{"id":9256,"date":"2025-04-18T15:30:40","date_gmt":"2025-04-18T08:30:40","guid":{"rendered":"https:\/\/bvndgiadinh.org.vn\/?p=9256"},"modified":"2025-04-18T15:30:40","modified_gmt":"2025-04-18T08:30:40","slug":"thong-tin-suc-khoe-cho-nguoi-benh-ky-thuat-hoa-giai-gian-co-ton-du-cuoi-mo-bang-neostigmine-hoac-sugammadex","status":"publish","type":"post","link":"https:\/\/bvndgiadinh.org.vn\/?p=9256","title":{"rendered":"TH\u00d4NG TIN S\u1ee8C KH\u1eceE CHO NG\u01af\u1edcI B\u1ec6NH K\u1ef8 THU\u1eacT H\u00d3A GI\u1ea2I GI\u00c3N C\u01a0 T\u1ed2N D\u01af CU\u1ed0I M\u1ed4 B\u1eb0NG NEOSTIGMINE HO\u1eb6C SUGAMMADEX"},"content":{"rendered":"\n<p class=\"has-text-align-left\"><strong>1. H\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0 g\u00ec?<\/strong><\/p>\n\n\n\n<p>H\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0 k\u1ef9 thu\u1eadt s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c t\u00e1c d\u1ee5ng gi\u00e3n c\u01a1 \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh g\u00e2y m\u00ea \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng c\u01a1 b\u1eafp b\u00ecnh th\u01b0\u1eddng tr\u01b0\u1edbc khi k\u1ebft th\u00fac ph\u1eabu thu\u1eadt. Hai lo\u1ea1i thu\u1ed1c ph\u1ed5 bi\u1ebfn \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng l\u00e0 <strong>Neostigmine<\/strong> v\u00e0 <strong>Sugammadex<\/strong>.<\/p>\n\n\n\n<p><strong>2. Khi n\u00e0o c\u1ea7n s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt n\u00e0y?<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Sau khi ph\u1eabu thu\u1eadt c\u00f3 s\u1eed d\u1ee5ng thu\u1ed1c gi\u00e3n c\u01a1 trong g\u00e2y m\u00ea.<\/li>\n\n\n\n<li>Khi \u0111\u00e1nh gi\u00e1 th\u1ea5y b\u1ec7nh nh\u00e2n v\u1eabn c\u00f2n t\u00e1c d\u1ee5ng gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0m \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn h\u00f4 h\u1ea5p v\u00e0 v\u1eadn \u0111\u1ed9ng.<\/li>\n\n\n\n<li>\u0110\u1ec3 \u0111\u1ea3m b\u1ea3o h\u1ed3i ph\u1ee5c nhanh ch\u00f3ng v\u00e0 an to\u00e0n ch\u1ee9c n\u0103ng c\u01a1 b\u1eafp.<\/li>\n<\/ul>\n\n\n\n<p><strong>3. Quy tr\u00ecnh th\u1ef1c hi\u1ec7n:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Chu\u1ea9n b\u1ecb tr\u01b0\u1edbc th\u1ee7 thu\u1eadt:<\/strong>\n<ul class=\"wp-block-list\">\n<li>\u0110\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 h\u1ed3i ph\u1ee5c c\u1ee7a c\u01a1 b\u1eafp b\u1eb1ng m\u00e1y \u0111o ch\u1ee9c n\u0103ng th\u1ea7n kinh-c\u01a1 (TOF &#8211; Train-of-Four).<\/li>\n\n\n\n<li>X\u00e1c \u0111\u1ecbnh m\u1ee9c \u0111\u1ed9 gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 c\u1ea7n h\u00f3a gi\u1ea3i.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Th\u1ef1c hi\u1ec7n h\u00f3a gi\u1ea3i:<\/strong>\n<ul class=\"wp-block-list\">\n<li><strong>S\u1eed d\u1ee5ng Neostigmine:<\/strong>\n<ul class=\"wp-block-list\">\n<li>Li\u1ec1u d\u00f9ng: 0,03-0,07 mg\/kg, ti\u00eam t\u0129nh m\u1ea1ch ch\u1eadm.<\/li>\n\n\n\n<li>Ph\u1ed1i h\u1ee3p v\u1edbi atropine ho\u1eb7c glycopyrrolate \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 nh\u1ecbp tim ch\u1eadm.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>S\u1eed d\u1ee5ng Sugammadex:<\/strong>\n<ul class=\"wp-block-list\">\n<li>Li\u1ec1u d\u00f9ng: 2-4 mg\/kg t\u00f9y m\u1ee9c \u0111\u1ed9 gi\u00e3n c\u01a1 t\u1ed3n d\u01b0.<\/li>\n\n\n\n<li>Thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng nhanh ch\u00f3ng v\u00e0 \u00edt t\u00e1c d\u1ee5ng ph\u1ee5.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Theo d\u00f5i sau h\u00f3a gi\u1ea3i:<\/strong>\n<ul class=\"wp-block-list\">\n<li>Theo d\u00f5i h\u00f4 h\u1ea5p, nh\u1ecbp tim v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1ed3i ph\u1ee5c v\u1eadn \u0111\u1ed9ng.<\/li>\n\n\n\n<li>\u0110\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o v\u00e0 c\u00f3 th\u1ec3 t\u1ef1 th\u1edf t\u1ed1t tr\u01b0\u1edbc khi xu\u1ea5t kh\u1ecfi ph\u00f2ng h\u1ed3i t\u1ec9nh.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>4. So s\u00e1nh \u01b0u \u0111i\u1ec3m v\u00e0 h\u1ea1n ch\u1ebf c\u1ee7a Neostigmine v\u00e0 Sugammadex:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Neostigmine:<\/strong>\n<ul class=\"wp-block-list\">\n<li><em>\u01afu \u0111i\u1ec3m:<\/em> Chi ph\u00ed th\u1ea5p, ph\u1ed5 bi\u1ebfn, v\u00e0 hi\u1ec7u qu\u1ea3 t\u1ed1t \u0111\u1ed1i v\u1edbi m\u1ee9c gi\u00e3n c\u01a1 nh\u1eb9 \u0111\u1ebfn trung b\u00ecnh.<\/li>\n\n\n\n<li><em>H\u1ea1n ch\u1ebf:<\/em> T\u00e1c d\u1ee5ng ch\u1eadm h\u01a1n so v\u1edbi sugammadex; c\u1ea7n ph\u1ed1i h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1ng cholinergic \u0111\u1ec3 gi\u1ea3m t\u00e1c d\u1ee5ng ph\u1ee5 nh\u01b0 nh\u1ecbp tim ch\u1eadm v\u00e0 t\u0103ng ti\u1ebft n\u01b0\u1edbc b\u1ecdt.<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li><strong>Sugammadex:<\/strong>\n<ul class=\"wp-block-list\">\n<li><em>\u01afu \u0111i\u1ec3m:<\/em> T\u00e1c d\u1ee5ng nhanh, hi\u1ec7u qu\u1ea3 cao ngay c\u1ea3 v\u1edbi m\u1ee9c gi\u00e3n c\u01a1 s\u00e2u, kh\u00f4ng c\u1ea7n ph\u1ed1i h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1ng cholinergic, \u00edt t\u00e1c d\u1ee5ng ph\u1ee5 h\u01a1n. C\u00e1c khuy\u1ebfn c\u00e1o th\u1ef1c h\u00e0nh t\u1ed1t hi\u1ec7n nay \u1ee7ng h\u1ed9 h\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 rocuronium ho\u1eb7c vecuronium b\u1eb1ng sugammadex v\u00ec ch\u1ee9ng m\u00ecnh \u0111\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 gi\u1ea3m nguy c\u01a1 bi\u1ebfn ch\u1ee9ng h\u00f4 h\u1ea5p sau m\u1ed5.<\/li>\n\n\n\n<li><em>H\u1ea1n ch\u1ebf:<\/em> Chi ph\u00ed cao h\u01a1n nhi\u1ec1u so v\u1edbi neostigmine.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>5. Thanh to\u00e1n b\u1ea3o hi\u1ec3m y t\u1ebf:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Neostigmine:<\/strong> \u0110\u01b0\u1ee3c thanh to\u00e1n b\u1ea3o hi\u1ec3m y t\u1ebf do chi ph\u00ed th\u1ea5p v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng r\u1ed9ng r\u00e3i trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng.<\/li>\n\n\n\n<li><strong>Sugammadex:<\/strong> Hi\u1ec7n nay \u0111\u00e3 \u0111\u01b0\u1ee3c b\u1ea3o hi\u1ec3m y t\u1ebf chi tr\u1ea3 khi c\u00f3 ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1edbi neostigmine.<\/li>\n<\/ul>\n\n\n\n<p><strong>6. Quy tr\u00ecnh G\u00e2y m\u00ea H\u1ed3i s\u1ee9c t\u1ea1i B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0110\u00e1nh gi\u00e1 ti\u1ec1n m\u00ea: X\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe t\u1ed5ng qu\u00e1t v\u00e0 ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd.<\/li>\n\n\n\n<li>Gi\u1ea3i th\u00edch quy tr\u00ecnh v\u00e0 h\u01b0\u1edbng d\u1eabn tr\u01b0\u1edbc ph\u1eabu thu\u1eadt.<\/li>\n\n\n\n<li>Chu\u1ea9n b\u1ecb d\u1ee5ng c\u1ee5 g\u00e2y m\u00ea v\u00e0 thu\u1ed1c.<\/li>\n\n\n\n<li>Theo d\u00f5i ch\u1eb7t ch\u1ebd d\u1ea5u hi\u1ec7u sinh t\u1ed3n trong qu\u00e1 tr\u00ecnh g\u00e2y m\u00ea v\u00e0 ph\u1eabu thu\u1eadt.<\/li>\n\n\n\n<li>H\u1ed3i s\u1ee9c sau ph\u1eabu thu\u1eadt \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh v\u00e0 an to\u00e0n.<\/li>\n<\/ul>\n\n\n\n<p><strong>7. C\u1ea3m gi\u00e1c sau h\u00f3a gi\u1ea3i gi\u00e3n c\u01a1:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>C\u01a1 th\u1ec3 h\u1ed3i ph\u1ee5c s\u1ee9c c\u01a1 nhanh ch\u00f3ng v\u00e0 c\u1ea3m th\u1ea5y t\u1ec9nh t\u00e1o.<\/li>\n\n\n\n<li>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u1ea3m th\u1ea5y nh\u1eb9 \u0111\u1ea7u ho\u1eb7c ch\u00f3ng m\u1eb7t tho\u00e1ng qua.<\/li>\n\n\n\n<li>H\u1ea7u h\u1ebft s\u1ebd tr\u1edf l\u1ea1i tr\u1ea1ng th\u00e1i b\u00ecnh th\u01b0\u1eddng trong v\u00f2ng v\u00e0i ph\u00fat \u0111\u1ebfn v\u00e0i gi\u1edd sau khi h\u00f3a gi\u1ea3i.<\/li>\n<\/ul>\n\n\n\n<p><strong>8. Bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Bu\u1ed3n n\u00f4n ho\u1eb7c n\u00f4n m\u1eeda nh\u1eb9.<\/li>\n\n\n\n<li>Nh\u1ecbp tim ch\u1eadm ho\u1eb7c h\u1ea1 huy\u1ebft \u00e1p.<\/li>\n\n\n\n<li>Ph\u1ea3n \u1ee9ng d\u1ecb \u1ee9ng (r\u1ea5t hi\u1ebfm g\u1eb7p).<\/li>\n\n\n\n<li>H\u00f3a gi\u1ea3i kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 n\u1ebfu li\u1ec1u l\u01b0\u1ee3ng kh\u00f4ng \u0111\u1ee7 ho\u1eb7c gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 qu\u00e1 s\u00e2u.<\/li>\n<\/ul>\n\n\n\n<p><strong>9. Ch\u0103m s\u00f3c sau ph\u1eabu thu\u1eadt:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Theo d\u00f5i h\u00f4 h\u1ea5p, nh\u1ecbp tim v\u00e0 m\u1ee9c \u0111\u1ed9 h\u1ed3i ph\u1ee5c c\u01a1 b\u1eafp th\u01b0\u1eddng xuy\u00ean.<\/li>\n\n\n\n<li>\u0110\u1ea3m b\u1ea3o b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 t\u1ef1 th\u1edf v\u00e0 v\u1eadn \u0111\u1ed9ng tr\u01b0\u1edbc khi xu\u1ea5t vi\u1ec7n.<\/li>\n\n\n\n<li>B\u00e1o ngay cho b\u00e1c s\u0129 n\u1ebfu xu\u1ea5t hi\u1ec7n b\u1ea5t k\u1ef3 tri\u1ec7u ch\u1ee9ng b\u1ea5t th\u01b0\u1eddng n\u00e0o sau khi r\u1eddi ph\u00f2ng m\u1ed5.<\/li>\n<\/ul>\n\n\n\n<p><strong>10. L\u1eddi khuy\u00ean quan tr\u1ecdng:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>B\u00e1o ngay cho nh\u00e2n vi\u00ean y t\u1ebf n\u1ebfu c\u00f3 kh\u00f3 th\u1edf, y\u1ebfu c\u01a1 ho\u1eb7c m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i sau ph\u1eabu thu\u1eadt.<\/li>\n\n\n\n<li>Tu\u00e2n th\u1ee7 c\u00e1c h\u01b0\u1edbng d\u1eabn ch\u0103m s\u00f3c v\u00e0 t\u00e1i kh\u00e1m n\u1ebfu \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh.<\/li>\n<\/ul>\n\n\n\n<p><strong>Ngu\u1ed3n t\u00e0i li\u1ec7u tham kh\u1ea3o:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>H\u01b0\u1edbng d\u1eabn th\u1ef1c h\u00e0nh G\u00e2y m\u00ea h\u1ed3i s\u1ee9c &#8211; B\u1ed9 Y t\u1ebf Vi\u1ec7t Nam.<\/li>\n\n\n\n<li>Quy tr\u00ecnh G\u00e2y m\u00ea h\u1ed3i s\u1ee9c &#8211; B\u1ec7nh vi\u1ec7n Nh\u00e2n d\u00e2n Gia \u0110\u1ecbnh.<\/li>\n<\/ul>\n\n\n\n<p>Hy v\u1ecdng th\u00f4ng tin n\u00e0y gi\u00fap ng\u01b0\u1eddi b\u1ec7nh hi\u1ec3u r\u00f5 h\u01a1n v\u1ec1 k\u1ef9 thu\u1eadt h\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 v\u00e0 c\u1ea3m th\u1ea5y an t\u00e2m khi tr\u1ea3i qua qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb.<\/p>\n\n\n\n<p>Th\u00f4ng tin chi ti\u1ebft tham kh\u1ea3o t\u1ea1i <a href=\"http:\/\/www.bvndgiadinh.org.vn\">www.bvndgiadinh.org.vn<\/a>.<\/p>\n\n\n\n<p class=\"has-text-align-right\">Hu\u1ef3nh V\u0103n B\u00ecnh<\/p>\n\n\n\n<p class=\"has-text-align-right\">BSCK2 G\u00e2y m\u00ea h\u1ed3i s\u1ee9c<\/p>\n","protected":false},"excerpt":{"rendered":"<p>1. H\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0 g\u00ec? H\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0 k\u1ef9 thu\u1eadt s\u1eed d\u1ee5ng thu\u1ed1c \u0111\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c t\u00e1c d\u1ee5ng gi\u00e3n c\u01a1 \u0111\u00e3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng trong qu\u00e1 tr\u00ecnh g\u00e2y m\u00ea \u0111\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng c\u01a1 b\u1eafp b\u00ecnh th\u01b0\u1eddng tr\u01b0\u1edbc khi k\u1ebft th\u00fac ph\u1eabu thu\u1eadt. 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H\u00f3a gi\u1ea3i gi\u00e3n c\u01a1 t\u1ed3n d\u01b0 l\u00e0 g\u00ec? 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