h\u1ecdc th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i n\u0103m 2023 kh\u00f4ng ch\u1ec9 cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c c\u1eadp nh\u1eadt m\u00e0 c\u00f2n l\u00e0 di\u1ec5n \u0111\u00e0n uy t\u00edn \u0111\u1ec3 trao \u0111\u1ed5i v\u1ec1 h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ngay t\u1ea1i b\u1ec7nh vi\u1ec7n. \u00a0 Trong phi\u00ean to\u00e0n th\u1ec3, 3 nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y v\u1edbi nhi\u1ec1u th\u00f4ng tin th\u00fa v\u1ecb. BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng - Tr\u01b0\u1edfng \u0110\u01a1n v\u1ecb Ch\u1ea5n th\u01b0\u01a1ng Ch\u1ec9nh h\u00ecnh - Khoa Ngo\u1ea1i t\u1ed5ng h\u1ee3p - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i v\u1edbi nghi\u00ean c\u1ee9u\u00a0B\u01b0\u1edbc \u0111\u1ea7u \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng\u00a0th\u1ef1c hi\u1ec7n tr\u00ean 34 b\u1ec7nh nh\u00e2n, tu\u1ed5i nh\u1ecf nh\u1ea5t 44 tu\u1ed5i, l\u1edbn nh\u1ea5t 86 tu\u1ed5i.\u00a0 Qua nghi\u00ean c\u1ee9u, chuy\u00ean gia cho r\u1eb1ng, m\u1eb7c d\u00f9 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng to\u00e0n ph\u1ea7n v\u00e0 b\u00e1n ph\u1ea7n kh\u00f4ng xi m\u0103ng t\u1ea1i b\u1ec7nh vi\u1ec7n mang l\u1ea1i k\u1ebft qu\u1ea3 ban \u0111\u1ea7u t\u1ed1t cho b\u1ec7nh nh\u00e2n, tuy nhi\u00ean c\u1ea7n ti\u1ebfp t\u1ee5c theo d\u00f5i trong th\u1eddi gian d\u00e0i h\u01a1n nh\u1eb1m ph\u00e1t hi\u1ec7n nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra mu\u1ed9n nhi\u1ec1u n\u0103m sau ph\u1eabu thu\u1eadt. BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n V\u1edbi nghi\u00ean c\u1ee9u \u201cK\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh \u1edf B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\u201d - BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n - Ph\u00f3 Tr\u01b0\u1edfng khoa Tim m\u1ea1ch 1 c\u1ee7a b\u1ec7nh vi\u1ec7n \u0111\u1eb7t v\u1ea5n \u0111\u1ec1 cho th\u1ea5y, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh g\u1ea7n \u0111\u00e2y c\u00f3 xu h\u01b0\u1edbng t\u0103ng v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u1ee9c t\u1ea1p c\u1ee7a b\u1ec7nh, \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 n\u1eb7ng. Can thi\u1ec7p n\u1ed9i m\u1ea1ch l\u00e0 h\u01b0\u1edbng ti\u1ebfp c\u1eadn m\u1edbi \u00edt x\u00e2m l\u1ea5n, hi\u1ec7u qu\u1ea3 cao, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ng\u1eafn, h\u1ed3i ph\u1ee5c s\u1edbm.\u00a0 Nghi\u00ean c\u1ee9u th\u1ef1c hi\u1ec7n tr\u00ean 22 tr\u01b0\u1eddng h\u1ee3p, trong \u0111\u00f3 c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, 91% t\u0103ng huy\u1ebft \u00e1p, 82% \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, 73% r\u1ed1i lo\u1ea1n lipid m\u00e1u, 73% h\u00fat thu\u1ed1c l\u00e1. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a th\u1ee7 thu\u1eadt l\u00e0 91% (20\/11), trong \u0111\u00f3 can thi\u1ec7p \u0111\u1eb7t stent 82% (18\/22), nong b\u00f3ng \u0111\u01a1n thu\u1ea7n 9% (2\/22).\u00a0 Qua nghi\u00ean c\u1ee9u ghi nh\u1eadn k\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u cho th\u1ea5y ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p n\u1ed9i m\u1ea1ch an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 cao trong \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh, ch\u01b0a ghi nh\u1eadn c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng nh\u01b0 t\u1eed vong, nh\u1ed3i m\u00e1u c\u01a1 tim, tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, ch\u1ea3y m\u00e1u n\u1eb7ng ph\u1ea3i truy\u1ec1n m\u00e1u.\u00a0 BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng\u00a0 \u201cNghi\u00ean c\u1ee9u hi\u1ec7u qu\u1ea3 c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi k\u1ebft h\u1ee3p nong nh\u00fa vater b\u1eb1ng b\u00f3ng trong \u0111i\u1ec1u tr\u1ecb s\u1ecfi m\u1eadt t\u1ea1i B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\u201d t\u1eeb BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng - Tr\u01b0\u1edfng khoa N\u1ed9i soi c\u1ee7a b\u1ec7nh vi\u1ec7n c\u0169ng cung c\u1ea5p g\u00f3c nh\u00ecn khoa h\u1ecdc h\u1ea5p d\u1eabn.\u00a0 Nghi\u00ean c\u1ee9u m\u00f4 t\u1ea3 c\u1eaft ngang 38 b\u1ec7nh nh\u00e2n, ng\u01b0\u1eddi c\u00f3 tr\u00ean 2 vi\u00ean s\u1ecfi chi\u1ebfm 35,2%, k\u00edch th\u01b0\u1edbc s\u1ecfi trung b\u00ecnh 13,39 \u00b1 2,86mm, \u0111\u01b0\u1eddng k\u00ednh s\u1ecfi \u1ed1ng m\u1eadt ch\u1ee7 (OMC) trung b\u00ecnh 16,53 \u00b1 3,51mm, can thi\u1ec7p th\u00e0nh c\u00f4ng l\u1ea7n 1 l\u00e0 89,5%, t\u00e1n s\u1ecfi c\u01a1 h\u1ecdc 10,5% v\u00e0 can thi\u1ec7p l\u1ea7n 2 l\u00e0 5,2%. Bi\u1ebfn ch\u1ee9ng vi\u00eam t\u1ee5y c\u1ea5p 5,2%. \u00a0 BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng cho r\u1eb1ng, n\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng k\u1ebft h\u1ee3p c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi v\u00e0 nong nh\u00fa Vater \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 s\u1ecfi OMC l\u1edbn v\u1edbi t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng cao, bi\u1ebfn ch\u1ee9ng th\u1ea5p.\u00a0 Ngu\u1ed3n t\u1eeb : AloBacsi\" \/>\n<meta property=\"og:url\" content=\"https:\/\/bvnguyentrai.org.vn\/en\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\" \/>\n<meta property=\"og:site_name\" content=\"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\" \/>\n<meta property=\"article:published_time\" content=\"2023-08-25T01:29:56+00:00\" \/>\n<meta name=\"author\" content=\"admin\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"admin\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\"},\"author\":{\"name\":\"admin\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/dfd03b7cab06c2f53326b99b3f2a0bf7\"},\"headline\":\"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i\",\"datePublished\":\"2023-08-25T01:29:56+00:00\",\"dateModified\":\"2023-08-25T01:29:56+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\"},\"wordCount\":43,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#organization\"},\"articleSection\":[\"Ho\u1ea1t \u0111\u1ed9ng b\u1ec7nh vi\u1ec7n\",\"Tin t\u1ee9c\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\",\"url\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\",\"name\":\"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\",\"isPartOf\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#website\"},\"datePublished\":\"2023-08-25T01:29:56+00:00\",\"dateModified\":\"2023-08-25T01:29:56+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/bvnguyentrai.org.vn\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#website\",\"url\":\"https:\/\/bvnguyentrai.org.vn\/\",\"name\":\"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\",\"description\":\"\",\"publisher\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/bvnguyentrai.org.vn\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#organization\",\"name\":\"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\",\"url\":\"https:\/\/bvnguyentrai.org.vn\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/bvnguyentrai.org.vn\/wp-content\/uploads\/2025\/12\/logo_bv-e1766206654320.png\",\"contentUrl\":\"https:\/\/bvnguyentrai.org.vn\/wp-content\/uploads\/2025\/12\/logo_bv-e1766206654320.png\",\"width\":1210,\"height\":352,\"caption\":\"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\"},\"image\":{\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#\/schema\/logo\/image\/\"}},{\"@type\":\"Person\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/dfd03b7cab06c2f53326b99b3f2a0bf7\",\"name\":\"admin\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/ebfe5c7ea59947bf8c6feaf02b7f1a6803f49d4f7c25004a459f6ebafb6b6e34?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/ebfe5c7ea59947bf8c6feaf02b7f1a6803f49d4f7c25004a459f6ebafb6b6e34?s=96&d=mm&r=g\",\"caption\":\"admin\"},\"sameAs\":[\"http:\/\/bvnguyentrai.org.vn\"],\"url\":\"https:\/\/bvnguyentrai.org.vn\/en\/author\/admin\/\"}]}<\/script>\n<!-- \/ Yoast SEO Premium plugin. -->","yoast_head_json":{"title":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/bvnguyentrai.org.vn\/en\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/","og_locale":"en_US","og_type":"article","og_title":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i","og_description":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21; C\u1eadp nh\u1eadt ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i; Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i c\u00f9ng h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng, can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh\u2026 l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 \u0111\u01b0\u1ee3c c\u00e1c chuy\u00ean gia b\u00e0n lu\u1eadn trong Phi\u00ean to\u00e0n th\u1ec3 c\u1ee7a H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt 2023 do B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i t\u1ed5 ch\u1ee9c. H\u1ed9i ngh\u1ecb \u0111\u01b0\u1ee3c t\u1ed5 ch\u1ee9c v\u00e0o ng\u00e0y 24\/8\/2023\u00a0v\u1eeba qua \u0111\u00e1nh d\u1ea5u c\u1ed9t m\u1ed1c l\u1ea7n \u0111\u1ea7u ti\u00ean B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i ghi nh\u1eadn ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 1.000. Trong 40 b\u00e0i b\u00e1o c\u00e1o ch\u1ea5t l\u01b0\u1ee3ng t\u1eeb c\u00e1c chuy\u00ean gia, gi\u1ea3ng vi\u00ean xuy\u00ean su\u1ed1t tr\u00ean 5 phi\u00ean (t\u1eeb N\u1ed9i khoa, Ngo\u1ea1i Khoa, \u0110i\u1ec1u d\u01b0\u1ee1ng), phi\u00ean To\u00e0n th\u1ec3 v\u1edbi 8 b\u00e0i b\u00e1o c\u00e1o \u0111\u1ec1 c\u1eadp \u0111\u1ebfn c\u00e1c v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe n\u1ed5i tr\u1ed9i c\u0169ng nh\u01b0 l\u00e0 th\u1ebf m\u1ea1nh, m\u0169i nh\u1ecdn m\u00e0 b\u1ec7nh vi\u1ec7n h\u01b0\u1edbng \u0111\u1ebfn trong n\u0103m 2023.\u00a0 H\u1ed9i ngh\u1ecb Khoa h\u1ecdc k\u1ef9 thu\u1eadt th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i thu h\u00fat h\u01a1n 1.000 ng\u01b0\u1eddi tham d\u1ef1 tr\u00ean 5 phi\u00ean Ch\u1ee7 t\u1ecda \u0111o\u00e0n phi\u00ean To\u00e0n th\u1ec3 Nh\u1eefng xu h\u01b0\u1edbng m\u1edbi trong ch\u1ee7ng ng\u1eeba \u1edf th\u1ebf k\u1ef7 21\u00a0 Trong b\u00e0i b\u00e1o c\u00e1o \u201cCh\u1ee7ng ng\u1eeba cho c\u1ea3 gia \u0111\u00ecnh\u201d - PGS.TS.BS Ph\u1ea1m L\u00ea An - Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM, Tr\u01b0\u1edfng Trung t\u00e2m B\u00e1c s\u0129 gia \u0111\u00ecnh - Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM nh\u1ea5n m\u1ea1nh, vi\u1ec7c ch\u1ee7ng ng\u1eeba cho tr\u1ebb em \u0111\u00e3 mang l\u1ea1i nh\u1eefng gi\u00e1 tr\u1ecb ngo\u1ea1n m\u1ee5c, h\u1eb1ng n\u0103m gi\u00fap d\u1ef1 ph\u00f2ng 3 tri\u1ec7u ca t\u1eed vong v\u00e0 750.000 tr\u1ebb kh\u00f4ng b\u1ecb t\u00e0n ph\u1ebf. Cho \u0111\u1ebfn nay \u0111\u00e3 c\u00f3 26 b\u1ec7nh \u0111\u01b0\u1ee3c d\u1ef1 ph\u00f2ng b\u1edfi thu\u1ed1c ti\u00eam ch\u1ee7ng.\u00a0 Tuy v\u1eady, chuy\u00ean gia n\u00eau l\u00ean th\u1ef1c t\u1ebf, ch\u1ee7ng ng\u1eeba tr\u00ean to\u00e0n th\u1ebf gi\u1edbi nh\u1eb1m v\u00e0o tr\u1ebb em, song \u0111i\u1ec1u n\u00e0y ch\u01b0a ho\u00e0n to\u00e0n ki\u1ec3m so\u00e1t \u0111\u01b0\u1ee3c c\u00e1c b\u1ec7nh ph\u00f2ng \u0111\u01b0\u1ee3c b\u1eb1ng v\u1eafc xin \u1edf v\u1ecb th\u00e0nh ni\u00ean v\u00e0 ng\u01b0\u1eddi l\u1edbn ngay c\u1ea3 khi \u0111\u1ea1t t\u1ef7 l\u1ec7 bao ph\u1ee7 cao \u1edf tr\u1ebb em. Do v\u1eady, trong th\u1ebf k\u1ef7 21, khuynh h\u01b0\u1edbng ch\u1ee7ng ng\u1eeba c\u1ed5 \u0111i\u1ec3n ch\u1ec9 \u1edf tr\u1ebb em \u0111\u00e3 ph\u00e1t tri\u1ec3n r\u1ed9ng th\u00e0nh ch\u1ee7ng ng\u1eeba cho m\u1ecdi l\u1ee9a tu\u1ed5i nh\u01b0 v\u1ecb th\u00e0nh ni\u00ean, thai k\u1ef3, ng\u01b0\u1eddi cao tu\u1ed5i, nh\u00f3m b\u1ec7nh m\u00e3n t\u00ednh\u2026 PGS.TS.BS Ph\u1ea1m L\u00ea An - Ch\u1ee7 t\u1ecbch H\u1ed9i B\u00e1c s\u0129 gia \u0111\u00ecnh TPHCM Xu h\u01b0\u1edbng m\u1edbi trong ti\u00eam ng\u1eeba c\u0169ng \u0111\u01b0\u1ee3c PGS.TS.BS Ph\u1ea1m L\u00ea An \u0111\u1ec1 c\u1eadp. Hi\u1ec7n nay v\u1eafc xin \u0111\u00e3 g\u1ed9p nhi\u1ec1u th\u00e0nh ph\u1ea7n trong 1 s\u1ea3n ph\u1ea9m \u0111\u1ec3 b\u1ea3o v\u1ec7 \u0111\u01b0\u1ee3c nhi\u1ec1u b\u1ec7nh ho\u1eb7c nhi\u1ec1u ch\u1ee7ng vi sinh v\u1eadt c\u1ee7a m\u1ed9t b\u1ec7nh, gi\u00fap gi\u1ea3m s\u1ed1 m\u0169i ti\u00eam v\u1eafc xin v\u00e0 b\u1ed5 sung nhanh s\u1ed1 m\u0169i v\u1eafc xin \u0111\u1ed1i v\u1edbi nh\u1eefng tr\u1ebb ch\u1ee7ng ng\u1eeba mu\u1ed9n.\u00a0 Trong khi \u0111\u00f3, ch\u1ee7ng ng\u1eeba \u1edf tr\u1ebb em \u0111\u00e3 c\u00f3 s\u1ef1 kh\u1edfi \u0111\u1ea7u c\u1ee7a v\u1eafc xin vi\u00eam gan si\u00eau vi A, B; v\u1eafc xin Hib; v\u1eafc xin b\u1ea1i li\u1ec7t chuy\u1ec3n t\u1eeb d\u1ea1ng u\u1ed1ng (OPV) sang d\u1ea1ng ti\u00eam (IPV); c\u00e1c d\u1ea1ng v\u1eafc xin li\u00ean h\u1ee3p m\u1edbi (vi\u00eam m\u00e0ng n\u00e3o pneumococcal v\u00e0 group C), \u0111\u1ed3ng th\u1eddi c\u00e1c nh\u00e0 s\u1ea3n s\u1ea3n xu\u1ea5t l\u1edbn \u0111\u00e3 ph\u00e1t tri\u1ec3n c\u00e1c lo\u1ea1i v\u1eafc xin \u0111a gi\u00e1 5 trong 1 \u0111\u1ebfn 6 trong 1. Ngo\u00e0i ra, theo khuy\u1ebfn c\u00e1o c\u1ee7a WHO (2019) c\u0169ng cho th\u1ea5y, c\u1ea7n ti\u00eam b\u1ed5 sung DTwP\/DtaP & Tdap\/Td trong tr\u01b0\u1eddng h\u1ee3p b\u1ecb tr\u00ec ho\u00e3n.\u00a0 Vi\u1ec7c thay th\u1ebf v\u1eafc xin (v\u00e0i thu\u1ed1c ch\u1ee7ng ng\u1eeba t\u1eeb c\u00e1c nh\u00e0 s\u1ea3n xu\u1ea5t kh\u00e1c nhau nh\u1eb1m b\u1ea3o v\u1ec7 c\u00f9ng m\u1ed9t t\u00e1c nh\u00e2n) c\u0169ng r\u1ea5t c\u1ea7n thi\u1ebft khi c\u00f3 s\u1ef1 thi\u1ebfu h\u1ee5t (nh\u01b0 HepB v\u00e0 Hib). Chuy\u00ean gia l\u1ea5y v\u00ed d\u1ee5 th\u1ef1c t\u1ebf nh\u01b0 thu\u1ed1c ch\u1ee7ng k\u1ebft h\u1ee3p v\u1edbi th\u00e0nh ph\u1ea7n kh\u00e1ng nguy\u00ean c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t (nh\u01b0 DTaP, DtaP-Hib, hay c\u00e1c DtaP kh\u00e1c trong c\u00e1c v\u1eafc xin k\u1ebft h\u1ee3p c\u00f3 ch\u1ee9a c\u00f9ng kh\u00e1ng nguy\u00ean v\u00f4 b\u00e0o ho g\u00e0 t\u1eeb c\u00f9ng m\u1ed9t nh\u00e0 s\u1ea3n xu\u1ea5t) c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thay th\u1ebf cho nhau. Cu\u1ed1i c\u00f9ng PGS.TS.BS Ph\u1ea1m L\u00ea An l\u01b0u \u00fd, kh\u00f4ng s\u1eed d\u1ee5ng v\u1eafc xin v\u1edbi kho\u1ea3ng c\u00e1ch \u00edt h\u01a1n th\u1eddi gian t\u1ed1i thi\u1ec3u quy \u0111\u1ecbnh hay s\u1eed d\u1ee5ng s\u1edbm h\u01a1n tu\u1ed5i \u0111\u1ec1 ngh\u1ecb. Li\u1ec1u v\u1eafc xin \u0111\u01b0\u1ee3c cho s\u1edbm \u2264 4 ng\u00e0y so v\u1edbi kho\u1ea3ng c\u00e1ch t\u1ed1i thi\u1ec3u hay v\u1edbi tu\u1ed5i quy \u0111\u1ecbnh c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c t\u00ednh l\u00e0 li\u1ec1u h\u1ee3p l\u1ec7, nh\u01b0ng nguy\u00ean t\u1eafc n\u00e0y kh\u00f4ng \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng cho v\u1eafc xin s\u1ed1ng. T\u0103ng kho\u1ea3ng c\u00e1ch gi\u1eefa c\u00e1c li\u1ec1u v\u1edbi v\u1eafc xin c\u1ea7n nhi\u1ec1u li\u1ec1u ti\u00eam kh\u00f4ng l\u00e0m gi\u1ea3m t\u00ednh hi\u1ec7u qu\u1ea3 c\u1ee7a v\u1eafc xin v\u00e0 kh\u00f4ng ti\u00eam l\u1ea1i t\u1eeb \u0111\u1ea7u n\u1ebfu b\u1ecf s\u00f3t.\u00a0 Ti\u1ebfp c\u1eadn v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i, \u0111\u00e2u l\u00e0 th\u00e1ch th\u1ee9c? PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n chia s\u1ebb v\u1ec1 C\u1eadp nh\u1eadt tron ch\u1ea9n \u0111o\u00e1n v\u00e0 \u0111i\u1ec1u tr\u1ecb H\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n - Tr\u01b0\u1edfng B\u1ed9 m\u00f4n L\u00e3o khoa, khoa Y Tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y D\u01b0\u1ee3c TPHCM, Tr\u01b0\u1edfng khoa Tim m\u1ea1ch C\u1ea5p c\u1ee9u v\u00e0 Can thi\u1ec7p B\u1ec7nh vi\u1ec7n Th\u1ed1ng Nh\u1ea5t TPHCM cho r\u1eb1ng, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p tr\u00ean ng\u01b0\u1eddi cao tu\u1ed5i g\u1eb7p r\u1ea5t nhi\u1ec1u th\u00e1ch th\u1ee9c, b\u1edfi s\u1ef1 l\u00e3o h\u00f3a c\u1ee7a h\u1ec7 th\u1ed1ng tim m\u1ea1ch, \u0111\u1ed1i di\u1ec7n v\u1edbi h\u1ed9i ch\u1ee9ng l\u00e3o khoa, t\u00ecnh tr\u1ea1ng suy y\u1ebfu, g\u00e1nh n\u1eb7ng b\u1ec7nh \u0111\u1ed3ng m\u1eafc. Khi \u0111\u00f3, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb s\u1ebd c\u00e2n nh\u1eafc d\u1ef1a tr\u00ean l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, trong \u0111\u00f3 nguy c\u01a1 c\u1ee7a ng\u01b0\u1eddi cao tu\u1ed5i l\u00e0 huy\u1ebft kh\u1ed1i v\u00e0 ch\u1ea3y m\u00e1u.\u00a0 Do v\u1eady, chuy\u00ean gia \u0111\u00e1nh gi\u00e1 ph\u00e1c \u0111\u1ed3 t\u1ed1i \u01b0u cho b\u1ec7nh nh\u00e2n \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng. Theo \u0111\u00f3, ti\u1ebfp c\u1eadn ban \u0111\u1ea7u trong h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u1ea7n d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng, ECG, men tim (hs-cTn) v\u00e0 ph\u00e2n t\u1ea7ng nguy c\u01a1, t\u1eeb \u0111\u00f3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1ee3p l\u00fd.\u00a0 V\u1ec1 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb, c\u00e1c khuy\u1ebfn c\u00e1o hi\u1ec7n nay \u0111\u1ec1u cho th\u1ea5y, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u00f3 ST ch\u00eanh l\u00ean, kh\u00f4ng d\u1ef1a v\u00e0o tu\u1ed5i m\u00e0 h\u1ea1n ch\u1ebf v\u1ea5n \u0111\u1ec1 \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u cho b\u1ec7nh nh\u00e2n, thay v\u00e0o \u0111\u00f3 s\u1ebd \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 ST ch\u00eanh l\u00ean. Tuy nhi\u00ean, ph\u1ea3i xem x\u00e9t c\u00e1c kh\u00eda c\u1ea1nh \u0111\u1ec3 ng\u0103n ng\u1eeba d\u1ef1 ph\u00f2ng nguy c\u01a1 c\u00f3 th\u1ec3 g\u1eb7p.\u00a0 Trong khi \u0111\u00f3, h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p kh\u00f4ng ST ch\u00eanh l\u00ean \u00e1p d\u1ee5ng chi\u1ebfn l\u01b0\u1ee3c ti\u1ebfp c\u1eadn ng\u01b0\u1eddi cao tu\u1ed5i t\u01b0\u01a1ng t\u1ef1 nh\u01b0 b\u1ec7nh nh\u00e2n kh\u00f4ng cao tu\u1ed5i. Song, tu\u1ed5i c\u00e0ng cao c\u00e0ng l\u00e0m gia t\u0103ng nguy c\u01a1 t\u1eed vong, do \u0111\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u s\u1edbm cho b\u1ec7nh nh\u00e2n hay tr\u00ec ho\u00e3n ph\u1ee5 thu\u1ed9c v\u00e0o vi\u1ec7c ph\u00e2n t\u1ea7ng nguy c\u01a1. N\u1ebfu nguy c\u01a1 r\u1ea5t cao, c\u1ea7n t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 2 gi\u1edd. Nguy c\u01a1 cao trung b\u00ecnh t\u00e1i t\u01b0\u1edbi m\u00e1u trong v\u00f2ng 24 gi\u1edd. Nguy c\u01a1 th\u1ea5p h\u01a1n, tr\u00ec ho\u00e3n.\u00a0 Chuy\u00ean gia c\u0169ng luu \u00fd, c\u1ea7n xem x\u00e9t t\u00ecnh tr\u1ea1ng suy y\u1ebfu c\u1ee7a b\u1ec7nh nh\u00e2n l\u1edbn tu\u1ed5i, n\u1ebfu c\u00f3 c\u1ea7n ph\u1ea3i \u0111\u1eb7t l\u00ean b\u00e0n c\u00e2n gi\u1eefa l\u1ee3i \u00edch v\u00e0 nguy c\u01a1, \u0111\u1ec3 \u0111\u01b0a ra chi\u1ebfn l\u01b0\u1ee3c ph\u00f9 h\u1ee3p. Hi\u1ec7n c\u00f3 r\u1ea5t nhi\u1ec1u thang \u0111i\u1ec3m \u0111\u1ec3 ph\u00e2n t\u1ea7ng nguy c\u01a1 ch\u1ea3y m\u00e1u tr\u00ean ng\u01b0\u1eddi l\u1edbn tu\u1ed5i, nh\u01b0ng g\u1ea7n \u0111\u00e2y ARC - HBR (2019) \u0111\u01b0\u1ee3c \u0111\u1ed3ng thu\u1eadn nh\u1ea5t. PGS.TS.BS Nguy\u1ec5n V\u0103n T\u00e2n \u0111\u1ec1 c\u1eadp th\u00eam, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb t\u00e1i t\u01b0\u1edbi m\u00e1u b\u1eb1ng can thi\u1ec7p hay ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1eb7c \u0111i\u1ec3m c\u1ee7a b\u1ec7nh nh\u00e2n, gi\u1ea3i ph\u1eabu m\u1ea1ch v\u00e0nh, nguy\u1ec7n v\u1ecdng c\u1ee7a b\u1ec7nh nh\u00e2n. N\u1ebfu ch\u1ecdn l\u1ef1a chi\u1ebfn l\u01b0\u1ee3c can thi\u1ec7p, khuy\u1ebfn c\u00e1o l\u00e0 ph\u1ee5 thu\u1ed9c b\u1ed1i c\u1ea3nh l\u00e2m s\u00e0ng, lo\u1ea1i t\u1ed5n th\u01b0\u01a1ng, tuy nhi\u00ean \u0111a s\u1ed1 \u0111\u1ec1u l\u00e0 stent ph\u1ee7 thu\u1ed1c. Chuy\u00ean gia n\u00f3i th\u00eam, \u0111i\u1ec1u tr\u1ecb ch\u1ed1ng huy\u1ebft kh\u1ed1i (kh\u00e1ng \u0111\u00f4ng v\u00e0 kh\u00e1ng k\u1ebft t\u1eadp ti\u1ec3u c\u1ea7u) ch\u00fa \u00fd thay \u0111\u1ed5i ph\u00e1c \u0111\u1ed3 tr\u00ean t\u1eebng tr\u01b0\u1eddng h\u1ee3p c\u1ee5 th\u1ec3 (n\u1ed9i khoa, x\u00e2m l\u1ea5n v\u00e0\/ ho\u1eb7c c\u00f3 rung nh\u0129 hay kh\u00f4ng). V\u1ea5n \u0111\u1ec1 quan tr\u1ecdng h\u01a1n l\u00e0, \u0111i\u1ec1u tr\u1ecb thu\u1ed1c ch\u1ed1ng huy\u1ebft kh\u1ed1i ph\u1ea3i c\u00e2n nh\u1eafc nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9 v\u00e0 nguy c\u01a1 xu\u1ea5t huy\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi l\u1edbn tu\u1ed5i s\u1ebd \u01b0u ti\u00ean nguy c\u01a1 xu\u1ea5t huy\u1ebft h\u01a1n nguy c\u01a1 thi\u1ebfu m\u00e1u c\u1ee5c b\u1ed9, b\u1edfi v\u00ec n\u1ebfu b\u1ec7nh nh\u00e2n \u0111\u00e3 xu\u1ea5t huy\u1ebft th\u00ec kh\u00f4ng th\u1ec3 d\u00f9ng t\u1ea5t c\u1ea3 c\u00e1c thu\u1ed1c kh\u00e1c.\u00a0 Can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i, chi\u1ebfn l\u01b0\u1ee3c n\u00e0o t\u1ed1i \u01b0u? BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean V\u1edbi b\u00e0i b\u00e1o c\u00e1o \u201cCan thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i: T\u1eeb l\u00fd thuy\u1ebft \u0111\u1ebfn th\u1ef1c ti\u1ec5n l\u00e2m s\u00e0ng\u201d - BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean - Ph\u00f3 khoa Tim m\u1ea1ch Can thi\u1ec7p - B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft, th\u00e2n chung v\u00e0nh tr\u00e1i cung c\u1ea5p m\u00e1u cho ph\u1ea7n l\u1edbn c\u01a1 tim th\u1ea5t tr\u00e1i (75-100%), do v\u1eady h\u1eb9p n\u1eb7ng th\u00e2n chung s\u1ebd \u0111\u1eb7t th\u1ea5t tr\u00e1i v\u00e0o nguy c\u01a1 cao.\u00a0 H\u1eb9p th\u00e2n chung th\u01b0\u1eddng c\u00f3 k\u00e8m theo h\u1eb9p nhi\u1ec1u nh\u00e1nh m\u1ea1ch v\u00e0nh v\u00e0 h\u1eb9p th\u00e2n chung \u0111\u01a1n \u0111\u1ed9c ch\u1ec9 x\u1ea3y ra \u1edf 4-6%. H\u1eb9p th\u00e2n chung c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf l\u1ed7 (23%), \u0111o\u1ea1n gi\u1eefa (15%) v\u00e0 \u0111i\u1ec1u kh\u00f4ng may l\u00e0 v\u1ecb tr\u00ed kh\u00f3 nh\u1ea5t l\u1ea1i chi\u1ebfm t\u1ef7 l\u1ec7 h\u1eb9p nhi\u1ec1u nh\u1ea5t, \u0111\u00f3 l\u00e0 \u0111o\u1ea1n xa (61%). T\u00f9y thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1eb9p, c\u00e1c chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 kh\u00e1c nhau.\u00a0 BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean khuy\u1ebfn ngh\u1ecb, \u0111\u1ed1i v\u1edbi sang th\u01b0\u01a1ng th\u00e2n chung, khi c\u00f3 m\u1ed9t h\u1eb9p th\u00e2n chung \u1edf c\u1ea3 3 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng c\u00f3 khuynh h\u01b0\u1edbng ch\u1ecdn l\u1ef1a ph\u1eabu thu\u1eadt b\u1eafc c\u1ea7u n\u1ed1i \u0111\u1ed9ng m\u1ea1ch v\u00e0nh, trong khi n\u1ebfu ch\u1ec9 h\u1eb9p \u0111\u01a1n gi\u1ea3n \u1edf l\u1ed7, \u1edf th\u00e2n ho\u1eb7c h\u1eb9p 1 nh\u00e1nh m\u1ea1ch v\u00e0nh th\u01b0\u1eddng s\u1ebd ch\u1ecdn l\u1ef1a can thi\u1ec7p m\u1ea1ch v\u00e0nh qua da.\u00a0 \u0110\u1ec3 c\u00f3 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb cho b\u1ec7nh nh\u00e2n, H\u1ed9i Tim m\u1ea1ch Hoa K\u1ef3, H\u1ed9i Tim m\u1ea1ch ch\u00e2u \u00c2u \u0111\u1ec1u nh\u1eadn \u0111\u1ecbnh vai tr\u00f2 quan tr\u1ecdng c\u1ee7a si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Qua k\u1ef9 thu\u1eadt n\u00e0y c\u00f3 th\u1ec3 x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c chi\u1ec1u d\u00e0i, \u0111\u01b0\u1eddng k\u00ednh v\u00e0 v\u1ecb tr\u00ed, t\u00ednh ch\u1ea5t c\u1ee7a sang th\u01b0\u01a1ng th\u00e2n chung c\u0169ng nh\u01b0 chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, t\u1ed1i \u01b0u h\u00f3a k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb sau \u0111\u00f3.\u00a0 Tuy nhi\u00ean, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean c\u0169ng \u0111\u1ec1 c\u1eadp, kh\u00f4ng ph\u1ea3i trung t\u00e2m n\u00e0o c\u0169ng \u0111\u01b0\u1ee3c trang b\u1ecb si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch. Do v\u1eady, m\u1eb7c d\u00f9 kh\u00f4ng th\u1ec3 thay th\u1ebf cho h\u00ecnh \u1ea3nh si\u00eau \u00e2m trong l\u00f2ng m\u1ea1ch, song chuy\u00ean gia \u0111\u01b0a ra g\u1ee3i \u00fd c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng d\u1ea5u hi\u1ec7u POT - PUFF \u0111\u1ec3 lo\u1ea1i tr\u1eeb t\u00ecnh tr\u1ea1ng stent kh\u00f4ng \u00e1p s\u00e1t, v\u1edbi t\u00ednh \u0111\u1eb7c hi\u1ec7u v\u00e0 gi\u00e1 tr\u1ecb ti\u00ean \u0111o\u00e1n \u00e2m t\u00ednh tr\u00ean 90%. Qua c\u00e1c nghi\u00ean c\u1ee9u, chuy\u00ean gia cho bi\u1ebft th\u00eam, n\u1ebfu v\u1ecb tr\u00ed h\u1eb9p th\u00e2n chung \u1edf \u0111o\u1ea1n sau, c\u00f3 li\u00ean quan \u0111\u1ebfn nh\u00e1nh chia, trong tr\u01b0\u1eddng h\u1ee3p \u0111\u01a1n gi\u1ea3n s\u1ebd s\u1eed d\u1ee5ng 1 stent ch\u1edd (\u0111\u1eb7t 1 stent b\u0103ng qua sang th\u01b0\u01a1ng v\u00e0 ki\u1ec3m tra t\u00ecnh tr\u1ea1ng ch\u1eb9n g\u00e2y m\u1ea5t d\u00f2ng c\u1ee7a nh\u00e1nh b\u00ean, n\u1ebfu c\u00f3 th\u00ec \u0111\u1eb7t stent th\u1ee9 2). Trong tr\u01b0\u1eddng h\u1ee3p sang th\u01b0\u01a1ng chia \u0111\u00f4i ph\u1ee9c t\u1ea1p, n\u00ean l\u1ef1a ch\u1ecdn chi\u1ebfn l\u01b0\u1ee3c \u0111\u1eb7t 2 stent ngay t\u1eeb \u0111\u1ea7u v\u00e0 \u01b0u ti\u00ean k\u1ef9 thu\u1eadt DK-Crush (\u0111\u00e2y l\u00e0 k\u1ef9 thu\u1eadt t\u1ea1p b\u1eadc nh\u1ea5t trong tim m\u1ea1ch can thi\u1ec7p, \u0111\u00f2i h\u1ecfi r\u1ea5t nhi\u1ec1u kinh nghi\u1ec7m) ho\u1eb7c 2 k\u1ef9 thu\u1eadt \u0111\u01a1n gi\u1ea3n h\u01a1n, bao g\u1ed3m Culotte v\u00e0 TAP (T and Protrusion). Cu\u1ed1i c\u00f9ng, BS.CK2 Nguy\u1ec5n Th\u00e1i Y\u00ean nh\u1ea5n m\u1ea1nh, chi\u1ebfn l\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1eb9p th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i ph\u1ea3i \u0111\u01b0\u1ee3c quy\u1ebft \u0111\u1ecbnh b\u1edfi m\u1ed9t h\u1ed9i \u0111\u1ed3ng chuy\u00ean gia g\u1ed3m c\u00f3 b\u00e1c s\u0129 ph\u1eabu thu\u1eadt tim, n\u1ed9i tim m\u1ea1ch v\u00e0 tim m\u1ea1ch can thi\u1ec7p. Qua \u0111\u00f3 \u0111\u00e1nh gi\u00e1 c\u1ea9n tr\u1ecdng d\u1ef1a tr\u00ean c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 b\u1ec7nh nh\u00e2n c\u00f3 kh\u1ea3 n\u0103ng t\u00e1i th\u00f4ng ho\u00e0n to\u00e0n, t\u1ef7 l\u1ec7 t\u1eed vong, nguy\u1ec7n v\u1ecdng c\u1ee7a gia \u0111\u00ecnh\u2026 BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng H\u1ed9i ngh\u1ecb Khoa h\u1ecdc th\u01b0\u1eddng ni\u00ean c\u1ee7a B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i n\u0103m 2023 kh\u00f4ng ch\u1ec9 cung c\u1ea5p c\u00e1c ki\u1ebfn th\u1ee9c c\u1eadp nh\u1eadt m\u00e0 c\u00f2n l\u00e0 di\u1ec5n \u0111\u00e0n uy t\u00edn \u0111\u1ec3 trao \u0111\u1ed5i v\u1ec1 h\u00e0ng lo\u1ea1t c\u00e1c nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n ngay t\u1ea1i b\u1ec7nh vi\u1ec7n. \u00a0 Trong phi\u00ean to\u00e0n th\u1ec3, 3 nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c tr\u00ecnh b\u00e0y v\u1edbi nhi\u1ec1u th\u00f4ng tin th\u00fa v\u1ecb. BS.CK1 Ph\u1ea1m Xu\u00e2n H\u01b0\u1eddng - Tr\u01b0\u1edfng \u0110\u01a1n v\u1ecb Ch\u1ea5n th\u01b0\u01a1ng Ch\u1ec9nh h\u00ecnh - Khoa Ngo\u1ea1i t\u1ed5ng h\u1ee3p - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i v\u1edbi nghi\u00ean c\u1ee9u\u00a0B\u01b0\u1edbc \u0111\u1ea7u \u0111\u00e1nh gi\u00e1 k\u1ebft qu\u1ea3 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng nh\u00e2n t\u1ea1o b\u00e1n ph\u1ea7n v\u00e0 to\u00e0n ph\u1ea7n kh\u00f4ng xi m\u0103ng\u00a0th\u1ef1c hi\u1ec7n tr\u00ean 34 b\u1ec7nh nh\u00e2n, tu\u1ed5i nh\u1ecf nh\u1ea5t 44 tu\u1ed5i, l\u1edbn nh\u1ea5t 86 tu\u1ed5i.\u00a0 Qua nghi\u00ean c\u1ee9u, chuy\u00ean gia cho r\u1eb1ng, m\u1eb7c d\u00f9 ph\u1eabu thu\u1eadt thay kh\u1edbp h\u00e1ng to\u00e0n ph\u1ea7n v\u00e0 b\u00e1n ph\u1ea7n kh\u00f4ng xi m\u0103ng t\u1ea1i b\u1ec7nh vi\u1ec7n mang l\u1ea1i k\u1ebft qu\u1ea3 ban \u0111\u1ea7u t\u1ed1t cho b\u1ec7nh nh\u00e2n, tuy nhi\u00ean c\u1ea7n ti\u1ebfp t\u1ee5c theo d\u00f5i trong th\u1eddi gian d\u00e0i h\u01a1n nh\u1eb1m ph\u00e1t hi\u1ec7n nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra mu\u1ed9n nhi\u1ec1u n\u0103m sau ph\u1eabu thu\u1eadt. BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n V\u1edbi nghi\u00ean c\u1ee9u \u201cK\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u can thi\u1ec7p n\u1ed9i m\u1ea1ch \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh \u1edf B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\u201d - BS.CK2 Tr\u1ea7n Ng\u1ecdc Tu\u1ea5n - Ph\u00f3 Tr\u01b0\u1edfng khoa Tim m\u1ea1ch 1 c\u1ee7a b\u1ec7nh vi\u1ec7n \u0111\u1eb7t v\u1ea5n \u0111\u1ec1 cho th\u1ea5y, b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh g\u1ea7n \u0111\u00e2y c\u00f3 xu h\u01b0\u1edbng t\u0103ng v\u1ec1 s\u1ed1 l\u01b0\u1ee3ng v\u00e0 m\u1ee9c \u0111\u1ed9 ph\u1ee9c t\u1ea1p c\u1ee7a b\u1ec7nh, \u0111\u1ec3 l\u1ea1i h\u1eadu qu\u1ea3 n\u1eb7ng. Can thi\u1ec7p n\u1ed9i m\u1ea1ch l\u00e0 h\u01b0\u1edbng ti\u1ebfp c\u1eadn m\u1edbi \u00edt x\u00e2m l\u1ea5n, hi\u1ec7u qu\u1ea3 cao, th\u1eddi gian \u0111i\u1ec1u tr\u1ecb ng\u1eafn, h\u1ed3i ph\u1ee5c s\u1edbm.\u00a0 Nghi\u00ean c\u1ee9u th\u1ef1c hi\u1ec7n tr\u00ean 22 tr\u01b0\u1eddng h\u1ee3p, trong \u0111\u00f3 c\u00f3 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1, 91% t\u0103ng huy\u1ebft \u00e1p, 82% \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, 73% r\u1ed1i lo\u1ea1n lipid m\u00e1u, 73% h\u00fat thu\u1ed1c l\u00e1. T\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng c\u1ee7a th\u1ee7 thu\u1eadt l\u00e0 91% (20\/11), trong \u0111\u00f3 can thi\u1ec7p \u0111\u1eb7t stent 82% (18\/22), nong b\u00f3ng \u0111\u01a1n thu\u1ea7n 9% (2\/22).\u00a0 Qua nghi\u00ean c\u1ee9u ghi nh\u1eadn k\u1ebft qu\u1ea3 b\u01b0\u1edbc \u0111\u1ea7u cho th\u1ea5y ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p n\u1ed9i m\u1ea1ch an to\u00e0n v\u00e0 hi\u1ec7u qu\u1ea3 cao trong \u0111i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi m\u1ea1n t\u00ednh, ch\u01b0a ghi nh\u1eadn c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng nh\u01b0 t\u1eed vong, nh\u1ed3i m\u00e1u c\u01a1 tim, tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o, ch\u1ea3y m\u00e1u n\u1eb7ng ph\u1ea3i truy\u1ec1n m\u00e1u.\u00a0 BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng\u00a0 \u201cNghi\u00ean c\u1ee9u hi\u1ec7u qu\u1ea3 c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi k\u1ebft h\u1ee3p nong nh\u00fa vater b\u1eb1ng b\u00f3ng trong \u0111i\u1ec1u tr\u1ecb s\u1ecfi m\u1eadt t\u1ea1i B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i\u201d t\u1eeb BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng - Tr\u01b0\u1edfng khoa N\u1ed9i soi c\u1ee7a b\u1ec7nh vi\u1ec7n c\u0169ng cung c\u1ea5p g\u00f3c nh\u00ecn khoa h\u1ecdc h\u1ea5p d\u1eabn.\u00a0 Nghi\u00ean c\u1ee9u m\u00f4 t\u1ea3 c\u1eaft ngang 38 b\u1ec7nh nh\u00e2n, ng\u01b0\u1eddi c\u00f3 tr\u00ean 2 vi\u00ean s\u1ecfi chi\u1ebfm 35,2%, k\u00edch th\u01b0\u1edbc s\u1ecfi trung b\u00ecnh 13,39 \u00b1 2,86mm, \u0111\u01b0\u1eddng k\u00ednh s\u1ecfi \u1ed1ng m\u1eadt ch\u1ee7 (OMC) trung b\u00ecnh 16,53 \u00b1 3,51mm, can thi\u1ec7p th\u00e0nh c\u00f4ng l\u1ea7n 1 l\u00e0 89,5%, t\u00e1n s\u1ecfi c\u01a1 h\u1ecdc 10,5% v\u00e0 can thi\u1ec7p l\u1ea7n 2 l\u00e0 5,2%. Bi\u1ebfn ch\u1ee9ng vi\u00eam t\u1ee5y c\u1ea5p 5,2%. \u00a0 BS.CK2 Nguy\u1ec5n \u0110\u1ee9c Th\u00f4ng cho r\u1eb1ng, n\u1ed9i soi m\u1eadt t\u1ee5y ng\u01b0\u1ee3c d\u00f2ng k\u1ebft h\u1ee3p c\u1eaft b\u00e1n ph\u1ea7n c\u01a1 v\u00f2ng Oddi v\u00e0 nong nh\u00fa Vater \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 s\u1ecfi OMC l\u1edbn v\u1edbi t\u1ef7 l\u1ec7 th\u00e0nh c\u00f4ng cao, bi\u1ebfn ch\u1ee9ng th\u1ea5p.\u00a0 Ngu\u1ed3n t\u1eeb : AloBacsi","og_url":"https:\/\/bvnguyentrai.org.vn\/en\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/","og_site_name":"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i","article_published_time":"2023-08-25T01:29:56+00:00","author":"admin","twitter_card":"summary_large_image","twitter_misc":{"Written by":"admin"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#article","isPartOf":{"@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/"},"author":{"name":"admin","@id":"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/dfd03b7cab06c2f53326b99b3f2a0bf7"},"headline":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i","datePublished":"2023-08-25T01:29:56+00:00","dateModified":"2023-08-25T01:29:56+00:00","mainEntityOfPage":{"@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/"},"wordCount":43,"commentCount":0,"publisher":{"@id":"https:\/\/bvnguyentrai.org.vn\/#organization"},"articleSection":["Ho\u1ea1t \u0111\u1ed9ng b\u1ec7nh vi\u1ec7n","Tin t\u1ee9c"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/","url":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/","name":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i - B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i","isPartOf":{"@id":"https:\/\/bvnguyentrai.org.vn\/#website"},"datePublished":"2023-08-25T01:29:56+00:00","dateModified":"2023-08-25T01:29:56+00:00","breadcrumb":{"@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/bvnguyentrai.org.vn\/xu-huong-trong-chung-ngua-dieu-tri-hoi-chung-mach-vanh-cap-o-nguoi-cao-tuoi-va-can-thiep-sang-thuong-than-chung-dong-mach-vanh-trai\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/bvnguyentrai.org.vn\/"},{"@type":"ListItem","position":2,"name":"Xu h\u01b0\u1edbng trong ch\u1ee7ng ng\u1eeba, \u0111i\u1ec1u tr\u1ecb h\u1ed9i ch\u1ee9ng m\u1ea1ch v\u00e0nh c\u1ea5p \u1edf ng\u01b0\u1eddi cao tu\u1ed5i v\u00e0 can thi\u1ec7p sang th\u01b0\u01a1ng th\u00e2n chung \u0111\u1ed9ng m\u1ea1ch v\u00e0nh tr\u00e1i"}]},{"@type":"WebSite","@id":"https:\/\/bvnguyentrai.org.vn\/#website","url":"https:\/\/bvnguyentrai.org.vn\/","name":"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i","description":"","publisher":{"@id":"https:\/\/bvnguyentrai.org.vn\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/bvnguyentrai.org.vn\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/bvnguyentrai.org.vn\/#organization","name":"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i","url":"https:\/\/bvnguyentrai.org.vn\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/bvnguyentrai.org.vn\/#\/schema\/logo\/image\/","url":"https:\/\/bvnguyentrai.org.vn\/wp-content\/uploads\/2025\/12\/logo_bv-e1766206654320.png","contentUrl":"https:\/\/bvnguyentrai.org.vn\/wp-content\/uploads\/2025\/12\/logo_bv-e1766206654320.png","width":1210,"height":352,"caption":"B\u1ec7nh vi\u1ec7n Nguy\u1ec5n Tr\u00e3i"},"image":{"@id":"https:\/\/bvnguyentrai.org.vn\/#\/schema\/logo\/image\/"}},{"@type":"Person","@id":"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/dfd03b7cab06c2f53326b99b3f2a0bf7","name":"admin","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/bvnguyentrai.org.vn\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/ebfe5c7ea59947bf8c6feaf02b7f1a6803f49d4f7c25004a459f6ebafb6b6e34?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/ebfe5c7ea59947bf8c6feaf02b7f1a6803f49d4f7c25004a459f6ebafb6b6e34?s=96&d=mm&r=g","caption":"admin"},"sameAs":["http:\/\/bvnguyentrai.org.vn"],"url":"https:\/\/bvnguyentrai.org.vn\/en\/author\/admin\/"}]}},"_links":{"self":[{"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/posts\/3193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/comments?post=3193"}],"version-history":[{"count":0,"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/posts\/3193\/revisions"}],"wp:attachment":[{"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/media?parent=3193"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/categories?post=3193"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/bvnguyentrai.org.vn\/en\/wp-json\/wp\/v2\/tags?post=3193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}