Benh dot quy va cach phong tranh
Theo dieu tra cua To chuc Y te The gioi, dot quy la mot trong 10 nguyen nhan gay tu vong hang dau. Tai 2/3 so quoc gia duoc khao sat, tai bien nay la 1 trong 3 nguyen nhan gay tu vong cao nhat. Neu phat hien va dieu tri som, benh nhan se duoc cuu song va tranh nhung di chung nang ne. Dot quy (con goi la tai bien mach mau nao, xuat huyet nao) la tinh trang roi loan chuc nang than kinh nhu hon me, liet nua nguoi, noi do, nuot bi sac... Cac bieu hien nay xuat hien nhanh, dot ngot, thuong ton tai tren 24 gio. Dua vao tien trien cua benh trong 2-3 tuan dau, gioi chuyen mon chia dot quy thanh 5 loai: - Con thieu mau nao cuc bo thoang qua: Khoi hoan toan truoc 24 gio. Ve sau, benh nhan co the bi tai bien mach mau nao thuc su neu khong quan tam den viec dieu tri va phong ngua. - Thieu mau nao co hoi phuc: Khoi hoan toan sau 24 gio bi liet. - Khoi mot phan va di chung keo dai. - Khong hoi phuc hoac nang len lien tuc. - Dien tien den tu vong.
- Yeu liet hoac te ran o vung mat, tay hoac chan, dac biet la mot ben co the, chi mot tay hoac mot chan. - Lu lan, roi loan loi noi hoac hieu biet (kho tim tu hoac khong hieu tu; noi liu riu, lap bap). - Khong nhin thay o mot hay ca hai mat, hoac nhin mot hoa hai. - Kho khan khi buoc di, mat thang bang, chong mat hoac kho phoi hop cac dong tac. - Nhuc dau du doi ma khong biet nguyen nhan. Suy giam y thuc nhanh chong. Mat thang bang, chong mat, non, kem theo nhuc dau. Trong mot so truong hop, nguoi benh van con tinh tao, nhung da so bi giam sut tri giac (nhu lo mo, ngu ga, co the hon me). Benh nhan co the liet nua nguoi, liet mat va cac co hau hong (gay nuot kho, sac khi an uong, noi kho), tieu tieu khong tu chu. Khi xuat hien cac trieu chung dot quy, nguoi nha benh nhan nen thuc hien 3 viec: - Lien he voi trung tam cap cuu hoac benh vien gan nhat, noi co trang bi phuong tien dieu tri tai bien mach mau nao. - Tran an benh nhan. - Theo doi thuong xuyen tri giac va tinh trang liet cua benh nhan. Da so benh nhan va gia dinh khong nhan biet duoc con dot quy dang xay ra, hoac khong biet la can cap cuu ngay khi benh khoi phat. Do do, ho mat nhieu thoi gian cho nhung phuong phap dan gian nhu cao gio, cat le... Nhung viec nay chang nhung khong co tac dung gi ma con lam giam co hoi chua khoi cho benh nhan. Kha nang dieu tri tai bien mach mau nao rat han che, kho khan va ton kem. Cac thuoc lam tan cuc mau dong co the khac phuc tinh trang tac nghen mach mau o tim va o nao khi con dot quy moi xuat hien nhung gia lai rat dat (gan 20 trieu dong /mui). Benh nhan dung thuoc nay phai duoc theo doi bang cac ky thuat hien dai va ton kem nhu chup SPECT hoac MRI co tiem thuoc can quang. Vi vay, doi voi dot quy, cach nhat la phong ngua va tranh tai phat bang cac phuong phap sau: - Ngung hut thuoc la, vi thuoc la la nguy co chinh cua benh mach mau nao. Nguoi hut thuoc la nhieu co the bi dot quy du chi o tuoi trung nien. - Dieu tri tot benh huyet ap cao (nguyen nhan chinh gay dut mach mau nao). - Phong va dieu tri tieu duong (yeu to nguy co gay mang xo vua dong mach lon, dan den thieu mau o nao). - Khac phuc tinh trang tang cholesterol mau cung voi triglyceride mau. - Phong va tri benh da hong cau (co the gay con thieu mau nao hay nhun nao). ThS Phan Huu Phuoc, Nguoi Lao Dong |
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Viet Bao
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