VCTC Y4moi

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    Vim cu thn cpsau nhim trng

    Nguyn Th Qunh Hng -2!

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    i cng

    V"T" sau nhim trng # c$ %i&n'

    V"T" () nhim trng (i *hu+n

    Vim thn , shunt. Vim n/i t0m m1c. Nung m s0u 34$ th&45nh th6ng7. 8iang mai 3H"TH 4+m sinh7

    V"T" () nhim *9 sinh trng :;t rt V8 " 3V"T t?ng sinh m)ng7. V8 @ 3V"T ng1i m)ng7. HAV

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    TB CD mEc *hFng rG nhng rt thp c=c nIc ph=t tri&n

    J K !2 tu$i. namLnM2

    VCTCsau nhim trng

    i cng

    @Dnh C9 min ,ch huyOt thanh 3"A"7 nhng cPng h1t h= cn%6ng # aCtrn R ca 4$ th& 4Sng N Cin cu gEn gian m1ch

    @i&u hiDn 4i tam chUng ph. ca HW () %=i m=u

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    Nhim trng TMH (7 ti 15 ngy) hoc da (3 ti 6 tun)

    o !i"n cu #$ta tan huy%t nh&m ' gy raThnh *+ ny c& ,rot$in T - M

    .rot$in M/ ty,$ 1, 2, 4, 12, 18, 25 (nhim trng hng)

    02 552 572 - 6 (nhim trng da) 4c #it gy -i"m thn

    VCTCsau nhim trng

    i cng

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    " chO 4Dnh sinh Nhim khun

    P KN-KT

    Vim ma m!"h Vim ma m!"h "#u th$n

    T%ng t&nh th'm " m!"h " m!"h "#u th$n Vim u't ti*t

    + Na n./" t%ng 0" "n thi*u m3u "" t%ng t&nh th'm gim i6n 7" gian ng!i in 9 th$n mng :3;

    T%ng ti*t r, Pr ni6u t%ng ?" "#u th$n gim

    Ph :3i &t @r< t%ng

    Au; tim "'B =Cn m, " gi$t 0u; th$n "'B

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    @i&u hiDn C0m s)ng

    Tam chUng (im thn

    Xh th6ng chY ,in 4iOn trng Z-! ng)y

    HW tr ([ 45nh th6ng sau 2-\ tun

    ]=i m=u %1i th& trng !-\ tun^ Vi th& c_ th& *

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    XN CLS

    H niu - .rot$in niu

    8ur" - cr9atinin$ m:u

    H5 - 3 gi;m

    ' ngy - ngy 1 ?nh ,h@m hAng n%u c& B nhim trng tiCm tng

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    @i&u hiDn cn C0m s)ng

    "\ tr ([ 45nh th6ng sau `- tun

    Xrtin niDu c_ th& 4iOn mt trng 2-\ th=ng^

    Thm chd Xrtin niDu t thO !-2 n?m sau^

    NOu Xe () H" niDu *

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    "=c th& C0m s)ng

    ThD thCng th.Eng thD "a hu;*t 3B

    thD :3i m3u thD 0u; th$n V>T> ti*n triDn nhanh

    V>T> thD k*t hFB V>T 3n "'B

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    +hi no thD nh, -in

    TEng H'

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    .hn thF #nh

    >G gH khG kh%n I BhJn thD 7Jm0ng

    PhJn thD gii BhLu 6nh

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    $ndoca,i!!air$ $Gtraca,i!!air$N9i m!"h Ng!i m!"h>M" m!"h

    TiDu O :i

    TiDu O :*nTr" gian m!"h

    Khang n./" tiDua Qman

    T iDu mC

    Rng 7.Fn g#n

    >#u th$n Hnh th.Eng

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    TEng inh nIi mJch

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    *T tEng inh nIi mJch !an to;

    St :#u :9t ng9t /i :3i m3u hUng:nh (:!i thD hW" i thD)X

    Prt

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    TEng inh nIi ngoJi mJch !an to;

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    TEng inh ngoJi mJch

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    *T tEng inh nIi ngoJi mJch

    VCT tng sinh : T%ng 0inh t/i \]-8]^ "#u th$n trn tiu

    n ( t%ng 0inh _\]-5]^ ti*n triDn thu$n

    7Fi, `5]^ thH t%ng = 0u; th$n 0aunhiIu n%m ti*n triDn)X

    T>?A th.Eng C ni6u nhiIu ng; 3i m3u kb i trn c th3ng Prt

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    *T tEng inh nIi ngoJi mJch

    d thD gim hUng :nh 0/m nga;khi St :#u 6nh

    i*n "hng "ea :ng muZi n./"> gi$t ( Bhu nf), 0u; tim /iBh Bhdi "'B

    !ng khCng :iDn hHnh /i :3i m3u

    i thD

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    *T tEng inh nIi ngoJi mJch

    VCT tng sinh lan to: T%ng 0inh trn 8]^ "#u th$n trn

    tiu n T>?A PrtT= tnt!i, t%ng =, 0u; th$n nga; khi St:#u hW" 0au i tu#n, ti*n triDn

    #n :*n 0u; th$n giai :!n "uZi

    VCTC th v niu, VCTC th cao HA, VCTC th kthp

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    TEng inh mng

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    *T tEng inh mng

    T>?A =>T=

    3i m3u hUng :nh T%ng = Au; th$n

    Tin 7.Fng th.Eng 'u

    VCTC th kt hp, VCTC th bn c!p, VCTC tin t"in nhanh

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    TEng inh mng

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    h@n 4o:n ,hn #it

    #nh #$%&$% WB j-1\ tudi, th.Eng tr trai 3i m3u t3i Bh3t, :Ci khi khi Bh3t i

    'u hi6u nhim trngX 3i m3u lY- Brt

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    h@n 4o:n ,hn #it

    HC Alpo"t: Tdn th.ng th$n tai o; ra nam, th.Eng "h*t :9 tudi 15-

    \] H 0u; th$nX Np 7nh t&nh/i :3i m3u ithD, T 7Wn, 7in k*t o 3i m3u "G thD hi6n nga; khi : 3i m3u :!i thD "G thD gWB, :3i m3u i

    thD tn t!i Prt\ Hnh th.Eng i*"

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    h@n 4o:n ,hn #it

    'i (u gia )*nh l+nh tnh: T tr9i, NAT th.Eng

    3i m3u :n :9" Ainh thi*t th$n mng :3; mqngXCc ngu-.n nh/n khc:@, 0qi,

    !ng, thuZ" nans

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    Ch nh sinh thit thn

    Lc bt !u b"nh# $nh gi$ % n&ng c'a b"nh (T)ng sinh ng*imch+

    K *L niu ngy

    K

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    $i1i -h2u b"nh

    Vi th3 *T tEng inh nIi mJch ( t% #o gian mJch - nIi mL)

    ti%t (?SN trung tUnh)2 4Li Rhi tEng inh ngoJi mJch =Vng 4Ang RhLng 4Cu -i c:c RhWi Xuay ra ,hUa ngoicYa mng 4:y cu thn

    T b/* h4c =Vng 4Ang RhLng 4Cu 3 ZP[ \g

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    i5u tr

    Tri"u ch6ng HJn ch% muWi n]c =^i tiFu SiCu tr_ tEng H' n%u c& (ch`n R"nh anGi) =Ac m:u

    &c hi"u =oJi # B nhim trng tiCm tng

    TMH2 rEng2 daSiCu tr_ ,$niGi!in2 dng !u di n%u c& B nhim trng

    tbn tJiSiCu tr_ corticoid2 h$,arin2 t:ch huy%t t]ngtrong c:c

    dJng nng

    SiCu tr_ -i tun 4%n -i th:ng

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    Tin tri3n

    +hi trong 5 tr]Qng h^,

    Ti"n !]^ng Geu f ng]Qi !n Nhim trng da Nng ngay Rhi #Vt 4u

    TEng inh ngoJi mJch

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    Tin tri3n th7ng th8ng

    .h - thiFu niu/ -i ngy

    TEng H' -i ngy 4%n 3 tun

    S:i m:u 4Ji thF 1 th:ng S:i m:u -i thF 1[1 th:ng

    .rot$in niu -i tun 4%n -i th:ng (Rho;ng 6 th:ng)

    ?B thF #Dnh th]Qng 6[ tun