{"id":9163,"date":"2025-04-12T09:00:00","date_gmt":"2025-04-12T02:00:00","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=9163"},"modified":"2025-04-11T15:25:12","modified_gmt":"2025-04-11T08:25:12","slug":"cuu-song-nguoi-benh-ngung-tim-do-roi-loan-nhip-that-khang-tri-bang-qui-trinh-hoi-suc-cap-cuu-ngung-tim-noi-vien-e-cpr","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=9163","title":{"rendered":"C\u1ee8U S\u1ed0NG NG\u01af\u1edcI B\u1ec6NH NG\u1eeaNG TIM DO R\u1ed0I LO\u1ea0N NH\u1ecaP TH\u1ea4T KH\u00c1NG TR\u1eca B\u1eb0NG QUI TR\u00ccNH H\u1ed2I S\u1ee8C C\u1ea4P C\u1ee8U NG\u1eeaNG TIM N\u1ed8I VI\u1ec6N E-CPR"},"content":{"rendered":"\n

B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba c\u1ea5p c\u1ee9u th\u00e0nh c\u00f4ng m\u1ed9t tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh nam, 55 tu\u1ed5i, t\u1eeb Ninh Thu\u1eadn \u0111\u1ebfn TP.HCM kh\u00e1m b\u1ec7nh v\u00e0 \u0111\u1ed9t ng\u1ed9t ng\u1eebng tim khi v\u1eeba \u0111\u1ebfn b\u1ec7nh vi\u1ec7n. B\u1eb1ng qui tr\u00ecnh h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u ng\u1eebng tim n\u1ed9i vi\u1ec7n E-CPR (h\u1ed3i s\u1ee9c tim ph\u1ed5i n\u00e2ng cao c\u00f3 k\u1ebft h\u1ee3p oxy ho\u00e1 m\u00e1u m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3 V-A ECMO), ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ee9u s\u1ed1ng ngo\u1ea1n m\u1ee5c trong b\u1ec7nh c\u1ea3nh nhanh th\u1ea5t kh\u00e1ng tr\u1ecb do nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p.<\/em><\/strong><\/p>\n\n\n\n

Anh T.Q.B, 55 tu\u1ed5i, ng\u1ee5 t\u1ec9nh Ninh Thu\u1eadn, \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh kh\u00e1m b\u1ec7nh v\u00ec tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c t\u1eebng c\u01a1n kho\u1ea3ng 2 tu\u1ea7n nay v\u00e0 \u0111i\u1ec1u tr\u1ecb ban \u0111\u1ea7u ch\u01b0a \u0111\u00e1p \u1ee9ng. Ng\u00e0y 26\/3\/2025, khi v\u1eeba \u0111\u1ebfn B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh \u0111\u0103ng k\u00fd kh\u00e1m b\u1ec7nh, anh B. \u0111\u1ed9t ng\u1ed9t g\u1ed3ng c\u1ee9ng ng\u01b0\u1eddi v\u00e0 ng\u1eebng tim. Ngay l\u1eadp t\u1ee9c, ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c nh\u00e2n vi\u00ean y t\u1ebf khoa Kh\u00e1m b\u1ec7nh h\u1ed3i sinh tim ph\u1ed5i v\u00e0 chuy\u1ec3n \u0111\u1ebfn ph\u00f2ng c\u1ea5p c\u1ee9u. Sau 15 ph\u00fat \u1ea5n tim ngo\u00e0i l\u1ed3ng ng\u1ef1c v\u00e0 s\u1ed1c \u0111i\u1ec7n nhi\u1ec1u l\u1ea7n v\u00ec nhanh th\u1ea5t kh\u00f4ng th\u00e0nh c\u00f4ng, qui tr\u00ecnh h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u ng\u1eebng tim n\u1ed9i vi\u1ec7n E-CPR \u0111\u01b0\u1ee3c k\u00edch ho\u1ea1t. Trong v\u00f2ng 5 ph\u00fat sau \u0111\u00f3, \u00ea-k\u00edp khoa H\u1ed3i s\u1ee9c tim m\u1ea1ch ph\u1ed1i h\u1ee3p v\u1edbi khoa C\u1ea5p c\u1ee9u ti\u1ebfn h\u00e0nh \u1ea5n tim ngo\u00e0i l\u1ed3ng ng\u1ef1c, can thi\u1ec7p V-A ECMO (oxy ho\u00e1 m\u00e1u m\u00e0ng ngo\u00e0i c\u01a1 th\u1ec3 ph\u01b0\u01a1ng th\u1ee9c \u0111\u1ed9ng m\u1ea1ch – t\u0129nh m\u1ea1ch) cho ng\u01b0\u1eddi b\u1ec7nh. Sau 35 ph\u00fat k\u1ec3 t\u1eeb khi ng\u1eebng tim, anh B. \u0111\u00e3 \u0111\u01b0\u1ee3c duy tr\u00ec \u1ed5n \u0111\u1ecbnh cung l\u01b0\u1ee3ng tim \u0111\u1ea3m b\u1ea3o t\u01b0\u1edbi m\u00e1u c\u01a1 quan. V\u1edbi nguy\u00ean nh\u00e2n ng\u1eebng tim \u0111\u01b0\u1ee3c ngh\u0129 \u0111\u1ebfn nhi\u1ec1u nh\u1ea5t l\u00e0 nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p, ngay sau can thi\u1ec7p V-A ECMO th\u00e0nh c\u00f4ng, trong t\u00ecnh tr\u1ea1ng nhanh th\u1ea5t li\u00ean t\u1ee5c kh\u00e1ng tr\u1ecb, anh B. \u0111\u01b0\u1ee3c chuy\u1ec3n ngay \u0111\u1ebfn ph\u00f2ng th\u00f4ng tim t\u1ea1i khoa Tim m\u1ea1ch can thi\u1ec7p \u0111\u1ec3 ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u1ee9u. K\u1ebft qu\u1ea3 ch\u1ee5p \u0111\u1ed9ng m\u1ea1ch v\u00e0nh cho th\u1ea5y anh B. b\u1ecb t\u1eafc ho\u00e0n to\u00e0n c\u1ea5p t\u00ednh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh b\u00ean tr\u00e1i nh\u00e1nh li\u00ean th\u1ea5t tr\u01b0\u1edbc. Anh B. \u0111\u01b0\u1ee3c can thi\u1ec7p \u0111\u1eb7t stent c\u1ea5p c\u1ee9u \u0111\u1ec3 t\u00e1i l\u1eadp d\u00f2ng ch\u1ea3y \u1edf \u0111\u1ed9ng m\u1ea1ch v\u00e0nh ch\u00ednh nu\u00f4i tim. Sau khi t\u00e1i t\u01b0\u1edbi m\u00e1u th\u00e0nh c\u00f4ng, r\u1ed1i lo\u1ea1n nh\u1ecbp th\u1ea5t h\u1ed3i ph\u1ee5c ngo\u1ea1n m\u1ee5c tr\u1edf v\u1ec1 nh\u1ecbp tim b\u00ecnh th\u01b0\u1eddng, anh B. \u0111\u01b0\u1ee3c ng\u1eebng V-A ECMO sau 48 gi\u1edd v\u00e0 \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n sau 7 ng\u00e0y.\u00a0<\/p>\n\n\n\n

Th\u1ea1c s\u0129 – B\u00e1c s\u0129 V\u00f5 V\u0103n Tr\u1eafng, khoa H\u1ed3i s\u1ee9c tim m\u1ea1ch, b\u00e1c s\u0129 \u0111i\u1ec1u tr\u1ecb ch\u00ednh cho anh B. cho bi\u1ebft: \u201cE-CPR l\u00e0 ph\u01b0\u01a1ng th\u1ee9c h\u1ed3i sinh tim ph\u1ed5i n\u00e2ng cao v\u1edbi h\u1ed7 tr\u1ee3 c\u1ee7a ECMO, v\u1edbi m\u1ee5c ti\u00eau duy tr\u00ec t\u01b0\u1edbi m\u00e1u c\u01a1 quan \u0111\u00edch trong t\u00ecnh hu\u1ed1ng ng\u01b0ng tim do nguy\u00ean nh\u00e2n tim m\u1ea1ch v\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng \u0111i\u1ec1u tr\u1ecb h\u1ed3i s\u1ee9c ban \u0111\u1ea7u. Nhi\u1ec1u nghi\u00ean c\u1ee9u tr\u00ean th\u1ebf gi\u1edbi \u0111\u00e3 ch\u1ee9ng minh E-CPR \u1ee9ng d\u1ee5ng trong c\u00e1c t\u00ecnh hu\u1ed1ng ng\u1eebng tim do nhanh th\u1ea5t kh\u00e1ng tr\u1ecb gi\u00fap c\u1ea3i thi\u1ec7n g\u1ea5p \u0111\u00f4i kh\u1ea3 n\u0103ng s\u1ed1ng s\u00f3t c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh v\u1edbi ch\u1ee9c n\u0103ng th\u1ea7n kinh t\u1ed1t. V\u1edbi h\u1ed3i sinh tim ph\u1ed5i th\u00f4ng th\u01b0\u1eddng, cung l\u01b0\u1ee3ng tim ch\u1ec9 \u0111\u01b0\u1ee3c \u0111\u1ea1t 10 – 20% so v\u1edbi cung l\u01b0\u1ee3ng tim b\u00ecnh th\u01b0\u1eddng; nh\u01b0ng v\u1edbi E-CPR, t\u01b0\u1edbi m\u00e1u c\u00e1c c\u01a1 quan tr\u1ecdng y\u1ebfu \u0111\u01b0\u1ee3c duy tr\u00ec kh\u00e1 t\u1ed1t v\u00e0 nguy c\u01a1 suy ch\u1ee9c n\u0103ng t\u1ea1ng sau ng\u1eebng tim k\u00e9o d\u00e0i \u0111\u01b0\u1ee3c gi\u1ea3m thi\u1ec3u. Tuy nhi\u00ean, \u0111\u1ec3 th\u1ef1c hi\u1ec7n E-CPR, \u00ea-k\u00edp c\u1ea7n c\u00f3 nhi\u1ec1u kinh nghi\u1ec7m \u0111\u1ec3 kh\u1edfi \u0111\u1ed9ng V-A ECMO c\u00e0ng nhanh c\u00e0ng t\u1ed1t\u201d.<\/p>\n\n\n\n

Theo BS.CKII Nguy\u1ec5n \u0110\u1ed7 Anh, tr\u01b0\u1edfng khoa Tim m\u1ea1ch can thi\u1ec7p, B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, nhanh th\u1ea5t kh\u00e1ng tr\u1ecb l\u00e0 t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh v\u00e0 k\u00e9o d\u00e0i xu\u1ea5t ph\u00e1t t\u1eeb t\u00e2m th\u1ea5t (kh\u00f4ng ph\u1ea3i \u1ed5 t\u1ea1o nh\u1ecbp tim th\u00f4ng th\u01b0\u1eddng) v\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c hay s\u1ed1c \u0111i\u1ec7n chuy\u1ec3n nh\u1ecbp. D\u1ea1ng r\u1ed1i lo\u1ea1n nh\u1ecbp n\u00e0y c\u00f2n \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 \u201cc\u01a1n b\u00e3o \u0111i\u1ec7n th\u1ebf\u201d v\u00e0 th\u01b0\u1eddng g\u00e2y \u0111\u1ed9t t\u1eed \u1edf ng\u01b0\u1eddi b\u1ec7nh b\u1ecb nh\u1ed3i m\u00e1u c\u01a1 tim c\u1ea5p. T\u00e1i t\u01b0\u1edbi m\u00e1u \u0111\u1ed9ng m\u1ea1ch v\u00e0nh c\u1ea5p c\u1ee9u l\u00e0 ph\u01b0\u01a1ng th\u1ee9c duy nh\u1ea5t \u0111\u1ec3 c\u1ee9u m\u1ea1ng ng\u01b0\u1eddi b\u1ec7nh. Trong t\u00ecnh hu\u1ed1ng kh\u00f3 nh\u01b0 ng\u1eebng tim k\u00e9o d\u00e0i, E-CPR gi\u00fap h\u1ed7 tr\u1ee3 th\u00e0nh c\u00f4ng th\u1ee7 thu\u1eadt t\u00e1i t\u01b0\u1edbi m\u00e1u m\u1ea1ch v\u00e0nh.<\/p>\n\n\n\n

T\u1ea1i B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh, qui tr\u00ecnh h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u ng\u1eebng tim n\u1ed9i vi\u1ec7n E-CPR \u0111\u00e3 \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n th\u1ed1ng nh\u1ea5t trong to\u00e0n b\u1ec7nh vi\u1ec7n, nh\u1eb1m \u0111\u1ea3m b\u1ea3o an to\u00e0n t\u1ed1i \u0111a cho ng\u01b0\u1eddi b\u1ec7nh \u0111\u1ebfn kh\u00e1m b\u1ec7nh c\u0169ng nh\u01b0 \u0111ang \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa. Tuy nhi\u00ean, t\u00ecnh hu\u1ed1ng ng\u1eebng tim \u0111\u1ed9t ng\u1ed9t nh\u01b0 anh B. v\u1eabn c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ng\u0103n ng\u1eeba hi\u1ec7u qu\u1ea3. \u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 tim m\u1ea1ch nh\u01b0 h\u00fat thu\u1ed1c l\u00e1, r\u1ed1i lo\u1ea1n lipid m\u00e1u, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p\u2026, tri\u1ec7u ch\u1ee9ng \u0111au ng\u1ef1c d\u00f9 l\u00e0 nh\u1eb9 c\u0169ng kh\u00f4ng n\u00ean xem th\u01b0\u1eddng v\u00e0 c\u1ea7n \u0111\u1ebfn b\u1ec7nh vi\u1ec7n s\u1edbm \u0111\u1ec3 \u0111\u01b0\u1ee3c c\u00e1c b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 v\u00e0 ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c nguy\u00ean nh\u00e2n.<\/p>\n\n\n

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

B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh v\u1eeba c\u1ea5p c\u1ee9u th\u00e0nh c\u00f4ng m\u1ed9t tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh nam, 55 tu\u1ed5i, t\u1eeb Ninh Thu\u1eadn \u0111\u1ebfn TP.HCM kh\u00e1m b\u1ec7nh v\u00e0 \u0111\u1ed9t ng\u1ed9t ng\u1eebng tim khi v\u1eeba \u0111\u1ebfn b\u1ec7nh vi\u1ec7n. B\u1eb1ng qui tr\u00ecnh h\u1ed3i s\u1ee9c c\u1ea5p c\u1ee9u ng\u1eebng tim n\u1ed9i vi\u1ec7n E-CPR (h\u1ed3i s\u1ee9c tim ph\u1ed5i n\u00e2ng cao c\u00f3 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