{"id":4209,"date":"2023-11-14T13:45:18","date_gmt":"2023-11-14T06:45:18","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=4209"},"modified":"2023-11-14T13:47:18","modified_gmt":"2023-11-14T06:47:18","slug":"cap-cuu-thanh-cong-thai-phu-san-giat-ton-thuong-da-co-quan-voi-2-lan-ngung-tim","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=4209","title":{"rendered":"C\u1ea4P C\u1ee8U TH\u00c0NH C\u00d4NG THAI PH\u1ee4 S\u1ea2N GI\u1eacT T\u1ed4N TH\u01af\u01a0NG \u0110A C\u01a0 QUAN V\u1edaI 2 L\u1ea6N NG\u01afNG TIM\u00a0"},"content":{"rendered":"\n<p><strong><em>\u1ede tu\u1ea7n thai th\u1ee9 31, ch\u1ecb L.T.K.Anh ch\u1ea9n \u0111o\u00e1n s\u1ea3n gi\u1eadt, t\u1ed5n th\u01b0\u01a1ng \u0111a c\u01a1 quan (suy th\u1eadn, suy gan c\u1ea5p, suy h\u00f4 h\u1ea5p n\u1eb7ng). Khi \u0111\u01b0\u1ee3c \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf m\u00e1y, b\u1ec7nh nh\u00e2n ti\u1ebfp t\u1ee5c di\u1ec5n ti\u1ebfn nguy k\u1ecbch, 2 l\u1ea7n ng\u01b0ng tim \u0111e d\u1ecda t\u00ednh m\u1ea1ng. B\u1eb1ng s\u1ef1 n\u1ed7 l\u1ef1c, ph\u1ed1i h\u1ee3p \u0111i\u1ec1u tr\u1ecb gi\u1eefa c\u00e1c chuy\u00ean khoa s\u1ea3n v\u00e0 h\u1ed3i s\u1ee9c tim m\u1ea1ch B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, ch\u1ecb L.T.K.Anh \u0111\u00e3 h\u1ed3i ph\u1ee5c ngo\u1ea1n m\u1ee5c sau 10 ng\u00e0y can thi\u1ec7p b\u1eb1ng VV ECMO (oxy h\u00f3a m\u00e1u qua m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3).<\/em><\/strong><\/p>\n\n\n\n<p>Ch\u1ecb L.T.K.Anh 26 tu\u1ed5i,ng\u1ee5 t\u1ea1i V\u0169ng T\u00e0u,mang thai con l\u1ea7n th\u1ee9 2. B\u1eaft \u0111\u1ea7u t\u1eeb th\u00e1ng th\u1ee9 3 thai k\u1ef3, ch\u1ecb K.Anh b\u1eaft \u0111\u1ea7u ph\u00f9 ch\u00e2n hai b\u00ean, ph\u00f9 m\u1eb7t v\u00e0 di\u1ec5n ti\u1ebfn ng\u00e0y c\u00e0ng t\u0103ng d\u1ea7n, \u0111\u1ebfn tu\u1ea7n th\u1ee9 30, ph\u00f9 to\u00e0n th\u00e2n di\u1ec5n ti\u1ebfn n\u1eb7ng, huy\u1ebft \u00e1p kh\u00f3 ki\u1ec3m so\u00e1t. Ng\u00e0y 30.10.2023 s\u1ea3n ph\u1ee5 nh\u1eadp b\u1ec7nh vi\u1ec7n t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng v\u1edbi ch\u1ea9n \u0111o\u00e1n s\u1ea3n gi\u1eadt t\u1ed5n th\u01b0\u01a1ng \u0111a c\u01a1 quan (t\u1ed5n th\u01b0\u01a1ng gan c\u1ea5p, t\u1ed5n th\u01b0\u01a1ng th\u1eadn c\u1ea5p),chuy\u1ec3n d\u1ea1 sanh non \u1edf thai k\u1ef3 31 tu\u1ea7n 4 ng\u00e0y. Nh\u1eadn th\u1ea5y t\u00ecnh tr\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh nguy k\u1ecbch v\u01b0\u1ee3t qu\u00e1 kh\u1ea3 n\u0103ng \u0111i\u1ec1u tr\u1ecb t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng, ch\u1ecb K.Anh \u0111\u01b0\u1ee3c chuy\u1ec3n vi\u1ec7n kh\u1ea9n \u0111\u1ebfn B\u1ec7nh vi\u1ec7n T\u1eeb D\u0169 TPHCM l\u00fac 2h30 s\u00e1ng 01.11.2023 v\u00e0 m\u1ed5 l\u1ea5y thai c\u1ea5p c\u1ee9u trong v\u00f2ng 1 gi\u1edd sau nh\u1eadp vi\u1ec7n. S\u1ea3n ph\u1ee5 sanh \u0111\u01b0\u1ee3c b\u00e9 trai, c\u00e2n n\u1eb7ng 1,600g, b\u00e9 kh\u1ecfe. Sau m\u1ed5 l\u1ea5y thai, s\u1ea3n ph\u1ee5 di\u1ec5n ti\u1ebfn suy h\u00f4 h\u1ea5p n\u1eb7ng, suy th\u1eadn c\u1ea5p ti\u1ebfn tri\u1ec3n nhanh, t\u1ed5n th\u01b0\u01a1ng gan c\u1ea5p ti\u1ebfn tri\u1ec3n, v\u00e0 ph\u00f9 to\u00e0n th\u00e2n t\u0103ng nhanh. S\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n li\u00ean b\u1ec7nh vi\u1ec7n v\u1edbi c\u00e1c chuy\u00ean gia h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c BV Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u00e0 chuy\u1ec3n vi\u1ec7n v\u00e0o ng\u00e0y 05.11.2023.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image aligncenter uagb-block-81184989 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-center\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/Hinh-4-1024x704.jpg\" alt=\"\" class=\"uag-image-4211\" width=\"1024\" height=\"704\" title=\"\" loading=\"lazy\" \/><\/figure><\/div>\n\n\n\n<p>ThS.BS Giang Minh Nh\u1eadt \u2013 Tr\u01b0\u1edfng \u0111\u01a1n v\u1ecb H\u1ed3i s\u1ee9c tim m\u1ea1ch B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: <em>\u201c Ng\u01b0\u1eddi b\u1ec7nh chuy\u1ec3n \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh trong t\u00ecnh tr\u1ea1ng suy h\u00f4 h\u1ea5p di\u1ec5n ti\u1ebfn nguy k\u1ecbch, \u0111\u01b0\u1ee3c \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 th\u1edf m\u00e1y x\u00e2m l\u1ea5n.Tuy nhi\u00ean, t\u1ed5n th\u01b0\u01a1ng nhu m\u00f4 ph\u1ed5i b\u1ec7nh nh\u00e2n ti\u1ebfn tri\u1ec3n nhanh, \u0111\u00f4ng \u0111\u1eb7c c\u1ea3 hai ph\u1ed5i. S\u1ea3n ph\u1ee5 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi th\u00f4ng kh\u00ed x\u00e2m l\u1ea5n, m\u1eb7c d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 th\u00f4ng kh\u00ed t\u1ed1i \u0111a v\u00e0 ng\u1eebng tim hai l\u1ea7n v\u00ec suy h\u00f4 h\u1ea5p n\u1eb7ng. Nh\u1eadn \u0111\u1ecbnh \u0111\u00e2y l\u00e0 m\u1ed9t tr\u01b0\u1eddng h\u1ee3p b\u1ec7nh r\u1ea5t n\u1eb7ng v\u1ec1 tim m\u1ea1ch-s\u1ea3n khoa, c\u00f3 t\u1ed5n th\u01b0\u01a1ng \u0111a c\u01a1 quan (t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i, t\u1ed5n th\u01b0\u01a1ng th\u1eadn, t\u1ed5n th\u01b0\u01a1ng gan), s\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n c\u1ea5p b\u1ec7nh vi\u1ec7n ngay trong \u0111\u00eam v\u00e0 ti\u1ebfn h\u00e0nh can thi\u1ec7p VV ECMO (oxy h\u00f3a m\u00e1u qua m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3 ch\u1ec9 \u0111\u1ecbnh trong tr\u01b0\u1eddng h\u1ee3p suy h\u00f4 h\u1ea5p n\u1eb7ng) t\u1ea1i \u0111\u01a1n v\u1ecb H\u1ed3i s\u1ee9c tim m\u1ea1ch.\u201d<\/em><\/p>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"aligncenter size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"969\" height=\"527\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/image-8.png\" alt=\"\" class=\"wp-image-4210\" srcset=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/image-8.png 969w, https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/image-8-300x163.png 300w, https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/image-8-768x418.png 768w, https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/image-8-600x326.png 600w\" sizes=\"auto, (max-width: 969px) 100vw, 969px\" \/><\/figure><\/div>\n\n\n<p>Sau can thi\u1ec7p VV-ECMO 8 ng\u00e0y k\u1ebft h\u1ee3p l\u1ecdc m\u00e1u li\u00ean t\u1ee5c, ki\u1ec3m so\u00e1t huy\u1ebft \u00e1p, ch\u1ee9c n\u0103ng gan v\u00e0 th\u1eadn b\u1ec7nh nh\u00e2n c\u1ea3i thi\u1ec7n, \u0111\u1ed3ng th\u1eddi, t\u1ed5n th\u01b0\u01a1ng ph\u1ed5i ph\u1ee5c h\u1ed3i ngo\u1ea1n m\u1ee5c. S\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c r\u00fat n\u1ed9i kh\u00ed qu\u1ea3n v\u00e0 t\u1ef1 th\u1edf kh\u00ed tr\u1eddi ng\u00e0y 13.11.2023 v\u00e0 ng\u01b0ng VV ECMO ng\u00e0y 14.11.2023.<\/p>\n\n\n\n<p>TS.BS B\u00f9i Ch\u00ed Th\u01b0\u01a1ng \u2013 Tr\u01b0\u1edfng kh\u1ed1i S\u1ea3n \u2013 B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: <em>\u201cS\u1ea3n gi\u1eadt l\u00e0 m\u1ed9t bi\u1ebfn ch\u1ee9ng n\u1eb7ng c\u1ee7a s\u1ea3n khoa, c\u00f3 th\u1ec3 g\u00e2y xu\u1ea5t huy\u1ebft n\u00e3o, suy h\u00f4 h\u1ea5p, suy \u0111a t\u1ea1ng v\u00e0 t\u1eed vong n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c x\u1eed tr\u00ed k\u1ecbp th\u1eddi v\u00e0 ph\u1ed1i h\u1ee3p \u0111a chuy\u00ean khoa ph\u00f9 h\u1ee3p. V\u00ec khi s\u1ea3n gi\u1eadt x\u1ea3y ra, BS s\u1ea3n khoa s\u1ebd \u0111i\u1ec1u tr\u1ecb b\u1eb1ng c\u00e1ch ch\u1ea5m d\u1ee9t thai k\u1ef3 nh\u01b0ng h\u1eadu qu\u1ea3 c\u1ee7a s\u1ea3n gi\u1eadt tr\u00ean c\u00e1c c\u01a1 quan c\u1ea7n s\u1ef1 ph\u1ed1i h\u1ee3p c\u1ee7a c\u00e1c chuy\u00ean khoa h\u1ed3i s\u1ee9c n\u1ed9i khoa c\u00f3 vai tr\u00f2 quy\u1ebft \u0111\u1ecbnh \u0111\u1ec3 c\u1ee9u b\u1ec7nh nh\u00e2n nh\u01b0 h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c, h\u1ed3i s\u1ee9c tim m\u1ea1ch, trong \u0111\u00f3 vai tr\u00f2 l\u1ecdc m\u00e1u v\u00e0 ECMO l\u00e0 y\u1ebfu t\u1ed1 s\u1ed1ng c\u00f2n\u2026\u0110i\u1ec1u may m\u1eafn trong tr\u01b0\u1eddng h\u1ee3p n\u00e0y l\u00e0 ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c h\u1ed9i ch\u1ea9n li\u00ean b\u1ec7nh vi\u1ec7n k\u1ecbp th\u1eddi v\u00e0 can thi\u1ec7p b\u1eb1ng ph\u01b0\u01a1ng ti\u1ec7n hi\u1ec7n \u0111\u1ea1i, k\u1ef9 thu\u1eadt chuy\u00ean s\u00e2u b\u1edfi c\u00e1c chuy\u00ean gia nhi\u1ec1u kinh nghi\u1ec7m n\u00ean s\u1ee9c kh\u1ecfe \u0111\u00e3 ph\u1ee5c h\u1ed3i ngo\u1ea1n m\u1ee5c.\u201d<\/em><\/p>\n\n\n\n<div class=\"wp-block-uagb-image aligncenter uagb-block-cfcd750b wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-center\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2023\/11\/Hinh-6-1024x683.jpg\" alt=\"\" class=\"uag-image-4212\" width=\"1024\" height=\"683\" loading=\"lazy\" \/><\/figure><\/div>\n\n\n\n<p>S\u1ea3n gi\u1eadt th\u01b0\u1eddng \u0111i sau ti\u1ec1n s\u1ea3n gi\u1eadt, \u0111\u01b0\u1ee3c \u0111\u1eb7c tr\u01b0ng b\u1edfi huy\u1ebft \u00e1p cao x\u1ea3y ra trong thai k\u1ef3 v\u00e0 hi\u1ebfm khi x\u1ea3y ra sau khi sinh.&nbsp; C\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn s\u1ea3n gi\u1eadt trong thai k\u1ef3 bao g\u1ed3m: T\u0103ng huy\u1ebft \u00e1p thai k\u1ef3 ho\u1eb7c m\u00e3n t\u00ednh (huy\u1ebft \u00e1p cao), b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng ho\u1eb7c m\u1ed9t t\u00ecnh tr\u1ea1ng kh\u00e1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn m\u1ea1ch m\u00e1u, b\u1ec7nh th\u1eadn\u2026C\u00e1c b\u00e1c s\u1ef9 c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n ra c\u00e1c d\u1ea5u hi\u1ec7u b\u1ea5t th\u01b0\u1eddng th\u00f4ng qua th\u0103m kh\u00e1m v\u00e0 c\u00e1c k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m trong thai k\u1ef3 c\u00f3 b\u1ea5t th\u01b0\u1eddng ch\u1eb3ng h\u1ea1n nh\u01b0 ch\u1ec9 s\u1ed1 protein trong n\u01b0\u1edbc ti\u1ec3u. Ch\u00ednh v\u00ec v\u1eady \u0111\u1ec3 ph\u00f2ng ng\u1eeba s\u1ea3n gi\u1eadt c\u0169ng nh\u01b0 c\u00e1c bi\u1ec3u hi\u1ec7n b\u1ea5t th\u01b0\u1eddng kh\u00e1c, c\u00e1c b\u00e0 m\u1eb9 h\u00e3y \u0111i kh\u00e1m thai \u0111\u1ecbnh k\u1ef3 v\u00e0 tu\u00e2n th\u1ee7 theo h\u01b0\u1edbng d\u1eabn c\u1ee7a b\u00e1c s\u1ef9.\/<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u1ede tu\u1ea7n thai th\u1ee9 31, ch\u1ecb L.T.K.Anh ch\u1ea9n \u0111o\u00e1n s\u1ea3n gi\u1eadt, t\u1ed5n th\u01b0\u01a1ng \u0111a c\u01a1 quan (suy th\u1eadn, suy gan c\u1ea5p, suy h\u00f4 h\u1ea5p n\u1eb7ng). Khi \u0111\u01b0\u1ee3c \u0111\u1eb7t n\u1ed9i kh\u00ed qu\u1ea3n, th\u1edf m\u00e1y, b\u1ec7nh nh\u00e2n ti\u1ebfp t\u1ee5c di\u1ec5n ti\u1ebfn nguy k\u1ecbch, 2 l\u1ea7n ng\u01b0ng tim \u0111e d\u1ecda t\u00ednh m\u1ea1ng. B\u1eb1ng s\u1ef1 n\u1ed7 l\u1ef1c, ph\u1ed1i h\u1ee3p 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