{"id":3970,"date":"2024-11-07T13:45:50","date_gmt":"2024-11-07T06:45:50","guid":{"rendered":"https:\/\/vietmyhospital.com\/?p=3970"},"modified":"2024-11-07T13:45:50","modified_gmt":"2024-11-07T06:45:50","slug":"nhiem-trung-huyet-va-nhung-dieu-can-biet","status":"publish","type":"post","link":"https:\/\/vietmyhospital.com\/?p=3970","title":{"rendered":"NHI\u1ec4M TR\u00d9NG HUY\u1ebeT V\u00c0 NH\u1eeeNG \u0110I\u1ec0U C\u1ea6N BI\u1ebeT"},"content":{"rendered":"

Nhi\u1ec5m tr\u00f9ng huy\u1ebft( Sepsis)<\/em><\/strong> l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng c\u00f3 c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 sinh l\u00fd, sinh h\u1ecdc v\u00e0 sinh h\u00f3a do r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a ph\u1ea3n \u1ee9ng c\u1ee7a v\u1eadt ch\u1ee7 \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng. Nhi\u1ec5m tr\u00f9ng huy\u1ebft c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u0111a c\u01a1 quan v\u00e0 t\u1eed vong.<\/p>\n

S\u1ed1c nhi\u1ec5m tr\u00f9ng(Septic shock)<\/em><\/strong> l\u00e0 m\u1ed9t lo\u1ea1i s\u1ed1c gi\u00e3n m\u1ea1ch ho\u1eb7c s\u1ed1c r\u1ed1i lo\u1ea1n ph\u00e2n b\u1ed1. \u0110\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 nhi\u1ec5m tr\u00f9ng huy\u1ebft k\u1ebft h\u1ee3p v\u1edbi h\u1ea1 huy\u1ebft \u00e1p m\u1eb7c d\u00f9 \u0111\u00e3 \u0111\u01b0\u1ee3c h\u1ed3i s\u1ee9c \u0111\u1ee7 d\u1ecbch, c\u1ea7n d\u00f9ng thu\u1ed1c v\u1eadn m\u1ea1ch \u0111\u1ec3 duy tr\u00ec huy\u1ebft \u00e1p trung b\u00ecnh (MAP) \u226565 mmHg v\u00e0 c\u00f3 lactate >2 mmol\/L (> 18 mg\/dL).<\/p>\n

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\"nhi\u1ec5m<\/p>\n

Vi khu\u1ea9n \u0111\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh l\u00e0 m\u1ea7m b\u1ec7nh chi\u1ebfm \u01b0u th\u1ebf \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, trong khi nhi\u1ec5m tr\u00f9ng huy\u1ebft do virus ch\u01b0a \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u00ean to\u00e0n th\u1ebf gi\u1edbi.Vi khu\u1ea9n gram d\u01b0\u01a1ng \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh th\u01b0\u1eddng xuy\u00ean nh\u1ea5t \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n nhi\u1ec5m tr\u00f9ng huy\u1ebft \u1edf Hoa K\u1ef3, m\u1eb7c d\u00f9 s\u1ed1 tr\u01b0\u1eddng h\u1ee3p nhi\u1ec5m tr\u00f9ng huy\u1ebft gram \u00e2m v\u1eabn c\u00f2n \u0111\u00e1ng k\u1ec3. T\u1ef7 l\u1ec7 nhi\u1ec5m tr\u00f9ng huy\u1ebft do n\u1ea5m \u0111\u00e3 t\u0103ng l\u00ean trong th\u1eadp k\u1ef7 qua, nh\u01b0ng v\u1eabn th\u1ea5p h\u01a1n nhi\u1ec5m tr\u00f9ng huy\u1ebft do vi khu\u1ea9n. M\u1ed9t n\u1eefa trong s\u1ed1 \u0111\u00f3 kh\u00f4ng \u0111\u1ecbnh danh \u0111\u01b0\u1ee3c vi khu\u1ea9n g\u00e2y b\u1ec7nh c\u00f2n g\u1ecdi l\u00e0 nhi\u1ec5m tr\u00f9ng huy\u1ebft \u00e2m t\u00ednh v\u1edbi c\u1ea5y m\u00e1u.<\/p>\n

V\u1eeba qua b\u1ec7nh vi\u1ec7n Vi\u1ec7t M\u1ef9 Ph\u00fa Y\u00ean \u0111\u00e3 ti\u1ebfp nh\u1eadn B\u1ec7nh nh\u00e2n nam 75 tu\u1ed5i \u0111\u1ebfn t\u1eeb \u0110\u00f4ng H\u00f2a-Ph\u00fa Y\u00ean. Kho\u1ea3ng 7 ng\u00e0y tr\u01b0\u1edbc \u0111\u00f3, b\u1ec7nh nh\u00e2n c\u00f3 bi\u1ec3u hi\u1ec7n ho, s\u1ed1t, \u0103n u\u1ed1ng k\u00e9m ngon v\u00e0 t\u1ef1 \u0111i\u1ec1u tr\u1ecb t\u1ea1i nh\u00e0, c\u00e0ng ng\u00e0y b\u1ec7nh nh\u00e2n c\u00e0ng m\u1ec7t h\u01a1n c\u0169ng nh\u01b0 c\u00f3 d\u1ea5u hi\u1ec7u gi\u00e1m tri gi\u00e1c n\u00ean ng\u01b0\u1eddi nh\u00e0 \u0111\u01b0a v\u00e0o vi\u1ec7n. T\u1ea1i th\u1eddi \u0111i\u1ec3m nh\u1eadp vi\u1ec7n ghi nh\u1eadn b\u1ec7nh nh\u00e2n th\u1ec3 tr\u1ea1ng suy ki\u1ec7t, t\u1ec9nh nh\u01b0ng ti\u1ebfp x\u00fac ch\u1eadm, kh\u00f3 th\u1edf, nh\u1ecbp tim nhanh, s\u1ed1t cao 40 \u0111\u1ed9 C, ho khan, \u0111\u1ed9 b\u00e3o h\u00f2a Oxy m\u00e1u ngo\u1ea1i bi\u00ean th\u1ea5p, huy\u1ebft \u00e1p h\u1ea1 tr\u00ean 40% so v\u1edbi huy\u1ebft \u00e1p n\u1ec1n v\u00e0 c\u00f3 d\u1ea5u hi\u1ec7u gi\u1ea3m t\u01b0\u1edbi m\u00e1u m\u00f4. Sau khi th\u0103m kh\u00e1m v\u00e0 l\u00e0m c\u00e1c c\u1eadn l\u00e2m s\u00e0ng\u00a0 ghi nh\u1eadn s\u1ed1 l\u01b0\u1ee3ng B\u1ea1ch c\u1ea7u t\u0103ng r\u1ea5t cao ( 34.8 ngh\u00ecn), phim Xquang ph\u1ed5i cho th\u1ea5y h\u00ecnh \u1ea3nh t\u1ed5n th\u01b0\u01a1ng th\u00e2m nhi\u1ec5m di\u1ec7n r\u1ed9ng \u1edf \u0111\u00e1y ph\u1ed5i tr\u00e1i, SOFA 3 \u0111i\u1ec3m. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n: Nhi\u1ec5m tr\u00f9ng huy\u1ebft ti\u00eau \u0111i\u1ec3m t\u1eeb \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p\/ Vi\u00eam ph\u1ed5i n\u1eb7ng. Sau kho\u1ea3ng g\u1ea7n 15 ng\u00e0y \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c; b\u1ec7nh nh\u00e2n h\u1ebft s\u1ed1t, \u0103n u\u1ed1ng ngon mi\u1ec7ng, h\u1ebft kh\u00f3 th\u1edf, \u0111i l\u1ea1i b\u00ecnh th\u01b0\u1eddng v\u00e0 \u0111\u00e3 \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n sau \u0111\u00f3.<\/p>\n

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\"nhiem<\/p>\n

Theo Bs \u0111i\u1ec1u tr\u1ecb cho bi\u1ebft, c\u00e1c bi\u1ec3u hi\u1ec7n ban \u0111\u1ea7u th\u01b0\u1eddng r\u1ea5t m\u01a1 h\u1ed3(s\u1ed1t, ho, th\u1edf nhanh) n\u00ean \u0111\u00f4i khi d\u1ec5 g\u00e2y c\u1ea3m gi\u00e1c ch\u1ee7 quan cho b\u1ec7nh nh\u00e2n v\u00e0 gia \u0111\u00ecnh. Nhi\u1ec5m tr\u00f9ng huy\u1ebft v\u00e0 s\u1ed1c nhi\u1ec5m tr\u00f9ng c\u00f3 t\u1ef7 l\u1ec7 t\u1eed vong cao, \u01b0\u1edbc t\u00ednh dao \u0111\u1ed9ng t\u1eeb 10% \u0111\u1ebfn 52%. T\u1ef7 l\u1ec7 t\u1eed vong t\u0103ng tuy\u1ebfn t\u00ednh theo m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh, t\u1ef7 l\u1ec7 t\u1eed vong li\u00ean quan \u0111\u1ebfn nhi\u1ec5m tr\u00f9ng huy\u1ebft kho\u1ea3ng \u00a0\u226510% v\u00e0 s\u1ed1c nhi\u1ec5m tr\u00f9ng kho\u1ea3ng \u226540%; t\u1ef7 l\u1ec7 th\u1ea5p h\u01a1n \u1edf nh\u1eefng b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i (<44 tu\u1ed5i) kh\u00f4ng c\u00f3 b\u1ec7nh \u0111i k\u00e8m (<10%). Ti\u1ec1n s\u1eed nh\u1eadp vi\u1ec7n tr\u01b0\u1edbc \u0111\u00e2y c\u00f3 li\u00ean quan \u0111\u1ebfn nguy c\u01a1 nhi\u1ec5m tr\u00f9ng huy\u1ebft t\u0103ng g\u1ea5p ba l\u1ea7n trong 90 ng\u00e0y ti\u1ebfp theo. Nh\u1eefng b\u1ec7nh nh\u00e2n n\u1eb1m \u1edf ICU(\u0111\u01a1n v\u1ecb ch\u0103m s\u00f3c \u0111\u1eb7c bi\u1ec7t), b\u1ec7nh nh\u00e2n tr\u00ean 65 tu\u1ed5i, t\u00ecnh tr\u1ea1ng nhi\u1ec5m khu\u1ea9n tr\u01b0\u1edbc \u0111\u00f3, \u00a0\u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, b\u00e9o ph\u00ec, b\u1ec7nh nh\u00e2n c\u00f3 nhi\u1ec1u b\u1ec7nh \u0111i k\u00e8m ho\u1eb7c s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch, vi\u00eam ph\u1ed5i m\u1eafc ph\u1ea3i \u1edf c\u1ed9ng \u0111\u1ed3ng l\u00e0 nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao m\u1eafc nhi\u1ec5m tr\u00f9ng huy\u1ebft<\/p>\n

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B\u1ec7nh vi\u1ec7n Vi\u1ec7t M\u1ef9, xin ch\u00e2n th\u00e0nh c\u1ea3m \u01a1n s\u1ef1 tin t\u01b0\u1edfng m\u00e0 qu\u00fd kh\u00e1ch h\u00e0ng \u0111\u00e3 d\u00e0nh cho ch\u00fang t\u00f4i trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb. Ch\u00ednh s\u1ef1 h\u1ed3i ph\u1ee5c v\u00e0 s\u1ee9c kh\u1ecfe c\u1ee7a qu\u00fd v\u1ecb l\u00e0 ni\u1ec1m \u0111\u1ed9ng vi\u00ean l\u1edbn nh\u1ea5t, ti\u1ebfp th\u00eam \u0111\u1ed9ng l\u1ef1c \u0111\u1ec3 ch\u00fang t\u00f4i lu\u00f4n n\u1ed7 l\u1ef1c h\u1ebft m\u00ecnh, kh\u00f4ng ng\u1eebng n\u00e2ng cao ch\u1ea5t l\u01b0\u1ee3ng ch\u0103m s\u00f3c y t\u1ebf. B\u1ec7nh vi\u1ec7n Vi\u1ec7t M\u1ef9 cam k\u1ebft lu\u00f4n \u0111\u1eb7t s\u1ee9c kh\u1ecfe c\u1ee7a b\u1ec7nh nh\u00e2n l\u00ean h\u00e0ng \u0111\u1ea7u, v\u00e0 ch\u00fang t\u00f4i t\u1ef1 h\u00e0o \u0111\u01b0\u1ee3c \u0111\u1ed3ng h\u00e0nh c\u00f9ng qu\u00fd v\u1ecb tr\u00ean h\u00e0nh tr\u00ecnh v\u01b0\u1ee3t qua nh\u1eefng th\u1eed th\u00e1ch v\u1ec1 s\u1ee9c kh\u1ecfe.<\/p>\n

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\n","protected":false},"excerpt":{"rendered":"

Nhi\u1ec5m tr\u00f9ng huy\u1ebft( Sepsis) l\u00e0 m\u1ed9t h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng c\u00f3 c\u00e1c b\u1ea5t th\u01b0\u1eddng v\u1ec1 sinh l\u00fd, sinh h\u1ecdc v\u00e0 sinh h\u00f3a do r\u1ed1i lo\u1ea1n \u0111i\u1ec1u h\u00f2a ph\u1ea3n \u1ee9ng c\u1ee7a v\u1eadt ch\u1ee7 \u0111\u1ed1i v\u1edbi nhi\u1ec5m tr\u00f9ng. Nhi\u1ec5m tr\u00f9ng huy\u1ebft c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u0111a c\u01a1 quan v\u00e0 t\u1eed vong. 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Nhi\u1ec5m tr\u00f9ng huy\u1ebft c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn h\u1ed9i ch\u1ee9ng r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng \u0111a c\u01a1 quan v\u00e0 t\u1eed vong. 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