{"id":4897,"date":"2024-01-19T11:25:05","date_gmt":"2024-01-19T04:25:05","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=4897"},"modified":"2024-01-19T11:25:08","modified_gmt":"2024-01-19T04:25:08","slug":"cap-cuu-thanh-cong-san-phu-thuyen-tac-oi-kem-bang-huyet-sau-sanh-voi-nhieu-lan-ngung-tim","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=4897","title":{"rendered":"C\u1ea4P C\u1ee8U TH\u00c0NH C\u00d4NG S\u1ea2N PH\u1ee4 THUY\u00caN T\u1eaeC \u1ed0I K\u00c8M B\u0102NG HUY\u1ebeT SAU SANH V\u1edaI NHI\u1ec0U L\u1ea6N NG\u01afNG TIM"},"content":{"rendered":"\n<p><strong><em>Ng\u01b0ng tim l\u1ea7n th\u1ee9 nh\u1ea5t ngay sau khi sinh con do thuy\u00ean t\u1eafc \u1ed1i, ch\u1ecb \u0110.H.N \u0111\u01b0\u1ee3c chuy\u1ec3n c\u1ea5p c\u1ee9u \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh. Khi v\u1eeba t\u1edbi khoa c\u1ea5p c\u1ee9u, ch\u1ecb N ti\u1ebfp t\u1ee5c ng\u01b0ng tim l\u1ea7n 2, m\u1ea5t m\u00e1u \u1ed3 \u1ea1t l\u01b0\u1ee3ng l\u1edbn. Ng\u01b0\u1eddi b\u1ec7nh nh\u00e2n r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng v\u00f4 c\u00f9ng nguy k\u1ecbch v\u1eeba cho\u00e1ng tim, ph\u00f9 ph\u1ed5i c\u1ea5p, cho\u00e1ng m\u1ea5t m\u00e1u v\u00e0 \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa. \u00ca-k\u00edp g\u1ea7n 10 b\u00e1c s\u0129 h\u1ed3i s\u1ee9c tim m\u1ea1ch v\u00e0 s\u1ea3n khoa \u0111\u00e3 ph\u1ed1i h\u1ee3p ph\u1eabu thu\u1eadt \u0111\u1eb7t VA-ECMO (oxy h\u00f3a m\u00e1u m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3) v\u00e0 v\u1eeba \u0111\u1eb7t b\u00f3ng ch\u00e8n t\u1eed cung \u0111\u1ec3 c\u1ea5p c\u1ee9u cho ng\u01b0\u1eddi b\u1ec7nh. Sau 12 gi\u1edd h\u1ed3i s\u1ee9c v\u1edbi c\u00e1c k\u1ef9 thu\u1eadt chuy\u00ean s\u00e2u, ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 h\u1ed3i ph\u1ee5c tri gi\u00e1c ho\u00e0n to\u00e0n, \u1ed5n \u0111\u1ecbnh sinh hi\u1ec7u, h\u00f4 h\u1ea5p, \u0111\u00f4ng m\u00e1u \u1ed5n \u0111\u1ecbnh v\u00e0 r\u00fat n\u1ed9i kh\u00ed qu\u1ea3n th\u00e0nh c\u00f4ng, s\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c b\u1ea3o to\u00e0n t\u1eed cung.<\/em><\/strong><\/p>\n\n\n\n<p>\u00a0Ch\u1ecb \u0110.H.N 34 tu\u1ed5i, ng\u1ee5 t\u1ea1i B\u00ecnh D\u01b0\u01a1ng, mang thai l\u1ea7n th\u1ee9 3 v\u1edbi thai k\u1ef3 ho\u00e0n to\u00e0n b\u00ecnh th\u01b0\u1eddng. \u0110\u1ebfn tu\u1ea7n th\u1ee9 40, ch\u1ecb nh\u1eadp b\u1ec7nh vi\u1ec7n t\u1ea1i \u0111\u1ecba ph\u01b0\u01a1ng \u0111\u1ec3 m\u1ed5 l\u1ea5y thai v\u00ec v\u1ebft m\u1ed5 c\u0169. Khi v\u1eeba sanh b\u00e9 g\u00e1i n\u1eb7ng 4.300g, s\u1ea3n ph\u1ee5 \u0111\u1ed9t ng\u1ed9t ng\u01b0ng tim ng\u01b0ng th\u1edf. M\u1eb7c d\u00f9 \u0111\u01b0\u1ee3c \u00ea-kip b\u00e1c s\u0129 g\u00e2y m\u00ea h\u1ed3i s\u1ee9c t\u1ea1i \u0111\u00e2y c\u1ea5p c\u1ee9u th\u00e0nh c\u00f4ng nh\u01b0ng nh\u1eadn th\u1ea5y \u0111\u00e2y l\u00e0 tr\u01b0\u1eddng h\u1ee3p c\u00f3 nhi\u1ec1u kh\u1ea3 n\u0103ng thuy\u00ean t\u1eafc \u1ed1i nguy k\u1ecbch n\u00ean s\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c chuy\u1ec3n vi\u1ec7n ngay l\u1eadp t\u1ee9c \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh. Nh\u1eadn \u0111\u01b0\u1ee3c th\u00f4ng tin t\u1eeb \u0111\u1ed3ng nghi\u1ec7p ngay tr\u00ean tr\u00ean xe c\u1ea5p c\u1ee9u khi c\u00e1ch c\u1ed5ng b\u1ec7nh vi\u1ec7n kho\u1ea3ng 5km, B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh \u0111\u00e3 k\u00edch ho\u1ea1t qui tr\u00ecnh b\u00e1o \u0111\u1ed9ng \u0111\u1ecf, huy \u0111\u1ed9ng \u0111a chuy\u00ean khoa (h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u, s\u1ea3n khoa, h\u1ed3i s\u1ee9c tim m\u1ea1ch) c\u00f3 m\u1eb7t l\u1eadp t\u1ee9c t\u1ea1i khoa c\u1ea5p c\u1ee9u \u0111\u1ec3 ti\u1ebfp nh\u1eadn ng\u01b0\u1eddi b\u1ec7nh. Khi v\u1eeba \u0111\u1ebfn khoa c\u1ea5p c\u1ee9u, s\u1ea3n ph\u1ee5 ng\u1eebng tim l\u1ea7n 2, ch\u1ea3y m\u00e1u \u00e2m \u0111\u1ea1o \u0111\u1ecf t\u01b0\u01a1i li\u00ean t\u1ee5c, v\u1edbi l\u01b0\u1ee3ng m\u00e1u m\u1ea5t \u01b0\u1edbc t\u00ednh kho\u1ea3ng 1 l\u00edt. C\u00e1c b\u00e1c s\u0129 c\u1ea5p c\u1ee9u v\u00e0 s\u1ea3n khoa \u0111\u00e3 ph\u1ed1i h\u1ee3p h\u1ed3i s\u1ee9c ng\u1eebng tim th\u00e0nh c\u00f4ng, \u0111\u01b0a b\u1ec7nh nh\u00e2n th\u1ef1c hi\u1ec7n c\u00e1c c\u1eadn l\u00e2m s\u00e0ng h\u00ecnh \u1ea3nh h\u1ecdc c\u1ea7n thi\u1ebft \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n thuy\u00ean t\u1eafc \u1ed1i v\u00e0 chuy\u1ec3n \u0111\u1ebfn khoa h\u1ed3i s\u1ee9c tim m\u1ea1ch trong v\u00f2ng 30 ph\u00fat k\u1ec3 t\u1eeb khi nh\u1eadp vi\u1ec7n.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-4b26e34e wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2024\/01\/DSC9851-1024x683.jpg\" alt=\"\" class=\"uag-image-4898\" width=\"805\" height=\"537\" title=\"\" loading=\"lazy\" \/><\/figure><\/div>\n\n\n\n<p><strong><em>Ths.BS Tr\u1ea7n<\/em><\/strong><strong><em> Thanh Nam <\/em><\/strong><strong><em>\u2013 \u0110\u01a1n v\u1ecb H\u1ed3i s\u1ee9c tim m\u1ea1ch B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: \u201c T\u1ea1i khoa H\u1ed3i s\u1ee9c tim m\u1ea1ch, s\u1ea3n ph\u1ee5 t\u1ee5t huy\u1ebft \u00e1p n\u1eb7ng, m\u1ea1ch kh\u00f3 b\u1eaft, huy\u1ebft \u00e1p kh\u00f4ng \u0111o \u0111\u01b0\u1ee3c, th\u1edf co k\u00e9o nhi\u1ec1u m\u1eb7c d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c th\u00f4ng kh\u00ed x\u00e2m l\u1ea5n, si\u00eau \u00e2m tim t\u1ea1i gi\u01b0\u1eddng ghi nh\u1eadn suy ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i n\u1eb7ng, v\u00e0 xu\u1ea5t huy\u1ebft \u00e2m \u0111\u1ea1o \u0111\u1ecf t\u01b0\u01a1i ti\u1ebfp t\u1ee5c di\u1ec5n ti\u1ebfn th\u00eam 1 l\u00edt do \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa. <a><\/a><a>\u00ca-k\u00edp g\u1ea7n 10 b\u00e1c s\u0129 h\u1ed3i s\u1ee9c tim m\u1ea1ch v\u00e0 s\u1ea3n khoa \u0111\u00e3 ph\u1ed1i h\u1ee3p v\u1eeba ph\u1eabu thu\u1eadt \u0111\u1eb7t VA-ECMO (oxy h\u00f3a m\u00e1u m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3) nh\u1eb1m \u1ed5n \u0111\u1ecbnh cho\u00e1ng tim, v\u1eeba \u0111\u1eb7t b\u00f3ng ch\u00e8n t\u1eed cung <\/a>\u0111\u1ec3 h\u1ea1n ch\u1ebf b\u0103ng huy\u1ebft sau sanh. B\u00ean c\u1ea1nh \u0111\u00f3, c\u00e1c ch\u1ebf ph\u1ea9m m\u00e1u (h\u1ed3ng c\u1ea7u l\u1eafng, ti\u1ec3u c\u1ea7u v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u) \u0111\u01b0\u1ee3c truy\u1ec1n li\u00ean t\u1ee5c v\u00e0 d\u1ef1 tr\u00f9 t\u00ecnh hu\u1ed1ng ph\u1ea3i thuy\u00ean t\u1eafc \u0111\u1ed9ng m\u1ea1ch t\u1eed cung, th\u1eadm ch\u00ed c\u1eaft t\u1eed cung n\u1ebfu b\u0103ng huy\u1ebft sau sanh kh\u00f3 ki\u1ec3m so\u00e1t.\u201d<\/em><\/strong><\/p>\n\n\n\n<p>\u00a0Khi v\u1eeba \u1ed5n \u0111\u1ecbnh cho\u00e1ng tim do suy ch\u1ee9c n\u0103ng th\u1ea5t ph\u1ea3i v\u1edbi VA-ECMO, ng\u01b0\u1eddi b\u1ec7nh di\u1ec5n ti\u1ebfn sang giai \u0111o\u1ea1n ph\u00f9 ph\u1ed5i c\u1ea5p trong di\u1ec5n ti\u1ebfn b\u1ec7nh sinh c\u1ee7a thuy\u00ean t\u1eafc \u1ed1i. Vi\u1ec7c h\u1ed3i s\u1ee9c b\u1ec7nh nh\u00e2n v\u1eeba cho\u00e1ng tim, v\u1eeba ph\u00f9 ph\u1ed5i c\u1ea5p, v\u1eeba cho\u00e1ng m\u1ea5t m\u00e1u v\u00e0 \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa \u0111\u00f2i h\u1ecfi c\u00e1c b\u00e1c s\u0129 h\u1ed3i s\u1ee9c tim m\u1ea1ch ph\u1ea3i h\u1ebft s\u1ee9c th\u1eadn tr\u1ecdng v\u00e0 t\u1ec9 m\u1ec9. T\u1ed5ng c\u1ed9ng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c v\u1edbi 10 \u0111\u01a1n v\u1ecb h\u1ed3ng c\u1ea7u l\u1eafng (3.500ml m\u00e1u), 2.200ml huy\u1ebft t\u01b0\u01a1ng t\u01b0\u01a1i, 500 ml k\u1ebft t\u1ee7a l\u1ea1nh v\u00e0 3 kh\u1ed1i ti\u1ec3u c\u1ea7u. Sau 12 gi\u1edd h\u1ed3i s\u1ee9c v\u1edbi c\u00e1c ph\u01b0\u01a1ng ti\u1ec7n chuy\u00ean s\u00e2u, b\u1ec7nh nh\u00e2n h\u1ed3i ph\u1ee5c tri gi\u00e1c ho\u00e0n to\u00e0n, \u1ed5n \u0111\u1ecbnh sinh hi\u1ec7u, h\u00f4 h\u1ea5p, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u h\u1ed3i ph\u1ee5c v\u00e0 r\u00fat n\u1ed9i kh\u00ed qu\u1ea3n th\u00e0nh c\u00f4ng, s\u1ea3n ph\u1ee5 \u0111\u01b0\u1ee3c b\u1ea3o to\u00e0n t\u1eed cung. Cho\u00e1ng tim do thuy\u00ean t\u1eafc \u1ed1i h\u1ed3i ph\u1ee5c sau 48 gi\u1edd v\u00e0 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c cai VA-ECMO th\u00e0nh c\u00f4ng trong v\u00f2ng ch\u01b0a \u0111\u1ebfn 72 gi\u1edd v\u00e0 xu\u1ea5t vi\u1ec7n trong v\u00f2ng 1 tu\u1ea7n.<\/p>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-edfa2fb5 wp-block-uagb-image--layout-default wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img decoding=\"async\" src=\"https:\/\/bvndgiadinh.org.vn\/wp-content\/uploads\/2024\/01\/DSC9851-scaled.jpg\" alt=\"\" class=\"uag-image-4898\" width=\"6000\" height=\"4000\" title=\"\" loading=\"lazy\" \/><\/figure><\/div>\n\n\n\n<p><strong><em>TS.BS Hu\u1ef3nh V\u0129nh Ph\u1ea1m Uy\u00ean \u2013 Ph\u00f3 tr\u01b0\u1edfng khoa Sanh B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh cho bi\u1ebft: \u201cThuy\u00ean t\u1eafc \u1ed1i l\u00e0 m\u1ed9t c\u1ea5p c\u1ee9u s\u1ea3n khoa nghi\u00eam tr\u1ecdng, x\u1ea3y ra khi d\u1ecbch \u1ed1i v\u00e0 c\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a nhau thai \u0111i v\u00e0o tu\u1ea7n ho\u00e0n m\u1eb9. Thuy\u00ean t\u1eafc \u1ed1i \u0111\u1eb7c tr\u01b0ng b\u1edfi 3 tri\u1ec7u ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh: t\u1ee5t huy\u1ebft \u00e1p, suy h\u00f4 h\u1ea5p gi\u1ea3m oxy m\u00e1u v\u00e0 \u0111\u00f4ng m\u00e1u n\u1ed9i m\u1ea1ch lan t\u1ecfa. T\u1ec9 l\u1ec7 thuy\u00ean t\u1eafc \u1ed1i trong y v\u0103n dao \u0111\u1ed9ng 1:8,000 \u0111\u1ebfn 1:80,000 s\u1ea3n ph\u1ee5, v\u1edbi t\u1ef7 l\u1ec7 t\u1eed vong m\u1eb9 v\u00e0 t\u1eed vong con g\u1ea7n 70%, v\u00e0 \u0111\u1ebfn 85% thai ph\u1ee5 s\u1ed1ng s\u00f3t m\u1eafc c\u00e1c di ch\u1ee9ng th\u1ea7n kinh v\u0129nh vi\u1ec5n do ng\u01b0ng tu\u1ea7n ho\u00e0n. Thuy\u00ean t\u1eafc \u1ed1i di\u1ec5n ti\u1ebfn l\u00e2m s\u00e0ng ph\u1ee9c t\u1ea1p, c\u1ea7n \u0111\u01b0\u1ee3c ph\u1ed1i h\u1ee3p x\u1eed tr\u00ed li\u00ean chuy\u00ean khoa s\u1ea3n khoa v\u00e0 tim m\u1ea1ch t\u1ea1i c\u00e1c trung t\u00e2m c\u00f3 kinh nghi\u1ec7m.\u201d<\/em><\/strong><\/p>\n\n\n\n<p>&nbsp;T\u1ea1i b\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, \u0111\u00e2y l\u00e0 l\u1ea7n th\u1ee9 2 trong v\u00f2ng 1 th\u00e1ng, b\u1ec7nh nh\u00e2n thuy\u00ean t\u1eafc \u1ed1i c\u00f3 ng\u1eebng tim \u0111\u01b0\u1ee3c c\u1ea5p c\u1ee9u v\u00e0 \u0111i\u1ec1u tr\u1ecb th\u00e0nh c\u00f4ng.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ng\u01b0ng tim l\u1ea7n th\u1ee9 nh\u1ea5t ngay sau khi sinh con do thuy\u00ean t\u1eafc \u1ed1i, ch\u1ecb \u0110.H.N \u0111\u01b0\u1ee3c chuy\u1ec3n c\u1ea5p c\u1ee9u \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh. Khi v\u1eeba t\u1edbi khoa c\u1ea5p c\u1ee9u, ch\u1ecb N ti\u1ebfp t\u1ee5c ng\u01b0ng tim l\u1ea7n 2, m\u1ea5t m\u00e1u \u1ed3 \u1ea1t l\u01b0\u1ee3ng l\u1edbn. Ng\u01b0\u1eddi b\u1ec7nh nh\u00e2n r\u01a1i v\u00e0o t\u00ecnh tr\u1ea1ng v\u00f4 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