{"id":11226,"date":"2021-11-18T11:12:01","date_gmt":"2021-11-18T04:12:01","guid":{"rendered":"https:\/\/cdcangiang.vn\/?p=11226"},"modified":"2021-11-18T11:12:01","modified_gmt":"2021-11-18T04:12:01","slug":"cac-tien-bo-trong-dieu-tri-benh-basedow","status":"publish","type":"post","link":"https:\/\/cdcangiang.vn\/index.php\/2021\/11\/18\/cac-tien-bo-trong-dieu-tri-benh-basedow\/","title":{"rendered":"C\u00c1C TI\u1ebeN B\u1ed8 TRONG \u0110I\u1ec0U TR\u1eca B\u1ec6NH BASEDOW"},"content":{"rendered":"

Bs, Nguy\u1ec5n Hu\u1ef3nh Nguy\u00ean – Khoa N\u1ed9i ti\u1ebft, B\u1ec7nh vi\u1ec7n \u0110KTT An Giang<\/em><\/strong><\/p>\n

B\u1ec7nh Basedow (c\u00f2n g\u1ecdi l\u00e0 b\u1ec7nh Graves) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd n\u1ed9i ti\u1ebft hay g\u1eb7p, v\u1edbi bi\u1ec3u hi\u1ec7n t\u00ecnh tr\u1ea1ng nhi\u1ec5m \u0111\u1ed9c gi\u00e1p k\u00e8m b\u01b0\u1edbu gi\u00e1p lan t\u1ecfa v\u00e0 c\u00f3 th\u1ec3 k\u00e8m theo bi\u1ec3u hi\u1ec7n \u1edf m\u1eaft nh\u01b0 l\u1ed3i m\u1eaft, ph\u00f9 ni\u00eam tr\u01b0\u1edbc x\u01b0\u01a1ng ch\u00e0y.<\/p>\n

\"\"<\/p>\n

\u0110\u00e2y l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd t\u1ef1 mi\u1ec5n, th\u01b0\u1eddng g\u1eb7p \u1edf n\u1eef gi\u1edbi (chi\u1ebfm 80%), v\u1edbi \u0111\u1ed9 tu\u1ed5i th\u01b0\u1eddng g\u1eb7p l\u00e0 20-50 tu\u1ed5i.<\/p>\n

N\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p, c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn c\u00e1c bi\u1ebfn ch\u1ee9ng: r\u1ed1i lo\u1ea1n nh\u1ecbp tim, suy tim, l\u1ed3i m\u1eaft… Tr\u01b0\u1eddng h\u1ee3p c\u1ea5p t\u00ednh c\u00f3 th\u1ec3 g\u00e2y b\u00e3o gi\u00e1p khi\u1ebfn b\u1ec7nh nh\u00e2n t\u1eed vong nhanh ch\u00f3ng.<\/p>\n

B\u1ec7nh nh\u00e2n Basedow c\u00f3 nh\u1eefng bi\u1ec3u hi\u1ec7n nh\u01b0:<\/p>\n

G\u1ea7y, s\u1ee5t c\u00e2n: th\u01b0\u1eddng g\u1eb7p, d\u00f9 ng\u01b0\u1eddi b\u1ec7nh \u0103n u\u1ed1ng v\u1eabn b\u00ecnh th\u01b0\u1eddng. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n trong \u0111\u1ed9 tu\u1ed5i ph\u00e1t tri\u1ec3n c\u01a1 th\u1ec3 th\u00ec c\u00f3 th\u1ec3 t\u0103ng c\u00e2n.<\/p>\n

Tinh th\u1ea7n: lo l\u1eafng, kh\u00f3 t\u1eadp trung, kh\u00f3 ng\u1ee7.<\/p>\n

Tim: c\u1ea3m gi\u00e1c h\u1ed3i h\u1ee3p, tim \u0111\u1eadp m\u1ea1nh, \u0111\u00e1nh tr\u1ed1ng ng\u1ef1c.<\/p>\n

N\u00f3ng, v\u00e3 m\u1ed3 h\u00f4i k\u00e8m kh\u00e1t, u\u1ed1ng nhi\u1ec1u.<\/p>\n

R\u1ed1i lo\u1ea1n ti\u00eau h\u00f3a: ti\u00eau l\u1ecfng, \u0111au b\u1ee5ng do t\u0103ng nhu \u0111\u1ed9ng ru\u1ed9t.<\/p>\n

Khi th\u0103m kh\u00e1m c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n:<\/p>\n

B\u01b0\u1edbu gi\u00e1p: to, lan t\u1ecfa. Nh\u01b0ng m\u1ed9t s\u1ed1 c\u00f3 th\u1ec3 kh\u00f4ng c\u00f3 b\u01b0\u1edbu gi\u00e1p.<\/p>\n

M\u1eaft: l\u1ed3i m\u1eaft, r\u1ed1i lo\u1ea1n \u1edf mi m\u1eaft, v\u1eadn nh\u00e3n.<\/p>\n

Th\u1ea7n kinh: run \u0111\u1ea7u chi, y\u1ebfu c\u01a1 g\u1ed1c chi.<\/p>\n

Tim: nhanh (>100 l\u1ea7n\/ph\u00fat), r\u1ed1i lo\u1ea1n nh\u1ecbp tim, suy tim.<\/p>\n

Ph\u00f9 ni\u00eam tr\u01b0\u1edbc x\u01b0\u01a1ng ch\u00e0y.<\/p>\n

B\u1ec7nh nh\u00e2n Basedow s\u1ebd \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh l\u00e0m nh\u1eefng c\u1eadn l\u00e2m s\u00e0ng sau:<\/p>\n

X\u00e9t nghi\u1ec7m m\u00e1u: ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p TSH gi\u1ea3m, T3 v\u00e0 FT4 t\u0103ng. Kh\u00e1ng th\u1ec3 kh\u00e1ng gi\u00e1 TRab t\u0103ng c\u0169ng g\u00f3p ph\u1ea7n ch\u1ea9n \u0111o\u00e1n Basedow.<\/p>\n

Si\u00eau \u00e2m tuy\u1ebfn gi\u00e1p: tuy\u1ebfn gi\u00e1p to, lan t\u1ecfa v\u00e0 c\u00f3 h\u00ecnh \u1ea3nh t\u0103ng sinh m\u1ea1ch m\u00e1u.<\/p>\n

X\u1ea1 h\u00ecnh tuy\u1ebfn gi\u00e1p: \u0111\u1ed9 t\u1eadp trung iod ph\u00f3ng x\u1ea1 t\u1ea1i tuy\u1ebfn gi\u00e1p t\u0103ng.<\/p>\n

\u0110i\u1ec1u tr\u1ecb: hi\u1ec7n nay c\u00f3 3 ph\u01b0\u01a1ng ph\u00e1p ch\u00ednh \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1ec7nh Basedow: n\u1ed9i khoa, ph\u1eabu thu\u1eadt, v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng Iod ph\u00f3ng x\u1ea1.<\/p>\n

1\/ N\u1ed9i khoa: d\u00f9ng thu\u1ed1c kh\u00e1ng gi\u00e1p t\u1ed5ng h\u1ee3p \u0111\u1ec3 ki\u1ec3m so\u00e1t ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p, \u0111\u01b0a ng\u01b0\u1eddi b\u1ec7nh t\u1eeb c\u01b0\u1eddng gi\u00e1p v\u1ec1 b\u00ecnh gi\u00e1p. Th\u00f4ng th\u01b0\u1eddng, sau 12-18 th\u00e1ng \u0111i\u1ec1u tr\u1ecb, t\u1ec9 l\u1ec7 lui b\u1ec7nh c\u00f3 th\u1ec3 \u0111\u1ea1t \u0111\u1ebfn 70% s\u1ed1 b\u1ec7nh nh\u00e2n.<\/p>\n

2\/ Ph\u1eabu thu\u1eadt: th\u01b0\u1eddng \u00e1p d\u1ee5ng cho nh\u1eefng b\u1ec7nh nh\u00e2n Basedow c\u00f3 b\u01b0\u1edbu gi\u00e1p to g\u00e2y m\u1ea5t th\u1ea9m m\u1ef9, ho\u1eb7c ch\u00e8n \u00e9p \u0111\u01b0\u1eddng th\u1edf g\u00e2y kh\u00f3 th\u1edf. Nh\u1eefng b\u1ec7nh nh\u00e2n t\u00e1i ph\u00e1t sau \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa c\u0169ng c\u00f3 th\u1ec3 l\u1ef1a ch\u1ecdn ph\u1eabu thu\u1eadt.<\/p>\n

B\u1ec7nh nh\u00e2n s\u1ebd \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh c\u1eaft b\u1ecf tuy\u1ebfn gi\u00e1p (ho\u00e0n to\u00e0n ho\u1eb7c g\u1ea7n ho\u00e0n to\u00e0n) \u0111\u1ec3 \u0111\u01b0a ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p v\u1ec1 b\u00ecnh th\u01b0\u1eddng.<\/p>\n

Bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 g\u1eb7p: kh\u00e0n gi\u1ecdng, h\u1ea1 canxi m\u00e1u\u2026<\/p>\n

3\/ Iod ph\u00f3ng x\u1ea1: d\u00f9ng Iod ph\u00f3ng x\u1ea1 I131 \u0111\u1ec3 ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o tuy\u1ebfn gi\u00e1p, \u0111\u01b0a ch\u1ee9c n\u0103ng tuy\u1ebfn gi\u00e1p v\u1ec1 b\u00ecnh th\u01b0\u1eddng.<\/p>\n

Do s\u1eed d\u1ee5ng Iod ph\u00f3ng x\u1ea1, n\u00ean kh\u00f4ng \u00e1p d\u1ee5ng cho tr\u1ebb em v\u00e0 ph\u1ee5 n\u1eef c\u00f3 thai.<\/p>\n

D\u00f9 l\u00e0 \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt hay Iod ph\u00f3ng x\u1ea1, th\u00ec b\u1ec7nh nh\u00e2n Basedow c\u0169ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa m\u1ed9t th\u1eddi gian, \u0111\u1ec3 \u1ed5n \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng c\u01b0\u1eddng gi\u00e1p.<\/p>\n

M\u1ed7i b\u1ec7nh nh\u00e2n Basedow s\u1ebd \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn gi\u1ea3i ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p ri\u00eang, v\u00e0 vi\u1ec7c n\u00e0y n\u00ean do b\u00e1c s\u0129 chuy\u00ean khoa h\u1ed7 tr\u1ee3. Ch\u00ednh v\u00ec v\u1eady, khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n nghi ng\u1edd b\u1ec7nh Basedow n\u00ean \u0111\u1ebfn c\u01a1 s\u1edf y t\u1ebf kh\u00e1m v\u00e0 \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p.\/.<\/p>\n","protected":false},"excerpt":{"rendered":"

Bs, Nguy\u1ec5n Hu\u1ef3nh Nguy\u00ean – Khoa N\u1ed9i ti\u1ebft, B\u1ec7nh vi\u1ec7n \u0110KTT An Giang B\u1ec7nh Basedow (c\u00f2n g\u1ecdi l\u00e0 b\u1ec7nh Graves) l\u00e0 m\u1ed9t b\u1ec7nh l\u00fd n\u1ed9i ti\u1ebft hay g\u1eb7p, v\u1edbi bi\u1ec3u hi\u1ec7n t\u00ecnh tr\u1ea1ng nhi\u1ec5m \u0111\u1ed9c gi\u00e1p k\u00e8m b\u01b0\u1edbu gi\u00e1p lan t\u1ecfa v\u00e0 c\u00f3 th\u1ec3 k\u00e8m theo bi\u1ec3u hi\u1ec7n \u1edf m\u1eaft nh\u01b0 l\u1ed3i m\u1eaft, ph\u00f9 ni\u00eam […]<\/p>\n","protected":false},"author":4,"featured_media":11227,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"limit_modified_date":"","last_modified_date":"","footnotes":""},"categories":[2,239],"tags":[],"class_list":["post-11226","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tin-tuc-su-kien","category-truyen-thong-theo-chu-de"],"_links":{"self":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/11226","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/comments?post=11226"}],"version-history":[{"count":1,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/11226\/revisions"}],"predecessor-version":[{"id":11229,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/posts\/11226\/revisions\/11229"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/media\/11227"}],"wp:attachment":[{"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/media?parent=11226"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/categories?post=11226"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cdcangiang.vn\/index.php\/wp-json\/wp\/v2\/tags?post=11226"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}