B\u1ec6NH \u00c1N TR\u00ccNH B\u1ec6NH
\nPh\u00f2ng: Ph\u1ee5 khoa
\nI. PH\u1ea6N H\u00c0NH CH\u00cdNH:
\n– H\u1ecd v\u00e0 t\u00ean:
\n– Tu\u1ed5i:
\n– Ngh\u1ec1 nghi\u1ec7p:
\n– D\u00e2n t\u1ed9c : kinh
\n– \u0110\u1ecba ch\u1ec9:
\n– Ng\u00e0y v\u00e0o vi\u1ec7n:
\n– Ng\u00e0y l\u00e0m b\u1ec7nh \u00e1n:
\nII. B\u1ec6NH S\u1eec:
\n1. L\u00fd do v\u00e0o vi\u1ec7n : \u0110au b\u1ee5ng v\u00f9ng h\u1ed1 ch\u1eadu ph\u1ea3i
\n2. Qu\u00e1 tr\u00ecnh b\u1ec7nh l\u00ed : L\u00fac hai gi\u1edd sang ng\u00e0y 15 th\u00e1ng 10, b\u1ec7nh nh\u00e2n l\u00ean \u0111\u1ed9t ng\u1ed9t \u0111au
\nb\u1ee5ng v\u00f9ng h\u1ed1 ch\u1eadu ph\u1ea3i, \u0111au lien t\u1ee5c kh\u00f4ng lan, \u0111au t\u0103ng d\u1ea7n, kh\u00f4ng s\u1ed1t k\u00e8m v\u00e3 m\u1ed3 h\u00f4i.
\nTrong c\u01a1n \u0111au b\u1ec7nh nh\u00e2n c\u00f3 bu\u1ed3n n\u00f4n v\u00e0 n\u00f4n ba l\u1ea7n, n\u00f4n ra th\u1ee9c \u0103n. \u0110\u1ebfn 4 gi\u1edd sang
\nb\u1ec7nh nh\u00e2n \u0111au t\u0103ng l\u00ean n\u00ean ng\u01b0\u1eddi nh\u00e0 lo l\u1eafng \u0111\u01b0a v\u00e0o khoa c\u1ea5p c\u1ee9u b\u1ec7nh vi\u00ean TW Hu\u1ebf.
\nT\u1ea1i khoa c\u1ea5p c\u1ee9u, b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ghi nh\u1eadn:
\n– M\u1ea1ch 100 l\u1ea7n\/ ph\u00fat
\n– Nhi\u1ec7t: 37 oC
\n– Huy\u1ebft \u00e1p: 120\/80 mmHg
\n– T\u1ea7n s\u1ed1 th\u1edf: 17 l\u1ea7n \/ ph\u00fat
\n– C\u00e2n n\u1eb7ng: 37 Kg
\n– \u0110au h\u1ea1 v\u1ecb v\u00e0 h\u1ed1 ch\u1eadu ph\u1ea3i nhi\u1ec1u, b\u1ee5ng m\u1ec1m, Macbrucney +\/-. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c si\u00eau
\n\u00e2m l\u1ea7n m\u1ed9t. K\u1ebft qu\u1ea3 : T\u1eed cung c\u00f3 hai t\u00fai thai chin tu\u1ea7n \u0111ang ph\u00e1t tri\u1ec3n, tim thai
\nd\u01b0\u01a1ng t\u00ednh, c\u1eed \u0111\u1ed9ng thai (+).
\n– B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u1eed tr\u00ed v\u1edbi Paracetamol 1g*l\u1ecd, Nacl 0,9% * 500 ml truy\u1ec1n t\u0129nh m\u1ea1ch.
\nSau \u0111\u00f3 b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c h\u1ed9i chu\u1ea9n v\u1edbi khoa s\u1ea3n l\u00fac 8h45, b\u1ec7nh nh\u00e2n kh\u00f4ng c\u00f3 m\u1eb7t t\u1ea1i
\ngi\u01b0\u1eddng. V\u1edbi k\u1ebft qu\u1ea3 si\u00eau \u00e2m khoa s\u1ea3n ch\u1ea9n \u0111o\u00e1n l\u00e0: Theo d\u00f5i ru\u1ed9t th\u1eeba vi\u00eam\/ Song thai ch\u00edn
\ntu\u1ea7n. V\u00e0 c\u00f3 \u0111\u1ec1 ngh\u1ecb n\u1ebfu khoa ngo\u1ea1i c\u00f3 ch\u1ec9 \u0111\u1ecbnh ph\u1ea9u thu\u1eadt \u0111\u1ec1 ngh\u1ecb d\u00f9ng gi\u1ea3m co ( papaverin
\n40mg*2 \u1ed1ng ti\u00eam b\u1eafp ) tr\u01b0\u1edbc v\u00e0 sau ph\u1ea9u thu\u1eadt.
\nL\u00fac 11h50 khoa s\u1ea3n h\u1ed9i chu\u1ea9n l\u1ea7n hai, ghi nh\u1eadn:
\n– Nhi\u1ec7t \u0111\u1ed9t : 37,3 oC, t\u1ec9nh t\u00e1o ti\u1ebfp x\u00fac t\u1ed1t,
\n– B\u1ee5ng m\u1ec1m
\n– \u00e2 m \u0111 \u1ea1 o kh\u00f4ng ra m\u00e1u.
\n– Kh\u00e1m trong :
\no T\u1eed cung t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi tu\u1ed5i thai hai th\u00e1ng, m\u1ec1m, c\u1ea1nh ph\u1ea3i t\u1eed cung s\u1edd
\nth\u1ea5y m\u1ed9t kh\u1ed1i m\u1ec1m, di \u0111\u1ed9ng, \u00edt \u0111au, c\u00f9ng \u0111\u1ed3 kh\u00f4ng c\u00f3 d\u1ecbch.
\nV\u00e0 ch\u1ea9n \u0111o\u00e1n v\u1edbi : Song thai ch\u00edn tu\u1ea7n \u0111ang ph\u00e1t tri\u1ec3n\/ Theo d\u00f5i nang c\u01a1 n\u0103ng bu\u1ed3ng
\ntr\u1ee9ng (P). Kh\u00f4ng x\u1eed tr\u00ed g\u00ec v\u00e0 \u0111\u1ec1 ngh\u1ecb ngo\u1ea1i h\u1ed9i ch\u1ea9n.
\nL\u00fac 12h30, Khoa ngo\u1ea1i h\u1ed9i chu\u1ea9n: Theo d\u00f5i ru\u1ed9t th\u1eeba vi\u00eam\/ Song thai ch\u00edn tu\u1ea7n
\n\u0111ang ph\u00e1t tri\u1ec3n v\u00e0 \u0111\u1ec1 ngh\u1ecb si\u00eau \u00e2m l\u1ea1i l\u1ea7n hai v\u1edbi k\u1ebft qu\u1ea3:
\n– T\u1eed cung c\u00f3 hai t\u00fai thai, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng 9 tu\u1ea7n c\u00f3 Yolksac, tim thai d\u01b0\u01a1ng t\u00ednh.
\n– Ph\u1ea7n ph\u1ee5: Bu\u1ed3ng tr\u1ee9ng ph\u1ea3i c\u00f3 hai c\u1ea5u tr\u00fac d\u1ea1ng nang: K\u00edch th\u01b0\u1edbc 41*37 mm v\u00e0
\n44*52 mm, v\u1ecf m\u1ecfng tr\u1ed1ng \u00e2m.
\nB\u1ec7nh nh\u00e2n sau \u0111\u00f3 \u0111\u01b0\u1ee3c l\u00e0m c\u00e1c x\u00e9t nghi\u1ec7m ti\u1ec1n ph\u1ea9u. \u0110\u1ebfn 16h, b\u1ec7nh nh\u00e2n chuy\u1ec3n \u0111\u1ebfn
\nph\u00f2ng m\u1ed5, t\u1ea1i \u0111\u00e2y b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ph\u1ea9u thu\u1eadt b\u00f3c u nang qua n\u1ed9i soi.
\nL\u01b0\u1ee3t \u0111\u1ed3 ph\u1ea9u thu\u1eadt:
\n– V\u00e0o Troca 10 tr\u00ean r\u1ed1n, b\u01a1m CO2 ki\u1ec3m tra: T\u1eed cung c\u00f3 thai hai th\u00e1ng
\n– U nang bu\u1ed3ng tr\u1ee9ng ph\u1ea3i, xo\u1eafn 1 v\u00f2ng ch\u01b0a t\u00edm, bu\u1ed3ng tr\u1ee9ng tr\u00e1i b\u00ecnh th\u01b0\u1eddng
\n– B\u00f3c u nang th\u00e1o xo\u1eafn, l\u1ea5y t\u1ed5 ch\u1ee9c b\u1ec7nh ph\u1ea9m qua t\u00fai nylong, r\u1eeda \u1ed5 ph\u00fac m\u1ea1c, r\u00fat
\n\u0111\u00f3ng c\u00e1c l\u1ed7 Troca.
\nCh\u1ea9n \u0111o\u00e1n sau ph\u1ea9u thu\u1eadt: U nang bu\u1ed3ng tr\u1ee9ng (P) xo\u1eafn\/ Thai 9 tu\u1ea7n song thai.
\nSau ph\u1ea9u thu\u1eadt \u0111\u01b0\u1ee3c chuy\u1ec3n v\u1ec1 ph\u00f2ng h\u1ed3i s\u1ee9c, t\u1ea1i \u0111\u00e2y b\u1ec7nh nh\u00e2n \u1ed5n \u0111\u1ecbnh v\u00e0 chuy\u1ec3n \u0111\u1ebfn
\nph\u00f2ng ph\u1ee5 khoa l\u00fac 11 gi\u1edd ng\u00e0y 17\/10.
\nIII. TI\u1ec0N S\u1eec:
\n1. B\u1ea3n th\u00e2n:
\n– S\u1ea3n ph\u1ee5 khoa
\no Ph\u1ee5 khoa: C\u00f3 kinh l\u00fac 15 tu\u1ed5i, kinh \u0111\u1ec1u, l\u01b0\u1ee3ng v\u1eeba, chu k\u1ef3 30 ng\u00e0y, th\u1eddi gian
\nh\u00e0nh kinh kho\u1ea3ng 3 ng\u00e0y. L\u1ea5y ch\u1ed3ng l\u00fac 20 tu\u1ed5i. Ch\u01b0a ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb
\nc\u00e1c b\u1ec7nh l\u00fd ph\u1ee5 khoa n\u00e0o.
\no S\u1ea3n khoa: PARA : 0010\u00a7 Thai ngo\u00e0i t\u1eed cung c\u00e1ch \u0111\u00e2y m\u1ed9t n\u0103m, \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa v\u1edbi
\nmetrothexate li\u1ec1u duy nh\u1ea5t. Ngo\u00e0i ra tr\u00ean si\u00eau \u00e2m c\u00f3 ph\u00e1t hi\u1ec7n nang
\nbu\u1ed3ng tr\u1ee9ng (P) nh\u1ecf. Sau m\u1ed9t th\u00e1ng theo d\u00f5i ( V\u1edbi bHCG ) b\u1ec7nh nh\u00e2n
\n\u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n.\u00a7 Ng\u00e0y \u0111\u1ea7u kinh cu\u1ed1i: Ng\u00e0y 11\/08\/2012. Sau khi tr\u1ec5 kinh 3 ng\u00e0y b\u1ec7nh
\nnh\u00e2n c\u00f3 th\u1eed thai (+), k\u00e8m c\u00e1c tri\u1ec7u ch\u1ee9ng ngh\u00e9n bu\u1ed3n n\u00f4n, n\u00f4n ch\u1ee7 y\u1ebfu
\nv\u00e0o bu\u1ed5i s\u00e1ng. Si\u00eau \u00e2m ph\u00e1t hi\u1ec7n song thai kho\u1ea3ng n\u0103m tu\u1ea7n.
\n– N\u1ed9i, ngo\u1ea1i khoa : Ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ea5t th\u01b0\u1eddng.
\n2. Gia \u0111\u00ecnh : Kh\u00f4ng ai m\u1eafc c\u00e1c b\u1ec7nh l\u00fd di truy\u1ec1n, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p..v.v.
\nIV. TH\u0102M KH\u00c1M HI\u1ec6N T\u1ea0I:
\n1. To\u00e0n th\u00e2n :
\n– M\u1ea1ch: 72 l\u1ea7n\/ ph\u00fat.
\n– Nhi\u1ec7t: 37 oC
\n– Huy\u1ebft \u00e1p: 110\/60 mmHg
\n– T\u1ea7n s\u1ed1 th\u1edf: 22 l\u1ea7n\/ ph\u00fat
\n– C\u00e2n n\u1eb7ng 37 Kg
\n– B\u1ec7nh nh\u00e2n t\u1ec9nh t\u00e1o ti\u1ebfp x\u00fac t\u1ed1t, t\u1ed5ng tr\u1ea1ng chung g\u1ea7y.
\n– Da ni\u00eam m\u1ea1c h\u1ed3ng nh\u1ea1t, kh\u00f4ng ph\u00f9 kh\u00f4ng xu\u1ea5t huy\u1ebft d\u01b0\u1edbi da.
\n– Tuy\u1ebfn gi\u00e1p kh\u00f4ng l\u1edbn, h\u1ea1ch ngo\u1ea1i bi\u00ean kh\u00f4ng s\u1edd th\u1ea5y,
\n2. Chuy\u00ean khoa:
\n– Bu\u1ed3n n\u00f4n, n\u00f4n v\u00e0o bu\u1ed5i s\u00e1ng.
\n– Ng\u00e0y \u0111\u1ea7u k\u1ef3 kinh cu\u1ed1i: 11\/08\/2012.
\n– Kh\u00e1m b\u1ee5ng:
\no B\u1ee5ng d\u00e0y m\u1ee1 kh\u00f4ng ch\u01b0\u1edbng, v\u1ebft m\u1ed5 n\u1ed9i soi \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i, tr\u00e1i, r\u1ed1n, ch\u01b0a
\nth\u1ea5y d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec5m tr\u00f9ng, v\u00f9ng da xung quanh m\u1ed1i ch\u1ec9 kh\u00f4ng \u0111\u1ecf, ko ph\u00f9
\nn\u1ec1, kh\u00f4ng r\u1ec9 d\u1ecbch. C\u00f2n \u0111au quanh v\u1ebft m\u1ed5.
\no B\u1ee5ng l\u1edbn, B\u1ec1 cao t\u1eed cung tr\u00ean v\u1ec7 4cm.
\n– Kh\u00e1m trong:
\no \u00c2m \u0111ao b\u00ecnh th\u01b0\u1eddng
\no C\u1ed5 t\u1eed cung m\u1ec1m
\no Ph\u1ea7n ph\u1ee5 ph\u1ea3i c\u00f3 kh\u1ed1i 5*6 cm
\no Ph\u1ea7n ph\u1ee5 tr\u00e1i b\u00ecnh th\u01b0\u1eddng
\no C\u00e1c t\u00fai c\u00f9ng kh\u00f4ng \u0111\u1ea7y kh\u00f4ng \u0111au
\n3. C\u01a1 quan:
\n– Tu\u1ea7n ho\u00e0n: Kh\u00f4ng h\u1ed3i h\u1ed9p \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c, nh\u1ecbp tim tr\u00f9ng m\u1ea1ch quay, m\u1ecfm tim
\n\u0111\u1eadp \u1edf gian s\u01b0\u1eddn 5 tr\u00ean \u0111\u01b0\u1eddng trung \u0111\u00f2n tr\u00e1i. Ch\u01b0a nghe th\u1ea5y ti\u1ebfng tim b\u1ec7nh l\u00fd.
\n– H\u00f4 h\u1ea5p: Kh\u00f4ng ho kh\u00f4ng kh\u00f3 th\u1edf, l\u1ed3ng ng\u1ef1c c\u00e2n x\u1ee9ng, ph\u1ed5i th\u00f4ng kh\u00ed t\u1ed1t, kh\u00f4ng
\nnghe th\u1ea5y rale.
\n– Ti\u00eau ho\u00e1: \u0110\u00e3 \u0111i c\u1ea7u \u0111\u01b0\u1ee3c, b\u1ee5ng m\u1ec1m kh\u00f4ng ch\u01b0\u1edbng, c\u00f2n \u0111au ch\u1ed7 v\u1ebft m\u1ed5
\n– Th\u1eadn ti\u1ebft ni\u1ec7u: Kh\u00f4ng ti\u1ec3u bu\u1ed1t ti\u1ec3u r\u00e1t, n\u01b0\u1edbc ti\u1ec3u v\u00e0ng trong l\u01b0\u1ee3ng v\u1eeba.
\n– C\u00e1c c\u01a1 quan kh\u00e1c ch\u01b0a ph\u00e1t hi\u1ec7n b\u1ec7nh l\u00fd.
\nV. C\u1eacN L\u00c2M S\u00c0NG:
\n1. C\u00f4ng th\u1ee9c m\u00e1u : ( 15\/10)
\n– WBC: 11,.0^9\/l
\no LYM: 1,8 16,8 %
\no MID: 0,3 3,1 %
\no GRAN: 8,8 80,1 %
\n– RBC: 3,72.10^12\/l
\no Hb: 111g\/l
\no Hct: 34,4 %
\no MCV: 92,18 fl
\no MCH: 29,8 pg
\no MCHC: 323 g\/l
\no RDW: 13,6 %
\n– PLT: 208.10^9\/l
\n– MPV: 7,6 fl
\n2. Si\u00eau \u00e2m: ( 15\/10)
\n– T\u1eed cung c\u00f3 hai t\u00fai thai, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng 9 tu\u1ea7n c\u00f3 Yolksac, tim thai d\u01b0\u01a1ng t\u00ednh.
\n– Ph\u1ea7n ph\u1ee5: Bu\u1ed3ng tr\u1ee9ng ph\u1ea3i c\u00f3 hai c\u1ea5u tr\u00fac d\u1ea1ng nang: K\u00edch th\u01b0\u1edbc 41*37 mm v\u00e0
\n44*52 mm, v\u1ecf m\u1ecfng tr\u1ed1ng \u00e2m.
\n3. Gi\u1ea3i ph\u1ea9u b\u1ec7nh :
\nU nang bu\u1ed3ng tr\u1ee9ng l\u00e0nh t\u00ednh.
\nVI. T\u00d3M T\u1eaeT BI\u1ec6N LU\u1eacN CH\u1ea8N \u0110O\u00c1N:
\n1. T\u00f3m t\u1eaft:
\nB\u1ec7nh nh\u00e2n n\u1eef 21 tu\u1ed5i c\u00f3 ti\u1ec1n s\u1eed \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa GEU v\u00e0 ph\u00e1t hi\u1ec7n nang bu\u1ed3ng tr\u1ee9ng
\n(P) ( kh\u00f4ng r\u00f5 k\u00edch th\u01b0\u1edbc) c\u00e1ch \u0111\u00e2y h\u01a1n 1 n\u0103m, v\u00e0o vi\u1ec7n v\u00ec \u0111au v\u00f9ng h\u1ed1 ch\u1eadu ph\u1ea3i \u0111\u00e3
\n\u0111\u01b0\u1ee3c ph\u1ea9u thu\u1eadt b\u00f3c u nang b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p m\u1ed5 n\u1ed9i soi. Qua h\u1ecfi b\u1ec7nh s\u1eed, th\u0103m
\nkh\u00e1m l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng ch\u00fang em r\u00fat ra c\u00e1c h\u1ed9i ch\u1ee9ng v\u00e0 d\u1ea5u ch\u1ee9ng sau:
\n– D\u1ea5u ch\u1ee9ng c\u00f3 thai:
\no T\u1eaft kinh ( KCC: 11\/08\/2012)
\no N\u00f4n, bu\u1ed3n n\u00f4n nhi\u1ec1u v\u00e0o bu\u1ed5i s\u00e1ng.
\no B\u1ee5ng l\u1edbn: T\u1eed cung tr\u00ean x\u01b0\u01a1ng v\u1ec7 4 cm, t\u01b0\u01a1ng \u0111\u01b0\u01a1ng v\u1edbi thai 2 th\u00e1ng.
\no Si\u00eau \u00e2m: Song thai 9 tu\u1ea7n, tim thai (+), c\u1eed \u0111\u1ed9ng thai (+).
\n– D\u1ea5u ch\u1ee9ng \u0111au b\u1ee5ng c\u1ea5p:
\no \u0110au b\u1ee5ng \u0111\u1ed9t ng\u1ed9t v\u00f9ng h\u1ed1 ch\u1eadu ph\u1ea3i, kh\u00f4ng lan, \u0111au li\u00ean t\u1ee5c, t\u0103ng d\u1ea7n k\u00e8m
\nn\u00f4n v\u00e0 bu\u1ed3n n\u00f4n nhi\u1ec1u l\u1ea7n.
\no Ph\u1ea3n \u1ee9ng th\u00e0nh b\u1ee5ng (+\/-)
\n– D\u1ea5u ch\u1ee9ng kh\u1ed1i u nang bu\u1ed3ng tr\u1ee9ng (P) l\u00e0nh t\u00ednh.
\no Kh\u00e1m s\u1edd th\u1ea5y kh\u1ed1i m\u1ec1m di \u0111\u1ed9ng \u00edt \u0111au.
\no Si\u00eau \u00e2m: Bu\u1ed3ng tr\u1ee9ng ph\u1ea3i c\u00f3 hai c\u1ea5u tr\u00fac d\u1ea1ng nang KT: 41*37 cm v\u00e0 44*52
\ncm.
\no Gi\u1ea3i ph\u1ea9u b\u1ec7nh: U nang bu\u1ed3ng tr\u1ee9ng l\u00e0nh t\u00ednh.
\n– D\u1ea5u ch\u1ee9ng h\u1eadu ph\u1ea9u:
\no B\u1ee5ng d\u00e0y m\u1ee1 kh\u00f4ng ch\u01b0\u1edbng, v\u1ebft m\u1ed5 n\u1ed9i soi \u1edf h\u1ed1 ch\u1eadu ph\u1ea3i, tr\u00e1i, r\u1ed1n, ch\u01b0a
\nth\u1ea5y d\u1ea5u hi\u1ec7u c\u1ee7a nhi\u1ec5m tr\u00f9ng, v\u00f9ng da xung quanh m\u1ed1i ch\u1ec9 kh\u00f4ng \u0111\u1ecf, ko ph\u00f9
\nn\u1ec1, kh\u00f4ng r\u1ec9 d\u1ecbch.
\nCh\u1ea9n \u0111o\u00e1n s\u01a1 b\u1ed9: H\u1eadu ph\u1ea9u m\u1ed5 n\u1ed9i soi u nang bu\u1ed3ng tr\u1ee9ng (P) ng\u00e0y th\u1ee9 2 \u0111\u00e3 \u1ed5n \u0111\u1ecbnh\/
\nsong thai 9 tu\u1ea7n.
\n2. Bi\u1ec7n lu\u1eadn:
\nB\u1ec7nh nh\u00e2n \u0111ang mang thai \u0111\u00e3 r\u00f5 v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng ( Si\u00eau
\n\u00e2m th\u1ea5y tin thai (+), c\u1eed \u0111\u1ed9ng thai (+) ).
\nTr\u00ean b\u1ec7nh nh\u00e2n ch\u00fang em h\u01b0\u1edbng \u0111\u1ebfn ch\u1ea9n \u0111o\u00e1n xo\u1eafn nang bu\u1ed3ng tr\u1ee9ng v\u1edbi c\u00e1c d\u1ea5u
\nch\u1ee9ng \u0111au b\u1ee5ng c\u1ea5p, ph\u1ea3n \u1ee9ng th\u00e0nh b\u1ee5ng (+), tr\u00ean l\u00e2m s\u00e0ng v\u00e0 c\u1eadn l\u00e2m s\u00e0ng ph\u00e1t
\nhi\u1ec7n kh\u1ed1i u \u1edf bu\u1ed3ng tr\u1ee9ng ph\u1ea3i. Ngo\u00e0i ra ph\u1ea9u thu\u1eadt n\u1ed9i soi c\u0169ng ph\u00e1t hi\u1ec7n v\u00e0 c\u1eaft kh\u1ed1i
\nu nang bu\u1ed3ng tr\u1ee9ng b\u1ecb xo\u1eafn \u0111\u00e3 kh\u1eb3ng \u0111\u1ecbnh ch\u1ea9n \u0111o\u00e1n. V\u1ea5n \u0111\u1ec1 \u0111\u1eb7t ra \u1edf tr\u00ean b\u1ec7nh nh\u00e2n
\nl\u00e0 b\u1ec7nh nh\u00e2n xu\u1ea5t hi\u1ec7n hai u nang \u1edf bu\u1ed3ng tr\u1ee9ng (P), v\u1eady hai kh\u1ed5i u nang bu\u1ed3ng tr\u1ee9ng
\nn\u00e0y li\u00ean quan \u0111\u1ebfn nang bu\u1ed3ng tr\u1ee9ng tr\u01b0\u1edbc kia v\u00e0 l\u1ea7n mang thai n\u00e0y nh\u01b0 th\u1ebf n\u00e0o. Hai l\u00e0
\nph\u1ea9u thu\u1eadt b\u00f3c u nang \u0111i\u1ec1u tr\u1ecb s\u1ebd \u1ea3nh h\u01b0\u1edfng nh\u01b0 th\u1ebf n\u00e0o \u0111\u1ebfn s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a thai nhi
\nc\u0169ng nh\u01b0 c\u1ea7n theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb ti\u1ebfp theo nh\u01b0 th\u1ebf n\u00e0o cho b\u1ec7nh nh\u00e2n.
\nB\u1ec7nh nh\u00e2n ph\u00e1t hi\u1ec7n nang bu\u1ed3ng tr\u1ee9ng tr\u01b0\u1edbc kia, tuy nhi\u00ean kh\u00f4ng kh\u00f4ng \u0111\u01b0\u1ee3c theo
\nd\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb, l\u1ea7n n\u00e0y v\u00e0o vi\u1ec7n khi \u0111ang mang song thai l\u1ea7n tu\u1ea7n th\u1ee9 9 v\u1edbi bi\u1ebfn ch\u1ee9ng
\nxo\u1eafn nang bu\u1ed3ng tr\u1ee9ng. Tr\u00ean si\u00eau \u00e2m ph\u00e1t hi\u1ec7n ra hai nang bu\u1ed3ng tr\u1ee9ng b\u00ean ph\u1ea3i. n\u00ean
\nch\u00fang em ngh\u0129 nhi\u1ec1u \u0111\u1ebfn m\u1ed9t nang th\u1ef1c th\u1ec3 k\u1ebft h\u1ee3p v\u1edbi m\u1ed9t nang ho\u00e0ng th\u1ec3. V\u00ec u nang
\nho\u00e0ng tuy\u1ebfn th\u01b0\u1eddng g\u1eb7p trong th\u1eddi k\u1ef3 thai ngh\u00e9n do c\u00f3 thai nhi\u1ec1u thai ph\u00f9 h\u1ee3p v\u1edbi t\u00ecnh
\ntr\u1ea1ng song thai tr\u00ean b\u1ec7nh nh\u00e2n. C\u0169ng kh\u00f4ng \u0111\u1eb7t ra ch\u1ea9n \u0111o\u00e1n ph\u00e2n bi\u1ec7t v\u1edbi c\u00e1c b\u1ec7nh l\u00fd
\nkh\u00e1c c\u0169ng kh\u00f4ng \u0111\u1eb7t ra v\u00ec b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u1ea9u thu\u1eadt b\u00f3c kh\u1ed1i u nang bu\u1ed3ng tr\u1ee9ng
\nb\u1ecb xo\u1eafn v\u00e0 hi\u1ec7n t\u1ea1i t\u00ecnh tr\u1ea1ng b\u1ec7nh nh\u00e2n \u0111\u00e3 \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n.
\nV\u1ec1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn thai nhi khi ph\u1ea9u thu\u1eadt c\u1eaft b\u1ecf u nang. Ta bi\u1ebft sau ph\u1ea9u thu\u1eadt u nang
\nbu\u1ed3ng tr\u1ee9ng c\u00f3 th\u1ec3 g\u00e2y s\u1ea9y thai do k\u00edch th\u00edch co t\u1eed cung v\u00e0 v\u1ee1 nang ho\u00e0ng th\u1ec3 s\u1ebd \u1ea3nh
\nh\u01b0\u1edfng \u0111\u1ebfn vi\u1ec7c nu\u00f4i d\u01b0\u1ee1ng thai. Do v\u1eady vi\u1ec7c theo d\u00f5i b\u1ec7nh nh\u00e2n sau m\u1ed5 c\u1ea7n \u0111\u1eb7c bi\u1ec7t
\nquan t\u00e2m.
\nVi\u1ec7c m\u1ed5 u nang bu\u1ed3ng tr\u1ee9ng c\u0169ng s\u1ebd \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn kh\u1ea3 n\u0103ng c\u00f3 thai c\u1ee7a b\u1ec7nh nh\u00e2n
\nl\u1ea7n sau.
\n3. Ch\u1ea9n \u0111o\u00e1n:
\nH\u1eadu ph\u1ea9u m\u1ed5 n\u1ed9i soi u nang bu\u1ed3ng tr\u1ee9ng (P) ng\u00e0y th\u1ee9 2 \u0111\u00e3 \u1ed5n \u0111\u1ecbnh\/ song thai 9 tu\u1ea7n.
\nVII. \u0110I\u1ec0U TR\u1eca:
\n– S\u1eed d\u1ee5ng kh\u00e1ng sinh d\u1ef1 ph\u00f2ng nhi\u1ec5m tr\u00f9ng h\u1eadu ph\u1ea9u :
\nCeftriaxone 1g * 2 l\u1ecd TMC 9h v\u00e0 18h.
\n– Thu\u1ed1c gi\u1ea3m co th\u1eaft c\u01a1 tr\u01a1n :<\/p>\n","protected":false},"excerpt":{"rendered":"
B\u1ec6NH \u00c1N TR\u00ccNH B\u1ec6NH Ph\u00f2ng: Ph\u1ee5 khoa I. PH\u1ea6N H\u00c0NH CH\u00cdNH: – H\u1ecd v\u00e0 t\u00ean: – Tu\u1ed5i: – Ngh\u1ec1 nghi\u1ec7p: – D\u00e2n t\u1ed9c : kinh – \u0110\u1ecba ch\u1ec9: – Ng\u00e0y v\u00e0o vi\u1ec7n: – Ng\u00e0y l\u00e0m b\u1ec7nh \u00e1n: II. B\u1ec6NH S\u1eec: 1. L\u00fd do v\u00e0o vi\u1ec7n : \u0110au b\u1ee5ng v\u00f9ng h\u1ed1 ch\u1eadu ph\u1ea3i 2. Qu\u00e1 tr\u00ecnh …<\/p>\n","protected":false},"author":15,"featured_media":1698,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[64,91,65],"tags":[],"class_list":["post-1697","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-san-khoa","category-benh-an","category-phu-san-1"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1697","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=1697"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1697\/revisions"}],"predecessor-version":[{"id":1699,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/1697\/revisions\/1699"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/1698"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=1697"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=1697"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=1697"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}