{"id":3449,"date":"2024-03-28T23:59:57","date_gmt":"2024-03-28T16:59:57","guid":{"rendered":"https:\/\/ykhoataynguyen.com\/site\/?p=3449"},"modified":"2024-09-14T22:21:25","modified_gmt":"2024-09-14T15:21:25","slug":"%f0%9d%90%81a%f0%9d%90%8d-%f0%9d%90%82o-%f0%9d%90%81%f0%9d%90%88e%f0%9d%90%93-%f0%9d%90%80%f0%9d%90%95%f0%9d%90%8d%f0%9d%90%91%f0%9d%90%93-%f0%9d%90%92%f0%9d%90%95%f0%9d%90%93%f0%9f%a4%94-%e2%9c%8d","status":"publish","type":"post","link":"https:\/\/ykhoataynguyen.com\/site\/%f0%9d%90%81a%f0%9d%90%8d-%f0%9d%90%82o-%f0%9d%90%81%f0%9d%90%88e%f0%9d%90%93-%f0%9d%90%80%f0%9d%90%95%f0%9d%90%8d%f0%9d%90%91%f0%9d%90%93-%f0%9d%90%92%f0%9d%90%95%f0%9d%90%93%f0%9f%a4%94-%e2%9c%8d\/","title":{"rendered":"\ud835\udc01\u1ea0\ud835\udc0d \ud835\udc02\u00d3 \ud835\udc01\ud835\udc08\u1ebe\ud835\udc13 \ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13\/\ud835\udc12\ud835\udc15\ud835\udc13?\ud83e\udd14 \u270d\ufe0f\ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13 (\ud835\udc00\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc28\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc27\ud835\udc28\ud835\udc1d\ud835\udc1a\ud835\udc25 \ud835\udc2b\ud835\udc1e-\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc1a\ud835\udc27\ud835\udc2d \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a) \ud835\udc2f\u00e0 \ud835\udc12\ud835\udc15\ud835\udc13\ud835\udc2c (\ud835\udc12\ud835\udc2e\ud835\udc29\ud835\udc2b\ud835\udc1a\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a\ud835\udc2c)"},"content":{"rendered":"
\ud835\udc01\u1ea0\ud835\udc0d \ud835\udc02\u00d3 \ud835\udc01\ud835\udc08\u1ebe\ud835\udc13 \ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13\/\ud835\udc12\ud835\udc15\ud835\udc13?\"\ud83e\udd14\"<\/span><\/div>\n
\"\u270d\ufe0f\"<\/span>\ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13 (\ud835\udc00\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc28\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc27\ud835\udc28\ud835\udc1d\ud835\udc1a\ud835\udc25 \ud835\udc2b\ud835\udc1e-\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc1a\ud835\udc27\ud835\udc2d \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a) \ud835\udc2f\u00e0 \ud835\udc12\ud835\udc15\ud835\udc13\ud835\udc2c (\ud835\udc12\ud835\udc2e\ud835\udc29\ud835\udc2b\ud835\udc1a\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a\ud835\udc2c)<\/div>\n
\n
Nh\u1ecbp nhanh tr\u00ean th\u1ea5t do v\u00f2ng v\u00e0o l\u1ea1i n\u00fat nh\u0129 th\u1ea5t AVNRT v\u00e0 Nh\u1ecbp nhanh k\u1ecbch ph\u00e1t tr\u00ean th\u1ea5t SVTs l\u00e0 m\u1ed9t v\u00e0 gi\u1ed1ng nhau. Tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3 m\u00f4 t\u1ea3 b\u1ea5t k\u1ef3 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh n\u00e0o c\u00f3 ngu\u1ed3n g\u1ed1c b\u00ean tr\u00ean B\u00f3 His<\/div>\n
\"\ud83c\udf35\"<\/span>\"\ud83d\udc49\"<\/span>AVNRT\/SVT l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a tri\u1ec7u ch\u1ee9ng h\u1ed3i h\u1ed9p (\u1edf ng\u01b0\u1eddi c\u00f3 c\u1ea5u tr\u00fac tim b\u00ecnh th\u01b0\u1eddng) th\u01b0\u1eddng kh\u1edfi k\u00edch b\u1edfi caffein, g\u1eafng s\u1ee9c, u\u1ed1ng r\u01b0\u1ee3u, thu\u1ed1c \u0111\u1ed3ng v\u1eadn beta ho\u1eb7c k\u00edch th\u00edch giao c\u1ea3m. T\u00ecnh tr\u1ea1ng n\u00e0y kh\u00f4ng g\u00e2y t\u1eed vong ngay c\u1ea3 \u1edf nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh l\u00fd v\u1ec1 tim.<\/div>\n
\"\ud83d\udc49\"<\/span>\u0110i\u1ec1u n\u00e0y g\u00e2y ra b\u1edfi n\u00fat nh\u0129 th\u1ea5t ho\u1eb7c t\u00e2m nh\u0129 v\u00e0 th\u01b0\u1eddng d\u1eabn t\u1edbi nh\u1ecbp tim nhanh (140 \u2013 280 l\u1ea7n\/ph\u00fat) v\u1edbi ph\u1ee9c b\u1ed9 QRS h\u1eb9p (< 0,12s = 3 \u00f4 nh\u1ecf) tr\u1eeb khi c\u00f3 v\u1ea5n \u0111\u1ec1 kh\u00e1c \u0111i k\u00e8m.<\/div>\n
\"\ud83d\udc49\"<\/span>S\u00f3ng P c\u00f3 th\u1ec3 nh\u00ecn th\u1ea5y \u0111\u01b0\u1ee3c, P \u0111\u1ea3o ng\u01b0\u1ee3c \u0111i tr\u01b0\u1edbc ho\u1eb7c \u0111i sau QRS \u1edf chuy\u1ec3n \u0111\u1ea1o DII, DIII, avF. N\u00f3 c\u0169ng c\u00f3 th\u1ec3 \u1ea9n v\u00e0o trong ph\u1ee9c b\u1ed9 QRS.<\/div>\n
\"\ud83d\udca5\"<\/span>SVT c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i theo ngu\u1ed3n g\u1ed1c v\u00e0 t\u00ednh \u0111\u1ec1u \u0111\u1eb7n:<\/div>\n
\"\ud83d\udc49\"<\/span>T\u00e2m nh\u0129<\/div>\n
\"\ud83d\udc49\"<\/span>Nh\u0129 th\u1ea5t<\/div>\n
\"\ud83d\udc49\"<\/span>V\u00f2ng v\u00e0o l\u1ea1i n\u00fat nh\u0129 th\u1ea5t (AVNRT)<\/div>\n
\"\ud83d\udc49\"<\/span>V\u00f2ng v\u00e0o l\u1ea1i nh\u0129 th\u1ea5t (AVRT)<\/div>\n
\"\ud83d\udc49\"<\/span>Nh\u1ecbp nhanh b\u1ed9 n\u1ed1i do t\u0103ng t\u1ef1 \u0111\u1ed9ng t\u00ednh<\/div>\n
\"\ud83d\udcaa\"<\/span>\"\ud83c\udf3c\"<\/span>\"\ud83c\udf3b\"<\/span>\u0110i\u1ec1u tr\u1ecb:<\/div>\n
\"\u270c\ufe0f\"<\/span>\"\ud83d\udc49\"<\/span>Ph\u1ee5 thu\u1ed9c v\u00e0o ti\u1ec1n s\u1eed b\u1ec7nh l\u00fd tim v\u00e0 ECG tr\u01b0\u1edbc \u0111\u00f3. \u0110i\u1ec1u tr\u1ecb bao g\u1ed3m nghi\u1ec7m ph\u00e1p c\u01b0\u1eddng ph\u1ebf v\u1ecb: xoa xoang c\u1ea3nh, Valsalva, t\u1ed1t nh\u1ea5t \u1edf t\u01b0 th\u1ebf Trendelenberg (tuy nhi\u00ean nh\u1eefng \u0111i\u1ec1u n\u00e0y ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh \u1edf ng\u01b0\u1eddi c\u00f3 t\u1ee5t huy\u1ebft \u00e1p).<\/div>\n
\"\ud83d\udc49\"<\/span>\u0110i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c c\u1eaft c\u01a1n c\u00f3 th\u1ec3 d\u00f9ng nh\u00f3m thu\u1ed1c l\u00e0m ch\u1eadm d\u1eabn truy\u1ec1n qua n\u00fat nh\u0129 th\u1ea5t nh\u01b0 Adenosin. Tr\u00e1nh t\u00e1i ph\u00e1t b\u1eb1ng c\u00e1ch s\u1eed d\u1ee5ng thu\u1ed1c ch\u1eb9n k\u00eanh canxi, ch\u1eb9n beta v\u00e0 amiodarone. N\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi thu\u1ed1c ho\u1eb7c b\u1ecb r\u1ed1i lo\u1ea1n huy\u1ebft \u0111\u1ed9ng th\u00ec s\u1ed1c \u0111i\u1ec7n chuy\u1ec3n nh\u1ecbp \u0111\u1ed3ng b\u1ed9 tr\u1ef1c ti\u1ebfp \u0111\u01b0\u1ee3c \u00e1p d\u1ee5ng. Nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng quy c\u00f3 th\u1ec3 tri\u1ec7t \u0111\u1ed1t qua catheter.<\/div>\n
\"\"<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

\ud835\udc01\u1ea0\ud835\udc0d \ud835\udc02\u00d3 \ud835\udc01\ud835\udc08\u1ebe\ud835\udc13 \ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13\/\ud835\udc12\ud835\udc15\ud835\udc13? \ud835\udc00\ud835\udc15\ud835\udc0d\ud835\udc11\ud835\udc13 (\ud835\udc00\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc28\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc27\ud835\udc28\ud835\udc1d\ud835\udc1a\ud835\udc25 \ud835\udc2b\ud835\udc1e-\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc1a\ud835\udc27\ud835\udc2d \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a) \ud835\udc2f\u00e0 \ud835\udc12\ud835\udc15\ud835\udc13\ud835\udc2c (\ud835\udc12\ud835\udc2e\ud835\udc29\ud835\udc2b\ud835\udc1a\ud835\udc2f\ud835\udc1e\ud835\udc27\ud835\udc2d\ud835\udc2b\ud835\udc22\ud835\udc1c\ud835\udc2e\ud835\udc25\ud835\udc1a\ud835\udc2b \ud835\udc2d\ud835\udc1a\ud835\udc1c\ud835\udc21\ud835\udc32\ud835\udc1c\ud835\udc1a\ud835\udc2b\ud835\udc1d\ud835\udc22\ud835\udc1a\ud835\udc2c) Nh\u1ecbp nhanh tr\u00ean th\u1ea5t do v\u00f2ng v\u00e0o l\u1ea1i n\u00fat nh\u0129 th\u1ea5t AVNRT v\u00e0 Nh\u1ecbp nhanh k\u1ecbch ph\u00e1t tr\u00ean th\u1ea5t SVTs l\u00e0 m\u1ed9t v\u00e0 gi\u1ed1ng nhau. Tuy nhi\u00ean, ch\u00fang c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3 m\u00f4 t\u1ea3 b\u1ea5t k\u1ef3 r\u1ed1i lo\u1ea1n nh\u1ecbp nhanh n\u00e0o c\u00f3 …<\/p>\n","protected":false},"author":27,"featured_media":4127,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[138],"tags":[],"class_list":["post-3449","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-tin-tuc"],"_links":{"self":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3449","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\/27"}],"replies":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/comments?post=3449"}],"version-history":[{"count":1,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3449\/revisions"}],"predecessor-version":[{"id":3452,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/posts\/3449\/revisions\/3452"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media\/4127"}],"wp:attachment":[{"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/media?parent=3449"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/categories?post=3449"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ykhoataynguyen.com\/site\/wp-json\/wp\/v2\/tags?post=3449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}