{"id":908,"date":"2021-09-05T01:14:02","date_gmt":"2021-09-04T18:14:02","guid":{"rendered":"http:\/\/phauthuatnhi.vn\/vi\/?p=908"},"modified":"2021-09-05T01:14:14","modified_gmt":"2021-09-04T18:14:14","slug":"con-ong-dong-mach","status":"publish","type":"post","link":"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/con-ong-dong-mach\/","title":{"rendered":"C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch"},"content":{"rendered":"\n<p class=\"has-medium-font-size\"><strong>\u0110\u1ea1i c\u01b0\u01a1ng<\/strong><\/p>\n\n\n\n<ul><li>C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch (PDA) (H\u00ecnh 1) l\u00e0 m\u1ed9t d\u1ecb t\u1eadt tim b\u1ea9m sinh x\u1ea3y ra ngay sau khi sinh \u1edf m\u1ed9t s\u1ed1 tr\u1ebb.<\/li><li>1\/5.000 \u2013 1\/2.000 tr\u1ebb s\u01a1 sinh s\u1ed1ng.<\/li><li>5-10% c\u00e1c tr\u01b0\u1eddng h\u1ee3p TBS (tr\u1eeb tr\u1ebb sanh non), N\u1eef:nam = 3:1.<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large\"><img loading=\"lazy\" width=\"654\" height=\"339\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-1.jpg\" alt=\"\" class=\"wp-image-910\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-1.jpg 654w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-1-300x156.jpg 300w\" sizes=\"(max-width: 654px) 100vw, 654px\" \/><figcaption><strong>H\u00ecnh 1: C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Nguy\u00ean nh\u00e2n<\/strong><\/p>\n\n\n\n<ul><li>\u1ed0ng \u0110M \u0111\u00f3ng sau sanh s\u1ebd \u0111\u00f3ng v\u1ec1 ch\u1ee9c n\u0103ng l\u00fac 48 gi\u1edd tu\u1ed5i, v\u1ec1 gi\u1ea3i ph\u1eabu l\u00fac 3 th\u00e1ng tu\u1ed5i th\u00e0nh d\u00e2y ch\u1eb1ng \u0110M b\u1eb1ng c\u00e1ch t\u0103ng n\u1ed3ng \u0111\u1ed9 oxy m\u00e1u v\u00e0 gi\u1ea3m n\u1ed3ng \u0111\u1ed9 prostaglandin E2.<\/li><\/ul>\n\n\n\n<ul><li><strong>Sau sanh \u1ed1ng \u0110M c\u00f2n t\u1ed3n t\u1ea1i do:<\/strong><ul><li>Sanh non nh\u1ea5t l\u00e0 &lt; 30 tu\u1ea7n tu\u1ed5i thai<\/li><li>M\u1eb9 b\u1ecb nhi\u1ec5m Rubella trong l\u00fac mang thai<\/li><li>Sanh ng\u1ea1t<\/li><li>M\u1eb9 s\u1ed1ng \u1edf v\u00f9ng cao nguy\u00ean<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/p>\n\n\n\n<ul><li>PDA nh\u1ecf: kh\u00f4ng tri\u1ec7u ch\u1ee9ng<\/li><li>PDA l\u1edbn<ul><li>Hay b\u1ecb nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p d\u01b0\u1edbi, x\u1eb9p ph\u1ed5i<\/li><li>Ch\u1eadm t\u0103ng c\u00e2n, s\u1ee5t c\u00e2n<\/li><li>Suy tim: th\u1edf nhanh, kh\u00f3 th\u1edf\/g\u1eafng s\u1ee9c, ph\u00f9, ti\u1ec3u \u00edt, v\u00e3 m\u1ed3 h\u00f4i, b\u00fa \u0103n k\u00e9m, qu\u1ea5y kh\u00f3c<\/li><\/ul><\/li><li><strong>Kh\u00e1m: <\/strong><ul><li>M\u1ea1ch Corrigan (n\u1ea9y m\u1ea1nh, ch\u00ecm nhanh), m\u1ea1ch nhanh (suy tim)<\/li><li>&nbsp;Hi\u1ec7u \u00e1p l\u1edbn, HA t\u00e2m thu cao. Th\u1edf nhanh, co l\u00f5m ng\u1ef1c<\/li><li>Kh\u00e1m tim: tim to, th\u1ea5t tr\u00e1i t\u0103ng \u0111\u1ed9ng, \u00e2m th\u1ed5i li\u00ean t\u1ee5c, c\u01b0\u1eddng \u0111\u1ed9 l\u1edbn, \u1edf kho\u1ea3ng<br>li\u00ean s\u01b0\u1eddn II-III ngay d\u01b0\u1edbi x\u01b0\u01a1ng \u0111\u00f2n tr\u00e1i, s\u1edd c\u00f3 rung mi\u00eau t\u00e2m thu v\u00e0 t\u00e2m<br>tr\u01b0\u01a1ng. T2 m\u1ea1nh kh\u00f4ng t\u00e1ch \u0111\u00f4i<\/li><\/ul><\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/p>\n\n\n\n<ul><li>Ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh d\u1ef1a v\u00e0o si\u00eau \u00e2m tim<\/li><li>XQ tim ph\u1ed5i: di\u1ec7n tim b\u00ecnh th\u01b0\u1eddng ho\u1eb7c l\u1edbn th\u1ea5t tr\u00e1i, nh\u0129 tr\u00e1i. Tu\u1ea7n ho\u00e0n ph\u1ed5i b\u00ecnh th\u01b0\u1eddng ho\u1eb7c t\u0103ng ch\u1ee7 \u0111\u1ed9ng. \u0110\u1ed9ng m\u1ea1ch ph\u1ed5i, quai \u0110MC d\u00e3n.<\/li><li>ECG: b\u00ecnh th\u01b0\u1eddng ho\u1eb7c l\u1edbn th\u1ea5t tr\u00e1i, l\u1edbn hai th\u1ea5t.<\/li><li>Si\u00eau \u00e2m tim Doppler: \u0111o \u0111\u01b0\u1eddng k\u00ednh \u1ed1ng \u0111\u1ed9ng m\u1ea1ch, x\u00e1c \u0111\u1ecbnh chi\u1ec1u lu\u1ed3ng th\u00f4ng, t\u00ecnh tr\u1ea1ng t\u0103ng g\u00e1nh th\u1ec3 t\u00edch th\u1ea5t tr\u00e1i, nh\u0129 tr\u00e1i, \u00e1p l\u1ef1c \u0110MP, ch\u1ee9c n\u0103ng tim.<\/li><\/ul>\n\n\n\n<p class=\"has-medium-font-size\"><strong>\u0110i\u1ec1u tr\u1ecb<\/strong><\/p>\n\n\n\n<p><strong>Nguy\u00ean t\u1eafc:<\/strong><\/p>\n\n\n\n<ul><li>\u0110\u00f3ng \u1ed1ng \u0111\u1ed9ng m\u1ea1ch.<\/li><li>Ph\u00f2ng ng\u1eeba v\u00e0 \u0111i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng.<\/li><\/ul>\n\n\n\n<p><strong>N\u1ed9i khoa<\/strong><\/p>\n\n\n\n<ul><li>Trong giai \u0111o\u1ea1n s\u01a1 sinh (d\u01b0\u1edbi 15 ng\u00e0y tu\u1ed5i) \u0111\u00f3ng \u1ed1ng \u0111\u1ed9ng m\u1ea1ch b\u1eb1ng thu\u1ed1c<br>Ibuprofen.<\/li><\/ul>\n\n\n\n<p><strong>\u0110\u00f3ng PDA b\u1eb1ng d\u1ee5ng c\u1ee5:<\/strong><\/p>\n\n\n\n<ul><li>\u0110i\u1ec1u ki\u1ec7n: PDA type A, B, C, D &lt; 10 mmm (h\u00ecnh 2), ch\u01b0a \u0111\u1ea3o shunt<\/li><li>PDA &lt; 4mm: \u0111\u00f3ng b\u1eb1ng coils (H\u00ecnh 3)<\/li><li>PDA 4-10 mm: \u0111\u00f3ng b\u1eb1ng Amplatzer<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-2.jpg\" alt=\"\" class=\"wp-image-912\" width=\"485\" height=\"288\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-2.jpg 970w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-2-300x178.jpg 300w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-2-768x455.jpg 768w\" sizes=\"(max-width: 485px) 100vw, 485px\" \/><figcaption><strong>H\u00ecnh 2. Ph\u00e2n lo\u1ea1i Krichenko c\u00e1c bi\u1ebfn th\u1ec3 h\u00ecnh th\u00e1i c\u1ee7a \u1ed1ng \u0111\u1ed9ng m\u1ea1ch<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-3.jpg\" alt=\"\" class=\"wp-image-913\" width=\"320\" height=\"377\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-3.jpg 426w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-3-254x300.jpg 254w\" sizes=\"(max-width: 320px) 100vw, 320px\" \/><figcaption><strong>H\u00ecnh 3: \u0110\u00f3ng \u1ed1ng \u0111\u1ed9ng m\u1ea1ch b\u1eb1ng d\u1ee5ng c\u1ee5<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<ul><li>Ki\u1ec3m tra si\u00eau \u00e2m tim sau \u0111\u00f3ng: 1 ng\u00e0y, 1 th\u00e1ng, 3 th\u00e1ng, 12 th\u00e1ng<\/li><\/ul>\n\n\n\n<p><strong>Ph\u1eabu thu\u1eadt<\/strong><\/p>\n\n\n\n<ul><li>Ch\u1ec9 \u0111\u1ecbnh: PDA ch\u01b0a \u0111\u1ea3o shunt, kh\u00f4ng \u0111\u00f3ng b\u1eb1ng d\u1ee5ng c\u1ee5 \u0111\u01b0\u1ee3c<\/li><li>C\u1ed9t \u1ed1ng \u0111\u1ed9ng m\u1ea1ch. (H\u00ecnh 4)<\/li><\/ul>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter size-large is-resized\"><img loading=\"lazy\" src=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-4.jpg\" alt=\"\" class=\"wp-image-916\" width=\"344\" height=\"312\" srcset=\"http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-4.jpg 458w, http:\/\/phauthuatnhi.vn\/vi\/wp-content\/uploads\/2021\/09\/CODM-4-300x272.jpg 300w\" sizes=\"(max-width: 344px) 100vw, 344px\" \/><figcaption><strong>H\u00ecnh 4: C\u1ed9t \u1ed1ng \u0111\u1ed9ng m\u1ea1ch<\/strong><\/figcaption><\/figure><\/div>\n\n\n\n<p class=\"has-medium-font-size\"><strong>T\u00e1i kh\u00e1m<\/strong><\/p>\n\n\n\n<ul><li>Gi\u1edbi h\u1ea1n ho\u1ea1t \u0111\u1ed9ng \u0111\u1ed1i v\u1edbi tr\u1ebb trong khi tr\u1ebb h\u1ed3i ph\u1ee5c<\/li><li>M\u1ed9t tu\u1ea7n, 3 th\u00e1ng , 6 th\u00e1ng, 12 th\u00e1ng sau m\u1ed5.<\/li><\/ul>\n\n\n\n<p><strong><em>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/em><\/strong><\/p>\n\n\n\n<ul><li>https:\/\/ctsurgerypatients.org\/pediatric-and-congenital-heart-disease\/patent-ductus-arteriosus<\/li><li>Constantine Mavroudis, Carl Backer, Richid F. Idriss. 2012. Pediatric Cardiac Surgery. Blackwell.<\/li><li>Mark Davenport, James D. Geiger. 2020. Operative Pediatric Surgery. London: CRC Press.<\/li><li>Mavroudis, Constantine, Backer, Carl Lewis (Eds.). 2015. Mavroudis, Constantine, Backer, Carl Lewis (Eds.). Springer.<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u0110\u1ea1i c\u01b0\u01a1ng C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch (PDA) (H\u00ecnh 1) l\u00e0 m\u1ed9t d\u1ecb t\u1eadt tim b\u1ea9m sinh x\u1ea3y ra ngay sau khi sinh \u1edf m\u1ed9t s\u1ed1 tr\u1ebb. 1\/5.000 \u2013 1\/2.000 tr\u1ebb s\u01a1 sinh s\u1ed1ng. 5-10% c\u00e1c <a class=\"mh-excerpt-more\" href=\"http:\/\/phauthuatnhi.vn\/vi\/cacloaibenh\/con-ong-dong-mach\/\" title=\"C\u00f2n \u1ed1ng \u0111\u1ed9ng m\u1ea1ch\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":4,"featured_media":910,"comment_status":"open","ping_status":"open","sticky":false,"template":"template-full.php","format":"standard","meta":[],"categories":[4,11],"tags":[],"_links":{"self":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/908"}],"collection":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/comments?post=908"}],"version-history":[{"count":5,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/908\/revisions"}],"predecessor-version":[{"id":919,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/posts\/908\/revisions\/919"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media\/910"}],"wp:attachment":[{"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/media?parent=908"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/categories?post=908"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/phauthuatnhi.vn\/vi\/wp-json\/wp\/v2\/tags?post=908"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}