{"id":8965,"date":"2025-03-27T15:49:57","date_gmt":"2025-03-27T08:49:57","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=8965"},"modified":"2025-03-27T15:54:13","modified_gmt":"2025-03-27T08:54:13","slug":"cac-phuong-phap-dieu-tri-benh-dong-mach-ngoai-bien","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=8965","title":{"rendered":"C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean"},"content":{"rendered":"\n

B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean, trong \u0111\u00f3 v\u00f9ng \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi chi\u1ebfm ph\u1ea7n l\u1edbn l\u00e0 t\u00ecnh tr\u1ea1ng t\u1eafc h\u1eb9p ho\u1eb7c t\u1eafc ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi do x\u01a1 v\u1eefa, d\u1eabn \u0111\u1ebfn gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u1edbi ch\u00e2n. B\u1ec7nh g\u00e2y tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au c\u00e1ch h\u1ed3i khi \u0111i b\u1ed9, l\u1ea1nh ch\u00e2n, t\u00edm t\u00e1i, th\u1eadm ch\u00ed lo\u00e9t ho\u1eb7c ho\u1ea1i t\u1eed \u1edf giai \u0111o\u1ea1n n\u1eb7ng, \u0111e d\u1ecda nguy c\u01a1 c\u1eaft c\u1ee5t chi.<\/em><\/strong><\/p>\n\n\n

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C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n

C\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean bao g\u1ed3m thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng (b\u1ecf thu\u1ed1c l\u00e1, t\u1eadp th\u1ec3 d\u1ee5c), d\u00f9ng thu\u1ed1c (ch\u1ed1ng \u0111\u00f4ng, gi\u00e3n m\u1ea1ch), ph\u1eabu thu\u1eadt m\u1edf v\u00e0 can thi\u1ec7p n\u1ed9i m\u1ea1ch.<\/p>\n\n\n\n

Can thi\u1ec7p n\u1ed9i m\u1ea1ch n\u1ed5i b\u1eadt v\u1edbi \u01b0u \u0111i\u1ec3m \u00edt x\u00e2m l\u1ea5n, gi\u1ea3m nguy c\u01a1 bi\u1ebfn ch\u1ee9ng so v\u1edbi ph\u1eabu thu\u1eadt m\u1edf, th\u1eddi gian h\u1ed3i ph\u1ee5c nhanh v\u00e0 ph\u00f9 h\u1ee3p cho c\u1ea3 t\u1ed5n th\u01b0\u01a1ng \u0111\u01a1n gi\u1ea3n l\u1eabn ph\u1ee9c t\u1ea1p. K\u1ef9 thu\u1eadt n\u00e0y s\u1eed d\u1ee5ng \u1ed1ng th\u00f4ng (catheter) \u0111\u01b0a qua \u0111\u01b0\u1eddng m\u1ea1ch m\u00e1u d\u01b0\u1edbi h\u01b0\u1edbng d\u1eabn h\u00ecnh \u1ea3nh h\u1ecdc \u0111\u1ec3 nong m\u1ea1ch, \u0111\u1eb7t stent ho\u1eb7c t\u00e1i th\u00f4ng c\u00e1c \u0111o\u1ea1n t\u1eafc ngh\u1ebdn, t\u1eeb \u0111\u1ed9ng m\u1ea1ch l\u1edbn nh\u01b0 \u0111\u1ed9ng m\u1ea1ch ch\u1ee7 – ch\u1eadu \u0111\u1ebfn c\u00e1c nh\u00e1nh nh\u1ecf \u1edf b\u00e0n ch\u00e2n.<\/p>\n\n\n\n

T\u1ea1i B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, \u0110\u01a1n v\u1ecb X Quang Can thi\u1ec7p \u0111\u00e3 th\u1ef1c hi\u1ec7n th\u00e0nh c\u00f4ng h\u01a1n 600 ca can thi\u1ec7p n\u1ed9i m\u1ea1ch, bao g\u1ed3m c\u00e1c tr\u01b0\u1eddng h\u1ee3p ph\u1ee9c t\u1ea1p nh\u01b0: t\u1eafc h\u1eb9p nhi\u1ec1u t\u1ea7ng, thi\u1ebfu m\u00e1u n\u1eb7ng g\u00e2y \u0111au l\u1ea1nh t\u00edm ch\u00e2n ho\u1eb7c bi\u1ebfn ch\u1ee9ng lo\u00e9t ho\u1ea1i t\u1eed \u0111e d\u1ecda \u0111o\u1ea1n chi. V\u1edbi trang thi\u1ebft b\u1ecb hi\u1ec7n \u0111\u1ea1i v\u00e0 \u0111\u1ea7y \u0111\u1ee7 d\u1ee5ng c\u1ee5 chuy\u00ean d\u1ee5ng nh\u01b0: d\u1ee5ng c\u1ee5 khoan ph\u00e1 m\u1ea3ng x\u01a1 v\u1eefa l\u00e0m r\u1ed9ng l\u00f2ng m\u1ea1ch, h\u1ec7 th\u1ed1ng h\u00fat huy\u1ebft kh\u1ed1i, c\u00e1c h\u1ec7 th\u1ed1ng gi\u00e1 \u0111\u1ee1 (stent) chuy\u00ean d\u1ee5ng ph\u00f9 h\u1ee3p cho c\u00e1c \u0111o\u1ea1n m\u1ea1ch kh\u00e1c nhau, c\u00e1c h\u1ec7 th\u1ed1ng b\u00f3ng nong t\u1eeb si\u00eau nh\u1ecf \u0111\u01b0\u1eddng k\u00ednh 1.5-3.5 mm cho v\u00f9ng c\u1eb3ng b\u00e0n ch\u00e2n \u0111\u1ebfn 10-20 mm cho \u0111\u1ed9ng m\u1ea1ch v\u00e0 t\u0129nh m\u1ea1ch ch\u1ee7 ch\u1eadu, b\u00f3ng nong ph\u1ee7 thu\u1ed1c ch\u1ed1ng t\u0103ng sinh n\u1ed9i m\u1ea1c ng\u0103n t\u00e1i h\u1eb9p v\u00e0 stent ph\u1ee7 thu\u1ed1c, \u0111\u01a1n v\u1ecb \u0111\u00e1p \u1ee9ng to\u00e0n di\u1ec7n t\u1eeb k\u1ef9 thu\u1eadt \u0111\u01a1n gi\u1ea3n \u0111\u1ebfn ph\u1ee9c t\u1ea1p, \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m y t\u1ebf chi tr\u1ea3. Can thi\u1ec7p n\u1ed9i m\u1ea1ch kh\u00f4ng ch\u1ec9 t\u00e1i th\u00f4ng hi\u1ec7u qu\u1ea3 c\u00e1c t\u1ed5n th\u01b0\u01a1ng h\u1eb9p hay t\u1eafc ngh\u1ebdn k\u00e9o d\u00e0i m\u00e0 c\u00f2n l\u00e0 gi\u1ea3i ph\u00e1p thay th\u1ebf ph\u1eabu thu\u1eadt m\u1edf \u1edf nh\u1eefng v\u00f9ng m\u1ea1ch g\u1ea7n kh\u1edbp v\u1eadn \u0111\u1ed9ng, gi\u00fap c\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng v\u00e0 b\u1ea3o t\u1ed3n chi cho ng\u01b0\u1eddi b\u1ec7nh.<\/p>\n\n\n\n

Nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao m\u1eafc b\u1ec7nh<\/strong><\/p>\n\n\n\n

C\u00e1c nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao m\u1eafc b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean bao g\u1ed3m ng\u01b0\u1eddi tr\u00ean 60 tu\u1ed5i, ng\u01b0\u1eddi h\u00fat thu\u1ed1c l\u00e1 l\u00e2u n\u0103m, ng\u01b0\u1eddi b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n lipid m\u00e1u, c\u00f3 ti\u1ec1n s\u1eed gia \u0111\u00ecnh m\u1eafc b\u1ec7nh tim m\u1ea1ch ho\u1eb7c \u0111\u1ed9t qu\u1ef5.<\/p>\n\n\n\n

Ph\u00f2ng ng\u1eeba<\/strong><\/strong><\/p>\n\n\n\n

\u0110\u1ec3 ph\u00f2ng ng\u1eeba v\u00e0 ph\u00e1t hi\u1ec7n s\u1edbm b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean, ng\u01b0\u1eddi b\u1ec7nh n\u00ean t\u1ea7m so\u00e1t \u0111\u1ecbnh k\u1ef3 b\u1eb1ng ch\u1ec9 s\u1ed1 ABI (ch\u1ec9 s\u1ed1 \u00e1p l\u1ef1c c\u1ed5 ch\u00e2n – c\u00e1nh tay) v\u00e0 si\u00eau \u00e2m Doppler m\u1ea1ch m\u00e1u.<\/p>\n\n\n\n

Khi c\u00f3 d\u1ea5u hi\u1ec7u nh\u01b0 \u0111au ch\u00e2n khi \u0111i b\u1ed9, l\u1ea1nh ho\u1eb7c \u0111\u1ed5i m\u00e0u da ch\u00e2n, c\u1ea7n th\u0103m kh\u00e1m ngay t\u1ea1i c\u00e1c c\u01a1 s\u1edf y t\u1ebf chuy\u00ean s\u00e2u. \u0110i\u1ec1u tr\u1ecb s\u1edbm, \u0111\u1eb7c bi\u1ec7t b\u1eb1ng can thi\u1ec7p n\u1ed9i m\u1ea1ch khi c\u1ea7n thi\u1ebft \u1edf nh\u1eefng trung t\u00e2m nhi\u1ec1u kinh nghi\u1ec7m v\u00e0 \u0111\u1ea7y \u0111\u1ee7 trang thi\u1ebft b\u1ecb, c\u00f3 th\u1ec3 ng\u0103n ti\u1ebfn tri\u1ec3n b\u1ec7nh, gi\u1ea3m nguy c\u01a1 bi\u1ebfn ch\u1ee9ng n\u1eb7ng v\u00e0 b\u1ea3o v\u1ec7 chi hi\u1ec7u qu\u1ea3.<\/p>\n\n\n\n

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T\u1eafc \u0111\u1ed9ng m\u1ea1ch ch\u1eadu ph\u1ea3i v\u00e0 h\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1eadu tr\u00e1i \u0111\u01b0\u1ee3c t\u00e1i th\u00f4ng v\u00e0 h\u00ecnh \u1ea3nh b\u00e0n ch\u00e2n l\u1ea1nh t\u00edm c\u00f3 ho\u1ea1i t\u1eed \u1edf ng\u00f3n ch\u00e2n do thi\u1ebfu m\u00e1u \u0111\u1ebfn nu\u00f4i d\u01b0\u1ee1ng.<\/em><\/strong><\/p>\n\n\n\n

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Thi\u1ebft b\u1ecb khoan c\u1eaft m\u1ea3ng x\u01a1 v\u1eefa – m\u1edf r\u1ed9ng l\u00f2ng m\u1ea1ch<\/em><\/strong><\/p>\n\n\n\n

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H\u1eb9p \u0111\u1ed9ng m\u1ea1ch ch\u1eadu ngo\u00e0i – t\u1eafc \u0111o\u1ea1n d\u00e0i \u0111\u1ed9ng m\u1ea1ch \u0111\u00f9i n\u00f4ng v\u00e0 khoeo<\/em><\/strong><\/p>\n\n\n\n

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Th\u1ee7 thu\u1eadt t\u00e1i th\u00f4ng th\u00e0nh c\u00f4ng nhi\u1ec1u t\u1ea7ng \u0111\u1ed9ng m\u1ea1ch<\/em><\/strong><\/p>\n\n\n\n

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\u0110i\u1ec1u tr\u1ecb b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p t\u1ea1i BV Nh\u00e2n D\u00e2n Gia \u0110\u1ecbnh, t\u1ec9 l\u1ec7 cao ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ea1t t\u00e1i th\u00f4ng \u0111\u1ebfn b\u00e0n ch\u00e2n<\/em><\/strong><\/p>\n\n\n\n

B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1edfi BS.CK2 Tr\u1ea7n Minh Hi\u1ec1n – \u0110\u01a1n v\u1ecb X Quang can thi\u1ec7p<\/em><\/strong><\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

B\u1ec7nh \u0111\u1ed9ng m\u1ea1ch ngo\u1ea1i bi\u00ean, trong \u0111\u00f3 v\u00f9ng \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi chi\u1ebfm ph\u1ea7n l\u1edbn l\u00e0 t\u00ecnh tr\u1ea1ng t\u1eafc h\u1eb9p ho\u1eb7c t\u1eafc ngh\u1ebdn \u0111\u1ed9ng m\u1ea1ch chi d\u01b0\u1edbi do x\u01a1 v\u1eefa, d\u1eabn \u0111\u1ebfn gi\u1ea3m l\u01b0u l\u01b0\u1ee3ng m\u00e1u t\u1edbi ch\u00e2n. B\u1ec7nh g\u00e2y tri\u1ec7u ch\u1ee9ng nh\u01b0 \u0111au c\u00e1ch h\u1ed3i khi \u0111i b\u1ed9, l\u1ea1nh ch\u00e2n, t\u00edm t\u00e1i, th\u1eadm ch\u00ed 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