tag:blogger.com,1999:blog-3729062628801977232024-03-06T00:13:42.274-08:00bacsydongyTất cả vì sức khỏe nòi giống việt namMr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.comBlogger44125tag:blogger.com,1999:blog-372906262880197723.post-4369216571592493932011-12-18T05:36:00.000-08:002011-12-18T05:36:15.051-08:00- PHƯƠNG PHÁP ĐIỀU TRỊ BỆNH TRĨ MỚI NHẤT<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dyuOtMfsbx9UaP71sFoyfPzFqwVska1Q4Cii3MnK-ZeFqdKcm0CWbdNWIuoiag3aLTpNTgaB4NFHst1lKoIrw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-81597962593191173612011-11-01T02:01:00.000-07:002011-11-01T02:01:26.932-07:00-LASER NỘI MẠCH - HIỆN ĐẠI VÀ ÍT TỐN KÉM<table border="0" cellpadding="0" cellspacing="0" style="background-color: white; font-family: Verdana, Helvetica, sans-serif;"><tbody>
<tr><td style="font-size: 11px;" width="100%"><span class="msgTitledetails" style="color: #004276; font-family: Arial; font-size: 14px; font-weight: bold; text-decoration: none; text-transform: uppercase;">LASER NỘI MẠCH - HIỆN ĐẠI VÀ ÍT TỐN KÉM</span></td></tr>
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<tr><td style="font-size: 11px;"><span class="msgQuotation" style="font-family: Arial, Verdana, Helvetica, sans-serif; font-size: 12px; text-align: justify;"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt;"><b><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Ưu việt của laser nội mạch<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;"> - Laser là chữ viết tắt của cụm từ Light Amplification by Stimulated Emission of Radiation, trong tiếng Anh có nghĩa là “khuếch đại ánh sáng bằng bức xạ cưỡng bức”. Khi laser được phát minh vào năm 1960, nó chỉ dành riêng cho quân sự, chưa được ứng dụng trong đời sống. Ngày nay, laser xuất hiện trong hầu hết các lĩnh vực nghiên cứu khoa học, công nghiệp, địa chất, vũ trụ... đặc biệt là ứng dụng trong y khoa nhiều đến nỗi trong giới y học người ta đã đặt cho nó một lĩnh vực riêng là y học laser.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Các nghiên cứu thăm dò ban đầu cho thấy liệu pháp laser có hiệu quả, ít tốn kém, thuận lợi cho người bệnh và dễ phổ biến. Mới đây, dòng máy laser nội mạch đã được cho ra đời. Chỉ cần sử dụng thủ thuật chọc kim đơn giản như truyền dịch và thay vì truyền nước, người ta truyền những chùm tia laser vào mạch máu. Tia laser tác dụng trực tiếp lên các tế bào máu trong vòng 30 phút là xong một lần điều trị. Theo nghiên cứu của nhiều tác giả Liên Xô (cũ) - một cường quốc về laser quân sự cũng như laser y học, tác dụng của laser nội mạch là thay đổi các đặc tính sinh hóa của máu: hiệu chỉnh miễn dịch tế bào và dịch thể; tăng hoạt tính thực bào của bạch cầu; tăng sức đề kháng không đặc hiệu của cơ thể; cải thiện tính chất lưu biến của máu và hệ vi tuần hoàn (giãn vi mạch, tăng heparin nội sinh, chống kết vón hồng cầu và tiểu cầu, kích thích hoạt động chức năng hồng cầu, tăng vận chuyển oxy của máu, giảm áp lực riêng phần CO2, cải thiện hoạt động chức năng thành mạch...); bình thường hóa các quá trình trao đổi chất và kích thích hệ thống sửa chữa các chất do tế bào tổn thương phóng ra; đào thải nhanh các chất chuyển hóa trung gian, giải dị ứng cục bộ và toàn thân; tăng khả năng kháng viêm, giảm đau và chống nhiễm trùng.</span><span style="font-family: Arial; font-size: 10pt; line-height: 19px;"></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt;"></div><table align="center" cellpadding="0" cellspacing="2" hasbox="2" style="height: 20px; width: 20px;"><tbody hasbox="2">
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<tr hasbox="2"><td hasbox="2" style="font-size: 11px;"><div align="center"> Laser nội mạch hiện đại mà ít tốn kém.</div></td></tr>
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<o:p></o:p></span><div class="MsoNormal" style="line-height: 16px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><b><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Đà Nẵng đã có laser nội mạch<o:p></o:p></span></b></div><div class="MsoNormal" style="line-height: 16px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Viện Vật lý Y Sinh học, Viện Công nghệ Laser Việt Nam đã từng bước sản xuất các thiết bị laser, ngoại trừ bóng laser và hệ quang dẫn mềm là còn phải nhập khẩu. Viện Vật lý Y Sinh học đã chuyển giao laser nội mạch cho một số bệnh viện và trung tâm đa khoa trên toàn quốc: Bệnh viện Thống Nhất Đồng Nai, Trung tâm Bác sĩ gia đình Đà Nẵng, Trường Đại học Y khoa Phạm Ngọc Thạch TPHCM, Bệnh viện Tâm thần Trung ương 2, Trường Nghiệp vụ thể thao...<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 16px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Hiện Đà Nẵng đã có laser nội mạch được trang bị tại Trung tâm Bác sĩ gia đình Đà Nẵng (73- Nguyễn Hữu Thọ, điện thoại 0511.3632111). Bác sĩ Lê Đình Đảm - người trực tiếp điều trị cho bệnh nhân tại Trung tâm Bác sĩ gia đình Đà Nẵng - cho biết: “Laser nội mạch là phương pháp ít tốn kém, hầu như không có tác dụng phụ, nhưng hiệu quả lại cao trong điều trị và dự phòng biến chứng. Chi phí cho mỗi lần điều trị chỉ có 60.000 đồng, bao gồm cả kim nhựa luồn tĩnh mạch dùng một lần”. Laser nội mạch có thể sử dụng độc lập hoặc kết hợp với các phương pháp khác. Thời gian điều trị tùy theo từng bệnh và chỉ mất khoảng 30 phút mỗi lần chiếu laser mà không phải nhập viện. Điều trị bằng máy laser nội mạch không gây đau đớn và bệnh nhân vẫn có thể làm việc bình thường trong quá trình điều trị bệnh.<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 16px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Các bệnh được điều trị bằng máy laser nội mạch được chia làm 2 nhóm. Nhóm 1: các bệnh nên điều trị định kỳ 6 tháng một đợt, mỗi đợt 10 ngày như hội chứng chuyển hóa (bao gồm tăng huyết áp, nhiễm mỡ máu, nhiễm mỡ gan, gout, tiểu đường), thiếu máu cơ tim, vữa xơ động mạch, thiếu máu não, di chứng tai biến mạch máu não. Nhóm 2: các bệnh cần điều trị theo phác đồ riêng như viêm tắc động tĩnh mạch, suy nhược thần kinh, nhức đầu mãn tính và di chứng chấn thương sọ não; bệnh da liễu nặng (tổ đỉa, chàm, vẩy nến, mụn trứng cá nặng); tăng sức đề kháng cho bệnh nhân ung thư...<o:p></o:p></span></div><div class="MsoNormal" style="line-height: 16px; margin-bottom: 6pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 10pt; line-height: 19px;">Laser nội mạch ngày càng trở nên phổ biến và trở thành vũ khí hữu hiệu trong điều trị hỗ trợ và dự phòng.</span></div></td></tr>
</tbody></table>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-91487323501291137822011-08-24T04:15:00.000-07:002011-11-05T18:42:04.925-07:00- QUY TRÌNH ĐIỀU TRỊ BỆNH TRĨ BẰNG KỸ THUẬT KHÂU TRIỆT MẠCH<div class="Title"><span class="Apple-style-span" style="font-size: large;">Quy trình điều trị bệnh trĩ bằng kỹ thuật khâu triệt mạch</span></div><div align="justify"><span style="font-size: large;"><span style="font-family: Arial;"><strong> </strong> </span> </span></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm 0pt; text-align: center;"><strong><span style="font-family: Arial; font-size: large;">QUI TRÌNH ĐIỀU TRỊ BỆNH TRĨ <o:p></o:p></span></strong></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm 0pt; text-align: center;"><b><span style="font-family: Arial; font-size: large;">BẰNG KỸ THUẬT KHÂU TRIỆT MẠCH TRĨ <o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm 0pt; text-align: center;"><b><span style="font-family: Arial; font-size: large;">DƯỚI HƯỚNG DẪN CỦA SIÊU ÂM DOPLLER<o:p></o:p></span></b></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;"></span></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm 0pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><br />
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<div class="MsoNormal" style="margin: 6pt 0cm 6pt 18pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18pt;"><b><span style="font-family: Arial; font-size: large;"><b>1.</b><b>Nguyên lý<o:p></o:p></b></span></b></div><br />
<div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 18pt;"><span style="font-family: Arial; font-size: large;">Năm 1995 Morinaga (Nhật bản) đưa ra và thực hiện kỹ thuật khâu thắt động mạch trĩ (Transanal haemorroidal dearterialisation-THD) dưới hướng dẫn của siêu âm dựa trên nguyên lý khâu thắt các nhánh tận của động mạch trực tràng trên do đó làm giảm đáng kể lưu lượng máu tới các búi trĩ và kết quả làm cho các búi trĩ thu nhỏ lại và dần trở về vị trí bình thường. Năm 2002 để tăng hiệu quả với các trường hợp sa trượt niêm mạc hai tác giả Ý Pier Paulo Dal Monte và Carlo Tagariello đã cải tiến kỹ thuật này bằng thực hiện kỹ thuật nâng và cố định niêm mạc sa đối với các búi trĩ có sa trượt niêm mạc bằng đường khâu vắt nên THD là phẫu thuật không cắt và ít sâm lấn tổ chức trong điều trị bệnh trĩ, do đó người bệnh rất ít đau sau mổ và trở về cuộc sống bình thường sớm. <o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 18pt;"><span style="font-family: Arial; font-size: large;">Dưới hướng dẫn của siêu âm dopller các động mạch trĩ được xác định chính xác và khâu thắt trên đường lược 2-3cm.</span></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 18pt;"><span style="font-family: Arial; font-size: large;"><img alt="" border="0" height="493" src="http://yhcotruyentw.org.vn/images/uploads/images/1_1.JPG" style="height: 354px; width: 550px;" width="746" /></span></div><span style="font-size: large;"> </span><br />
<div class="MsoNormal" style="margin: 6pt 0cm 6pt 18pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18pt;"><span style="font-family: Arial; font-size: large;"><b>1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></b><b>Chỉ định, chống chỉ định.<o:p></o:p></b></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><b><span style="font-family: Arial; font-size: large;">2.1. Chỉ định.<o:p></o:p></span></b></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 36pt;"><span style="font-family: Arial; font-size: large;">- Bệnh trĩ độ II, III, IV.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><b><span style="font-family: Arial; font-size: large;">2.2. Chống chỉ định: <o:p></o:p></span></b></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;"> - Trĩ tắc mạch.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;"> - Các chống chỉ định ngoại khoa.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm 6pt 18pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18pt;"><span style="font-family: Arial; font-size: large;"><b>2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></b><b>Kỹ thuật.<o:p></o:p></b></span></div><div class="MsoNormal" style="margin: 0cm 0cm 6pt; mso-outline-level: 1; text-align: justify;"><span style="font-family: Arial; font-size: large;"><b>2.1. Thiết bị:</b> THD EVOLUTION Equipment do hãng THD S.p.A <st1:country-region w:st="on"><st1:place w:st="on">Italy</st1:place></st1:country-region> sản xuất.<o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 18pt;"><span style="font-family: Arial; font-size: large;"><img alt="" border="0" height="329" src="http://yhcotruyentw.org.vn/images/uploads/images/2.JPG" style="height: 327px; width: 479px;" width="487" /></span></div><div class="MsoNormal" style="margin: 0cm 0cm 6pt; mso-outline-level: 1; text-align: justify;"><b><span style="font-family: Arial; font-size: large;">2.2.Tiến hành:<o:p></o:p></span></b></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;"><i>a.</i> <i>Chuẩn bị bệnh nhân trước mổ</i><o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+Khám lâm sàng<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Soi trực tràng <o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Xét nghiệm cơ bản: <o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">. Huyết học: máu đông, máu chảy hoặc đông máu cơ bản, công thức máu …<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify; text-indent: 36pt;"><span style="font-family: Arial; font-size: large;">. Sinh hóa máu: Đường máu, ure, creatinin, SGOT, SGPT…<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Thụt hậu môn trước mổ bằng Microlax hoặc Fleet<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;"><i>b. Phương thức vô cảm :</i> gây tê tủy sống, gây tê tại chỗ hoặc tê khoang cùng.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;"><i>c. Chuẩn bị máy:</i> THD EVOLUTION Equipment<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><i><span style="font-family: Arial; font-size: large;">d. Thực hiện phẫu thuật:<o:p></o:p></span></i></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Tư thế bệnh nhân: bệnh nhân nằm theo tư thế phụ khoa<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Lắp máy: <o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Nối nguồn điện.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Nối dây quang.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Lắp thiết bị siêu âm.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Nong hậu môn: xác định vị trí và đánh giá các búi trĩ.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Dò mạch trĩ dưới hướng dẫn của đầu dò siêu âm Doopler và khâu thắt ở các vị trí 11h, 1h, 3h, 5h, 7h, 9h trong đó các động mạch chính ở 11h,5h,7h<o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin: 6pt 0cm; text-align: justify; text-indent: 18pt;"><span style="font-family: Arial; font-size: large;"><img alt="" border="0" height="342" src="http://yhcotruyentw.org.vn/images/uploads/images/3.JPG" style="height: 249px; width: 477px;" width="673" /></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Làm đường khâu vắt nâng và cố định niêm mạc trực tràng bị sa trượt bằng chỉ Vicryl 2.0 ,độ cong của kim 5/8.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Kiểm tra kỹ chảy máu và lau sạch hậu môn. Đặt meche có mỡ và rút sau 3 giờ.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><i><span style="font-family: Arial; font-size: large;">e. Chăm sóc sau mổ:<o:p></o:p></span></i></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Kháng sinh:<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Giảm đau: Trong YHCT có thể dùng châm cứu để giảm đau: châm các huyệt Thận du, đại trường du…<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Điều trị bí đái sau mổ:<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Chườm ấm vùng bụng dưới.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Châm cứu các huyệt: Trung cực, quan nguyên, khí hải, khúc cốt…<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Chống táo bón:<o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt 36pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">- Một số thuốc YHCT có tác dụng thanh nhiệt lương huyết, nhuận trường như: Sinh địa, huyền sâm, mạch môn, đương qui, sa sâm… <o:p></o:p></span></div><div class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify;"><span style="font-family: Arial; font-size: large;">+ Ngâm hậu môn : Bằng thuốc YHCT<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm 6pt 18pt; mso-list: l0 level1 lfo1; tab-stops: list 18.0pt; text-align: justify; text-indent: -18pt;"><span style="font-family: Arial; font-size: large;"><b>1.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></b><b>Kết quả. </b><o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;">Nhằm mục tiêu áp dụng, triển khai và đánh giá kết quả bước đầu của kỹ thuật THD, từ tháng 7.2009 lần đầu tiên tại khoa ngoại Bệnh viện Y học cổ truyền trung ương đã triển khai kỹ thuật THD trong điều trị bệnh trĩ và cho kết quả như sau:<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;"><o:p> </o:p><o:p> </o:p></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom: medium none; border-collapse: collapse; border-left: medium none; border-right: medium none; border-top: medium none; mso-border-alt: solid windowtext .5pt; mso-border-insideh: .5pt solid windowtext; mso-border-insidev: .5pt solid windowtext; mso-padding-alt: 0cm 5.4pt 0cm 5.4pt; mso-yfti-tbllook: 480;"><tbody>
<tr> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; border-right: windowtext 1pt solid; border-top: windowtext 1pt solid; mso-border-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 83.95pt;" valign="top" width="112"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">Đánh giá<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: windowtext 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 94.05pt;" valign="top" width="125"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">Số bệnh nhân<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: windowtext 1pt solid; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 62.15pt;" valign="top" width="83"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">Tỷ lệ %<o:p></o:p></span></div></td></tr>
<tr> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 83.95pt;" valign="top" width="112"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: Arial; font-size: large;"> Tốt<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 94.05pt;" valign="top" width="125"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">28<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 62.15pt;" valign="top" width="83"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">93%<o:p></o:p></span></div></td></tr>
<tr> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 83.95pt;" valign="top" width="112"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: Arial; font-size: large;"> Trung bình<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 94.05pt;" valign="top" width="125"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">2<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 62.15pt;" valign="top" width="83"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">7%<o:p></o:p></span></div></td></tr>
<tr> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 83.95pt;" valign="top" width="112"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: Arial; font-size: large;"> Xấu<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 94.05pt;" valign="top" width="125"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">0<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 62.15pt;" valign="top" width="83"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">0%<o:p></o:p></span></div></td></tr>
<tr> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: windowtext 1pt solid; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 83.95pt;" valign="top" width="112"><div class="MsoNormal" style="margin: 0cm 0cm 0pt;"><span style="font-family: Arial; font-size: large;"> Tổng số<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 94.05pt;" valign="top" width="125"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">30<o:p></o:p></span></div></td> <td style="background-color: transparent; border-bottom: windowtext 1pt solid; border-left: #d4d0c8; border-right: windowtext 1pt solid; border-top: #d4d0c8; mso-border-alt: solid windowtext .5pt; mso-border-left-alt: solid windowtext .5pt; mso-border-top-alt: solid windowtext .5pt; padding-bottom: 0cm; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0cm; width: 62.15pt;" valign="top" width="83"><div align="center" class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: center;"><span style="font-family: Arial; font-size: large;">100%<o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;"><o:p> </o:p><b>2.<span style="font: normal normal normal 7pt/normal 'Times New Roman';"> </span></b><b>Kết luận<o:p></o:p></b></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;">Ưu điểm của phương pháp.<o:p></o:p></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial; font-size: large;"> <span style="color: #ffa352;"> </span><span style="color: #ffa352;">-</span><span style="color: red;"> Ít chấn thương tổ chức<o:p></o:p></span></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial;"><span style="color: red; font-size: large;"> - Giảm đau sau mổ.<o:p></o:p></span></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial;"><span style="color: red; font-size: large;"> - Không có biến chứng nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial;"><span style="color: red; font-size: large;"> - Thời gian nằm viện ngắn.<o:p></o:p></span></span></div><div class="MsoNormal" style="margin: 6pt 0cm; text-align: justify;"><span style="font-family: Arial;"><span style="color: red; font-size: large;"> - Chỉ định được cho tất cả các thể bệnh và cho kết quả tốt</span></span><br />
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<span class="Apple-style-span" style="color: red; font-family: Arial; font-size: large;">http://www.mediafire.com/?99agv1r44809p3n</span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-60711281086698638832011-07-03T03:05:00.000-07:002011-07-03T03:05:45.701-07:00- CHỤP CẮT LỚP ĐIỆN TOÁN SỌ NÃO<span class="Apple-style-span" style="color: #3e638f; font-family: Tahoma, Geneva, sans-serif; font-size: 12px; line-height: 25px;"></span><br />
<div class="div_news_intro" style="clear: both; color: #444444; float: left; margin-top: 10px; width: 468px;"><div class="div_news_title_intro" style="clear: both; color: #444444; float: left; font: normal normal bold 20px/30px 'Times New Roman', Times, serif; margin-top: 10px; width: 468px;">CHỤP CẮT LỚP ĐIỆN TOÁN SỌ NÃO</div><div class="div_news_img" style="border-bottom-color: rgb(218, 218, 218); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(218, 218, 218); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(218, 218, 218); border-right-style: solid; border-right-width: 1px; border-top-color: rgb(218, 218, 218); border-top-style: solid; border-top-width: 1px; clear: right; float: left; height: 99px; margin-bottom: 0px; margin-left: 0px; margin-right: 10px; margin-top: 5px; width: 132px;"><img class="news_img" height="300" src="http://www.ycantho.com/upload/content/content_sec_7_cat_35_130439298837ff1.gif" style="border-bottom-width: 0px; border-color: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; height: 99px; margin-bottom: 0px; margin-left: 0px; margin-right: 0px; margin-top: 0px; padding-bottom: 0px; padding-left: 0px; padding-right: 0px; padding-top: 0px; width: 132px;" width="400" /></div><b><br />
</b></div><div class="div_news_detail" style="clear: both; color: #444444; float: left; font: normal normal normal 16px/27px 'Times New Roman', Times, serif; margin-bottom: 10px; margin-left: 0px; margin-right: 0px; margin-top: 10px; padding-bottom: 10px; text-align: justify; width: 468px;"><div class="MsoNormal"><b>MỤC TIÊU HỌC TẬP:</b> Qua bài này sinh viên có khả năng:</div><div class="MsoNormal"><span>1.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>Giải thích được nguyên tắc cơ bản của phương pháp chụp cắt lớp điện toán (CLĐT).</div><div class="MsoNormal"><span>2.<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span>Trình bày các chỉ định của CLĐT trong chấn thương sọ não & một số bệnh lý của hệ thần kinh trung ương.</div><div class="MsoNormal">3. Đọc được các dấu hiệu máu tụ, dập não, phù não trên CLĐT sọ não</div><b>1. ĐẠI CƯƠNG</b>:<br />
<div class="MsoNormal" style="text-indent: 14.2pt;">Năm 1895 Nhà vật lý Đức W.C. R<span style="font-size: 8pt;">Ö</span>ntgen đã tìm ra tia X, từ đó về sau đã có nhiều cải tiến kỹ thuật nhưng vẫn còn hạn chế trong khảo sát và chẩn đoán các tạng. Năm 1972 G.N. Hounsfield & A.M. Cormack đã phát minh ra phương pháp chụp cắt lớp điện toán (CLĐT), có thể xem đây là bước tiến bộ lớn nhất kể từ thời đại sau R<span style="font-size: 8pt;">Ö</span>ntgen; chính vì công lao to lớn này mà hai tác giả trên đã nhận được giải Nobel y học vào năm 1979. Cho đến ngày nay, phương pháp này càng được phổ biến và kỹ thuật ngày càng được nâng cao.</div><div class="MsoNormal" style="margin-top: 6pt;"><b>2. NGUYÊN TẮC </b></div><div class="MsoNormal"><span> </span>Phương pháp chụp CLĐT là phép đo mật độ của các điểm khối (voxel) của 1 lớp cắt sọ não, chụp CLĐT nghiên cứu độ suy giảm của chùm tia X khi qua một lớp cắt của não. Chùm tia X được nén mỏng, chỉ quét một lớp mỏng để tránh hiện tượng chồng chất hình ảnh, hạn chế tối thiểu</div><div class="MsoNormal">sự tán xạ.</div><div class="MsoNormal"><span> </span>Nhờ máy vi tính xử lý sẽ cho hình ảnh 100 lần chính xác hơn phương pháp chụp X Quang cổ điển, tuy nhiên một mặt phẳng chiếu không đủ để tái tạo trọn vẹn hình ảnh của một lớp cắt nên cần có chuyển động xoay quanh trục chính của bệnh nhân.</div><div class="MsoNormal"><span> </span>Các bộ dò hay bộ phận cảm biến (detectors) tạo bởi những tinh thể nhấp nháy (scintillation</div><div class="MsoNormal">crystals) hay các buồng khí Xenon, cho phép đo độ suy giảm của chùm tia X khi qua lớp cắt của sọ.</div><div class="MsoNormal"><span> </span>Độ hấp thu chùm tia X của các khối vật chất được tính theo phương trình Lamor:</div><div class="MsoNormal"><span> </span>I= I<sub>0 </sub>e<sup>-</sup><sup><span lang="FR" style="font-family: Symbol;"><span>m</span></span>L</sup>.</div><div class="MsoNormal"><span> </span><span lang="IT">I<sub>0</sub>: cường độ tia ban đầu</span></div><div class="MsoNormal"><span lang="IT"><span> </span>I: cường độ tia sau khi xuyên qua lớp cắt</span></div><div class="MsoNormal"><span lang="IT"><span> </span></span><span lang="FR" style="font-family: Symbol;"><span>m</span></span><span lang="IT">: hệ số hấp thu, phụ thuộc vào mật độ điện tử, bậc nguyên tử của cấu trúc mô khác nhau trong</span></div><div class="MsoNormal">cơ thể.</div><div class="MsoNormal"><span> </span>L: bề dày của lớp cắt.</div><div class="MsoNormal" style="text-indent: 14.2pt;"><span lang="FR">Biết đ ược I<sub>0, </sub>I, L ta tính được các hệ số hấp thu của khối vật chất mà chùm tia X đi qua. Trên một lớp cắt, chùm tia X quét theo nhiều hướng khác nhau và lớp cắt được chia thành nhiều khối bằng nhau, ta có thể tính được từng hệ số hấp thu </span><span lang="FR" style="font-family: Symbol;"><span>m</span></span><sub><span lang="FR">1</span></sub><span lang="FR">,</span><span lang="FR" style="font-family: Symbol;"><span>m</span></span><sub><span lang="FR">2</span></sub><span lang="FR">,</span><span lang="FR" style="font-family: Symbol;"><span>m</span></span><sub><span lang="FR">3</span></sub><span lang="FR">…</span><span lang="FR" style="font-family: Symbol;"><span>m</span></span><sub><span lang="FR">n</span></sub><span lang="FR">, nghĩa là ta biết được bản chất của từng khối vật chất cấu thành lớp cắt đó.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>Các dữ liệu suy giảm của chùm tia X sau khi đi qua lớp cắt sẽ được chuyển đến một hệ thống vi tính để xử lý , chuyển giá trị số thành giá trị hình tương tự nghĩa là hình ảnh lớp cắt được tái tạo với các mức xám (Gray shadows) khác nhau.</span></div><div class="MsoNormal"><b><span lang="FR">3. KỸ THUẬT </span></b></div><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013346184/ct1.jpg" /><br />
<br />
<div class="MsoNormal" style="text-indent: 14.2pt;"><b><span lang="FR">3.1. Thực hiện</span></b></div><div class="MsoNormal"><span lang="FR"><span> </span>- Bệnh nhân nằm ngữa, đầu bất động. Thực hiện các lớp cắt sát nhau từ 5 đến 10mm theo mặt phẳng đuôi mắt- ống tai ngoài.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>- Cho thuốc an thần hoặc gây mê cho bệnh nhân kích động hay trẻ em.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>- Thực hiện lớp quét toàn bộ theo tư thế nghiêng (scout view) từ đó xác định vị trí và hướng các lớp cắt ngang theo mặt phẳng đuôi mắt-ống tai ngoài.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>- Thực hiện một chuổi lớp cắt ngang<span> </span>khoảng 20 lớp cắt không tiêm thuốc cản quang, dày 5mm ở hố sau và 10mm ở tầng trên lều tiểu não; ít khi cần tiêm thuốc cản quang trong bệnh nhân chấn thương sọ não.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>- Trên màn hình TV quan sát các cấu trúc mô não dưới cửa sổ hẹp và cấu trúc xương dưới cửa sổ rộng. Có thể tái tạo theo mặt phẳng trán (coronal plan) hay đứng dọc (sagittal plan) nhưng hình ảnh không rõ nét.</span></div><div class="MsoNormal" style="text-indent: 14.2pt;"><b><span lang="FR">3.2. Thang mật độ HOUNSFIELD </span></b></div><div class="MsoNormal"><span lang="FR"><span> </span><span> </span>G.N.Hounsfield<span> </span>đã xây dựng 1 hệ thống đơn vị để đo mật độ gọi là hệ thống đơn vị Hounsfield (UH), phân chia sự hấp thu tia X thành 2000 mức khác nhau. Do mắt thường chỉ phân biệt được khoảng 20 mức nên phải quan sát dưới nhiều cửa sổ.</span></div><div class="MsoNormal"><span lang="FR"><span> </span><span> </span>- <b>cửa sổ hẹp</b>: để khảo sát nhu mô não, dùng cửa sổ có độ rộng khoảng 100 UH, điểm trung tâm ở mức + 20.</span></div><div class="MsoNormal"><span lang="FR"><span> </span><span> </span>- <b>cửa sổ rộng: (> 400 UH)</b> để khảo sát xương: xương sọ sẽ thấy rõ, các cấu trúc khác có màu xám nhạt.</span></div><div class="MsoNormal">Thang mật độ G.N. Hounsfield gồm :</div><div class="MsoNormal"><span> </span>- <b>mật độ cao:<i> </i></b> từ + 40 đến +1000.</div><div class="MsoNormal"><span> </span>- <b>mật độ ngang</b>: từ + 25 UH đến + 40UH, tương ứng với mật độ của chất trắng và chất xám. Hai chất này có mật độ hơi khác nhau do thành phần nước và lipid: chất trắng có 82% nước, chất xám có 71% nước và lipid là 8%.</div><div class="MsoNormal"><span> </span>- <b>mật độ thấp</b>: < + 25 UH.</div><div class="MsoNormal"><img alt="" src="http://farm2.anhso.net/pic/l/46362/352011101338234/ct2.jpg" /></div><div class="MsoNormal"></div><div class="MsoNormal"><b><span lang="FR">4. CHỈ ĐỊNH </span></b></div><div class="MsoHeader" style="margin-left: 0.75in; text-indent: -0.25in;"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Chấn thương sọ não</span></div><div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.25in;"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Tràn dịch<span> </span>não thất, teo não.</span></div><div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.25in;"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">U não</span></div><div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.25in;"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Áp xe não</span></div><div class="MsoNormal" style="margin-left: 0.75in; text-indent: -0.25in;"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Bệnh lý mạch máu não (nhồi máu não, xuất huyết não), dị dạng mạch máu não (túi phình động mạch, u mạch máu).</span></div><div class="MsoNormal" style="margin-top: 6pt;"><b><span lang="FR">5. TRIỆU CHỨNG CỦA CLĐT </span></b></div><div class="MsoNormal"><span lang="FR"><span> </span>Một tổn thương trên<span> </span>chụp CLĐT được trình bày bằng vị trí, thể tích và mật độ riêng so với mật độ của các cấu trúc bình thường là giảm, đẳng hay tăng mật độ.</span></div><div class="MsoNormal"><span lang="FR"><span> </span>Khi tiêm thuốc cản quang sẽ cho phép ta nghiên cứu ảnh hưởng lên hàng rào máu não của tổn thương và phân bố mạch máu của tổn thương.</span><span lang="FR"><br />
</span></div><h2 align="center" style="border-bottom-style: none; border-bottom-width: medium; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; text-align: center;"><b><span lang="FR">CHỤP CLĐT VÀ CHẤN THƯƠNG SỌ NÃO</span></b><span lang="FR"><span><br />
</span></span></h2><div class="MsoNormal"><b><span lang="FR">1. CHỈ ĐỊNH</span></b></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Bệnh nhân tĩnh (TĐ Glasgow: 14-15), có nứt sọ trên phim X Quang sọ, hay có nhức đầu tăng, nôn ói v.v.</span></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Các bệnh nhân lơ mơ Glasgow <13.</span></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Các bệnh nhân có giảm tri giác hay/ và có dấu thần kinh khu trú.</span></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Bệnh nhân đa thương : cần loại trừ CTSN để can thiệp phẩu thuật ngực, bụng, gãy xương.</span></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Các bệnh nhân có vở nền sọ, vết thương sọ não.</span></div><div class="MsoNormal"><span lang="FR"><span>-<span style="font-family: 'Times New Roman'; font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;"> </span></span></span><span lang="FR">Trẻ em < 2 tuổi hay người già > 65 tuổi.</span></div><div class="MsoHeader" style="margin-top: 6pt;"><b><span lang="FR">2. CHỐNG CHỈ ĐỊNH</span></b></div><div class="MsoHeader"><span lang="FR"><span> </span>Bệnh nhân bị choáng & suy hô hấp, bệnh nhân hôn mê sâu (Glasgow =3 ) và mất phản xạ thân não.</span></div><div class="MsoHeader"></div><div class="MsoHeader" style="margin-top: 6pt;"><b><span lang="FR">. ĐỌC KẾT QUẢ CLĐT </span></b></div><div class="MsoHeader" style="margin-left: 14.2pt;"><b><span lang="FR">3.1. Chấn thương sọ não sớm (< 48 giờ) :<span> </span></span></b><span lang="FR">CLĐT cần thực hiện cho tất cả bệnh nhân có bất tĩnh và rối loạn trí nhớ sau chấn thương. Theo Narayan RK, qua 658 bệnh nhân CTSN nhẹ (thang điểm Glasgow : 13-15), 18% có bất thường trên CLĐT. Trong nhóm CTSN vừa (TĐ Glasgow : 9- 12), qua nghiên cứu 341 bệnh nhân có 40% có bất thường trên CLĐT.<sup>3</sup></span></div><div class="MsoHeader"><b><span lang="FR"><span> </span>3.1.1. Tổn thương ngoài não:</span></b></div><div class="MsoHeader"><span lang="FR"><span> </span></span>- Máu tụ ngoài màng cứng (H.1): hình ảnh tăng mật độ, hình thấu kính lồi, khu trú thường ở vùng thái dương, trán, đỉnh.</div><div class="MsoHeader"> <span> </span>- Máu tụ dưới màng cứng cấp (hình 2): hình ảnh tăng mật độ hình liềm lan toả bờ lõm hướng vô trong.</div><div class="MsoHeader"><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013413973/ct3.jpg" /></div><div class="MsoHeader"></div><div class="MsoHeader"><span lang="FR">- Chảy máu màng nhện: xảy ra từ 25- 33% trong CTSN, trên CLĐT có hình ảnh tăng mật độ ở các bể dịch não tủy hay rãnh vỏ não.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- Tụ dịch não tủy dưới màng cứng: hình ảnh dạng liềm ngoài não và giảm mật độ.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- Dấu hiệu tổn thương xương sọ hoặc xoang: nứt sọ, lõm sọ, giãn khớp sọ, tụ dịch trong các xoang.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- Tổn thương da đầu: giúp hồi cứu cơ chế chấn thương, cơ chế dội.</span></div><div class="MsoHeader"><span lang="FR"> </span><b><span lang="FR">3.1.2. Các tổn thương trong mô não</span></b><span lang="FR">: gồm :</span></div><div class="MsoHeader"><span lang="FR"><span> </span><span> </span>- máu tụ trong não (hình 4): tổn thương mật độ cao (>5ml) trong mô não.</span></div><div class="MsoHeader"><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013452893/ct4.jpg" /></div><div class="MsoHeader"><br />
</div><div class="MsoHeader"><span lang="FR"><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013452893/ct4.jpg" /></span></div><div class="MsoHeader"><span lang="FR"><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013452893/ct4.jpg" /></span></div><div class="MsoHeader"></div><div class="MsoHeader"><span lang="FR">- phù não: tổn thương mật độ thấp, khu trú quanh ổ dập hay lan toả cả bán cầu.</span></div><div class="MsoHeader"><span lang="FR">- dập não: các tổn thương mật độ hổn hợp dạng muối tiêu gồm tổ chức phù nề và xuất huyết.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- tổn thương sợi trục lan toả (hình 5): các đốm chảy máu li ti vài mm ở thể chai, phần ranh giới giữa chất xám và chất trắng, phần sau bên trung não v.v.</span></div><div class="MsoHeader"><span lang="FR"><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013479313/ct5.jpg" /></span></div><div class="MsoHeader"></div><div class="MsoHeader"><span lang="FR">- tụ khí trong não: vùng mật độ thấp trong mô não.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- xuất huyết não thất: xảy ra từ 3-10% trong CTSN, có thể đơn thuần hay phối hợp với máu tụ trong não hay tổn thương sợi trục.</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- nhồi máu não: vùng giảm mật độ, có thể phân bố theo khu vực tưới máu của động mạch hay chung quanh ổ máu tụ. Ví dụ động mạch não sau.</span></div><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111014434393/ct6.jpg" /><br />
<br />
<div class="MsoHeader"><b><span lang="FR">3.2. Chấn thương sọ não muộn (sau 48 giờ)</span></b></div><div class="MsoHeader"><span lang="FR"><span> </span>- máu tụ dưới màng cứng bán cấp, mãn tính: giai đoạn này các huyết cầu tố (hemoglobin) bị phân hủy thành methemoglobin hay hemosiderin<span> </span>sẽ có mật độ ngang hay mật độ giảm.</span></div><div class="MsoHeader"><span lang="FR"><span> </span><span> </span>- tụ mũ dưới màng cứng, áp xe não…</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- chảy dịch não tủy qua tai hay qua mũi: chụp CLĐT khảo sát xương đá và nền sọ trước bằng các lớp cắt theo mặt phẳng trán để tìm mức nước hơi hay tụ dịch trong các xoang sàng, xoang bướm</span></div><div class="MsoHeader"><span lang="FR"><span> </span>- dò động mạch cảnh – xoang TM hang : Chụp CLĐT + tiêm thuốc cảng quang sẽ thấy sự giãn tĩnh mạch mắt và xoang TM hang.</span><span lang="FR"><br />
</span></div><div class="MsoHeader"><b><u><span lang="FR">TÀI LIỆU THAM KHẢO :</span></u></b><span lang="FR"><br />
</span></div><div class="MsoBodyText" style="text-align: justify;"><span lang="FR" style="font-family: 'Times New Roman';">1. CLARISSE J., et al. (1993). <i>Scanner du crâne et de l’encéphale.</i>Méthode de lecture et d’interprètation.; Masson: Paris.</span></div><div class="MsoBodyText" style="text-align: justify;"><span lang="FR" style="font-family: 'Times New Roman';">2. MONNIER J.P., TUBIANA J.M., (1990). </span><i><span lang="IT" style="font-family: 'Times New Roman';">Radiodiagnostic</span></i><span lang="IT" style="font-family: 'Times New Roman';">. 4<sup>e</sup> Edit;<span> </span>Masson: Paris.</span></div><div class="MsoNormal">3. <span><span> </span></span>Narayan RK (1994). <i>Closed Head Injury. In: Rengachary SS & Wilkins RH eds. Priciples of Neurosurgery</i>. Wolfe: London, 20p.</div><div class="MsoHeader"><b>CÂU HỎI LƯỢNG GIÁ</b></div><div class="MsoHeader" style="margin-top: 6pt;">A. Chọn 1 câu đúng:</div><div class="MsoHeader" style="margin-top: 6pt;">1. Xét nghiệm hình ảnh học có giá trị nhất đế chẩn đoán CTSN cấp:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. Mạch não đồ</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. Cắt lớp điện toán@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. Cộng hưởng từ</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. Siêu âm não.</div><div class="MsoHeader" style="margin-top: 6pt;">2. Xét nghiệm hình ảnh có giá trị nhất cho CTSN bán cấp/mãn tính:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. Cắt lớp điện toán</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. Cộng hưởng từ@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. mạch não đồ</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. Xạ hình não.</div><div class="MsoHeader" style="margin-top: 6pt;">3. <span> </span>Một tổn thương tăng mật độ, hình liềm, lan rộng bán cầu là đặc trưng của:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. máu tụ dưới màng cứng@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. ngoài màng cứng</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. chảy máu màng nhện</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. chảy máu não thất.</div><div class="MsoHeader" style="margin-top: 6pt;">4. Mật độ của máu tụ trong não sẽ giảm dần đến giai đoạn đẳng mật độ và giảm mật độ từ:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. ngày thứ hai</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. ngày thứ tư</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. tuần lễ thứ nhất</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. tuần lễ thứ hai.@</div><div class="MsoHeader" style="margin-top: 6pt;">5. Một tổ thương tăng mật độ khu trú hình thấu kính lồi là đặc trưng của:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. máu tụ trong não</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. máu tụ ngoài màng cứng@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. máu tụ dưới màng cứng</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. máu tụ trong não thất.</div><div class="MsoHeader" style="margin-top: 6pt;">6. Xuất độ tổn thương trên CLĐT ở nhóm bệnh nhân nhẹ có bất tĩnh và rối loạn trí nhớ:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. 5%</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. 12%</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. 18%@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. 22%.</div><div class="MsoHeader" style="margin-top: 6pt;">7. Xuất độ tổn thương trên CLĐT ở bệnh nhân CTSN trung bình là:</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. 10%</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. 2)%</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. 30%</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. 40%.@</div><div class="MsoHeader" style="margin-top: 6pt;">B. Chọn 1 hoặc nhiều câu đúng:</div><div class="MsoHeader" style="margin-top: 6pt;">Câu 1.</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>A. Mật độ trên CLĐT phụ thuộc vào bậc nguyên tử@.</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>B. Mật độ tăng khi giảm hồng cầu dung tích.</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>C. trong giai đoạn mãn tính thường mật độ giảm.@</div><div class="MsoHeader" style="margin-top: 6pt;"><span> </span>D. CLĐT là phương pháp khảo sát bằng từ trường.@</div><div class="MsoHeader" style="margin-top: 6pt;">C.</div><div class="MsoHeader"></div><div class="MsoHeader" style="margin-top: 6pt;">Câu 1-4: Điền vào các hình sau:</div><img alt="" src="http://farm2.anhso.net/pic/o/46362/3520111013317254/ct7.jpg" /></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-83624392711639550532011-05-10T00:47:00.000-07:002011-05-10T00:47:24.935-07:00- RUNG NHĨ<span style="font-size: small;"><span class="Apple-style-span" style="border-collapse: separate; color: black; font-family: 'Times New Roman'; font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; orphans: 2; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px;"><span class="Apple-style-span" style="color: #003333; font-family: Arial;"><h1 align="center" style="color: blue; font-family: Verdana; font-weight: bold;"><span style="font-family: Arial;">RUNG NHĨ</span></h1><h2 align="left" style="color: maroon; font-family: Verdana; font-weight: bold;"><span style="font-family: Arial;">Nguyên nhân</span></h2><span style="font-family: Arial;">* Cấp tính :</span><br />
<span style="font-family: Arial;">- Do tim: thiếu máu cơ tim, nhối máu cơ tim, suy tim, viêm cơ tim / viêm màng ngoài tim, cơn tăng HA.</span><br />
<span style="font-family: Arial;">- Do phổi:<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;">®</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>oxy hoá, htuyên tắc phổi.</span><br />
<span style="font-family: Arial;">- Do chuyển hoá: tình trạng catecholamines cao (stress, nhiễm trùng, sau mổ), nhiễm độc giáp.</span><br />
<span style="font-family: Arial;">- Do thuốc: alcohol, cocaine, amphetamines.</span><br />
<span style="font-family: Arial;">* Mãn tính: tăng huyết áp, thiếu máu cơ tim, bệnh van tim (hẹp van hai lá, hở van hai lá), bệnh cơ tim.</span><br />
<div class="MsoNormal" style="text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border-style: none; border-width: medium; font-family: Arial;"><tbody>
<tr><td colspan="4" style="background-color: #999999; border-color: windowtext; border-style: solid; border-width: 1pt; padding: 0in 5.4pt; width: 783px;" valign="top"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Kiểm soát tần số đối với rung nhĩ</span></b></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Tác nhân</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Nhóm</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Liều lượng</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Tác dụng phụ và lới bàn</span></b></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Verapamil</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">ức chế calci</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">5-10mg IV trong 2 phút. Có thể lặp lại trong vòng 30 phút.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Symbol;">¯<span class="Apple-converted-space"> </span></span><span style="font-family: Arial;">HA (điều trị với gluconate Ca). chống chỉ định trong nhịp nhanh phức bộ rộng.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Diltiazem</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">ức chế calci</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">20mg IV trong vòng hai phát. Có thể bolus lần nữa sau 15phút.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">giống như Verapamil</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Metoprolol</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">chẹn bêta</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">5mg IV trong 2 phút. Có thể lặp lại mỗi 5 phút x 3 lần.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">co thắt phế quản,<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;">¯</span><span style="font-family: Arial;">HA</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Proprandol</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">chẹn bêta</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">1mg IV mỗi hai phút</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">co thắt phế quản,<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;">¯</span><span style="font-family: Arial;">HA</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 103px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Digoxin</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 108px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><br />
</div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 216px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">0,5 mg IV x1, rồi sau đó 0,25 mg IV mỗi 6 giờ x 2</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 311px;" valign="top"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">hiệu quả khi kết hợp với ức chế calci hoặc chẹn bêta. Tốt cho bệnh nhân bị suy tim. Không có bằng chứng rõ ràng đối với tác động ổn định nhĩ.</span></div></td></tr>
</tbody></table><div class="MsoNormal" style="text-align: justify;"><br />
</div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-collapse: collapse; border-style: none; border-width: medium; font-family: Arial;"><tbody>
<tr><td colspan="5" style="border-color: windowtext; border-style: solid; border-width: 1pt; padding: 0in 5.4pt; width: 541.8pt;" valign="top" width="722"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Thuốc chống rối loạn nhịp đối với rung nhĩ</span></b></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Tác nhân</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Týp</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">đường dùng</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Liều lượng</span></b></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div align="center" class="MsoNormal" style="text-align: center;"><b><span style="font-family: Arial;">Lời bàn</span></b></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Procainamide</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IA</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IV</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">10-15 mg/kg trong 1 giờ</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Symbol;">¯</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>HA (co sợi cơ(-). Đ</span><span style="font-family: Arial;">iều trị trước bằng thuốc ức chế nút nhĩ thất. Theo dõi chiều rộng QRS và sự kéo dài QT.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Ibutilide</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">III</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IV</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">10mg trong 10 phút. Có thể lặp lại.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Theo dõi sự kéo dài QT. 3-8% có nguy cơ xoắn đỉnh.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Amiodarone</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">III</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IV</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">150mg IV trong 10 phút, sau đó 1mg/ phút x 6 giờ, sau đó 0,5 mg/phút.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Tác nhân ổn định nhĩn ngăn ngừa sự tái phát rung nhĩ cơn hơn là thúc đẩy sự chuyển nhịp. Theo dõi sự kéo dài QT.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Quinidine</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IA</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">324-648 mg (u) mỗi 12-18 giờ Procainamide được phóng thích chậm.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Theo dõi QRS và sự kéo dài QT</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Procainamide</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IA</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">500-750 mg (u) 4 lần / ngày, dạng procainamide được phóng thích chậm.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Theo dõi QRS và sự kéo dài QT</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Flecainide</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IC</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span lang="DE" style="font-family: Arial;">300mg (u) x</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span></span><span lang="DE" style="font-family: Arial;">1 hoặc 150-300 mg ung 3 lần/ ngày.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span lang="DE" style="font-family: Arial;">chống<span class="Apple-converted-space"> </span></span><span style="font-family: Arial;">chỉ<span class="Apple-converted-space"> </span></span><span lang="DE" style="font-family: Arial;"> định</span><span style="font-family: Arial;"></span><span lang="DE" style="font-family: Arial;">nếu có bệnh lý cấu trúc tim. Điều trị trước bằng thuốc ức chế nút nhĩ thất.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Propafenone</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">IC</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">600mg uống x 1 hoặc 150-300mg uống 3 lần/ ngày</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">chống chỉ định nếu có bệnh lý cấu trúc tim. Điều trị trước bằng thuốc ức chế nút nhĩ thất.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Metoprolol</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">II</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">25mg uống mỗi 6 giờ, sau đó nếu dung nạp được.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">đặc biệt có ích nếu rung nhĩ bị thúc đẩy bởi sự</span><span style="font-family: Arial;">catecholamin</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Amiodarone</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">III</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">400 mg uống 2 lần/ ngày x ~1 tuần rồi 200-400mg uống mỗi ngày.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Theo dõi sự kéo dài QT lâu dài</span><span style="font-family: Symbol;">®</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>nhiễm độc trên tuyến giáp, gan, phổi.</span></div></td></tr>
<tr><td style="border-bottom: 1pt solid windowtext; border-left: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid; border-width: medium 1pt 1pt; padding: 0in 5.4pt; width: 79.5pt;" valign="top" width="106"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Sotalol</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 33.9pt;" valign="top" width="45"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">III</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 45pt;" valign="top" width="60"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Uống</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 153pt;" valign="top" width="204"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">80-240mg uống, 2 lần/ngày.</span></div></td><td style="border-bottom: 1pt solid windowtext; border-right: 1pt solid windowtext; border-style: none solid solid none; border-width: medium 1pt 1pt medium; padding: 0in 5.4pt; width: 3.2in;" valign="top" width="307"><div class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;">Theo dõi<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;">¯</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>tần số tim và sự kéo dài QT.</span></div></td></tr>
</tbody></table><div class="MsoNormal" style="text-align: justify;"><br />
</div><span style="font-family: Arial;">Shốc điện chuyển nhịp chọn lọc:</span><br />
<span style="font-family: Arial;">- Khả năng tùy thuộc vào rung nhĩ đã kéo dài bao lâu và có thể vào kích thước nhĩ T.</span><br />
<span style="font-family: Arial;">- Xem xét lại việc điều trị trước đó bằng thuốc chống rối loạn nhịp.</span><br />
<span style="font-family: Arial;">- Nếu rung nhĩ kéo dài > 48 giờ, sốc điện chuyển nhịp có 2-5% trường hợp bị TBMMN, như vậy phải quan sát nhĩ T bằng siêu âm tim qua thực quản để loại trừ huyết khối hoậc chống đông theo kinh nghiệm trong £ 3 tuần trước đó.</span><br />
<span style="font-family: Arial;">- Mặc dù có thể trở về nhịp xoang, nhĩ đã bị choáng váng về mặt cơ học ( có thể rung nhĩ kéo dài bao nhiêu, nhĩ bị choáng váng bấy nhiêu), do đó phải chống đông sau shốc điện 4 tuần.</span><br />
<span style="font-family: Arial;">Điều trị chống đông (Arch Intern Med 154: 1449, 1994)</span><br />
<span style="font-family: Arial;">- Nguy cơ TBMMN / năm</span><br />
<span style="font-family: Symbol;">»</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>15-20% nếu rung nhĩ hậu thấp (vd: hẹp van hai lá).</span><br />
<span style="font-family: Symbol;">»</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>4-5% nếu rung nhĩ không hậu thấp.</span><br />
<span style="font-family: Symbol;">»</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>1% nếu rung nhĩ đơn độc.</span><br />
<ul style="margin-top: 0in;" type="disc"><li><span style="font-family: Arial;">Yếu tố nguy cơ đối với huyết khối lấp mạch:</span></li>
</ul><span style="font-family: Arial;">- Lâm sàng: bệnh sử của cơn thoáng thiếu máu não / TBMMN, tăng huyết áp, đái tháo đường, suy tim, tuổi > 65.</span><br />
<span style="font-family: Arial;">- Siêu âm tim:<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;">¯</span><span style="font-family: Arial;"><span class="Apple-converted-space"> </span>chức năng thất T,<span class="Apple-converted-space"> </span></span><span style="font-family: Symbol;"><span class="Apple-converted-space"> </span></span><span style="font-family: Arial;">kích thước nhĩ T?, vôi hoá vòng van 2 lá?.</span><br />
<ul style="margin-top: 0in;" type="disc"><li><span style="font-family: Arial;">Rung nhĩ đơn độc (vd: không có yếu tố nguy cơ, có nguy cơ có TBMMN » nguy cơ chảy máu trầm trọng do thuốc kháng đông, nên không có lợi ích rõ ràng từ thuốc kháng đông.</span></li>
<li><span style="font-family: Arial;">Tất cả những bệnh nhân khác phải được dùng Warfarin lâu dài (mục tiêu INR : 2-3)</span><span style="font-family: Symbol;">¯®<span class="Apple-converted-space"> </span></span><span style="font-family: Arial;">68% nguy cơ TBMMN</span></li>
<li><span style="font-family: Arial;">Rung nhĩ kịch phát mang đến nguy cơ TBMMN giống như trong rung nhĩ mãn tính.</span></li>
</ul><span style="font-family: Arial;">Điều trị lâu dài</span><br />
<ul style="margin-top: 0in;" type="disc"><li><span style="font-family: Arial;">Thuốc chẹn bêta, ức chế calci, digoxin.</span></li>
<li><span style="font-family: Arial;">Thuốc chống rối loạn nhịp (vd: sotalol, amiodarone)</span></li>
<li><span style="font-family: Arial;">Cắt đốt bằng tia với tần số cao các ổ tại tĩnh mạch phổi (N Eng J Med 339: 659, 1998), cắt bỏ ổ tạo nhịp bằng phẫu thuật hoặc bằng catheter (Ann Thorac Surg 56: 814, 1993), cắt đốt nút nhĩ thất + máy tạo nhịp vĩnh viễn?.</span></li>
</ul></span></span></span>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-59059199292765385002011-05-07T02:46:00.000-07:002011-05-07T02:46:02.786-07:00- CHẨN ĐOÁN VÀ ĐIỀU TRỊ THẬN HƯ THỨ PHÁT<div align="center" class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: center;"><span style="color: black; font-family: Arial; font-size: 14pt; font-weight: bold;">CHẨN ĐOÁN VÀ ĐIỀU TRỊ THẬN HƯ THỨ PHÁT<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">I. ĐẠI CƯƠNG<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Định nghĩa:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Hội chứng thận hư là một hội chứng của bệnh cầu thận xảy ra một cách đột ngột do tổn thương ở cầu thận được đặc trưng bởi:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đái máu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đái ít.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Protein niệu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phù.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Đặc điểm dịch tễ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Hội chứng thận hư thứ phát gặp chủ yếu ở người lớn tuổi. Theo thống kê của Trần Văn Chất và Trần Thị Thịnh từ năm 1991-1995 tại khoa thận tiết niệu Bệnh viện Bạch Mai có 31,5% số bệnh nhân nằm tại trong khoa với số tuổi trung bình từ 36-54 tuổi chiếm 98,32%, bệnh không liên quan về giới và địa dư, như vậy bệnh gặp nhiều ở lứa tuổi lao động trong đó đã có biến chứng suy thận mạn chiếm 26%. Việc điều trị chẩn đoán đúng có ý nghĩa rất quan trọng để tránh biến chứng của hội chứng thận hư thứ phát đỡ gánh nặng cho gia đình và xã hội.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">II. NGUYÊN NHÂN VÀ CƠ CHẾ BỆNH SINH<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Nguyên nhân:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.1. <span style="font-style: italic;">Bệnh hệ thống và chuyển hóa</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Lupus ban đỏ hệ thống.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hội chứng ban xuất huyết dạng thấp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đái đường.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Thận nhiễm bột.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.2. <span style="font-style: italic;">Thuốc và độc chất</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phenindion, Tridion.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Captopril.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Lợi tiểu thuỷ ngân.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Ong đốt.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Heroin.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.3. <span style="font-style: italic;">Tim mạch</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Viêm ngoại tâm mạc.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp ác tính.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hẹp động mạch thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.4. <span style="font-style: italic;">Nhiễm khuẩn - ký sinh vật</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Sốt rét.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Giang mai.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- AIDS.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Viêm gan B.<span style="font-size: 12pt;"> </span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.5. <span style="font-style: italic;">Ung thư</span> (vú, phế quản, đại tràng).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1.6. <span style="font-style: italic;">Sau tiêm</span> (Bismuth, vacxin bại liệt).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Cơ chế bệnh sinh:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Bệnh sinh của hội chứng thận hư chưa được hiểu biết đầy đủ. Về giải phẫu bệnh học, thì tổn thương ở màng đáy cầu thận là chủ yếu. Bình thường màng đáy không cho các phân tử lớn như protein đi qua. Khi có một nguyên nhân nào đó làm màng đáy bị tổn thương điện thế của màng đáy bị thay đổi thì protein lọt qua được. Protein niệu càng nhiều thì Protein máu càng giảm, albumin ra nhiều nhất (80%) làm giảm áp lực keo của huyết tương. Nước thoát ra ngoài lòng mạch hậu quả là gây phù và giảm thể tích tuần hoàn hiệu dụng. Từ đó một mặt trực tiếp gây tái hấp thu nước và natri ở ống lượn gần, mặt khác gián tiếp qua hệ thống điều hoà nội tiết làm tăng ADH và Aldosteron.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- ADH tăng sẽ tái hấp thu nước ở ống góp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Aldosteron tăng sẽ tái hấp thu Na+ và nước ở ống lượn xa và ống góp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Kết quả của quá trình trên là quá trình giữ Na+, giữ nước, do đó sẽ đái ít và dẫn đến phù toàn thân kéo theo các rối loạn nước và điện giải.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Sơ đồ cơ chế gây phù</span><span style="font-family: Arial; font-size: 12pt;">:</span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt;"><img alt="" border="0" src="http://img257.imageshack.us/img257/4957/hcththuphat.jpg" /><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><v:shapetype coordsize="21600,21600" filled="f" id="_x0000_t75" o:preferrelative="t" o:spt="75" path="m@4@5l@4@11@9@11@9@5xe" stroked="f"><v:stroke joinstyle="miter"></v:stroke><v:formulas><v:f eqn="if lineDrawn pixelLineWidth 0"></v:f><v:f eqn="sum @0 1 0"></v:f><v:f eqn="sum 0 0 @1"></v:f><v:f eqn="prod @2 1 2"></v:f><v:f eqn="prod @3 21600 pixelWidth"></v:f><v:f eqn="prod @3 21600 pixelHeight"></v:f><v:f eqn="sum @0 0 1"></v:f><v:f eqn="prod @6 1 2"></v:f><v:f eqn="prod @7 21600 pixelWidth"></v:f><v:f eqn="sum @8 21600 0"></v:f><v:f eqn="prod @7 21600 pixelHeight"></v:f><v:f eqn="sum @10 21600 0"></v:f></v:formulas><v:path gradientshapeok="t" o:connecttype="rect" o:extrusionok="f"></v:path><o:lock aspectratio="t" v:ext="edit"></o:lock></v:shapetype><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">III. TRIỆU CHỨNG LÂM SÀNG VÀ CẬN LÂM SÀNG<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1. <span style="font-style: italic;">Phù</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Ở thể điển hình thì triệu chứng lâm sàng chủ yếu là phù.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phù to toàn thân, phù mặt.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đặc biệt là mi mắt, rồi xuống chi dưới và bộ phần sinh dục.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Cổ trướng, tràn dịch màng phổi một hoặc hai bên.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Trường hợp nặng có thể phù não.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">2. <span style="font-style: italic;">Đái ít</span>: Nước tiểu thường dưới 500 ml/24h.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">3. <span style="font-style: italic;">Mệt mỏi, ăn kém</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">4. <span style="font-style: italic;">Thiếu máu nhẹ</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">5. <span style="font-style: italic;">Protein niệu cao</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Protein niệu thường lớn hơn hoặc bằng 3,5 g/24h, thành phần chủ yếu là albumin, ngoài ra nước tiểu còn có thể mỡ, lưỡng chiết quang, trụ mỡ, trụ hạt, hồng cầu niệu và bạch cầu niệu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">6. <span style="font-style: italic;">Protein máu giảm</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Do một lượng lớn albumin bị mất qua nước tiểu, kết quả dẫn đến albumin huyết tương giảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Trường hợp nặng albumin giảm dưới 30 g/l.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Alpha 2 globulin thường tăng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Gamma globulin bình thường hoặc giảm trong hội chứng thận hư sau viêm cầu thận lipid thường tăng cao.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">7. <span style="font-style: italic;">Lipid máu tăng</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng lipid máu được xem như là một đặc trưng cơ bản của hội chứng thận hư. Có thể tăng > 9 g/l. Trong đó cholesterol > 2,5 mg/l.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">8. <span style="font-style: italic;">Na+ trong máu thường thấp</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">9. <span style="font-style: italic;">Na+ niệu thường thấp</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">10. <span style="font-style: italic;">Máu</span>: Máu lắng thường tăng, số lượng hồng cầu, hemoglobin và hematorit giảm nhẹ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">11. <span style="font-style: italic;">Mức lọc cầu thận</span>: Bình thường, khi suy thận thì giảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">12. <span style="font-style: italic;">Sinh thiết thận</span>: Thấy tổn thương ở cầu thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Như vậy triệu chứng lâm sàng quan trọng là phù với tính chất phù rất to và nhanh có thể có tràn dịch các màng. Ở cộng đồng có thể nghĩ đến hội chứng thận hư. Nếu trên một bệnh nhân có các bệnh khác hoặc phù tái phát nhiều lần thì nghĩ đến hội chứng thận hư thứ phát.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">IV. CHẨN ĐOÁN<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Chẩn đoán xác định:</span><span style="font-family: Arial; font-size: 12pt;"> Dựa vào tiêu chuẩn chẩn đoán:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Protein niệu > 3,5 g/24h.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Protein máu < 60 g/l, albumin < 30g/l.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Lipid máu > 900 mg%, Cholesterol máu > 250 mg%.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Trong nước tiểu có hạt mỡ, trụ mỡ, thể lưỡng chiết quang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tiêu chuẩn 2 và 3 là tiêu chuẩn bắt buộc, các tiêu chuẩn khác cũng có thể không đầy đủ cũng được coi là hội chứng thận hư.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Chẩn đoán biến chứng:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Nhiễm khuẩn</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Cấp tính: viêm tổ chức tế bào, viêm phúc mạc tiên phát, viêm phổi, viêm cơ...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Mạn tính: lao phổi, lao phúc mạc...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Tắc mạch</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tắc tĩnh mạch thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tắc tĩnh mạch ngoại vi.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tắc động mạch ngoại vi.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Suy thận cấp</span>: do giảm thể tích tuần hoàn hiệu dụng từ đó có thể gây nên suy thận cấp trước thận hoặc hoại tử ống thận cấp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Thiếu dinh dưỡng</span>: do mất nhiều protein qua đường nước tiểu kèm theo chán ăn và ăn kém do có cổ trướng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">V. ĐIỀU TRỊ<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Chống phù:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Lợi tiểu</span>: phải theo dõi điện giải đồ vì rất hay gây giảm kali máu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Bù protein cho cơ thể</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tăng protein trong khẩu phần thức ăn (l,5-2 g/kg cân nặng) tăng calo, hạn chế muối và nước.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Truyền các dung dịch đạm như Plasma, Moriamin...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Liệu pháp Corticoid:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Liều tấn công l-1,5 mg/kg/24h, kéo dài 1-2 tháng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Liều củng cố bằng 1/2 liều tấn công, kéo dài 4-6 tháng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Liều duy trì 10 mg/24h, kéo dài hàng năm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Cần theo dõi các biến chứng do dùng Corticoid kéo dài.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3. Thuốc giảm miễn dịch khác:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- <span style="font-style: italic;">Dùng khi không đáp ứng với Corticoid</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Cyclophosphamid 2-2,5 mg/kg/24h kéo dài 1-2 tháng. Khi protein niệu âm tính thì duy trì 50 mg/24h, kéo dài 1-2 tháng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Chú ý</span><span style="font-family: Arial; font-size: 12pt;">: Một số biến chứng do dùng thuốc giảm miễn dịch như:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Nhiễm khuẩn.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Giảm bạch cầu, nếu bạch cầu dưới 3000 bạch cầu/mm<sup>3</sup> máu thì phải ngừng thuốc.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4. Điều trị các triệu chứng và các biến chứng khác:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị nhiễm trùng tốt nhất dựa vào kháng sinh đồ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị tăng huyết áp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị đề phòng tắc mạch: nên cho thuốc chống đông cho tất cả các bệnh nhân hội chứng thận hư.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị suy thận cấp (nếu có): bù nước, điện giải, truyền Plasma.<span style="font-size: 12pt;"> </span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">5. Điều trị bệnh chính dẫn đến hội chứng thận hư thứ phát:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Cần điều trị theo nguyên nhân.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Hội chứng thận hư thứ phát do các bệnh khác tổn thương giải phẫu bệnh học chủ yếu ở cầu thận. Chẩn đoán chủ yếu dựa vào:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phù, protein niệu cao, protid máu giảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị chủ yếu bằng Corticoid và thuốc giảm miễn dịch, bệnh thường tái phát nhiều lần cuối cùng dẫn đến suy thận trong khoảng 10-15 năm, thời gian dài hay ngắn tuỳ thuộc vào việc chẩn đoán và điều trị hội chứng thận hư và bệnh chính gây nên hội chứng thận hư.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><br />
</div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-54982226583914276882011-05-06T09:27:00.001-07:002011-05-06T09:27:36.837-07:00- BỆNH VIỆN ĐA KHOA KHU VƯC BẮC QUẢNG BÌNH ĐẠT GIẢI VĂN NGHỆ NGÀNH Y TẾ TỈNH QUẢNG BÌNH<div class="separator" style="clear: both; text-align: center;"><iframe allowfullscreen='allowfullscreen' webkitallowfullscreen='webkitallowfullscreen' mozallowfullscreen='mozallowfullscreen' width='320' height='266' src='https://www.blogger.com/video.g?token=AD6v5dx9AO2Yww0lS4A9VRuwBNeBTRdQHocfK-x5wrBDfrti4tP_4ABCbenoBqza1RWQqIFpTG0ioDdZBVeFK5uEmw' class='b-hbp-video b-uploaded' frameborder='0'></iframe></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-46777672171851147842011-05-01T06:32:00.000-07:002011-05-01T06:32:38.926-07:00- ĐIỀU TRỊ ĐAU THẮT LƯNG BẰNG ĐÔNG Y<span class="link_hot_newsdetail"><a href="http://www.blogger.com/post-edit.g?blogID=372906262880197723&postID=4677767217185114784">Đông y điều trị đau thắt lưng</a></span><br />
Đau thắt lưng là đau một bên hay hai bên cột sống là một chứng bệnh do nhiều nguyên nhân gây ra có thể chia làm hai loại: đau lưng cấp và đau lưng mạn.<br />
Đau lưng cấp thường do bị lạnh gây co cứng các cơ ở sống lưng, dây chằng, cột sống bị viêm, bị phù nề chèn ép vào dây thần kinh khi vác nặng, sai tư thế, sang chấn vùng sống lưng. Đau lưng mạn thường do viêm cột sống, thoái hóa cột sống, lao ung thư, đau các nội tạng ở ngực, đau lan tỏa ra sau lưng, đau lưng cơ năng do động kinh, suy nhược thần kinh. Theo y học cổ truyền, thắt lưng là phủ của thận, nên đau thắt lưng có quan hệ mật thiết với thận.<br />
<span style="color: navy; font-weight: bold;"></span><br />
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<tr><td style="text-align: center; vertical-align: top;"><div><img src="http://skds.vcmedia.vn/Images/Uploaded/Share/2008/9/5/200895164545528/2008/09/700-00074815.JPG" width="320" /></div><div></div></td></tr>
</tbody></table><span style="color: navy; font-weight: bold;">Đau thắt lưng cấp do phong hàn thấp</span><br />
<span style="font-weight: bold;">Triệu chứng:</span> Đau thắt lưng xảy ra đột ngột, sau khi bị lạnh, mưa, ẩm thấp không cúi được, ho và trở mình cũng đau, thường đau một bên. Thắt lưng đau tăng khi gặp lạnh, vặn lưng, cúi ngửa khó khăn và gây đau, nằm yên vẫn đau, gặp thời tiết âm u ẩm thấp, mưa thì đau tăng.<br />
Phương pháp chữa: Khu phong, tán hàn, trừ thấp, ôn kinh hoạt lạc (hành khí, hoạt huyết).<br />
<span style="font-weight: bold;">Bài thuốc: </span>Độc hoạt ký sinh thang.<br />
Độc hoạt 12g, tang ký sinh 12g, tần giao 8g, phòng phong 8g, tế tân 8g, đương quy 12g, thược dược 10g, xuyên khung 12g, địa hoàng 8g, đỗ trọng 12g, ngưu tất 8g, nhân sâm 8g, phục linh 8g, cam thảo 6g, quế tâm 8g. Sắc uống ngày một thang.<br />
Độc hoạt, tế tân, phòng phong, quế tâm, tần giao, phục linh để khu tán hàn trừ thấp, đương quy, thược dược, xuyên khung, địa hoàng để hoạt huyết thông lạc chỉ đau. Cam thảo, nhân sâm để bổ khí. Tang ký sinh, đỗ trọng, ngưu tất để ích thận dưỡng can, khỏe lưng gối.<br />
<span style="color: navy; font-weight: bold;">Đau lưng cấp khi thay đổi tư thế hay vác nặng lệch tư thế do khí trệ, huyết ứ</span><br />
<span style="font-weight: bold;">Triệu chứng:</span> Sau khi vác nặng lệch người, hoặc sau một động tác thay đổi tư thế đột nhiên bị đau một bên sống lưng, đau dữ dội ở một chỗ, vận động hạn chế nhiều khi không cúi, đi lại được, cơ co cứng, sợ ấn vào chỗ đau (cự án).<br />
<span style="font-weight: bold;">Phương pháp chữa: </span>Hoạt huyết hóa ứ, lý khí chỉ đau.<br />
<span style="font-weight: bold;">Bài thuốc:</span> Tân thống trục ứ thang.<br />
Đào nhân 12g, hồng hoa 12g, đương quy 12g, cam thảo 8g, xuyên khung 12g, ngưu tất 12g, ngũ linh chi 8g, hương phụ 4g, địa long 8g, tần giao 4g, khương hoạt 4g, một dược 8g. Sắc uống ngày một thang.<br />
Đương quy, đào nhân, hồng hoa, ngũ linh chi, một dược để hoạt huyết hóa ứ, hợp với hương phụ, xuyên khung, địa long, ngưu tất để lý khí thông lạc chỉ đau. Khương hoạt, tần giao, ngũ linh chi để tăng tác dụng tán hàn chỉ đau.<br />
<span style="color: navy; font-weight: bold;">Đau thắt lưng do thận hư</span><br />
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<tr><td style="text-align: center; vertical-align: top;"><div><img src="http://skds.vcmedia.vn/Images/Uploaded/Share/2008/9/5/200895164545528/2008/09/4267211_5c67baedd8.JPG" width="250" /></div><div><span style="color: mediumblue; font-size: 8pt;"> Quế.</span></div></td></tr>
</tbody></table><br />
<span style="font-weight: bold;">Triệu chứng:</span> Thắt lưng đau ê ẩm, chân yếu, lúc mệt đau tăng, nằm thì giảm.<br />
Nếu thận dương hư là chính, có thêm chân tay lạnh, mặt sắc trắng, bụng dưới câu cấp, lưỡi nhạt, mạch trầm tế.<br />
Nếu thận âm hư là chính, có thêm tâm phiền mất ngủ, miệng họng khô, má hồng, lòng bàn chân tay nóng, lưỡi đỏ, mạch tế sác.<br />
<span style="font-weight: bold;">Phương pháp chữa:</span><br />
- Với thể thận dương hư là chính: Bổ thận trợ dương.<br />
<span style="font-weight: bold;">Bài thuốc:</span> Hữu quy hoàn.<br />
Thục địa 32g, sơn dược 16g, sơn thù 16g, kỷ tử 16g, đỗ trọng 16g, thỏ ty tử 16g, phụ tử 12g, nhục quế 12g, đương quy 12g, lộc giác giao 16g. Sắc uống ngày một thang.<br />
Quế, phụ tử, lộc giác giao để ôn bổ thận dương điều tinh tủy, thục địa, sơn dược, sơn thù, thỏ ty tử, kỷ tử. Đỗ trọng để tư âm ích thận, dưỡng can bổ tỳ, đương quy để bổ huyết dưỡng can.<br />
- Với thể thận âm hư là chính: Bổ thận tư âm.<br />
<span style="font-weight: bold;">Bài thuốc:</span> Tả quy hoàn.<br />
Thục địa 32g, sơn dược 16g, sơn thù 16g, kỷ tử 16g, thỏ ty tử 16g, ngưu tất 12g, lộc giác giao 16g, quy bản giao 16g, tục đoạn 12g, đỗ trọng 12g. Sắc uống ngày một thang.<br />
Thục địa để tư bổ chân âm, kỷ tử để minh mục ích tinh, sơn thù để sáp tinh liễm hãn, đương quy, lộc giác để tư âm bổ dương thông nhâm đốc, ích tinh tủy. Thỏ ty tử, tục đoạn, ngưu tất, đỗ trọng để khỏe lưng gối gân cốt. Sơn dược để tư ích tỳ thận.<br />
Các bài thuốc trên sắc uống ngày một thang, cho 750ml nước sắc hai lần, mỗi lần chắt lấy 250ml, trộn hai nước chia 3 lần uống lúc thuốc còn nóng. Uống liền 10 thang.Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-59660496375326287442011-04-30T20:04:00.000-07:002011-05-01T07:01:19.279-07:00- HƯỚNG DẪN CHẨN ĐOÁN VÀ ĐIỀU TRỊ TĂNG HUYẾT ÁP<div class="Section1"><div align="center" class="MsoNormal" style="font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;"><span class="Apple-style-span" style="color: #cc0000;">HƯỚNG DẪN<br />
CHẨN ĐOÁN VÀ ĐIỀU TRỊ TĂNG HUYẾT ÁP<o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 08 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. ĐỊNH NGHĨA<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp là khi huyết áp tâm thu ≥ 140mmHg và/hoặc huyết áp tâm trương ≥ 90mmHg.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. NGUYÊN NHÂN<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Phần lớn tăng huyết áp (THA) ở người trưởng thành là không rõ nguyên nhân (THA nguyên phát), chỉ có khoảng 10% các trường hợp là có nguyên nhân (THA thứ phát, xem Phụ lục 1 - Nguyên nhân gây THA thứ phát, các yếu tố nguy cơ tim mạch, biến chứng & tổn thương cơ quan đích do THA).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3. CHẨN ĐOÁN<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3.1. Chẩn đoán xác định THA: </span><span style="font-family: Arial; font-size: 12pt;">dựa vào trị số huyết áp đo được sau khi đo huyết áp đúng quy trình (xem Phụ lục 2 - Quy trình đo huyết áp). Ngưỡng chẩn đoán THA thay đổi tùy theo từng cách đo huyết áp (Bảng 1).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-weight: bold;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Bảng 1. Các ngưỡng chẩn đoán tăng huyết áp theo từng cách đo<o:p></o:p></span></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 120pt;" width="160"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 132pt;" width="176"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm trương<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 239.4pt;" valign="top" width="319"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1. Cán bộ y tế đo theo đúng quy trình<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2. Đo bằng máy đo HA tự động 24 giờ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">3. Tự đo tại nhà <span style="font-style: italic;">(đo nhiều lần)</span><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 87.65pt;" valign="top" width="117"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 140 mmHg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 130 mmHg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 135 mmHg<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74.35pt;" width="99"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.25in;" valign="top" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 90 mmHg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 80 mmHg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">≥ 85 mmHg<o:p></o:p></span></div></td></tr>
<tr height="0"><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="319"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="117"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="43"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="56"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="120"></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3.2. Phân độ THA:</span><span style="font-family: Arial; font-size: 12pt;"> dựa vào trị số huyết áp do cán bộ y tế đo được (xem Bảng 2).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-weight: bold;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Bảng 2. Phân độ huyết áp<o:p></o:p></span></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 203.9pt;" width="272"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Phân độ huyết áp<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 155.5pt;" width="207"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu (mmHg)<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 132pt;" width="176"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm trương (mmHg)<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 203.9pt;" valign="top" width="272"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tối ưu<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp bình thường<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tiền tăng huyết áp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 107.5pt;" valign="top" width="143"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">< 120<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">120 – 129<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">130 – 139<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" width="128"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" valign="top" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">< 80<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">80 – 84<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">85 – 89<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 203.9pt;" valign="top" width="272"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp độ 1<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp độ 2<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp độ 3<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 107.5pt;" valign="top" width="143"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">140 – 159<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">160 – 179<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">≥ 180<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" width="128"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và/hoặc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" valign="top" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">90 – 99<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">100 – 109<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">≥ 110<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 203.9pt;" valign="top" width="272"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp tâm thu đơn độc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 107.5pt;" valign="top" width="143"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">≥ 140<o:p></o:p></span></div></td><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" width="128"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">và<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" valign="top" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">< 90<o:p></o:p></span></div></td></tr>
<tr height="0"><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="272"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="143"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="64"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="64"></td><td style="background-color: transparent; border-bottom-color: rgb(240, 240, 240); border-bottom-style: none; border-bottom-width: medium; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: rgb(240, 240, 240); border-right-style: none; border-right-width: medium; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="112"></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Nếu huyết áp tâm thu và huyết áp tâm trương không cùng mức phân độ thì chọn mức cao hơn để xếp loại. THA tâm thu đơn độc cũng được phân độ theo các mức biến động của huyết áp tâm thu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3.3. Phân tầng nguy cơ tim mạch: </span><span style="font-family: Arial; font-size: 12pt;">dựa vào phân độ huyết áp, số lượng các yếu tố nguy cơ tim mạch (YTNCTM) và biến cố tim mạch (xem Bảng 3 - Phân tầng nguy cơ tim mạch) để có chiến lược quản lý, theo dõi và điều trị lâu dài.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-weight: bold;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Bảng 3. Phân tầng nguy cơ tim mạch<o:p></o:p></span></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td rowspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84.6pt;" width="113"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Bệnh cảnh<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Bình thường<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Tiền<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">THA<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Độ 1<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Độ 2<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Độ 3<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu 120-129 mmHg và Huyết áp tâm trương 80-84 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu 130-139 mmHg và/hoặc Huyết áp tâm trương 85-89 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu 140-159 mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span>Huyết áp tâm trương 90-99 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu 160-179 mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span>Huyết áp tâm trương 100-109 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Huyết áp tâm thu ≥ 180 mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span>Huyết áp tâm trương ≥ 110 mmHg<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84.6pt;" width="113"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Không có yếu tố nguy cơ tim mạch nào<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ thấp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ trung bình<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84.6pt;" width="113"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Có từ 1-2 yếu tố nguy cơ tim mạch (YTNCTM)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ thấp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ thấp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ trung bình<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ trung bình<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84.6pt;" width="113"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Có ≥ 3 YTNCTM hoặc hội chứng chuyển hóa hoặc tổn thương cơ quan đích hoặc đái tháo đường<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ trung bình<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84.6pt;" width="113"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đã có biến cố hoặc có bệnh tim mạch hoặc có bệnh thận mạn tính<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1.15in;" width="110"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nguy cơ rất cao<o:p></o:p></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4. ĐIỀU TRỊ<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4.1. Nguyên tắc chung:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp là bệnh mạn tính nên cần theo dõi đều, điều trị đúng và đủ hàng ngày, điều trị lâu dài.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Mục tiêu điều trị là đạt “huyết áp mục tiêu” và giảm tối đa “nguy cơ tim mạch”.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- “Huyết áp mục tiêu” cần đạt là < 140/90 mmHg và thấp hơn nữa nếu người bệnh vẫn dung nạp được. Nếu nguy cơ tim mạch từ cao đến rất cao thì huyết áp mục tiêu cần đạt là < 130/80 mmHg. Khi điều trị đã đạt huyết áp mục tiêu, cần tiếp tục duy trì phác đồ điều trị lâu dài kèm theo việc theo dõi chặt chẽ, định kỳ để điều chỉnh kịp thời.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị cần hết sức tích cực ở bệnh nhân đã có tổn thương cơ quan đích. Không nên hạ huyết áp quá nhanh để tránh biến chứng thiếu máu ở các cơ quan đích, trừ tình huống cấp cứu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4.2. Các biện pháp tích cực thay đổi lối sống: </span><span style="font-family: Arial; font-size: 12pt;">áp dụng cho mọi bệnh nhân để ngăn ngừa tiến triển và giảm được huyết áp, giảm số thuốc cần dùng …<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Chế độ ăn hợp lý, đảm bảo đủ kali và các yếu tố vi lượng:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Giảm ăn mặn (< 6 gam muối hay 1 thìa cà phê muối mỗi ngày).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tăng cường rau xanh, hoa quả tươi.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Hạn chế thức ăn có nhiều cholesterol và axít béo no.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tích cực giảm cân (nếu quá cân), duy trì cân nặng lý tưởng với chỉ số khối cơ thể (BMI: body mass index) từ 18,5 đến 22,9 kg/m<sup>2</sup>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Cố gắng duy trì vòng bụng dưới 90cm ở nam và dưới 80cm ở nữ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hạn chế uống rượu, bia: số lượng ít hơn 3 cốc chuẩn/ngày (nam), ít hơn 2 cốc chuẩn/ngày (nữ) và tổng cộng ít hơn 14 cốc chuẩn/tuần (nam), ít hơn 9 cốc chuẩn/tuần (nữ). 1 cốc chuẩn chứa 10g ethanol tương đương với 330ml bia hoặc 120ml rượu vang, hoặc 30ml rượu mạnh.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Ngừng hoàn toàn việc hút thuốc lá hoặc thuốc lào.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng cường hoạt động thể lực ở mức thích hợp: tập thể dục, đi bộ hoặc vận động ở mức độ vừa phải, đều đặn khoảng 30-60 phút mỗi ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tránh lo âu, căng thẳng thần kinh; cần chú ý đến việc thư giãn, nghỉ ngơi hợp lý.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tránh bị lạnh đột ngột.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4.3. Điều trị tăng huyết áp bằng thuốc tại tuyến cơ sở:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Chọn thuốc khởi đầu:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tăng huyết áp độ 1: có thể lựa chọn một thuốc trong số các nhóm: lợi tiểu thiazide liều thấp; ức chế men chuyển; chẹn kênh canxi loại tác dụng kéo dài; chẹn beta giao cảm (nếu không có chống chỉ định).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Tăng huyết áp từ độ 2 trở lên: nên phối hợp 2 loại thuốc (lợi tiểu, chẹn kênh canxi, ức chế men chuyển, ức chế thụ thể AT1 của angiotensin II, chẹn bêta giao cảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">+ Từng bước phối hợp các thuốc hạ huyến áp cơ bản, bắt đầu từ liều thấp như lợi tiểu thiazide (hydrochlorothiazide 12,5 mg/ngày), chẹn kênh canxi dạng phóng thích chậm (nifedipine chậm (retard) 10-20 mg/ngày), ức chế men chuyển (enalapril 5 mg/ngày; perindopril 2,5-5 mg/ngày …).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Quản lý người bệnh ngay tại tuyến cơ sở để đảm bảo bệnh nhân được uống thuốc đúng, đủ và đều; đồng thời giám sát quá trình điều trị, tái khám, phát hiện sớm các biến chứng và tác dụng phụ của thuốc theo 4 bước quản lý tăng huyết áp ở tuyến cơ sở (Phụ lục 3 - Quy trình 4 bước điều trị tăng huyết áp tại tuyến cơ sở).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Nếu chưa đạt huyết áp mục tiêu: chỉnh liều tối ưu hoặc bổ sung thêm một loại thuốc khác cho đến khi đạt huyết áp mục tiêu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Nếu vẫn không đạt huyết áp mục tiêu hoặc có biến cố: cần chuyển tuyến trên hoặc gửi khám chuyên khoa tim mạch.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4.4. Các lý do chuyển tuyến trên hoặc chuyên khoa tim mạch:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Cân nhắc chuyển đến các đơn vị quản lý THA tuyến trên hoặc chuyên khoa tim mạch trong các trường hợp sau:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp tiến triển: THA đe dọa có biến chứng (như tai biến mạch não thoáng qua, suy tim …) hoặc khi có các biến cố tim mạch.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Nghi ngờ tăng huyết áp thứ phát hoặc THA ở người trẻ hoặc khi cần đánh giá các tổn thương cơ quan đích.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp kháng trị mặc dù đã dùng nhiều loại thuốc phối hợp (≥ 3 thuốc, trong đó ít nhất có 1 thuốc lợi tiểu) hoặc không thể dung nạp với các thuốc hạ áp, hoặc có quá nhiều bệnh nặng phối hợp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- THA ở phụ nữ có thai hoặc một số trường hợp đặc biệt khác.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4.5. Điều trị tăng huyết áp và các yếu tố nguy cơ tim mạch khác ở tuyến trên:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Quản lý tăng huyết áp và các yếu tố nguy cơ tim mạch khác ở tuyến trên bao gồm:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phát hiện tổn thương cơ quan đích ngay ở giai đoạn tiền lâm sàng (Phụ lục 1 - Nguyên nhân gây THA thứ phát, các yếu tố nguy cơ tim mạch, biến chứng & tổn thương cơ quan đích do THA).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Loại trừ các nguyên nhân gây tăng huyết áp thứ phát (Phụ lục 1).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Chọn chiến lược điều trị vào độ huyết áp và mức nguy cơ tim mạch (Phụ lục 4 - Chiến lược điều trị theo độ huyết áp và nguy cơ tim mạch).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tối ưu hóa phác đồ điều trị tăng huyết áp: dựa vào các chỉ định bắt buộc hoặc ưu tiên của từng nhóm thuốc hạ huyết áp trong các thể bệnh cụ thể. Phối hợp nhiều thuốc để tăng khả năng kiểm soát huyết áp thành công, giảm tác dụng phụ và tăng việc tuân thủ điều trị của người bệnh (Phụ lục 5 - Chỉ định bắt buộc và ưu tiên đối với một số thuốc hạ áp, sơ đồ phối hợp thuốc và Phụ lục 6, mục 1 - Một số loại thuốc hạ huyết áp đường uống thường dùng).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Điều trị các bệnh phối hợp và điều trị dự phòng ở nhóm có nguy cơ tim mạch cao hoặc rất cao.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Sử dụng các thuốc hạ huyết áp đường tĩnh mạch trong các tình huống khẩn cấp như THA ác tính; tách thành động mạch chủ; suy thận tiến triển nhanh; sản giật; THA có kèm nhồi máu cơ tim (NMCT) cấp hoặc suy tim trái cấp … (Phụ lục 6, mục 2 - Một số loại thuốc hạ huyết áp đường tĩnh mạch thường dùng).</span></div><div class="MsoNormal" style="color: #333333; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span class="Apple-style-span" style="font-family: Arial; font-size: small;"><br />
</span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">5. TIẾN TRIỂN<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Tăng huyết áp không được điều trị và kiểm soát tốt sẽ dẫn đến tổn thương nặng các cơ quan đích và gây các biến chứng nguy hiểm như tai biến mạch não, nhồi máu cơ tim, phình tách thành động mạch chủ, suy tim, suy thận … thậm chí dẫn đến tử vong (Phụ lục 1).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">6. PHÒNG BỆNH<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">Các biện pháp tích cực thay đổi lối sống (Phần 4.2) là những biện pháp để phòng ngừa tăng huyết áp ở người trưởng thành, phối hợp với việc giáo dục truyền thông nâng cao nhận thức và hiểu biết về bệnh tăng huyết áp cũng như các biến chứng của tăng huyết áp và các yếu tố nguy cơ tim mạch khác./.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 1<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">NGUYÊN NHÂN GÂY TĂNG HUYẾT ÁP THỨ PHÁT, CÁC YẾU TỐ NGUY CƠ TIM MẠCH, BIẾN CHỨNG VÀ TỔN THƯƠNG CƠ QUAN ĐÍCH DO TĂNG HUYẾT ÁP<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Nguyên nhân gây tăng huyết áp thứ phát </span><span style="font-family: Arial; font-size: 12pt;">(cần chú ý tìm kiếm nguyên nhân trong các trường hợp như THA ở tuổi trẻ (dưới 30 tuổi); THA kháng trị; THA tiến triển hoặc ác tính)<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Bệnh thận cấp hoặc mạn tính: viêm cầu thận cấp/mạn, viên thận kẽ, sỏi thận, thận đa nang, thận ứ nước, suy thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hẹp động mạch thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- U tủy thượng thận (Pheocromocytome).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Cường Aldosterone tiên phát (Hội chứng Conn).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hội chứng Cushing’s.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Bệnh lý tuyến giáp/cận giáp, tuyến yên.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Do thuốc, liên quan đến thuốc (kháng viêm non-steroid, thuốc tránh thai, corticoid, cam thảo, hoạt chất giống giao cảm trong thuốc cảm/thuốc nhỏ mũi …).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hẹp eo động mạch chủ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Bệnh Takayasu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Nhiễm độc thai nghén.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Ngừng thở khi ngủ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Yếu tố tâm thần …<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Các yếu tố nguy cơ tim mạch<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tăng huyết áp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Rối loạn lipid máu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đái tháo đường.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Có microalbumin niệu hoặc mức lọc cầu thận ước tính < 60 ml/ph.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tuổi (nam > 55 tuổi, nữ > 65 tuổi).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Tiền sử gia đình mắc bệnh tim mạch sớm (nam trước 55, nữ trước 65 tuổi).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Thừa cân/béo phì; béo bụng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Hút thuốc lá, thuốc lào.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Uống nhiều rượu, bia.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Ít hoạt động thể lực.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Stress và căng thẳng tâm lý.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Chế độ ăn quá nhiều muối (yếu tố nguy cơ đối với THA), ít rau quả …<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3. Biến chứng của tăng huyết áp hoặc tổn thương cơ quan đích do THA<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Đột quị, thiếu máu não thoáng qua, sa sút trí tuệ, hẹp động mạch cảnh.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Phì đại thất trái (trên điện tâm đồ hay siêu âm tim), suy tim.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Nhồi máu cơ tim, cơn đau thắt ngực.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Bệnh mạch máu ngoại vi.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Xuất huyết hoặc xuất tiết võng mạc, phù gai thị.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Protein niệu, tăng creatinin huyết thanh, suy thận …<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">4. Các xét nghiệm tìm tổn thương cơ quan đích, nguyên nhân tăng huyết áp và yếu tố nguy cơ tim mạch<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Xét nghiệm thường quy:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Sinh hóa máu: đường máu khi đói; thành phần lipid máu (Cholesterol toàn phần, HDL-C, LDL-C, Triglycerid); điện giải máu (đặc biệt là kali); axít uric máu; creatinine máu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Huyết học: Hemoglobin and hematocrit.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Phân tích nước tiểu (albumine niệu và soi vi thể).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Điện tâm đồ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Xét nghiệm nên làm (nếu có điều kiện):<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Siêu âm Doppler tim<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Siêu âm Doppler mạch cảnh.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Định lượng protein niệu (nếu que thử protein dương tính).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Chỉ số huyết áp mắt cá chân/cánh tay (ABI: Ankle Brachial Index).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Soi đáy mắt.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Nghiệm pháp dung nạp glucose.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Theo dõi huyết áp tự động 24 giờ (Holter huyết áp).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Đo vận tốc lan truyền sóng mạch …<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">- Xét nghiệm khi đã có biến chứng hoặc để tìm nguyên nhân:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Định lượng renin, aldosterone, corticosteroids, catecholamines máu/niệu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Chụp động mạch.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Siêu âm thận và thượng thận.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">. Chụp cắt lớp, cộng hưởng từ …<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 2<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">QUY TRÌNH ĐO HUYẾT ÁP ĐÚNG<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">1. Nghỉ ngơi trong phòng yên tĩnh ít nhất 5 - 10 phút trước khi đo huyết áp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">2. Không dùng chất kích thích (cà phê, hút thuốc, rượu bia) trước đó 2 giờ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">3. Tư thế đo chuẩn: người được đo huyết áp ngồi ghế tựa, cánh tay duỗi thẳng trên bàn, nếp khuỷu ngang mức với tim. Ngoài ra, có thể đo ở các tư thế nằm, đứng. Đối với người cao tuổi hoặc có bệnh đái tháo đường, nên đo thêm huyết áp tư thế đứng nhằm xác định có <span style="font-style: italic;">hạ huyết áp tư thế </span>hay không.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">4. Sử dụng huyết áp kế thủy ngân, huyết áp kế đồng hồ hoặc huyết áp kế điện tử (loại đo ở cánh tay). Các thiết bị đo cần được kiểm chuẩn định kỳ. Bề dài bao đo (nằm trong băng quấn) tối thiểu bằng 80% chu vi cánh tay, bề rộng tối thiểu bằng 40% chu vi cánh tay. Quấn băng quấn đủ chặt, bờ dưới của bao đo ở trên nếp lằn khuỷu 2cm. Đặt máy ở vị trí để đảm bảo máy hoặc mốc 0 của thang đo ngang mức với tim.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">5. Nếu không dùng thiết bị đo tự động, trước khi đo phải xác định vị trí động mạnh cánh tay để đặt ống nghe. Bơm hơi thêm 30mmHg sau khi không còn thấy mạch đập. Xả hơi với tốc độ 2-3mmHg/nhịp đập. Huyết áp tâm thu tương ứng với lúc xuất hiện tiếng đập đầu tiên (pha I của Korotkoff) và huyết áp tâm trương tương ứng với khi mất hẳn tiếng đập (pha V của Korotkoff).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">6. Không nói chuyện khi đang đo huyết áp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">7. Lần đo đầu tiên, cần đo huyết áp ở cả hai cánh tay, tay nào có chỉ số huyết áp cao hơn sẽ dùng để theo dõi huyết áp về sau.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">8. Nên đo huyết áp ít nhất hai lần, mỗi lần cách nhau ít nhất 1-2 phút. Nếu số đo huyết áp giữa 2 lần đo chênh nhau trên 10mmHg, cần đo lại một vài lần sau khi đã nghỉ trên 5 phút. Giá trị huyết áp ghi nhận là trung bình của hai lần đo cuối cùng.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">9. Trường hợp nghi ngờ, có thể theo dõi huyết áp bằng máy đo tự động tại nhà hoặc bằng máy đo huyết áp tự động 24 giờ (Holter huyết áp).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;">10. Ghi lại số đo theo đơn vị mmHg dưới dạng HA tâm thu/HA tâm trương (ví dụ 126/82 mmHg) không làm tròn số quá hàng đơn vị và thông báo kết quả cho người được đo.<o:p></o:p></span></div></div><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px;"><span style="font-family: Arial; font-size: 12pt;"><br clear="all" style="page-break-before: always;" /></span></span><br />
<div class="Section2" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px;"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 3<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">QUY TRÌNH 4 BƯỚC ĐIỀU TRỊ TĂNG HUYẾT ÁP TẠI TUYẾN CƠ SỞ<span style="font-family: Arial; font-size: 12pt; text-decoration: underline;"><o:p></o:p></span></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><o:p><span style="font-family: Arial; font-size: 12pt;"> </span></o:p></span><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 4<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">CHIẾN LƯỢC ĐIỀU TRỊ TĂNG HUYẾT ÁP THEO ĐỘ HUYẾT ÁP VÀ NGUY CƠ TIM MẠCH<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; width: 671px;"><tbody>
<tr><td rowspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Bệnh cảnh<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Huyết áp<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Bình thường<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Tiền<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">THA<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Độ 1<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Độ 2<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">THA<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Độ 3<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm thu</span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">120-129 mmHg và</span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm trương 80-84 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm thu</span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">130-139 mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span></span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt;"></span>HA tâm trương 85-89 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm thu 140-159mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span></span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt;"></span>HA tâm trương 90-99 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm thu 160-179</span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> </span></span><span style="font-family: Arial; font-size: 12pt;">HA tâm trương</span></div><div align="center" class="MsoNormal" style="margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">100-109 mmHg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">HA tâm thu ≥ 180 mmHg và/hoặc<span style="font-family: Arial; font-size: 12pt;"> HA</span>tâm trương ≥ 110 mmHg<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Không có yếu tố nguy cơ tim mạch nào<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Theo dõi huyết áp định kỳ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Theo dõi huyết áp định kỳ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát YTNC vài tháng<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc nếu không kiểm soát được huyết áp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát YTNC vài tuần<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc nếu không kiểm soát được huyết áp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt;"> </span>+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Có từ 1-2 yếu tố nguy cơ tim mạch (YTNCTM)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát YTNC vài tuần<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc nếu không kiểm soát được huyết áp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát YTNC vài tuần<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc nếu không kiểm soát được huyết áp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt;"> </span>+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Có ≥ 3 YTNCTM hoặc hội chứng chuyển hóa hoặc tổn thương cơ quan đích<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Cân nhắc điều trị thuốc<o:p></o:p></span></div></td><td rowspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Điều trị thuốc<o:p></o:p></span></div></td><td rowspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Điều trị thuốc<o:p></o:p></span></div></td><td rowspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Có đái tháo đường<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Điều trị thuốc<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 79.45pt;" width="106"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đã có biến cố hoặc có bệnh tim mạch hoặc có bệnh thận mạn tính<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 1.25in;" width="120"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 84pt;" width="112"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 81.9pt;" width="109"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 1.45pt; padding-right: 1.45pt; padding-top: 0in; width: 78pt;" width="104"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tích cực thay đổi lối sống Kiểm soát yếu tố nguy cơ<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">+<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dùng thuốc ngay<o:p></o:p></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt;"><o:p><span style="font-family: Arial; font-size: 12pt;"> </span></o:p></span><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 5<o:p></o:p></span></div></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">CHỈ ĐỊNH BẮT BUỘC VÀ ƯU TIÊN ĐỐI VỚI MỘT SỐ THUỐC HẠ ÁP, SƠ ĐỒ PHỐI HỢP THUỐC<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Chỉ định bắt buộc đối với một số nhóm thuốc hạ huyết áp<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: justify;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Lợi tiểu<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Chẹn kênh canxi<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Ức chế men chuyển<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Ức chế thụ thể AT1<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Chẹn bêta<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">Kháng aldosterone<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Sau nhồi máu cơ tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Bệnh ĐMV (nguy cơ cao)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đái tháo đường<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy thận mạn<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(lợi tiểu quai)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 137.4pt;" valign="top" width="183"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Dự phòng tái phát đột quỵ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 59.8pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 54.2pt;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 0.75in;" width="72"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt;">X<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 60pt;" width="80"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 47.8pt;" width="64"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 78pt;" width="104"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><br />
</div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Chỉ định ưu tiên và chống chỉ định đối với một số nhóm thuốc hạ huyết áp<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" width="135"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Nhóm thuốc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" width="224"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Chỉ định ưu tiên<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" width="168"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Thận trọng<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" width="128"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Chống chỉ định<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lợi tiểu thiazide<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">THA tâm thu đơn độc (người cao tuổi), suy tim, dự phòng thứ phát đột quỵ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hội chứng chuyển hóa, rối loạn dung nạp glucose, thai nghén<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Bệnh gút<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lợi tiểu quai<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy thận giai đoạn cuối, suy tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lợi tiểu (loại kháng aldosterone)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy tim, sau nhồi máu cơ tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy thận, kali máu cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Ức chế men chuyển (ƯCMC)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy tim, rối loạn chức năng thất trái, sau nhồi máu cơ tim, phì đại thất trái, bệnh thận do đái tháo đường, có protein hoặc microalbumin niệu, rung nhĩ, hội chứng chuyển hóa, xơ vữa động mạch cảnh<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy thận, bệnh mạch máu ngoại biên<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Thai nghén, hẹp động mạch thận hai bên, kali máu cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Ức chế thụ thể AT1 của angiotensin II (ƯCTT)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy tim, sau nhồi máu cơ tim, phì đại thất trái, bệnh thận do đái tháo đường, có protein hoặc micro albumin niệu, rung nhĩ, hội chứng chuyển hóa, có chỉ định dùng nhưng không dung nạp với ƯCMC<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Suy thận, bệnh mạch máu ngoại biên<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Thai nghén, hẹp động mạch thận hai bên, kali máu cao<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn kênh canxi (loại dihydropyridin)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">THA tâm thu đơn độc (người cao tuổi), đau thắt ngực, phì đại thất trái, THA ở phụ nữ có thai<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nhịp tim nhanh, suy tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn kênh canxi (loại ức chế nhịp tim)<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đau thắt ngực, nhịp nhanh trên thất<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Blốc nhĩ thất độ 2-3, suy tim<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn bêta<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đau thắt ngực, sau NMCT, suy tim, nhịp tim nhanh, tăng nhãn áp, THA ở phụ nữ có thai<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Bệnh mạch máu ngoại vi, hội chứng chuyển hóa, rối loạn dung nạp glucose<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hen phế quản, bệnh phổi tắc nghẽn mạn tính, blốc nhĩ thất độ 2-3<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 101.4pt;" valign="top" width="135"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn anpha<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 168pt;" valign="top" width="224"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Phì đại lành tính tiền liệt tuyến<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.8pt;" valign="top" width="168"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hạ huyết áp tư thế đứng, suy tim<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96.2pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Đái dầm<o:p></o:p></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">3. Sơ đồ phối hợp các thuốc trong điều trị tăng huyết áp<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span class="Apple-style-span" style="font-family: Arial; font-size: small;"><br />
</span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold; text-decoration: underline;">PHỤ LỤC 6<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">MỘT SỐ LOẠI THUỐC HẠ HUYẾT ÁP THƯỜNG DÙNG<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">(Ban hành kèm theo Quyết định số 3192/QĐ-BYT ngày 31 tháng 8 năm 2010 của Bộ trưởng Bộ Y tế)<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">1. Một số loại thuốc hạ huyết áp đường uống thường dùng<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" width="167"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Nhóm thuốc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" width="229"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Loại thuốc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" width="131"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Liều ban đầu<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" width="128"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Liều duy trì<span style="font-family: Arial; font-size: 12pt;"> </span>hàng ngày<o:p></o:p></span></div></td></tr>
<tr><td rowspan="6" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lợi tiểu<o:p></o:p></span></div></td><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Lợi tiểu thiazide</span><span style="font-family: Arial; font-size: 12pt;"><o:p></o:p></span></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hydrochlorothiazide<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Indapamide<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">12,5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1,5 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">12,5-25 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1,5-3 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Lợi tiểu tác động lên quai Henle</span><span style="font-family: Arial; font-size: 12pt;"><o:p></o:p></span></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Furosemide<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">20 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">20-80 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Lợi tiểu giữ kali</span><span style="font-family: Arial; font-size: 12pt;"><o:p></o:p></span></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Spironolactone<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25-75 mg<o:p></o:p></span></div></td></tr>
<tr><td rowspan="6" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn kênh canxi<o:p></o:p></span></div></td><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại Dihydropyridine (DHP)<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Amlodipine<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Felodipine<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lacidipine<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nicardipine SR<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nifedipine Retard<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nifedipine LA<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">20 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">30 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5-10 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5-20 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2-6 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">60-120 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10-80 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">30-90 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại Benzothiazepine<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Diltiazem<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">60 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">60-180 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại Diphenylalkylamine<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Verapamil<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Verapamil LA<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">80 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">120 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">80-160 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">120-240 mg<o:p></o:p></span></div></td></tr>
<tr><td rowspan="4" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tác động lên hệ renin angiotensin<o:p></o:p></span></div></td><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại ức chế men chuyển (ƯCMC)<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Benazepril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Captopril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Enalapril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Imidapril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Lisinopril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Perindopril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Quinapril<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Ramipril<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10-40 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25-100 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-40 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-20 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10-40 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-10 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10-40 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5-20 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại ức chế thụ thể AT1 của angiotensin II (ƯCTT)</span><span style="font-family: Arial; font-size: 12pt;"><o:p></o:p></span></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Candesartan<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Irbesartan<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Losartan<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Telmisartan<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Valsartan<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">4 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">75 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">40 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">80 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">4-32 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">150-300 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25-100 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">20-80 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">80-160 mg<o:p></o:p></span></div></td></tr>
<tr><td rowspan="6" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn bêta giao cảm<o:p></o:p></span></div></td><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại chẹn bêta chọn lọc β1<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Atenolol<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Bisoprolol<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Metoprolol<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Acebutolol<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">50 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">200 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25-100 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2,5-10 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">50-100 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">200-800 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại chẹn cả bêta và anpha giao cảm<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Labetalol<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Carvedilol<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">100 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">6,25 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">100-600 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">6,25-50 mg<o:p></o:p></span></div></td></tr>
<tr><td colspan="3" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 366pt;" valign="top" width="488"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt; font-style: italic;">Loại chẹn bêta không chọn lọc<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Propranolol<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">40 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">40-160 mg<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Chẹn anpha giao cảm<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Doxazosin mesylate<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Prazosin hydrochloride<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1-8 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1-6 mg<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tác động lên hệ giao cảm trung ương<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Clonidine<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Methyldopa<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">0,1 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">250 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">0,1-0,8 mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">250-2000 mg<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 125.4pt;" valign="top" width="167"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Giãn mạch trực tiếp<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 171.6pt;" valign="top" width="229"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hydralazine<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 98.4pt;" valign="top" width="131"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10 mg<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 96pt;" valign="top" width="128"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">25-100 mg<o:p></o:p></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">2. Một số loại thuốc hạ huyết áp dùng qua đường tĩnh mạch<o:p></o:p></span></div><table border="1" cellpadding="0" cellspacing="0" class="MsoTableGrid" style="border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-color: initial; border-left-style: none; border-left-width: medium; border-right-style: none; border-right-width: medium; border-top-style: none; border-top-width: medium; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; width: 655px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" width="108"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Tên thuốc<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" width="107"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Bắt đầu tác dụng<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" width="96"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Kéo dài<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" width="344"><div align="center" class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt; text-align: center;"><span style="font-family: Arial; font-size: 12pt; font-weight: bold;">Liều dùng<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nitroglycerin<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">2-5 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-10 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Truyền TM 5-100 mcg/ph<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Nicardipine<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-10 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">15-30 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Truyền TM khởi đầu 1-2 mg/giờ, tăng dần 0,5-2 mg/giờ sau 15 phút, liều truyền tối đa 15 mg/giờ<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Natri nitroprusside<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Ngay lập tức<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1-2 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Truyền TM 0,3 mcg/kg/phút, tăng dần 0,5 mcg/kg/ph sau 10 phút, liều truyền tối đa 10 mcg/kg/phút<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Esmolol<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1-5 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">10 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tiêm TM 500 mcg/kg/ph trong phút đầu, truyền TM 50-100 cmg/kg/ph, liều truyền tối đa 300 mcg/kg/phút<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Labetalol<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-10 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">3-6 giờ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tiêm TM chậm 10-20mg trong vòng 2 phút, lặp lại sau 10-15 phút đến khi đạt tổng liều tối đa 300mg<o:p></o:p></span></div><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Truyền TM 0,5-2mg/phút<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Hydralazine<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-10 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">4-6 giờ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tiêm TM chậm 5-10 mg, lặp lại sau 4-6 giờ/lần<o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.85pt;" valign="top" width="108"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Enalaprilat<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 80.55pt;" valign="top" width="107"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">5-15 phút<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 1in;" valign="top" width="96"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">1-6 giờ<o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(240, 240, 240); border-left-style: none; border-left-width: medium; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(240, 240, 240); border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 258pt;" valign="top" width="344"><div class="MsoNormal" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 3pt; margin-left: 0in; margin-right: 0in; margin-top: 3pt;"><span style="font-family: Arial; font-size: 12pt;">Tiêm TM 0,625-1,25 mg, lặp lại 6 giờ/lần<o:p></o:p></span></div></td></tr>
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</div><div class="MsoNormal" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; font-size: 13px; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 6pt; text-align: justify;"><br />
</div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-64271217157151468922011-04-30T20:01:00.000-07:002011-04-30T20:07:13.509-07:00-HỞ VAN HAI LÁ<table border="0" cellpadding="6" cellspacing="0" class="tborder" style="background-attachment: initial; background-clip: initial; background-color: white; background-image: initial; background-origin: initial; border-bottom-color: rgb(212, 212, 212); border-bottom-style: solid; border-bottom-width: 1px; border-left-color: rgb(212, 212, 212); border-left-style: solid; border-left-width: 1px; border-right-color: rgb(212, 212, 212); border-right-style: solid; border-right-width: 1px; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; width: 733px;"><tbody>
<tr><td align="left" colspan="4" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;"><div id="articletext" style="width: 733px;"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt; text-align: center;"><span class="Apple-style-span" style="color: orange; font-size: large;"><span lang="EN" style="font-weight: bold;">Hở<span style="letter-spacing: -0.8pt;"> </span>van<span style="letter-spacing: 0.95pt;"> </span>hai<span style="letter-spacing: 1.4pt;"> </span>lá</span><span lang="EN"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.75pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;"><span class="Apple-style-span" style="color: orange;">(Mitralvalve <span style="letter-spacing: 0.6pt;"> </span>regurgitation)</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: right;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">1.<span style="letter-spacing: 2.9pt;"> </span>Đại<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: -0.05pt;">c</span></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 0.5pt;">ư</span><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">ơng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.1.<span style="letter-spacing: 2.85pt;"> </span>Định<span style="letter-spacing: 0.5pt;"> </span>nghĩa:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">Hở<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: 0.5pt;"> </span>hai<span style="letter-spacing: 0.85pt;"> </span>lá<span style="letter-spacing: 2pt;"> </span>là<span style="letter-spacing: 1.85pt;"> </span>tình<span style="letter-spacing: -1.05pt;"> </span>trạng<span style="letter-spacing: 1.45pt;"> </span>van<span style="letter-spacing: 0.5pt;"> </span>đóng<span style="letter-spacing: -1.1pt;"> </span>không<span style="letter-spacing: 1.25pt;"> </span>kín<span style="letter-spacing: -1.1pt;"> </span>trong<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ì<span style="letter-spacing: 1pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu,<span style="letter-spacing: 0.8pt;"> </span>làm<span style="letter-spacing: 1.5pt;"> </span>cho<span style="letter-spacing: 0.85pt;"> </span>một<span style="letter-spacing: 0.8pt;"> </span>lượng<span style="letter-spacing: 1pt;"> </span>máu phụt<span style="letter-spacing: 0.35pt;"> </span>ngược<span style="letter-spacing: 1pt;"> </span>trở<span style="letter-spacing: 0.85pt;"> </span>lại<span style="letter-spacing: 1.7pt;"> </span>từ<span style="letter-spacing: 0.9pt;"> </span>thất<span style="letter-spacing: 2.9pt;"> </span>trái<span style="letter-spacing: 1.55pt;"></span>lên<span style="letter-spacing: -1.15pt;"> </span>n<span style="letter-spacing: -0.1pt;">h</span>ĩ<span style="letter-spacing: 1pt;"> </span>trái<span style="letter-spacing: 1.55pt;"> </span>trong<span style="letter-spacing: 0.75pt;"> </span>thì<span style="letter-spacing: -1.05pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu.<span style="letter-spacing: 0.8pt;"> </span>Tỷ<span style="letter-spacing: 0.6pt;"> </span>lệ<span style="letter-spacing: 0.25pt;"> </span>gặp<span style="letter-spacing: 0.65pt;"> </span>từ<span style="letter-spacing: 0.9pt;"> </span>5-24%<span style="letter-spacing: 1pt;"> </span>trong<span style="letter-spacing: 0.75pt;"> </span>tổng<span style="letter-spacing: 1.6pt;"> </span>số<span style="letter-spacing: 1.6pt;"> </span>các bệnh<span style="letter-spacing: -0.7pt;"> </span>lý<span style="letter-spacing: -0.1pt;"> </span>tim-mạch.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.2.<span style="letter-spacing: -0.2pt;"> </span>Nguyên<span style="letter-spacing: -0.8pt;"> </span>nhân</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">Khi<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>tổn<span style="letter-spacing: 0.95pt;"> </span>thương<span style="letter-spacing: 0.35pt;"> </span>bất<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: -0.05pt;">k</span>ỳ<span style="letter-spacing: 0.35pt;"> </span>một<span style="letter-spacing: 0.15pt;"> </span>bộ<span style="letter-spacing: 0.35pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ận<span style="letter-spacing: 2.05pt;"> </span>nào<span style="letter-spacing: 0.85pt;"> </span>của tim<span style="letter-spacing: 0.2pt;"> </span>như:<span style="letter-spacing: 0.35pt;"> </span>vòng<span style="letter-spacing: 0.6pt;"> </span>van,<span style="letter-spacing: -0.25pt;"> </span>lá<span style="letter-spacing: 1.2pt;"> </span>van,<span style="letter-spacing: -0.25pt;"> </span>dây<span style="letter-spacing: 0.7pt;"> </span>chằng,<span style="letter-spacing: 1.05pt;"> </span>cột<span style="letter-spacing: 0.2pt;"> </span>cơ,<span style="letter-spacing: 1.25pt;"> </span>cơ tim<span style="letter-spacing: -0.15pt;"> </span>đều<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Thấp<span style="letter-spacing: 1.35pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ẫn là<span style="letter-spacing: 0.85pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>hàng<span style="letter-spacing: -0.2pt;"> </span>đầu<span style="letter-spacing: -0.25pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>hở lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.8pt;"> </span>Một<span style="letter-spacing: 0.6pt;"> </span>số<span style="letter-spacing: 1.4pt;"> </span>bệnh<span style="letter-spacing: 0.1pt;"> </span>rối<span style="letter-spacing: 1.45pt;"> </span>loạn<span style="letter-spacing: 1.25pt;"> </span>cấu<span style="letter-spacing: 2.7pt;"> </span>trúc<span style="letter-spacing: 0.4pt;"> </span>van:<span style="letter-spacing: 0.2pt;"> </span>sa<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.3pt;"> </span>hai<span style="letter-spacing: 0.65pt;"> </span>lá,<span style="letter-spacing: 0.05pt;"> </span>viêm màng<span style="letter-spacing: 2.15pt;"> </span>trong<span style="letter-spacing: 0.55pt;"> </span>tim<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span><span style="letter-spacing: 0.35pt;">i</span><span style="letter-spacing: 0.3pt;">ễ</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">kh</span><span style="letter-spacing: 0.25pt;">u</span><span style="letter-spacing: 0.3pt;">ẩ</span>n<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">b</span><span style="letter-spacing: 0.35pt;">á</span>n <span style="letter-spacing: 0.3pt;">cấ</span>p<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: 0.3pt;">(Osler)</span>,<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">nhồ</span>i<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>ơ<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"></span><span style="letter-spacing: 0.3pt;">(N</span><span style="letter-spacing: 0.25pt;">M</span><span style="letter-spacing: 0.35pt;">C</span><span style="letter-spacing: 0.3pt;">T)</span>,<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: 0.3pt;">t</span><span style="letter-spacing: 0.25pt;">h</span><span style="letter-spacing: 0.3pt;">iế</span>u<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>ơ<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">cụ</span>c<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.3pt;">bộ.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Bệnh<span style="letter-spacing: 2.2pt;"> </span>cơ<span style="letter-spacing: -0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>giãn,<span style="letter-spacing: 0.4pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>cơ<span style="letter-spacing: 0.55pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phì<span style="letter-spacing: 2pt;"> </span>đại,<span style="letter-spacing: -0.55pt;"> </span>tăng <span style="letter-spacing: 1pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Luput<span style="letter-spacing: -0.3pt;"> </span>ban<span style="letter-spacing: -0.15pt;"> </span>đỏ<span style="letter-spacing: 0.45pt;"> </span>hệ<span style="letter-spacing: -0.7pt;"> </span>thống.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Xơ<span style="letter-spacing: 0.5pt;"> </span>cứng<span style="letter-spacing: -0.25pt;"> </span>bì.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Thoái<span style="letter-spacing: 0.35pt;"> </span>hóa<span style="letter-spacing: 0.65pt;"> </span>van,<span style="letter-spacing: -0.6pt;"> </span>vôi<span style="letter-spacing: 0.55pt;"> </span>hóa<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>bẩm<span style="letter-spacing: 1.85pt;"> </span>sinh:<span style="letter-spacing: -0.25pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span>hình <span style="letter-spacing: 0.45pt;"> </span>dù.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Chấ</span>n<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.3pt;">thươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">ha</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">lá</span>:<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">rác</span>h <span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>á<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">van</span>,<span style="letter-spacing: -0.3pt;"> thủn</span>g<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">van</span>,<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: -0.25pt;">đứ</span>t<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">dâ</span>y<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">chằn</span>g<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span>2<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">lá.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.3.<span style="letter-spacing: 2.85pt;"> </span>Giải<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.1pt;">p</span>hẫu<span style="letter-spacing: 1.2pt;"> </span>bệnh:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 1.2pt;"> </span>Van<span style="letter-spacing: 1.2pt;"> </span>hai<span style="letter-spacing: 1.05pt;"> </span>lá<span style="letter-spacing: 1.95pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>thể<span style="letter-spacing: 0.45pt;"> </span>bị<span style="letter-spacing: 1.3pt;"> </span>viêm <span style="letter-spacing: 0.4pt;"> </span>dày,<span style="letter-spacing: 1.65pt;"> </span>co<span style="letter-spacing: 1.1pt;"> </span>rút<span style="letter-spacing: 0.95pt;"> </span>ngắn<span style="letter-spacing: 0.9pt;"> </span>lại,<span style="letter-spacing: 1.75pt;"> </span>sù<span style="letter-spacing: 0.85pt;"> </span>sì,<span style="letter-spacing: -0.9pt;"> </span>vôi<span style="letter-spacing: 1.75pt;"> </span>hóa;<span style="letter-spacing: 1.8pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>khi<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>thủng,<span style="letter-spacing: 0.9pt;"> </span>rách<span style="letter-spacing: 1.6pt;"> </span>v<span style="letter-spacing: 0.1pt;">a</span>n trong<span style="letter-spacing: -0.25pt;"> </span>NMCT,<span style="letter-spacing: -1.15pt;"> </span>Osler.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Dây<span style="letter-spacing: 0.55pt;"> </span>chằng<span style="letter-spacing: 0.35pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>rút<span style="letter-spacing: -0.25pt;"> </span>ngắn<span style="letter-spacing: -0.25pt;"> </span>lại,<span style="letter-spacing: -0.05pt;"> </span>dính<span style="letter-spacing: 2.1pt;"> </span>vào<span style="letter-spacing: -0.25pt;"> </span>nhau<span style="letter-spacing: -0.25pt;"> </span>thành<span style="letter-spacing: 0.35pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>khối.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Nhĩ<span style="letter-spacing: 1.55pt;"> </span>trái<span style="letter-spacing: 0.2pt;"> </span>giãn,<span style="letter-spacing: 1.25pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>một<span style="letter-spacing: 0.35pt;"> </span>vùng<span style="letter-spacing: -0.2pt;"> </span>nhĩ<span style="letter-spacing: 1.5pt;"> </span>trái<span style="letter-spacing: 0.4pt;"> </span>màu<span style="letter-spacing: 1pt;"> </span>trắng<span style="letter-spacing: 0.3pt;"> </span>ngà,<span style="letter-spacing: 1.55pt;"> </span>xơ<span style="letter-spacing: 0.9pt;"> </span>hóa<span style="letter-spacing: 1.2pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>dòng<span style="letter-spacing: 1pt;"> </span>máu<span style="letter-spacing: 0.95pt;"> </span>phụt<span style="letter-spacing: -0.1pt;"> </span>n<span style="letter-spacing: -0.1pt;">g</span>ược<span style="letter-spacing: 0.55pt;"> </span>trở<span style="letter-spacing: 0.4pt;"> </span>lại từ<span style="letter-spacing: -0.1pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>l<span style="letter-spacing: -0.05pt;">ê</span>n<span style="letter-spacing: 0.9pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Thất<span style="letter-spacing: 1.6pt;"> </span>trái<span style="letter-spacing: 1.2pt;"> </span>phì<span style="letter-spacing: 2pt;"> </span>đại,<span style="letter-spacing: -0.55pt;"> </span>dần<span style="letter-spacing: -0.15pt;"> </span>dần<span style="letter-spacing: -0.15pt;"> </span>giãn<span style="letter-spacing: 0.45pt;"> </span>ra<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 0.8pt;"> </span>gánh<span style="letter-spacing: -0.2pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.<span style="letter-spacing: -0.1pt;"> </span>Sinh<span style="letter-spacing: -1pt;"> </span>lý<span style="letter-spacing: 0.25pt;"> </span>bệnh.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Hở<span style="letter-spacing: 0.25pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.2pt;"> </span>lá:<span style="letter-spacing: 0.9pt;"> </span>phụ<span style="letter-spacing: -0.3pt;"> </span>thuộc vào<span style="letter-spacing: -0.35pt;"> </span>kích<span style="letter-spacing: 1.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ước<span style="letter-spacing: 0.25pt;"> </span>lỗ<span style="letter-spacing: 0.85pt;"> </span>hở<span style="letter-spacing: 0.25pt;"> </span>và<span style="letter-spacing: -0.55pt;"> </span>độ<span style="letter-spacing: 0.65pt;"> </span>chênh <span style="letter-spacing: 1.7pt;"> </span>áp<span style="letter-spacing: -0.1pt;"> </span>lực<span style="letter-spacing: 0.1pt;"> </span>nhĩ<span style="letter-spacing: 2.05pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span>i<span style="letter-spacing: 1.1pt;"> </span>và<span style="letter-spacing: -0.35pt;"> </span>thất<span style="letter-spacing: 2.15pt;"> </span>trái.<span style="letter-spacing: 0.7pt;"> </span>Máu<span style="letter-spacing: 0.95pt;"> </span>dội ngược<span style="letter-spacing: 0.45pt;"> </span>từ<span style="letter-spacing: 0.35pt;"> </span>thất<span style="letter-spacing: 2.35pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>lên<span style="letter-spacing: 1.45pt;"></span>nhĩ<span style="letter-spacing: 1.6pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>trong<span style="letter-spacing: 0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ì<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.85pt;"> </span>thu<span style="letter-spacing: 0.3pt;"> </span>nên<span style="letter-spacing: 0.8pt;"> </span>gây<span style="letter-spacing: 0.8pt;"> </span>ứ<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 0.85pt;"> </span>nhĩ<span style="letter-spacing: 1.2pt;"> </span>trái;<span style="letter-spacing: 0.65pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>thời<span style="letter-spacing: 0.25pt;"> </span>kỳ<span style="letter-spacing: 0.45pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ương<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 0.85pt;"> </span>từ nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>xu<span style="letter-spacing: -0.05pt;">ố</span>ng<span style="letter-spacing: 0.7pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hiều<span style="letter-spacing: -0.75pt;"> </span>l<span style="letter-spacing: -0.05pt;">à</span>m<span style="letter-spacing: 0.05pt;"> </span>tă<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 1.7pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>tích<span style="letter-spacing: 0.3pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.25pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ương.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">V</span>ì<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">tăn</span>g<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ể<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">tíc</span>h<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.3pt;">cu</span><span style="letter-spacing: -0.35pt;">ố</span>i<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.25pt;">t</span><span style="letter-spacing: -0.3pt;">â</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.3pt;">trươn</span>g<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>t<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i <span style="letter-spacing: -0.25pt;">nê</span>n<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>t<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">giã</span>n<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.3pt;">ra</span>,<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">dầ</span>n<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">dầ</span>n<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">gâ</span>y<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.3pt;">su</span>y<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">trái</span>,<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">gâ</span>y<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.3pt;">h</span>ở<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">van ha</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">nặn</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">thêm.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.2pt;"> </span>ứ<span style="letter-spacing: 1.65pt;"> </span>máu<span style="letter-spacing: 0.55pt;"> </span>nhĩ<span style="letter-spacing: 0.9pt;"> </span>trái<span style="letter-spacing: -0.2pt;"> </span>gây<span style="letter-spacing: 1.15pt;"> </span>ứ<span style="letter-spacing: 0.15pt;"> </span>máu<span style="letter-spacing: 0.55pt;"> </span>ở<span style="letter-spacing: 0.15pt;"> </span>tĩnh<span style="letter-spacing: 0.75pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>phổi,<span style="letter-spacing: 0.35pt;"> </span>mao mạch<span style="letter-spacing: 0.55pt;"> </span>phổi,<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 0.8pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>phổi<span style="letter-spacing: 0.55pt;"> </span>làm<span style="letter-spacing: 0.7pt;"> </span>cao<span style="letter-spacing: 0.05pt;"> </span>áp<span style="letter-spacing: 0.85pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>nhưng triệu<span style="letter-spacing: -0.7pt;"></span>chứng<span style="letter-spacing: -0.3pt;"> </span>này<span style="letter-spacing: -0.45pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.<span style="letter-spacing: -0.1pt;"> </span>Lâm<span style="letter-spacing: -0.5pt;"> </span>sàng</span><span lang="EN">.<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">Triệu<span style="letter-spacing: 0.05pt;"> </span>chứng<span style="letter-spacing: 0.8pt;"> </span>lâm<span style="letter-spacing: -1.1pt;"> </span>sàng<span style="letter-spacing: 1.45pt;"> </span>có<span style="letter-spacing: 1.75pt;"> </span>khi<span style="letter-spacing: 0.95pt;"> </span>kín<span style="letter-spacing: -1pt;"> </span>đ<span style="letter-spacing: -0.1pt;">á</span>o,<span style="letter-spacing: 1.05pt;"> </span>nếu<span style="letter-spacing: 0.4pt;"> </span>hở<span style="letter-spacing: 1.1pt;"> </span>van<span style="letter-spacing: 0.55pt;"> </span>hai<span style="letter-spacing: 0.9pt;"> </span>lá<span style="letter-spacing: 1.9pt;"> </span>mức<span style="letter-spacing: 0.85pt;"> </span>độ<span style="letter-spacing: 1.6pt;"> </span>nhẹ.<span style="letter-spacing: 0.2pt;"> </span>Triệu<span style="letter-spacing: -0.05pt;"> </span>chứng<span style="letter-spacing: 0.75pt;"> </span>rõ,<span style="letter-spacing: 1.65pt;"> </span>suy<span style="letter-spacing: 1.05pt;"> </span>tim diễn<span style="letter-spacing: -0.85pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"></span>chóng<span style="letter-spacing: 0.55pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.1.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>n<span style="letter-spacing: 0.05pt;">ă</span>ng:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.45pt;"> </span>nhân<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>mệt<span style="letter-spacing: -0.75pt;"> </span>mỏi,<span style="letter-spacing: 0.65pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>hộp<span style="letter-spacing: -0.35pt;"> </span>trống<span style="letter-spacing: 0.5pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Ho<span style="letter-spacing: -0.15pt;"> </span>về<span style="letter-spacing: -1.2pt;"> </span>đêm.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>cơn<span style="letter-spacing: 0.4pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>về<span style="letter-spacing: -1.2pt;"> </span>đêm.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">C</span>ó<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>ể<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">he</span>n<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">tim</span>,<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">p</span><span style="letter-spacing: 0.25pt;">h</span>ù<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.3pt;">phổ</span>i<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">c</span><span style="letter-spacing: 0.25pt;">ấ</span>p<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.3pt;">nhưn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">í</span>t<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">gặ</span>p<span style="letter-spacing: 0.25pt;"> hơ</span>n<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">s</span>o<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">vớ</span>i<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: 0.3pt;">bện</span>h<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.3pt;">hẹ</span>p<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>ỗ<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.3pt;">ha</span>i<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">l</span><span style="letter-spacing: 0.2pt;">á</span>.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.2.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>thực<span style="letter-spacing: 1.85pt;"> </span>thể:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Mỏm<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>mạnh <span style="letter-spacing: 0.6pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>lệch<span style="letter-spacing: -0.85pt;"> </span>sang trái.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Tĩnh<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>cổ<span style="letter-spacing: 0.65pt;"> </span>nổi<span style="letter-spacing: 0.6pt;"> </span>căng <span style="letter-spacing: 0.6pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>nẩy.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Nghe<span style="letter-spacing: -0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>dấu<span style="letter-spacing: 1.85pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>lâm<span style="letter-spacing: 0.8pt;"> </span>sàng<span style="letter-spacing: 0.15pt;"> </span>quan<span style="letter-spacing: -0.25pt;"> </span>trọng<span style="letter-spacing: 0.5pt;"> </span>để<span style="letter-spacing: 0.7pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. T<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 0.85pt;"> </span></span>mờ.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">.<span style="letter-spacing: 1pt;"> </span>Tiếng<span style="letter-spacing: -0.15pt;"> </span>thổi<span style="letter-spacing: 1.55pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu<span style="letter-spacing: 0.85pt;"> </span>chiếm<span style="letter-spacing: 0.1pt;"> </span>toàn<span style="letter-spacing: 1.6pt;"> </span>bộ<span style="letter-spacing: 1pt;"> </span>thì<span style="letter-spacing: -1.05pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu.<span style="letter-spacing: 0.8pt;"> </span>Tiếng<span style="letter-spacing: -0.15pt;"> </span>thổi<span style="letter-spacing: 1.55pt;"> </span>có<span style="letter-spacing: 1.7pt;"> </span>đặc<span style="letter-spacing: 1.65pt;"> </span>điểm: <span style="letter-spacing: 0.15pt;"> </span>thô<span style="letter-spacing: 1.45pt;"> </span>ráp,<span style="letter-spacing: 1pt;"> </span>lan<span style="letter-spacing: 0.85pt;"> </span>ra nách<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>sau lưng, cường độ<span style="letter-spacing: 0.55pt;"></span>t<span style="letter-spacing: -0.05pt;">h</span>ường mạnh<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>rung miu<span style="letter-spacing: -0.2pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. T<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 0.85pt;"> </span></span>đanh <span style="letter-spacing: 0.85pt;"> </span>và<span style="letter-spacing: -0.25pt;"> </span>tách<span style="letter-spacing: 2.05pt;"> </span>đôi<span style="letter-spacing: -0.4pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>cao<span style="letter-spacing: -0.15pt;"> </span>áp<span style="letter-spacing: -0.7pt;"> </span>động<span style="letter-spacing: 2.1pt;"> </span>mạch<span style="letter-spacing: 1.65pt;"> </span>phổi.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">.<span style="letter-spacing: 1.15pt;"> </span>Có<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 1pt;"> </span>nghe<span style="letter-spacing: 0.9pt;"> </span>được<span style="letter-spacing: 2pt;"> </span>m<span style="letter-spacing: -0.05pt;">ộ</span>t<span style="letter-spacing: 0.95pt;"> </span>tiếng<span style="letter-spacing: 0.3pt;"> </span>rùng<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: -1.05pt;"> </span>trương<span style="letter-spacing: 1.15pt;"> </span>nhẹ<span style="letter-spacing: 0.45pt;"> </span>đi<span style="letter-spacing: 1.85pt;"> </span>kèm trong<span style="letter-spacing: 0.9pt;"> </span>hở<span style="letter-spacing: 1.15pt;"> </span>van<span style="letter-spacing: 0.65pt;"> </span>hai<span style="letter-spacing: 1pt;"> </span>lá<span style="letter-spacing: 2pt;"> </span>mức<span style="letter-spacing: 0.95pt;"> </span>độ nặng.<span style="letter-spacing: -0.2pt;"> </span>Đó<span style="letter-spacing: 1.95pt;"> </span>là<span style="letter-spacing: 0.9pt;"> </span>do<span style="letter-spacing: -0.05pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>lỗ<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.6pt;"> </span>hai<span style="letter-spacing: -0.1pt;"></span>lá<span style="letter-spacing: -0.45pt;"> </span>cơ<span style="letter-spacing: 0.5pt;"> </span>năng <span style="letter-spacing: 1pt;"> </span>khi<span style="letter-spacing: -0.1pt;"> </span>một<span style="letter-spacing: -0.15pt;"> </span>thể<span style="letter-spacing: -0.7pt;"> </span>tích<span style="letter-spacing: 0.8pt;"> </span>máu<span style="letter-spacing: -0.05pt;"> </span>lớn<span style="letter-spacing: -0.25pt;"> </span>từ<span style="letter-spacing: -0.05pt;"> </span>nhĩ<span style="letter-spacing: 1pt;"> </span>trái<span style="letter-spacing: -0.1pt;"> </span>xuống<span style="letter-spacing: 0.65pt;"> </span>thất<span style="letter-spacing: 1.95pt;"> </span>trái<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.2pt;"> </span>thì tâm<span style="letter-spacing: 0.35pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ương.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.<span style="letter-spacing: -0.1pt;"> </span>Cận<span style="letter-spacing: 0.75pt;"> </span>lâm<span style="letter-spacing: -0.95pt;"> </span>sàng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.1.<span style="letter-spacing: 2.85pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>đồ</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Thường thấy<span style="letter-spacing: 1.85pt;"> </span>dấu<span style="letter-spacing: 1.85pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>trục<span style="letter-spacing: -0.35pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>trái.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 17px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span>Sóng<span style="letter-spacing: 0.35pt;"> </span>P<span style="letter-spacing: 0.25pt;"> </span>biểu<span style="letter-spacing: -0.25pt;"> </span>hiện<span style="letter-spacing: -0.25pt;"> </span>của<span style="letter-spacing: 0.25pt;"> </span>dày<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 1.55pt;"> </span>trái:<span style="letter-spacing: 1.05pt;"> </span>P<span style="letter-spacing: 0.25pt;"> </span>rộng<span style="letter-spacing: 0.6pt;"> </span>và<span style="letter-spacing: 1.4pt;"> </span>hai<span style="letter-spacing: 0.45pt;"> </span>đỉnh <span style="letter-spacing: 0.85pt;"> </span>≥<span style="letter-spacing: -0.1pt;"> </span>0,12<span style="letter-spacing: 0.6pt;"> </span>s<span style="letter-spacing: 0.6pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.1pt;">D</span><span style="position: relative; top: 2.5pt;">II</span>;<span style="letter-spacing: 0.3pt;"> </span>P<span style="letter-spacing: 0.25pt;"> </span>hai<span style="letter-spacing: 0.45pt;"> </span>pha,<span style="letter-spacing: 0.35pt;"> </span>pha<span style="letter-spacing: 0.2pt;"> </span>âm<span style="letter-spacing: 1pt;"> </span>><span style="letter-spacing: 0.5pt;"> </span>pha dương ở V<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: -0.05pt;"> </span></span>và<span style="letter-spacing: 0.8pt;"> </span>V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">2</span>.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Khi<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>d<span style="letter-spacing: -0.05pt;">ấ</span>u<span style="letter-spacing: 1.95pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>dày<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải,<span style="letter-spacing: 0.4pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>thành<span style="letter-spacing: 1.35pt;"> </span>dày<span style="letter-spacing: 0.05pt;"> </span>2 thất.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.2.<span style="letter-spacing: -0.2pt;"> </span>X<span style="letter-spacing: -0.1pt;"> </span>quang<span style="letter-spacing: 2.35pt;"> </span>tim-phổi:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN" style="font-size: large;">- Thấy<span style="letter-spacing: 1.6pt;"> </span>hình<span style="letter-spacing: 1.6pt;"> </span>ảnh<span style="letter-spacing: -0.2pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>trái<span style="letter-spacing: -0.35pt;"> </span>to<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>to.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Trên<span style="letter-spacing: 0.3pt;"> </span>phim<span style="letter-spacing: -0.25pt;"> </span>nghiêng <span style="letter-spacing: 0.55pt;"> </span>trái<span style="letter-spacing: -0.8pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>to,<span style="letter-spacing: -0.1pt;"> </span>chèn<span style="letter-spacing: 1.85pt;"> </span>thực<span style="letter-spacing: -0.2pt;"> </span>quản.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Trên<span style="letter-spacing: 0.3pt;"> </span>phim<span style="letter-spacing: -0.25pt;"> </span>thẳng:<span style="letter-spacing: 0.35pt;"> </span>cung<span style="letter-spacing: -0.25pt;"> </span>dưới trái<span style="letter-spacing: -0.15pt;"> </span>giãn,<span style="letter-spacing: 1pt;"> </span>chỉ<span style="letter-spacing: 0.95pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>tim/lồng<span style="letter-spacing: 0.4pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>50% khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>phì <span style="letter-spacing: 0.6pt;"> </span>đại<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Hình<span style="letter-spacing: 1.7pt;"> </span>ảnh<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ường Kerley<span style="letter-spacing: -0.35pt;"> </span>B<span style="letter-spacing: -0.9pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>phù<span style="letter-spacing: -0.55pt;"> </span>tổ<span style="letter-spacing: 0.6pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>kẽ.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 1.75pt;"> </span>Có<span style="letter-spacing: 1.85pt;"> </span>thể<span style="letter-spacing: 0.95pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span>y <span style="letter-spacing: 0.65pt;"> </span>vôi<span style="letter-spacing: 2.3pt;"> </span>hóa<span style="letter-spacing: 2.35pt;"> </span>van<span style="letter-spacing: 1.25pt;"> </span>hai<span style="letter-spacing: 1.6pt;"> </span>lá,<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ôi <span style="letter-spacing: 0.4pt;"> </span>hóa<span style="letter-spacing: 2.35pt;"> </span>vòng<span style="letter-spacing: 2pt;"> </span>van<span style="letter-spacing: 1.25pt;"> </span>hai<span style="letter-spacing: 1.6pt;"> </span>lá <span style="letter-spacing: 0.45pt;"> </span>(khi<span style="letter-spacing: 1.55pt;"> </span>chụp<span style="letter-spacing: 1.25pt;"> </span>chếch<span style="letter-spacing: 0.9pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ước <span style="letter-spacing: -1.3pt;"> </span>phải<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">nghiêng<span style="letter-spacing: 0.15pt;"> </span>trái).<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.3.<span style="letter-spacing: -0.2pt;"> </span>Siêu<span style="letter-spacing: 0.2pt;"> </span>âm<span style="letter-spacing: -0.85pt;"> </span>ti<span style="letter-spacing: 0.05pt;">m</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">Siêu<span style="letter-spacing: 1.05pt;"> </span>âm<span style="letter-spacing: 1.05pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>giúp<span style="letter-spacing: 0.05pt;"> </span>cho<span style="letter-spacing: 0.5pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ẩn<span style="letter-spacing: 2.55pt;"> </span>đoán<span style="letter-spacing: 0.7pt;"> </span>xác<span style="letter-spacing: 1.65pt;"> </span>định<span style="letter-spacing: 1.5pt;"> </span>hở<span style="letter-spacing: 0.7pt;"> </span>van<span style="letter-spacing: 0.15pt;"> </span>hai<span style="letter-spacing: 0.55pt;"> </span>lá<span style="letter-spacing: 0.3pt;"> </span>là<span style="letter-spacing: 0.2pt;"> </span>siêu <span style="letter-spacing: 1pt;"> </span>âm tim<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">2</span>D<span style="letter-spacing: 0.4pt;"> </span>và<span style="letter-spacing: 0.1pt;"> </span>siêu <span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.75pt;"> </span>Doppler mầu.<span style="letter-spacing: 0.05pt;"> </span>Siêu<span style="letter-spacing: 0.7pt;"> </span>âm<span style="letter-spacing: 0.7pt;"> </span>giúp<span style="letter-spacing: -0.35pt;"> </span>đánh<span style="letter-spacing: 0.3pt;"></span>giá<span style="letter-spacing: 0.85pt;"> </span>tình <span style="letter-spacing: 0.3pt;"> </span>trạng <span style="letter-spacing: 0.15pt;"> </span>lá<span style="letter-spacing: -0.2pt;"> </span>van,<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>òng<span style="letter-spacing: 0.4pt;"> </span>van,<span style="letter-spacing: -0.3pt;"> </span>dây<span style="letter-spacing: 1.5pt;"> </span>chằng,<span style="letter-spacing: 2.5pt;"> </span>để<span style="letter-spacing: -0.4pt;"> </span>chỉ<span style="letter-spacing: 1.25pt;"> </span>định<span style="letter-spacing: -0.05pt;"> </span>phẫu<span style="letter-spacing: 2pt;"> </span>thuật,<span style="letter-spacing: 2.3pt;"> </span>theo dõi trong<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>sau mổ<span style="letter-spacing: 0.6pt;"> </span>van,<span style="letter-spacing: -0.6pt;"> </span>đánh<span style="letter-spacing: 0.3pt;"> </span>giá<span style="letter-spacing: 0.8pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>năng<span style="letter-spacing: 0.25pt;"></span>tim<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: 0.1pt;">r</span>ước và<span style="letter-spacing: 0.8pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.25pt; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.3pt;">Đ</span>o<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: 0.25pt;">đượ</span>c<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.3pt;">vậ</span>n<span style="letter-spacing: 2.7pt;"> </span><span style="letter-spacing: 0.3pt;">tố</span>c<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: 0.3pt;">dòn</span>g<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.3pt;">phụ</span>t<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">ngượ</span>c<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.3pt;">t</span>ừ<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">thấ</span>t <span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: 0.25pt;">trá</span>i<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.3pt;">lê</span>n<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span>ĩ<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: 0.25pt;">trái</span>:<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.25pt;">khoản</span>g <span style="letter-spacing: 0.15pt;"> </span>5<span style="letter-spacing: 0.7pt;"> </span>-<span style="letter-spacing: 0.75pt;"> </span>6<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.05pt;">m/</span>s,<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">k</span>éo<span style="letter-spacing: -0.15pt;"> </span>dài hết<span style="letter-spacing: -0.75pt;"> </span>thì<span style="letter-spacing: 0.25pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.3pt;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.95pt;"> </span>Tính<span style="letter-spacing: 1.25pt;"> </span>mức<span style="letter-spacing: 0.75pt;"> </span>độ<span style="letter-spacing: 1.5pt;"> </span>hở<span style="letter-spacing: 0.95pt;"> </span>van<span style="letter-spacing: 0.45pt;"> </span>2<span style="letter-spacing: 0.95pt;"> </span>lá<span style="letter-spacing: 1.8pt;"> </span>theo<span style="letter-spacing: 0.75pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 0.95pt;"> </span>pháp<span style="letter-spacing: 1.35pt;"> </span>tính<span style="letter-spacing: -1.1pt;"> </span>tỷ<span style="letter-spacing: 0.85pt;"> </span>lệ<span style="letter-spacing: 0.2pt;"> </span>%<span style="letter-spacing: 0.95pt;"> </span>của<span style="letter-spacing: 0.6pt;"> </span>diện<span style="letter-spacing: 0.1pt;"> </span>tích<span style="letter-spacing: -1.05pt;"> </span>dòng<span style="letter-spacing: 1.4pt;"> </span>hở/diện<span style="letter-spacing: 0.2pt;"> </span>tích<span style="letter-spacing: -1.05pt;"> </span>nhĩ </span><span lang="EN">trái:<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">. Hở nhẹ:<span style="letter-spacing: -0.85pt;"> </span>1/4<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>tỷ<span style="letter-spacing: -0.1pt;"> </span>lệ<span style="letter-spacing: -0.75pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>20%.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Hở vừa:<span style="letter-spacing: -0.6pt;"> </span>2/4<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>tỷ<span style="letter-spacing: -0.1pt;"> </span>lệ<span style="letter-spacing: -0.75pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>21- 40%.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Hở nặng:<span style="letter-spacing: -0.25pt;"> </span>3/4<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>tỷ<span style="letter-spacing: -0.1pt;"> </span>lệ<span style="letter-spacing: -0.75pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>40%.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: 0.25pt;">Siê</span>u<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.3pt;">â</span>m<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.3pt;">cò</span>n<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>o<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.2pt;">đ</span><span style="letter-spacing: 0.25pt;">ượ</span>c<span style="letter-spacing: 2.3pt;"> </span><span style="letter-spacing: 0.3pt;">kíc</span>h<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: 0.3pt;">thướ</span>c <span style="letter-spacing: -1.4pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span>ĩ<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: 0.25pt;">t</span><span style="letter-spacing: 0.2pt;">r</span><span style="letter-spacing: 0.25pt;">ái</span>,<span style="letter-spacing: 2.3pt;"> </span><span style="letter-spacing: 0.3pt;">thấ</span>t <span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">trái</span>;<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.3pt;">thườn</span>g <span style="letter-spacing: -1.4pt;"> </span><span style="letter-spacing: 0.3pt;">gặ</span>p<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.25pt;">giã</span>n<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span>ĩ<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: 0.25pt;">trá</span>i <span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.25pt;">v</span>à<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.3pt;">thất trái.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>vận<span style="letter-spacing: 1.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>thành<span style="letter-spacing: 0.05pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái,<span style="letter-spacing: -0.55pt;"> </span>tăng<span style="letter-spacing: 0.8pt;"> </span>phân<span style="letter-spacing: 0.8pt;"> </span>suất<span style="letter-spacing: 1.9pt;"> </span>tống<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 0.35pt;"> </span>(khi<span style="letter-spacing: -0.2pt;"> </span>c<span style="letter-spacing: 0.1pt;">h</span>ưa có<span style="letter-spacing: 0.65pt;"> </span>suy tim).<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Siêu<span style="letter-spacing: 0.4pt;"> </span>âm<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>giúp<span style="letter-spacing: -0.65pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>phân <span style="letter-spacing: 0.05pt;"> </span>biệt<span style="letter-spacing: -0.8pt;"> </span>hở lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>vôi<span style="letter-spacing: 0.55pt;"> </span>hoá<span style="letter-spacing: 0.75pt;"> </span>vòng<span style="letter-spacing: 0.25pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.<span style="letter-spacing: -0.1pt;"> </span>Biến<span style="letter-spacing: -0.75pt;"> </span>chứng<span style="letter-spacing: -0.55pt;"> </span>của<span style="letter-spacing: -0.6pt;"> </span>hở<span style="letter-spacing: -0.6pt;"> </span>van<span style="letter-spacing: -1.25pt;"> </span>hai<span style="letter-spacing: -0.55pt;"> </span>lá.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">Các<span style="letter-spacing: 0.5pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gặp<span style="letter-spacing: -0.35pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>hở lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.1pt;"> </span>là:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Viêm<span style="letter-spacing: 1.15pt;"> </span>màng<span style="letter-spacing: -0.3pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>vi<span style="letter-spacing: -0.45pt;"> </span>khuẩn.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Phù<span style="letter-spacing: -0.55pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>tính,<span style="letter-spacing: 0.25pt;"> </span>bội<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>phổi.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Run</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">rố</span>i<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">loạ</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.25pt;">khác</span>:<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">ngoạ</span>i<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>u<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">nhĩ</span>,<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">ngoạ</span>i<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>u<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">thất.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.7pt;"> </span>Biến<span style="letter-spacing: -0.9pt;"> </span>chứ<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.45pt;"> </span>tắc<span style="letter-spacing: 0.6pt;"> </span>mạch:<span style="letter-spacing: 1.1pt;"> </span>tắc<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 1.75pt;"> </span>não,<span style="letter-spacing: 0.9pt;"> </span>tắc<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 1.1pt;"> </span>chi,<span style="letter-spacing: 0.55pt;"> </span>tắc<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>thân,<span style="letter-spacing: 1.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ưng<span style="letter-spacing: 0.75pt;"> </span>ít<span style="letter-spacing: 1.45pt;"> </span>gặp<span style="letter-spacing: 0.35pt;"> </span>hơn<span style="letter-spacing: 1.15pt;"> </span>so<span style="letter-spacing: 0.6pt;"> </span>với bệnh<span style="letter-spacing: -0.7pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Suy<span style="letter-spacing: -0.95pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước tiên là<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>uy tim<span style="letter-spacing: -0.15pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>au<span style="letter-spacing: -0.05pt;"> </span>đó<span style="letter-spacing: 0.45pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>toàn<span style="letter-spacing: 0.45pt;"> </span>bộ.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.<span style="letter-spacing: -0.1pt;"> </span>Chẩn<span style="letter-spacing: -1.55pt;"> </span>đoán<span style="letter-spacing: -0.55pt;"> </span>và<span style="letter-spacing: 2.5pt;"> </span>chẩn<span style="letter-spacing: -2.05pt;"> </span>đoán<span style="letter-spacing: -1.85pt;"> </span>phân<span style="letter-spacing: 1.85pt;"> </span>b<span style="letter-spacing: 0.05pt;">i</span>ệt.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.1.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN" style="font-size: large;">Dựa<span style="letter-spacing: -0.2pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>lâm<span style="letter-spacing: 2.15pt;"> </span>sàng<span style="letter-spacing: 1.85pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>cận<span style="letter-spacing: 1.9pt;"> </span>lâm<span style="letter-spacing: 0.55pt;"> </span>sàng,<span style="letter-spacing: 0.1pt;"> </span>đặc biệt<span style="letter-spacing: -0.75pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>siêu <span style="letter-spacing: 0.35pt;"> </span>âm<span style="letter-spacing: 1.75pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>Doppler.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 18px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Nghe<span style="letter-spacing: -0.15pt;"> </span>tim:<span style="letter-spacing: -0.05pt;"> </span>ở<span style="letter-spacing: 0.15pt;"> </span>mỏm<span style="letter-spacing: 0.65pt;"> </span>thấy<span style="letter-spacing: 1.95pt;"> </span>tiếng<span style="letter-spacing: -0.65pt;"> </span>T<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.1pt;"> </span></span>mờ;<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>tiếng<span style="letter-spacing: -0.6pt;"> </span>thổi<span style="letter-spacing: 0.7pt;"> </span>tâm<span style="letter-spacing: 0.5pt;"> </span>thu,<span style="letter-spacing: -0.05pt;"> </span>c<span style="letter-spacing: -0.05pt;">ư</span>ờng<span style="letter-spacing: 0.15pt;"> </span>độ<span style="letter-spacing: 0.2pt;"> </span>mạnh<span style="letter-spacing: 1.85pt;"> </span>thô<span style="letter-spacing: 0.8pt;"> </span>ráp,<span style="letter-spacing: 0.4pt;"> </span>chiếm<span style="letter-spacing: 2.45pt;"> </span>toàn thì<span style="letter-spacing: 0.25pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu,<span style="letter-spacing: -0.2pt;"> </span>lan<span style="letter-spacing: -0.15pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>nách;<span style="letter-spacing: 0.35pt;"></span>có<span style="letter-spacing: 0.6pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>kèm<span style="letter-spacing: 1.85pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>rung miu<span style="letter-spacing: -0.2pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Ngh</span>e<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.75pt;"> </span>ở<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">liê</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">sườ</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">II</span>-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">II</span>I<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">bê</span>n<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.35pt;">cạ</span><span style="letter-spacing: -0.3pt;">n</span>h<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ứ</span>c<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.35pt;">T</span><span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 0.25pt;"> </span></span><span style="letter-spacing: -0.3pt;">van</span>g<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">T</span><span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 0.25pt;"> </span></span><span style="letter-spacing: -0.25pt;">tác</span>h<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">đôi.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- X<span style="letter-spacing: -0.15pt;"> </span>quang,<span style="letter-spacing: -0.3pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ:<span style="letter-spacing: 0.75pt;"> </span>hình<span style="letter-spacing: 1.6pt;"> </span>ảnh<span style="letter-spacing: -0.2pt;"> </span>g<span style="letter-spacing: 0.05pt;">i</span>ãn<span style="letter-spacing: 0.15pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>trái,<span style="letter-spacing: 0.2pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.4pt;"> </span>Siêu<span style="letter-spacing: 0.8pt;"> </span>âm<span style="letter-spacing: 0.8pt;"> </span>tim:<span style="letter-spacing: 0.2pt;"> </span>hình<span style="letter-spacing: 1.7pt;"> </span>ảnh<span style="letter-spacing: -0.05pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>hai<span style="letter-spacing: 0.25pt;"> </span>lá<span style="letter-spacing: -0.7pt;"> </span>đóng <span style="letter-spacing: 0.1pt;"> </span>không <span style="letter-spacing: 0.25pt;"> </span>kín<span style="letter-spacing: 1.35pt;"> </span>trong<span style="letter-spacing: 0.25pt;"> </span>thì<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: 1.2pt;"> </span>thu<span style="letter-spacing: 0.25pt;"> </span>trên<span style="letter-spacing: 0.95pt;"> </span>siêu<span style="letter-spacing: 0.95pt;"> </span>âm<span style="letter-spacing: 0.4pt;"> </span>2D.<span style="letter-spacing: 0.05pt;"> </span>Trên<span style="letter-spacing: 0.7pt;"> </span>siêu<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">âm<span style="letter-spacing: 0.45pt;"> </span>Doppl<span style="letter-spacing: -0.05pt;">e</span>r<span style="letter-spacing: -0.65pt;"> </span>tim<span style="letter-spacing: -0.1pt;"> </span>thấy<span style="letter-spacing: 1.9pt;"> </span>dò<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.55pt;"> </span>phụt<span style="letter-spacing: -0.6pt;"> </span>n<span style="letter-spacing: -0.1pt;">g</span>ược<span style="letter-spacing: 0.05pt;"> </span>lại<span style="letter-spacing: 0.75pt;"> </span>từ<span style="letter-spacing: -0.05pt;"> </span>thất<span style="letter-spacing: 1.95pt;"> </span>trái<span style="letter-spacing: 0.15pt;"> </span>lên<span style="letter-spacing: 1.05pt;"> </span>nhĩ<span style="letter-spacing: 1.2pt;"> </span>trái<span style="letter-spacing: -0.1pt;"> </span>trong<span style="letter-spacing: -0.2pt;"> </span>thì<span style="letter-spacing: 0.3pt;"> </span>tâm<span style="letter-spacing: 0.85pt;"> </span>thu;<span style="letter-spacing: -0.15pt;"> </span>vận<span style="letter-spacing: 1.6pt;"> </span>tốc<span style="letter-spacing: 0.6pt;"> </span>dòng<span style="letter-spacing: 0.5pt;"> </span>phụt qua<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>5-6 m/s.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.2.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>phân<span style="letter-spacing: 0.5pt;"> </span>b<span style="letter-spacing: 0.1pt;">i</span>ệt:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Hở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>các<span style="letter-spacing: -0.8pt;"> </span>nguyên<span style="letter-spacing: 2.6pt;"> </span>nhân<span style="letter-spacing: 1.35pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>phải<span style="letter-spacing: -0.6pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>thấp:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Sa<span style="letter-spacing: -0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.25pt;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">.<span style="letter-spacing: 0.6pt;"> </span>Đứt<span style="letter-spacing: 1.75pt;"> </span>dây<span style="letter-spacing: 0.95pt;"> </span>chằng,<span style="letter-spacing: 1.3pt;"> </span>trụ<span style="letter-spacing: 0.35pt;"> </span>cơ<span style="letter-spacing: 1.2pt;"> </span>trong<span style="letter-spacing: 0.35pt;"> </span>viêm<span style="letter-spacing: 1.2pt;"> </span>màng<span style="letter-spacing: 0.65pt;"> </span>trong<span style="letter-spacing: 0.35pt;"> </span>tim<span style="letter-spacing: 0.45pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>iễm<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">k</span>huẩn<span style="letter-spacing: 2.5pt;"> </span>bán<span style="letter-spacing: 1.1pt;"> </span>cấp,<span style="letter-spacing: 2.35pt;"> </span>nhồi<span style="letter-spacing: 1.2pt;"> </span>máu<span style="letter-spacing: 1.8pt;"> </span>cơ<span style="letter-spacing: 0.7pt;"> </span>tim</span><span lang="EN"> cấp.<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">. Hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: -0.5pt;"> </span>cơ<span style="letter-spacing: 0.45pt;"> </span>năng <span style="letter-spacing: 0.95pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Hẹp<span style="letter-spacing: -1.05pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Hở van<span style="letter-spacing: -0.5pt;"> </span>ba<span style="letter-spacing: -0.1pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Thông<span style="letter-spacing: 0.65pt;"> </span>liên<span style="letter-spacing: 0.1pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">Hiện<span style="letter-spacing: 0.25pt;"> </span>nay,<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hờ<span style="letter-spacing: 0.95pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>kỹ<span style="letter-spacing: 0.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>uật<span style="letter-spacing: 2.75pt;"> </span>siêu<span style="letter-spacing: 1.7pt;"> </span>âm<span style="letter-spacing: 1.15pt;"> </span>tim,<span style="letter-spacing: 0.7pt;"> </span>đặc<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.05pt;">b</span><span style="letter-spacing: 0.05pt;">i</span><span style="letter-spacing: -0.05pt;">ệ</span>t<span style="letter-spacing: 0.1pt;"> </span>siêu<span style="letter-spacing: -1.2pt;"> </span><span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.05pt;">Do</span>ppler<span style="letter-spacing: 0.05pt;"> </span>tim<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ã <span style="letter-spacing: 0.15pt;"> </span>giúp<span style="letter-spacing: 0.25pt;"> </span>chẩn<span style="letter-spacing: 2.75pt;"> </span>đoán<span style="letter-spacing: 1.6pt;"> </span>phân biệt<span style="letter-spacing: -0.75pt;"> </span>các<span style="letter-spacing: -0.8pt;"> </span>nguyên<span style="letter-spacing: 2.6pt;"> </span>nhân<span style="letter-spacing: 1.35pt;"></span>trên.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.<span style="letter-spacing: -0.1pt;"> </span>Điều<span style="letter-spacing: -0.95pt;"> </span>trị:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>hở <span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"> </span>bao<span style="letter-spacing: -0.15pt;"> </span>gồm<span style="letter-spacing: 0.6pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>nội<span style="letter-spacing: -0.15pt;"> </span>khoa<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>ngoại <span style="letter-spacing: 0.6pt;"> </span>khoa:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.1.<span style="letter-spacing: 2.85pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>nội<span style="letter-spacing: 0.6pt;"> </span>khoa:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.65pt;"> </span>Điều<span style="letter-spacing: 1.1pt;"> </span>trị<span style="letter-spacing: 1.15pt;"> </span>s<span style="letter-spacing: -0.05pt;">u</span>y<span style="letter-spacing: 0.65pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: 0.55pt;"> </span>hở<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: 0.15pt;"> </span>hai<span style="letter-spacing: 0.5pt;"> </span>lá <span style="letter-spacing: 0.05pt;"> </span>đã<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 1.5pt;"> </span>nhiều<span style="letter-spacing: -0.15pt;"> </span>tác<span style="letter-spacing: 0.25pt;"> </span>giả<span style="letter-spacing: 0.4pt;"> </span>nghiên <span style="letter-spacing: 1.65pt;"> </span>cứu<span style="letter-spacing: 0.5pt;"> </span>và<span style="letter-spacing: 1.45pt;"> </span>thống<span style="letter-spacing: 1.2pt;"> </span>nhất,<span style="letter-spacing: 2.6pt;"> </span>đầu<span style="letter-spacing: 2pt;"> </span>tiên <span style="letter-spacing: 0.15pt;"> </span>là thuốc<span style="letter-spacing: 0.7pt;"> </span>giảm<span style="letter-spacing: 0.6pt;"> </span>hậu<span style="letter-spacing: 2.2pt;"> </span>gánh,<span style="letter-spacing: 0.85pt;"></span>g<span style="letter-spacing: 0.1pt;">i</span>ảm<span style="letter-spacing: 0.65pt;"> </span>lượng<span style="letter-spacing: 0.2pt;"> </span>máu<span style="letter-spacing: 0.6pt;"> </span>phụt<span style="letter-spacing: -0.45pt;"> </span>ngược<span style="letter-spacing: 0.2pt;"> </span>lên<span style="letter-spacing: 0.8pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái,<span style="letter-spacing: 0.4pt;"> </span>giảm<span style="letter-spacing: 0.9pt;"> </span>gánh<span style="letter-spacing: 0.9pt;"> </span>nặng<span style="letter-spacing: -0.05pt;"> </span>cho<span style="letter-spacing: 0.05pt;"> </span>tim: dùng<span style="letter-spacing: -0.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>uốc ức<span style="letter-spacing: -0.1pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>men<span style="letter-spacing: -0.2pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>giãn<span style="letter-spacing: 1.55pt;"> </span>mạch <span style="letter-spacing: 0.2pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"></span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp<span style="letter-spacing: 0.7pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>phép.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 2.4pt; text-align: justify;"><span lang="EN" style="font-size: large;">.<span style="letter-spacing: 0.35pt;"> </span>Coversyl<span style="letter-spacing: -0.95pt;"> </span>4<span style="letter-spacing: 0.35pt;"> </span>mg<span style="letter-spacing: 0.25pt;"> x </span>1viên/ngày;<span style="letter-spacing: 0.65pt;"> </span>hoặc<span style="letter-spacing: 0.1pt;"> </span>renitec 5<span style="letter-spacing: 0.35pt;"> </span>mg<span style="letter-spacing: 0.15pt;"> x </span>1viên/ngày,<span style="letter-spacing: 0.65pt;"> </span>zestril<span style="letter-spacing: 0.05pt;"> </span>5<span style="letter-spacing: 0.35pt;"> </span>mg<span style="letter-spacing: 0.2pt;"> x </span>1viên/ngày;<span style="letter-spacing: 0.65pt;"> </span>hoặc hydralazin<span style="letter-spacing: -0.5pt;"> </span>25 mg<span style="letter-spacing: -0.15pt;"> x </span>1 viên/ngày.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">. Dùng<span style="letter-spacing: -0.55pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>chẹn<span style="letter-spacing: -0.7pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>C<span style="letter-spacing: -0.05pt;">a</span><span style="position: relative; top: -5pt;">++<span style="letter-spacing: 0.7pt;"> </span></span>liều<span style="letter-spacing: -0.75pt;"> </span>t<span style="letter-spacing: -0.05pt;">hấ</span>p: ma<span style="letter-spacing: -0.05pt;">d</span><span style="letter-spacing: 0.05pt;">i</span><span style="letter-spacing: -0.05pt;">p</span><span style="letter-spacing: 0.05pt;">l</span>ot<span style="letter-spacing: -0.7pt;"> </span>5 mg<span style="letter-spacing: -0.15pt;"> x </span>1 viên/<span style="letter-spacing: 0.3pt;"> </span>ngày.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">Khi<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>suy<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.35pt;"> </span>rõ,<span style="letter-spacing: 1.05pt;"> </span>loạn<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 1.8pt;"> </span>hoàn<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: -0.1pt;">o</span>àn,<span style="letter-spacing: 0.95pt;"> </span>giảm<span style="letter-spacing: 1.2pt;"> </span>chức<span style="letter-spacing: 0.25pt;"> </span>năng<span style="letter-spacing: 1.3pt;"> </span>tâm<span style="letter-spacing: 0.6pt;"> </span>thu<span style="letter-spacing: 0.35pt;"> </span>thất<span style="letter-spacing: 0.25pt;"> </span>trái<span style="letter-spacing: 0.6pt;"> </span>thì<span style="letter-spacing: 1.25pt;"> </span>dùng<span style="letter-spacing: 0.25pt;"> </span>thêm<span style="letter-spacing: 0.75pt;"> </span>lợi<span style="letter-spacing: 0.35pt;"> </span>tiểu và<span style="letter-spacing: 0.8pt;"> </span>digit<span style="letter-spacing: -0.05pt;">a</span>lis.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.45pt;"> </span>Tuy<span style="letter-spacing: 0.05pt;"> </span>vậy,<span style="letter-spacing: 1.9pt;"> </span>đối<span style="letter-spacing: 0.8pt;"> </span>với trường<span style="letter-spacing: 0.4pt;"> </span>hợp<span style="letter-spacing: 0.05pt;"> </span>hở<span style="letter-spacing: 0.4pt;"> </span>van<span style="letter-spacing: -0.05pt;"> </span>hai<span style="letter-spacing: 0.3pt;"> </span>lá<span style="letter-spacing: 1.25pt;"> </span>thực<span style="letter-spacing: 0.25pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>mức<span style="letter-spacing: 0.25pt;"> </span>độ<span style="letter-spacing: 0.85pt;"> </span>nặng<span style="letter-spacing: 0.2pt;"> </span>thì<span style="letter-spacing: 0.85pt;"> </span>điều<span style="letter-spacing: 0.85pt;"> </span>trị<span style="letter-spacing: 0.6pt;"> </span>ngoại<span style="letter-spacing: 1.45pt;"> </span>khoa<span style="letter-spacing: 0.15pt;"> </span>vẫn<span style="letter-spacing: 2pt;"> </span>là<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">phương pháp<span style="letter-spacing: -0.75pt;"> </span>tốt<span style="letter-spacing: 0.6pt;"> </span>nhất.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.2.<span style="letter-spacing: 2.85pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>ngoại:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Chỉ<span style="letter-spacing: 1.05pt;"> </span>định<span style="letter-spacing: -0.05pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"> </span>dựa<span style="letter-spacing: -0.15pt;"> </span>vào:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: -0.3pt;">Mứ</span>c<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ộ<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.3pt;">h</span>ở<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">van</span>: <span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.25pt;">địn</span>h<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">l</span><span style="letter-spacing: -0.3pt;">ượn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">bằn</span>g<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.25pt;">siê</span>u<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">â</span>m<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">ha</span>y<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">chụ</span>p<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.3pt;">buồn</span>g <span style="letter-spacing: -0.3pt;">tim.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Các<span style="letter-spacing: 0.5pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>cơ<span style="letter-spacing: -0.4pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>suy tim.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Sự<span style="letter-spacing: -0.9pt;"> </span>tiến<span style="letter-spacing: -0.75pt;"> </span>tri<span style="letter-spacing: -0.05pt;">ể</span>n<span style="letter-spacing: -0.85pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"> </span>và<span style="letter-spacing: 1pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>suy tim.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.7pt;"> </span>Hở<span style="letter-spacing: 0.7pt;"> </span>van<span style="letter-spacing: 0.2pt;"> </span>2<span style="letter-spacing: 0.7pt;"> </span>lá<span style="letter-spacing: 1.55pt;"> </span>mức<span style="letter-spacing: 0.5pt;"> </span>độ<span style="letter-spacing: 1.25pt;"> </span>nặng<span style="letter-spacing: 0.45pt;"> </span>(độ<span style="letter-spacing: 1.15pt;"> </span>3,<span style="letter-spacing: 0.7pt;"> </span>4)<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.35pt;"> </span>kèm<span style="letter-spacing: 2.55pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>iệu<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: 0.4pt;"> </span>cơ<span style="letter-spacing: 0.3pt;"> </span>năng <span style="letter-spacing: 0.05pt;"> </span>rõ<span style="letter-spacing: 1.35pt;"> </span>(suy<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>theo<span style="letter-spacing: 0.5pt;"> </span>NYHA<span style="letter-spacing: 0.35pt;"> </span>3,4) thì<span style="letter-spacing: 0.4pt;"> </span>cần<span style="letter-spacing: -0.15pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"></span>ngay.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.3pt;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.35pt;"> </span>Hở<span style="letter-spacing: 0.35pt;"> </span>van<span style="letter-spacing: -0.15pt;"> </span>2<span style="letter-spacing: 0.35pt;"> </span>lá<span style="letter-spacing: 1.2pt;"> </span>nặng<span style="letter-spacing: 0.1pt;"> </span>(độ<span style="letter-spacing: 0.8pt;"> </span>3,<span style="letter-spacing: 0.35pt;"> </span>4)<span style="letter-spacing: 0.35pt;"> </span>nhưng<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.1pt;">c</span><span style="letter-spacing: -0.05pt;">á</span>c<span style="letter-spacing: 0.4pt;"> </span>triệu<span style="letter-spacing: -0.3pt;"> </span>chứng<span style="letter-spacing: 0.1pt;"> </span>cơ năng<span style="letter-spacing: 2.35pt;"> </span>nhẹ<span style="letter-spacing: -0.3pt;"> </span>NYHA<span style="letter-spacing: 0.05pt;"> </span>2<span style="letter-spacing: 0.4pt;"> </span>thì<span style="letter-spacing: 0.8pt;"> </span>cần<span style="letter-spacing: 0.25pt;"> </span>được<span style="letter-spacing: 1.2pt;"> </span>theo<span style="letter-spacing: 0.15pt;"> </span>dõi </span><span lang="EN">sát.<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.05pt;"> </span>Nếu<span style="letter-spacing: -0.75pt;"> </span>đường<span style="letter-spacing: 0.05pt;"> </span>kính<span style="letter-spacing: 0.35pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>trái<span style="letter-spacing: -0.05pt;"> </span>ngày<span style="letter-spacing: 1.1pt;"> </span>càng<span style="letter-spacing: 0.8pt;"> </span>lớn<span style="letter-spacing: -0.05pt;"> </span>(nhĩ<span style="letter-spacing: 1.15pt;"> </span>trái,<span style="letter-spacing: -0.05pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>trái),<span style="letter-spacing: 0.5pt;"> </span>xuất<span style="letter-spacing: 1.9pt;"> </span>hiện<span style="letter-spacing: -0.75pt;"> </span>ru<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.05pt;"> </span>nhĩ<span style="letter-spacing: 0.65pt;"> </span>thì<span style="letter-spacing: 0.35pt;"> </span>cần<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.35pt;">đ</span>ược<span style="letter-spacing: 0.8pt;"> </span>điều </span><span lang="EN">trị<span style="letter-spacing: 0.15pt;"> </span>ngoại<span style="letter-spacing: 1pt;"> </span>kh<span style="letter-spacing: -0.1pt;">o</span>a.<o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Các<span style="letter-spacing: 0.5pt;"> </span>yếu<span style="letter-spacing: -0.7pt;"> </span>tố<span style="letter-spacing: 0.6pt;"> </span>tiên<span style="letter-spacing: 0.35pt;"> </span>lượng nặng<span style="letter-spacing: -0.25pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN" style="font-size: large;">- Tuổi<span style="letter-spacing: 0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân,<span style="letter-spacing: 0.25pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.1pt;"> </span>độ<span style="letter-spacing: 1.3pt;"> </span>suy tim,<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">k</span>ết<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ợp<span style="letter-spacing: -0.25pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>vành...<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">- Chỉ<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>tim/lồng<span style="letter-spacing: 0.4pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>70%.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">- Chỉ<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>tố<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.6pt;"> </span>máu:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt;"><span lang="EN" style="font-size: large;">. Phân<span style="letter-spacing: 0.25pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>tống<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>50-55%.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. Phân<span style="letter-spacing: 0.25pt;"> </span>suất<span style="letter-spacing: 1.9pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>ngắn<span style="letter-spacing: -0.25pt;"> </span>sợi<span style="letter-spacing: -0.15pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>25%.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">- Các chỉ<span style="letter-spacing: 0.95pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>th<span style="letter-spacing: -0.05pt;">u</span>:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. <span style="letter-spacing: -0.05pt;">Đ</span>ường kính<span style="letter-spacing: 0.25pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.4pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>50mm<span style="letter-spacing: -0.3pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>25mm/<span style="letter-spacing: -0.05pt;">m<span style="position: relative; top: -5pt;">2</span></span>.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. Chỉ<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ể<span style="letter-spacing: -0.8pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span>t<span style="letter-spacing: 1.85pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.4pt;"> </span>thu<span style="letter-spacing: -0.2pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>60-70ml/m<span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.6pt;"><span lang="EN" style="font-size: large;">- Chỉ<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>giảm<span style="letter-spacing: 0.4pt;"> </span>≤<span style="letter-spacing: 0.25pt;"> </span>2<span style="letter-spacing: -0.05pt;"> </span>lít/phút/m<span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>,<span style="letter-spacing: 0.5pt;"> </span>áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>100 mmHg.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.85pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: -0.5pt;">- <span style="letter-spacing: -0.05pt;">á</span>p<span style="letter-spacing: -0.4pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.25pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.4pt;"> </span>trương ≥<span style="letter-spacing: 0.2pt;"> </span>12mmHg.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 3.15pt;"><span lang="EN" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Có<span style="letter-spacing: 0.15pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ương pháp<span style="letter-spacing: 0.4pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị<span style="letter-spacing: 0.15pt;"> </span>ngoại<span style="letter-spacing: 1pt;"> </span>khoa:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">- <span style="letter-spacing: 0.85pt;"> </span>Sửa<span style="letter-spacing: -0.45pt;"> </span>van<span style="letter-spacing: -0.05pt;"> </span>và<span style="letter-spacing: -0.7pt;"> </span>dây<span style="letter-spacing: 1.9pt;"> </span>chằng: <span style="letter-spacing: 0.55pt;"> </span>can<span style="letter-spacing: 0.3pt;"> </span>thiệp<span style="letter-spacing: -0.55pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>vòng<span style="letter-spacing: 0.7pt;"> </span>van,<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 1.3pt;"> </span>van,<span style="letter-spacing: -0.15pt;"> </span>d<span style="letter-spacing: 0.1pt;">â</span>y<span style="letter-spacing: 0.8pt;"> </span>chằng,<span style="letter-spacing: 1.15pt;"> </span>cột<span style="letter-spacing: 0.3pt;"> </span>cơ:<span style="letter-spacing: 0.95pt;"> </span>đánh<span style="letter-spacing: -0.6pt;"> </span>đai,<span style="letter-spacing: 1.35pt;"> </span>khâu <span style="letter-spacing: 0.45pt;"> </span>hẹp vòng<span style="letter-spacing: 0.5pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.1pt;"> </span>lá,<span style="letter-spacing: -0.35pt;"> </span>khâu<span style="letter-spacing: 0.25pt;"> </span>vùi<span style="letter-spacing: -0.55pt;"> </span>bớt<span style="letter-spacing: 0.1pt;"> </span>dây<span style="letter-spacing: 1.25pt;"> </span>chằng<span style="letter-spacing: 1.65pt;"> </span>vào<span style="letter-spacing: -0.35pt;"> </span>cột<span style="letter-spacing: 0.1pt;"> </span>cơ<span style="letter-spacing: 0.85pt;"> </span>trong tr<span style="letter-spacing: -0.05pt;">ư</span>ờng<span style="letter-spacing: 0.25pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>sa<span style="letter-spacing: 0.25pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.1pt;"> </span>lá,<span style="letter-spacing: 0.95pt;"> </span>cắt<span style="letter-spacing: 0.1pt;"> </span>mảng<span style="letter-spacing: 1.6pt;"> </span>vôi<span style="letter-spacing: 0.15pt;"> </span>hóa ở lá<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá,<span style="letter-spacing: -0.6pt;"> </span>khâu<span style="letter-spacing: 2.5pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>thủng<span style="letter-spacing: -0.3pt;"> </span>ở lá<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"></span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Thay<span style="letter-spacing: -0.25pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.1pt;"> </span>lá<span style="letter-spacing: 0.05pt;"> </span>bằng <span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>nhân<span style="letter-spacing: 1.9pt;"> </span>tạo:<span style="letter-spacing: -0.3pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>nhân<span style="letter-spacing: 2.45pt;"> </span>tạo<span style="letter-spacing: -0.3pt;"> </span>làm<span style="letter-spacing: 0.25pt;"> </span>bằng<span style="letter-spacing: 1.25pt;"> </span>chất<span style="letter-spacing: 2.25pt;"> </span>dẻo,<span style="letter-spacing: -0.6pt;"> </span>tương<span style="letter-spacing: 0.25pt;"> </span>đối<span style="letter-spacing: 0.6pt;"> </span>bền<span style="letter-spacing: -0.45pt;"> </span>nhưng<span style="letter-spacing: 0.25pt;"> </span>phải dùng<span style="letter-spacing: 1.25pt;"> </span>thuốc<span style="letter-spacing: 2pt;"> </span>chống<span style="letter-spacing: 2.05pt;"></span>đông<span style="letter-spacing: 2.05pt;"> </span>kéo<span style="letter-spacing: 0.6pt;"> </span>dài<span style="letter-spacing: 2.05pt;"> </span>(n<span style="letter-spacing: -0.05pt;">h</span>ư<span style="letter-spacing: 1.45pt;"> </span>sintrome<span style="letter-spacing: 1.1pt;"> </span>1mg/ngày).<span style="letter-spacing: 1.7pt;"> </span>Nếu<span style="letter-spacing: 0.6pt;"> </span>dùng<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: -1.15pt;"> </span>vật thì<span style="letter-spacing: -0.55pt;"> </span>ít<span style="letter-spacing: 2.2pt;"> </span>có<span style="letter-spacing: 2.15pt;"> </span>biến chứng<span style="letter-spacing: -0.2pt;"> </span>đông<span style="letter-spacing: -0.3pt;"> </span>máu<span style="letter-spacing: 1.05pt;"> </span>hơn<span style="letter-spacing: 1.2pt;"> </span>nhưng<span style="letter-spacing: 0.1pt;"> </span>theo<span style="letter-spacing: -0.05pt;"> </span>thời<span style="letter-spacing: -0.05pt;"></span>gian<span style="letter-spacing: -0.05pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>vẫn<span style="letter-spacing: 1.7pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>thể<span style="letter-spacing: -0.6pt;"> </span>bị<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ơ<span style="letter-spacing: 0.65pt;"> </span>cứng,<span style="letter-spacing: -0.15pt;"> </span>vôi<span style="letter-spacing: 0.7pt;"> </span>hoá<span style="letter-spacing: 0.85pt;"> </span>do lắng<span style="letter-spacing: -0.05pt;"> </span>đọng<span style="letter-spacing: 0.35pt;"> </span>fibrin<span style="letter-spacing: -0.1pt;"> </span>và canxi.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN" style="font-size: large;">+<span style="letter-spacing: 0.7pt;"> </span>Sau<span style="letter-spacing: -0.15pt;"> </span>mổ<span style="letter-spacing: 1.35pt;"> </span>sửa<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>hay<span style="letter-spacing: 0.6pt;"> </span>thay<span style="letter-spacing: 0.55pt;"> </span>van,<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>nhân<span style="letter-spacing: 1pt;"> </span>cần<span style="letter-spacing: 0.6pt;"> </span>được<span style="letter-spacing: 1.6pt;"> </span>theo<span style="letter-spacing: 0.55pt;"> </span>dõi<span style="letter-spacing: 1.35pt;"> </span>kiểm tra<span style="letter-spacing: 0.6pt;"> </span>định<span style="letter-spacing: 1.3pt;"> </span>kỳ<span style="letter-spacing: 0.75pt;"> </span>mỗi<span style="letter-spacing: 1.3pt;"> </span>tháng<span style="letter-spacing: 1.1pt;"> </span>một lần<span style="letter-spacing: 0.2pt;"> </span>trong<span style="letter-spacing: 0.1pt;"> </span>thời<span style="letter-spacing: 0.15pt;"> </span>gian<span style="letter-spacing: 0.15pt;"> </span>6<span style="letter-spacing: 0.35pt;"></span>th<span style="letter-spacing: -0.1pt;">á</span>ng<span style="letter-spacing: 0.85pt;"> </span>đầu,<span style="letter-spacing: 0.7pt;"> </span>sau<span style="letter-spacing: 0.35pt;"> </span>đó<span style="letter-spacing: 0.8pt;"> </span>2-3<span style="letter-spacing: 0.35pt;"> </span>tháng<span style="letter-spacing: 0.7pt;"> </span>kiểm<span style="letter-spacing: -0.35pt;"> </span>tra<span style="letter-spacing: 0.2pt;"> </span>một<span style="letter-spacing: 0.15pt;"> </span>lần<span style="letter-spacing: 0.2pt;"> </span>trong<span style="letter-spacing: 0.1pt;"> </span>suốt<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>h<span style="letter-spacing: -0.05pt;">ờ</span>i<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.05pt;">g</span><span style="letter-spacing: 0.05pt;">i</span>an<span style="letter-spacing: 0.2pt;"> </span>sau<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>hay<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an <span style="position: relative; top: 0.5pt;">để phát<span style="letter-spacing: 1.55pt;"> </span>hiện<span style="letter-spacing: -0.9pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ứng<span style="letter-spacing: -0.1pt;"> </span>và<span style="letter-spacing: 0.1pt;"> </span>đánh<span style="letter-spacing: 1.3pt;"> </span>giá<span style="letter-spacing: 1.4pt;"></span>chức<span style="letter-spacing: -0.25pt;"> </span>nă<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.7pt;"> </span>tâm<span style="letter-spacing: 0.1pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: -0.4pt;"> </span>tim.</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">- Các chỉ<span style="letter-spacing: 0.95pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>là:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. Còn<span style="letter-spacing: 0.2pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>không,<span style="letter-spacing: 0.25pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">.<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.4pt;">The</span>o<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.4pt;">dõ</span>i<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: 0.3pt;">á</span>p <span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.4pt;">lự</span>c<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.4pt;">độn</span>g<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: 0.35pt;">mạc</span>h<span style="letter-spacing: 2.45pt;"> </span><span style="letter-spacing: 0.4pt;">phổi</span>,<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.4pt;">c</span>ó<span style="letter-spacing: 2.6pt;"> </span><span style="letter-spacing: 0.4pt;">h</span>ở<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.35pt;">v</span><span style="letter-spacing: 0.45pt;">a</span>n<span style="letter-spacing: 1.5pt;"> </span>3<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>á <span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.35pt;">v</span>à <span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: 0.45pt;">c</span>ó<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.4pt;">r</span><span style="letter-spacing: 0.35pt;">à</span>n <span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: 0.4pt;">dịc</span>h<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.35pt;">m</span><span style="letter-spacing: 0.4pt;">à</span><span style="letter-spacing: 0.35pt;">n</span>g<span style="letter-spacing: 2.65pt;"> </span><span style="letter-spacing: 0.35pt;">ngo</span><span style="letter-spacing: 0.4pt;">à</span>i<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: 0.4pt;">ti</span>m<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.4pt;">h</span><span style="letter-spacing: 0.45pt;">a</span>y <span style="letter-spacing: 0.4pt;">không?</span><o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">. Độ<span style="letter-spacing: 1.35pt;"> </span>chênh <span style="letter-spacing: 0.7pt;"> </span>áp<span style="letter-spacing: -0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. Biến<span style="letter-spacing: 0.2pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>chống<span style="letter-spacing: 0.55pt;"> </span>đông<span style="letter-spacing: 0.55pt;"> </span>máu.<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font-size: 12pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: large;">. Đánh<span style="letter-spacing: 1.8pt;"> </span>giá<span style="letter-spacing: -0.7pt;"> </span>tình<span style="letter-spacing: 1pt;"> </span>trạng<span style="letter-spacing: 0.4pt;"> </span>suy<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>au<span style="letter-spacing: -0.05pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ẫ</span>u<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>thay<span style="letter-spacing: -0.2pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá.<o:p></o:p></span></div><div><span lang="EN" style="font-size: large;"><br />
</span></div></div></td></tr>
</tbody></table>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-52152664823730268132011-04-30T19:59:00.000-07:002011-04-30T19:59:40.836-07:00-LOẠN NHỊP TIM VÀ ĐIỀU TRỊ<div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.45pt; text-align: center;"><span class="Apple-style-span" style="color: blue; font-size: large;"><span style="font-weight: bold;">Loạn<span style="letter-spacing: -1.5pt;"> </span>nh<span style="letter-spacing: 0.05pt;">ị</span>p<span style="letter-spacing: -0.35pt;"> </span>tim<span style="letter-spacing: 0.6pt;"> </span>và<span style="letter-spacing: -0.4pt;"> </span>điều<span style="letter-spacing: -2.25pt;"> </span><span style="letter-spacing: 0.05pt;">t</span><span style="letter-spacing: -0.05pt;">r</span>ị</span><o:p></o:p></span></div><div style="font-family: Geneva, Arial, Helvetica, sans-serif; text-align: center;"></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.8pt; text-align: center;"><span class="Apple-style-span" style="color: blue; font-size: large;"><span style="font-weight: bold;">(Dysrhythmias<span style="letter-spacing: -0.2pt;"> </span>and<span style="letter-spacing: 1.9pt;"> </span>therapy)</span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.8pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"></span></span><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.<span style="letter-spacing: -0.1pt;"> </span>Phần<span style="letter-spacing: -1.05pt;"> </span>đại<span style="letter-spacing: -0.9pt;"> </span>c</span><span lang="VI">ư<span style="font-weight: bold; letter-spacing: 0.05pt;">ơng:</span></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.1.<span style="letter-spacing: -0.2pt;"> </span>Khái <span style="letter-spacing: 0.05pt;"><span> </span></span>niệm:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">Loạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 0.95pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>là<span style="letter-spacing: 0.95pt;"> </span>sự<span style="letter-spacing: 0.1pt;"> </span>rối<span style="letter-spacing: 0.75pt;"> </span>loạn<span style="letter-spacing: 0.55pt;"> </span>h<span style="letter-spacing: -0.1pt;">o</span>ạt<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.9pt;"> </span>điện<span style="letter-spacing: 0.8pt;"> </span>sinh<span style="letter-spacing: -0.1pt;"> </span>học<span style="letter-spacing: 0.75pt;"> </span>của<span style="letter-spacing: -0.25pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>về<span style="letter-spacing: -1.1pt;"> </span>ba mặt:<span style="letter-spacing: -0.1pt;"> </span>sự<span style="letter-spacing: 0.1pt;"> </span>tạo<span style="letter-spacing: -0.15pt;"> </span>thành<span style="letter-spacing: 1.8pt;"> </span>xung<span style="letter-spacing: 0.1pt;"> </span>động, dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"></span><span style="letter-spacing: -0.05pt;">x</span>ung<span style="letter-spacing: 0.05pt;"> </span>động,<span style="letter-spacing: 0.25pt;"> </span>sự phối<span style="letter-spacing: 0.4pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>giữa<span style="letter-spacing: -0.2pt;"> </span>tạo<span style="letter-spacing: 0.6pt;"> </span>thành <span style="letter-spacing: 0.6pt;"><span> </span></span>và<span style="letter-spacing: -0.45pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"> </span>xung động.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Rối<span style="letter-spacing: 1.35pt;"> </span>loạn<span style="letter-spacing: 0.4pt;"> </span>nhịp<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>nhiều<span style="letter-spacing: -0.4pt;"> </span>loại,<span style="letter-spacing: 0.9pt;"> </span>gặp<span style="letter-spacing: 0.1pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>tất<span style="letter-spacing: 2.35pt;"> </span>cả<span style="letter-spacing: 0.7pt;"> </span>các<span style="letter-spacing: 1.9pt;"> </span>kh<span style="letter-spacing: -0.1pt;">o</span>a<span style="letter-spacing: 0.2pt;"> </span>lâm<span style="letter-spacing: 2.4pt;"> </span>sàng<span style="letter-spacing: 2pt;"> </span>và<span style="letter-spacing: -0.35pt;"> </span>ngay<span style="letter-spacing: 0.2pt;"> </span>cả<span style="letter-spacing: 1.2pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>những<span style="letter-spacing: 0.45pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ười</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">bình <span style="letter-spacing: 0.05pt;">t</span></span><span lang="VI" style="line-height: 22px;">hường,</span><span lang="VI" style="letter-spacing: 0.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">một<span style="letter-spacing: -0.15pt;"></span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">bệnh<span style="letter-spacing: -0.65pt;"> </span>cùng<span style="letter-spacing: -0.4pt;"> </span>một<span style="letter-spacing: -0.15pt;"> </span>lúc<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.7pt;"> </span>thể<span style="letter-spacing: -0.7pt;"> </span>gặp<span style="letter-spacing: -0.3pt;"> </span>nhiều<span style="letter-spacing: -0.75pt;"> </span>loại<span style="letter-spacing: 0.4pt;"> </span>rối<span style="letter-spacing: 0.7pt;"> </span>loạn<span style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>khác<span style="letter-spacing: 0.45pt;"> </span>nhau,<span style="letter-spacing: -0.2pt;"> </span>mặt<span style="letter-spacing: -0.15pt;"> </span>khác<span style="letter-spacing: 0.45pt;"> </span>từ rối<span style="letter-spacing: 0.95pt;"> </span>loạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>này<span style="letter-spacing: 0.8pt;"></span>có<span style="letter-spacing: 0.85pt;"> </span>thể<span style="letter-spacing: -0.45pt;"> </span>chuyển<span style="letter-spacing: -0.4pt;"> </span>thành<span style="letter-spacing: 1.65pt;"> </span>các<span style="letter-spacing: 0.15pt;"> </span>rối<span style="letter-spacing: 0.95pt;"> </span>loạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>khác.<span style="letter-spacing: 0.65pt;"> </span>Ngay cả<span style="letter-spacing: 0.5pt;"> </span>các<span style="letter-spacing: 1.7pt;"> </span>thuốc<span style="letter-spacing: 0.75pt;"> </span>điều<span style="letter-spacing: 0.95pt;"> </span>trị<span style="letter-spacing: 0.55pt;"> </span>rối loạn<span style="letter-spacing: 1.6pt;"> </span>nhịp<span style="letter-spacing: -1.2pt;"> </span>tim<span style="letter-spacing: 1pt;"> </span>cũng<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>thể<span style="letter-spacing: 0.4pt;"></span>gây<span style="letter-spacing: -1pt;"> </span>rối<span style="letter-spacing: 1.8pt;"> </span>loạn<span style="letter-spacing: 1.6pt;"> </span>nhịp<span style="letter-spacing: -1.2pt;"> </span>tim.<span style="letter-spacing: 0.95pt;"> </span>Nếu<span style="letter-spacing: 0.3pt;"> </span>phân<span style="letter-spacing: -1.15pt;"> </span>tích<span style="letter-spacing: -0.85pt;"> </span>kỹ<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.1pt;">l</span></span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ỡng<span style="letter-spacing: 1.15pt;"> </span>từng<span style="letter-spacing: 0.95pt;"> </span>tr</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ờng<span style="letter-spacing: 1.15pt;"> </span>hợp<span style="letter-spacing: 0.8pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>loại loạn<span style="letter-spacing: 0.5pt;"> </span>nhịp<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: 0.45pt;"> </span>cần<span style="letter-spacing: 0.4pt;"> </span>thiết<span style="letter-spacing: -0.3pt;"> </span>phải<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span style="letter-spacing: 0.05pt;">i</span>ều<span style="letter-spacing: 0.6pt;"> </span>trị,<span style="letter-spacing: 1pt;"></span></span><span lang="VI" style="line-height: 22px;">nhưng</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">cũng<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>khi<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>những<span style="letter-spacing: 0.6pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>l<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 0.4pt;"> </span>nhịp<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: 0.45pt;"> </span>không<span style="letter-spacing: 0.85pt;"> </span>cần<span style="letter-spacing: 0.45pt;"> </span>phải điều<span style="letter-spacing: 0.45pt;"> </span>trị,<span style="letter-spacing: 0.65pt;"> </span>những<span style="letter-spacing: 0.05pt;"> </span>vấn<span style="letter-spacing: 1.6pt;"> </span>đề<span style="letter-spacing: 0.2pt;"> </span>này<span style="letter-spacing: 1.25pt;"> </span>các<span style="letter-spacing: 1.05pt;"> </span>t<span style="letter-spacing: -0.15pt;">h</span>ầy<span style="letter-spacing: -0.15pt;"> </span>thuốc<span style="letter-spacing: 0.6pt;"> </span>cần<span style="letter-spacing: -0.05pt;"></span>phải<span style="letter-spacing: 0.55pt;"> </span>nắm<span style="letter-spacing: -0.1pt;"> </span>vững<span style="letter-spacing: -0.45pt;"> </span>để<span style="letter-spacing: 0.75pt;"> </span>đ<span style="letter-spacing: -0.25pt;">á</span>p<span style="letter-spacing: 0.05pt;"> </span>ứng<span style="letter-spacing: 0.05pt;"> </span>yêu<span style="letter-spacing: 0.4pt;"> </span>cầu<span style="letter-spacing: -0.1pt;"> </span>thực<span style="letter-spacing: -0.15pt;"> </span>tiễn<span style="letter-spacing: -0.7pt;"> </span>trong<span style="letter-spacing: -0.2pt;"> </span>lâm sàng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.45pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold; position: relative; top: 0.5pt;">1.2.<span style="letter-spacing: -0.2pt;"> </span>Nguyên <span style="letter-spacing: 0.25pt;"><span> </span></span>nhân:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Rối<span style="letter-spacing: 1.4pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>tim<span style="letter-spacing: 0.4pt;"> </span>chức<span style="letter-spacing: 0.3pt;"> </span>năng:<span style="letter-spacing: 0.8pt;"> </span>xuất<span style="letter-spacing: 2.4pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>ở<span style="letter-spacing: 0.55pt;"> </span>những<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span><span lang="VI">ười</span><span lang="VI" style="letter-spacing: 0.55pt;"> </span>bình<span style="letter-spacing: 0.8pt;"> </span><span lang="VI">thường</span><span lang="VI" style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>rối<span style="letter-spacing: 1.2pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>tâm<span style="letter-spacing: 1.35pt;"> </span>lý;<span style="letter-spacing: 0.4pt;"> </span>lao động<span style="letter-spacing: 0.3pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức;<span style="letter-spacing: -0.2pt;"></span>liên<span style="letter-spacing: 0.35pt;"> </span>quan<span style="letter-spacing: -0.25pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>ăn<span style="letter-spacing: 0.65pt;"> </span>uống;<span style="letter-spacing: 0.55pt;"> </span>hút<span style="letter-spacing: -0.3pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>lá;<span style="letter-spacing: 0.65pt;"> </span>uống<span style="letter-spacing: 0.45pt;"> </span>chè,<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.05pt;">r</span><span lang="VI">ượu, cà</span><span lang="VI" style="letter-spacing: 0.75pt;"> </span>phê...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.45pt;"> </span>Rối<span style="letter-spacing: 1.3pt;"> </span>loạn<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hịp<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>thực<span style="letter-spacing: 0.25pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>do<span style="letter-spacing: 0.35pt;"> </span>tổn<span style="letter-spacing: 1.05pt;"> </span></span><span lang="VI" style="line-height: 22px;">thương</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">thực<span style="letter-spacing: 0.25pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>tại<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span></span><span lang="VI" style="line-height: 22px;">như:</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">t<span style="letter-spacing: -0.05pt;">h</span>iếu<span style="letter-spacing: -0.35pt;"> </span>máu<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: 0.2pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ồi<span style="letter-spacing: 1.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">máu cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">v</span><span style="letter-spacing: 0.05pt;">i</span>êm<span style="letter-spacing: 2pt;"></span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: -0.2pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>bẩm<span style="letter-spacing: 1.85pt;"> </span>si<span style="letter-spacing: -0.05pt;">n</span>h...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.45pt;"> </span>Rối<span style="letter-spacing: 1.3pt;"> </span>loạn<span style="letter-spacing: 0.35pt;"> </span>nhịp<span style="letter-spacing: 1.5pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>do<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.25pt;"> </span>của<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: 1.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.9pt; line-height: 22px;"> </span><span style="line-height: 22px;">quan<span style="letter-spacing: 0.2pt;"> </span>khác,<span style="letter-spacing: 2.4pt;"> </span>ví<span style="letter-spacing: 0.4pt;"> </span>dụ:<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.1pt;">c</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">chức<span style="letter-spacing: 0.2pt;"> </span>năng<span style="letter-spacing: 0.7pt;"> </span>tuyến<span style="letter-spacing: -0.35pt;"> </span>giáp,<span style="letter-spacing: 0.8pt;"> </span>bệnh viêm<span style="letter-spacing: 1.5pt;"> </span>phổi-phế<span style="letter-spacing: 0.75pt;"></span>quản<span style="letter-spacing: 1.6pt;"> </span>cấp<span style="letter-spacing: 2.95pt;"> </span>hay<span style="letter-spacing: 1.05pt;"> </span>mạn<span style="letter-spacing: 1.65pt;"> </span>tính,<span style="letter-spacing: -0.95pt;"> </span>thiếu<span style="letter-spacing: 0.45pt;"> </span>máu,<span style="letter-spacing: 1.6pt;"> </span>r<span style="letter-spacing: -0.05pt;">ố</span>i<span style="letter-spacing: 1.8pt;"> </span>loạn<span style="letter-spacing: 1.65pt;"> </span>thăng<span style="letter-spacing: -1.1pt;"> </span>bằng<span style="letter-spacing: 1.6pt;"> </span>kiềm-toan<span style="letter-spacing: 0.2pt;"> </span>và<span style="letter-spacing: 0.6pt;"> </span>điện <span style="letter-spacing: 0.55pt;"><span> </span></span>giải, <span style="letter-spacing: 0.3pt;"><span> </span></span>do thuốc<span style="letter-spacing: 0.5pt;"> </span>...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.3.<span style="letter-spacing: -0.2pt;"> </span>Bệnh<span style="letter-spacing: 0.25pt;"> </span>sinh<span style="letter-spacing: 1.2pt;"> </span>của<span style="letter-spacing: -0.85pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span>nhịp<span style="letter-spacing: 0.2pt;"> </span>tim:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: 0.2pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ủa<span style="letter-spacing: -0.35pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hịp<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>phức<span style="letter-spacing: -0.25pt;"> </span>tạp,<span style="letter-spacing: 0.55pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>ch<span lang="VI" style="letter-spacing: -0.05pt;">ư</span>a rõ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI" style="line-height: 22px;">Nhưng</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">cũng<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>nhiều<span style="letter-spacing: -0.25pt;"> </span>vấn<span style="letter-spacing: 2.1pt;"> </span>đề <span style="letter-spacing: 0.15pt;"><span> </span></span>đã<span style="letter-spacing: 0.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">sáng<span style="letter-spacing: 2.1pt;"> </span>tỏ:<span style="letter-spacing: 1.15pt;"> </span>những<span style="letter-spacing: 0.55pt;"> </span>yếu<span style="letter-spacing: -0.15pt;"> </span>tố<span style="letter-spacing: 1.15pt;"> </span>nguy<span style="letter-spacing: 0.55pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">và<span style="letter-spacing: 0.85pt;"> </span>nguyên<span style="letter-spacing: 1.15pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>đã<span style="letter-spacing: -0.45pt;"> </span>gây <span style="letter-spacing: 1.75pt;"><span> </span></span>ra những<span style="letter-spacing: 0.3pt;"> </span>biến<span style="letter-spacing: -0.55pt;"></span>đổi<span style="letter-spacing: 0.65pt;"> </span>chức<span style="letter-spacing: 0.05pt;"> </span>năng<span style="letter-spacing: 0.55pt;"> </span>hoặc<span style="letter-spacing: 0.05pt;"> </span>thực<span style="letter-spacing: 0.1pt;"> </span>thể<span style="letter-spacing: -0.45pt;"> </span>hệ<span style="letter-spacing: -0.4pt;"> </span>thần<span style="letter-spacing: 0.1pt;"> </span>kinh<span style="letter-spacing: 0.1pt;"> </span>tự<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>của<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>(nút<span style="letter-spacing: -0.1pt;"> </span>xoang, <span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.15pt;"> </span>truyền nhĩ-thất,<span style="letter-spacing: -0.4pt;"> </span>nút<span style="letter-spacing: -0.3pt;"> </span>Tawara,<span style="letter-spacing: -0.8pt;"></span>bó<span style="letter-spacing: 0.55pt;"> </span>His...) và<span style="letter-spacing: 0.3pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Rối <span style="letter-spacing: 3pt;"><span> </span></span>loạn<span style="letter-spacing: 1.55pt;"> </span>cân <span style="letter-spacing: 0.1pt;"><span> </span></span>bằng<span style="letter-spacing: 1.65pt;"> </span>của <span style="letter-spacing: 1.8pt;"><span> </span></span>hệ <span style="letter-spacing: 1.45pt;"><span> </span></span>giao <span style="letter-spacing: 1.9pt;"><span> </span></span>cảm<span style="letter-spacing: 1.65pt;"> </span>(a<span style="letter-spacing: -0.05pt;">d</span>ren<span style="letter-spacing: -0.05pt;">a</span>lin, <span style="letter-spacing: 1.65pt;"><span> </span></span>nor-adrenalin) <span style="letter-spacing: 1.45pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">v</span>à<span> </span><span style="letter-spacing: -0.85pt;"><span> </span></span>hệ <span style="letter-spacing: 1.45pt;"><span> </span></span>phó <span style="letter-spacing: 2.5pt;"><span> </span></span>giao <span style="letter-spacing: 1.95pt;"><span> </span></span>cảm (acet<span style="letter-spacing: -0.05pt;">y</span><span style="letter-spacing: 0.05pt;">l</span>cholin).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span><span lang="VI">hưng phấn</span><span lang="VI" style="letter-spacing: 1.7pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>ức<span style="letter-spacing: -0.1pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>thụ<span style="letter-spacing: -0.3pt;"> </span>cảm<span style="letter-spacing: 0.45pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.05pt;">b</span>êta giao<span style="letter-spacing: -0.2pt;"> </span>cảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Rối<span style="letter-spacing: 1.05pt;"> </span>loạn<span style="letter-spacing: 0.4pt;"> </span>quá trình<span style="letter-spacing: 1.85pt;"> </span>khử<span style="letter-spacing: 0.2pt;"> </span>cực<span style="letter-spacing: 0.05pt;"> </span>và<span style="letter-spacing: 0.65pt;"> </span>tái<span style="letter-spacing: 1.4pt;"> </span>cực<span style="letter-spacing: 0.05pt;"> </span>màng<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: -0.15pt;"> </span>tế<span style="letter-spacing: -0.55pt;"> </span>bào<span style="letter-spacing: 1.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim, tế<span style="letter-spacing: -0.55pt;"> </span>bào<span style="letter-spacing: 0.7pt;"> </span>thuộc<span style="letter-spacing: -0.05pt;"> </span>hệ<span style="letter-spacing: -0.5pt;"> </span>thần kinh tự<span style="letter-spacing: 0.1pt;"> </span>động của<span style="letter-spacing: -0.35pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 26px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 28px;">Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>hệ<span style="letter-spacing: -0.7pt;"> </span>men<span style="letter-spacing: -0.2pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>(ATPaza),<span style="letter-spacing: -1pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 0.9pt;"> </span>giải<span style="letter-spacing: 0.25pt;"> </span>đồ<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>máu:<span style="letter-spacing: 0.4pt;"> </span>natri,<span style="letter-spacing: -0.3pt;"> </span>kali,<span style="letter-spacing: -0.2pt;"> </span>can<span style="letter-spacing: -0.05pt;">x</span>i,<span style="letter-spacing: -0.1pt;"> </span>magie... Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"></span></span><span lang="VI" style="line-height: 28px;">hướng dẫn</span><span lang="VI" style="letter-spacing: 1.85pt; line-height: 28px;"> </span><span style="line-height: 28px;">truyền<span style="letter-spacing: -0.95pt;"> </span>xung động<span style="letter-spacing: 0.3pt;"> </span>(thuyết<span style="letter-spacing: -0.7pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>lại-Reentry).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">Xung<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 2.4pt;"> </span>đi<span style="letter-spacing: -0.2pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="position: relative; top: 0.5pt;">những đường dẫn</span><span lang="VI" style="letter-spacing: 1.85pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">truyền<span style="letter-spacing: -0.95pt;"> </span>tắt<span style="letter-spacing: -0.1pt;"> </span>(<span style="letter-spacing: -0.05pt;">v</span>í dụ:<span style="letter-spacing: -0.3pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>Wolf-Parkinson-Wite:WPW).</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.4.<span style="letter-spacing: -0.2pt;"> </span>Biểu<span style="letter-spacing: 1.9pt;"> </span>hiện<span style="letter-spacing: 0.8pt;"> </span>lâm<span style="letter-spacing: 0.1pt;"> </span>sàng<span style="letter-spacing: 0.35pt;"> </span>của<span style="letter-spacing: -0.85pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span>nhịp:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">Lâm<span style="letter-spacing: 1.15pt;"> </span>sàng<span style="letter-spacing: -0.1pt;"> </span>của<span style="letter-spacing: -0.3pt;"> </span>rối<span style="letter-spacing: 0.7pt;"> </span>loạn<span style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.1pt;"> c</span>ũng<span style="letter-spacing: -0.35pt;"> </span>phức<span style="letter-spacing: -0.2pt;"> </span>tạp<span style="letter-spacing: 1.3pt;"> </span>và<span style="letter-spacing: 0.35pt;"> </span>phụ<span style="letter-spacing: -0.5pt;"> </span>thuộc<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ào<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>ừng thể<span style="letter-spacing: -0.7pt;"> </span>bệnh,<span style="letter-spacing: -0.75pt;"> </span>từng<span style="letter-spacing: -0.15pt;"> </span>loại<span style="letter-spacing: 1.8pt;"> </span>và<span style="letter-spacing: -0.05pt;"> </span>bệnh gây<span style="letter-spacing: 1.05pt;"> </span>ra<span style="letter-spacing: 0.55pt;"> </span>rối<span style="letter-spacing: 1.35pt;"></span>l<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 0.5pt;"> </span>nhịp.<span style="letter-spacing: 2.1pt;"> </span>M<span style="letter-spacing: -0.05pt;">ộ</span>t<span style="letter-spacing: 0.65pt;"> </span>số<span style="letter-spacing: 1.3pt;"> </span>rối<span style="letter-spacing: 1.35pt;"> </span>l<span style="letter-spacing: -0.05pt;">o</span>ạn<span style="letter-spacing: 0.45pt;"> </span>nhịp<span style="letter-spacing: 1.8pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>l<span style="letter-spacing: -0.05pt;">u</span>ôn<span style="letter-spacing: 1.85pt;"> </span>phải<span style="letter-spacing: 0.9pt;"> </span>c<span style="letter-spacing: -0.1pt;">ấ</span>p<span style="letter-spacing: 2.35pt;"> </span>cứu<span style="letter-spacing: 0.55pt;"> </span>vì<span style="letter-spacing: 1.35pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>tỉ<span style="letter-spacing: 1.4pt;"> </span>lệ<span style="letter-spacing: -0.05pt;"> </span>tử<span style="letter-spacing: 0.5pt;"> </span>vong cao<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: 0.6pt;"> </span>rối<span style="letter-spacing: 1.35pt;"> </span>loạn huyết<span style="letter-spacing: -0.8pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"></span>nề.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Ví<span style="letter-spacing: 0.4pt;"> </span>dụ:<span style="letter-spacing: -0.3pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất,<span style="letter-spacing: 1.9pt;"> </span>rung thất,<span style="letter-spacing: 1.9pt;"> </span>blốc<span style="letter-spacing: 0.65pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.35pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>III, yếu<span style="letter-spacing: -0.7pt;"> </span>nút<span style="letter-spacing: -0.3pt;"> </span>xoang...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.5.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: 1.8pt;"> </span>đoán rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 2.75pt;"> </span>nhịp<span style="letter-spacing: 0.2pt;"> </span>tim:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Dựa<span style="letter-spacing: -0.2pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>lâm<span style="letter-spacing: 2.15pt;"> </span>sàng<span style="letter-spacing: 1.85pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>điện<span style="letter-spacing: 1.75pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Yếu tố<span style="letter-spacing: 1.45pt;"> </span>quyết<span style="letter-spacing: 0.05pt;"> </span>định<span style="letter-spacing: 1.4pt;"> </span>nhất<span style="letter-spacing: 2.7pt;"> </span>vẫn<span style="letter-spacing: 2.4pt;"> </span>là<span style="letter-spacing: 0.65pt;"> </span>điện <span style="letter-spacing: 1.1pt;"><span> </span></span>tim<span style="letter-spacing: 0.7pt;"> </span>đồ;<span style="letter-spacing: 1.2pt;"> </span>(ng<span style="letter-spacing: -0.1pt;">o</span>ài<span style="letter-spacing: 0.85pt;"> </span>ghi<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.7pt;"> </span>thông<span style="letter-spacing: 1.1pt;"> </span>t<span style="letter-spacing: -0.15pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường,</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">hiện nay<span style="letter-spacing: 0.7pt;"> </span>còn<span style="letter-spacing: 1.5pt;"> </span>có các<span style="letter-spacing: 1.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">phương</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"></span><span style="line-height: 22px;">pháp<span style="letter-spacing: 1.15pt;"> </span>mới<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư:</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">ghi<span style="letter-spacing: 0.65pt;"> </span>điện<span style="letter-spacing: 1.2pt;"> </span>tim<span style="letter-spacing: 0.65pt;"> </span>từ<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>a-Tele<span style="letter-spacing: 0.3pt;"> </span>electroca<span style="letter-spacing: -0.15pt;">r</span>diography,<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.05pt;">g</span>hi<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: 0.6pt;"> </span>liên<span style="letter-spacing: 1.1pt;"> </span>tục<span style="letter-spacing: 0.45pt;"> </span>tro<span style="letter-spacing: -0.05pt;">n</span>g<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">24<span style="letter-spacing: 0.85pt;"> </span>giờ-Holter;<span style="letter-spacing: 0.3pt;"> </span>ghi<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 1.1pt;"> </span>cực<span style="letter-spacing: 0.7pt;"> </span>thực<span style="letter-spacing: 0.65pt;"> </span>quản,<span style="letter-spacing: 1.2pt;"> </span>ghi<span style="letter-spacing: 0.7pt;"> </span>điện<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.7pt;"> </span>đ<span style="letter-spacing: 0.05pt;">i</span>ện<span style="letter-spacing: 1.45pt;"> </span>cực<span style="letter-spacing: 0.7pt;"> </span>trong<span style="letter-spacing: 0.6pt;"> </span>buồng<span style="letter-spacing: 1.4pt;"> </span>tim,<span style="letter-spacing: 0.6pt;"> </span>lập<span style="letter-spacing: 2.55pt;"> </span>bản<span style="letter-spacing: 1.3pt;"> </span>đồ</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">điện<span style="letter-spacing: 0.4pt;"> </span>tim-<span style="letter-spacing: -0.2pt;"> </span>mapping<span style="letter-spacing: -0.4pt;"> </span>ECG,<span style="letter-spacing: -0.75pt;"> </span>ghi<span style="letter-spacing: -0.15pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>thế<span style="letter-spacing: -0.75pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His ...).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.6.<span style="letter-spacing: -0.2pt;"> </span>Phân<span style="letter-spacing: 0.15pt;"> </span>loại<span style="letter-spacing: 2.3pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span>nhịp<span style="letter-spacing: 0.2pt;"> </span>tim:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Dựa<span style="letter-spacing: -0.2pt;"> </span>vào<span style="letter-spacing: 0.8pt;"> </span><span lang="VI">cơ</span><span lang="VI" style="letter-spacing: 0.6pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 1.1pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>n<span style="letter-spacing: -0.1pt;">g</span><span lang="VI">ười ta</span><span lang="VI" style="letter-spacing: -0.1pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>thành<span style="letter-spacing: 0.35pt;"> </span>3 nhóm:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.4pt;"> </span>Rối<span style="letter-spacing: 2.25pt;"> </span>loạn<span style="letter-spacing: 2.1pt;"> </span>quá<span style="letter-spacing: 1.65pt;"> </span>trình<span style="letter-spacing: -0.8pt;"> </span>tạo<span style="letter-spacing: 1.15pt;"> </span>thành <span style="letter-spacing: 0.55pt;"><span> </span></span>xung<span style="letter-spacing: 1.35pt;"> </span>động:<span style="letter-spacing: 1.65pt;"> </span>nhịp<span style="letter-spacing: -0.95pt;"> </span>xoang<span style="letter-spacing: 1.05pt;"> </span>nhanh<span style="letter-spacing: 1.1pt;"> </span>hoặc<span style="letter-spacing: 1.15pt;"> </span>chậm, <span style="letter-spacing: 0.3pt;"><span> </span></span>ngoại<span style="letter-spacing: 1.75pt;"> </span>tâm<span style="letter-spacing: -0.8pt;"> </span>thu, cuồng<span style="letter-spacing: 0.55pt;"> </span>động <span style="letter-spacing: 0.55pt;"><span> </span></span>và<span style="letter-spacing: -0.6pt;"></span>rung...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.2pt;"> </span>quá<span style="letter-spacing: -0.2pt;"> </span>trình<span style="letter-spacing: 1.65pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"> </span>xung động:<span style="letter-spacing: 0.25pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: -0.25pt;"> </span>nhĩ,<span style="letter-spacing: 0.3pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>nhĩ-thất,<span style="letter-spacing: -0.4pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thất...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Kết<span style="letter-spacing: -0.6pt;"> </span>hợp<span style="letter-spacing: -0.05pt;"> </span>giữa<span style="letter-spacing: 0.1pt;"> </span>rối<span style="letter-spacing: 0.95pt;"> </span>l<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 0.9pt;"> </span>tạo<span style="letter-spacing: 0.05pt;"> </span>thành<span style="letter-spacing: 2pt;"> </span>xung<span style="letter-spacing: 0.3pt;"> </span>động <span style="letter-spacing: 0.85pt;"><span> </span></span>và<span style="letter-spacing: -0.3pt;"> </span>dẫn<span style="letter-spacing: 2.15pt;"> </span>truyền<span style="letter-spacing: -0.65pt;"> </span>xung<span style="letter-spacing: 0.3pt;"> </span>động:<span style="letter-spacing: 0.9pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ân<span style="letter-spacing: 0.75pt;"> </span>ly<span style="letter-spacing: 0.2pt;"> </span>nhĩ-<span style="letter-spacing: 0.6pt;"> </span>thất,<span style="letter-spacing: 2.2pt;"> </span>hội chứng<span style="letter-spacing: -0.3pt;"> </span>quá<span style="letter-spacing: -0.7pt;"> </span>kích<span style="letter-spacing: 1.05pt;"></span>thích<span style="letter-spacing: 1.4pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"> </span>sớm...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+ Trong<span style="letter-spacing: -0.55pt;"> </span>lâm<span style="letter-spacing: 0.65pt;"> </span>sàng,<span style="letter-spacing: 0.15pt;"> </span>dựa<span style="letter-spacing: -0.1pt;"> </span>vào<span style="letter-spacing: -0.1pt;"> </span>vị<span style="letter-spacing: -0.15pt;"> </span>trí,<span style="letter-spacing: 1pt;"> </span>tính<span style="letter-spacing: 1.65pt;"> </span>chất<span style="letter-spacing: 2.1pt;"> </span>của<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.65pt;"> </span>rối<span style="letter-spacing: 0.75pt;"> </span>loạn nhịp<span style="letter-spacing: 1.15pt;"> </span>tim,<span style="letter-spacing: -0.1pt;"> </span>n<span style="letter-spacing: -0.2pt;">g</span><span lang="VI">ười</span><span lang="VI" style="letter-spacing: 0.1pt;"> </span>ta chia<span style="letter-spacing: -0.1pt;"> </span>thành<span style="letter-spacing: 0.45pt;"> </span>4<span style="letter-spacing: 0.05pt;"> </span>nhóm<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">để<span style="letter-spacing: 0.7pt;"> </span>ứng dụng<span style="letter-spacing: -0.25pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: 0.3pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>điều<span style="letter-spacing: 2.05pt;"> </span>trị<span style="letter-spacing: 1.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>tiện<span style="letter-spacing: -0.75pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span><span lang="VI">hơn:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hịp<span style="letter-spacing: 0.9pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span><span style="letter-spacing: 0.05pt;">t</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Nhịp<span style="letter-spacing: 0.25pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>xoang;<span style="letter-spacing: -0.35pt;"> </span>chậm<span style="letter-spacing: 1.9pt;"> </span>xoang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Nhanh<span style="letter-spacing: -0.3pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>kịch<span style="letter-spacing: 1.05pt;"> </span>phát,<span style="letter-spacing: -0.2pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>bộ nối<span style="letter-spacing: 0.6pt;"> </span>kịch<span style="letter-spacing: 0.25pt;"> </span>phát.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>(nhĩ).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Rung nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Cuồng động<span style="letter-spacing: 0.3pt;"> </span>nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Hội chứng<span style="letter-spacing: -0.3pt;"> </span>yếu<span style="letter-spacing: -0.7pt;"> </span>nút<span style="letter-spacing: -0.3pt;"> </span>xoang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hịp<span style="letter-spacing: 1.15pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span>t:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. <span> </span>Ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Nhanh<span style="letter-spacing: -0.3pt;"> </span>thất,<span style="letter-spacing: 1.9pt;"> </span>rung thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Blốc<span style="letter-spacing: -0.2pt;"> </span>tim.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Blốc<span style="letter-spacing: -0.2pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Blốc<span style="letter-spacing: -0.2pt;"> </span>nhĩ-thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">.<span> </span>Blốc<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Hội chứng<span style="letter-spacing: -0.3pt;"> </span>tiền<span style="letter-spacing: -0.75pt;"> </span>kích<span style="letter-spacing: 0.25pt;"> </span>thích.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.9pt;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">1.7.<span style="letter-spacing: 2.85pt;"> </span>Điều<span style="letter-spacing: -0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span><span style="letter-spacing: -0.1pt;">n</span>hịp tim:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Có<span style="letter-spacing: 2.25pt;"> </span>nhiều<span style="letter-spacing: 1.3pt;"> </span>p<span style="letter-spacing: 0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ương </span><span lang="VI" style="letter-spacing: -0.9pt; line-height: 22px;"><span> </span></span><span style="line-height: 22px;">pháp<span style="letter-spacing: 2.5pt;"> </span>điều<span style="letter-spacing: 2.5pt;"> </span>trị<span style="letter-spacing: 0.05pt;"> </span>r<span style="letter-spacing: -0.05pt;">ố</span>i<span style="letter-spacing: 2.7pt;"> </span>loạn<span> </span>nhịp<span style="letter-spacing: -0.25pt;"> </span>tim;<span style="letter-spacing: 1.9pt;"> </span>có<span style="letter-spacing: 2.75pt;"> </span>thể<span style="letter-spacing: 1.35pt;"> </span>dùng<span style="letter-spacing: 1.85pt;"> </span>độc<span style="letter-spacing: -0.7pt;"> </span>lập <span style="letter-spacing: 0.85pt;"><span> </span></span>hay<span style="letter-spacing: 1.95pt;"> </span>phối<span style="letter-spacing: 2.5pt;"> </span>hợp<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">nhiều phương pháp</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"></span><span style="line-height: 22px;">theo<span style="letter-spacing: -0.2pt;"> </span>những nguyên<span style="letter-spacing: 0.2pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>chung:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Loại<span style="letter-spacing: 0.45pt;"> </span>trừ<span style="letter-spacing: -0.15pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>yếu<span style="letter-spacing: -0.7pt;"> </span>tố<span style="letter-spacing: 0.6pt;"> </span>tác<span style="letter-spacing: -0.4pt;"> </span>động<span style="letter-spacing: 1.8pt;"> </span>xấu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.1pt;"> </span>Dùng<span style="letter-spacing: -0.4pt;"> </span>các<span style="letter-spacing: 0.7pt;"> </span>nghiệm<span style="letter-spacing: -0.6pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.05pt;"> </span>gây<span style="letter-spacing: 0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 0.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">phó<span style="letter-spacing: 0.45pt;"> </span>giao<span style="letter-spacing: -0.05pt;"> </span>cảm<span style="letter-spacing: 0.35pt;"> </span>làm<span style="letter-spacing: -0.1pt;"> </span>giảm<span style="letter-spacing: 0.8pt;"> </span>nhịp<span style="letter-spacing: 1.45pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>khác<span style="letter-spacing: 0.5pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư:</span><span lang="VI" style="letter-spacing: 0.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">ấn<span style="letter-spacing: 2.1pt;"> </span>nhãn<span style="letter-spacing: 0.55pt;"> </span>cầu,<span style="letter-spacing: -0.05pt;"> </span>ấn và<span style="letter-spacing: 0.8pt;"> </span>xoa<span style="letter-spacing: -0.15pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"></span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>cảnh,<span style="letter-spacing: 0.35pt;"> </span>nghiệm<span style="letter-spacing: -0.75pt;"> </span>pháp<span style="letter-spacing: 0.4pt;"> </span>Valsalva,...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.3pt;">Dùn</span>g<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">thuố</span>c<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.3pt;">chốn</span>g<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: 0.25pt;">loạ</span>n<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: 0.3pt;">nhị</span>p<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: 0.25pt;">phả</span>i<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: 0.3pt;">lự</span>a<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">chọ</span>n<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: 0.3pt;">the</span>o<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.25pt;">bản</span>g<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.3pt;">phâ</span>n<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: 0.25pt;">loạ</span>i<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.3pt;">củ</span>a<span style="letter-spacing: 1.1pt;"> </span>V.<span style="letter-spacing: 1.15pt;"> </span>W<span style="letter-spacing: 0.05pt;">i</span><span style="letter-spacing: -0.05pt;">l</span><span style="letter-spacing: 0.05pt;">li</span><span style="letter-spacing: -0.05pt;">a</span><span style="letter-spacing: 0.05pt;">m</span>s<span style="letter-spacing: 0.75pt;"> </span>gồm<span style="letter-spacing: 1.7pt;"> </span>4 nhóm<span style="letter-spacing: 0.55pt;"> </span></span><span lang="VI" style="line-height: 22px;">như sau:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.05pt;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">. <span style="letter-spacing: 0.05pt;"><span> </span></span>Nhóm <span style="letter-spacing: 0.35pt;"><span> </span></span>chẹn<span style="letter-spacing: 2.35pt;"> </span>dòng <span style="letter-spacing: 0.5pt;"><span> </span></span>Na<span style="position: relative; top: -5pt;">+</span>:<span style="letter-spacing: 2.9pt;"> </span>quinidin,<span style="letter-spacing: 2.6pt;"> </span>procainamit,<span style="letter-spacing: 2.45pt;"> </span>lidoca<span style="letter-spacing: -0.05pt;">i</span>n,<span style="letter-spacing: 2.7pt;"> </span>ajmalin,<span style="letter-spacing: 2.65pt;"> </span>s<span style="letter-spacing: -0.1pt;">o</span>danton,<span style="letter-spacing: 2.6pt;"> </span>rythmodan, propafenon...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19.3pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1.5pt;">. Chẹn<span style="letter-spacing: 0.15pt;"> </span>thụ<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ảm thể<span style="letter-spacing: -0.75pt;"> </span>β<span style="letter-spacing: -0.65pt;"> </span>giao<span style="letter-spacing: -0.2pt;"> </span>cảm:<span style="letter-spacing: 0.4pt;"> </span>propranolol,<span style="letter-spacing: -1.2pt;"> </span>avlocardyl,<span style="letter-spacing: -0.55pt;"> </span>atenolol...</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.7pt;"><span class="Apple-style-span" style="font-size: large;">. Nhóm<span style="letter-spacing: 0.3pt;"> </span>chẹn<span style="letter-spacing: -0.7pt;"> </span>kênh<span style="letter-spacing: 0.25pt;"> </span>K<span style="position: relative; top: -5pt;">+</span>:<span style="letter-spacing: -0.1pt;"> </span>amiodarone<span style="letter-spacing: -0.55pt;"> </span>(cordarone,<span style="letter-spacing: -0.55pt;"> </span>sedacoron).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Nhóm<span style="letter-spacing: 0.3pt;"> </span>chẹn<span style="letter-spacing: -0.7pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>C<span style="letter-spacing: -0.05pt;">a</span><span style="position: relative; top: -5pt;">++</span>:<span style="letter-spacing: -0.55pt;"> </span>isoptin,<span style="letter-spacing: -0.35pt;"> </span>nifedipine,<span style="letter-spacing: -0.5pt;"> </span>verapamin,<span style="letter-spacing: -1.1pt;"> </span>corontin...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Những<span style="letter-spacing: 1.45pt;"> </span>thuốc<span style="letter-spacing: 2.3pt;"> </span>không<span style="letter-spacing: -1.15pt;"> </span>xếp<span style="letter-spacing: 0.9pt;"> </span>vào<span style="letter-spacing: 1.65pt;"> </span>bảng <span style="letter-spacing: 0.55pt;"><span> </span></span>phân<span style="letter-spacing: -0.5pt;"> </span>loại<span style="letter-spacing: 2.05pt;"> </span>này,<span style="letter-spacing: 2.5pt;"> </span><span lang="VI">nhưng </span><span lang="VI" style="letter-spacing: -1.2pt;"><span> </span></span>có<span style="letter-spacing: 2.45pt;"> </span>tác<span> </span>dụng<span style="letter-spacing: 1.55pt;"> </span>điều<span style="letter-spacing: 2.2pt;"> </span>trị<span style="letter-spacing: -0.2pt;"> </span>loạn<span style="letter-spacing: 2.25pt;"> </span>nhịp<span style="letter-spacing: -0.55pt;"> </span>tim:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">digitalis,<span style="letter-spacing: -0.4pt;"> </span>adrenalin,<span style="letter-spacing: -0.5pt;"> </span>nor-adreanlin,<span style="letter-spacing: -0.7pt;"> </span>i<span style="letter-spacing: -0.05pt;">s</span>uprel,<span style="letter-spacing: -0.4pt;"> </span>aramin,<span style="letter-spacing: -0.4pt;"> </span>atropin,<span style="letter-spacing: -0.4pt;"> </span>ephedrin...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span></span><span lang="VI" style="line-height: 22px;">Phương</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 0.65pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.45pt;"> </span>loạn<span style="letter-spacing: 0.5pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>bằng<span style="letter-spacing: 1pt;"> </span>điện:<span style="letter-spacing: 1pt;"> </span>sốc<span style="letter-spacing: 0.9pt;"> </span>đ<span style="letter-spacing: 0.1pt;">i</span>ện,<span style="letter-spacing: 1.25pt;"> </span>máy<span style="letter-spacing: 0.95pt;"> </span>tạo<span style="letter-spacing: -0.2pt;"> </span>nhịp<span style="letter-spacing: 1.85pt;"> </span>tim,<span style="letter-spacing: 0.05pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.45pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>nhanh bằng<span style="letter-spacing: 1.05pt;"></span></span><span lang="VI" style="line-height: 22px;">phương</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 1.05pt;"> </span>ức<span style="letter-spacing: 0.55pt;"> </span>chế<span style="letter-spacing: -0.05pt;"> v</span></span><span lang="VI" style="line-height: 22px;">ượt</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần<span style="letter-spacing: 0.5pt;"> </span>số<span style="letter-spacing: 1.25pt;"> </span>(overdriving),<span style="letter-spacing: -0.7pt;"> </span>cấy<span style="letter-spacing: 2.6pt;"> </span>m<span style="letter-spacing: -0.1pt;">á</span>y<span style="letter-spacing: 1.25pt;"> </span>sốc<span style="letter-spacing: 1.25pt;"> </span>tự<span style="letter-spacing: 0.55pt;"> </span>động,<span style="letter-spacing: 1.55pt;"> </span>đốt<span style="letter-spacing: 0.8pt;"> </span>bằng<span style="letter-spacing: 0.45pt;"> </span>năng<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">lượng</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần số<span style="letter-spacing: 0.6pt;"> </span>radio<span style="letter-spacing: -0.25pt;"> </span>qua<span style="letter-spacing: -0.15pt;"></span>ống<span style="letter-spacing: 0.5pt;"> </span>thống...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1pt;"> </span>Điều<span style="letter-spacing: 1.5pt;"> </span>trị<span style="letter-spacing: -1pt;"> </span>loạn<span style="letter-spacing: 0.95pt;"> </span>nhịp<span style="letter-spacing: 2.15pt;"> </span>tim<span style="letter-spacing: 0.9pt;"> </span>bằng<span style="letter-spacing: 1.45pt;"> </span>p</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">hư</span><span lang="VI" style="line-height: 22px;">ơng</span><span lang="VI" style="letter-spacing: 1pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 1.1pt;"> </span>ngoại<span style="letter-spacing: 1.75pt;"> </span>khoa:<span style="letter-spacing: 0.8pt;"> </span>cắt<span style="letter-spacing: 0.9pt;"> </span>bỏ<span style="letter-spacing: 1.55pt;"> </span>phần<span style="letter-spacing: 0.75pt;"> </span>phình<span style="letter-spacing: 1.25pt;"> </span>tim,<span style="letter-spacing: 0.85pt;"> </span>cắt<span style="letter-spacing: 0.9pt;"> </span>các<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường dẫn</span><span lang="VI" style="letter-spacing: 1.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">truyền<span style="letter-spacing: -0.95pt;"></span>tắt,<span style="letter-spacing: -0.15pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">phương pháp</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">COX<span style="letter-spacing: -0.75pt;"> </span>để<span style="letter-spacing: -0.2pt;"> </span>điều<span style="letter-spacing: 1.5pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span>rung nhĩ...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Điều<span style="letter-spacing: 2.5pt;"> </span>trị loạn<span style="letter-spacing: 2.5pt;"> </span>nhịp<span style="letter-spacing: -0.3pt;"> </span>tim<span style="letter-spacing: 1.9pt;"> </span>theo<span style="letter-spacing: 1.85pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ương </span><span lang="VI" style="letter-spacing: -0.95pt; line-height: 22px;"><span> </span></span><span style="line-height: 22px;">pháp<span style="letter-spacing: 2.45pt;"> </span>y<span style="letter-spacing: 2.05pt;"> </span>học<span style="letter-spacing: 2.7pt;"> </span>dân<span style="letter-spacing: -0.1pt;"> </span>tộc:<span style="letter-spacing: 1.85pt;"> </span>châm<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: 0.3pt;">cứ</span>u<span style="letter-spacing: 2.4pt;"> </span><span style="letter-spacing: 0.3pt;">(</span><span style="letter-spacing: 0.25pt;">a</span><span style="letter-spacing: 0.3pt;">cupunc</span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.25pt;">u</span><span style="letter-spacing: 0.3pt;">rê</span><span style="letter-spacing: 0.25pt;">)</span>, <span style="letter-spacing: -0.5pt;"><span> </span></span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.3pt;">hủ</span>y </span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;">xươn</span><span style="line-height: 22px;">g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">bồ</span>,<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.25pt;">tâ</span>m<span style="letter-spacing: 1pt;"></span><span style="letter-spacing: 0.3pt;">sen</span>,<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ủ<span style="letter-spacing: 0.25pt;"> câ</span>y<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.25pt;">bìn</span>h<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">vôi...</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">2.<span style="letter-spacing: -0.1pt;"> </span>Một<span style="letter-spacing: -1.45pt;"> </span>số<span style="letter-spacing: -1.05pt;"> </span>thể<span style="letter-spacing: -2.7pt;"> </span>bệnh<span style="letter-spacing: -0.8pt;"> </span>rối<span style="letter-spacing: -2.45pt;"> </span>loạn<span style="letter-spacing: -2.25pt;"> </span>nhịp<span style="letter-spacing: -0.65pt;"> </span>tim.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">2.1.<span style="letter-spacing: -0.2pt;"> </span>Rối<span style="letter-spacing: 0.55pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span>nhịp<span style="letter-spacing: 0.2pt;"> </span>trên<span style="letter-spacing: -0.8pt;"> </span>thất<span style="letter-spacing: -0.85pt;"> </span></span>(supra<span style="letter-spacing: -0.05pt;">v</span>entricular<span style="letter-spacing: -1.2pt;"> </span>dysrhythmias):<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.1.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh <span style="letter-spacing: 0.2pt;"><span> </span></span>xoang<span style="letter-spacing: 1.15pt;"> </span>(sinus<span style="letter-spacing: 1.15pt;"> </span>tachycardia):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span>Khi<span style="letter-spacing: 0.1pt;"> </span>nhịp<span style="letter-spacing: 0.6pt;"> </span>xoang có<span style="letter-spacing: 0.95pt;"> </span>tần<span style="letter-spacing: 0.15pt;"> </span>số<span style="letter-spacing: 0.9pt;"> </span>><span style="letter-spacing: 0.25pt;"> </span>100<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: 0.05pt;">c</span>k/phút<span style="letter-spacing: -0.25pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">lớn,<span style="letter-spacing: 0.1pt;"> </span>hoặc<span style="letter-spacing: 0.05pt;"> </span>>120<span style="letter-spacing: 0.05pt;"> </span>ck/phút<span style="letter-spacing: -0.4pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>trẻ<span style="letter-spacing: -0.5pt;"> </span>em<span style="letter-spacing: 0.15pt;"> </span>thì<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi là<span style="letter-spacing: -0.5pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh<span style="letter-spacing: -0.3pt;"> </span>xoang.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span>Nguyên<span style="letter-spacing: 1.75pt;"> </span>nhân<span style="letter-spacing: 0.8pt;"> </span>gây<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 0.35pt;"> </span>nhanh xoang:<span style="letter-spacing: -0.05pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">thần<span style="letter-spacing: 0.1pt;"> </span>kinh<span style="letter-spacing: 0.1pt;"> </span>giao cảm,<span style="letter-spacing: 0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">chức<span style="letter-spacing: 0.05pt;"> </span>năng<span style="letter-spacing: 0.55pt;"> </span>tuyến<span style="letter-spacing: -0.5pt;"> </span>giáp, sốt,<span style="letter-spacing: 0.65pt;"> </span>xúc<span style="letter-spacing: -0.35pt;"> </span>độ<span style="letter-spacing: -0.05pt;">n</span>g,<span style="letter-spacing: 0.55pt;"></span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>k<span style="letter-spacing: -0.05pt;">h</span>uẩn,<span style="letter-spacing: 1.85pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>màng<span style="letter-spacing: 0.35pt;"> </span>ngoài<span style="letter-spacing: 0.35pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>bẩm<span style="letter-spacing: 1.85pt;"> </span>sin<span style="letter-spacing: -0.05pt;">h</span>...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Lâm<span style="letter-spacing: 0.8pt;"> </span>sàng:<span style="letter-spacing: 0.05pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>hộp<span style="letter-spacing: -0.35pt;"> </span>đ<span style="letter-spacing: -0.1pt;">á</span>nh trống<span style="letter-spacing: 0.5pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở,<span style="letter-spacing: -0.2pt;"> </span>tê<span style="letter-spacing: 0.55pt;"> </span>tay<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>chân, <span style="letter-spacing: 1.2pt;"><span> </span></span>đau<span style="letter-spacing: 1.55pt;"> </span>tức<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ùng<span style="letter-spacing: -0.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span><span lang="VI">ước tim.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">Điệ</span>n <span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">đ</span><span style="letter-spacing: -0.3pt;">ồ</span>:<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">són</span>g<span style="letter-spacing: 0.15pt;"> </span>P<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">tha</span>y<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">đổi</span>, <span style="letter-spacing: -0.3pt;">són</span>g<span style="letter-spacing: 0.15pt;"> </span>T<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">cao</span>,<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">S</span>T<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: -0.25pt;">h</span>ạ<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>p<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.3pt;">xuốn</span>g<span style="letter-spacing: 0.1pt;"> </span><span lang="VI" style="letter-spacing: -0.3pt;">dướ</span>i<span style="letter-spacing: -0.45pt;"> </span><span lang="VI" style="letter-spacing: -0.3pt;">đườn</span>g<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">đẳn</span>g<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.25pt;">điện</span>,<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: -0.3pt;">tầ</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">s</span>ố<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">nhanh</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: -0.3pt;">>10</span>0<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">ck/phú</span>t<span style="letter-spacing: -0.2pt;"> </span>ở<span style="letter-spacing: -0.6pt;"> </span><span lang="VI" style="letter-spacing: -0.3pt;">ngườ</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">lớ</span>n<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.2pt;">v</span>à<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">>12</span>0<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">ck/phú</span>t<span style="letter-spacing: -0.2pt;"> </span>ở<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">tr</span>ẻ<span style="letter-spacing: -0.3pt;"> em.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>xoang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Tiến<span style="letter-spacing: -1.15pt;"> </span>hành<span style="letter-spacing: 0.4pt;"> </span>nghiệm<span style="letter-spacing: -0.75pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.05pt;">c</span><span lang="VI">ường phó</span><span lang="VI" style="letter-spacing: 0.35pt;"> </span>giao<span style="letter-spacing: -0.2pt;"> </span>cảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Thuốc:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.95pt;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 1pt;">.<span style="letter-spacing: 0.4pt;"> </span>Seduxen<span style="letter-spacing: -0.4pt;"> </span>5-10<span style="letter-spacing: 0.4pt;"> </span>mg/ngày<span style="letter-spacing: 0.6pt;"> </span>~<span style="letter-spacing: 0.7pt;"> </span>5-10<span style="letter-spacing: 0.4pt;"> </span>ngày<span style="letter-spacing: 0.85pt;"> </span>tùy<span style="letter-spacing: 0.15pt;"> </span>theo<span style="letter-spacing: 0.25pt;"> </span>tần<span style="letter-spacing: 0.3pt;"> </span>số<span style="letter-spacing: 1pt;"> </span>nhịp,<span style="letter-spacing: 0.65pt;"> </span>nếu<span style="letter-spacing: -0.25pt;"> </span>không<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>tác<span style="letter-spacing: 1.05pt;"> </span>dụng<span style="letter-spacing: 0.15pt;"> </span>thì<span style="letter-spacing: 0.85pt;"> </span>dùng </span>thêm:<o:p> </o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 1pt;">.<span style="letter-spacing: 1.75pt;"> </span>Nhóm<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>h<span style="letter-spacing: -0.05pt;">u</span>ốc<span style="letter-spacing: 2.3pt;"> </span><span style="letter-spacing: 0.3pt;">chẹ</span>n<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>ụ<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.25pt;">cả</span>m <span style="letter-spacing: 0.2pt;"><span> </span></span><span style="letter-spacing: 0.3pt;">th</span>ể<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.2pt;">b</span>ê <span style="letter-spacing: 0.3pt;"><span> </span>t</span>a<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: 0.3pt;">(β</span>)<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.25pt;">g</span><span style="letter-spacing: 0.35pt;">i</span><span style="letter-spacing: 0.3pt;">a</span>o<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: 0.25pt;">cả</span>m <span style="letter-spacing: 0.15pt;"><span> </span></span><span style="letter-spacing: 0.3pt;">n</span><span style="letter-spacing: 0.25pt;">h</span></span><span lang="VI" style="position: relative; top: 1pt;">ư </span><span lang="VI" style="letter-spacing: -0.85pt; position: relative; top: 1pt;"><span> </span></span><span style="letter-spacing: 0.3pt; position: relative; top: 1pt;">propranolo</span><span style="position: relative; top: 1pt;">l<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">40-8</span>0<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: 0.3pt;">m</span>g<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: 0.3pt;">chia </span></span><span style="letter-spacing: 0.3pt;">nhiề</span>u<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: 0.3pt;">lầ</span>n<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">tron</span>g<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Chú<span style="letter-spacing: -0.3pt;"> </span>ý<span style="letter-spacing: 0.5pt;"> </span>những<span style="letter-spacing: 0.5pt;"> </span>chống<span style="letter-spacing: 1.05pt;"> </span>chỉ <span style="letter-spacing: 0.05pt;"><span> </span></span>định<span style="letter-spacing: 1.6pt;"> </span>và<span style="letter-spacing: 0.05pt;"> </span>tác<span style="letter-spacing: 1.1pt;"> </span>dụng<span style="letter-spacing: 0.25pt;"> </span>phụ<span style="letter-spacing: -0.05pt;"> </span>của<span style="letter-spacing: 0.15pt;"> </span>nhóm<span style="letter-spacing: 1.05pt;"> </span>thuốc<span style="letter-spacing: 1pt;"> </span>chẹn<span style="letter-spacing: -0.2pt;"> </span>thụ<span style="letter-spacing: 0.2pt;"> </span>cảm<span style="letter-spacing: 0.95pt;"> </span>thể<span style="letter-spacing: -0.25pt;"> </span>bê<span style="letter-spacing: 1pt;"> </span>ta<span style="letter-spacing: 0.4pt;"> </span>giao<span style="letter-spacing: 0.3pt;"> </span></span><span lang="VI" style="line-height: 22px;">cảm như: hen</span><span lang="VI" style="letter-spacing: -0.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">p<span style="letter-spacing: -0.05pt;">h</span>ế<span style="letter-spacing: -0.95pt;"></span>quản,<span style="letter-spacing: 0.35pt;"> </span>loét<span style="letter-spacing: -0.95pt;"> </span>dạ dày,<span style="letter-spacing: 1.8pt;"> </span>loét<span style="letter-spacing: -0.95pt;"> </span>hành<span style="letter-spacing: 2.15pt;"> </span>tá<span style="letter-spacing: -0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>à<span style="letter-spacing: -0.05pt;">n</span>g, <span style="letter-spacing: 0.4pt;"><span> </span></span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp<span style="letter-spacing: 0.7pt;"> </span>thấp,<span style="letter-spacing: 1.75pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>chậm,<span style="letter-spacing: 1.9pt;"> </span>bl<span style="letter-spacing: -0.05pt;">ố</span>c<span style="letter-spacing: 0.55pt;"> </span>tim...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.2.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>chậm<span style="letter-spacing: 0.6pt;"> </span>xoang<span style="letter-spacing: 1.15pt;"> </span>(sinus<span style="letter-spacing: 1.15pt;"> </span>bradycardia):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Khi<span style="letter-spacing: -0.2pt;"> </span>tần<span style="letter-spacing: -0.15pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>50 ck/phút<span style="letter-spacing: -0.7pt;"> </span>thì<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span lang="VI">ược</span><span lang="VI" style="letter-spacing: 0.2pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nhịp <span style="letter-spacing: 0.55pt;"><span> </span></span>chậm<span style="letter-spacing: 1.9pt;"> </span>xoang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1pt;"> </span>Nguyên<span style="letter-spacing: 1.65pt;"> </span>nhân:<span style="letter-spacing: 0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 1.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">phó<span style="letter-spacing: 1.35pt;"> </span>giao<span style="letter-spacing: 0.85pt;"> </span>cảm;<span style="letter-spacing: 1.45pt;"> </span>tăng<span style="letter-spacing: -1pt;"> </span>cảm<span style="letter-spacing: 1.5pt;"> </span>xoang<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 1.9pt;"> </span>mạch<span style="letter-spacing: 1.4pt;"> </span>cảnh;<span style="letter-spacing: 1.4pt;"> </span>phẫu<span style="letter-spacing: 2.7pt;"> </span>thuật <span style="letter-spacing: 0.05pt;"><span> </span></span>vùng<span style="letter-spacing: 0.3pt;"> </span>thắt <span style="letter-spacing: 0.05pt;">l</span></span><span lang="VI" style="line-height: 22px;">ưng,</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">tủy<span style="letter-spacing: 0.1pt;"></span>sống,<span style="letter-spacing: 0.9pt;"> </span>mắt;<span style="letter-spacing: 0.25pt;"> </span>nhồi<span style="letter-spacing: 1pt;"> </span>máu<span style="letter-spacing: 1.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim;<span style="letter-spacing: 0.25pt;"> </span>hội<span style="letter-spacing: 0.15pt;"> </span>chứng<span style="letter-spacing: 0.1pt;"> </span>yếu<span style="letter-spacing: -0.3pt;"> </span>nút<span style="letter-spacing: 0.1pt;"> </span>x<span style="letter-spacing: -0.1pt;">o</span>ang;<span style="letter-spacing: 0.05pt;"> </span>do<span style="letter-spacing: 0.3pt;"> </span>thuốc<span style="letter-spacing: 0.9pt;"> </span></span><span lang="VI" style="line-height: 22px;">như:</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">chẹn<span style="letter-spacing: -0.3pt;"> </span>thụ<span style="letter-spacing: 0.1pt;"> </span>cảm<span style="letter-spacing: 0.85pt;"> </span>thể<span style="letter-spacing: -0.35pt;"> </span>bê ta<span style="letter-spacing: -0.1pt;"> </span>giao<span style="letter-spacing: -0.2pt;"> </span>cảm,<span style="letter-spacing: 0.4pt;"></span>digitalis,<span style="letter-spacing: -0.4pt;"> </span>quinidin,<span style="letter-spacing: -0.3pt;"> </span>cordaron,<span style="letter-spacing: -0.45pt;"> </span>morphin...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">+<span style="letter-spacing: -0.05pt;"> </span>Lâm<span style="letter-spacing: 1.1pt;"> </span>sàng:<span style="letter-spacing: 0.35pt;"> </span>đau<span style="letter-spacing: -0.05pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>choáng<span style="letter-spacing: 1.1pt;"> </span>váng,<span style="letter-spacing: 0.05pt;"> </span>ngất,<span style="letter-spacing: 1.95pt;"> </span>lịm,<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong<span style="letter-spacing: -0.7pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>vô<span style="letter-spacing: -0.25pt;"> </span>tâm<span style="letter-spacing: 1.5pt;"> </span>thu.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điện<span style="letter-spacing: 0.45pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>đều<span style="letter-spacing: 0.5pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>đều,<span style="letter-spacing: -0.35pt;"> </span>tần<span style="letter-spacing: -0.15pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>chậm<span style="letter-spacing: 1.9pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>50 ck/phút.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>trị: nâng<span style="letter-spacing: 1.1pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>x<span style="letter-spacing: -0.1pt;">o</span>ang<span style="letter-spacing: -0.3pt;"> </span>đạt<span style="letter-spacing: 0.9pt;"> </span>60-80 ck/phút.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.65pt;"><span class="Apple-style-span" style="font-size: large;">- Atropin<span style="letter-spacing: -0.35pt;"> </span>1/4<span style="letter-spacing: -0.15pt;"> </span>mg<span style="letter-spacing: -0.15pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>4-8 ống/ngày,<span style="letter-spacing: 0.2pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>2-3 lần<span style="letter-spacing: -0.15pt;"> </span>tiêm<span style="letter-spacing: 0.25pt;"> </span><span lang="VI">dưới da.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">- Ephedrin<span style="letter-spacing: -0.45pt;"> </span>0,01 ~<span style="letter-spacing: 0.25pt;"> </span>2-6 v/ngày,<span style="letter-spacing: 0.3pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>2-3 lần<span style="letter-spacing: -0.15pt;"> </span>uống;<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>atropin.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">-<span style="letter-spacing: 1.15pt;"> </span>Hoặc<span style="letter-spacing: 0.9pt;"> </span>isuprel<span style="letter-spacing: 0.8pt;"> </span>1mg<span style="letter-spacing: 0.9pt;"> </span>~<span style="letter-spacing: 1.4pt;"> </span>1-2<span style="letter-spacing: 1.15pt;"> </span>viên/ngày,<span style="letter-spacing: 1.5pt;"> </span>chia<span style="letter-spacing: 0.95pt;"> </span>2<span style="letter-spacing: 1.15pt;"> </span>lần,<span style="letter-spacing: 0.95pt;"> </span>ngậm <span style="letter-spacing: 0.1pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">d</span></span><span lang="VI" style="position: relative; top: -1pt;">ưới</span><span lang="VI" style="letter-spacing: 1.15pt; position: relative; top: -1pt;"><span> </span></span><span style="letter-spacing: -0.05pt; position: relative; top: -1pt;">l</span><span lang="VI" style="position: relative; top: -1pt;">ưỡ</span><span style="letter-spacing: 0.05pt; position: relative; top: -1pt;">i</span><span style="position: relative; top: -1pt;">;<span style="letter-spacing: 1.15pt;"> </span>h<span style="letter-spacing: -0.05pt;">o</span>ặc<span style="letter-spacing: 0.9pt;"> </span>1<span style="letter-spacing: -0.05pt;">-</span>2<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.4pt;">ốn</span>g<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.4pt;">ph</span>a<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">và</span>o<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.4pt;">dung </span><span style="letter-spacing: -0.35pt;">dịc</span>h<span style="letter-spacing: -0.4pt;"> g</span><span style="letter-spacing: -0.35pt;">l</span><span style="letter-spacing: -0.4pt;">u</span><span style="letter-spacing: -0.35pt;">c</span><span style="letter-spacing: -0.4pt;">os</span>e<span style="letter-spacing: -1.15pt;"></span><span style="letter-spacing: -0.4pt;">5</span>%<span style="letter-spacing: -0.85pt;"> </span>~<span style="letter-spacing: -1.85pt;"> </span><span style="letter-spacing: -0.4pt;">10</span>0<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.4pt;">m</span>l<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.35pt;">truyề</span>n<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: -0.35pt;">t</span><span style="letter-spacing: -0.3pt;">ĩ</span><span style="letter-spacing: -0.35pt;">n</span>h<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">m</span><span style="letter-spacing: -0.35pt;">ạc</span>h<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.4pt;">10-2</span>0<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.4pt;">giọt/phút.</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.8pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 20px;">-<span style="letter-spacing: 0.25pt;"> </span>Hoặc adrenalin<span style="letter-spacing: -0.2pt;"> </span>hoặc <span style="letter-spacing: -0.05pt;">no</span>r-adrenalin<span style="letter-spacing: -0.45pt;"> </span>1<span style="letter-spacing: 0.25pt;"> </span>mg<span style="letter-spacing: 0.05pt;"> </span>~<span style="letter-spacing: 0.5pt;"> </span>1-2<span style="letter-spacing: 0.25pt;"> </span>ống<span style="letter-spacing: 0.75pt;"> </span>pha<span style="letter-spacing: -0.1pt;"> </span>vào<span style="letter-spacing: 0.7pt;"> </span>dung<span style="letter-spacing: 0.25pt;"> </span>dịch<span style="letter-spacing: 0.5pt;"> </span>glucose<span style="letter-spacing: -0.1pt;"> </span>5%<span style="letter-spacing: 0.15pt;"> </span>~<span style="letter-spacing: 0.45pt;"> </span>100<span style="letter-spacing: 0.25pt;"> </span>ml, truyền<span style="letter-spacing: 0.3pt;"> </span>tĩnh<span style="letter-spacing: -0.8pt;"></span>mạch<span style="letter-spacing: 1.6pt;"> </span>10-20<span style="letter-spacing: 1.25pt;"> </span>giọt/phút.<span style="letter-spacing: 1.2pt;"> </span>Khi<span style="letter-spacing: 1.05pt;"> </span>truyền<span style="letter-spacing: 0.3pt;"> </span>phải<span style="letter-spacing: 1.75pt;"> </span>che<span style="letter-spacing: 1.1pt;"> </span>ánh<span style="letter-spacing: 1.75pt;"> </span>sáng <span style="letter-spacing: 0.05pt;"><span> </span></span>để<span style="letter-spacing: 0.9pt;"> </span>tránh <span style="letter-spacing: 0.65pt;"><span> </span></span>sự<span style="letter-spacing: 1.25pt;"> </span>phân<span style="letter-spacing: -1.05pt;"> </span>hủy<span style="letter-spacing: 0.9pt;"> </span>của<span style="letter-spacing: 0.9pt;"> </span>thuốc, thuốc<span style="letter-spacing: 0.5pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"></span></span><span lang="VI" style="line-height: 20px;">được</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 20px;"> </span><span style="line-height: 20px;">ở bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>nhịp<span style="letter-spacing: 0.05pt;"> </span>chậm<span style="letter-spacing: 1.9pt;"> </span>kèm<span style="letter-spacing: 1.9pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 2.4pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.5pt;"> </span>Nhịp<span style="letter-spacing: 0.75pt;"> </span>chậm<span style="letter-spacing: 2.4pt;"> </span>xoang<span style="letter-spacing: 0.2pt;"> </span>do<span style="letter-spacing: 0.4pt;"> </span>tăng<span style="letter-spacing: 1.55pt;"> </span>cảm<span style="letter-spacing: 0.15pt;"> </span>xoang<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 1.4pt;"> </span>mạch<span style="letter-spacing: 0.8pt;"> </span>cảnh<span style="letter-spacing: 0.35pt;"> </span>gây<span style="letter-spacing: 1.05pt;"> </span>ngất<span style="letter-spacing: 2.35pt;"> </span>thì<span style="letter-spacing: 1.1pt;"> </span>điều<span style="letter-spacing: 1.2pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span>bằng<span style="letter-spacing: 1.5pt;"> </span>phẫu<span style="letter-spacing: 2.2pt;"> </span>thuật cắt<span style="letter-spacing: -0.15pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>xoang<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>cảnh<span style="letter-spacing: -0.15pt;"> </span>(denervation).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.35pt;"> </span>Nhịp<span style="letter-spacing: 0.6pt;"> </span>ch<span style="letter-spacing: -0.05pt;">ậ</span>m<span style="letter-spacing: 2.15pt;"> </span>xoang<span style="letter-spacing: 0.05pt;"> </span>do<span style="letter-spacing: 0.25pt;"> </span>hội<span style="letter-spacing: 0.2pt;"> </span>chứng<span style="letter-spacing: 0.05pt;"> </span>yếu<span style="letter-spacing: -0.35pt;"> </span>nút<span style="letter-spacing: 0.05pt;"> </span>xoang<span style="letter-spacing: 0.05pt;"> </span>hoặc<span style="letter-spacing: 0.1pt;"> </span>không <span style="letter-spacing: 1.35pt;"><span> </span></span>điều<span style="letter-spacing: 1.85pt;"> </span>trị<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">bằng<span style="letter-spacing: 2.25pt;"> </span>thuốc<span style="letter-spacing: 0.85pt;"> </span>thì<span style="letter-spacing: 0.75pt;"> </span>phải kích<span style="letter-spacing: 0.25pt;"> </span>thích<span style="letter-spacing: 0.55pt;"></span>tim<span style="letter-spacing: -0.15pt;"> </span>nhờ đặt<span style="letter-spacing: 0.3pt;"> </span>máy<span style="letter-spacing: 0.7pt;"> </span>tạo<span style="letter-spacing: -0.45pt;"> </span>nhịp<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>(artificial<span style="letter-spacing: -0.45pt;"> </span>pacing).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.3.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh <span style="letter-spacing: 0.2pt;"><span> </span></span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>(atrial<span style="letter-spacing: 1.7pt;"> </span>tachycardia):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.35pt;"> </span>Nhịp<span style="letter-spacing: 0.65pt;"> </span>nhanh<span style="letter-spacing: 0.1pt;"> </span>nhĩ<span style="letter-spacing: 2pt;"> </span>ít<span style="letter-spacing: 0.4pt;"> </span>gặp<span style="letter-spacing: 0.05pt;"> </span>trong<span style="letter-spacing: 0.15pt;"> </span>lâm<span style="letter-spacing: 0.95pt;"> </span>sàng,<span style="letter-spacing: 0.45pt;"> </span>ổ<span style="letter-spacing: 1pt;"> </span>phát<span style="letter-spacing: -0.25pt;"> </span>nhịp<span style="letter-spacing: 0.95pt;"> </span>kích<span style="letter-spacing: 1.2pt;"> </span>thí<span style="letter-spacing: -0.05pt;">c</span>h<span style="letter-spacing: 1.6pt;"> </span>cho<span style="letter-spacing: 0.25pt;"> </span>nhịp<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>đập<span style="letter-spacing: -0.5pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">ở<span style="letter-spacing: 0.4pt;"> </span>phần trên,<span style="letter-spacing: 0.25pt;"> </span>phần<span style="letter-spacing: -0.25pt;"></span><span style="letter-spacing: -0.05pt;">d</span></span><span lang="VI" style="line-height: 22px;">ưới nhĩ</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">phải,<span style="letter-spacing: 0.1pt;"> </span>hiếm<span style="letter-spacing: -0.7pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gặp<span style="letter-spacing: -0.35pt;"> </span>ở nhĩ<span style="letter-spacing: 0.35pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Nguyên<span style="letter-spacing: 0.6pt;"> </span>nhân:<span style="letter-spacing: -0.1pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>digit<span style="letter-spacing: 0.05pt;">a</span>lis,<span style="letter-spacing: -0.4pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>khuẩn,<span style="letter-spacing: 1.8pt;"> </span>viêm<span style="letter-spacing: 0.3pt;"> </span>phổi.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 1.35pt;"> </span>Biểu<span style="letter-spacing: -0.25pt;"> </span>hiện<span style="letter-spacing: 0.55pt;"> </span>lâm<span style="letter-spacing: -0.8pt;"> </span>sàng:<span style="letter-spacing: 1.75pt;"> </span>hồi<span style="letter-spacing: 2pt;"> </span>hộp,<span style="letter-spacing: 1.15pt;"> </span>đánh<span style="letter-spacing: 2.05pt;"> </span>trống<span style="letter-spacing: 1.9pt;"> </span>ngực,<span style="letter-spacing: 1.15pt;"> </span>đau<span style="letter-spacing: 1.8pt;"> </span>ngực<span style="letter-spacing: 1.15pt;"> </span>trái,<span style="letter-spacing: 1.85pt;"> </span>hoa<span style="letter-spacing: 1.25pt;"> </span>mắt,<span style="letter-spacing: 1.2pt;"> </span>chóng<span style="letter-spacing: 1.95pt;"> </span>mặt,<span style="letter-spacing: 1.2pt;"> </span>choáng váng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.2pt;"> </span>Điện<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>đồ:<span style="letter-spacing: -0.85pt;"> </span>sóng<span style="letter-spacing: 1.9pt;"> </span>P<span style="letter-spacing: 0.9pt;"> </span>đi<span style="letter-spacing: 1.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">trước</span><span lang="VI" style="letter-spacing: 1.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">phức<span style="letter-spacing: 1pt;"> </span>bộ<span style="letter-spacing: 1.25pt;"> </span><st1:place w:st="on"><st1:city w:st="on">QRS</st1:city>,<span style="letter-spacing: 0.45pt;"> </span><st1:state w:st="on">PQ</st1:state></st1:place><span style="letter-spacing: 0.95pt;"> </span>bình<span style="letter-spacing: -0.85pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 1.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">hoặc<span style="letter-spacing: 1pt;"> </span>kéo<span style="letter-spacing: 0.35pt;"> </span>dài,<span style="letter-spacing: 1.75pt;"> </span>sóng<span style="letter-spacing: 1.9pt;"> </span>P<span style="letter-spacing: 0.9pt;"> </span>có<span style="letter-spacing: 1.9pt;"> </span>dạng khác<span style="letter-spacing: 0.5pt;"> </span>so với<span style="letter-spacing: -0.35pt;"> </span>P<span style="letter-spacing: -0.25pt;"></span>của<span style="letter-spacing: -0.25pt;"> </span>nhịp<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang.<span style="letter-spacing: -0.15pt;"> </span>Nếu<span style="letter-spacing: -0.75pt;"> </span>ổ<span style="letter-spacing: 0.75pt;"> </span>phát nhịp<span style="letter-spacing: 1.2pt;"> </span>ở<span style="letter-spacing: 0.1pt;"> </span>phần<span style="letter-spacing: -0.15pt;"> </span>trên<span style="letter-spacing: 0.4pt;"> </span>của<span style="letter-spacing: -0.25pt;"> </span>nhĩ<span style="letter-spacing: 0.85pt;"> </span>phải<span style="letter-spacing: 0.05pt;"> </span>thì<span style="letter-spacing: 0.5pt;"> </span>sóng<span style="letter-spacing: 0.75pt;"> </span>P<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.1pt;">d</span></span><span lang="VI" style="line-height: 22px;">ương</span><span lang="VI" style="letter-spacing: 0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">ở<span style="letter-spacing: 0.1pt;"> </span>đạo<span style="letter-spacing: 0.9pt;"> </span>trình D<span style="position: relative; top: 2.5pt;">I</span>,<span style="letter-spacing: -0.25pt;"> </span>D<span style="letter-spacing: -1.25pt;"> </span><span style="position: relative; top: 2.5pt;">II</span>, D<span style="position: relative; top: 2.5pt;">III</span>,<span style="letter-spacing: -0.25pt;"> </span>aVF, V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">6</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.2pt;"><span class="Apple-style-span" style="font-size: large;">Nếu<span style="letter-spacing: -0.85pt;"> </span>ổ<span style="letter-spacing: 0.65pt;"> </span>phát<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 1.1pt;"> </span>ở phần<span style="letter-spacing: -0.25pt;"> </span>thấp<span style="letter-spacing: 1.7pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>p<span style="letter-spacing: 0.1pt;">h</span>ải<span style="letter-spacing: 0.35pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>âm<span style="letter-spacing: 0.2pt;"> </span>tính<span style="letter-spacing: 0.75pt;"> </span>ở đạo<span style="letter-spacing: 0.8pt;"> </span>trình D<span style="position: relative; top: 2.5pt;">I</span>,<span style="letter-spacing: -0.25pt;"> </span>D<span style="letter-spacing: -1.25pt;"> </span><span style="position: relative; top: 2.5pt;">III</span>, aVF.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Sóng<span style="letter-spacing: -0.2pt;"> </span>P<span style="letter-spacing: -0.3pt;"> </span>có<span style="letter-spacing: 0.7pt;"> </span>thể<span style="letter-spacing: -0.65pt;"> </span>khó<span style="letter-spacing: 0.55pt;"> </span>nhận<span style="letter-spacing: 1.95pt;"> </span>dạng<span style="letter-spacing: 0.45pt;"> </span>nếu<span style="letter-spacing: -0.65pt;"> </span>chồng<span style="letter-spacing: 0.6pt;"> </span>vào<span style="letter-spacing: 0.6pt;"> </span>sóng<span style="letter-spacing: 0.7pt;"> </span>T.<span style="letter-spacing: -0.35pt;"> </span>Nếu<span style="letter-spacing: -0.75pt;"> </span>sóng<span style="letter-spacing: 0.7pt;"> </span>P<span style="letter-spacing: -0.3pt;"> </span>không<span style="letter-spacing: 0.3pt;"> </span>chồng<span style="letter-spacing: 0.6pt;"> </span>lên<span style="letter-spacing: 0.5pt;"> </span>sóng<span style="letter-spacing: 0.7pt;"> </span>T<span style="letter-spacing: -0.3pt;"> </span>thì<span style="letter-spacing: 0.5pt;"> </span>PR kéo<span style="letter-spacing: -0.6pt;"> </span>dài<span style="letter-spacing: 0.85pt;"></span>giống<span style="letter-spacing: 0.85pt;"> </span>blốc<span style="letter-spacing: 0.9pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.05pt;"> </span>độ<span style="letter-spacing: 0.85pt;"> </span>I.<span style="letter-spacing: 0.3pt;"> </span>Hoặc<span style="letter-spacing: 0.05pt;"> </span>1,<span style="letter-spacing: 0.3pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>hoặc<span style="letter-spacing: 0.05pt;"> </span>3...<span style="letter-spacing: 0.3pt;"> </span>sóng<span style="letter-spacing: 0.95pt;"> </span>P<span style="letter-spacing: -0.05pt;"> </span>mới<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>1<span style="letter-spacing: 0.3pt;"> </span>phức<span style="letter-spacing: 0.05pt;"> </span>bộ<span style="letter-spacing: 0.3pt;"> </span>QRS<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: 1.15pt;"> </span>nhịp nhanh<span style="letter-spacing: -0.3pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>1:1;<span style="letter-spacing: -0.2pt;"></span>2:1;<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">3:1...nhưng có</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">đặc<span style="letter-spacing: 1.75pt;"> </span>điểm <span style="letter-spacing: 0.1pt;"><span> </span></span>là<span style="letter-spacing: -0.5pt;"> </span>giữa<span style="letter-spacing: -0.2pt;"> </span>2 sóng<span style="letter-spacing: 0.65pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường đẳng</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">điện.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.25pt;"> </span>Thực<span style="letter-spacing: -0.25pt;"> </span>hiện<span style="letter-spacing: -0.6pt;"> </span>những<span style="letter-spacing: 0.25pt;"> </span>nghiệm<span style="letter-spacing: -0.5pt;"> </span>pháp<span style="letter-spacing: 0.6pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">phó<span style="letter-spacing: 0.55pt;"> </span>giao<span style="letter-spacing: 0.05pt;"> </span>cảm:<span style="letter-spacing: 0.65pt;"> </span>xoa<span style="letter-spacing: 0.05pt;"> </span>x<span style="letter-spacing: -0.1pt;">o</span>ang<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 1.45pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>cảnh,<span style="letter-spacing: 0.95pt;"> </span>làm<span style="letter-spacing: -0.2pt;"> </span>nghiệm pháp<span style="letter-spacing: 0.4pt;"></span>Valsalva...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 1.4pt;"> </span>Truyền<span style="letter-spacing: 0.35pt;"> </span>tĩnh<span style="letter-spacing: -0.65pt;"> </span>mạch<span style="letter-spacing: 1.75pt;"> </span>thuốc<span style="letter-spacing: 1.9pt;"> </span>verapamil,<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: 1.15pt;"> </span>thuốc<span style="letter-spacing: 1.9pt;"> </span>nhóm<span style="letter-spacing: 1.95pt;"> </span>I</span><span style="position: relative; top: -4.5pt;">C<span style="letter-spacing: 0.1pt;"> </span></span><span style="position: relative; top: 0.5pt;">(ajmaline,<span style="letter-spacing: 0.9pt;"> </span>pr<span style="letter-spacing: -0.1pt;">o</span>pafenone,<span style="letter-spacing: 0.45pt;"> </span>flecaini<span style="letter-spacing: -0.05pt;">d</span>e,</span>disopyramide,<span style="letter-spacing: -0.7pt;"> </span>quinidine).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Sốc<span style="letter-spacing: -0.15pt;"> </span>điện<span style="letter-spacing: 0.15pt;"> </span>ngoài<span style="letter-spacing: 0.7pt;"> </span>lồng<span style="letter-spacing: 0.6pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>độ<span style="letter-spacing: -0.3pt;"> </span>đồng<span style="letter-spacing: 2pt;"> </span>bộ, mức<span style="letter-spacing: -0.2pt;"> </span>năng<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">l</span><span lang="VI">ượng</span><span lang="VI" style="letter-spacing: -0.05pt;"> </span>50j.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.85pt;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.4.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh <span style="letter-spacing: 0.2pt;"><span> </span></span>nút<span style="letter-spacing: -0.95pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.55pt;"> </span>(<span style="letter-spacing: -0.1pt;">A</span>V<span style="letter-spacing: 1.7pt;"> </span>nodal<span style="letter-spacing: 1.05pt;"> </span>tachycardia):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Vị<span style="letter-spacing: 0.6pt;"> </span>trí<span style="letter-spacing: 0.3pt;"> </span>ổ<span style="letter-spacing: 0.65pt;"> </span>phát<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 1.1pt;"> </span>luôn<span style="letter-spacing: 0.65pt;"> </span>luôn<span style="letter-spacing: 0.65pt;"> </span>ở nút<span style="letter-spacing: -0.3pt;"> </span>nhĩ-thất,<span style="letter-spacing: -0.4pt;"> </span><span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>duy trì<span style="letter-spacing: 0.5pt;"> </span><span lang="VI">nhờ cơ</span><span lang="VI" style="letter-spacing: 0.6pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>“vòng <span style="letter-spacing: 1pt;"><span> </span></span>vào<span style="letter-spacing: 0.55pt;"> </span>lại”.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.05pt;"> </span>Nguyên<span style="letter-spacing: 1.2pt;"> </span>nhân:<span style="letter-spacing: 0.4pt;"> </span>nhịp<span style="letter-spacing: -0.15pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>anh nút<span style="letter-spacing: -0.15pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.2pt;"> </span>hay gặp<span style="letter-spacing: -0.25pt;"> </span>ở<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: 0.65pt;"> </span>bệnh<span style="letter-spacing: -0.6pt;"> </span>van<span style="letter-spacing: -0.4pt;"> </span>tim,<span style="letter-spacing: -0.05pt;"> </span>bệ<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: -0.6pt;"> </span>thiếu<span style="letter-spacing: -0.6pt;"> </span>máu<span style="letter-spacing: 1.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim c<span style="letter-spacing: -0.05pt;">ụ</span>c bộ, nhồi<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 1.25pt;"></span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: -0.15pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>tính,<span style="letter-spacing: 1.35pt;"> </span>viêm<span style="letter-spacing: 1.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: -0.15pt;"> </span>cấp<span style="letter-spacing: 1.7pt;"> </span>tí<span style="letter-spacing: -0.05pt;">n</span>h,<span style="letter-spacing: 0.6pt;"> </span>viêm<span style="letter-spacing: 0.3pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổi</span>,<span style="letter-spacing: 0.3pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>digitalis...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.15pt;"> </span>Biểu<span style="letter-spacing: -0.45pt;"> </span>hiện<span style="letter-spacing: 0.35pt;"> </span>lâm<span style="letter-spacing: -1pt;"> </span>sàng:<span style="letter-spacing: 1.55pt;"> </span>hồi<span style="letter-spacing: 1.8pt;"> </span>hộp,<span style="letter-spacing: 1pt;"> </span>đánh<span style="letter-spacing: 1.85pt;"> </span>trống<span style="letter-spacing: 1.7pt;"> </span>ngực,<span style="letter-spacing: 0.95pt;"> </span>mệt<span style="letter-spacing: 0.45pt;"> </span>mỏi,<span style="letter-spacing: 1.85pt;"> </span>chán<span style="letter-spacing: 1.6pt;"> </span>ăn,<span style="letter-spacing: -0.9pt;"> </span>l<span style="letter-spacing: 0.1pt;">ị</span>m,<span style="letter-spacing: 1.65pt;"> </span>những<span style="letter-spacing: 1.2pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ười</span><span lang="VI" style="letter-spacing: 1.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 1.85pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn nhịp</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhanh<span style="letter-spacing: -0.3pt;"></span>nút<span style="letter-spacing: -0.3pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.35pt;"> </span>kịch<span style="letter-spacing: 1.05pt;"> </span>phát<span style="letter-spacing: -0.35pt;"> </span>k<span style="letter-spacing: -0.1pt;">h</span>i<span style="letter-spacing: -0.05pt;"> </span>hết<span style="letter-spacing: -0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 0.65pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>đái<span style="letter-spacing: 0.85pt;"> </span>nhiều.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 21px;">+<span style="letter-spacing: 0.9pt;"> </span>Điện<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.8pt;"> </span>đồ:<span style="letter-spacing: -1.15pt;"> </span>sóng<span style="letter-spacing: 1.6pt;"> </span>P<span style="letter-spacing: 0.6pt;"> </span>luôn<span style="letter-spacing: 1.75pt;"> </span>âm<span style="letter-spacing: 1.35pt;"> </span>tính<span style="letter-spacing: -1.1pt;"> </span>ở<span style="letter-spacing: 0.95pt;"> </span>đạo<span style="letter-spacing: -0.6pt;"> </span>trình <span style="letter-spacing: 1.25pt;"><span> </span></span><span style="letter-spacing: 0.1pt;">D</span><span style="position: relative; top: 2.5pt;">II</span>,<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">D</span><span style="position: relative; top: 2.5pt;">III</span>,<span style="letter-spacing: 0.7pt;"> </span>a<span style="letter-spacing: -0.05pt;">V</span>F;<span style="letter-spacing: 0.85pt;"> </span>sóng<span style="letter-spacing: 1.6pt;"> </span>P<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>thể<span style="letter-spacing: 0.2pt;"> </span>đứng<span style="letter-spacing: 1.25pt;"> </span></span><span lang="VI" style="line-height: 21px;">trước,</span><span lang="VI" style="letter-spacing: 0.95pt; line-height: 21px;"> </span><span style="line-height: 21px;">hoặc ngay<span style="letter-spacing: 0.6pt;"> </span>sau,<span style="letter-spacing: 0.85pt;"></span>hoặc<span style="letter-spacing: 0.6pt;"> </span>hoà<span style="letter-spacing: 1.6pt;"> </span>vào<span style="letter-spacing: 1.2pt;"> </span>phức<span style="letter-spacing: 0.6pt;"> </span>bộ<span style="letter-spacing: 0.85pt;"> </span>QRS;<span style="letter-spacing: 0.05pt;"> </span>tần<span style="letter-spacing: 0.7pt;"> </span>số<span style="letter-spacing: 1.45pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>nhĩ<span style="letter-spacing: 1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 21px;">ường</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 21px;"> </span><span style="line-height: 21px;">gặp<span style="letter-spacing: 0.45pt;"> </span></span><span lang="VI" style="line-height: 21px;">140-180ck/phút, nhưng</span><span lang="VI" style="letter-spacing: 0.9pt; line-height: 21px;"> </span><span style="line-height: 21px;">cũng<span style="letter-spacing: 0.45pt;"> </span>có khi<span style="letter-spacing: -0.15pt;"> </span>đạt<span style="letter-spacing: 0.9pt;"> </span>tới<span style="letter-spacing: -0.15pt;"></span>250ck/phút.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.3pt;"> </span>Điều<span style="letter-spacing: 0.8pt;"> </span>trị:<span style="letter-spacing: 0.75pt;"> </span>giống<span style="letter-spacing: 0.9pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ư</span><span lang="VI" style="letter-spacing: 0.35pt;"> </span>nhịp<span style="letter-spacing: 0.65pt;"> </span>nhanh<span style="letter-spacing: 0.05pt;"> </span>nhĩ,<span style="letter-spacing: 0.65pt;"> </span>nếu<span style="letter-spacing: -0.35pt;"> </span>có<span style="letter-spacing: 1pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: 0.3pt;"> </span>nhịp<span style="letter-spacing: 1.2pt;"> </span>nhanh<span style="letter-spacing: 0.05pt;"> </span>nút<span style="letter-spacing: 0.1pt;"> </span>nhĩ-thất kịch<span style="letter-spacing: 1.65pt;"> </span>phát,<span style="letter-spacing: 0.45pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>cấp<span style="letter-spacing: 2.1pt;"> </span>cứu phục<span style="letter-spacing: 1pt;"> </span>hồi<span style="letter-spacing: 2.05pt;"></span>nhịp<span style="letter-spacing: -0.9pt;"> </span>xoang<span style="letter-spacing: 1.15pt;"> </span>bằng:<span style="letter-spacing: 1.8pt;"> </span>ATP<span style="letter-spacing: 0.75pt;"> </span>(adenosin<span style="letter-spacing: 1pt;"> </span>tri-phosphat)<span style="letter-spacing: 0.85pt;"> </span>20<span style="letter-spacing: 1.45pt;"> </span>mg<span style="letter-spacing: 1.25pt;"> </span>~<span style="letter-spacing: 1.6pt;"> </span>1ống<span style="letter-spacing: 1.85pt;"> </span>tiêm<span style="letter-spacing: -0.7pt;"> </span>tĩnh<span style="letter-spacing: -0.65pt;"> </span>mạch<span style="letter-spacing: 1.75pt;"> </span>trong<span style="letter-spacing: 1.15pt;"> </span>1-2<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">phút.<span style="letter-spacing: 0.65pt;"> </span>Điều<span style="letter-spacing: 1.6pt;"> </span>trị<span style="letter-spacing: -0.9pt;"> </span>triệt<span style="letter-spacing: 0.35pt;"> </span>để<span style="letter-spacing: 0.8pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ịp <span style="letter-spacing: 0.85pt;"><span> </span></span>nhanh<span style="letter-spacing: 0.85pt;"> </span>nút<span style="letter-spacing: 0.85pt;"> </span>nhĩ-thất<span style="letter-spacing: 0.8pt;"> </span>bằng<span style="letter-spacing: 1.55pt;"> </span></span><span lang="VI" style="line-height: 22px;">phương</span><span lang="VI" style="letter-spacing: 1.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 1.5pt;"> </span>đốt<span style="letter-spacing: -0.95pt;"> </span>năng<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: 0.05pt;">l</span></span><span lang="VI" style="line-height: 22px;">ượng</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần<span style="letter-spacing: 1pt;"> </span>số<span style="letter-spacing: 1.75pt;"> </span>radio<span style="letter-spacing: 0.9pt;"> </span>qua ống<span style="letter-spacing: 0.5pt;"> </span>thông,<span style="letter-spacing: 0.25pt;"><span> </span></span>để<span style="letter-spacing: -0.55pt;"> </span>cắt<span style="letter-spacing: -0.15pt;"> </span>“vòng <span style="letter-spacing: 1pt;"><span> </span></span>vào<span style="letter-spacing: 0.55pt;"> </span>lại”.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.5.<span style="letter-spacing: -0.25pt;"> </span>Ngoại<span style="letter-spacing: 2.2pt;"> </span>tâm<span style="letter-spacing: 0.45pt;"> </span>thu<span style="letter-spacing: 1.25pt;"> </span>trên <span style="letter-spacing: 0.15pt;"><span> </span></span>thất<span style="letter-spacing: 0.3pt;"> </span>(supraventric<span style="letter-spacing: -0.1pt;">u</span><span style="letter-spacing: 0.05pt;">l</span>ar<span style="letter-spacing: 0.65pt;"> </span>ectopic<span style="letter-spacing: -0.35pt;"> </span>beats):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Còn<span style="letter-spacing: 0.2pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>ngoại <span style="letter-spacing: 0.6pt;"><span> </span></span>tâm<span> </span>thu<span style="letter-spacing: -0.15pt;"> </span>nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>nhĩ<span style="letter-spacing: 2pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>chỉ<span style="letter-spacing: 1.95pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>ổ<span style="letter-spacing: 0.65pt;"> </span>phát<span style="letter-spacing: -0.65pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>k<span style="letter-spacing: 0.1pt;">í</span>ch<span style="letter-spacing: 0.7pt;"> </span>thích<span style="letter-spacing: 1.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>nằm<span style="letter-spacing: 0.45pt;"> </span>ở nhĩ<span style="letter-spacing: 0.35pt;"> </span>ngoài<span style="letter-spacing: 0.35pt;"> </span>nút<span style="letter-spacing: -0.3pt;"> </span>xoang.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.75pt;"> </span>Nguyên<span style="letter-spacing: 1.4pt;"> </span>nhân:<span style="letter-spacing: 0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">gặp<span style="letter-spacing: 0.45pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>những<span style="letter-spacing: 0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">bị<span style="letter-spacing: 1.35pt;"> </span>bệnh<span style="letter-spacing: 0.1pt;"> </span>phổi<span style="letter-spacing: 1.2pt;"> </span>mạn<span style="letter-spacing: 0.45pt;"> </span>tính,<span style="letter-spacing: 1.85pt;"> </span>bệnh<span style="letter-spacing: 0.1pt;"> </span>thiếu<span style="letter-spacing: 0.05pt;"> </span>máu<span style="letter-spacing: 2.05pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.9pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.65pt;"> </span>cục bộ, viêm<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 22px;"></span><span style="line-height: 22px;">tim,<span style="letter-spacing: -0.2pt;"> </span>suy tim,<span style="letter-spacing: -0.25pt;"> </span>nghiện<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: 0.05pt;">r</span></span><span lang="VI" style="line-height: 22px;">ượu...</span><span style="line-height: 22px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.85pt;"> </span>Ngoại<span style="letter-spacing: 1.25pt;"> </span>tâm<span style="letter-spacing: 1.45pt;"> </span>thu<span style="letter-spacing: 0.75pt;"> </span>nhĩ<span style="letter-spacing: -1.2pt;"> </span>không<span style="letter-spacing: 1.55pt;"> </span>gây<span style="letter-spacing: 1pt;"> </span>rối<span style="letter-spacing: 1.55pt;"> </span>loạn<span style="letter-spacing: 1.35pt;"> </span>nặng<span style="letter-spacing: 0.5pt;"> </span>về<span style="letter-spacing: -0.3pt;"> </span>huyết<span style="letter-spacing: 0.1pt;"> </span>động,<span style="letter-spacing: 1.15pt;"> </span>bệnh<span style="letter-spacing: 0.2pt;"> </span>nhân<span style="letter-spacing: -1.15pt;"> </span>chỉ<span style="letter-spacing: -1.1pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>cảm<span style="letter-spacing: 1.35pt;"> </span>giác<span style="letter-spacing: 1.35pt;"> </span>nhịp tim<span style="letter-spacing: -0.15pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>kh<span style="letter-spacing: -0.05pt;">ô</span>ng<span style="letter-spacing: 0.5pt;"></span>đều.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.3pt;"> </span>Điện<span style="letter-spacing: 0.8pt;"> </span>tim<span style="letter-spacing: 0.2pt;"> </span>đồ:<span style="letter-spacing: 0.7pt;"> </span>sóng<span style="letter-spacing: 1pt;"> </span>P’<span style="letter-spacing: 1.35pt;"> </span>biến<span style="letter-spacing: -0.5pt;"> </span>dạng<span style="letter-spacing: 0.75pt;"> </span>so<span style="letter-spacing: 0.25pt;"> </span>với<span style="letter-spacing: -0.1pt;"> </span>sóng<span style="letter-spacing: 1pt;"> </span>P<span style="letter-spacing: 0.1pt;"> </span>của nút<span style="letter-spacing: 0.05pt;"> </span>xoang,<span style="letter-spacing: 0.05pt;"> </span>P’-<span style="letter-spacing: 1.35pt;"> </span>Q’<span style="letter-spacing: 1.15pt;"> </span>ngắn,<span style="letter-spacing: 0.1pt;"> </span>và<span style="letter-spacing: 0.65pt;"> </span>P’<span style="letter-spacing: -0.3pt;"> </span>luôn <span style="letter-spacing: 1.65pt;"><span> </span></span>đi<span style="letter-spacing: 1.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">trước phức</span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">bộ Q’R’S’.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.05pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Nhịp<span style="letter-spacing: -1.05pt;"> </span>ngoại<span style="letter-spacing: 1.65pt;"> </span>tâm<span style="letter-spacing: -0.9pt;"> </span>thu<span style="letter-spacing: 1.15pt;"> </span>nhĩ<span style="letter-spacing: -0.8pt;"> </span>có<span style="letter-spacing: 1.95pt;"> </span>thể<span style="letter-spacing: 0.55pt;"> </span>đến<span style="letter-spacing: 1.8pt;"> </span>sớm,<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 1.95pt;"> </span>nghỉ<span style="letter-spacing: -0.75pt;"> </span>bù<span style="letter-spacing: 1.1pt;"> </span>hoặc<span style="letter-spacing: 1.1pt;"> </span>xen<span style="letter-spacing: 1.3pt;"> </span>kẽ,<span style="letter-spacing: 0.6pt;"> </span>hoặc<span style="letter-spacing: 1.1pt;"> </span>dịch<span style="letter-spacing: -0.7pt;"> </span>nhịp<span style="letter-spacing: -1.05pt;"> </span>so<span style="letter-spacing: 1.15pt;"> </span>với<span style="letter-spacing: 0.9pt;"> </span>nhịp xoang.<span style="letter-spacing: 0.7pt;"> </span>Nếu<span style="letter-spacing: 0.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">hơn</span><span lang="VI" style="letter-spacing: 1.4pt; line-height: 22px;"></span><span style="line-height: 22px;">3<span style="letter-spacing: 1pt;"> </span>ngoại<span style="letter-spacing: 1.35pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu<span style="letter-spacing: 0.85pt;"> </span>nhĩ<span style="letter-spacing: -1.1pt;"> </span>liên<span style="letter-spacing: -1.1pt;"> </span>tiếp<span style="letter-spacing: 0.05pt;"> </span>thay<span style="letter-spacing: 0.8pt;"> </span>thế<span style="letter-spacing: 0.25pt;"> </span>n<span style="letter-spacing: -0.1pt;">h</span>ịp<span style="letter-spacing: 1.35pt;"> </span>xoang<span style="letter-spacing: 0.7pt;"> </span>thì<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 1.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 1.6pt;"> </span>là <span style="letter-spacing: 1.7pt;"><span> </span></span>“phó <span style="letter-spacing: 0.7pt;"><span> </span></span>t<span style="letter-spacing: -0.05pt;">â</span>m <span style="letter-spacing: 0.6pt;"><span> </span></span>t<span style="letter-spacing: -0.05pt;">h</span>u<span style="letter-spacing: 0.95pt;"> </span>- Parasystole”.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">Sau<span style="letter-spacing: -0.9pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>điều<span style="letter-spacing: -0.4pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân,<span style="letter-spacing: 1.2pt;"> </span>lựa<span style="letter-spacing: -0.15pt;"> </span>c<span style="letter-spacing: -0.1pt;">h</span>ọn<span style="letter-spacing: 0.45pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>sau đây:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.65pt;"><span class="Apple-style-span" style="font-size: large;">. Quinidin<span style="letter-spacing: -0.45pt;"> </span>0,30 ~<span style="letter-spacing: 0.25pt;"> </span>1 v/ngày,<span style="letter-spacing: 1.55pt;"> </span>đợt<span style="letter-spacing: 0.05pt;"> </span>10-15 ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">.<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">A</span><span style="letter-spacing: -0.15pt;">j</span><span style="letter-spacing: -0.2pt;">mali</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.2pt;">(ta</span><span style="letter-spacing: -0.15pt;">c</span><span style="letter-spacing: -0.25pt;">h</span><span style="letter-spacing: -0.15pt;">m</span><span style="letter-spacing: -0.2pt;">ali</span><span style="letter-spacing: -0.25pt;">n</span>)<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">5</span>0<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">m</span>g<span style="letter-spacing: -0.6pt;"> </span>~<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.2pt;">1ống/ngày</span>,<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.2pt;">tiê</span>m<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.2pt;">bắ</span>p<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.15pt;">thịt</span>,<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.15pt;">đợ</span>t<span style="letter-spacing: -0.2pt;"> 10-1</span>5<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">ngày.</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.7pt;"><span class="Apple-style-span" style="font-size: large;">. Isoptin<span style="letter-spacing: -0.35pt;"> </span>75-150 mg/ngày,<span style="letter-spacing: 0.25pt;"> </span>uống,<span style="letter-spacing: 0.55pt;"> </span>đợt<span style="letter-spacing: 0.45pt;"> </span>10-15 ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.65pt;"><span class="Apple-style-span" style="font-size: large;">. Rytmonorm<span style="letter-spacing: -0.6pt;"> </span>(propafenon)<span style="letter-spacing: 2.35pt;"> </span>0,15 ~<span style="letter-spacing: 0.25pt;"> </span>1- 2 v/<span style="letter-spacing: -0.45pt;"> </span>ngày,<span style="letter-spacing: 0.35pt;"> </span>uống,<span style="letter-spacing: 0.55pt;"> </span>đợt<span style="letter-spacing: 0.45pt;"> </span>15 ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.6.<span style="letter-spacing: -0.25pt;"> </span>Cuồng<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>nhĩ<span style="letter-spacing: 0.55pt;"> </span>(atrial<span style="letter-spacing: 1.7pt;"> </span>flutter):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.4pt;"> </span>Cuồng<span style="letter-spacing: 0.45pt;"> </span>động<span> </span>nhĩ<span style="letter-spacing: 1.6pt;"> </span>là<span style="letter-spacing: -0.6pt;"> </span>hoạt<span style="letter-spacing: 1.15pt;"> </span>động<span> </span>của<span style="letter-spacing: 0.15pt;"> </span>nhĩ<span style="letter-spacing: 0.8pt;"> </span>do<span style="letter-spacing: 0.35pt;"> </span>những<span style="letter-spacing: 0.45pt;"> </span>xung<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.5pt;"> </span>kích<span style="letter-spacing: 0.75pt;"> </span>thích<span style="letter-spacing: 1.05pt;"> </span>bệnh<span style="letter-spacing: -0.25pt;"> </span>lý<span style="letter-spacing: 0.35pt;"> </span>chạy<span style="letter-spacing: 0.85pt;"> </span>vòng<span style="letter-spacing: 0.7pt;"> </span>tròn (có<span style="letter-spacing: 0.6pt;"> </span>chu<span style="letter-spacing: -0.15pt;"> </span>vi<span style="letter-spacing: -0.45pt;"></span><span style="letter-spacing: -0.05pt;">v</span>ài xentimet) ở nhĩ<span style="letter-spacing: 0.35pt;"> </span>phải.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.55pt;"> </span>Nguyên<span style="letter-spacing: 1.2pt;"> </span>nhân:<span style="letter-spacing: 0.5pt;"> </span>cuồng<span style="letter-spacing: 1.15pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>hay<span style="letter-spacing: 0.45pt;"> </span>gặp<span style="letter-spacing: 0.25pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>những<span style="letter-spacing: 0.6pt;"> </span>b<span style="letter-spacing: -0.05pt;">ệ</span>nh<span style="letter-spacing: -0.1pt;"> </span>nhân<span style="letter-spacing: 2.25pt;"> </span>bị<span style="letter-spacing: 0.4pt;"> </span>thiếu<span style="letter-spacing: -0.15pt;"> </span>máu<span style="letter-spacing: 1.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.7pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.45pt;"> </span>cục<span style="letter-spacing: 0.25pt;"> </span>bộ,<span style="letter-spacing: 0.6pt;"> </span>bệnh van<span style="letter-spacing: -0.5pt;"> </span>2 lá,<span style="letter-spacing: -0.4pt;"> </span>viêm<span style="letter-spacing: 2.35pt;"></span>tràn<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">d</span><span style="letter-spacing: 0.05pt;">ị</span>ch màng<span style="letter-spacing: 0.35pt;"> </span>ngoài<span style="letter-spacing: 0.35pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>t<span style="letter-spacing: -0.05pt;">i</span>m-ph<span style="letter-spacing: -0.05pt;">ổ</span>i<span style="letter-spacing: 0.2pt;"> </span>mạn<span style="letter-spacing: -0.35pt;"> </span>tính,<span style="letter-spacing: 1.05pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>hormon<span style="letter-spacing: -0.35pt;"> </span>tuyến<span style="letter-spacing: -0.8pt;"> </span>giáp...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.75pt;"> </span>Biểu<span style="letter-spacing: -0.85pt;"> </span>hiện<span style="letter-spacing: -0.05pt;"> </span>lâm<span style="letter-spacing: 1.35pt;"> </span>sàng:<span style="letter-spacing: 1.15pt;"> </span>phụ<span style="letter-spacing: 0.25pt;"> </span>thuộc<span style="letter-spacing: 0.55pt;"> </span>vào<span style="letter-spacing: 1.35pt;"> </span>tần<span style="letter-spacing: 0.65pt;"> </span>số<span style="letter-spacing: 1.3pt;"> </span>nhịp<span style="letter-spacing: 1.1pt;"> </span>thất/trong<span style="letter-spacing: 2.6pt;"> </span>1<span style="letter-spacing: 0.8pt;"> </span>phút<span style="letter-spacing: 0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">(cơn</span><span lang="VI" style="letter-spacing: 1.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">cuồng<span style="letter-spacing: 1.3pt;"> </span>động<span style="letter-spacing: 1.05pt;"> </span>nhĩ-nhanh kịch<span style="letter-spacing: 1.75pt;"> </span>phát<span style="letter-spacing: 0.35pt;"></span>nhĩ-thất<span style="letter-spacing: 0.4pt;"> </span>200-250ck/phút)<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.75pt;"> </span>tình<span style="letter-spacing: 1.45pt;"> </span>trạng<span style="letter-spacing: 0.8pt;"> </span>chức<span style="letter-spacing: 0.45pt;"> </span>năng<span style="letter-spacing: 0.95pt;"> </span>tim.<span style="letter-spacing: 0.5pt;"> </span>Cuồng<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>nhĩ<span style="letter-spacing: 1.05pt;"> </span>gây<span style="letter-spacing: 1.25pt;"> </span>hồi<span style="letter-spacing: 1.3pt;"> </span>hộp<span style="letter-spacing: 0.35pt;"> </span>đ<span style="letter-spacing: -0.1pt;">á</span>nh trống<span style="letter-spacing: 0.5pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>đau<span style="letter-spacing: 0.4pt;"></span>ngực,<span style="letter-spacing: -0.25pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở,<span style="letter-spacing: -0.2pt;"> </span>ngất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.35pt;"> </span>Điện<span style="letter-spacing: 0.85pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>đồ<span style="letter-spacing: 0.85pt;"> </span>cuồng<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>nhĩ:<span style="letter-spacing: 0.7pt;"> </span>không<span style="letter-spacing: 1.05pt;"> </span>thấy<span style="letter-spacing: 2.25pt;"> </span>sóng<span style="letter-spacing: 1.05pt;"> </span>P<span style="letter-spacing: 0.05pt;"> </span>của<span style="letter-spacing: 0.05pt;"> </span>nhịp<span style="letter-spacing: 0.7pt;"> </span>xoang<span style="letter-spacing: 0.1pt;"> </span>mà<span style="letter-spacing: 0.95pt;"> </span>thay<span style="letter-spacing: 0.2pt;"> </span>bằng<span style="letter-spacing: 0.8pt;"> </span>sóng<span style="letter-spacing: 1.05pt;"> </span>F,<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>tần số<span style="letter-spacing: 0.8pt;"> </span>từ<span style="letter-spacing: 0.1pt;"> </span>200-3<span style="letter-spacing: -0.05pt;">5</span>0<span style="letter-spacing: 0.2pt;"> </span>ck/phút,<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.05pt;">bi</span>ên<span style="letter-spacing: 1.85pt;"> </span>độ<span style="letter-spacing: 0.05pt;"> </span>giao động<span style="letter-spacing: 0.5pt;"> </span>từ<span style="letter-spacing: 0.1pt;"> </span>2,5-3<span style="letter-spacing: 0.1pt;"> </span>mm; nếu<span style="letter-spacing: -0.5pt;"> </span>cứ 1<span style="letter-spacing: 0.2pt;"> </span>sóng<span style="letter-spacing: 0.85pt;"> </span>F<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>1<span style="letter-spacing: 0.2pt;"> </span>phức<span style="letter-spacing: -0.05pt;"> </span>bộ<span style="letter-spacing: 0.2pt;"> </span>QRS<span style="letter-spacing: -0.5pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>gọi<span style="letter-spacing: 0.8pt;"> </span>là cuồng<span style="letter-spacing: 1.1pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>nhĩ<span style="letter-spacing: 0.7pt;"></span>1:1;<span style="letter-spacing: 0.35pt;"> </span>nếu<span style="letter-spacing: -0.15pt;"> </span>2<span style="letter-spacing: 0.55pt;"> </span>sóng<span style="letter-spacing: 1.2pt;"> </span>F<span style="letter-spacing: 0.5pt;"> </span>mới<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>1<span style="letter-spacing: 0.55pt;"> </span>phức<span style="letter-spacing: 0.3pt;"> </span>bộ<span style="letter-spacing: 0.55pt;"> </span>QRS<span style="letter-spacing: -0.15pt;"> </span>thì<span style="letter-spacing: 1.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.7pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 1.1pt;"> </span>là<span style="letter-spacing: 1.4pt;"> </span>cuồng<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.05pt;"> </span>nhĩ<span style="letter-spacing: 0.7pt;"> </span>2:1,<span style="letter-spacing: 0.35pt;"> </span>bằng cách<span style="letter-spacing: -0.15pt;"> </span>tính<span style="letter-spacing: 0.75pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư vậy</span><span lang="VI" style="letter-spacing: 1.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>gặp<span style="letter-spacing: -0.35pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>3:1<span style="letter-spacing: -0.15pt;"> </span>,<span> </span>4:1,<span style="letter-spacing: -0.2pt;"> </span>...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Phức<span style="letter-spacing: 1.25pt;"> </span>bộ<span style="letter-spacing: 1.75pt;"> </span>QRS<span style="letter-spacing: 1.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ường </span><span lang="VI" style="letter-spacing: -1.25pt;"><span> </span></span><<span style="letter-spacing: 1.7pt;"> </span>0,12<span style="letter-spacing: 1.75pt;"> </span>giây;<span style="letter-spacing: -0.35pt;"> </span><span lang="VI">nhưng </span><span lang="VI" style="letter-spacing: -1.25pt;"><span> </span></span>nếu<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 2.4pt;"> </span>blốc<span style="letter-spacing: 2.35pt;"> </span>nhánh,<span style="letter-spacing: 2.45pt;"> </span>ngoại<span style="letter-spacing: 1.8pt;"> </span>tâm<span style="letter-spacing: -0.45pt;"> </span>thu<span style="letter-spacing: 1.6pt;"> </span>thất, <span style="letter-spacing: 0.65pt;"><span> </span></span>hội<span style="letter-spacing: 1.6pt;"> </span>chứng WPW<span style="letter-spacing: -0.3pt;"> </span>thì<span style="letter-spacing: 0.4pt;"></span>phức<span style="letter-spacing: -0.25pt;"> </span>bộ QRS<span style="letter-spacing: -0.7pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>0,12 giây.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI">-<span> </span>Cơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>tính:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.6pt;"><span class="Apple-style-span" style="font-size: large;">. Digoxin<span style="letter-spacing: -0.4pt;"> </span>1/4-1/2<span style="letter-spacing: -0.35pt;"> </span>mg<span style="letter-spacing: -0.15pt;"> </span>pha<span style="letter-spacing: -0.3pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>dung dịch<span style="letter-spacing: 0.25pt;"> </span>glucose<span style="letter-spacing: -0.35pt;"> </span>5% ~ <span style="letter-spacing: 0.45pt;"><span> </span></span>5-10 ml,<span style="letter-spacing: -0.15pt;"> </span>tiêm<span style="letter-spacing: 0.8pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>ch<span style="letter-spacing: -0.05pt;">ậ</span><span style="letter-spacing: 0.05pt;">m</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.75pt;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.65pt;"> </span>Verapamil<span style="letter-spacing: 0.15pt;"> </span>5-10<span style="letter-spacing: 0.65pt;"> </span>mg,<span style="letter-spacing: 0.45pt;"> </span>tiêm<span style="letter-spacing: 1.45pt;"> </span>tĩnh<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>chậm<span style="letter-spacing: 2.55pt;"> </span>trong<span style="letter-spacing: 0.4pt;"> </span>2<span style="letter-spacing: 0.65pt;"> </span>phút,<span style="letter-spacing: 0.15pt;"> </span>sau<span style="letter-spacing: 0.65pt;"> </span>đó<span style="letter-spacing: 1.1pt;"> </span>30<span style="letter-spacing: 0.65pt;"> </span>phút tiêm<span style="letter-spacing: 1.45pt;"> </span>tĩnh<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>10 mg,<span style="letter-spacing: -0.2pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>không<span style="letter-spacing: 0.25pt;"></span>kết<span style="letter-spacing: -0.75pt;"> </span>quả<span style="letter-spacing: 0.25pt;"> </span>thì<span style="letter-spacing: 0.75pt;"> </span>ngừng thuốc.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Cả<span style="letter-spacing: 1.85pt;"> </span>hai<span style="letter-spacing: 1pt;"> </span>loại<span style="letter-spacing: 1.65pt;"> </span>thuốc<span style="letter-spacing: 1.6pt;"> </span>này<span style="letter-spacing: 1.65pt;"> </span>hầu<span style="letter-spacing: 1pt;"> </span>hết<span style="letter-spacing: 0.4pt;"> </span>các<span style="letter-spacing: 1.7pt;"> </span>t<span style="letter-spacing: -0.1pt;">r</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">hợp<span style="letter-spacing: 0.8pt;"> </span>đều<span style="letter-spacing: 1.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">đưa</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 1.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp <span style="letter-spacing: 1.05pt;"><span> </span></span>thất<span> </span>về<span style="letter-spacing: -0.1pt;"> </span>bình<span style="letter-spacing: -1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">hoặc phục<span style="letter-spacing: -0.45pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>đ</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ợc<span style="letter-spacing: 0.2pt;"></span>nhịp<span style="letter-spacing: 2.4pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>ngay<span style="letter-spacing: -0.25pt;"> </span>sau tiêm<span style="letter-spacing: 0.25pt;"> </span>ở những bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ưa có</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">suy<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>ứ trệ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 0.7pt;"> </span>Những<span style="letter-spacing: 0.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 1.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">cuồng<span style="letter-spacing: 1.25pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>nhĩ<span style="letter-spacing: 0.85pt;"> </span>cấp<span style="letter-spacing: 2.45pt;"> </span>tính<span style="letter-spacing: 1pt;"> </span>ở<span style="letter-spacing: 0.7pt;"> </span>bệnh nhân<span style="letter-spacing: 1pt;"> </span>nhồi<span style="letter-spacing: 1.3pt;"> </span>máu<span style="letter-spacing: 1.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.55pt;"> </span>cấp,<span style="letter-spacing: 2.45pt;"> </span>suy<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>ứ<span style="letter-spacing: 0.7pt;"> </span>trệ<span style="letter-spacing: -0.1pt;"> </span>hoặc sốc<span style="letter-spacing: 0.85pt;"> </span>tim,<span style="letter-spacing: 0.05pt;"> </span>điều<span style="letter-spacing: 0.95pt;"> </span>trị<span style="letter-spacing: 0.55pt;"></span>tốt<span style="letter-spacing: 0.85pt;"> </span>nhất<span style="letter-spacing: 2.1pt;"> </span>là<span style="letter-spacing: 1.1pt;"> </span>sốc<span style="letter-spacing: 0.85pt;"> </span>điện<span style="letter-spacing: 0.3pt;"> </span>ngoài<span style="letter-spacing: 0.95pt;"> </span>lồng<span style="letter-spacing: 0.85pt;"> </span>ngực với<span style="letter-spacing: -0.2pt;"> </span>chế<span style="letter-spacing: -0.45pt;"> </span>độ<span style="letter-spacing: -0.05pt;"> </span>đồng<span style="letter-spacing: 2.25pt;"> </span>bộ,<span style="letter-spacing: 0.25pt;"> </span>mức<span style="letter-spacing: 0.05pt;"> </span>năng<span style="letter-spacing: 0.5pt;"> </span>l</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ợng<span style="letter-spacing: 0.25pt;"> </span>25j<span style="letter-spacing: 0.1pt;"> </span>sẽ<span style="letter-spacing: -0.5pt;"> </span>đạt hiệu<span style="letter-spacing: -0.85pt;"> </span>quả<span style="letter-spacing: 0.5pt;"> </span>phục<span style="letter-spacing: -0.45pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"></span>xoang<span style="letter-spacing: -0.15pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>sang rung nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 1.4pt;"> </span>Dẫn<span> </span>nhĩ<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span></span><span lang="VI" style="line-height: 22px;">ượt</span><span lang="VI" style="letter-spacing: 1.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần<span style="letter-spacing: 1.2pt;"> </span>số<span style="letter-spacing: 1.95pt;"> </span>ở<span style="letter-spacing: 1.35pt;"> </span>tần<span style="letter-spacing: 1.2pt;"> </span>số<span style="letter-spacing: 1.95pt;"> </span>nh<span style="letter-spacing: 0.1pt;">ị</span>p<span style="letter-spacing: -0.95pt;"> </span>cao<span style="letter-spacing: 1.25pt;"> </span>350-400ck/phút,<span style="letter-spacing: 0.6pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 1.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">ứng<span style="letter-spacing: 1.35pt;"> </span>dụng<span style="letter-spacing: 1.1pt;"> </span>để<span style="letter-spacing: 1.35pt;"> </span>điều <span style="letter-spacing: 0.75pt;"><span> </span></span>trị<span style="letter-spacing: -0.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn cuồng</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">động<span style="letter-spacing: 0.8pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"></span>cấp<span style="letter-spacing: 1.9pt;"> </span>tính<span style="letter-spacing: 0.5pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>bệnh<span style="letter-spacing: -0.5pt;"> </span>nhân<span style="letter-spacing: 0.35pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>thời kỳ<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.05pt;">sa</span>u<span style="letter-spacing: 0.15pt;"> </span>phẫu<span style="letter-spacing: 1.9pt;"> </span>thuật<span style="letter-spacing: 2.2pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ì<span style="letter-spacing: 0.2pt;"> </span>đã<span style="letter-spacing: 1.25pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>sẵn<span style="letter-spacing: -0.65pt;"> </span>điện<span style="letter-spacing: 0.6pt;"> </span>c<span style="letter-spacing: -0.05pt;">ự</span>c<span style="letter-spacing: 0.05pt;"> </span>đặt<span style="letter-spacing: 0.9pt;"> </span>tạm<span style="letter-spacing: 0.7pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ời ở nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>dự phòng<span style="letter-spacing: 0.3pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>kịch<span style="letter-spacing: 0.25pt;"> </span>phát:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Lựa<span style="letter-spacing: 1.85pt;"> </span>chọn<span style="letter-spacing: 2.5pt;"> </span>một<span style="letter-spacing: 1.85pt;"> </span>trong<span style="letter-spacing: 1.8pt;"> </span>các <span style="letter-spacing: 0.15pt;"><span> </span></span>thuốc<span style="letter-spacing: 2.55pt;"> </span>sau<span style="letter-spacing: 2.05pt;"> </span>đây <span style="letter-spacing: 0.65pt;"><span> </span></span>để <span style="letter-spacing: 0.45pt;"><span> </span></span>duy<span style="letter-spacing: 2.05pt;"> </span>trì:<span style="letter-spacing: -0.05pt;"> </span>digitalis,<span style="letter-spacing: 1.65pt;"> </span>disopyramide,<span style="letter-spacing: 1.35pt;"> </span>propafenone, flec<span style="letter-spacing: -0.05pt;">a</span>inide,<span style="letter-spacing: -0.5pt;"></span><span style="letter-spacing: -0.05pt;">v</span>erap<span style="letter-spacing: -0.05pt;">a</span>mil,<span style="letter-spacing: -0.85pt;"> </span>p<span style="letter-spacing: -0.05pt;">r</span>opanolol,<span style="letter-spacing: -1.05pt;"> </span>amiodarone,<span style="letter-spacing: -0.6pt;"> </span>đốt<span style="letter-spacing: 0.35pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His bằng<span style="letter-spacing: -0.2pt;"> </span>năng<span style="letter-spacing: 1.1pt;"> </span>l</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ợng tần<span style="letter-spacing: -0.15pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>radio.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 16px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 17px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.6pt;"> </span>Điều<span style="letter-spacing: 2.1pt;"> </span>trị<span style="letter-spacing: -0.4pt;"> </span>cuồng<span style="letter-spacing: 2.2pt;"> </span>động<span style="letter-spacing: -1.05pt;"> </span>nhĩ<span style="letter-spacing: -0.45pt;"> </span>mạn<span style="letter-spacing: 2.1pt;"> </span>tính:<span style="letter-spacing: -0.5pt;"> </span>duy<span style="letter-spacing: 1.6pt;"> </span>trì<span style="letter-spacing: -0.4pt;"> </span>nhịp<span style="letter-spacing: -0.85pt;"> </span>thất <span style="letter-spacing: 0.55pt;"><span> </span></span>60-80ck/phút<span style="letter-spacing: 0.95pt;"> </span>bằng<span style="letter-spacing: 2pt;"> </span>một<span style="letter-spacing: 1.45pt;"> </span>trong<span style="letter-spacing: 1.35pt;"> </span>các<span style="letter-spacing: 1.9pt;"> </span>loại thuốc:<span style="letter-spacing: 1.95pt;"></span>digitalis,<span style="letter-spacing: 0.95pt;"> </span>blốc<span style="letter-spacing: 1.9pt;"> </span>β,<span style="letter-spacing: 0.5pt;"> </span>verapamil<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: 1.05pt;"> </span>amio<span style="letter-spacing: -0.05pt;">d</span>aron;<span style="letter-spacing: 0.75pt;"> </span>tốt<span style="letter-spacing: 1.95pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: 1.1pt;"> </span>là<span style="letter-spacing: 2.1pt;"> </span>sốc<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span style="letter-spacing: 0.05pt;">i</span>ện<span style="letter-spacing: 1.35pt;"> </span>để<span style="letter-spacing: 2.05pt;"> </span>chuyển<span style="letter-spacing: 0.65pt;"> </span>về<span style="letter-spacing: 0.15pt;"> </span>nhịp<span style="letter-spacing: -1.05pt;"> </span>xoang hoặc<span style="letter-spacing: -0.25pt;"> </span>rung nhĩ<span style="letter-spacing: 0.75pt;"></span>mạn<span style="letter-spacing: 0.2pt;"> </span>tính.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.7.<span style="letter-spacing: -0.25pt;"> </span>Rung<span style="letter-spacing: 1.05pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>(atri<span style="letter-spacing: -0.05pt;">a</span>l<span style="letter-spacing: 1.75pt;"> </span>fibrill<span style="letter-spacing: -0.05pt;">a</span>tion):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+ <span style="letter-spacing: -0.3pt;">Run</span>g<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>à<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">tìn</span>h <span style="letter-spacing: 0.15pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">trạn</span>g<span style="letter-spacing: 2.4pt;"> </span><span style="letter-spacing: -0.3pt;">từn</span>g<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>ó<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.3pt;">sợ</span>i<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">c</span></span><span lang="VI" style="line-height: 22px;">ơ</span><span lang="VI" style="letter-spacing: 0.1pt; line-height: 22px;"> </span><span style="letter-spacing: -0.25pt; line-height: 22px;">nh</span><span style="line-height: 22px;">ĩ<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>o<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">bó</span>p<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.25pt;">đồn</span>g<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.3pt;">thời</span>,<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">d</span>o<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">nhữ</span><span style="letter-spacing: -0.35pt;">n</span>g<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">xun</span>g<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.25pt;">kíc</span>h<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.3pt;">thích bện</span>h<span style="letter-spacing: -0.3pt;"> l</span>ý<span style="letter-spacing: -0.7pt;"></span><span style="letter-spacing: -0.25pt;">khá</span>c<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">nha</span>u<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>ề<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="letter-spacing: -0.3pt; line-height: 22px;">hướng</span><span style="line-height: 22px;">,<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">thờ</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">gia</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.35pt;">v</span>à<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">biê</span>n<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ộ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">...</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.65pt;"> </span>Nguyên<span style="letter-spacing: 1.3pt;"> </span>nhân:<span style="letter-spacing: 0.6pt;"> </span>nhiễm<span style="letter-spacing: -0.2pt;"> </span>khuẩn<span style="letter-spacing: 2.6pt;"> </span>cấp<span style="letter-spacing: 2.45pt;"> </span>tính,<span style="letter-spacing: 0.95pt;"> </span>nhồi<span style="letter-spacing: 1.3pt;"> </span>m<span style="letter-spacing: -0.1pt;">á</span>u<span style="letter-spacing: 2.05pt;"> </span><span lang="VI">cơ</span><span lang="VI" style="letter-spacing: 0.95pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>cấp<span style="letter-spacing: 2.45pt;"> </span>tính,<span style="letter-spacing: 0.95pt;"> </span>nghẽn<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.75pt;"> </span>phổi,<span style="letter-spacing: 0.95pt;"> </span>ngộ độc<span style="letter-spacing: 0.4pt;"> </span><span lang="VI">rượu, hẹp</span><span lang="VI" style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 l<span style="letter-spacing: -0.1pt;">á</span>, Basedow,<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.05pt;">so</span>i<span style="letter-spacing: -0.15pt;"> </span>dạ dày,<span style="letter-spacing: 1.8pt;"> </span>soi<span style="letter-spacing: -0.15pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>quản,<span style="letter-spacing: 0.05pt;"> </span>thông<span style="letter-spacing: 0.95pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>vô<span style="letter-spacing: 0.6pt;"> </span>căn...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.2pt;"> </span>Biểu<span style="letter-spacing: 0.45pt;"> </span>hiện<span style="letter-spacing: -0.6pt;"> </span>lâm<span style="letter-spacing: 0.8pt;"> </span>sàng:<span style="letter-spacing: 0.6pt;"> </span>giống<span style="letter-spacing: 0.8pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư</span><span lang="VI" style="letter-spacing: 0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">cuồng<span style="letter-spacing: 0.8pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>nhĩ,<span style="letter-spacing: 0.8pt;"> </span>nhịp<span style="letter-spacing: 0.8pt;"> </span>không<span style="letter-spacing: 1.25pt;"> </span>đều,<span style="letter-spacing: -0.35pt;"> </span>tần<span style="letter-spacing: 0.1pt;"> </span>số<span style="letter-spacing: 0.85pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>cao<span style="letter-spacing: 0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">hơn</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">Mấ</span>t<span style="letter-spacing: 2.5pt;"> </span><span style="letter-spacing: 0.3pt;">són</span>g<span style="letter-spacing: 1.25pt;"> </span>P<span style="letter-spacing: 0.25pt;"> m</span>à<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">tha</span>y<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">bằn</span>g<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.3pt;">són</span>g<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">f</span>;<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">són</span>g<span style="letter-spacing: 1.25pt;"> </span>f<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.3pt;">tha</span>y<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">đổ</span>i<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.25pt;">liê</span>n<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">tụ</span>c<span style="letter-spacing: 0.3pt;"> v</span>ề<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: 0.25pt;">biê</span>n<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: 0.25pt;">độ</span>,<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">tầ</span>n<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">số...</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 1.3pt;"> </span>Phức<span style="letter-spacing: 0.8pt;"> </span>bộ<span style="letter-spacing: 1.3pt;"> </span>QRS<span style="letter-spacing: 0.6pt;"> </span>cũng<span style="letter-spacing: 0.85pt;"> </span>thay<span style="letter-spacing: 1.15pt;"> </span>đổi:<span style="letter-spacing: -0.7pt;"> </span>thời<span style="letter-spacing: 1.15pt;"> </span>gian<span style="letter-spacing: 1.15pt;"> </span>khoảng<span style="letter-spacing: 1.6pt;"> </span>RR<span style="letter-spacing: 1.6pt;"> </span>không<span style="letter-spacing: 2.65pt;"> </span>đều,<span style="letter-spacing: 0.95pt;"> </span>biên<span style="letter-spacing: -0.7pt;"> </span>độ<span style="letter-spacing: 1.85pt;"> </span>các<span style="letter-spacing: 2.05pt;"> </span>sóng<span style="letter-spacing: 1.95pt;"> </span>R<span style="letter-spacing: 1.45pt;"> </span>cũng không<span style="letter-spacing: 2pt;"> </span>đều,<span style="letter-spacing: 0.3pt;"></span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">độ<span style="letter-spacing: 1.2pt;"> </span>rộng<span style="letter-spacing: 0.65pt;"> </span>phức<span style="letter-spacing: 0.4pt;"> </span>bộ<span style="letter-spacing: 0.65pt;"> </span>QRS<span style="letter-spacing: -0.05pt;"> </span><<span style="letter-spacing: 0.6pt;"> </span>0,12<span style="letter-spacing: 0.65pt;"> </span>giây,<span style="letter-spacing: 0.9pt;"> </span></span><span lang="VI" style="line-height: 22px;">nhưng</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">cũng<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 0.5pt;"> </span>><span style="letter-spacing: 0.6pt;"> </span>0,12<span style="letter-spacing: 0.65pt;"> </span>giây<span style="letter-spacing: 0.9pt;"> </span>nếu<span style="letter-spacing: -0.05pt;"> </span>là<span style="letter-spacing: 1.5pt;"> </span>ngo<span style="letter-spacing: 0.05pt;">ạ</span>i tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất,<span style="letter-spacing: 1.9pt;"> </span>hội<span style="letter-spacing: -0.15pt;"></span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI">- Cơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>tính:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 0.75pt;"> </span>Điều<span style="letter-spacing: 1.2pt;"> </span>trị<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.05pt;">bệ</span>nh<span style="letter-spacing: 0.05pt;"> </span>gây<span style="letter-spacing: 1.1pt;"> </span>ra<span style="letter-spacing: 0.65pt;"> </span>c</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ơ</span><span style="line-height: 22px;">n<span style="letter-spacing: 1.4pt;"> </span>rung<span style="letter-spacing: 0.75pt;"> </span>nhĩ<span style="letter-spacing: 1.1pt;"> </span>cấp<span style="letter-spacing: 2.5pt;"> </span>tín<span style="letter-spacing: -0.05pt;">h</span>:<span style="letter-spacing: 1.1pt;"> </span>bệ<span style="letter-spacing: -0.05pt;">n</span>h viêm<span style="letter-spacing: 1.05pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổ</span><span style="letter-spacing: 0.05pt;">i</span>,<span style="letter-spacing: 0.95pt;"> </span>nhồi<span style="letter-spacing: 1.35pt;"> </span>máu<span style="letter-spacing: 2pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.6pt;"> </span>cấp,<span style="letter-spacing: 2.5pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>ghẽn mạch<span style="letter-spacing: 0.35pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>sốc...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">. <span style="letter-spacing: 0.8pt;"><span> </span></span>Dùng <span style="letter-spacing: 0.25pt;"><span> </span></span>thuốc: <span style="letter-spacing: 1.4pt;"><span> </span></span>digitali<span style="letter-spacing: -0.05pt;">s</span>, <span style="letter-spacing: 0.4pt;"><span> </span></span>verapamil,<span style="letter-spacing: 2.75pt;"> </span>cordar<span style="letter-spacing: -0.05pt;">o</span>n, <span style="letter-spacing: 0.45pt;"><span> </span></span>blốc <span style="letter-spacing: 1.4pt;"><span> </span></span>thụ <span style="letter-spacing: 0.5pt;"><span> </span></span>cảm<span style="letter-spacing: 0.3pt;"> </span>thể <span style="letter-spacing: 0.05pt;"><span> </span></span>bê<span style="letter-spacing: 1.65pt;"> </span>ta, <span style="letter-spacing: 0.7pt;"><span> </span></span>disopyrami<span style="letter-spacing: -0.05pt;">d</span>e, ajmaline,<span style="letter-spacing: -0.5pt;"></span>propafenone,<span style="letter-spacing: -1.2pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>flecai<span style="letter-spacing: -0.05pt;">n</span>ide.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">Đả</span>o<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">bằn</span>g<span style="letter-spacing: -0.6pt;"> </span></span><span lang="VI" style="letter-spacing: -0.3pt; line-height: 22px;">phươn</span><span style="line-height: 22px;">g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">phá</span>p <span style="letter-spacing: -0.3pt;">số</span>c <span style="letter-spacing: -0.25pt;">điện</span>,<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>ề<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.35pt;">xo</span><span style="letter-spacing: -0.3pt;">an</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ì<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">dùn</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">tron</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">s</span>ố <span style="letter-spacing: -0.3pt;">thuố</span>c<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">trê</span>n<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ể<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">duy </span><span style="letter-spacing: -0.25pt;">tr</span>ì<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.65pt;"></span><span style="letter-spacing: -0.3pt;">xoang</span>,<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ỉ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">ngừn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">thuố</span>c<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">tá</span>i<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">phá</span>t<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.3pt;">run</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">nhĩ.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.6pt;"> </span>Điều<span style="letter-spacing: 1.05pt;"> </span>trị<span style="letter-spacing: 1.1pt;"> </span>thuốc<span style="letter-spacing: 1.1pt;"> </span>chống<span style="letter-spacing: 1.15pt;"> </span>đông<span style="letter-spacing: 1.15pt;"> </span>máu<span style="letter-spacing: 2.35pt;"> </span>để<span style="letter-spacing: 0.6pt;"> </span>dự<span style="letter-spacing: 0.6pt;"> </span>phòng<span style="letter-spacing: 0.85pt;"> </span>tắc<span style="letter-spacing: 0.45pt;"> </span>mạch:<span style="letter-spacing: 0.95pt;"> </span>thuốc<span style="letter-spacing: 1.1pt;"> </span>kháng<span style="letter-spacing: 0.95pt;"> </span>vitamin<span style="letter-spacing: -0.15pt;"> </span>K<span style="letter-spacing: 0.5pt;"> </span>(warfarin, sintrom...uống kéo<span style="letter-spacing: -0.9pt;"> </span>dài,<span style="letter-spacing: 0.5pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>những tai<span style="letter-spacing: -0.1pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>chảy<span style="letter-spacing: 0.4pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>ra).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.1.8.<span style="letter-spacing: -0.25pt;"> </span>Hội<span style="letter-spacing: 0.6pt;"> </span>chứng<span style="letter-spacing: 2.6pt;"> </span>yếu<span style="letter-spacing: 1.3pt;"> </span>nút<span style="letter-spacing: -0.95pt;"> </span>xoang<span style="letter-spacing: 1.15pt;"> </span>(sick<span style="letter-spacing: -0.25pt;"> </span>sinus<span style="letter-spacing: 1.25pt;"> </span>sy<span style="letter-spacing: -0.1pt;">n</span>drome:<span style="letter-spacing: 0.9pt;"> </span>SS<span style="letter-spacing: -0.1pt;">S</span>):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.75pt;"> </span>Hội<span style="letter-spacing: 0.8pt;"> </span>chứng<span style="letter-spacing: 0.5pt;"> </span>yếu<span style="letter-spacing: 0.1pt;"> </span>nút<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: 0.55pt;"> </span>là tình <span style="letter-spacing: 0.45pt;"><span> </span></span>trạng <span style="letter-spacing: 0.25pt;"><span> </span></span>mệt mỏi,<span style="letter-spacing: 1.4pt;"> </span>choáng<span style="letter-spacing: 1.85pt;"> </span>váng<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: 0.65pt;"> </span>rối<span style="letter-spacing: 1.4pt;"> </span>loạn<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 1.85pt;"> </span>mạn<span style="letter-spacing: 0.65pt;"> </span>tính,<span style="letter-spacing: 2.1pt;"> </span>kết hợp<span style="letter-spacing: -0.35pt;"> </span>giữa<span style="letter-spacing: -0.2pt;"> </span>rối<span style="letter-spacing: 0.65pt;"></span>loạn<span style="letter-spacing: -0.35pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.25pt;"> </span>(từng<span style="letter-spacing: -0.25pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">hay<span style="letter-spacing: -0.15pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài)<span style="letter-spacing: 0.5pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>ngừng xoang.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+ Nguyên<span style="letter-spacing: 0.65pt;"> </span>nhân:<span style="letter-spacing: -0.05pt;"> </span>hay<span style="letter-spacing: -0.1pt;"> </span>gặp<span style="letter-spacing: -0.3pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>bệnh<span style="letter-spacing: -0.65pt;"> </span>nhân<span style="letter-spacing: 1.15pt;"> </span>đau<span style="letter-spacing: -0.2pt;"> </span>thắt<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.1pt;">n</span>gực,<span style="letter-spacing: -0.15pt;"> </span>nhồi<span style="letter-spacing: 0.65pt;"> </span>máu<span style="letter-spacing: 0.45pt;"> </span>cũ<span style="letter-spacing: -0.3pt;"> </span><span lang="VI">cơ</span><span lang="VI" style="letter-spacing: 0.65pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>tăng<span style="letter-spacing: 0.3pt;"> </span>huyết<span style="letter-spacing: -0.75pt;"> </span>áp,<span style="letter-spacing: 0.65pt;"> </span>bệnh<span style="letter-spacing: -0.65pt;"> </span><span lang="VI">cơ</span><span lang="VI"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"></span>tim<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>thấp,...<span style="letter-spacing: 1.55pt;"> </span>ở lứa<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">u</span>ổi<span style="letter-spacing: 0.5pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>50-70.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 1.05pt;"> </span>Biểu<span style="letter-spacing: -0.55pt;"> </span>hiện<span style="letter-spacing: 0.25pt;"> </span>lâm<span style="letter-spacing: -1.1pt;"> </span>sàng:<span style="letter-spacing: 1.45pt;"> </span>khi<span style="letter-spacing: 0.95pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.95pt;"> </span>chậm<span> </span>t<span style="letter-spacing: -0.05pt;">h</span>ì<span style="letter-spacing: 1.1pt;"> </span>bệnh<span style="letter-spacing: 0.4pt;"> </span>nhân<span style="letter-spacing: -0.95pt;"> </span>cảm<span style="letter-spacing: 1.55pt;"> </span>thấy<span style="letter-spacing: 2.95pt;"> </span>mệt<span style="letter-spacing: 0.35pt;"> </span>nhọc,<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span><span style="letter-spacing: -0.35pt;">oá</span><span style="letter-spacing: -0.3pt;">n</span>g<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.3pt;">v</span><span style="letter-spacing: -0.35pt;">á</span><span style="letter-spacing: -0.3pt;">ng</span>;<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i <span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">nhan</span>h<span style="letter-spacing: -0.85pt;"></span><span style="letter-spacing: -0.25pt;">lạ</span>i<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">t</span><span style="letter-spacing: -0.45pt;">h</span><span style="letter-spacing: -0.3pt;">ấ</span>y<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.3pt;">hồ</span>i<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">hộ</span>p<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.25pt;">đán</span>h<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">trốn</span>g<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">ngực</span>.<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">Ha</span>i<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">biể</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.3pt;">hiệ</span>n<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">trê</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">luâ</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">phiê</span>n<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">nha</span>u<span style="letter-spacing: -0.8pt;"> </span>ở<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">nhữn</span>g<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">bện</span>h<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.3pt;">nhâ</span>n<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">có hộ</span>i<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">chứn</span>g<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: 0.25pt;"></span><span style="letter-spacing: -0.3pt;">chậm-nhanh</span>,<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: -0.3pt;">nế</span>u<span style="letter-spacing: -0.3pt;"> ké</span>o<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">dà</span>i<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.3pt;">s</span>ẽ<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">d</span><span style="letter-spacing: -0.25pt;">ẫ</span>n<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: -0.25pt;">đế</span>n<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.3pt;">su</span>y<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: 0.25pt;"> </span>ứ<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">tr</span>ệ<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">mạ</span>n<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.25pt;">tín</span>h<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">nghẽ</span>n<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.3pt;">mạch não.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.5pt;"> </span>Biểu<span style="letter-spacing: -1.1pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>trên<span style="letter-spacing: 1.3pt;"> </span>điện<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.4pt;"> </span>đồ:<span style="letter-spacing: 0.9pt;"> </span>hội<span style="letter-spacing: 0.4pt;"> </span>chứng<span style="letter-spacing: 0.25pt;"> </span>yếu<span style="letter-spacing: -0.15pt;"> </span>nút<span style="letter-spacing: 0.25pt;"> </span>xoang<span style="letter-spacing: 0.25pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 1.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">biểu<span style="letter-spacing: -0.3pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>điển<span style="letter-spacing: 0.45pt;"> </span>hình<span style="letter-spacing: 1.6pt;"> </span>bởi<span style="letter-spacing: 0.4pt;"> </span>hội<span style="letter-spacing: 0.4pt;"> </span>chứng nhịp<span style="letter-spacing: 0.3pt;"> </span>chậm-nhanh<span style="letter-spacing: 1.7pt;"> </span>(tachycardia-bradycardia syndrome).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.25pt;">Nhị</span>p<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span><span style="letter-spacing: -0.35pt;">ậ</span>m<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: -0.25pt;">trê</span>n<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.35pt;">t</span><span style="letter-spacing: -0.4pt;">h</span><span style="letter-spacing: -0.35pt;">ấ</span>t<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ể<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">là</span>:<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.3pt;">chậ</span>m<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.3pt;">xo</span><span style="letter-spacing: -0.35pt;">a</span><span style="letter-spacing: -0.3pt;">ng</span>;<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">ngoạ</span>i<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>u<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">nút</span>,<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">blố</span>c<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.35pt;">xo</span><span style="letter-spacing: -0.3pt;">an</span>g<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.25pt;">nhĩ</span>,<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">blố</span>c<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">nhĩ-thất</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: -0.25pt;">đ</span>ộ<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">2</span>;<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.25pt;">ngoạ</span>i<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>u<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">nhĩ</span>,<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.3pt;">sa</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">ngoạ</span>i<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>u<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">thờ</span>i<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">gia</span>n<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>ô<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.3pt;">thu</span>,<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">run</span>g<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">nhĩ</span>,<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">cuồng </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.2pt;"></span><span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: -0.3pt;"> vớ</span>i<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>t<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span><span style="letter-spacing: -0.35pt;">ậ</span><span style="letter-spacing: -0.25pt;">m</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.5pt;"> </span></span><span lang="VI" style="line-height: 22px;">Cơn</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 1.35pt;"> </span>nhanh<span style="letter-spacing: 0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">gặp<span style="letter-spacing: 0.15pt;"> </span>là<span style="letter-spacing: 1.35pt;"> </span>rung<span style="letter-spacing: 0.5pt;"> </span>nhĩ<span style="letter-spacing: 0.85pt;"> </span>hoặc<span style="letter-spacing: 0.25pt;"> </span>cuồng<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.05pt;"> </span>nhĩ<span style="letter-spacing: 0.65pt;"> </span>với<span style="letter-spacing: 0.05pt;"> </span>đáp<span style="letter-spacing: 1.3pt;"> </span>ứng<span style="letter-spacing: 0.5pt;"> </span>nhịp<span style="letter-spacing: 0.8pt;"> </span>thất<span style="letter-spacing: 2.4pt;"> </span>nhanh, hoặc<span style="letter-spacing: -0.25pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nút<span style="letter-spacing: -0.3pt;"></span>nhanh,<span style="letter-spacing: -0.3pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 1.4pt;"> </span>Điều<span style="letter-spacing: 1.9pt;"> </span>trị:<span style="letter-spacing: -0.65pt;"> </span>phải<span style="letter-spacing: 1.95pt;"> </span>cấy <span style="letter-spacing: 0.35pt;"><span> </span></span>máy <span style="letter-spacing: 0.2pt;"><span> </span></span>tạo<span style="letter-spacing: 1.5pt;"> </span>nhịp,<span style="letter-spacing: -0.9pt;"> </span>tùy<span style="letter-spacing: 1.15pt;"> </span>theo<span style="letter-spacing: 1.25pt;"> </span>loại<span style="letter-spacing: 2pt;"> </span>rối<span style="letter-spacing: 2.15pt;"> </span>loạn<span style="letter-spacing: 1.95pt;"> </span>nhịp<span style="letter-spacing: -0.9pt;"> </span>mà<span style="letter-spacing: 2.05pt;"> </span>l<span style="letter-spacing: -0.05pt;">ự</span>a<span style="letter-spacing: 1.3pt;"> </span>chọn<span style="letter-spacing: 1.9pt;"> </span>loại:<span style="letter-spacing: 1.95pt;"> </span>DDI,<span style="letter-spacing: 0.95pt;"> </span>DDD, AAI-R, DDI-R...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">2.2.<span style="letter-spacing: -0.2pt;"> </span>Rối<span style="letter-spacing: 0.55pt;"> </span>loạn<span style="letter-spacing: 2.85pt;"> </span>nhịp<span style="letter-spacing: 0.2pt;"> </span>thất<span style="letter-spacing: -0.85pt;"> </span>của<span style="letter-spacing: -0.85pt;"> </span>ti<span style="letter-spacing: -0.05pt;">m</span></span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.2.1.<span style="letter-spacing: -0.25pt;"> </span>Loạn<span style="letter-spacing: 3pt;"> </span>nhịp<span style="letter-spacing: 0.25pt;"> </span>ngoại<span style="letter-spacing: 3pt;"> </span>tâm<span style="letter-spacing: 0.45pt;"> </span>thu<span style="letter-spacing: 1.25pt;"> </span>thất<span style="letter-spacing: 0.3pt;"> </span>(ventricular<span style="letter-spacing: 2.25pt;"> </span>extrasystoles):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Loạn<span style="letter-spacing: 0.1pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>ổ<span style="letter-spacing: 0.65pt;"> </span>phát<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>nằm<span style="letter-spacing: 0.2pt;"> </span>ở thất<span style="letter-spacing: 1.9pt;"> </span>kích<span style="letter-spacing: 0.25pt;"> </span>thích<span style="letter-spacing: 0.55pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đập.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.5pt;"> </span>Nguyên<span style="letter-spacing: 1.15pt;"> </span>nhân:<span style="letter-spacing: 0.45pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span></span><span lang="VI" style="line-height: 22px;">rượu,</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">cà<span style="letter-spacing: 0.1pt;"> </span>phê, <span style="letter-spacing: 0.4pt;"><span> </span></span>thuốc<span style="letter-spacing: 1.05pt;"> </span>lá,<span style="letter-spacing: 1.25pt;"> </span>nhiễm<span style="letter-spacing: -0.35pt;"> </span>trùng,<span style="letter-spacing: 0.25pt;"> </span>nhiễm<span style="letter-spacing: -0.35pt;"> </span>độc,<span style="letter-spacing: 0.9pt;"> </span>mất<span style="letter-spacing: 2.45pt;"> </span>ngủ;<span style="letter-spacing: 0.1pt;"> </span>nguyên<span style="letter-spacing: 1.15pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>hay gặp<span style="letter-spacing: 1.1pt;"> </span>và <span style="letter-spacing: 0.05pt;"><span> </span></span>có<span style="letter-spacing: 2.1pt;"> </span>ý<span style="letter-spacing: 1.45pt;"></span>nghĩa<span style="letter-spacing: -0.55pt;"> </span>tiên<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.1pt;">l</span></span><span lang="VI" style="line-height: 22px;">ượng</span><span lang="VI" style="letter-spacing: 1.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">nặng<span style="letter-spacing: 1.2pt;"> </span>là:<span style="letter-spacing: 2.15pt;"> </span>nhồi<span style="letter-spacing: 2.05pt;"> </span>máu <span style="letter-spacing: 0.2pt;"><span> </span></span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 1.3pt;"> </span>cấp, <span style="letter-spacing: 0.15pt;"><span> </span></span>bệnh<span style="letter-spacing: 0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 2.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 1.3pt;"> </span>tiên<span style="letter-spacing: -0.75pt;"> </span>phát,<span style="letter-spacing: 1.8pt;"> </span>viêm<span style="letter-spacing: -1.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 2.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim, nhiễm<span style="letter-spacing: -0.9pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>digitalis,<span style="letter-spacing: -0.4pt;"> </span>sa<span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>2 lá...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.8pt;"> </span>Lâm<span style="letter-spacing: 1.65pt;"> </span>sàng:<span style="letter-spacing: 0.9pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.7pt;"> </span>không<span style="letter-spacing: 2.2pt;"> </span>đều,<span style="letter-spacing: 0.45pt;"> </span>tức<span style="letter-spacing: 0.7pt;"> </span>ngực,<span style="letter-spacing: 0.6pt;"> </span>khó<span style="letter-spacing: 1.35pt;"> </span>thở,<span style="letter-spacing: 0.65pt;"> </span>cảm<span style="letter-spacing: 1.3pt;"> </span>gi<span style="letter-spacing: -0.1pt;">á</span>c<span style="letter-spacing: 1.3pt;"> </span>hẫng<span style="letter-spacing: 2.75pt;"> </span>hụt<span style="letter-spacing: 0.55pt;"> </span>rõ<span style="letter-spacing: 1.5pt;"> </span>cả<span style="letter-spacing: 1.6pt;"> </span>khi<span style="letter-spacing: 0.7pt;"> </span>bắt<span style="letter-spacing: 0.7pt;"> </span>mạch <span style="letter-spacing: 1.4pt;"><span> </span></span>và nghe<span style="letter-spacing: -0.25pt;"> </span>tim;<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 0.65pt;"></span>thể<span style="letter-spacing: -0.75pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>ngất<span style="letter-spacing: 1.85pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>đột<span style="letter-spacing: 0.45pt;"> </span>tử...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span>Điện<span style="letter-spacing: 0.75pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>đồ:<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>ngoại<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu<span style="letter-spacing: 0.15pt;"> </span>thất,<span style="letter-spacing: 2.2pt;"> </span>không<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>sóng<span style="letter-spacing: 0.95pt;"> </span>P<span style="letter-spacing: -0.05pt;"> </span>đi<span style="letter-spacing: 1pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span></span><span lang="VI" style="line-height: 22px;">ước</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">phức<span style="letter-spacing: 0.05pt;"> </span>bộ <span style="letter-spacing: 0.6pt;"><span> </span></span>Q’R<span style="letter-spacing: 0.05pt;">’</span>S’, <span style="letter-spacing: 0.1pt;"><span> </span></span>Q<span style="letter-spacing: -0.05pt;">’</span>R’S’<span style="letter-spacing: 1.05pt;"> </span>gi<span style="letter-spacing: -0.05pt;">ã</span>n rộng ><span style="letter-spacing: -0.05pt;"></span>0,12 giây,<span style="letter-spacing: 0.25pt;"> </span>S’T’<span style="letter-spacing: 1pt;"> </span>chênh<span style="letter-spacing: 2.25pt;"> </span>trái<span style="letter-spacing: -0.6pt;"> </span>chiều<span style="letter-spacing: -0.8pt;"> </span>so<span style="letter-spacing: -0.15pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>R’,<span style="letter-spacing: 2.35pt;"> </span>nhịp<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: -0.4pt;">ng</span><span style="letter-spacing: -0.45pt;">o</span><span style="letter-spacing: -0.4pt;">ạ</span>i<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.35pt;">t</span><span style="letter-spacing: -0.4pt;">â</span>m<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.4pt;">th</span>u<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.4pt;">thấ</span>t<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.35pt;">t</span></span><span lang="VI" style="letter-spacing: -0.4pt; line-height: 22px;">hư</span><span style="letter-spacing: -0.45pt; line-height: 22px;">ờn</span><span style="line-height: 22px;">g<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.35pt;">đ</span><span style="letter-spacing: -0.3pt;">ế</span>n<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.35pt;">sớ</span>m<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">v</span>à<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.45pt;">c</span>ó<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.4pt;">ngh</span>ỉ<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.45pt;">bù </span><span style="letter-spacing: -0.4pt;">s</span>o<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.4pt;">vớ</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">nhị</span>p<span style="letter-spacing: 0.2pt;"></span><span style="letter-spacing: -0.4pt;">xoan</span>g<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.35pt;">(RR</span><span style="letter-spacing: -0.3pt;">’</span><span style="letter-spacing: -0.35pt;">R</span>=<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.4pt;">2RR)</span>.<span style="letter-spacing: 0.3pt;"> </span>Trên<span style="letter-spacing: 0.4pt;"> </span>80%<span style="letter-spacing: 0.45pt;"> </span>c<span style="letter-spacing: -0.05pt;">á</span>c<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">t</span><span style="letter-spacing: 0.05pt;">r</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">hợp<span style="letter-spacing: 0.05pt;"> </span>ngoại<span style="letter-spacing: 0.75pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>thu<span style="letter-spacing: 0.25pt;"> </span>thất<span style="letter-spacing: 2.3pt;"> </span>là<span style="letter-spacing: -0.4pt;"> </span>ngoại <span style="letter-spacing: 0.3pt;"><span> </span></span>tâm<span style="letter-spacing: 2.35pt;"> </span>thu<span style="letter-spacing: 0.25pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span>thất phải,<span style="letter-spacing: 0.4pt;"> </span>gần<span style="letter-spacing: -0.15pt;"> </span>20% ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.05pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.05pt;">nằ</span>m ở thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Lown<span style="letter-spacing: -0.55pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>thành<span style="letter-spacing: 0.35pt;"> </span>5 độ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>0<span> </span>:<span style="letter-spacing: -0.05pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>I<span> </span>:<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>30 nhịp<span style="letter-spacing: 0.3pt;"> </span>ng<span style="letter-spacing: -0.05pt;">o</span>ại tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất/1<span style="letter-spacing: 1.75pt;"> </span>giờ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>II<span> </span>:<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>30 nhịp<span style="letter-spacing: 0.3pt;"> </span>ng<span style="letter-spacing: -0.05pt;">o</span>ại tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất/1<span style="letter-spacing: 1.75pt;"> </span>giờ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>III<span style="letter-spacing: -0.35pt;"> </span>:<span style="letter-spacing: -0.05pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>dạng,<span style="letter-spacing: 0.35pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>ổ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>IV<span style="position: relative; top: -5pt;">a<span> </span></span>:<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>2 nhịp<span style="letter-spacing: 0.55pt;"> </span>ngoại<span style="letter-spacing: 0.05pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>đi<span style="letter-spacing: 0.7pt;"> </span>liền<span style="letter-spacing: -0.75pt;"> </span>nhau.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>IV<span style="position: relative; top: -5pt;">b<span> </span></span>:<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>3 nhịp<span style="letter-spacing: 0.55pt;"> </span>ngoại<span style="letter-spacing: 0.05pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>đi<span style="letter-spacing: 0.7pt;"> </span>liền<span style="letter-spacing: -0.75pt;"> </span>nhau.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Độ<span style="letter-spacing: 1.35pt;"> </span>V<span> </span>:<span style="letter-spacing: 0.55pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>ngoại<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>thu<span style="letter-spacing: 0.45pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>r<span lang="VI" style="letter-spacing: -0.1pt;">ơ</span>i<span style="letter-spacing: 1.35pt;"> </span>vào<span style="letter-spacing: 1.15pt;"> </span>sóng<span style="letter-spacing: 1.25pt;"> </span>T<span style="letter-spacing: 0.25pt;"> </span>của<span style="letter-spacing: 0.25pt;"> </span>nhịp<span style="letter-spacing: 0.9pt;"> </span>ngay<span style="letter-spacing: 0.35pt;"> </span>liền<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span><span lang="VI">ước</span><span lang="VI" style="letter-spacing: 0.6pt;"> </span>nó<span style="letter-spacing: 1.15pt;"> </span>(R<span style="letter-spacing: 0.7pt;"> </span>on<span style="letter-spacing: 0.5pt;"> </span>T<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">phenoment).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Ng</span><span lang="VI" style="line-height: 22px;">ười</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">ta<span style="letter-spacing: 0.7pt;"> </span>còn<span style="letter-spacing: 1.45pt;"> </span>phân<span style="letter-spacing: 1.05pt;"> </span>chia<span style="letter-spacing: 0.6pt;"> </span>ngoại<span style="letter-spacing: 1.15pt;"> </span>tâm<span style="letter-spacing: 1.35pt;"> </span>thu<span style="letter-spacing: 0.65pt;"> </span>thất:<span style="letter-spacing: 2.75pt;"> </span>m<span style="letter-spacing: -0.1pt;">ộ</span>t<span style="letter-spacing: 0.6pt;"> </span>ổ,<span style="letter-spacing: 1.45pt;"> </span>một<span style="letter-spacing: 0.6pt;"> </span>dạng,<span style="letter-spacing: 2.45pt;"> </span>đa<span style="letter-spacing: 0.7pt;"> </span>ổ,<span style="letter-spacing: 1.45pt;"> </span>đa<span style="letter-spacing: 0.55pt;"> </span>dạng,<span style="letter-spacing: 2.15pt;"> </span>nhịp<span style="letter-spacing: 2.4pt;"> </span>đôi,<span style="letter-spacing: -0.65pt;"> </span>nhịp<span style="letter-spacing: 2.4pt;"> </span>ba, hàng<span style="letter-spacing: 0.4pt;"> </span>loạt.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.3pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p> </o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.5pt;"> </span>Loại<span style="letter-spacing: 0.95pt;"> </span>trừ<span style="letter-spacing: 0.35pt;"> </span>c<span style="letter-spacing: -0.1pt;">á</span>c<span style="letter-spacing: 1.1pt;"> </span>yếu<span style="letter-spacing: -0.2pt;"> </span>tố<span style="letter-spacing: 1.1pt;"> </span>nguy<span style="letter-spacing: 0.5pt;"> </span></span><span lang="VI" style="position: relative; top: 0.5pt;">cơ</span><span lang="VI" style="letter-spacing: 1.1pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">và<span style="letter-spacing: 0.05pt;"> </span>điều <span style="letter-spacing: 0.15pt;"><span> </span></span>trị<span style="letter-spacing: 1.55pt;"> </span>những<span style="letter-spacing: 0.5pt;"> </span>nguyên<span style="letter-spacing: 1.9pt;"> </span>nhân<span style="letter-spacing: 1pt;"> </span>gây<span style="letter-spacing: 0.4pt;"> </span>ra<span style="letter-spacing: 0.4pt;"> </span>loạn<span style="letter-spacing: 0.15pt;"> </span>nhịp<span style="letter-spacing: 1.3pt;"> </span>ngoại<span style="letter-spacing: 0.85pt;"> </span>tâm<span style="letter-spacing: 1.05pt;"> </span>thu </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.5pt;"> </span>Nghỉ<span style="letter-spacing: 1.05pt;"> </span></span><span lang="VI" style="position: relative; top: 0.5pt;">ngơi,</span><span lang="VI" style="letter-spacing: 0.8pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">cho<span style="letter-spacing: 0.35pt;"> </span>liều<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.05pt;">l</span></span><span lang="VI" style="position: relative; top: 0.5pt;">ượng</span><span lang="VI" style="letter-spacing: 0.5pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">thấp<span style="letter-spacing: 2.2pt;"> </span>diazepam<span style="letter-spacing: -0.4pt;"> </span>(sedu<span style="letter-spacing: -0.05pt;">x</span>en,<span style="letter-spacing: 0.35pt;"> </span>valium)<span style="letter-spacing: -0.3pt;"> </span>hoặc<span style="letter-spacing: 0.2pt;"> </span>chlordiaz<span style="letter-spacing: 0.05pt;">e</span>poxit<span style="letter-spacing: -0.3pt;"> </span>(librium)</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 17px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.65pt;"><span style="line-height: 18px;"><span class="Apple-style-span" style="font-size: large;">5-10<span style="letter-spacing: 0.7pt;"> </span>mg,<span style="letter-spacing: 0.5pt;"> </span>uống<span style="letter-spacing: 1.15pt;"> </span>~<span style="letter-spacing: 1pt;"> </span>3-5<span style="letter-spacing: 0.7pt;"> </span>tối,<span style="letter-spacing: 1.35pt;"> </span>nếu<span style="letter-spacing: 0.05pt;"> </span>không<span style="letter-spacing: 0.95pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>tác<span style="letter-spacing: 1.35pt;"> </span>dụng<span style="letter-spacing: 0.45pt;"> </span>thì<span style="letter-spacing: 1.35pt;"> </span>phải<span style="letter-spacing: 0.9pt;"> </span>lựa<span style="letter-spacing: 0.6pt;"> </span>chọn<span style="letter-spacing: 1.2pt;"> </span>một<span style="letter-spacing: 0.55pt;"> </span>trong<span style="letter-spacing: 0.45pt;"> </span>các<span style="letter-spacing: 1.3pt;"> </span>thuốc<span style="letter-spacing: 1.25pt;"> </span>chống<span style="letter-spacing: 1.3pt;"> </span>loạn nhịp<span style="letter-spacing: 0.3pt;"> </span>sau đây:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.9pt;"><span class="Apple-style-span" style="font-size: large;">. Disopyramide<span style="letter-spacing: -0.7pt;"> </span>(rythm<span style="letter-spacing: -0.1pt;">o</span>dan,<span style="letter-spacing: -0.6pt;"> </span>norpace)<span style="letter-spacing: -0.4pt;"> </span>100-200 mg<span style="letter-spacing: -0.15pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>1-4v/ngày<span style="letter-spacing: 0.25pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>2 lần;<span style="letter-spacing: -0.2pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>10-15 ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 17px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.75pt;"><span style="line-height: 18px;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1.05pt;"> </span>Thuốc<span style="letter-spacing: 1.35pt;"> </span>chẹn<span style="letter-spacing: 0.35pt;"> </span>thụ<span style="letter-spacing: 0.75pt;"> </span>cảm<span style="letter-spacing: 1.5pt;"> </span>thể<span style="letter-spacing: 0.25pt;"> </span>β:<span style="letter-spacing: 0.3pt;"> </span>propranolol<span style="letter-spacing: -0.1pt;"> </span>(inderal)<span style="letter-spacing: 0.65pt;"> </span>20-40<span style="letter-spacing: 1pt;"> </span>mg/ngày<span style="letter-spacing: 1.2pt;"> </span>~<span style="letter-spacing: 1.3pt;"> </span>10-15<span style="letter-spacing: 1pt;"> </span>ngày<span style="letter-spacing: 1.45pt;"> </span>(ngừng<span style="letter-spacing: 1pt;"> </span>thuốc khi<span style="letter-spacing: -0.15pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>tim<span style="letter-spacing: -0.15pt;"></span>chậm<span style="letter-spacing: 1.9pt;"> </span>và<span style="letter-spacing: 0.65pt;"> </span>hạ<span style="letter-spacing: 1.1pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 17px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.85pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 18px;">.<span style="letter-spacing: 0.65pt;"> </span>Procainamide (pronestyl)<span style="letter-spacing: 0.1pt;"> </span>250<span style="letter-spacing: 0.65pt;"> </span>mg<span style="letter-spacing: 0.5pt;"> </span>~<span style="letter-spacing: 0.9pt;"> </span>2-<span style="letter-spacing: 0.65pt;"> </span>4v/ngày;<span style="letter-spacing: 0.9pt;"> </span>hoặc<span style="letter-spacing: 0.4pt;"> </span>2-<span style="letter-spacing: 0.65pt;"> </span>4<span style="letter-spacing: 0.65pt;"> </span>ống,<span style="letter-spacing: 1.25pt;"> </span>tiêm<span style="letter-spacing: 0.9pt;"> </span>bắp<span style="letter-spacing: 0.3pt;"> </span>thịt,<span style="letter-spacing: 1.65pt;"> </span>đợt<span style="letter-spacing: 0.7pt;"> </span>10-15<span style="letter-spacing: 0.65pt;"> </span>ngày. Hạ<span style="letter-spacing: 0.6pt;"> </span>liều<span style="letter-spacing: -0.75pt;"> </span>và<span style="letter-spacing: 0.8pt;"></span>ngừng thuốc<span style="letter-spacing: 0.5pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>mệt<span style="letter-spacing: -0.75pt;"> </span>mỏi,<span style="letter-spacing: 0.65pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span></span><span lang="VI" style="line-height: 18px;">ược cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 18px;"> </span><span style="line-height: 18px;">hoặc<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>giả<span style="letter-spacing: 0.55pt;"> </span>luput<span style="letter-spacing: -0.25pt;"> </span>ban<span style="letter-spacing: -0.15pt;"> </span>đỏ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.9pt;"><span class="Apple-style-span" style="font-size: large;">. Cordaron<span style="letter-spacing: -0.9pt;"> </span>0,20 ~<span style="letter-spacing: 0.25pt;"> </span>1-3 v/ngày,<span style="letter-spacing: 1.55pt;"> </span>đợt<span style="letter-spacing: 0.05pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>10-15 ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.8pt;"> </span>Những<span style="letter-spacing: 0.45pt;"> </span>tr</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ờng<span style="letter-spacing: 0.75pt;"> </span>hợp<span style="letter-spacing: 0.4pt;"> </span>nặng,<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>ngất<span style="letter-spacing: 2.6pt;"> </span>lịm,<span style="letter-spacing: 1.05pt;"> </span>nhanh<span style="letter-spacing: 0.45pt;"> </span>thất<span style="letter-spacing: 2.65pt;"> </span>do<span style="letter-spacing: 0.65pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">t</span></span><span lang="VI" style="line-height: 22px;">ượng</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">“R<span style="letter-spacing: 1.3pt;"> </span>on<span style="letter-spacing: 0.65pt;"> </span>T<span style="letter-spacing: 0.4pt;"> </span>pheno<span style="letter-spacing: 0.05pt;">m</span>ent” <span style="letter-spacing: 1.35pt;"><span> </span></span>thì<span style="letter-spacing: 0.65pt;"> </span>phải dùng<span style="letter-spacing: 1pt;"></span>mexiletin<span style="letter-spacing: 1.25pt;"> </span>(mexitil)<span style="letter-spacing: 1.25pt;"> </span>hoặc<span style="letter-spacing: 1pt;"> </span>lidocain<span style="letter-spacing: 0.85pt;"> </span>100-200mg,<span style="letter-spacing: 0.65pt;"> </span>tiêm<span style="letter-spacing: -0.85pt;"> </span>bắp<span style="letter-spacing: 0.9pt;"> </span>thịt<span style="letter-spacing: -0.9pt;"> </span>hoặc<span style="letter-spacing: 1pt;"> </span>1/2<span style="letter-spacing: 1.1pt;"> </span>liều<span style="letter-spacing: 0.5pt;"> </span>tiêm<span style="letter-spacing: -0.85pt;"> </span>trực<span style="letter-spacing: 1.05pt;"> </span>tiếp<span style="letter-spacing: 0.3pt;"> </span>tĩnh mạch<span style="letter-spacing: 1.55pt;"> </span>(thử<span style="letter-spacing: 1pt;"></span>nghiệm<span style="letter-spacing: 0.45pt;"> </span>trong<span style="letter-spacing: 0.95pt;"> </span>da<span style="letter-spacing: 1.1pt;"> </span>âm<span style="letter-spacing: -0.95pt;"> </span>tính)<span style="letter-spacing: -1pt;"> </span>và<span style="letter-spacing: 2pt;"> </span>1/2<span style="letter-spacing: 1.05pt;"> </span>liều<span style="letter-spacing: 0.45pt;"> </span>pha<span style="letter-spacing: 0.85pt;"> </span>vào<span style="letter-spacing: 1.75pt;"> </span>50-100ml<span style="letter-spacing: 1.05pt;"> </span>huyết<span style="letter-spacing: 0.4pt;"> </span>thanh<span style="letter-spacing: 0.95pt;"> </span>natri<span style="letter-spacing: 1pt;"> </span>clorua<span style="letter-spacing: 0.9pt;"> </span>0,9% (nếu<span style="letter-spacing: 0.45pt;"> </span>không<span style="letter-spacing: 1.6pt;"> </span>có<span style="letter-spacing: 2pt;"> </span>suy<span style="letter-spacing: 1.35pt;"></span>tim)<span style="letter-spacing: 1.15pt;"> </span>hoặc<span style="letter-spacing: 1.1pt;"> </span>dung<span style="letter-spacing: 1.35pt;"> </span>dịch<span style="letter-spacing: -0.7pt;"> </span>glucose<span style="letter-spacing: 1pt;"> </span>5%<span style="letter-spacing: 1.35pt;"> </span>(<span style="letter-spacing: -0.05pt;">n</span>ếu<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 2.05pt;"> </span>suy<span style="letter-spacing: 1.35pt;"> </span>tim)<span style="letter-spacing: 1.2pt;"> </span>để<span style="letter-spacing: 2.1pt;"> </span>truyền<span style="letter-spacing: 0.55pt;"> </span>tĩnh<span style="letter-spacing: -0.7pt;"> </span>mạch<span style="letter-spacing: 1.7pt;"> </span>20-30 giọt/phút, d</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ới sự ki<span style="letter-spacing: -0.05pt;">ể</span>m<span style="letter-spacing: -0.85pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>a<span style="letter-spacing: -0.15pt;"></span>theo<span style="letter-spacing: -0.2pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ<span style="letter-spacing: 0.1pt;"> </span>tr<span style="letter-spacing: -0.05pt;">ê</span>n<span style="letter-spacing: 1pt;"> </span>monitori<span style="letter-spacing: -0.05pt;">n</span>g.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.4pt;">Nế</span>u <span style="letter-spacing: 0.4pt;">nhồ</span>i<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.35pt;">má</span>u<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.35pt;">c</span></span><span lang="VI" style="line-height: 22px;">ơ</span><span lang="VI" style="letter-spacing: 1pt; line-height: 22px;"> </span><span style="letter-spacing: 0.4pt; line-height: 22px;">tim</span><span style="line-height: 22px;">,<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.35pt;">ngoà</span>i<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.4pt;">l</span><span style="letter-spacing: 0.45pt;">i</span><span style="letter-spacing: 0.4pt;">docai</span>n<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.4pt;">n</span><span style="letter-spacing: 0.35pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="letter-spacing: 0.45pt; line-height: 22px;">t</span><span style="letter-spacing: 0.4pt; line-height: 22px;">r</span><span style="letter-spacing: 0.45pt; line-height: 22px;">ê</span><span style="line-height: 22px;">n<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.45pt;">p</span><span style="letter-spacing: 0.35pt;">h</span><span style="letter-spacing: 0.4pt;">ả</span>i<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.45pt;">c</span><span style="letter-spacing: 0.4pt;">h</span>o<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.45pt;">r</span><span style="letter-spacing: 0.35pt;">y</span><span style="letter-spacing: 0.4pt;">th</span><span style="letter-spacing: 0.45pt;">m</span><span style="letter-spacing: 0.35pt;">o</span><span style="letter-spacing: 0.4pt;">d</span><span style="letter-spacing: 0.45pt;">a</span>n<span style="letter-spacing: 0.3pt;"> </span>0,10<span style="letter-spacing: 0.25pt;"> </span>x<span style="letter-spacing: 0.3pt;"> </span>2-4v/ngày,<span style="letter-spacing: 0.45pt;"> </span>chia uống<span style="letter-spacing: 0.45pt;"> </span>sáng <span style="letter-spacing: 0.05pt;"><span> </span></span>và<span style="letter-spacing: -0.25pt;"></span>chiều<span style="letter-spacing: -0.8pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>hết<span style="letter-spacing: -0.75pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">- Nếu<span style="letter-spacing: -0.85pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>ngộ<span style="letter-spacing: 0.1pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>digitalis<span style="letter-spacing: -0.4pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>phải<span style="letter-spacing: 0.2pt;"> </span>dừng ngay<span style="letter-spacing: -0.2pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>digitalis<span style="letter-spacing: -0.4pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>thuốc:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">Lidocain<span style="letter-spacing: -0.45pt;"> </span>cách<span style="letter-spacing: 0.4pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span><span lang="VI">như trên. Sodanton</span><span lang="VI" style="letter-spacing: 0.1pt;"> </span>0,10 ~<span style="letter-spacing: 0.25pt;"> </span>1-2v/ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">Panangin<span style="letter-spacing: -0.45pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>kaliclorua<span style="letter-spacing: -0.5pt;"> </span>0,60<span style="letter-spacing: -0.05pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-4v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.7pt;"><span class="Apple-style-span" style="font-size: large;">Những<span style="letter-spacing: -0.35pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>này<span style="letter-spacing: 0.5pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>hết<span style="letter-spacing: -0.8pt;"> </span>loạn<span style="letter-spacing: -0.35pt;"> </span>nhịp<span style="letter-spacing: 0.8pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.8pt;"> </span>Trong<span style="letter-spacing: 0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">trường</span><span lang="VI" style="letter-spacing: 0.8pt; line-height: 22px;"> </span><span style="line-height: 22px;">hợp<span style="letter-spacing: 0.45pt;"> </span>ngoại<span style="letter-spacing: 1.15pt;"> </span>tâm<span style="letter-spacing: 1.35pt;"> </span>thu<span style="letter-spacing: 0.65pt;"> </span>thất<span style="letter-spacing: 2.7pt;"> </span>mức<span style="letter-spacing: 0.6pt;"> </span>độ<span style="letter-spacing: 1.35pt;"> </span>nặng,<span style="letter-spacing: 0.5pt;"> </span>dai<span style="letter-spacing: 0.65pt;"> </span>dẳng,<span style="letter-spacing: 1.15pt;"> </span>kéo<span style="letter-spacing: -0.1pt;"> </span>dài,<span style="letter-spacing: 0.35pt;"> </span>không<span style="letter-spacing: 2.5pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>tác<span style="letter-spacing: 1.4pt;"> </span>dụng<span style="letter-spacing: 0.55pt;"> </span>khi dùng<span style="letter-spacing: 0.05pt;"> </span>thuốc<span style="letter-spacing: 0.8pt;"> </span>thì<span style="letter-spacing: 0.9pt;"></span>phải<span style="letter-spacing: 0.5pt;"> </span>tiến<span style="letter-spacing: -0.45pt;"> </span>hành<span style="letter-spacing: 0.7pt;"> </span>biện<span style="letter-spacing: -0.5pt;"> </span>pháp<span style="letter-spacing: 0.4pt;"> </span>đốt<span style="letter-spacing: 0.85pt;"> </span>ổ<span style="letter-spacing: 0.95pt;"> </span>phát<span style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>gây<span style="letter-spacing: 0.8pt;"> </span>ngoại<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: 0.85pt;"> </span>thu<span style="letter-spacing: 0.15pt;"> </span>thất<span style="letter-spacing: 2.2pt;"> </span>bằng<span style="letter-spacing: 0.1pt;"> </span>năng<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.05pt;">l</span></span><span lang="VI" style="line-height: 22px;">ượng</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần số<span style="letter-spacing: 0.6pt;"> </span>radio<span style="letter-spacing: -0.25pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>ống<span style="letter-spacing: 0.5pt;"> </span>thông.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.25pt;"> </span>Một<span style="letter-spacing: 0.05pt;"> </span>số<span style="letter-spacing: 0.85pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span></span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ờng<span style="letter-spacing: 0.25pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>châm<span style="letter-spacing: 0.5pt;"> </span>cứu<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: 0.8pt;"> </span>huyệt:<span style="letter-spacing: -0.65pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>cốc,<span style="letter-spacing: 0.8pt;"> </span>nội<span style="letter-spacing: 0.1pt;"> </span>quan (tay<span style="letter-spacing: 0.05pt;"> </span>trái)<span style="letter-spacing: 0.7pt;"> </span>hoặc uống<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.1pt;">n</span></span><span lang="VI" style="line-height: 22px;">ước</span><span lang="VI" style="letter-spacing: 0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">sắc<span style="letter-spacing: 0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">“thủy xương bồ”</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"></span><span style="line-height: 22px;">10-20 g/ngày<span style="letter-spacing: 0.3pt;"> </span>cũng<span style="letter-spacing: -0.45pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>quả<span style="letter-spacing: 0.25pt;"> </span>điều<span style="letter-spacing: 0.95pt;"> </span>trị.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.2.2.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>tự<span style="letter-spacing: 1.3pt;"> </span>thất<span style="letter-spacing: 0.3pt;"> </span>(idioventricular<span style="letter-spacing: 2.25pt;"> </span>rythm):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.7pt;"> </span>Khi<span style="letter-spacing: 1.55pt;"> </span>nhịp<span style="letter-spacing: -0.6pt;"> </span>ngoại<span style="letter-spacing: 2.1pt;"> </span>tâm<span style="letter-spacing: -0.45pt;"> </span>thu<span style="letter-spacing: 1.5pt;"> </span>thất <span style="letter-spacing: 0.65pt;"><span> </span></span>đứng<span style="letter-spacing: -0.9pt;"> </span>làm<span style="letter-spacing: 2.25pt;"> </span>chủ<span style="letter-spacing: 1.4pt;"> </span>nhịp,<span style="letter-spacing: -0.65pt;"> </span>kích<span style="letter-spacing: -0.3pt;"> </span>thích<span style="letter-spacing: -0.25pt;"> </span>cho<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 1.6pt;"> </span>đập<span style="letter-spacing: 0.85pt;"> </span>với<span style="letter-spacing: 1.3pt;"> </span>tần<span style="letter-spacing: 1.6pt;"> </span>số<span style="letter-spacing: 2.35pt;"> </span><<span style="letter-spacing: 1.7pt;"> </span>120 ck/phút<span style="letter-spacing: -0.7pt;"> </span>thì<span style="letter-spacing: 1.15pt;"></span><span style="letter-spacing: -0.1pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nhịp <span style="letter-spacing: 0.55pt;"><span> </span></span>tự<span style="letter-spacing: -0.1pt;"> </span>thất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.1pt;"> </span>Nhịp<span style="letter-spacing: 0.4pt;"> </span>tự<span style="letter-spacing: -0.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.1pt;"> </span>là<span style="letter-spacing: 1pt;"> </span>m<span style="letter-spacing: -0.05pt;">ộ</span>t<span style="letter-spacing: -0.05pt;"> </span>lo<span style="letter-spacing: -0.05pt;">ạ</span>i<span style="letter-spacing: 0.9pt;"> </span>r<span style="letter-spacing: -0.05pt;">ố</span>i<span style="letter-spacing: 0.75pt;"> </span>loạn<span style="letter-spacing: 0.05pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ịp<span style="letter-spacing: 1.3pt;"> </span>rất<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>ặng<span style="letter-spacing: -0.05pt;"> </span>gây<span style="letter-spacing: 0.45pt;"> </span>ra tình<span style="letter-spacing: 1.35pt;"> </span>trạng<span style="letter-spacing: 0.8pt;"> </span>“phân<span style="letter-spacing: -0.5pt;"> </span>ly<span style="letter-spacing: -0.1pt;"> </span>điện<span style="letter-spacing: 1.85pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ”,</span><span lang="VI" style="letter-spacing: -0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">nghĩa <span style="letter-spacing: 1.7pt;"><span> </span></span>là<span style="letter-spacing: -0.55pt;"> </span>tim còn<span style="letter-spacing: 1.6pt;"> </span>hoạt<span style="letter-spacing: 0.85pt;"></span>động<span style="letter-spacing: 2.15pt;"> </span>điện<span style="letter-spacing: 1.1pt;"> </span>học<span style="letter-spacing: 1.6pt;"> </span></span><span lang="VI" style="line-height: 22px;">nhưng</span><span lang="VI" style="letter-spacing: 0.95pt; line-height: 22px;"> </span><span style="line-height: 22px;">không<span style="letter-spacing: 1.2pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>hiệu<span style="letter-spacing: 0.1pt;"> </span>lực<span style="letter-spacing: 0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">học;<span style="letter-spacing: 1.55pt;"> </span>biểu<span style="letter-spacing: 0.1pt;"> </span>hiện<span style="letter-spacing: 0.1pt;"> </span>lâm <span style="letter-spacing: 0.45pt;"><span> </span></span>sàng <span style="letter-spacing: 0.05pt;"><span> </span></span>là<span style="letter-spacing: 0.15pt;"> </span>ngừng<span style="letter-spacing: 0.95pt;"> </span>tuần<span style="letter-spacing: 0.75pt;"> </span>ho<span style="letter-spacing: 0.05pt;">à</span>n;<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="position: relative; top: 0.5pt;">ư cấp</span><span lang="VI" style="letter-spacing: 1.75pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">cứu<span style="letter-spacing: -0.15pt;"> </span>ngừng tim<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>vô<span style="letter-spacing: -0.25pt;"> </span>tâm<span style="letter-spacing: 1.5pt;"> </span>thu.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.2.3.<span style="letter-spacing: -0.25pt;"> </span>Nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh <span style="letter-spacing: 0.2pt;"><span> </span></span>thất<span style="letter-spacing: 0.3pt;"> </span>(ventricular<span style="letter-spacing: 2.25pt;"> </span>tachycardia):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Đây<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.45pt;"> </span>loại <span style="letter-spacing: 0.15pt;"><span> </span></span>rối<span style="letter-spacing: 1.15pt;"> </span>loạn<span style="letter-spacing: 0.4pt;"> </span>nhịp<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 0.35pt;"> </span>nặng,<span style="letter-spacing: 0.25pt;"> </span>luôn<span> </span>phải<span style="letter-spacing: 1.5pt;"> </span>đ<span lang="VI" style="letter-spacing: -0.05pt;">ư</span>ợc<span style="letter-spacing: 0.7pt;"> </span>theo<span style="letter-spacing: 0.3pt;"> </span>dõi<span style="letter-spacing: 1.1pt;"> </span>và<span style="letter-spacing: -0.1pt;"> </span>điều<span style="letter-spacing: 2.25pt;"> </span>trị<span style="letter-spacing: 1.45pt;"> </span>cấp<span style="letter-spacing: 2.25pt;"> </span>cứu<span style="letter-spacing: 0.35pt;"> </span>tại<span style="letter-spacing: 1.2pt;"> </span>bệnh<span style="letter-spacing: -0.2pt;"> </span>viện,<span style="letter-spacing: -0.7pt;"> </span>vì có<span style="letter-spacing: 0.65pt;"> </span>tỷ<span style="letter-spacing: -0.1pt;"> </span>lệ<span style="letter-spacing: -0.75pt;"> </span>tử<span style="letter-spacing: -0.1pt;"></span>vong<span style="letter-spacing: -0.7pt;"> </span>cao.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.55pt;"> </span>Khi<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>từ<span style="letter-spacing: 0.5pt;"> </span>><span style="letter-spacing: 0.55pt;"> </span>3<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>ngoại<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>thu<span style="letter-spacing: 0.45pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>liền<span style="letter-spacing: -0.15pt;"> </span>nh<span style="letter-spacing: -0.05pt;">a</span>u,<span style="letter-spacing: 0.45pt;"> </span>liên<span style="letter-spacing: 0.95pt;"> </span>tiếp,<span style="letter-spacing: -0.5pt;"> </span>với<span style="letter-spacing: 0.15pt;"> </span>tần<span style="letter-spacing: 0.45pt;"> </span>số<span style="letter-spacing: 1.2pt;"> </span>từ<span style="letter-spacing: 0.5pt;"> </span>120-<span style="letter-spacing: 0.6pt;"> </span>250<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.05pt;">c</span>k/<span style="letter-spacing: 0.5pt;"> </span>phút<span style="letter-spacing: -0.05pt;"> </span>thì <span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"></span>nhịp <span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Nếu<span style="letter-spacing: -0.85pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài<span style="letter-spacing: 0.55pt;"> </span><30<span style="letter-spacing: -0.2pt;"> </span>giây<span style="letter-spacing: 1.05pt;"> </span>thì<span style="letter-spacing: 0.05pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nhịp <span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>ngắn,<span style="letter-spacing: -0.25pt;"> </span>thoáng<span style="letter-spacing: 0.3pt;"> </span>qua.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Nếu<span style="letter-spacing: -0.85pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài<span style="letter-spacing: 0.55pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>30 giây<span style="letter-spacing: 0.25pt;"> </span>thì gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nhịp <span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>bền<span style="letter-spacing: -0.7pt;"> </span>bỉ,<span style="letter-spacing: 0.4pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.3pt;"> </span>Nếu<span style="letter-spacing: -0.55pt;"> </span>các<span style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>nhanh t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: 0.05pt;"> </span>giống<span style="letter-spacing: 0.85pt;"> </span>nhau<span style="letter-spacing: 0.05pt;"> </span>trong<span style="letter-spacing: 0.05pt;"> </span>một<span style="letter-spacing: 0.1pt;"> </span>đạo<span style="letter-spacing: -0.5pt;"> </span>trình <span style="letter-spacing: 1.5pt;"><span> </span></span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: -0.1pt;"> </span>điện<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ồ<span style="letter-spacing: 0.3pt;"> </span>thì<span style="letter-spacing: 0.7pt;"> </span>gọi<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: -0.2pt;"> </span>nhịp <span style="letter-spacing: 0.85pt;"><span> </span></span>nhanh thất<span style="letter-spacing: 2.45pt;"> </span>một<span style="letter-spacing: 0.35pt;"></span>dạ<span style="letter-spacing: -0.05pt;">n</span>g;<span style="letter-spacing: 0.95pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">lại<span style="letter-spacing: 1.25pt;"> </span>nếu<span style="letter-spacing: -0.15pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>nhanh<span style="letter-spacing: 0.25pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>khác<span style="letter-spacing: 0.95pt;"> </span>dạng<span style="letter-spacing: 0.95pt;"> </span>nhau<span style="letter-spacing: 0.3pt;"> </span>trên<span style="letter-spacing: 0.85pt;"> </span>cùng<span style="letter-spacing: 0.1pt;"> </span>một<span style="letter-spacing: 0.35pt;"> </span>đạo<span style="letter-spacing: -0.5pt;"> </span>trì<span style="letter-spacing: -0.05pt;">n</span>h <span style="letter-spacing: 1.6pt;"><span> </span></span>của<span style="letter-spacing: 0.2pt;"> </span>điện<span style="letter-spacing: 0.95pt;"> </span>tim đồ<span style="letter-spacing: 0.45pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>đa<span style="letter-spacing: 0.6pt;"> </span>dạng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 1.7pt;"> </span>Nhịp<span style="letter-spacing: -0.65pt;"> </span>nhanh<span style="letter-spacing: 1.4pt;"> </span>thất <span style="letter-spacing: 0.6pt;"><span> </span></span>kéo<span style="letter-spacing: 0.8pt;"> </span>dài,<span style="letter-spacing: 2.2pt;"> </span>một<span style="letter-spacing: 1.5pt;"> </span>dạng,<span style="letter-spacing: 2.05pt;"> </span>do<span style="letter-spacing: 1.6pt;"> </span>m<span style="letter-spacing: -0.1pt;">ộ</span>t<span style="letter-spacing: 1.45pt;"> </span>ổ<span style="letter-spacing: 2.3pt;"> </span>phát<span style="letter-spacing: 2.1pt;"> </span>nhịp<span style="letter-spacing: -0.7pt;"> </span>thất, <span style="letter-spacing: 0.55pt;"><span> </span></span>với<span style="letter-spacing: 1.2pt;"> </span>tần<span style="letter-spacing: 1.5pt;"> </span>số<span style="letter-spacing: 2.25pt;"> </span>nhanh<span style="letter-spacing: 1.35pt;"> </span>từ<span style="letter-spacing: 1.55pt;"> </span>180-250 ck/phút<span style="letter-spacing: -0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"></span><span style="line-height: 22px;">gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>(ventricular<span style="letter-spacing: -0.55pt;"> </span>flutter).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.65pt;"> </span>Nhịp<span style="letter-spacing: 0.9pt;"> </span>nhanh<span style="letter-spacing: 0.35pt;"> </span>thất<span style="letter-spacing: 2.55pt;"> </span>đa<span style="letter-spacing: 1.25pt;"> </span>ổ,<span style="letter-spacing: 1.3pt;"> </span>đa<span style="letter-spacing: 0.55pt;"> </span>dạng,<span style="letter-spacing: 2.3pt;"> </span>kéo<span style="letter-spacing: -0.25pt;"> </span>dài,<span style="letter-spacing: 1.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">xuyên<span style="letter-spacing: 1.9pt;"> </span>đổi<span style="letter-spacing: 0.6pt;"> </span>trục<span style="letter-spacing: 0.25pt;"> </span>(18<span style="letter-spacing: -0.05pt;">0<span style="position: relative; top: -5pt;">o</span></span>),<span style="letter-spacing: 0.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">gặp<span style="letter-spacing: 0.3pt;"> </span>ở<span style="letter-spacing: 0.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">có khoảng<span style="letter-spacing: 2.45pt;"> </span>QT<span style="letter-spacing: 1.4pt;"></span>kéo<span style="letter-spacing: 0.8pt;"> </span>dài<span style="letter-spacing: 2.25pt;"> </span>(trên<span style="letter-spacing: -0.5pt;"> </span>60<span style="letter-spacing: 1.7pt;"> </span>giây)<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: 0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược </span><span lang="VI" style="letter-spacing: 0.15pt; line-height: 22px;"><span> </span></span><span style="line-height: 22px;">gọi<span style="letter-spacing: 2.3pt;"> </span>là<span style="letter-spacing: 1.8pt;"> </span>“nhịp <span style="letter-spacing: 2.05pt;"><span> </span></span>xoắn<span style="letter-spacing: 1.45pt;"> </span>đỉnh” <span style="letter-spacing: 0.15pt;"><span> </span></span>(torsade<span style="letter-spacing: 1.3pt;"> </span>de<span style="letter-spacing: 1.6pt;"> </span>pointes<span style="letter-spacing: 1.35pt;"> </span>ventricular tachycardia).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Vị<span style="letter-spacing: -1.1pt;"> </span>trí<span style="letter-spacing: -1.2pt;"> </span>ổ<span style="letter-spacing: 1.5pt;"> </span>phát<span style="letter-spacing: 0.75pt;"> </span>nhịp<span style="letter-spacing: 1.95pt;"> </span>ở<span style="letter-spacing: 0.85pt;"> </span>thất<span style="letter-spacing: 2.75pt;"> </span>gây<span style="letter-spacing: 1.2pt;"> </span>nhịp<span style="letter-spacing: 1.45pt;"> </span>nhanh<span style="letter-spacing: 0.55pt;"> </span>thất<span style="letter-spacing: 2.75pt;"> </span>hay<span style="letter-spacing: 0.7pt;"> </span>gặp<span style="letter-spacing: 0.5pt;"> </span>nhất<span style="letter-spacing: 2.7pt;"> </span>là<span style="letter-spacing: 1.7pt;"> </span>vòng<span style="letter-spacing: 0.95pt;"> </span>vào<span style="letter-spacing: 1.9pt;"> </span>lại<span style="letter-spacing: 1.15pt;"> </span>ở<span style="letter-spacing: 0.85pt;"> </span>sợi<span style="letter-spacing: 0.7pt;"> </span>Purkinje;<span style="letter-spacing: 0.4pt;"> </span>nhịp nhanh<span style="letter-spacing: 0.2pt;"> </span>thất<span style="letter-spacing: 2.45pt;"></span>còn<span style="letter-spacing: 1.15pt;"> </span>gọi<span style="letter-spacing: 1.1pt;"> </span>là<span style="letter-spacing: 0.5pt;"> </span>“phân <span style="letter-spacing: 0.9pt;"><span> </span></span>ly<span style="letter-spacing: 0.4pt;"> </span>nhĩ<span style="letter-spacing: 0.9pt;"> </span>thất”<span style="letter-spacing: -0.95pt;"> </span>vì<span style="letter-spacing: 1.2pt;"> </span>tần<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 1.1pt;"> </span>nhịp<span style="letter-spacing: 0.8pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>cao<span style="letter-spacing: 0.4pt;"> </span></span><span lang="VI" style="line-height: 22px;">hơn</span><span lang="VI" style="letter-spacing: 0.9pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần<span style="letter-spacing: 0.35pt;"> </span>số<span style="letter-spacing: 1.1pt;"> </span>nhịp<span style="letter-spacing: 2.4pt;"> </span>nhĩ,<span style="letter-spacing: 2.2pt;"> </span>và<span style="letter-spacing: -0.65pt;"> </span>không <span style="letter-spacing: 0.75pt;"><span> </span></span>có<span style="letter-spacing: 1.15pt;"> </span>sự liên<span style="letter-spacing: 0.35pt;"> </span>hệ<span style="letter-spacing: -0.7pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>nhau,<span style="letter-spacing: -0.25pt;"></span>trừ<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span></span><span lang="VI" style="line-height: 22px;">ường hợp</span><span lang="VI" style="letter-spacing: -0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 0.3pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ược thất-nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.3pt;"> </span>Nguyên<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hân:<span style="letter-spacing: 0.4pt;"> </span>nhồi<span style="letter-spacing: 0.95pt;"> </span>máu<span style="letter-spacing: 1.6pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.2pt;"> </span>cấp<span style="letter-spacing: 2.1pt;"> </span>tính,<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.05pt;">v</span><span style="letter-spacing: 0.05pt;">i</span>êm<span style="letter-spacing: 1.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: -0.4pt;"> </span>thiếu<span style="letter-spacing: -0.4pt;"> </span>máu<span style="letter-spacing: 1.6pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.2pt;"> </span>cục b<span style="letter-spacing: -0.05pt;">ộ</span>,<span style="letter-spacing: 0.35pt;"> </span>bệnh<span style="letter-spacing: -0.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ tim</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">tiên<span style="letter-spacing: 1.7pt;"></span>phát,<span style="letter-spacing: 1pt;"> </span>cũng<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>khi<span style="letter-spacing: 0.75pt;"> </span>gặp<span style="letter-spacing: 0.55pt;"> </span>ở<span style="letter-spacing: 0.9pt;"> </span>nguời<span style="letter-spacing: 0.65pt;"> </span>bình<span style="letter-spacing: -1.2pt;"> </span>t</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">hư</span><span style="line-height: 22px;">ờng,<span style="letter-spacing: 0.9pt;"> </span>do<span style="letter-spacing: 0.8pt;"> </span>các<span style="letter-spacing: 1.45pt;"> </span>thuốc<span style="letter-spacing: 1.4pt;"> </span>chống<span style="letter-spacing: 1.35pt;"> </span>loạn<span style="letter-spacing: 0.8pt;"> </span>nhịp<span style="letter-spacing: 2pt;"> </span>nhóm<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.05pt;">I</span><span style="position: relative; top: -5pt;">c <span style="letter-spacing: 0.4pt;"><span> </span></span></span>(ví<span style="letter-spacing: 1.4pt;"> </span>dụ: encaini<span style="letter-spacing: -0.05pt;">d</span>e,<span style="letter-spacing: 0.3pt;"></span>flecaini<span style="letter-spacing: -0.05pt;">d</span>e)<span style="letter-spacing: 0.3pt;"> </span>và<span style="letter-spacing: 1.55pt;"> </span>nhiều<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.4pt;">bện</span>h<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.4pt;">ti</span>m <span style="letter-spacing: -0.35pt;">khá</span>c<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.4pt;">c</span>ó<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.4pt;">tổ</span>n<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.4pt;">t</span><span style="letter-spacing: -0.45pt;">h</span></span><span lang="VI" style="letter-spacing: -0.4pt; line-height: 22px;">ươn</span><span style="line-height: 22px;">g<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">c</span></span><span lang="VI" style="line-height: 22px;">ơ</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="letter-spacing: -0.4pt; line-height: 22px;">ti</span><span style="line-height: 22px;">m <span style="letter-spacing: -0.4pt;">nặn</span>g<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.4pt;">k</span><span style="letter-spacing: -0.35pt;">è</span>m<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: -0.4pt;">the</span>o<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.35pt;">nhị</span>p<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.4pt;">nhan</span>h<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.4pt;">180</span><span style="letter-spacing: -0.35pt;">-</span><span style="letter-spacing: -0.4pt;">200 ck/phút.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">+<span style="letter-spacing: 0.35pt;"> </span>Lâm<span style="letter-spacing: 1.2pt;"> </span>sàng:<span style="letter-spacing: 0.45pt;"> </span>biểu<span style="letter-spacing: -0.4pt;"> </span>hiện<span style="letter-spacing: -0.4pt;"> </span>lâm<span style="letter-spacing: 1.25pt;"> </span>sàng<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: 0.05pt;"> </span>nhịp<span style="letter-spacing: 0.7pt;"> </span>nhanh<span style="letter-spacing: 0.1pt;"> </span>thất<span style="letter-spacing: 2.25pt;"> </span>là<span style="letter-spacing: 1.3pt;"> </span>suy<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>mức<span style="letter-spacing: 0.25pt;"> </span>độ<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>ặng<span style="letter-spacing: 0.35pt;"> </span>và<span style="letter-spacing: 1.25pt;"> </span>sốc<span style="letter-spacing: 1pt;"> </span>tim,<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>thể</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">gây<span style="letter-spacing: 0.35pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điện<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ:<span style="letter-spacing: 0.35pt;"> </span>biểu<span style="letter-spacing: -0.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>điện<span style="letter-spacing: -0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ<span style="letter-spacing: 0.45pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Phức<span style="letter-spacing: -0.5pt;"> </span>bộ QRS<span style="letter-spacing: -0.7pt;"> </span>rộng từ<span style="letter-spacing: -0.1pt;"> </span>0,12- 0,24 giây<span style="letter-spacing: 0.25pt;"> </span>(trung<span style="letter-spacing: -0.3pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>0,16 giây).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Rr’<span style="letter-spacing: 0.65pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>R<span style="letter-spacing: 0.15pt;"> </span>ở V1; QS<span style="letter-spacing: 2.1pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>rS<span style="letter-spacing: -0.85pt;"> </span>ở V6.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">. Hoặc<span style="letter-spacing: -0.25pt;"> </span>đồng<span style="letter-spacing: 1.1pt;"> </span>dạng<span style="letter-spacing: -0.2pt;"> </span>R<span style="letter-spacing: 0.15pt;"> </span><span lang="VI">dương tính</span><span lang="VI" style="letter-spacing: 0.3pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">V</span>1 đến<span style="letter-spacing: 0.5pt;"> </span>V6<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Trục<span style="letter-spacing: -0.7pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>trái.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Tần<span style="letter-spacing: -0.35pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>cao<span style="letter-spacing: -0.15pt;"> </span><span lang="VI">hơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>tần<span style="letter-spacing: -0.15pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhĩ<span style="letter-spacing: -0.05pt;"> </span>(phân<span style="letter-spacing: 0.9pt;"> </span>ly<span style="letter-spacing: -0.1pt;"> </span>nhĩ-<span style="letter-spacing: 0.3pt;"> </span>thất).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Cấp<span style="letter-spacing: 1.2pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Bất<span style="letter-spacing: 1.05pt;"> </span>động,<span style="letter-spacing: 1.25pt;"> </span>nằm<span style="letter-spacing: -0.35pt;"> </span>ngang<span style="letter-spacing: -0.3pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>đầu<span style="letter-spacing: 0.4pt;"> </span>thấp.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Thở<span style="letter-spacing: -0.4pt;"> </span>ôxy<span style="letter-spacing: 0.4pt;"> </span>3-8 lít/phút.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Phục<span style="letter-spacing: -0.75pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>thuốc:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1.9pt;"> </span>Lidocain<span style="letter-spacing: 1.45pt;"> </span>1mg/kg,<span style="letter-spacing: 1.55pt;"> </span>tiêm<span style="letter-spacing: -0.15pt;"> </span>tĩnh<span style="letter-spacing: -0.1pt;"> </span>mạch;<span style="letter-spacing: 2.3pt;"> </span>sau<span style="letter-spacing: 1.9pt;"> </span>đó<span style="letter-spacing: -0.2pt;"> </span>lấy <span style="letter-spacing: 0.85pt;"><span> </span></span>200mg<span style="letter-spacing: 1.6pt;"> </span>lidocain<span style="letter-spacing: 1.55pt;"> </span>pha<span style="letter-spacing: 1.55pt;"> </span>trong<span style="letter-spacing: 1.65pt;"> </span>dịch<span style="letter-spacing: -0.1pt;"> </span>glucose<span style="letter-spacing: 1.6pt;"> </span>5%, truyền<span style="letter-spacing: -0.95pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>liều<span style="letter-spacing: -0.75pt;"> </span>20-50<span style="letter-spacing: -0.05pt;"> </span>àg/kg/phút.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Hoặc<span style="letter-spacing: -0.25pt;"> </span>procainamide<span style="letter-spacing: -0.65pt;"> </span>100-500mg,<span style="letter-spacing: -0.6pt;"> </span>tiêm<span style="letter-spacing: 0.8pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>50mg/phút.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.55pt;"> </span>Hoặc<span style="letter-spacing: 0.3pt;"> </span>cordarone<span style="letter-spacing: 0.05pt;"> </span>5<span style="letter-spacing: 0.55pt;"> </span>mg/kg,<span style="letter-spacing: 0.2pt;"> </span>pha<span style="letter-spacing: 0.2pt;"> </span>trong<span style="letter-spacing: 0.3pt;"> </span>250<span style="letter-spacing: 0.55pt;"> </span>ml<span style="letter-spacing: 0.4pt;"> </span>dung<span style="letter-spacing: 0.55pt;"> </span>d<span style="letter-spacing: -0.05pt;">ị</span>ch<span style="letter-spacing: 0.95pt;"> </span>glucose<span style="letter-spacing: 0.2pt;"> </span>5%,<span style="letter-spacing: 0.55pt;"> </span>truyền<span style="letter-spacing: -0.4pt;"> </span>tĩnh<span style="letter-spacing: 1.1pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: 0.3pt;"> </span>20 phút<span style="letter-spacing: -0.65pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>2 giờ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Phục<span style="letter-spacing: -0.75pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>bằng<span style="letter-spacing: -0.5pt;"> </span>kích<span style="letter-spacing: 0.55pt;"> </span>thích<span style="letter-spacing: 0.8pt;"> </span>thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Phục<span style="letter-spacing: -0.5pt;"> </span>hồi<span style="letter-spacing: 0.85pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>xoang<span style="letter-spacing: -0.05pt;"> </span>bằng<span style="letter-spacing: 0.65pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ương</span><span lang="VI" style="letter-spacing: 0.2pt;"> </span>pháp<span style="letter-spacing: 0.6pt;"> </span>sốc<span style="letter-spacing: 0.8pt;"> </span>điện<span style="letter-spacing: 0.35pt;"> </span>ngoài<span style="letter-spacing: 0.9pt;"> </span>lồng<span style="letter-spacing: 0.8pt;"> </span>ngực chế<span style="letter-spacing: -0.45pt;"> </span>độ<span style="letter-spacing: -0.05pt;"> </span>đồng<span style="letter-spacing: 2.25pt;"> </span>bộ<span style="letter-spacing: 0.25pt;"> </span>(nếu<span style="letter-spacing: -0.65pt;"> </span>cuồng động<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>thì<span style="letter-spacing: 0.4pt;"></span>sốc<span style="letter-spacing: 0.6pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>độ<span style="letter-spacing: -0.65pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>đồng<span style="letter-spacing: 1.4pt;"> </span>bộ), mức<span style="letter-spacing: -0.2pt;"> </span>năng<span style="letter-spacing: 0.25pt;"> </span><span lang="VI">lượng từ</span><span lang="VI" style="letter-spacing: -0.1pt;"> </span>100-150j.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.25pt;"> </span>Hoặc phục<span style="letter-spacing: -0.2pt;"> </span>hồi<span style="letter-spacing: 0.85pt;"> </span>nhịp<span style="letter-spacing: 0.55pt;"> </span>xoang<span style="letter-spacing: -0.05pt;"> </span>bằng<span style="letter-spacing: 0.65pt;"> </span>p<span style="letter-spacing: -0.1pt;">h</span></span><span lang="VI" style="line-height: 22px;">ương</span><span lang="VI" style="letter-spacing: 0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 0.35pt;"> </span>đốt<span style="letter-spacing: 0.8pt;"> </span>ổ<span style="letter-spacing: 0.9pt;"> </span>phát<span style="letter-spacing: 0.15pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>lý<span style="letter-spacing: 0.15pt;"> </span>bằng<span style="letter-spacing: 0.05pt;"> </span>năng<span style="letter-spacing: 1.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">lượng</span><span lang="VI" style="letter-spacing: 0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">tần<span style="letter-spacing: 0.1pt;"> </span>số radio<span style="letter-spacing: -0.25pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>ống<span style="letter-spacing: 0.5pt;"></span>thông.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Phục<span style="letter-spacing: -0.75pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>xoắn<span style="letter-spacing: -0.25pt;"> </span>đỉnh:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Magiesulphat<span style="letter-spacing: -0.65pt;"> </span>15%, tiêm<span style="letter-spacing: 0.8pt;"> </span>tĩnh<span style="letter-spacing: 0.5pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>5-10 ml<span style="letter-spacing: -0.15pt;"> </span>tr<span style="letter-spacing: -0.1pt;">o</span>ng<span style="letter-spacing: -0.15pt;"> </span>2 phút,<span style="letter-spacing: -0.5pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>tiêm<span style="letter-spacing: 2.1pt;"> </span>lại<span style="letter-spacing: -0.6pt;"> </span>sau 1 giờ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 20px;">.<span style="letter-spacing: 2.35pt;"> </span>Kaliclorua<span style="letter-spacing: 1.85pt;"> </span>15%<span style="letter-spacing: 2.4pt;"> </span>~<span style="letter-spacing: 2.6pt;"> </span>20ml,<span style="letter-spacing: 2.05pt;"> </span>pha<span style="letter-spacing: 2pt;"> </span>vào <span style="letter-spacing: 0.5pt;"><span> </span></span>100-250<span style="letter-spacing: 2.35pt;"> </span>ml<span style="letter-spacing: 2.2pt;"> </span>dung<span style="letter-spacing: 2.35pt;"> </span>dịch<span style="letter-spacing: 0.3pt;"> </span>glucose,<span style="letter-spacing: 1.95pt;"> </span>truyền<span style="letter-spacing: 1.4pt;"> </span>tĩnh<span style="letter-spacing: 0.3pt;"> </span>mạch<span style="letter-spacing: -1.2pt;"> </span>20 giọt/phút<span style="letter-spacing: 0.3pt;"> </span>(không<span style="letter-spacing: 0.55pt;"></span>dùng<span style="letter-spacing: 0.05pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>suy<span style="letter-spacing: 0.3pt;"> </span>thân <span style="letter-spacing: 1.55pt;"><span> </span></span>mạn, <span style="letter-spacing: 1.05pt;"><span> </span></span>đái<span style="letter-spacing: -0.5pt;"> </span>tháo <span style="letter-spacing: 0.3pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 20px;">ường</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 20px;"> </span><span style="line-height: 20px;">nặng,<span style="letter-spacing: 0.05pt;"> </span>đang<span style="letter-spacing: 0.65pt;"> </span>dùng<span style="letter-spacing: 0.05pt;"> </span>thuốc<span style="letter-spacing: 0.8pt;"> </span>chống<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.75pt;"> </span>nhịp nhóm<span style="letter-spacing: 0.55pt;"> </span>III).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.95pt;"> </span>Khi<span style="letter-spacing: 0.75pt;"> </span>nhịp<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: 0.7pt;"> </span>đã <span style="letter-spacing: 0.05pt;"><span> </span></span>phục<span style="letter-spacing: 0.5pt;"> </span>hồi<span style="letter-spacing: 1.55pt;"> </span>thì<span style="letter-spacing: -1.1pt;"> </span>lựa<span style="letter-spacing: 0.8pt;"> </span>chọn<span style="letter-spacing: 1.4pt;"> </span>thuốc<span style="letter-spacing: 1.4pt;"> </span>chống<span style="letter-spacing: 1.5pt;"> </span>loạn<span style="letter-spacing: 0.6pt;"> </span>nhịp,<span style="letter-spacing: 2.1pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>cấy<span style="letter-spacing: 2.85pt;"> </span>máy<span style="letter-spacing: 1.35pt;"> </span>sốc<span style="letter-spacing: 1.55pt;"> </span>điện <span style="letter-spacing: 0.3pt;"><span> </span></span>để chống<span style="letter-spacing: 0.55pt;"> </span>tái<span style="letter-spacing: 0.65pt;"></span>phát.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.1pt;"> </span>Những<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ường</span><span lang="VI" style="letter-spacing: 0.1pt;"> </span>dùng<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: -0.15pt;"> </span>lâm<span style="letter-spacing: 1.6pt;"> </span>sàng<span style="letter-spacing: 1.1pt;"> </span>để<span style="letter-spacing: -0.45pt;"> </span>điều<span style="letter-spacing: 1.05pt;"> </span>trị<span style="letter-spacing: 0.6pt;"> </span>củng<span style="letter-spacing: -0.35pt;"> </span>cố<span style="letter-spacing: 0.7pt;"> </span>tránh<span style="letter-spacing: 1.4pt;"> </span>tái<span style="letter-spacing: -0.55pt;"> </span>phát<span style="letter-spacing: 0.55pt;"> </span>nhịp<span style="letter-spacing: 1.7pt;"> </span>nhanh<span style="letter-spacing: -0.2pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>là<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">một<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>những thuốc<span style="letter-spacing: 0.5pt;"> </span>sau:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.65pt;"><span class="Apple-style-span" style="font-size: large;">. Amiodaron<span style="letter-spacing: -0.55pt;"> </span>(cordarone)<span style="letter-spacing: -0.55pt;"> </span>200 mg<span style="letter-spacing: -0.1pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-4v/ngày.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Disopyramide<span style="letter-spacing: -0.7pt;"> </span>(rythm<span style="letter-spacing: -0.1pt;">o</span>dan)<span style="letter-spacing: -0.6pt;"> </span>100mg<span style="letter-spacing: -0.4pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-4v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Propanolol<span style="letter-spacing: -1.05pt;"> </span>40 mg<span style="letter-spacing: -0.15pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>1-2v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Mexiletin (mexitil, ritalmex) 200 mg<span style="letter-spacing: -0.05pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-4v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Flecai<span style="letter-spacing: -0.05pt;">n</span><span style="letter-spacing: 0.05pt;">i</span>d<span style="letter-spacing: -0.4pt;"> </span>(flecain)<span style="letter-spacing: -0.4pt;"> </span>100 mg<span style="letter-spacing: -0.15pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-3v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Propafenon<span style="letter-spacing: -1.1pt;"> </span>(rythmonorm)<span style="letter-spacing: -0.7pt;"> </span>300 mg<span style="letter-spacing: -0.2pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-3v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1pt;">. Verap<span style="letter-spacing: -0.05pt;">a</span>mil<span style="letter-spacing: -0.5pt;"> </span>(isoptin)<span style="letter-spacing: -0.4pt;"> </span>40 mg<span style="letter-spacing: -0.15pt;"> </span>~<span style="letter-spacing: 0.25pt;"> </span>2-3v/ngày.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.2.4.<span style="letter-spacing: -0.25pt;"> </span>Rung<span style="letter-spacing: 1.05pt;"> </span>thất<span style="letter-spacing: 0.3pt;"> </span>(ve<span style="letter-spacing: -0.05pt;">n</span>tri<span style="letter-spacing: -0.1pt;">c</span>ular<span style="letter-spacing: 2.15pt;"> </span>fibrillation):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.55pt;"> </span>Rung<span style="letter-spacing: 1.6pt;"> </span>thất: <span style="letter-spacing: 0.6pt;"><span> </span></span>là <span style="letter-spacing: 0.35pt;"><span> </span></span>tình<span style="letter-spacing: -0.45pt;"> </span>trạng<span style="letter-spacing: 2pt;"> </span>từng<span style="letter-spacing: 1.4pt;"> </span>v<span style="letter-spacing: -0.05pt;">ù</span>ng<span style="letter-spacing: 0.85pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 2.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">thất <span style="letter-spacing: 0.5pt;"><span> </span></span>rung<span style="letter-spacing: 1.6pt;"> </span>lên,<span style="letter-spacing: -0.6pt;"> </span>các<span style="letter-spacing: 2.15pt;"> </span>bó<span style="letter-spacing: 2.15pt;"> </span>sợi<span style="letter-spacing: 1.45pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 2.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">thất <span style="letter-spacing: 0.5pt;"><span> </span></span>co<span style="letter-spacing: 1.5pt;"> </span>bóp<span style="letter-spacing: 1.95pt;"> </span>khác<span style="letter-spacing: 2pt;"> </span>nhau, không<span style="letter-spacing: 0.8pt;"> </span>đồng<span style="letter-spacing: 1.1pt;"></span>bộ,<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>những<span style="letter-spacing: 0.55pt;"> </span>ổ<span style="letter-spacing: 1.2pt;"> </span>lạc<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ị<span style="letter-spacing: 0.55pt;"> </span>trí<span style="letter-spacing: 1.05pt;"> </span>trong<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>phát<span style="letter-spacing: 1pt;"> </span>xung<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 2.35pt;"> </span>loạn<span style="letter-spacing: 1pt;"> </span>xạ<span style="letter-spacing: -0.2pt;"> </span>gây<span style="letter-spacing: 1.75pt;"> </span>ra.<span style="letter-spacing: 0.45pt;"> </span>Hậu<span style="letter-spacing: 2.55pt;"> </span>quả <span style="letter-spacing: 0.15pt;"><span> </span></span>là<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: 0.4pt;"> </span>mất chức<span style="letter-spacing: -0.25pt;"> </span>năng <span style="letter-spacing: 1.55pt;"><span> </span></span></span><span lang="VI" style="line-height: 22px;">“bơm”</span><span lang="VI" style="letter-spacing: -0.2pt; line-height: 22px;"></span><span style="line-height: 22px;">máu, <span style="letter-spacing: 0.45pt;"><span> </span></span>tim<span style="letter-spacing: -0.15pt;"> </span>ngừng đ<span style="letter-spacing: -0.05pt;">ậ</span>p,<span style="letter-spacing: -1pt;"> </span>m<span style="letter-spacing: -0.05pt;">ấ</span>t<span style="letter-spacing: 1.85pt;"> </span>mạch,<span style="letter-spacing: 0.35pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>ý thức<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.4pt;"> </span>Nguyên<span style="letter-spacing: 1.05pt;"> </span>nhân:<span style="letter-spacing: 0.35pt;"> </span>rung<span style="letter-spacing: 0.4pt;"> </span>thất<span style="letter-spacing: 2.35pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>gặp<span style="letter-spacing: 0.05pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 1pt;"> </span>trái<span style="letter-spacing: 1pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>bì<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 0.7pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">gây<span style="letter-spacing: 1.25pt;"> </span>đột<span style="letter-spacing: 0.5pt;"> </span>tử;<span style="letter-spacing: 0.3pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ưng</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">hầu<span style="letter-spacing: 0.25pt;"> </span>hết gặp<span style="letter-spacing: -0.1pt;"> </span>ở<span style="letter-spacing: 0.25pt;"> </span>những<span style="letter-spacing: 0.25pt;"></span></span><span lang="VI" style="line-height: 22px;">người</span><span lang="VI" style="letter-spacing: 0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 0.9pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>nặng,<span style="letter-spacing: -0.05pt;"> </span>suy<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>nặ<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.1pt;"> </span>do<span style="letter-spacing: 0.15pt;"> </span>nhồi<span style="letter-spacing: 0.85pt;"> </span>máu<span style="letter-spacing: 1.5pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">b</span>ệnh<span style="letter-spacing: -0.45pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.1pt;"> </span>tiên<span style="letter-spacing: 1.05pt;"> </span>phát,<span style="letter-spacing: 0.35pt;"> </span>bệ<span style="letter-spacing: -0.05pt;">n</span>h van<span style="letter-spacing: -0.5pt;"> </span>2 lá,<span style="letter-spacing: 0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"></span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ,<span style="letter-spacing: -0.4pt;"> </span>viêm<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">Rung<span style="letter-spacing: 0.15pt;"> </span>thất<span style="letter-spacing: 2.05pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>thể<span style="letter-spacing: -0.6pt;"> </span>gặp<span style="letter-spacing: -0.2pt;"> </span>khi dùng<span style="letter-spacing: -0.1pt;"> </span>thuốc<span style="letter-spacing: 0.65pt;"> </span>nhóm<span style="letter-spacing: 0.7pt;"> </span>digit<span style="letter-spacing: -0.05pt;">a</span>lis,<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.65pt;"> </span>chống<span style="letter-spacing: 0.7pt;"> </span>loạn<span style="letter-spacing: -0.5pt;"> </span>nhịp...<span style="letter-spacing: 1.7pt;"> </span>hoặc<span style="letter-spacing: -0.1pt;"> </span>khi tiến<span style="letter-spacing: -0.6pt;"> </span>hành những kỹ thuật<span style="letter-spacing: 2pt;"> </span>thông<span style="letter-spacing: 0.25pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>chụp<span style="letter-spacing: -0.45pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành,<span style="letter-spacing: 0.7pt;"> </span>đặt<span style="letter-spacing: 0.05pt;"> </span>tạo<span style="letter-spacing: -0.65pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>tim...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Biểu<span style="letter-spacing: 0.2pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>lâm<span style="letter-spacing: 0.35pt;"> </span>sàn<span style="letter-spacing: -0.05pt;">g</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">Khi<span style="letter-spacing: 1.05pt;"> </span>rung<span style="letter-spacing: 1.25pt;"> </span>thất <span style="letter-spacing: 0.15pt;"><span> </span></span>trong<span style="letter-spacing: 1pt;"> </span>8-10<span style="letter-spacing: 1.25pt;"> </span>giây,<span style="letter-spacing: -0.8pt;"> </span>bệnh<span style="letter-spacing: 0.55pt;"> </span>nhân<span style="letter-spacing: -0.8pt;"> </span>bắt<span style="letter-spacing: 1.1pt;"> </span>đầu<span style="letter-spacing: 1.65pt;"> </span>mất <span style="letter-spacing: 0.15pt;"><span> </span></span>ý<span style="letter-spacing: 1.25pt;"> </span>thức;<span style="letter-spacing: 1pt;"> </span>nếu<span style="letter-spacing: 0.55pt;"> </span>ti<span style="letter-spacing: -0.05pt;">ế</span>p<span style="letter-spacing: 0.25pt;"> </span>tục<span style="letter-spacing: 0.9pt;"> </span>rung<span style="letter-spacing: 1.2pt;"> </span>thất <span style="letter-spacing: 0.15pt;"><span> </span></span>t<span style="letter-spacing: -0.05pt;">h</span>ì<span style="letter-spacing: 1.25pt;"> </span>bệnh nhân<span style="letter-spacing: 0.25pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong<span style="letter-spacing: -0.7pt;"></span>trong<span style="letter-spacing: -0.25pt;"> </span>vòng<span style="letter-spacing: 0.25pt;"> </span>3-5 phút.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Diễn<span style="letter-spacing: -0.95pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>lâm<span style="letter-spacing: 0.8pt;"> </span>sàng<span style="letter-spacing: 0.15pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>rung t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.25pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>biểu<span style="letter-spacing: -0.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>ngừng tim:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Hồi<span style="letter-spacing: 0.5pt;"> </span>hộp,<span style="letter-spacing: -0.2pt;"> </span>đau<span style="letter-spacing: 0.4pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>nông,<span style="letter-spacing: 0.25pt;"> </span>hốt<span style="letter-spacing: 0.6pt;"> </span>hoảng <span style="letter-spacing: 0.75pt;"><span> </span></span>và<span style="letter-spacing: -0.6pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>giật.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">. Đột<span style="letter-spacing: 1.15pt;"> </span>ngột<span style="letter-spacing: -0.2pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>ý thức,<span style="letter-spacing: -0.25pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>vận<span style="letter-spacing: 1.55pt;"> </span>động,<span style="letter-spacing: 0.25pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>phản<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ạ, mất<span style="letter-spacing: 1.9pt;"> </span>cảm<span style="letter-spacing: 0.45pt;"> </span>giác.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Không<span style="letter-spacing: 0.25pt;"> </span>bắt<span style="letter-spacing: -0.15pt;"> </span><span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.2pt;"> </span>động <span style="letter-spacing: 0.2pt;"><span> </span></span>mạch<span style="letter-spacing: 2.3pt;"> </span>cảnh<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.05pt;">v</span><span lang="VI">à động</span><span lang="VI" style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span><span lang="VI">đùi;</span><span lang="VI" style="letter-spacing: -0.05pt;"> </span>ngừng thở.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Không<span style="letter-spacing: 0.25pt;"> </span>nghe<span style="letter-spacing: -0.25pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đập.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">Gia</span>i<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">đoạ</span>n<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.25pt;">đầ</span>u<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.25pt;">đồn</span>g <span style="letter-spacing: 0.95pt;"><span> </span></span><span style="letter-spacing: -0.3pt;">t</span>ử<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">c</span><span style="letter-spacing: -0.4pt;">o</span>,<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">cò</span>n<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>n<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: -0.25pt;">x</span>ạ<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">vớ</span>i<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.25pt;">án</span>h<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.25pt;">s</span><span style="letter-spacing: -0.35pt;">á</span><span style="letter-spacing: -0.25pt;">ng</span>;<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.3pt;">sa</span>u<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ó<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">đồn</span>g<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>ử<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">giã</span>n<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">mấ</span>t<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>n<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.35pt;">x</span>ạ<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">vớ</span>i<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">ánh </span><span style="letter-spacing: -0.25pt;">sáng</span>.<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.25pt;">Bện</span>h<span style="letter-spacing: 1.75pt;"></span><span style="letter-spacing: -0.25pt;">nhâ</span>n<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.25pt;">b</span>ị<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>ử<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">von</span>g <span style="letter-spacing: 0.9pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">nế</span>u<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g <span style="letter-spacing: 0.2pt;"><span> </span></span></span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 22px;">đượ</span><span style="line-height: 22px;">c<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">cấ</span>p<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.3pt;">cứ</span>u<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">kị</span>p<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">thời.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Biểu<span style="letter-spacing: 0.2pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Mất<span style="letter-spacing: 2.45pt;"> </span>các<span style="letter-spacing: 1.1pt;"> </span>sóng<span style="letter-spacing: 1.2pt;"> </span>P,<span style="letter-spacing: 0.25pt;"> </span>Q,<span style="letter-spacing: 0.55pt;"> </span>R,<span style="letter-spacing: 0.65pt;"> </span>S,<span style="letter-spacing: -0.3pt;"> </span>T<span style="letter-spacing: 0.2pt;"> </span>mà<span style="letter-spacing: 1.1pt;"> </span>thay<span style="letter-spacing: 0.35pt;"> </span>bằng<span style="letter-spacing: 1.8pt;"> </span>các<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.05pt;">s</span>óng<span style="letter-spacing: 1.05pt;"> </span>dao<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>rung<span style="letter-spacing: 0.55pt;"> </span>với<span style="letter-spacing: 0.1pt;"> </span>hình<span style="letter-spacing: 1.6pt;"> </span>dạng,<span style="letter-spacing: 0.9pt;"> </span>biên<span style="letter-spacing: 1.6pt;"> </span>độ,<span style="letter-spacing: 0.2pt;"> </span>thời gian<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>tần<span style="letter-spacing: -0.15pt;"> </span>số<span style="letter-spacing: 0.6pt;"></span>không<span style="letter-spacing: 1.35pt;"> </span>đều,<span style="letter-spacing: -0.35pt;"> </span>luôn<span style="letter-spacing: 0.35pt;"> </span>thay<span style="letter-spacing: -0.2pt;"> </span>đổi<span style="letter-spacing: 0.15pt;"> </span>khoảng<span style="letter-spacing: 0.7pt;"> </span>300-400 ck/phút.<span style="letter-spacing: -0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">Người ta</span><span lang="VI" style="letter-spacing: -0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">chia<span style="letter-spacing: -0.2pt;"> </span>rung thất<span style="letter-spacing: 1.9pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>3 l<span style="letter-spacing: -0.1pt;">o</span>ại:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19.3pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1.5pt;">. Rung thất<span style="letter-spacing: 1.9pt;"> </span>mắt<span style="letter-spacing: -0.2pt;"> </span>lớn:<span style="letter-spacing: -0.2pt;"> </span>biên<span style="letter-spacing: 1.55pt;"> </span>độ<span style="letter-spacing: -0.3pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>rung<span style="letter-spacing: 0.05pt;"> </span>≥<span style="letter-spacing: 0.25pt;"> </span>0,3 mv.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.7pt;"><span class="Apple-style-span" style="font-size: large;">. Rung thất<span style="letter-spacing: 1.9pt;"> </span>mắt<span style="letter-spacing: -0.2pt;"> </span>bé:<span style="letter-spacing: -0.75pt;"> </span>biên<span style="letter-spacing: 1.55pt;"> </span>độ<span style="letter-spacing: -0.3pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>rung <<span style="letter-spacing: -0.05pt;"> </span>0,3 mv.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">. Nhịp<span style="letter-spacing: 0.25pt;"> </span>tự<span style="letter-spacing: -0.1pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.05pt;">đ</span><span lang="VI">ường đẳng</span><span lang="VI" style="letter-spacing: 0.65pt;"> </span>điện.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Cấp<span style="letter-spacing: 1.2pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">- Thực<span style="letter-spacing: -0.5pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span><span lang="VI">bước cấp</span><span lang="VI" style="letter-spacing: 1.75pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>ngừng<span style="letter-spacing: -0.05pt;"> </span>tuần<span style="letter-spacing: -0.2pt;"> </span>hoàn<span style="letter-spacing: 0.7pt;"> </span>(hô<span style="letter-spacing: 0.45pt;"> </span>hấp<span style="letter-spacing: 1.7pt;"> </span>viện<span style="letter-spacing: 0.2pt;"> </span>trợ,<span style="letter-spacing: -0.15pt;"> </span>bóp<span style="letter-spacing: 0.35pt;"> </span>tim<span style="letter-spacing: -0.05pt;">.</span>..).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Phá<span style="letter-spacing: 0.5pt;"> </span>rung bằng<span style="letter-spacing: 0.4pt;"> </span><span lang="VI">phương pháp</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>sốc<span style="letter-spacing: 0.6pt;"> </span>điện,<span style="letter-spacing: 0.4pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>độ<span style="letter-spacing: -0.65pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>đồng<span style="letter-spacing: 1.4pt;"> </span>bộ từ<span style="letter-spacing: -0.1pt;"> </span>200-360j.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Nếu<span style="letter-spacing: -0.45pt;"> </span>là<span style="letter-spacing: 1.25pt;"> </span>rung<span style="letter-spacing: 0.4pt;"> </span>thất<span style="letter-spacing: 2.3pt;"> </span>mắt<span style="letter-spacing: 0.2pt;"> </span>bé<span style="letter-spacing: -0.3pt;"> </span>thì<span style="letter-spacing: 0.8pt;"> </span>cho<span style="letter-spacing: 0.25pt;"> </span>thuốc<span style="letter-spacing: 0.95pt;"> </span>adrenalin 1mg,<span style="letter-spacing: 0.2pt;"> </span>tiêm<span style="letter-spacing: 1.75pt;"> </span>vào<span style="letter-spacing: -0.4pt;"> </span>tĩnh<span style="letter-spacing: 1.45pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"> </span>trung<span style="letter-spacing: 0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">ương,</span><span lang="VI" style="letter-spacing: 1.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">hoặc<span style="letter-spacing: 0.15pt;"> </span>trực tiếp<span style="letter-spacing: -0.75pt;"> </span>vào<span style="letter-spacing: 0.75pt;"></span>buồng<span style="letter-spacing: 0.8pt;"> </span>tim, hoặc<span style="letter-spacing: -0.05pt;"> </span></span><span lang="VI" style="line-height: 22px;">bơm</span><span lang="VI" style="letter-spacing: 0.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">qua<span style="letter-spacing: 0.05pt;"> </span>ống<span style="letter-spacing: 0.7pt;"> </span>nội<span style="letter-spacing: 0.05pt;"> </span>khí<span style="letter-spacing: 1.35pt;"> </span>quản<span style="letter-spacing: 1.5pt;"> </span>để<span style="letter-spacing: -0.35pt;"> </span>chuyển<span style="letter-spacing: -0.5pt;"> </span>thành<span style="letter-spacing: 0.55pt;"> </span>rung<span style="letter-spacing: 0.2pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>mắt lớn<span style="letter-spacing: -0.05pt;"> </span>rồi<span style="letter-spacing: 0.85pt;"> </span>tiến<span style="letter-spacing: -0.55pt;"> </span>hà<span style="letter-spacing: -0.05pt;">n</span>h sốc<span style="letter-spacing: 0.6pt;"> </span>điện.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 1.4pt;"> </span>Nếu<span style="letter-spacing: 0.55pt;"> </span>không<span style="letter-spacing: 1.65pt;"> </span>có<span style="letter-spacing: 2.05pt;"> </span>máy<span style="letter-spacing: 1.8pt;"> </span>sốc<span style="letter-spacing: 2pt;"> </span>điện<span style="letter-spacing: 1.8pt;"> </span>thì<span style="letter-spacing: -0.65pt;"> </span>điều<span style="letter-spacing: 1.8pt;"> </span>trị<span style="letter-spacing: -0.65pt;"> </span>phục<span style="letter-spacing: 0.9pt;"> </span>hồi<span style="letter-spacing: 2pt;"> </span>nhịp<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: 1.15pt;"> </span>và<span> </span>chống<span style="letter-spacing: 1.95pt;"> </span>tái<span style="letter-spacing: 1.15pt;"> </span>phát<span style="letter-spacing: 2.35pt;"> </span>bằng <span style="letter-spacing: 0.5pt;"><span> </span></span>thuốc giống<span style="letter-spacing: 0.55pt;"> </span></span><span lang="VI" style="line-height: 22px;">như cấp</span><span lang="VI" style="letter-spacing: 1.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">cứu<span style="letter-spacing: -0.15pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">2.3.<span style="letter-spacing: -0.2pt;"> </span>Blốc<span style="letter-spacing: -0.15pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>(heart <span style="letter-spacing: 0.05pt;"><span> </span></span><span style="letter-spacing: -0.1pt;">b</span><span style="letter-spacing: -0.05pt;">l</span>ock):</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Blốc<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.8pt;"> </span>là<span style="letter-spacing: 1.8pt;"> </span>những<span style="letter-spacing: 0.95pt;"> </span>rối<span style="letter-spacing: 1.55pt;"> </span>loạn<span style="letter-spacing: 1.65pt;"> </span>tạo<span style="letter-spacing: 0.7pt;"> </span>thành <span style="letter-spacing: 0.1pt;"><span> </span></span>xung<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>dẫn<span style="letter-spacing: 2.8pt;"> </span>truyền xung<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>từ<span style="letter-spacing: 0.85pt;"> </span>nút<span style="letter-spacing: 0.65pt;"> </span>xoang<span style="letter-spacing: 0.65pt;"> </span>đến mạng<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.05pt;">l</span></span><span lang="VI" style="line-height: 22px;">ưới</span><span style="letter-spacing: -0.1pt; line-height: 22px;">P</span><span style="line-height: 22px;">urkinje.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Nguyên<span style="letter-spacing: 1.4pt;"> </span>nhân<span style="letter-spacing: 0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">gặp<span style="letter-spacing: 0.4pt;"> </span>gây<span style="letter-spacing: 1.1pt;"> </span>blốc<span style="letter-spacing: 1.35pt;"> </span>tim<span style="letter-spacing: 0.6pt;"> </span>là:<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.05pt;">c</span></span><span lang="VI" style="line-height: 22px;">ườ</span><span style="letter-spacing: -0.05pt; line-height: 22px;">n</span><span style="line-height: 22px;">g<span style="letter-spacing: 0.8pt;"> </span>phó<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">g</span><span style="letter-spacing: 0.05pt;">i</span>ao<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ảm,<span style="letter-spacing: 0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">bệnh cơ</span><span lang="VI" style="letter-spacing: 1.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim,<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>iếu<span style="letter-spacing: -0.15pt;"> </span>máu<span style="letter-spacing: 2.05pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.9pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim cục<span style="letter-spacing: -0.35pt;"> </span>bộ, bệnh<span style="letter-spacing: -0.75pt;"></span>van<span style="letter-spacing: -0.5pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>thấp<span style="letter-spacing: 1.7pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>viêm<span style="letter-spacing: 1.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.3.1.<span style="letter-spacing: -0.25pt;"> </span>Ngừng<span style="letter-spacing: -0.4pt;"> </span>xoang<span style="letter-spacing: 1.15pt;"> </span></span></span>(si<span style="letter-spacing: -0.05pt;">n</span>us arr<span style="letter-spacing: -0.05pt;">e</span>st)<span style="letter-spacing: -0.2pt;"> </span>(<span style="letter-spacing: -0.05pt;">h</span>oặc<span style="letter-spacing: -0.25pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>nhĩ).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span>Khi<span style="letter-spacing: 0.15pt;"> </span>nút xoang ngừng<span style="letter-spacing: 0.3pt;"> </span>phát<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tr<span style="letter-spacing: -0.05pt;">o</span>ng<span style="letter-spacing: 0.2pt;"> </span>khoảng<span style="letter-spacing: 0.6pt;"> </span>thời<span style="letter-spacing: 0.15pt;"> </span>gian<span style="letter-spacing: 0.15pt;"> </span>ngắn<span style="letter-spacing: 0.1pt;"> </span>thì<span style="letter-spacing: 1.5pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: 1.2pt;"> </span>ngừng<span style="letter-spacing: 0.3pt;"> </span>xoang h<span style="letter-spacing: 0.1pt;">a</span>y blốc<span style="letter-spacing: 0.6pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"></span>nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.45pt;"> </span>Biểu<span style="letter-spacing: -1.15pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>lâm<span style="letter-spacing: 1.1pt;"> </span>sàng:<span style="letter-spacing: 0.85pt;"> </span>phụ<span style="letter-spacing: -0.05pt;"> </span>thuộc<span style="letter-spacing: 0.3pt;"> </span>vào<span style="letter-spacing: 1.05pt;"> </span>từng<span style="letter-spacing: 0.3pt;"> </span>thời<span style="letter-spacing: 0.35pt;"> </span>gian<span style="letter-spacing: 0.35pt;"> </span>ngừng<span style="letter-spacing: 0.5pt;"> </span>xoang<span style="letter-spacing: 0.2pt;"> </span>d<span style="letter-spacing: 0.05pt;">à</span>i<span style="letter-spacing: 1.2pt;"> </span>hay<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.2pt;">n</span><span style="letter-spacing: -0.25pt;">g</span><span style="letter-spacing: -0.15pt;">ắ</span><span style="letter-spacing: -0.25pt;">n</span>:<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">t</span>ừ<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.2pt;">hồ</span>i<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.2pt;">h</span><span style="letter-spacing: -0.25pt;">ộ</span>p <span style="letter-spacing: -0.2pt;">đá</span><span style="letter-spacing: -0.25pt;">n</span>h <span style="letter-spacing: -0.2pt;">trốn</span>g<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.2pt;">ngự</span>c<span style="letter-spacing: -0.65pt;"></span><span style="letter-spacing: -0.2pt;">ch</span>o<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.15pt;">đế</span>n<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.15pt;">lịm</span>,<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.2pt;">ngất</span>,<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.25pt;">A</span><span style="letter-spacing: -0.2pt;">dams-St</span><span style="letter-spacing: -0.25pt;">o</span><span style="letter-spacing: -0.2pt;">kes</span>,<span style="letter-spacing: -0.2pt;"> hoặ</span>c<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.15pt;">độ</span>t<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.2pt;">tử.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 1pt;"> </span>Điện<span style="letter-spacing: 1.5pt;"> </span>tim<span style="letter-spacing: 0.95pt;"> </span>đồ:<span style="letter-spacing: -1.05pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>x<span style="letter-spacing: -0.1pt;">o</span>ang<span style="letter-spacing: 0.75pt;"> </span>xen<span style="letter-spacing: 1.05pt;"> </span>kẽ<span style="letter-spacing: 0.35pt;"> </span>những<span style="letter-spacing: 1.05pt;"> </span>thời<span style="letter-spacing: 0.85pt;"> </span>khoảng<span style="letter-spacing: 1.35pt;"> </span>mất<span> </span>sóng<span style="letter-spacing: 1.7pt;"> </span>P<span style="letter-spacing: 0.7pt;"> </span>và<span style="letter-spacing: 1.9pt;"> </span>phức<span style="letter-spacing: 0.8pt;"> </span>bộ<span style="letter-spacing: 1.05pt;"> </span>QRST,<span style="letter-spacing: 0.05pt;"> </span>tùy<span style="letter-spacing: 0.75pt;"> </span>tình trạng<span style="letter-spacing: 0.4pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>1, 2, 3, 4... nhịp<span style="letter-spacing: 2.15pt;"> </span>để<span style="letter-spacing: -0.35pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>nhĩ<span style="letter-spacing: 0.4pt;"> </span>1:1,<span style="letter-spacing: -0.2pt;"> </span>2:1,<span style="letter-spacing: -0.2pt;"> </span>3:1,<span style="letter-spacing: -0.2pt;"> </span>4:1...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: -0.25pt;"> </span>nhĩ:<span style="letter-spacing: 0.3pt;"> </span>l<span style="letter-spacing: -0.1pt;">ự</span>a<span style="letter-spacing: -0.15pt;"> </span>chọn<span style="letter-spacing: 0.45pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>biện<span style="letter-spacing: -0.85pt;"> </span>pháp<span style="letter-spacing: 0.4pt;"> </span>sau đây:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 1.55pt;"> </span>Atropin<span style="letter-spacing: 1.2pt;"> </span>1/4mg-2mg/ngày,<span style="letter-spacing: 1.65pt;"> </span>tiêm<span style="letter-spacing: -0.55pt;"> </span></span><span lang="VI" style="line-height: 22px;">dưới </span><span lang="VI" style="letter-spacing: -1.45pt; line-height: 22px;"><span> </span></span><span style="line-height: 22px;">da<span style="letter-spacing: 1.45pt;"> </span>hoặc<span style="letter-spacing: 1.3pt;"> </span>tiêm<span style="letter-spacing: -0.55pt;"> </span>tĩnh<span style="letter-spacing: -0.5pt;"> </span>mạ<span style="letter-spacing: -0.05pt;">c</span>h,<span style="letter-spacing: 1.95pt;"> </span>duy<span style="letter-spacing: 1.55pt;"> </span>trì<span style="letter-spacing: -0.45pt;"> </span>nhịp<span style="letter-spacing: -0.8pt;"> </span>xoang<span style="letter-spacing: 1.25pt;"> </span>60-80 ck/phút.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: -1.5pt;">. Ephedrin<span style="letter-spacing: -0.45pt;"> </span>0,01 ~<span style="letter-spacing: 0.25pt;"> </span>2-6v/ngày,<span style="letter-spacing: 0.2pt;"> </span>uống.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.75pt;"><span class="Apple-style-span" style="font-size: large;">. Isopren<span style="letter-spacing: -0.05pt;">a</span>lin<span style="letter-spacing: -0.6pt;"> </span>(isu<span style="letter-spacing: -0.05pt;">p</span>rel)<span style="letter-spacing: -0.35pt;"> </span>1-2 mg<span style="letter-spacing: -0.15pt;"> </span>(1-2v/ngày)<span style="letter-spacing: 0.2pt;"> </span>ngậm<span style="letter-spacing: 1.95pt;"> </span><span lang="VI">dưới </span><span style="letter-spacing: 0.05pt;">l</span><span lang="VI">ưỡi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Đặt<span style="letter-spacing: 1.3pt;"> </span>máy<span style="letter-spacing: 0.7pt;"> </span>tạo<span style="letter-spacing: -0.45pt;"> </span>nhịp<span style="letter-spacing: 1.6pt;"> </span>(pacemaker).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.85pt;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.3.2.<span style="letter-spacing: -0.25pt;"> </span>Blốc<span style="letter-spacing: -0.15pt;"> </span>nhĩ-thất<span style="letter-spacing: 0.45pt;"> </span>(atrial<span style="letter-spacing: 1.7pt;"> </span>ventricular<span style="letter-spacing: 2.1pt;"> </span>block):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Blốc<span style="letter-spacing: -0.2pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span lang="VI">ược</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>3 độ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.5pt;"> </span>Độ<span style="letter-spacing: 1.9pt;"> </span>1:<span style="letter-spacing: 0.45pt;"> </span>là<span style="letter-spacing: 1.4pt;"> </span>thời<span style="letter-spacing: 0.35pt;"> </span>gian<span style="letter-spacing: 0.35pt;"> </span>dẫn<span style="letter-spacing: 2.4pt;"> </span>truyền<span style="letter-spacing: -0.4pt;"> </span>từ<span style="letter-spacing: 0.45pt;"> </span>nhĩ<span style="letter-spacing: 0.9pt;"> </span>xuống<span style="letter-spacing: 1.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất;<span style="letter-spacing: 2.35pt;"> </span>biểu<span style="letter-spacing: -0.3pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>trên<span style="letter-spacing: 1.3pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: 0.4pt;"> </span>đồ<span style="letter-spacing: 1.5pt;"> </span>là<span style="letter-spacing: -0.25pt;"> </span>khoảng <span style="letter-spacing: 1.75pt;"><span> </span></span>PQ<span style="letter-spacing: 0.25pt;"> </span>kéo dài<span style="letter-spacing: 0.55pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>0,20 giây.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Độ<span style="letter-spacing: 1.35pt;"> </span>2:<span style="letter-spacing: -0.1pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>2 loại<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 1.25pt;"> </span><st1:place w:st="on">Chu</st1:place><span style="letter-spacing: 0.65pt;"> </span>kỳ<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.1pt;">L</span>uciani-Wenckebach:<span style="letter-spacing: 0.3pt;"> </span>kh<span style="letter-spacing: -0.1pt;">o</span>ảng<span style="letter-spacing: 1.7pt;"> </span>PQ<span style="letter-spacing: 0.95pt;"> </span>dài<span style="letter-spacing: 1.8pt;"> </span>dần<span style="letter-spacing: 1.1pt;"> </span>(t<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 1.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">2-3<span style="letter-spacing: 1.25pt;"> </span>nhịp)<span style="letter-spacing: 1.5pt;"> </span>sau<span style="letter-spacing: 1.25pt;"> </span>đó<span style="letter-spacing: -0.85pt;"> </span>kết<span style="letter-spacing: 0.5pt;"> </span>thức<span style="letter-spacing: 1.05pt;"> </span>bằng sóng<span style="letter-spacing: 0.65pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>mà<span style="letter-spacing: 0.55pt;"> </span>sau nó<span style="letter-spacing: 0.55pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>phức<span style="letter-spacing: -0.25pt;"> </span>bộ QRST,<span style="letter-spacing: -1pt;"> </span>cứ<span style="letter-spacing: -0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">như </span><span style="line-height: 22px;">thế<span style="letter-spacing: -0.75pt;"> </span>lập<span style="letter-spacing: 1.75pt;"> </span>lại<span style="letter-spacing: -0.25pt;"> </span>thành<span style="letter-spacing: 2.35pt;"> </span>chu<span style="letter-spacing: -0.15pt;"> </span>kỳ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.7pt;"> </span>Mobitz I<span style="letter-spacing: -0.05pt;">I</span>:<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 1pt;"> </span>xo<span style="letter-spacing: -0.05pt;">a</span>ng<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 1.35pt;"> </span>khoảng<span style="letter-spacing: 1pt;"> </span>PQ<span style="letter-spacing: 0.4pt;"> </span>bình<span style="letter-spacing: 0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường,</span><span lang="VI" style="letter-spacing: 0.7pt; line-height: 22px;"> </span><span style="line-height: 22px;">xen<span style="letter-spacing: 0.7pt;"> </span>kẽ<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>một<span style="letter-spacing: 0.55pt;"> </span>hay<span style="letter-spacing: 0.6pt;"> </span>nhiều<span style="letter-spacing: -0.05pt;"> </span>sóng<span style="letter-spacing: 1.35pt;"> </span>P<span style="letter-spacing: 0.35pt;"> </span>mà<span style="letter-spacing: 1.3pt;"> </span>sau nó<span style="letter-spacing: 0.55pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"></span>phức<span style="letter-spacing: -0.25pt;"> </span>bộ QRST,<span style="letter-spacing: -1pt;"> </span>tạo<span style="letter-spacing: -0.45pt;"> </span>thành<span style="letter-spacing: 1.35pt;"> </span>dạng<span style="letter-spacing: 1pt;"> </span>blốc:<span style="letter-spacing: 0.45pt;"> </span>1:1,<span style="letter-spacing: -0.2pt;"> </span>2:1,<span style="letter-spacing: -0.2pt;"> </span>3:1...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.1pt;"> </span>Độ<span style="letter-spacing: 2.5pt;"> </span>3:<span style="letter-spacing: 1.05pt;"> </span>nhịp<span style="letter-spacing: -1.2pt;"> </span>nhĩ.<span style="letter-spacing: -0.9pt;"> </span>Biểu<span style="letter-spacing: -0.5pt;"> </span>hiện<span style="letter-spacing: 0.3pt;"> </span>bằng<span style="letter-spacing: 1.55pt;"> </span>sóng<span style="letter-spacing: 1.8pt;"> </span>P<span style="letter-spacing: 0.8pt;"> </span>trên<span style="letter-spacing: -0.9pt;"> </span>điện<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: 1pt;"> </span>đồ<span style="letter-spacing: -0.95pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>tần<span style="letter-spacing: 1pt;"> </span>số<span style="letter-spacing: 1.75pt;"> </span>bình<span style="letter-spacing: -0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">hoặc<span style="letter-spacing: 0.9pt;"> </span>nhanh. Nhịp<span style="letter-spacing: 0.35pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.15pt;"></span>t<span style="letter-spacing: -0.1pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">biểu<span style="letter-spacing: -0.8pt;"> </span>hiện<span style="letter-spacing: -0.8pt;"> </span>bằng<span style="letter-spacing: 0.45pt;"> </span>phức<span style="letter-spacing: -0.2pt;"> </span>bộ<span style="letter-spacing: 0.05pt;"> </span>QRST<span style="letter-spacing: -1.2pt;"> </span>có<span style="letter-spacing: 0.7pt;"> </span>tần<span style="letter-spacing: -0.1pt;"> </span>số<span style="letter-spacing: 0.4pt;"> </span>chậm<span style="letter-spacing: 1.95pt;"> </span>30-40<span style="letter-spacing: 0.05pt;"> </span>ck/phút.<span style="letter-spacing: -0.75pt;"> </span>Mất<span style="letter-spacing: 1.95pt;"> </span>sự<span style="letter-spacing: 0.05pt;"> </span>liên<span style="letter-spacing: 0.4pt;"> </span>hệ<span style="letter-spacing: -0.65pt;"> </span>giữa<span style="letter-spacing: -0.15pt;"> </span>P và<span style="letter-spacing: 0.8pt;"> </span>QRS.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Blốc<span style="letter-spacing: 0.2pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>thất<span style="letter-spacing: 2.3pt;"> </span>độ<span style="letter-spacing: 0.95pt;"> </span>2,<span style="letter-spacing: 0.4pt;"> </span>3<span style="letter-spacing: 0.4pt;"> </span>là<span style="letter-spacing: 1.2pt;"> </span>những<span style="letter-spacing: 0.4pt;"> </span>rối<span style="letter-spacing: 1.05pt;"> </span>l<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.5pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>nặng,<span style="letter-spacing: 0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">h</span><span lang="VI">ường</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>gây<span style="letter-spacing: 0.75pt;"> </span>ngất,<span style="letter-spacing: 2.35pt;"> </span>lịm,<span style="letter-spacing: 0.7pt;"> </span>h<span style="letter-spacing: -0.05pt;">o</span>ặc<span style="letter-spacing: 0.15pt;"> </span>tử<span style="letter-spacing: 0.3pt;"> </span>vong<span style="letter-spacing: -0.3pt;"> </span>do<span style="letter-spacing: 0.3pt;"> </span>vô tâm<span style="letter-spacing: 0.35pt;"> </span>thu.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: -0.05pt; line-height: 22px;">P</span><span lang="VI" style="line-height: 22px;">hương</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 0.85pt;"> </span>điều<span style="letter-spacing: 0.9pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>blốc<span style="letter-spacing: 0.8pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.15pt;"> </span>giống<span style="letter-spacing: 0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">như</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">điều<span style="letter-spacing: 0.9pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>blốc<span style="letter-spacing: 0.8pt;"> </span>xoang<span style="letter-spacing: -0.15pt;"> </span>nhĩ.<span style="letter-spacing: 0.5pt;"> </span>Đối<span style="letter-spacing: 2.1pt;"> </span>với<span style="letter-spacing: -0.25pt;"> </span>blốc<span style="letter-spacing: 0.8pt;"> </span>nhĩ<span style="letter-spacing: 0.55pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>độ<span style="letter-spacing: 0.75pt;"> </span>3, <span style="letter-spacing: 0.05pt;">t</span></span><span lang="VI" style="line-height: 22px;">hường phải</span><span lang="VI" style="letter-spacing: 0.5pt; line-height: 22px;"> </span><span style="line-height: 22px;">truyền<span style="letter-spacing: -0.95pt;"> </span>tĩnh<span style="letter-spacing: 0.3pt;"> </span>mạch:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19.3pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: -0.2pt; position: relative; top: -1.5pt;">Isupre</span><span style="position: relative; top: -1.5pt;">l<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.2pt;">1-</span>2<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">mg</span>,<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">ph</span>a<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.15pt;">v</span><span style="letter-spacing: -0.1pt;">à</span>o<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.2pt;">dun</span>g<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">dịc</span>h<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.2pt;">glucos</span>e<span style="letter-spacing: -0.2pt;"> hoặ</span>c<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.2pt;">natr</span>i<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">cloru</span>a<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.2pt;">0,9</span>%<span style="letter-spacing: 0.15pt;"> </span>~<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.25pt;">5</span><span style="letter-spacing: -0.2pt;">0</span>0<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">m</span><span style="letter-spacing: -0.15pt;">l</span>,<span style="letter-spacing: 0.05pt;"> </span>truyền<span style="letter-spacing: -0.55pt;"> </span>tĩnh<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>10-</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.7pt;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">20<span style="letter-spacing: 0.55pt;"> </span>giọt/phút<span style="letter-spacing: 0.55pt;"> </span>để<span style="letter-spacing: 1.25pt;"> </span>duy<span style="letter-spacing: 0.55pt;"> </span>trì<span style="letter-spacing: 0.55pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>60-80<span style="letter-spacing: 0.55pt;"> </span>ck/phút.<span style="letter-spacing: -0.25pt;"> </span>Nếu<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 1.4pt;"> </span>blốc<span style="letter-spacing: 1.15pt;"> </span>nhĩ<span style="letter-spacing: 0.9pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>độ<span style="letter-spacing: 1.05pt;"> </span>3<span style="letter-spacing: 0.5pt;"> </span>cấp<span style="letter-spacing: 2.3pt;"> </span>tính<span style="letter-spacing: 1.8pt;"> </span>thì<span style="letter-spacing: 0.95pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>cấy<span style="letter-spacing: 2.45pt;"> </span>máy tạo<span style="letter-spacing: -0.25pt;"></span>nhịp<span style="letter-spacing: 1.9pt;"> </span>tạm<span style="letter-spacing: 0.25pt;"> </span>thời;<span style="letter-spacing: -0.2pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>mạn<span style="letter-spacing: 1.8pt;"> </span>tính <span style="letter-spacing: 0.25pt;"><span> </span></span>t<span style="letter-spacing: 0.05pt;">h</span>ì phải<span style="letter-spacing: 0.5pt;"> </span>cấy<span style="letter-spacing: 1.9pt;"> </span>máy<span style="letter-spacing: 0.4pt;"> </span>tạo<span style="letter-spacing: -0.65pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>vĩnh<span style="letter-spacing: 1.1pt;"> </span>viễn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.45pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic; position: relative; top: 0.5pt;">2.3.3.<span style="letter-spacing: -0.25pt;"> </span>Blốc<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: 1.25pt;"> </span>thất<span style="letter-spacing: 0.3pt;"> </span>(in<span style="letter-spacing: 0.55pt;"> </span>traventricular <span style="letter-spacing: 0.25pt;"><span> </span></span>block):</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Blốc<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span><span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>ra:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Blốc<span style="letter-spacing: -0.2pt;"> </span>nhánh<span style="letter-spacing: 1.4pt;"> </span>phải<span style="letter-spacing: -0.05pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His hoàn<span style="letter-spacing: 0.1pt;"> </span>toàn,<span style="letter-spacing: 0.1pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>hoàn<span style="letter-spacing: 0.1pt;"> </span>toàn.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Blốc<span style="letter-spacing: -0.2pt;"> </span>nhánh<span style="letter-spacing: 1.75pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His hoàn<span style="letter-spacing: 0.1pt;"> </span>toàn,<span style="letter-spacing: 0.1pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>hoàn<span style="letter-spacing: 0.1pt;"> </span>toàn.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Blốc<span style="letter-spacing: -0.2pt;"> </span>phân<span style="letter-spacing: 1.4pt;"> </span>nhánh<span style="letter-spacing: 1.05pt;"> </span>trái<span style="letter-spacing: -0.6pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span><span lang="VI">ước trên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">. Blốc<span style="letter-spacing: -0.2pt;"> </span>phân<span style="letter-spacing: 1.4pt;"> </span>nhánh<span style="letter-spacing: 1.05pt;"> </span>trái<span style="letter-spacing: -0.6pt;"> </span>sau <span style="letter-spacing: 0.05pt;">d</span><span lang="VI">ưới.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Nhiều<span style="letter-spacing: -0.9pt;"> </span>blốc<span style="letter-spacing: 0.55pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp:<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">b</span><span style="letter-spacing: 0.05pt;">l</span><span style="letter-spacing: -0.05pt;">ố</span>c<span style="letter-spacing: 0.55pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span>t<span style="letter-spacing: 1.85pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: -0.05pt;">-</span><span style="letter-spacing: 0.05pt;">t</span>hất<span style="letter-spacing: -0.25pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>loại<span style="letter-spacing: 0.75pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">k</span>hác.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 21px;">-<span style="letter-spacing: 1.2pt;"> </span>Blốc<span style="letter-spacing: 1pt;"> </span>nhá<span style="letter-spacing: -0.05pt;">n</span>h <span style="letter-spacing: 0.15pt;"><span> </span></span>phải<span style="letter-spacing: 1.15pt;"> </span>bó<span style="letter-spacing: 1.75pt;"> </span>His:<span style="letter-spacing: 1pt;"> </span>trên<span style="letter-spacing: -0.85pt;"> </span>điện<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: 1.05pt;"> </span>đồ<span style="letter-spacing: -0.9pt;"> </span>thấy<span> </span>phức<span style="letter-spacing: 0.95pt;"> </span>bộ<span style="letter-spacing: 1.2pt;"> </span>QRS<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>dạng<span style="letter-spacing: 1.6pt;"> </span>chữ<span style="letter-spacing: 1.05pt;"> </span>M<span style="letter-spacing: 1.2pt;"> </span>hoặc<span style="letter-spacing: 0.95pt;"> </span>W<span style="letter-spacing: 1.1pt;"> </span>ở<span style="letter-spacing: 1.2pt;"> </span>đạo trình<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.05pt;">V</span><span style="position: relative; top: 2.5pt;">1 <span style="letter-spacing: 0.4pt;"><span> </span></span></span>V<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 0.45pt;"><span> </span></span></span>hoặc<span style="letter-spacing: 0.7pt;"> </span>V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">3</span>,<span style="letter-spacing: 0.9pt;"> </span>D<span style="position: relative; top: 2.5pt;">I<span style="letter-spacing: 0.05pt;">I</span></span>,<span style="letter-spacing: 0.65pt;"> </span>D<span style="position: relative; top: 2.5pt;">III</span>,<span style="letter-spacing: 0.65pt;"> </span>aVF.<span style="letter-spacing: 0.9pt;"> </span>Nếu<span style="letter-spacing: 0.1pt;"> </span>độ<span style="letter-spacing: 1.5pt;"> </span>rộng<span style="letter-spacing: 0.9pt;"> </span>của<span style="letter-spacing: 0.55pt;"> </span>phức<span style="letter-spacing: 0.6pt;"> </span>bộ<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.2pt;">QR</span>S <<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.25pt;">0,</span><span style="letter-spacing: -0.2pt;">1</span>2<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.25pt;">g</span><span style="letter-spacing: -0.2pt;">i</span><span style="letter-spacing: -0.15pt;">â</span>y<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.2pt;">th</span>ì<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.2pt;">đ</span></span><span lang="VI" style="letter-spacing: -0.15pt; line-height: 21px;">ượ</span><span style="line-height: 21px;">c<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.2pt;">gọ</span>i<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.15pt;">l</span>à<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.2pt;">blốc </span><span style="letter-spacing: -0.15pt;">nhán</span>h<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: -0.15pt;">phả</span>i<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.2pt;">b</span>ó<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.25pt;">H</span><span style="letter-spacing: -0.15pt;">i</span>s<span style="letter-spacing: 0.5pt;"></span><span style="letter-spacing: -0.15pt;">khôn</span>g<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: -0.15pt;">hoà</span>n<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.15pt;">toàn</span>;<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.2pt;">ng</span></span><span lang="VI" style="letter-spacing: -0.25pt; line-height: 21px;">ư</span><span style="letter-spacing: -0.2pt; line-height: 21px;">ợ</span><span style="line-height: 21px;">c<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.15pt;">lại</span>,<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.2pt;">nế</span>u<span style="letter-spacing: -0.15pt;"> đ</span>ộ<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.2pt;">rộn</span>g<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.2pt;">phứ</span>c<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.2pt;">b</span>ộ<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.2pt;">Q</span><span style="letter-spacing: -0.25pt;">R</span>S<span style="letter-spacing: -0.1pt;"> </span>><span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.2pt;">0,1</span>2<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.15pt;">giâ</span>y <span style="letter-spacing: 0.55pt;"><span> </span></span><span style="letter-spacing: -0.15pt;">th</span>ì<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.2pt;">đ</span></span><span lang="VI" style="letter-spacing: -0.15pt; line-height: 21px;">ượ</span><span style="line-height: 21px;">c<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.2pt;">gọ</span>i<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.15pt;">l</span>à <span style="letter-spacing: -0.2pt;">b</span><span style="letter-spacing: -0.15pt;">l</span><span style="letter-spacing: -0.2pt;">ố</span>c<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.15pt;">nhán</span>h<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.15pt;">phả</span>i<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.2pt;">b</span>ó<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.2pt;">H</span><span style="letter-spacing: -0.15pt;">i</span>s<span style="letter-spacing: -0.4pt;"></span><span style="letter-spacing: -0.15pt;">hoà</span>n<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.15pt;">t</span><span style="letter-spacing: -0.2pt;">oàn.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.2pt;"> </span>Blốc nhánh<span style="letter-spacing: 1.95pt;"> </span>trái<span style="letter-spacing: 0.05pt;"> </span>bó<span style="letter-spacing: 0.75pt;"> </span>His: trên<span style="letter-spacing: 0.95pt;"> </span>điện<span style="letter-spacing: 0.1pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span>đồ<span style="letter-spacing: 0.65pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ấy<span style="letter-spacing: 2.05pt;"> </span>phức<span style="letter-spacing: -0.05pt;"> </span>bộ<span style="letter-spacing: 0.2pt;"> </span>QRS<span style="letter-spacing: -0.5pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>dạng<span style="letter-spacing: 0.6pt;"> </span>chữ<span style="letter-spacing: 0.05pt;"> </span>M<span style="letter-spacing: 0.2pt;"> </span>hoặc<span style="letter-spacing: -0.05pt;"> </span>W<span style="letter-spacing: 0.1pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>đạo<span style="letter-spacing: 1pt;"> </span>trình V5, V6, có<span style="letter-spacing: 0.65pt;"></span>khi<span style="letter-spacing: -0.15pt;"> </span>gặp<span style="letter-spacing: -0.35pt;"> </span>cả<span style="letter-spacing: 0.75pt;"> </span>ở đạo<span style="letter-spacing: -0.5pt;"> </span>trình <span style="letter-spacing: 1.55pt;"><span> </span></span>D<span style="position: relative; top: 2.5pt;">I</span>,<span style="letter-spacing: -0.25pt;"> </span>aVL.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Nếu độ<span style="letter-spacing: 1.4pt;"> </span>rộng<span style="letter-spacing: 0.85pt;"> </span>của<span style="letter-spacing: 0.5pt;"> </span>phức<span style="letter-spacing: 0.6pt;"> </span>bộ<span style="letter-spacing: 0.85pt;"> </span>QRS<span style="letter-spacing: 0.15pt;"> </span><<span style="letter-spacing: 0.8pt;"> </span>0,12<span style="letter-spacing: 0.85pt;"> </span>giây<span style="letter-spacing: -1.2pt;"> </span>thì<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 1.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 1.45pt;"> </span>là<span style="letter-spacing: 1.7pt;"> </span>blốc<span style="letter-spacing: 1.45pt;"> </span>nhánh <span style="letter-spacing: 0.05pt;"><span> </span></span>trái<span style="letter-spacing: 0.7pt;"> </span>bó<span style="letter-spacing: 1.4pt;"> </span>His<span style="letter-spacing: 0.85pt;"> </span>không<span style="letter-spacing: 1.1pt;"> </span>hoàn toàn;<span style="letter-spacing: 0.4pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>><span style="letter-spacing: -0.05pt;"></span>0,12 giây <span style="letter-spacing: 0.1pt;"><span> </span></span>thì<span style="letter-spacing: 1.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>nhánh<span style="letter-spacing: 1.75pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His hoàn<span style="letter-spacing: 0.4pt;"> </span>toàn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 6.8pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">I<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 3.8pt;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Blốc<span style="letter-spacing: 0.35pt;"> </span>phân<span style="letter-spacing: 1.95pt;"> </span>nhánh<span style="letter-spacing: 1.6pt;"> </span>trái<span style="letter-spacing: -0.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span><span lang="VI">ước</span><span lang="VI" style="letter-spacing: 0.6pt;"> </span>trên:<span style="letter-spacing: 0.85pt;"> </span>trục<span style="letter-spacing: 0.2pt;"> </span>chuyển<span style="letter-spacing: -0.1pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span>i<span style="letter-spacing: 1.75pt;"> </span>≥<span style="letter-spacing: -0.8pt;"> </span>-<span style="letter-spacing: 0.6pt;"> </span>4<span style="letter-spacing: -0.05pt;">5<span style="position: relative; top: -5pt;">o</span></span>;<span style="letter-spacing: 0.5pt;"> </span>(q)<span style="letter-spacing: 0.6pt;"> </span>R<span style="letter-spacing: 0.75pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>đạo<span style="letter-spacing: -0.45pt;"> </span>trình <span style="letter-spacing: 1.5pt;"><span> </span></span>D<span style="letter-spacing: -0.9pt;"> </span>,<span style="letter-spacing: 0.6pt;"> </span>aVL;<span style="letter-spacing: 0.35pt;"> </span>rS <span style="letter-spacing: 0.3pt;"><span> </span></span>ở<span style="letter-spacing: 0.6pt;"> </span>đạo trình<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">D</span><span style="position: relative; top: 2.5pt;">II</span>,<span style="letter-spacing: -0.25pt;"></span>D<span style="position: relative; top: 2.5pt;">II<span style="letter-spacing: -0.05pt;">I</span></span>,<span style="letter-spacing: -0.25pt;"> </span>aVF.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Blốc<span style="letter-spacing: -0.2pt;"> </span>phân<span style="letter-spacing: 1.4pt;"> </span>nhánh<span style="letter-spacing: 1.05pt;"> </span>trái<span style="letter-spacing: -0.6pt;"> </span>sau <span style="letter-spacing: 0.1pt;">d</span><span lang="VI">ưới:</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Trục chuyển phải<span> </span>≥ + 110o; rS ở đạo trình<span> </span>DI , aVL và (q) R ở đạo trình<span> </span>DII , DIII, aVF.</span></div><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="position: relative; top: 0.5pt;">Blốc<span style="letter-spacing: -0.2pt;"> </span>phân<span style="letter-spacing: 1.4pt;"> </span>nhánh<span style="letter-spacing: 1.05pt;"> </span>trái<span style="letter-spacing: -0.6pt;"> </span>tr</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span lang="VI" style="letter-spacing: -0.05pt; position: relative; top: 0.5pt;">ư</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="position: relative; top: 0.5pt;">ớc trên<span style="letter-spacing: 2.45pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span></span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span lang="VI" style="position: relative; top: 0.5pt;">sau dưới hay</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span lang="VI" style="letter-spacing: -0.15pt; position: relative; top: 0.5pt;"><span> </span></span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="position: relative; top: 0.5pt;">phối<span style="letter-spacing: 0.4pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>nhánh<span style="letter-spacing: 1.4pt;"> </span>phải<span style="letter-spacing: -0.05pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His.</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><o:p></o:p></span></span><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Nguyên<span style="letter-spacing: 1.45pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>gây<span style="letter-spacing: -0.1pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thất:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.7pt;"> </span>Bệnh<span style="letter-spacing: -0.85pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>bẩm<span style="letter-spacing: 2.55pt;"> </span>sinh:<span style="letter-spacing: 0.45pt;"> </span>thông<span style="letter-spacing: 1.65pt;"> </span>liên<span style="letter-spacing: 1.05pt;"> </span>nh<span style="letter-spacing: -0.1pt;">ĩ</span>,<span style="letter-spacing: 1.15pt;"> </span>thông<span style="letter-spacing: 1.65pt;"> </span>liên<span style="letter-spacing: 1.05pt;"> </span>thất,<span style="letter-spacing: 2.6pt;"> </span>hẹp<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.8pt;"> </span>phổi,<span style="letter-spacing: 0.95pt;"> </span>tứ<span style="letter-spacing: 0.6pt;"> </span>chứng<span style="letter-spacing: 0.4pt;"> </span>Fallot,<span style="letter-spacing: 0.4pt;"> </span>hội chứng<span style="letter-spacing: -0.3pt;"></span>Eisemenger.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.6pt;"> </span>Bệnh<span style="letter-spacing: -0.95pt;"> </span>tim-phổi<span style="letter-spacing: 1pt;"> </span>mạn<span style="letter-spacing: 0.25pt;"> </span>tính,<span style="letter-spacing: 1.65pt;"> </span>tắc<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>phổi<span style="letter-spacing: 1pt;"> </span>cấp<span style="letter-spacing: 2.35pt;"> </span>tính,<span style="letter-spacing: 0.85pt;"> </span>bệnh<span style="letter-spacing: -0.1pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>chủ,<span style="letter-spacing: 0.2pt;"> </span>bệnh<span style="letter-spacing: -0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim phì<span style="letter-spacing: 2pt;"> </span>đại,<span style="letter-spacing: -0.55pt;"> </span>tăng<span style="letter-spacing: 1pt;"><span> </span></span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>nhồi<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span><span lang="VI">cơ</span><span lang="VI" style="letter-spacing: 0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>tính,<span style="letter-spacing: 1.35pt;"> </span>viêm<span style="letter-spacing: 1.15pt;"> </span><span lang="VI">cơ</span><span lang="VI" style="letter-spacing: -0.6pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>...<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Biểu<span style="letter-spacing: 0.2pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>lâm<span style="letter-spacing: 0.35pt;"> </span>sàn<span style="letter-spacing: -0.05pt;">g</span>:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.95pt;"> </span>Blốc<span style="letter-spacing: 0.75pt;"> </span>nhánh<span style="letter-spacing: 2.35pt;"> </span>phải<span style="letter-spacing: 0.9pt;"> </span>bó<span style="letter-spacing: 1.5pt;"> </span>His<span style="letter-spacing: 0.95pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>thể<span style="letter-spacing: 0.2pt;"> </span>gặp<span style="letter-spacing: 0.6pt;"> </span>ở<span style="letter-spacing: 0.95pt;"> </span><span lang="VI">người</span><span lang="VI" style="letter-spacing: 0.95pt;"> </span>bình<span style="letter-spacing: -1.15pt;"> </span><span lang="VI">thường,</span><span lang="VI" style="letter-spacing: 0.95pt;"> </span><span lang="VI">nhưng</span><span lang="VI" style="letter-spacing: 0.95pt;"> </span>blốc<span style="letter-spacing: 1.55pt;"> </span>nhánh <span style="letter-spacing: 0.15pt;"><span> </span></span>trái<span style="letter-spacing: 0.8pt;"> </span>bó<span style="letter-spacing: 1.5pt;"> </span>His<span style="letter-spacing: 0.95pt;"> </span>chỉ gặp<span style="letter-spacing: -0.35pt;"> </span><span lang="VI">ở những người bị</span><span lang="VI" style="letter-spacing: 0.55pt;"> </span>b<span style="letter-spacing: -0.05pt;">ệ</span>nh<span style="letter-spacing: -0.7pt;"> </span>tim.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.4pt;"> </span>Những<span style="letter-spacing: 0.05pt;"> </span><span lang="VI">người</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>bị<span style="letter-spacing: 0.95pt;"> </span>blốc<span style="letter-spacing: 1pt;"> </span>trong<span style="letter-spacing: 0.15pt;"> </span>thất<span style="letter-spacing: 0.15pt;"> </span>mà<span style="letter-spacing: 0.95pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>bệnh<span style="letter-spacing: -0.3pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ường</span><span lang="VI" style="letter-spacing: 0.45pt;"> </span>bị<span style="letter-spacing: 0.4pt;"> </span>choáng<span style="letter-spacing: 2.35pt;"> </span>váng,<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>khi<span style="letter-spacing: 0.3pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>hội<span style="letter-spacing: 0.3pt;"> </span>chứng Stokes-Adams.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Những<span style="letter-spacing: -0.35pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tiên<span style="letter-spacing: 0.35pt;"> </span><span lang="VI">lượng nặng.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>trị:<span style="letter-spacing: 0.4pt;"> </span>giống<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ư điều</span><span lang="VI" style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>nhĩ-thất.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;">2.4.<span style="letter-spacing: -0.2pt;"> </span>Hội<span style="letter-spacing: 0.6pt;"> </span>ch<span style="letter-spacing: -0.1pt;">ứ</span>ng<span style="letter-spacing: 2.45pt;"> </span>tiền<span style="letter-spacing: 2.5pt;"> </span>kích<span style="letter-spacing: -0.2pt;"> </span>thích<span style="letter-spacing: 1pt;"> </span></span>(<span style="letter-spacing: -0.05pt;">p</span>re-<span style="letter-spacing: -0.35pt;"> </span>excit<span style="letter-spacing: -0.05pt;">a</span>tion<span style="letter-spacing: -0.2pt;"> </span>s<span style="letter-spacing: -0.05pt;">y</span>ndromes):<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Hội<span style="letter-spacing: 0.45pt;"> </span>chứng<span style="letter-spacing: 0.15pt;"> </span>tiền<span style="letter-spacing: -0.3pt;"> </span>kích<span style="letter-spacing: 2.5pt;"> </span>thích <span style="letter-spacing: 0.5pt;"><span> </span></span>là<span style="letter-spacing: -0.65pt;"> </span>xung<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.95pt;"> </span>không<span style="letter-spacing: 2.5pt;"> </span>đi<span style="letter-spacing: -0.2pt;"> </span>qua<span style="letter-spacing: 0.25pt;"> </span>bộ<span style="letter-spacing: 0.45pt;"> </span>phận<span style="letter-spacing: 2.15pt;"> </span>giữ<span style="letter-spacing: 0.3pt;"> </span>chậm<span style="letter-spacing: 2.35pt;"> </span>của<span style="letter-spacing: 0.1pt;"> </span>nút<span style="letter-spacing: 0.15pt;"> </span>nhĩ-thất,<span style="letter-spacing: 0.05pt;"> </span>mà<span style="letter-spacing: 1.45pt;"> </span>đi theo<span style="letter-spacing: 0.95pt;"> </span>con<span style="letter-spacing: 1pt;"></span></span><span lang="VI" style="line-height: 22px;">đường</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 3pt;"> </span>truyền<span style="letter-spacing: 0.2pt;"> </span>nhanh<span style="letter-spacing: 0.85pt;"> </span>nối<span style="letter-spacing: 1.75pt;"> </span>tắt<span style="letter-spacing: 1.05pt;"> </span>từ<span style="letter-spacing: 1pt;"> </span>nhĩ<span style="letter-spacing: -0.95pt;"> </span>xuống<span style="letter-spacing: 1.7pt;"> </span>thất <span style="letter-spacing: 0.05pt;"><span> </span></span>(thất<span style="letter-spacing: 2.95pt;"> </span>sẽ<span style="letter-spacing: 0.4pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 2pt; line-height: 22px;"> </span><span style="line-height: 22px;">khử<span style="letter-spacing: 1.15pt;"> </span>cực<span style="letter-spacing: 1pt;"> </span>sớm<span style="letter-spacing: 0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">hơn</span><span lang="VI" style="letter-spacing: 1.55pt; line-height: 22px;"> </span><span style="line-height: 22px;">so<span style="letter-spacing: 1.05pt;"> </span>với bình<span style="letter-spacing: 1.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường),</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"></span><span style="line-height: 22px;">hoặc<span style="letter-spacing: 0.6pt;"> </span>từ<span style="letter-spacing: 0.75pt;"> </span>thất<span style="letter-spacing: 2.75pt;"> </span>dẫn<span style="letter-spacing: 2.7pt;"> </span>truyền<span style="letter-spacing: -0.1pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">lên<span style="letter-spacing: 1.05pt;"> </span>nhĩ<span style="letter-spacing: 1.2pt;"> </span>(nhĩ<span style="letter-spacing: 1.65pt;"> </span>sẽ<span style="letter-spacing: 0.1pt;"> </span>khử<span style="letter-spacing: 0.85pt;"> </span>cực<span style="letter-spacing: 0.7pt;"> </span>sớm<span style="letter-spacing: 0.65pt;"> </span></span><span lang="VI" style="line-height: 22px;">hơn</span><span lang="VI" style="letter-spacing: 1.25pt; line-height: 22px;"> </span><span style="line-height: 22px;">so<span style="letter-spacing: 0.75pt;"> </span>với<span style="letter-spacing: 0.4pt;"> </span>bình<span style="letter-spacing: 1.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">thường); những</span><span lang="VI" style="letter-spacing: 0.95pt; line-height: 22px;"> </span><span style="line-height: 22px;">con<span style="letter-spacing: 0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">đường</span><span lang="VI" style="letter-spacing: 0.95pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.8pt;"></span>truyền xung<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>nhanh<span style="letter-spacing: 0.65pt;"> </span>này<span style="letter-spacing: 0.95pt;"> </span>nằm<span style="letter-spacing: 1.4pt;"> </span>ngoài<span style="letter-spacing: 2.3pt;"> </span>nút<span style="letter-spacing: 0.65pt;"> </span>nhĩ-thất<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.1pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư</span><span lang="VI" style="letter-spacing: 0.95pt; line-height: 22px;"> </span><span style="line-height: 22px;">cầu<span style="letter-spacing: 0.75pt;"> </span>Ken<span style="letter-spacing: 0.75pt;"> </span>bó<span style="letter-spacing: 1.5pt;"> </span>Jam<span style="letter-spacing: 0.1pt;">e</span>, Mahain,<span style="letter-spacing: -0.4pt;"> </span>nh</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ng lại<span style="letter-spacing: -0.25pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">liên<span style="letter-spacing: 1.95pt;"> </span>hệ<span style="letter-spacing: -0.7pt;"></span>với<span style="letter-spacing: -0.45pt;"> </span>nút<span style="letter-spacing: -0.3pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.35pt;"> </span>b<span style="letter-spacing: 0.05pt;">ằ</span>ng<span style="letter-spacing: 0.65pt;"> </span>cầu<span style="letter-spacing: -0.15pt;"> </span>nối<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>những bó<span style="letter-spacing: 0.55pt;"> </span>sợi<span style="letter-spacing: -0.15pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Bằng<span style="letter-spacing: 0.9pt;"> </span></span><span lang="VI" style="line-height: 22px;">phương</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: -0.35pt;"> </span>nghiên<span style="letter-spacing: 2.15pt;"> </span>cứu<span style="letter-spacing: 0.3pt;"> </span>điện<span style="letter-spacing: 0.85pt;"> </span>sinh<span style="letter-spacing: 0.25pt;"> </span>lý<span style="letter-spacing: 0.35pt;"> </span>học<span style="letter-spacing: 1.1pt;"> </span>của<span style="letter-spacing: 0.1pt;"> </span>tim,<span style="letter-spacing: 0.25pt;"> </span>ng</span><span lang="VI" style="letter-spacing: -0.05pt; line-height: 22px;">ư</span><span style="line-height: 22px;">ời<span style="letter-spacing: 0.45pt;"> </span>ta<span style="letter-spacing: 0.35pt;"> </span>chia<span style="letter-spacing: 0.25pt;"> </span>hội<span style="letter-spacing: 0.3pt;"> </span>chứng<span style="letter-spacing: 0.15pt;"> </span>tiền<span style="letter-spacing: -0.3pt;"> </span>kích<span style="letter-spacing: 0.7pt;"> </span>thích ra<span style="letter-spacing: -0.1pt;"> </span>l<span style="letter-spacing: -0.05pt;">à</span>m<span style="letter-spacing: 0.55pt;"> </span>3 loại<span style="letter-spacing: 0.5pt;"></span>(3 typ<span style="letter-spacing: -0.05pt;">e</span>):<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Type<span style="letter-spacing: -0.75pt;"> </span>A:<span style="letter-spacing: -0.1pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW<span style="letter-spacing: -0.3pt;"> </span>(Wolff<span style="letter-spacing: -0.4pt;"> </span>-<span style="letter-spacing: -0.1pt;">P</span>arkinson-White<span style="letter-spacing: -1.05pt;"> </span>syndrome).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Type<span style="letter-spacing: -0.75pt;"> </span>B:<span style="letter-spacing: -0.9pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW<span style="letter-spacing: -0.3pt;"> </span>ẩn<span style="letter-spacing: 1.95pt;"> </span>(concealed<span style="letter-spacing: -0.5pt;"> </span>WPW<span style="letter-spacing: -0.3pt;"> </span>syndrome).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">. Type<span style="letter-spacing: -0.75pt;"> </span>C:<span style="letter-spacing: -0.45pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>PR<span style="letter-spacing: -0.15pt;"> </span>ngắn:<span style="letter-spacing: -0.25pt;"> </span>(LGL:<span style="letter-spacing: -0.6pt;"> </span>Lown-Ganon-Lewin<span style="letter-spacing: 0.05pt;"> </span>syndrome).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.4.1.<span style="letter-spacing: -0.25pt;"> </span>Hội<span style="letter-spacing: 0.6pt;"> </span>chứng<span style="letter-spacing: 2.6pt;"> </span>WPW:</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.4pt;"> </span>Hội<span style="letter-spacing: 0.45pt;"> </span>chứng<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>đặc<span style="letter-spacing: 1.55pt;"> </span>điểm<span style="letter-spacing: 2.05pt;"> </span>là:<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.45pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.3pt;"> </span>truyền<span style="letter-spacing: -0.5pt;"> </span>nhanh<span style="letter-spacing: 0.15pt;"> </span>từ<span style="letter-spacing: 0.35pt;"> </span>nhĩ<span style="letter-spacing: 0.8pt;"> </span>xuống<span style="letter-spacing: 1pt;"> </span>thất<span style="letter-spacing: 2.35pt;"> </span>chạy<span style="letter-spacing: 0.85pt;"> </span>song<span style="letter-spacing: 0.15pt;"> </span>song<span style="letter-spacing: 0.15pt;"> </span>với nút nhĩ-thất<span style="letter-spacing: 0.5pt;"> </span>và<span style="letter-spacing: 1.65pt;"></span>bó<span style="letter-spacing: 1.4pt;"> </span>His;<span style="letter-spacing: 0.65pt;"> </span>xung<span style="letter-spacing: 0.85pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span>thể<span style="letter-spacing: 0.1pt;"> </span>đi<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 1.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">2<span style="letter-spacing: 0.8pt;"> </span>chiều:<span style="letter-spacing: -0.05pt;"> </span>từ<span style="letter-spacing: 0.7pt;"> </span>nhĩ<span style="letter-spacing: 1.15pt;"> </span>xuống<span style="letter-spacing: 1.4pt;"> </span>thất<span style="letter-spacing: 2.75pt;"> </span>hoặc<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 0.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">lại<span style="letter-spacing: 1.55pt;"> </span>từ<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: 0.6pt;"> </span>lên nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Những<span style="letter-spacing: -0.2pt;"> </span>bó<span style="letter-spacing: 0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">sợi cơ</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: 0.05pt;"> </span>tạo<span style="letter-spacing: 0.75pt;"> </span>cầu nối<span style="letter-spacing: 0.75pt;"> </span>từ<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.1pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.05pt;"> </span>truyền<span style="letter-spacing: -0.75pt;"> </span>nhanh<span style="letter-spacing: -0.1pt;"> </span>với<span style="letter-spacing: -0.25pt;"> </span>nút<span style="letter-spacing: -0.1pt;"> </span>nhĩ-<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>những<span style="letter-spacing: 0.2pt;"> </span>vị<span style="letter-spacing: 0.45pt;"> </span>trí<span style="letter-spacing: 1.15pt;"> </span>khác nhau<span style="letter-spacing: 0.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">như:</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"></span><span style="line-height: 22px;">thành<span style="letter-spacing: 0.95pt;"> </span>tự<span style="letter-spacing: 0.5pt;"> </span>do<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>trái,<span style="letter-spacing: 1.05pt;"> </span>vùng<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">trước</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">hoặc<span style="letter-spacing: 0.35pt;"> </span>sau<span style="letter-spacing: 0.6pt;"> </span>vách<span style="letter-spacing: 0.45pt;"> </span>liên<span style="letter-spacing: 1.4pt;"> </span>thất,<span style="letter-spacing: 2.5pt;"> </span>thành<span style="letter-spacing: 0.95pt;"> </span>tự<span style="letter-spacing: 0.5pt;"> </span>do<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>phải,<span style="letter-spacing: 1pt;"> </span>một<span style="letter-spacing: 0.4pt;"> </span>bệnh nhân<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có <span style="letter-spacing: 0.65pt;"><span> </span></span>một<span style="letter-spacing: -0.2pt;"></span>hoặc<span style="letter-spacing: -0.25pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">đường dẫn</span><span lang="VI" style="letter-spacing: 1.85pt; line-height: 22px;"> </span><span style="line-height: 22px;">truyền<span style="letter-spacing: -0.95pt;"> </span>tắt<span style="letter-spacing: -0.1pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>lý.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.25pt;"> </span>Nguyên<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hân:<span style="letter-spacing: 0.35pt;"> </span>hội<span style="letter-spacing: 0.15pt;"> </span>ch<span style="letter-spacing: -0.05pt;">ứ</span>ng<span style="letter-spacing: 0.1pt;"> </span>WPW thuộc<span style="letter-spacing: 0.05pt;"> </span>nhóm<span style="letter-spacing: 0.85pt;"> </span>rối<span style="letter-spacing: 0.95pt;"> </span>loạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>bẩm<span style="letter-spacing: 2.15pt;"> </span>sinh,<span style="letter-spacing: 0.05pt;"> </span>80-90<span style="letter-spacing: 0.3pt;"> </span>%<span style="letter-spacing: 0.3pt;"> </span>hội<span style="letter-spacing: 0.15pt;"> </span>chứng WPW<span style="letter-spacing: -0.25pt;"> </span>gặp<span style="letter-spacing: -0.3pt;"> </span>ở<span style="letter-spacing: 0.05pt;"></span>tim<span style="letter-spacing: -0.05pt;"> </span>bình<span style="letter-spacing: 0.3pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span></span><span lang="VI" style="line-height: 22px;">ường,</span><span lang="VI" style="letter-spacing: 0.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">số<span style="letter-spacing: 0.65pt;"> </span>còn<span style="letter-spacing: 0.7pt;"> </span>lại<span style="letter-spacing: 0.75pt;"> </span>gặp<span style="letter-spacing: -0.3pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>những<span style="letter-spacing: 0.05pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span></span><span lang="VI" style="line-height: 22px;">ười</span><span lang="VI" style="letter-spacing: 0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">có<span style="letter-spacing: 0.75pt;"> </span>bệnh<span style="letter-spacing: -0.6pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>bẩm<span style="letter-spacing: 1.95pt;"> </span>sinh<span style="letter-spacing: -0.1pt;"> </span>hay<span style="letter-spacing: -0.05pt;"> </span>mắc<span style="letter-spacing: -0.1pt;"> </span>phải<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.2pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư: Ebstein,</span><span lang="VI" style="letter-spacing: -0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">sa <span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>2 lá,<span style="letter-spacing: 0.7pt;"></span>bệnh<span style="letter-spacing: -0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">tim<span style="letter-spacing: -0.15pt;"> </span>phì<span style="letter-spacing: 1.2pt;"> </span>đại...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.9pt;"> </span>Biểu<span style="letter-spacing: -0.7pt;"> </span>hiện<span style="letter-spacing: 0.1pt;"> </span>lâm<span style="letter-spacing: 1.75pt;"> </span>sàng<span style="letter-spacing: 1.1pt;"> </span>của<span style="letter-spacing: 0.6pt;"> </span>hội<span style="letter-spacing: 0.8pt;"> </span>chứng<span style="letter-spacing: 0.65pt;"> </span>WPW<span style="letter-spacing: 0.65pt;"> </span>là<span style="letter-spacing: 1.8pt;"> </span>do<span style="letter-spacing: 0.8pt;"> </span>nhịp<span style="letter-spacing: 1.25pt;"> </span>nhanh<span style="letter-spacing: 0.65pt;"> </span>vào<span style="letter-spacing: 2pt;"> </span>lại<span style="letter-spacing: 1.25pt;"> </span>kịch<span style="letter-spacing: -1.1pt;"> </span>phát,<span style="letter-spacing: 1.35pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>rung<span style="letter-spacing: 0.95pt;"> </span>nhĩ, cuồng<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 0.45pt;"></span>nhĩ.<span style="letter-spacing: 0.45pt;"> </span>Những<span style="letter-spacing: -0.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 1pt;"> </span>nhanh<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>thể<span style="letter-spacing: -0.6pt;"> </span>tái<span style="letter-spacing: 0.45pt;"> </span>phát<span style="letter-spacing: 1.95pt;"> </span>lại<span style="letter-spacing: 0.35pt;"> </span>sau<span style="letter-spacing: 0.2pt;"> </span>vài<span style="letter-spacing: 0.85pt;"> </span>tuần hoặc<span style="letter-spacing: -0.15pt;"> </span>vài<span style="letter-spacing: -0.2pt;"> </span>tháng, <span style="letter-spacing: 0.2pt;"><span> </span></span>bệnh<span style="letter-spacing: -0.5pt;"> </span>nhân<span style="letter-spacing: 0.45pt;"> </span>có thể<span style="letter-spacing: -0.4pt;"> </span>tự<span style="letter-spacing: 0.25pt;"> </span>chữa<span style="letter-spacing: 0.1pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 0.3pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 1.2pt;"></span>n<span style="letter-spacing: -0.1pt;">h</span>anh<span style="letter-spacing: 0.2pt;"> </span>cho<span style="letter-spacing: 0.2pt;"> </span>mình<span style="letter-spacing: 2.05pt;"> </span>bằng<span style="letter-spacing: 0.75pt;"> </span>các<span style="letter-spacing: -0.25pt;"> </span>p<span style="letter-spacing: 0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ương</span><span lang="VI" style="letter-spacing: 0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 0.45pt;"> </span>gây<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.05pt;">c</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">phó<span style="letter-spacing: 0.7pt;"> </span>giao<span style="letter-spacing: 0.15pt;"> </span>cảm<span style="letter-spacing: 0.8pt;"> </span>(ấn<span style="letter-spacing: 2.2pt;"> </span>nhãn<span style="letter-spacing: 0.75pt;"> </span>cầu, xoa<span style="letter-spacing: -0.15pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>cảnh<span style="letter-spacing: -0.15pt;"></span>hoặc<span style="letter-spacing: -0.25pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>nghiệm<span style="letter-spacing: -0.75pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.45pt;"> </span>Valsalva...).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Trong<span style="letter-spacing: -0.35pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 1.1pt;"> </span>nhanh,<span style="letter-spacing: -0.05pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>bị<span style="letter-spacing: 0.8pt;"> </span>ngất,<span style="letter-spacing: 2.1pt;"> </span>nếu<span style="letter-spacing: -0.45pt;"> </span>rung<span style="letter-spacing: 0.25pt;"> </span>nhĩ<span style="letter-spacing: 0.6pt;"> </span>nhanh<span style="letter-spacing: -0.05pt;"> </span>dẫn<span style="letter-spacing: 2.1pt;"> </span>đến<span style="letter-spacing: 0.75pt;"> </span>rung<span style="letter-spacing: 0.25pt;"> </span>thất<span style="letter-spacing: 2.15pt;"> </span>thì<span style="letter-spacing: 0.65pt;"> </span>bệnh nhân<span style="letter-spacing: 1.95pt;"> </span>bị<span style="letter-spacing: -0.05pt;"> </span>đột<span style="letter-spacing: 0.25pt;"></span>tử.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Biểu<span style="letter-spacing: 0.2pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ<span style="letter-spacing: 0.45pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. PR<span style="letter-spacing: -0.15pt;"> </span>(hoặc<span style="letter-spacing: -0.25pt;"> </span>PQ)<span style="letter-spacing: -0.4pt;"> </span>ngắn<span style="letter-spacing: -0.25pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>0,12 giây.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Sóng<span style="letter-spacing: -0.25pt;"> </span>delta,<span style="letter-spacing: -0.25pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>trát<span style="letter-spacing: 0.55pt;"> </span>đ<span style="letter-spacing: -0.05pt;">ậ</span>m<span style="letter-spacing: -0.8pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>R.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.6pt;"><span class="Apple-style-span" style="font-size: large;">. Độ<span style="letter-spacing: 1.35pt;"> </span>rộng của<span style="letter-spacing: -0.35pt;"> </span>QRS<span style="letter-spacing: -0.7pt;"> </span>≥<span style="letter-spacing: 0.25pt;"> </span>0,12 giây.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 2.75pt;"><span class="Apple-style-span" style="font-size: large;">. Sóng<span style="letter-spacing: -0.25pt;"> </span>T<span style="letter-spacing: -0.35pt;"> </span>âm<span style="letter-spacing: 0.4pt;"> </span>tính.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Có<span style="letter-spacing: 0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nh<span style="letter-spacing: 0.1pt;">ị</span>p <span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh,<span style="letter-spacing: -0.3pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>nhĩ,<span style="letter-spacing: 0.3pt;"> </span>rung nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.15pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>vào<span style="letter-spacing: 1.05pt;"> </span>lại<span style="letter-spacing: 0.3pt;"> </span>WPW:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: 0.35pt;"> </span>Các<span style="letter-spacing: 0.85pt;"> </span>biện<span style="letter-spacing: -0.5pt;"> </span>pháp<span style="letter-spacing: 0.75pt;"> </span></span><span lang="VI" style="line-height: 22px;">cường</span><span lang="VI" style="letter-spacing: 0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">phó<span style="letter-spacing: 0.7pt;"> </span>giao<span style="letter-spacing: 0.15pt;"> </span>cảm:<span style="letter-spacing: 0.75pt;"> </span>xoa<span style="letter-spacing: 0.2pt;"> </span>xoang<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>cảnh,<span style="letter-spacing: 0.7pt;"> </span>nghiệm<span style="letter-spacing: -0.4pt;"> </span>pháp<span style="letter-spacing: 0.75pt;"> </span>Valsalva,<span style="letter-spacing: -0.1pt;"> </span>cho ngón<span style="letter-spacing: 0.45pt;"> </span>tay<span style="letter-spacing: -0.15pt;"> </span>ngoáy<span style="letter-spacing: 0.35pt;"></span>họng...<span style="letter-spacing: 0.65pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>không<span style="letter-spacing: 2.4pt;"> </span>tác<span style="letter-spacing: -0.4pt;"> </span>dụng<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>phải<span style="letter-spacing: 0.2pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>thuốc.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 2.45pt;"> </span>Lựa<span style="letter-spacing: 2.25pt;"> </span>chọn<span style="letter-spacing: 2.9pt;"> </span>thuốc<span style="letter-spacing: 2.95pt;"> </span>chống<span> </span>loạn<span style="letter-spacing: -1.15pt;"> </span>nhịp<span style="letter-spacing: 0.1pt;"> </span><span lang="VI">đường </span><span lang="VI" style="letter-spacing: -0.55pt;"><span> </span></span>tĩnh<span style="letter-spacing: 0.4pt;"> </span>mạch,<span style="letter-spacing: -1.1pt;"> </span>một<span style="letter-spacing: 2.25pt;"> </span>trong<span style="letter-spacing: 2.2pt;"> </span>số <span style="letter-spacing: 0.05pt;"><span> </span></span>thuốc<span style="letter-spacing: 2.95pt;"> </span>sau:<span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">Nhóm<span style="letter-spacing: 2.75pt;"> </span>Ic (ajmali<span style="letter-spacing: -0.05pt;">n</span>e,<span style="letter-spacing: -0.5pt;"> </span>propafenone,<span style="letter-spacing: -0.65pt;"> </span>flecai<span style="letter-spacing: -0.05pt;">n</span><span style="letter-spacing: 0.05pt;">i</span>de)<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.05pt;">ho</span>ặc<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;"><st1:place w:st="on"><st1:city w:st="on">Nhóm</st1:city><span style="letter-spacing: 0.25pt;"> </span><st1:state w:st="on">Ia</st1:state></st1:place><span style="letter-spacing: -0.15pt;"> </span>(procainamide,<span style="letter-spacing: -0.75pt;"> </span>d<span style="letter-spacing: 0.1pt;">i</span>sopyramide,<span style="letter-spacing: -0.7pt;"> </span>quinidine).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Nếu<span style="letter-spacing: -0.85pt;"> </span>vẫn<span style="letter-spacing: 1.55pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>cắt<span style="letter-spacing: -0.15pt;"> </span><span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.2pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: 1.35pt;"> </span>nhịp<span style="letter-spacing: 2.4pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>phải<span style="letter-spacing: 0.2pt;"> </span>sốc<span style="letter-spacing: 0.6pt;"> </span>điện <span style="letter-spacing: 0.55pt;"><span> </span></span>đảo<span style="letter-spacing: -0.35pt;"> </span>nhịp <span style="letter-spacing: 1.4pt;"><span> </span></span>với<span style="letter-spacing: -0.45pt;"> </span>liều<span style="letter-spacing: -0.75pt;"> </span>khởi<span style="letter-spacing: -0.2pt;"> </span>đầu<span style="letter-spacing: 0.4pt;"> </span>50j.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span><span lang="VI">cơn</span><span lang="VI" style="letter-spacing: 0.65pt;"> </span>rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>WPW.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">.<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Lự</span>a<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">chọ</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">thuố</span>c<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">chốn</span>g<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">loạ</span>n<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.35pt;">đ</span></span><span lang="VI" style="letter-spacing: -0.3pt; line-height: 22px;">ườn</span><span style="line-height: 22px;">g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">tĩn</span>h<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">mạch</span>,<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">tron</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">s</span>ố <span style="letter-spacing: -0.3pt;">thuố</span>c<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">sau: </span>Thuốc<span style="letter-spacing: 0.3pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>Ic<span style="letter-spacing: -0.1pt;"> </span>(ajmaline,<span style="letter-spacing: -0.5pt;"></span>propafenone,<span style="letter-spacing: -0.65pt;"> </span>flecainide)<span style="letter-spacing: -0.5pt;"> </span>hoặc <st1:place w:st="on"><st1:city w:st="on"><span style="position: relative; top: 0.5pt;">Nhóm</span></st1:city><span style="letter-spacing: 0.3pt; position: relative; top: 0.5pt;"><span> </span></span><st1:state w:st="on"><span style="position: relative; top: 0.5pt;">Ia</span></st1:state></st1:place><span style="letter-spacing: -0.1pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">(procainamide,<span style="letter-spacing: -0.7pt;"> </span>disopyramide,<span style="letter-spacing: -0.7pt;"> </span>quinidine)<span style="letter-spacing: -0.5pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>tốt<span style="letter-spacing: 0.6pt;"> </span>nhất<span style="letter-spacing: 1.8pt;"> </span>là<span style="letter-spacing: 0.85pt;"></span>amiodarone<span style="letter-spacing: -0.55pt;"> </span>(cordaron).</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.2pt;"> </span>Nếu<span style="letter-spacing: -0.6pt;"> </span>dùng<span style="letter-spacing: -0.05pt;"> </span>thuốc<span style="letter-spacing: 0.75pt;"> </span>không<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>tác<span style="letter-spacing: 0.8pt;"> </span>dụng,<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.65pt;"> </span>huyết<span style="letter-spacing: -0.55pt;"> </span>động,<span style="letter-spacing: 0.45pt;"> </span>sốc,<span style="letter-spacing: 0.75pt;"> </span>h<span style="letter-spacing: -0.05pt;">o</span>ặc suy<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>ứ<span style="letter-spacing: 0.25pt;"> </span>đọ<span style="letter-spacing: -0.1pt;">n</span>g<span style="letter-spacing: 1.4pt;"> </span>thì<span style="letter-spacing: 0.1pt;"> </span>phải tiến<span style="letter-spacing: -0.75pt;"> </span>hành<span style="letter-spacing: 0.4pt;"> </span>sốc<span style="letter-spacing: 0.6pt;"></span>điện<span style="letter-spacing: 1.25pt;"> </span>để<span style="letter-spacing: -0.35pt;"> </span>điều<span style="letter-spacing: 1.25pt;"> </span>trị.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Hội<span style="letter-spacing: 1.2pt;"> </span>chứng<span style="letter-spacing: 0.9pt;"> </span>WPW<span style="letter-spacing: 0.9pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>biến<span style="letter-spacing: 0.35pt;"> </span>chứng<span style="letter-spacing: 0.9pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 1.6pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: -1.2pt;"> </span>nhanh,<span style="letter-spacing: 0.9pt;"> </span>rung<span style="letter-spacing: 1.2pt;"> </span>nhĩ,<span style="letter-spacing: -0.85pt;"> </span>cuồng<span style="letter-spacing: 1.75pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>nhĩ<span style="letter-spacing: -0.9pt;"> </span>không <span style="letter-spacing: 2.2pt;"><span> </span></span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 1.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">dùng digoxin<span style="letter-spacing: 1.1pt;"> </span>và<span style="letter-spacing: 0.05pt;"><span> </span></span>verapamil,<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ì<span style="letter-spacing: 1.45pt;"> </span>những<span style="letter-spacing: 1.45pt;"> </span>th<span style="letter-spacing: -0.05pt;">u</span>ốc<span style="letter-spacing: 1.9pt;"> </span>này<span style="letter-spacing: 1.95pt;"> </span>rút<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>gắn<span style="letter-spacing: 1.35pt;"> </span>quá<span style="letter-spacing: 1.95pt;"> </span>trì<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: -0.6pt;"> </span>tái<span style="letter-spacing: 2.1pt;"> </span>cực<span style="letter-spacing: 1.3pt;"> </span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: 1.05pt;"> </span>nút<span style="letter-spacing: 1.15pt;"> </span>nhĩ-t<span style="letter-spacing: -0.05pt;">h</span>ất,<span style="letter-spacing: 1.45pt;"> </span>nên<span style="letter-spacing: -0.7pt;"> </span>kh<span style="letter-spacing: -0.05pt;">ô</span>ng khống<span style="letter-spacing: 0.6pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span></span><span lang="VI" style="line-height: 22px;">được</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 2.4pt;"></span>thất<span style="letter-spacing: 1.9pt;"> </span>(nhịp<span style="letter-spacing: 0.25pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>giải<span style="letter-spacing: 0.5pt;"> </span>phóng)<span style="letter-spacing: 0.3pt;"> </span>nhất<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI">Nhưng</span><span lang="VI" style="letter-spacing: 0.3pt;"> </span>thuốc<span style="letter-spacing: 0.8pt;"> </span>digoxin<span style="letter-spacing: -0.05pt;"> </span>hoặc<span style="letter-spacing: 0.05pt;"> </span>verapamil<span style="letter-spacing: -0.65pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>thể<span style="letter-spacing: -0.45pt;"> </span>dùng<span style="letter-spacing: 0.05pt;"> </span><span lang="VI">được</span><span lang="VI" style="letter-spacing: 1.15pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>trẻ<span style="letter-spacing: -0.5pt;"> </span>em,<span style="letter-spacing: 0.1pt;"> </span>vì<span style="letter-spacing: 0.95pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>trẻ<span style="letter-spacing: -0.5pt;"> </span>em<span style="letter-spacing: 0.15pt;"> </span>rất<span style="letter-spacing: 2.2pt;"> </span>hiếm<span style="letter-spacing: -0.45pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>WPW gây<span style="letter-spacing: 0.35pt;"> </span>biến<span style="letter-spacing: -0.85pt;"></span>chứng<span style="letter-spacing: -0.3pt;"> </span>rung nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.05pt;"> </span>Điều<span style="letter-spacing: 0.5pt;"> </span>trị<span style="letter-spacing: 0.55pt;"> </span>kéo<span style="letter-spacing: -0.85pt;"> </span>dài<span style="letter-spacing: 0.6pt;"> </span>dự<span style="letter-spacing: 0.05pt;"> </span>phòng<span style="letter-spacing: 0.35pt;"> </span>những<span style="letter-spacing: 0.05pt;"> </span>biến<span style="letter-spacing: -0.8pt;"> </span>chứng<span style="letter-spacing: -0.25pt;"> </span>rối<span style="letter-spacing: 0.6pt;"> </span>loạn nhịp<span style="letter-spacing: 1.15pt;"> </span>do<span style="letter-spacing: -0.05pt;"> </span>hội<span style="letter-spacing: -0.05pt;"> </span>chứng<span style="letter-spacing: -0.2pt;"> </span>WPW<span style="letter-spacing: -0.2pt;"> </span>gây<span style="letter-spacing: 0.45pt;"> </span>ra, lựa<span style="letter-spacing: -0.05pt;"> </span>chọn một<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>số<span style="letter-spacing: 0.6pt;"></span>thuốc<span style="letter-spacing: 0.5pt;"> </span>sau đây:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;">Thuốc<span style="letter-spacing: 0.3pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>Ic<span style="letter-spacing: -0.1pt;"> </span>(propafenone,<span style="letter-spacing: -0.65pt;"> </span>flecainide).<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 26px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span style="line-height: 28px;"><span class="Apple-style-span" style="font-size: large;">Thuốc<span style="letter-spacing: 0.3pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>Ia<span style="letter-spacing: -0.1pt;"> </span>(quinidine,<span style="letter-spacing: -0.5pt;"> </span>procainamide,<span style="letter-spacing: -0.7pt;"> </span>disopyramide). Thuốc<span style="letter-spacing: 0.3pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>blốc<span style="letter-spacing: 0.6pt;"> </span>thụ<span style="letter-spacing: -0.3pt;"> </span>cảm<span style="letter-spacing: 0.45pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>bêta<span style="letter-spacing: 0.3pt;"> </span>giao<span style="letter-spacing: -0.2pt;"> </span>cảm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0.05pt;"><span class="Apple-style-span" style="font-size: large;">Nếu<span style="letter-spacing: -0.6pt;"> </span>vẫn<span style="letter-spacing: 1.8pt;"> </span>không<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>tác<span style="letter-spacing: 0.85pt;"> </span>dụng thì<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>phối<span style="letter-spacing: 0.65pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>thuốc<span style="letter-spacing: 0.8pt;"> </span>nhóm<span style="letter-spacing: 0.8pt;"> </span>Ic<span style="letter-spacing: 0.15pt;"> </span>với<span style="letter-spacing: -0.2pt;"> </span>thuốc<span style="letter-spacing: 0.75pt;"> </span>nhóm<span style="letter-spacing: 0.8pt;"> </span>blốc<span style="letter-spacing: 0.85pt;"> </span>thụ<span style="letter-spacing: -0.05pt;"> </span>cảm<span style="letter-spacing: 0.7pt;"> </span>thể bêta<span style="letter-spacing: 0.3pt;"> </span>giao<span style="letter-spacing: -0.2pt;"></span>cảm.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">-<span style="letter-spacing: 0.65pt;"> </span>Điều<span style="letter-spacing: 1.1pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 1.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp<span style="letter-spacing: 2pt;"> </span>nhanh<span style="letter-spacing: 0.35pt;"> </span>bằng<span style="letter-spacing: 1.05pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ương</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">pháp<span style="letter-spacing: 1.05pt;"> </span>phẫu<span style="letter-spacing: 2.35pt;"> </span>thuật<span style="letter-spacing: 2.65pt;"> </span>hoặc<span style="letter-spacing: 0.4pt;"> </span>đốt<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.5pt;"> </span>truyền<span style="letter-spacing: -0.3pt;"> </span>tắt<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.05pt;"> </span>lý bằng<span style="letter-spacing: -0.2pt;"> </span>năng<span style="letter-spacing: 1.1pt;"></span><span style="letter-spacing: -0.05pt;">l</span></span><span lang="VI" style="line-height: 22px;">ượng tần</span><span lang="VI" style="letter-spacing: -0.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">số<span style="letter-spacing: 0.6pt;"> </span>radio<span style="letter-spacing: -0.25pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>ống<span style="letter-spacing: 0.5pt;"> </span>thông,<span style="letter-spacing: 0.25pt;"> </span>nhất<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>những t<span style="letter-spacing: 0.05pt;">r</span></span><span lang="VI" style="line-height: 22px;">ường hợp</span><span lang="VI" style="letter-spacing: -0.35pt; line-height: 22px;"> </span><span style="line-height: 22px;">sau đây:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">. Đã<span style="letter-spacing: 0.8pt;"> </span>bị<span style="letter-spacing: 0.25pt;"> </span>ngừng tim<span style="letter-spacing: -0.15pt;"> </span>đ<span style="letter-spacing: -0.05pt;">ộ</span>t<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span>ột<span style="letter-spacing: -0.1pt;"> </span>mà<span style="letter-spacing: 0.8pt;"> </span></span><span lang="VI" style="position: relative; top: 0.5pt;">được</span><span lang="VI" style="letter-spacing: 0.85pt; position: relative; top: 0.5pt;"><span> </span></span><span style="position: relative; top: 0.5pt;">cấp<span style="letter-spacing: 1.75pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>sống<span style="letter-spacing: 0.65pt;"> </span>lại.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI">. Cơn</span><span lang="VI" style="letter-spacing: 0.4pt;"> </span>rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>g<span style="letter-spacing: -0.05pt;">â</span>y<span style="letter-spacing: 0.55pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>ngất<span style="letter-spacing: 1.85pt;"> </span>lịm<span style="letter-spacing: 1.6pt;"> </span>mà<span style="letter-spacing: 0.35pt;"> </span>không <span style="letter-spacing: 1pt;"><span> </span></span>điều<span style="letter-spacing: 1.5pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.1pt;">đ</span><span lang="VI">ược</span><span lang="VI" style="letter-spacing: 0.2pt;"> </span>bằng<span style="letter-spacing: 1.9pt;"> </span>thuốc.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: -0.6pt;"> </span><span lang="VI" style="letter-spacing: -0.3pt;">Thườn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">nhữn</span>g<span style="letter-spacing: -0.6pt;"> </span><span lang="VI" style="letter-spacing: -0.25pt;">cơ</span>n<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">nhị</span>p<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">nhan</span>h<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.25pt;">m</span>à<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.3pt;">khốn</span>g <span style="letter-spacing: -0.25pt;">ch</span>ế<span style="letter-spacing: 2.25pt;"> </span><span lang="VI" style="letter-spacing: -0.25pt;">đượ</span>c<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">bằn</span>g<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.3pt;">thuốc.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic; letter-spacing: -0.3pt;">2.4.2</span></span><span style="font-weight: bold;"><span style="font-style: italic;">.<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">Hộ</span>i <span style="letter-spacing: -0.3pt;">c</span><span style="letter-spacing: -0.4pt;">h</span><span style="letter-spacing: -0.3pt;">ứn</span>g<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.3pt;">WP</span>W<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">ẩ</span>n<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">(hoặ</span>c<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">hộ</span>i<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">chứn</span>g<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: -0.3pt;">WP</span>W<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">đ</span></span></span><span lang="VI" style="letter-spacing: -0.3pt;">ư</span><span style="font-weight: bold;"><span style="font-style: italic; letter-spacing: -0.3pt;">ờn</span></span><span style="font-weight: bold;"><span style="font-style: italic;">g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">dẫ</span>n <span style="letter-spacing: -0.3pt;">truyề</span>n<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: -0.3pt;">ẩn):</span></span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.75pt;"> </span>Hội<span style="letter-spacing: 0.8pt;"> </span>chứ<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.55pt;"> </span>WPW<span style="letter-spacing: 0.5pt;"> </span>ẩn<span style="letter-spacing: 2.75pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>đặc<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span style="letter-spacing: 0.05pt;">i</span>ểm<span style="letter-spacing: 0.8pt;"> </span>là<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span></span><span lang="VI" style="line-height: 22px;">ường</span><span lang="VI" style="letter-spacing: 0.75pt; line-height: 22px;"> </span><span style="line-height: 22px;">dẫn<span style="letter-spacing: 2.6pt;"> </span>truyền<span style="letter-spacing: -0.2pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>lý<span style="letter-spacing: 0.65pt;"> </span>liên<span style="letter-spacing: 1.1pt;"> </span>hệ<span style="letter-spacing: 0.2pt;"> </span>với<span style="letter-spacing: 0.35pt;"> </span>n<span style="letter-spacing: -0.05pt;">ú</span>t<span style="letter-spacing: 0.5pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ĩ-th<span style="letter-spacing: -0.05pt;">ấ</span>t<span style="letter-spacing: 0.55pt;"> </span>tạo<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.05pt;">r</span>a vòng<span style="letter-spacing: 1.4pt;"> </span>dẫn<span style="letter-spacing: 3pt;"></span>truyền<span style="letter-spacing: 0.2pt;"> </span>blốc<span style="letter-spacing: 1.75pt;"> </span>một<span style="letter-spacing: 0.95pt;"> </span>chiều,<span style="letter-spacing: 0.25pt;"> </span>nghĩa<span style="letter-spacing: -0.85pt;"> </span>là<span style="letter-spacing: 2pt;"> </span>chỉ<span style="letter-spacing: -0.85pt;"> </span>cho<span style="letter-spacing: 1pt;"> </span>xung<span style="letter-spacing: 1.15pt;"> </span>động <span style="letter-spacing: 1.05pt;"><span> </span></span>đi<span style="letter-spacing: 0.95pt;"> </span></span><span lang="VI" style="line-height: 22px;">ngược</span><span lang="VI" style="letter-spacing: 1.15pt; line-height: 22px;"> </span><span style="line-height: 22px;">từ<span style="letter-spacing: 1.05pt;"> </span>thất <span style="letter-spacing: 0.05pt;"><span> </span></span>lên<span style="letter-spacing: -1pt;"> </span>nhĩ<span style="letter-spacing: -0.95pt;"> </span>(không<span style="letter-spacing: 1.4pt;"> </span>cho xung động<span style="letter-spacing: 2.4pt;"> </span>đi<span style="letter-spacing: -0.2pt;"> </span>theo<span style="letter-spacing: -0.2pt;"></span></span><span lang="VI" style="line-height: 22px;">hướng từ</span><span lang="VI" style="letter-spacing: -0.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhĩ<span style="letter-spacing: 0.35pt;"> </span>xuống<span style="letter-spacing: 0.6pt;"> </span>thất).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 0.35pt;"> </span>Biểu<span style="letter-spacing: 0.6pt;"> </span>hiện<span style="letter-spacing: -0.45pt;"> </span>lâm<span style="letter-spacing: 0.95pt;"> </span>sàng:<span style="letter-spacing: 0.75pt;"> </span>giống<span style="letter-spacing: 0.95pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư</span><span lang="VI" style="letter-spacing: 0.4pt; line-height: 22px;"> </span><span style="line-height: 22px;">hội<span style="letter-spacing: 0.25pt;"> </span>chứng<span style="letter-spacing: 0.1pt;"> </span>WPW,<span style="letter-spacing: 0.1pt;"> </span>chỉ<span style="letter-spacing: 1.6pt;"> </span>khác<span style="letter-spacing: 1.65pt;"> </span>là<span style="letter-spacing: -0.65pt;"> </span>hoạt<span style="letter-spacing: 1.1pt;"> </span>động<span style="letter-spacing: 2.5pt;"> </span>nhĩ<span style="letter-spacing: 1.55pt;"> </span>nhanh<span style="letter-spacing: 0.1pt;"> </span>khi<span style="letter-spacing: 0.25pt;"> </span>bị<span style="letter-spacing: 0.95pt;"> </span>rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"></span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>nhĩ,<span style="letter-spacing: 0.3pt;"> </span>rất<span style="letter-spacing: 1.9pt;"> </span>ít<span style="letter-spacing: 0.65pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>ngất,<span style="letter-spacing: 1.95pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>gây<span style="letter-spacing: 0.55pt;"> </span>đột<span style="letter-spacing: -0.2pt;"> </span>tử.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điện<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ồ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.95pt;"> </span>Khi<span style="letter-spacing: 0.75pt;"> </span>nhịp<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.05pt;">xo</span>ang<span style="letter-spacing: 0.7pt;"> </span>bình<span style="letter-spacing: -1.15pt;"> </span><span lang="VI">thường,</span><span lang="VI" style="letter-spacing: 0.95pt;"> </span>rung<span style="letter-spacing: 0.95pt;"> </span>nhĩ<span style="letter-spacing: -1.15pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>c<span style="letter-spacing: -0.05pt;">u</span>ồng<span style="letter-spacing: 1.35pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>nhĩ,<span style="letter-spacing: -1.1pt;"> </span>điện<span style="letter-spacing: 1.35pt;"> </span>tim<span style="letter-spacing: 0.8pt;"> </span>đồ<span style="letter-spacing: -1.15pt;"> </span>không<span style="letter-spacing: 1.2pt;"> </span>chẩn<span style="letter-spacing: 2.8pt;"> </span>đoán<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="VI">được</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW<span style="letter-spacing: -0.3pt;"> </span>ẩn.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.55pt;"> </span>Khi<span style="letter-spacing: 0.35pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>nhanh<span style="letter-spacing: 0.25pt;"> </span>vào<span style="letter-spacing: 1.6pt;"> </span>lại<span style="letter-spacing: 0.85pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>WPW<span style="letter-spacing: 0.25pt;"> </span>ẩn<span style="letter-spacing: 2.5pt;"> </span>thấy<span style="letter-spacing: 2.4pt;"> </span>nhịp <span style="letter-spacing: 1.05pt;"><span> </span></span>nhĩ <span style="letter-spacing: 0.15pt;"><span> </span></span>đảo<span style="letter-spacing: -0.55pt;"> </span>lại:<span style="letter-spacing: 1.35pt;"> </span>sóng<span style="letter-spacing: 1.15pt;"> </span>P<span style="letter-spacing: 0.15pt;"> </span>âm<span style="letter-spacing: 0.75pt;"> </span>tính<span style="letter-spacing: 1.3pt;"> </span>sau<span style="letter-spacing: 0.55pt;"> </span>phức<span style="letter-spacing: 0.3pt;"> </span>bộ<span style="letter-spacing: 0.55pt;"> </span>QRS<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">và<span style="letter-spacing: -0.1pt;"> </span><span lang="VI">rơi</span><span lang="VI" style="letter-spacing: 1.45pt;"> </span>vào<span style="letter-spacing: 1.3pt;"> </span>đoạn<span style="letter-spacing: 0.65pt;"> </span>ST,<span style="letter-spacing: -1.2pt;"> </span>đoạn<span style="letter-spacing: 0.65pt;"> </span>P’R<span style="letter-spacing: 0.9pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>RP<span style="letter-spacing: 0.1pt;">’</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Giống<span style="letter-spacing: 0.5pt;"> </span></span><span lang="VI" style="line-height: 22px;">như</span><span lang="VI" style="letter-spacing: 0.2pt; line-height: 22px;"> </span><span style="line-height: 22px;">điều<span style="letter-spacing: 0.9pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>hội<span style="letter-spacing: 0.05pt;"> </span>chứng<span style="letter-spacing: -0.1pt;"> </span>WPW,<span style="letter-spacing: -0.1pt;"> </span>ngoài<span style="letter-spacing: 0.55pt;"> </span>ra<span style="letter-spacing: 0.1pt;"> </span>hội<span style="letter-spacing: 0.05pt;"> </span>chứng<span style="letter-spacing: -0.1pt;"> </span>WPW<span style="letter-spacing: -0.1pt;"> </span>ẩn<span style="letter-spacing: 2.15pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>thể<span style="letter-spacing: -0.55pt;"> </span>dùng<span style="letter-spacing: -0.05pt;"> đ</span></span><span lang="VI" style="line-height: 22px;">ược</span><span lang="VI" style="letter-spacing: 1.05pt; line-height: 22px;"> </span><span style="line-height: 22px;">thuốc<span style="letter-spacing: 0.7pt;"> </span>nhóm digitalis<span style="letter-spacing: 0.75pt;"></span>hoặc<span style="letter-spacing: 0.9pt;"> </span>verapamil<span style="letter-spacing: 0.2pt;"> </span>vì<span style="letter-spacing: 0.95pt;"> </span>không <span style="letter-spacing: 1.4pt;"><span> </span></span>gây<span style="letter-spacing: -1pt;"> </span>ra<span style="letter-spacing: 1.05pt;"> </span>tình<span style="letter-spacing: -0.9pt;"> </span>trạng<span style="letter-spacing: 1.65pt;"> </span>tăng<span style="letter-spacing: -0.9pt;"> </span>nhịp<span style="letter-spacing: -1.2pt;"> </span>thất <span style="letter-spacing: 0.05pt;"><span> </span></span>khi<span style="letter-spacing: 1pt;"> </span>rung<span style="letter-spacing: 1.15pt;"> </span>nhĩ<span style="letter-spacing: -0.95pt;"> </span>ho<span style="letter-spacing: 0.05pt;">ặ</span>c<span style="letter-spacing: 0.9pt;"> </span>khi<span style="letter-spacing: 1pt;"> </span>bị<span style="letter-spacing: 1.7pt;"> </span>cuồng<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">động<span style="letter-spacing: 0.3pt;"> </span>nhĩ.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span style="font-style: italic;">2.4.3.<span style="letter-spacing: -0.25pt;"> </span>Hội<span style="letter-spacing: 0.6pt;"> </span>chứng<span style="letter-spacing: 2.6pt;"> </span>PR<span style="letter-spacing: 0.6pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ắn:</span></span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: -0.2pt;">Hộ</span>i<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.2pt;">chứn</span>g<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.2pt;">P</span>R<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.2pt;">ngắ</span>n<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">cò</span>n<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.2pt;">c</span>ó<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.15pt;">tê</span>n<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.15pt;">l</span>à<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.2pt;">hộ</span>i<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.15pt;">c</span><span style="letter-spacing: -0.2pt;">hứn</span>g<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.2pt;">Lown</span><span style="letter-spacing: -0.15pt;">-</span><span style="letter-spacing: -0.25pt;">G</span><span style="letter-spacing: -0.15pt;">a</span><span style="letter-spacing: -0.2pt;">nong</span><span style="letter-spacing: -0.15pt;">-</span><span style="letter-spacing: -0.2pt;">L</span><span style="letter-spacing: -0.15pt;">e</span><span style="letter-spacing: -0.2pt;">w</span><span style="letter-spacing: -0.15pt;">i</span><span style="letter-spacing: -0.2pt;">n</span>e<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.2pt;">(LG</span><span style="letter-spacing: -0.25pt;">L</span><span style="letter-spacing: -0.2pt;">)</span>,<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.15pt;">đ</span>ể<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.15pt;">ch</span>ỉ<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.15pt;">khoản</span>g <span style="letter-spacing: 0.35pt;"><span> </span></span><span style="letter-spacing: -0.2pt;">P</span>R<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.2pt;">trên </span><span style="letter-spacing: -0.15pt;">điệ</span>n<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.2pt;">ti</span>m<span style="letter-spacing: 0.35pt;"></span><span style="letter-spacing: -0.15pt;">đ</span>ồ<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.2pt;">ngắn</span>,<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.2pt;">sa</span>u<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.15pt;">đ</span>ó<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: -0.15pt;">l</span>à<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.2pt;">phứ</span>c<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.2pt;">b</span>ộ<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.2pt;">QR</span>S<span style="letter-spacing: -0.2pt;"> bìn</span>h<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.2pt;">t</span><span style="letter-spacing: -0.3pt;">h</span><span lang="VI" style="letter-spacing: -0.2pt;">ườn</span>g<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.2pt;">(khôn</span>g<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.2pt;">c</span>ó<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.2pt;">són</span>g<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.2pt;">delta</span>)<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.2pt;">phố</span>i<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.2pt;">hợ</span>p<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">vớ</span>i<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.2pt;">bện</span>h<span style="letter-spacing: -0.2pt;"> s</span>ử<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.2pt;">có </span><span style="letter-spacing: -0.15pt;">c</span><span lang="VI" style="letter-spacing: -0.2pt;">ơ</span>n<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">nhị</span>p<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.2pt;">nhan</span>h<span style="letter-spacing: -0.7pt;"></span><span style="letter-spacing: -0.2pt;">kị</span><span style="letter-spacing: -0.15pt;">c</span>h<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.15pt;">p</span><span style="letter-spacing: -0.2pt;">há</span><span style="letter-spacing: -0.15pt;">t</span>.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">Bản<span style="letter-spacing: 1.6pt;"> </span>chất <span style="letter-spacing: 0.05pt;"><span> </span></span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: 0.65pt;"> </span>PR<span style="letter-spacing: 0.9pt;"> </span>ngắn<span style="letter-spacing: 0.8pt;"> </span>và<span style="letter-spacing: 0.45pt;"> </span>nhịp <span style="letter-spacing: 1.3pt;"><span> </span></span>tim<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hanh<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: 1.9pt;"> </span>do<span style="letter-spacing: 0.95pt;"> </span>những<span style="letter-spacing: 1.05pt;"> </span>sợi<span style="letter-spacing: 0.9pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 1.65pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhĩ<span style="letter-spacing: -1.05pt;"> </span>nối<span style="letter-spacing: 1.65pt;"> </span>tắt<span style="letter-spacing: 0.95pt;"> </span>giữa<span style="letter-spacing: 0.85pt;"> </span>phần<span style="letter-spacing: 0.8pt;"> </span>dẫn<span style="letter-spacing: 2.9pt;"> </span>truyền chậm<span style="letter-spacing: 2.1pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>phía<span style="letter-spacing: 0.5pt;"></span>trên<span style="letter-spacing: 0.5pt;"> </span>nút<span style="letter-spacing: -0.1pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.15pt;"> </span>đến<span style="letter-spacing: 0.7pt;"> </span>phần<span style="letter-spacing: -0.05pt;"> </span>xa<span style="letter-spacing: 0.2pt;"> </span>của<span style="letter-spacing: -0.2pt;"> </span>nút<span style="letter-spacing: -0.1pt;"> </span>nhĩ-thất<span style="letter-spacing: -0.15pt;"> </span>hoặc<span style="letter-spacing: -0.05pt;"> </span>bó<span style="letter-spacing: 0.75pt;"> </span>His,<span style="letter-spacing: 0.2pt;"> </span>tạo<span style="letter-spacing: 0.8pt;"> </span>ra<span style="letter-spacing: 0.1pt;"> </span>vòng<span style="letter-spacing: 0.45pt;"> </span>vào<span style="letter-spacing: 1.25pt;"> </span>lại<span style="letter-spacing: 0.5pt;"> </span>nhỏ<span style="letter-spacing: 0.7pt;"> </span>n<span style="letter-spacing: 0.05pt;">ằ</span>m ở phần<span style="letter-spacing: -0.25pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơ</span><span lang="VI" style="letter-spacing: 0.6pt; line-height: 22px;"> </span><span style="letter-spacing: -0.05pt; line-height: 22px;">n</span><span style="line-height: 22px;">hĩ của<span style="letter-spacing: -0.35pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 1.35pt;"><span class="Apple-style-span" style="font-size: large;"><span style="line-height: 22px;">+<span style="letter-spacing: 1.05pt;"> </span>Biểu<span style="letter-spacing: -0.55pt;"> </span>hiện<span style="letter-spacing: 0.25pt;"> </span>lâm<span style="letter-spacing: -1.1pt;"> </span>sàng<span style="letter-spacing: 1.5pt;"> </span>giống<span style="letter-spacing: 1.65pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span></span><span lang="VI" style="line-height: 22px;">ư</span><span lang="VI" style="letter-spacing: 1.1pt; line-height: 22px;"> </span><span style="line-height: 22px;">hội<span style="letter-spacing: 0.95pt;"> </span>chứng<span style="letter-spacing: 0.8pt;"> </span>W<span style="letter-spacing: -0.1pt;">P</span>W,<span style="letter-spacing: 0.6pt;"> </span>phụ<span style="letter-spacing: 0.55pt;"> </span>thuộc<span style="letter-spacing: 0.85pt;"> </span>vào<span style="letter-spacing: 0.95pt;"> </span>các<span style="letter-spacing: 1.2pt;"> </span></span><span lang="VI" style="line-height: 22px;">cơn</span><span lang="VI" style="letter-spacing: 2pt; line-height: 22px;"> </span><span style="line-height: 22px;">nhịp <span style="letter-spacing: 0.45pt;"><span> </span></span>nhanh<span style="letter-spacing: 0.8pt;"> </span>vào<span style="letter-spacing: 1.65pt;"> </span>lại, rung nhĩ<span style="letter-spacing: 0.35pt;"></span>nhanh,<span style="letter-spacing: -0.3pt;"> </span>cuồng<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>nhanh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="position: relative; top: 0.5pt;">Rung nhĩ<span style="letter-spacing: 0.35pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>đáp<span style="letter-spacing: 0.8pt;"> </span>ứng nhịp<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>anh<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>rung thất<span style="letter-spacing: 1.9pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong.</span><o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span style="line-height: 22px;"><span class="Apple-style-span" style="font-size: large;">Cuồng<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 0.8pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>nhanh<span style="letter-spacing: -0.1pt;"> </span>phối<span style="letter-spacing: 0.6pt;"> </span>hợp<span style="letter-spacing: -0.15pt;"> </span>với<span style="letter-spacing: -0.25pt;"> </span>dẫn<span style="letter-spacing: 2.05pt;"> </span>truyền<span style="letter-spacing: -0.75pt;"> </span>nhĩ<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>1:1, nhịp<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>nhanh<span style="letter-spacing: -0.1pt;"> </span>từ<span style="letter-spacing: 0.1pt;"> </span>220-300<span style="letter-spacing: 0.2pt;"> </span>ck/phút sẽ<span style="letter-spacing: -0.75pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>ngất,<span style="letter-spacing: 1.95pt;"></span>lịm...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Biểu<span style="letter-spacing: 0.2pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ:<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Khoảng<span style="letter-spacing: 0.25pt;"> </span>PR<span style="letter-spacing: -0.15pt;"> </span>ngắn<span style="letter-spacing: -0.25pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>0,12 giây.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.6pt;"><span class="Apple-style-span" style="font-size: large;">. Phức<span style="letter-spacing: -0.5pt;"> </span>bộ QRS<span style="letter-spacing: -0.7pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>th<span lang="VI" style="letter-spacing: -0.05pt;">ư</span>ờng hoặc<span style="letter-spacing: -0.25pt;"> </span><span lang="VI">rộng hơn</span><span lang="VI" style="letter-spacing: -0.1pt;"> </span>bình<span style="letter-spacing: 0.8pt;"> </span><span lang="VI">thường nhưng không</span><span lang="VI" style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>delta.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">. Trong<span style="letter-spacing: -0.6pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>sử đã<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>lầm<span style="letter-spacing: -0.2pt;"> </span>ghi<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span><span lang="VI">ược</span><span lang="VI" style="letter-spacing: 0.85pt;"> </span>những c<span lang="VI">ơn</span><span lang="VI" style="letter-spacing: -0.05pt;"> </span>nhịp<span style="letter-spacing: 0.85pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>kịch<span style="letter-spacing: 0.25pt;"> </span>phát.<o:p></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: -0.35pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>giống<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span><span lang="VI">ư điều</span><span lang="VI" style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>WPW.</span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-67776614815962162232011-04-29T05:21:00.001-07:002011-04-30T20:57:19.039-07:00- SUY TIM<span class="Apple-style-span" style="font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><span class="Apple-style-span" style="color: blue;"> SUY TIM</span></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong>1. Định nghĩa. </strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim là một hội chứng bệnh lý khi tim không bơm đủ số lượng máu cần thiết theo nhu cầu chuyển hoá của cơ thể. Thông thường (nhưng không phải là bắt buộc), suy tim là do rối loạn co bóp của cơ tim. Tuy nhiên, ở một số bệnh nhân suy tim không có rối loạn chức năng cơ tim (thường do tăng đột ngột thể tích hoặc rối loạn đổ đầy thất).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Cần phải phân biệt suy tim với suy tuần hoàn: suy tuần hoàn là tình trạng có bất thường ở một vài thành phần của hệ tuần hoàn như tim, thể tích máu, nồng độ hemoglobin ôxy hoá trong máu động mạch hoặc giường mạch máu không đáp ứng đủ cho cung lượng tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Đầu tiên, suy giảm chức năng tim chỉ biểu hiện khi gắng sức, sau đó khi suy tim nặng dần thì các biểu hiện ứ trệ có cả khi nghỉ ngơi.</span><br />
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<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong>2. Sinh lý bệnh của suy tim.</strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Trong khi nghỉ ngơi và khi gắng sức, quả tim co bóp để tống máu vào hệ thống động mạch. Sự phân phối máu trong cơ thể để cung cấp ôxy cho tổ chức được điều hoà bởi các yếu tố thần kinh-thể dịch và các yếu tố trong tim. Các yếu tố làm ảnh hưởng đến sức co bóp của tim là tiền gánh, tình trạng co bóp, hậu gánh, nhịp co bóp và độ lớn của tổ chức cơ tim bị tổn thương.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Tim có một khả năng dự trữ rất lớn thông qua cơ chế thay đổi nhịp tim, thay đổi thể tích tâm thu và tâm trương, thể tích nhát bóp và khả năng trao đổi ôxy của tổ chức. Ở người bình thường, khi gắng sức tối đa thì cung lượng tim có thể tăng từ 6 lít/phút lên đến trên 25 lít/phút, sự tiêu thụ ôxy có thể tăng từ 250 - 1500 ml/phút hoặc hơn. Nhịp tim có thể tăng từ 70 chu kỳ/phút đến 180 chu kỳ/phút. Khi nghỉ ngơi, máu động mạch chứa 18 ml ôxy/dl, máu động mạch phổi và tĩnh mạch chứa 14ml ôxy/dl. Sự chênh lệch ôxy của động mạch và tĩnh mạch khoảng 4 </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">±</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 0,4 ml/dl. Khi gắng sức nhiều, do khả năng lấy ôxy của tổ chức tăng lên nên chênh lệch nồng độ ôxy giữa động mạch và tĩnh mạch có thể lên đến 12 - 14 ml/dl.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Khi suy tim sẽ có biểu hiện triệu chứng ở nhiều cơ quan khác nhau. Nhịp tim thường nhanh để bù trừ lại việc cung lượng tim không đủ cho nhu cầu chuyển hoá của cơ thể.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim trái làm phù và tăng áp lực tĩnh mạch phổi gây khó thở, thở nhanh. Tăng áp lực tĩnh mạch phổi gây thoát dịch qua các mao mạch vào các khoảng gian bào và phế nang. Thường gây tràn dịch màng phổi phải trước, sau đó tràn dịch màng phổi 2 bên.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim làm giảm dòng máu tới thận và làm giảm mức lọc cầu thận. Tuy nhiên lại làm tăng tái hấp thu Na<sup>+</sup> ở ống thận. Giảm dòng máu tới thận làm tăng tiết renin từ cơ quan cận tiểu cầu thận làm tăng chuyển angiotensin I thành angiotensin II. Angiotensin II gây co mạch và kích thích tiết aldosteron tại tuyến thượng thận. Nếu lượng huyết tương giảm thì ADH sẽ tăng lên trong máu. Tất cả các biến đổi về nội tiết và thay đổi chức năng thận trên sẽ dẫn đến lượng nước trong cơ thể tăng lên. Chính vì vậy làm tăng thể tích máu trong thất, tăng sức căng thành tim và làm tăng các triệu chứng lâm sàng của suy tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Khi suy tim, dòng máu đến lách giảm, tăng áp lực tĩnh mạch cửa, máu không được hút về tim thích đáng làm cho gan to. Ở bệnh nhân suy tim phải thường có rối loạn chức năng gan do tăng áp lực tĩnh mạch chủ dưới, tăng áp lực tĩnh mạch cửa và thường có tăng bilirulin máu, tăng thời gian prothrombin, tăng các men huỷ hoại tế bào gan. Gan giảm khả năng hủy aldosteron cũng góp phần làm ứ nước trong cơ thể.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim gây tăng áp lực tĩnh mạch mãn tính cũng liên quan đến hội chứng mất protein trong ruột mà biểu hiện bằng giảm albumin máu, nhồi máu ruột, chảy máu đường tiêu hoá, rối loạn hấp thu. Đôi khi có hoại tử đầu chi mà không có tắc mạch lớn ở bệnh nhân có suy tim mà cung lượng tim rất thấp. Suy tim cũng gây kích thích vật vã hoặc giảm khả năng hoạt động trí óc do giảm dòng máu đến não. Suy tim gây giảm khả năng hoạt động của cơ gây mệt nhanh khi hoạt động cơ bắp.</span><br />
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<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong>3. Phân loại suy tim.</strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Có nhiều cách phân loại suy tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Dựa vào thời gian tiến triển suy tim: suy tim cấp tính và suy tim mãn tính.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim trái cấp tính thường do cơn tăng huyết áp kịch phát, sau nhồi máu cơ tim diện rộng... Suy tim phải cấp tính thường xảy ra sau nhồi máu phổi. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim mãn tính thường là hậu quả của nhiều bệnh, của nhiều bệnh lý tim mạch hoặc các bệnh liên quan đến tim mạch khác nhau.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Dựa vào tăng tiền gánh hay do tăng hậu gánh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Dựa vào giải phẫu: suy tim trái, suy tim phải và suy tim toàn bộ. Đây là cách phân loại hay được sử dụng trên thực tế lâm sàng.</span><br />
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<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong>4. Triệu chứng của suy tim.</strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em>4.1. Suy tim phải:</em></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em></em></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.1.1. Nguyên nhân:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Do tăng gánh tâm thu thất phải:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Hẹp van 2 lá.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Tăng áp lực động mạch phổi tiên phát.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Tăng áp lực động mạch phổi thứ phát do các bệnh lý của cơ quan hô hấp, cơ, xương, lồng ngực, thần kinh (như bệnh phổi tắc nghẽn mãn tính, hen phế quản, khí phế thũng, viêm phế quản mãn, giãn phế quản, xơ phổi, dày dính màng phổi, gù vẹo cột sống, xơ cứng bì da, nhược cơ, béo bệu...).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Hẹp lỗ van động mạch phổi, hẹp phễu động mạch phổi, hội chứng Eisenmenger.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Suy tim trái nặng và kéo dài.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Rối loạn nhịp tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Do tăng gánh tâm trương thất phải:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Hở van 3 lá.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Hở van động mạch phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Thông động-tĩnh mạch.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Thông liên nhĩ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Thông liên thất.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Các nguyên nhân khác:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Bệnh cơ tim thể giãn.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Bệnh giãn buồng thất phải bẩm sinh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Nhồi máu cơ tim thất phải, thiếu máu cơ tim thất phải, thiếu máu cơ tim cục bộ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Ngoài ra, có một số bệnh lý gây hạn chế giãn thất phải (không gây tổn thương thực thể tế bào cơ tim) như viêm màng ngoài tim co thắt, tràn dịch màng ngoài tim co thắt, tràn dịch màng ngoài tim (gây ép tim) cũng tạo ra các triệu chứng ứ máu ngoại vi như trong suy tim phải.</span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.1.2. Triệu chứng suy tim phải:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Triệu chứng cơ năng:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Đau tức vùng gan: lúc đầu bệnh nhân thấy đau tức vùng gan khi gắng sức, sau nặng dần cảm thấy cả khi nghỉ ngơi. Đau tức âm ỉ này do gan to làm căng giãn bao Glisson. Đau tức vùng gan giảm đi khi nghỉ ngơi và sau khi dùng thuốc điều trị suy tim, đặc biệt là lợi tiểu.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Khó thở ở mức độ vừa phải, thường không có cơn khó thở kịch phát.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Triệu chứng thực thể:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Triệu chứng tại tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Có thể nghe thấy các tiếng tim bệnh lý của bệnh gây nên suy tim phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Nghe có thể thấy ngựa phi thất phải ở mũi ức.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Nhịp tim thường nhanh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Tiếng thổi tâm thu ở mũi ức do hở van 3 lá cơ năng (vì thất phải giãn to làm giãn vòng van 3 lá). Tiếng thổi này mạnh lên khi thở hít vào sâu gọi là dấu hiệu Rivero- Carvalho dương tính.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Tiếng T<sub>2</sub> đanh, tách đôi ở ổ van động mạch phổi do tăng áp lực động mạch phổi (tiếng thổi Graham-Steel) do giãn thất phải làm vòng van động mạch phổi giãn to gây hở van động mạch phổi cơ năng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Có thể nhìn và sờ thấy tim đập ở mũi ức do thất phải to (dấu hiệu Harzer dương tính).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Các triệu chứng khác.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Gan to: là triệu chứng quan trọng, xuất hiện khá sớm. Gan to, mật độ mềm, mặt nhẵn, tức khi sờ nắn. Phản hồi gan-tĩnh mạch cổ dương tính (ấn vào vùng gan sẽ thấy tĩnh mạch cổ nổi to hơn) chứng tỏ gan ứ huyết.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Gan to lên hoặc nhỏ lại theo diễn biến và mức độ suy tim (gan đàn xếp), gan thường nhỏ lại khi dùng thuốc lợi tiểu, thuốc cường tim. Gan có thể đập theo nhịp tim ở bệnh nhân có hở van 3 lá nặng. Khi gan bị ứ máu lâu ngày sẽ bị xơ gan-tim, lúc này gan sờ thấy mật độ chắc, không co nhỏ được nữa và phản hồi gan-tĩnh mạch cổ âm tính.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Tĩnh mạch cổ nổi to khi bệnh nhân ở tư thế nửa nằm, nửa ngồi. Tĩnh mạch cổ có thể đập theo nhịp tim khi hở van 3 lá nặng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Phù: xuất hiện muộn hơn, sau khi có gan to. Phù thường ở chân trước, sau đó phù lên toàn thân, tràn dịch đa màng (màng bụng, màng tim, màng phổi... tràn dịch do suy tim là dịch thấm). Bệnh nhân thường tiểu ít.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Tím: tím do ứ máu ở ngoại vi (môi, lưỡi, dái tai, đầu chi...). Khi có tím là hemoglobin khử trong máu </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 5g/100ml.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Các triệu chứng cận lâm sàng:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- X quang tim-phổi: </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Trên phim chụp tim-phổi thẳng:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Hình ảnh thất phải to: mỏm tim hếch lên trên cơ hoành (tim hình mũi hia) và cung dưới phải to, có thể thấy cung động mạch phổi vồng cao. Phổi mờ do ứ huyết hoặc sáng (khi hẹp động mạch phổi, tứ chứng Fallot gây suy tim phải).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Trên phim chụp tim-phổi nghiêng: mất khoảng sáng trước tim (sau ức) do thất phải to.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Điện tâm đồ:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Nhịp tim nhanh, nhịp xoang hoặc có rung nhĩ, rối loạn nhịp khác.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Dày thất phải (trục phải, R cao ở V<sub>1</sub>và V<sub>2</sub>, R/S </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 1 ở V<sub>1</sub>và V<sub>2 </sub>, thời gian xuất hiện nhánh nội điện ở V<sub>1</sub>và V<sub>2</sub> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 0,035 giây, S sâu ở V<sub>5</sub>và V<sub>6</sub>, RV<sub>1 </sub>+ SV<sub>5</sub> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 11mm).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Siêu âm tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Giãn buồng thất phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Giãn nhĩ phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Thành thất phải dày.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Có thể có biểu hiện tăng áp lực động mạch phổi: di động nghịch thường vách liên thất, hình ảnh thất trái hình chữ D ở trục cắt ngang tim, ước lượng áp lực động mạch phổi qua siêu âm Doppler phổ hở van 3 lá thấy tăng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Hở van 3 lá, hở van động mạch phổi (cơ năng).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Thông tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Áp lực tĩnh mạch ngoại vi tăng (bình thường < 12 cmH<sub>2</sub>O).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Áp lực cuối tâm trương thất phải tăng(bình thường < 5mmHg).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Áp lực động mạch phổi thường tăng nhưng có thể giảm (ở bệnh nhân hẹp động mạch phổi, tứ chứng Fallot).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Cung lượng tim và chỉ số tim giảm.</span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em><br />
</em></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em>4.2. Suy tim trái:</em></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em></em></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.2.1. Nguyên nhân:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Do tăng gánh thất trái:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Tăng gánh tâm thu: tăng huyết áp, hẹp lỗ van động mạch chủ, hẹp eo động mạch chủ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Tăng gánh tâm trương: hở van động mạch chủ, hở van 2 lá, thông động-tĩnh mạch, tồn tại ống động mạch (ống Botal), thông liên thất...</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Tổn thương cơ tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Bệnh tim thiếu máu cục bộ, nhồi máu cơ tim cấp tính.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Bệnh cơ tim giãn, bệnh cơ tim hạn chế, bệnh cơ tim phì đại.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Viêm cơ tim (do thấp, do nhiễm độc, nhiễm khuẩn, do xạ...).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.2.2. Triệu chứng:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Triệu chứng của suy tim trái chủ yếu biểu hiện về phổi do thất trái suy gây ứ máu giật lùi ở vòng tiểu tuần hoàn.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Triệu chứng cơ năng:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Khó thở: khó thở lúc đầu xuất hiện khi gắng sức, sau tăng dần và khi suy tim nặng thì biểu hiện khó thở thường xuyên. Khó thở thường giảm khi nghỉ ngơi, khi được dùng thuốc cường tim, lợi tiểu và giãn mạch. Khi suy tim nặng, bệnh nhân bị khó thở tăng lên khi nằm (do máu ứ về tiểu tuần hoàn tăng lên) nên bệnh nhân phải ngồi hoặc nằm tư thế Fowler.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Đôi khi có khó thở kịch phát do phù phổi cấp hoặc cơn hen tim. Bệnh nhân rất khó thở, thở nhanh, nông, vật vã, ngột ngạt. Nhịp tim nhanh, môi, da và niêm mạc nhợt nhạt hoặc tím. Nghe phổi có ran phế quản nếu là cơn hen tim, có nhiều rên ẩm ở hai đáy phổi dâng nhanh lên khắp 2 phổi như nước thủy triều dâng ở bệnh nhân bị phù phổi cấp (bệnh nhân này thường ho nhiều và khạc ra đờm bọt màu hồng).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Ho, đôi khi có ho ra máu tươi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Triệu chứng thực thể:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Triệu chứng tại tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Diện tim to về bên trái (mỏm tim thường xuống thấp và sang trái).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Nhịp tim nhanh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Tiếng tim nhỏ hoặc ngựa phi thất trái.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Thổi tâm thu ở mỏm tim do hở van 2 lá cơ năng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Triệu chứng khác:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Huyết áp thấp hoặc “kẹt” (huyết áp tâm thu hạ, huyết áp tâm trương bình thường hoặc tăng).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Nghe thấy rên nổ, rên ẩm ở 2 phế trường.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Có thể có tràn dịch màng phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Triệu chứng cận lâm sàng:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- X quang tim-phổi:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Thất trái to: trên phim X quang tim-phổi nghiêng thấy khoảng sáng sau tim giảm hoặc mất, chèn ép thực quản (khi uống baryt) ở 1/3 dưới.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Cung động mạch phổi vồng, các nhánh động mạch phổi giãn. Hình ảnh ứ máu ở phổi: rốn phổi đậm, có các đường Kerley B (đường dài 1-2 cm, vuông góc với bìa phổi, thường ở đáy phổi: biểu hiện phù tổ chức kẽ ở phổi).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Có thể có hình ảnh tràn dịch màng phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Điện tâm đồ: dày thất trái:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Trục trái.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. R cao </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 25 mm ở V<sub>5</sub>.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. S sâu ở V<sub>2</sub> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 12mm.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. RV<sub>5</sub> + SV<sub>2</sub> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">³</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 35mm.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Thời gian xuất hiện nhánh nội điện muộn ở V<sub>5 </sub>và V<sub>6</sub>.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Siêu âm tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Giãn thất trái. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Hở van 2 lá cơ năng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Phì đại thành thất trái (> 10mm).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. EF% và FS% giảm; Mvcf giảm, cung lượng tim giảm.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Có thể thấy các dạng suy chức năng tâm trương thất trái thông qua phổ Doppler dòng vào thất trái qua van 2 lá (trên Doppler xung).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">- Thông tim:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Cung lượng tim giảm (< 4,0 lít/phút).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Chỉ số tim giảm (< 2,5 lít/ phút/m<sup>2</sup>).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">. Áp lực mao mạch phổi tăng.</span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em><br />
</em></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em>4.3. Suy tim toàn bộ:</em></strong></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em></em></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.3.1. Nguyên nhân:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Suy tim trái nặng gây suy tim toàn bộ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Kết hợp nguyên nhân gây suy tim trái và suy tim phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Viêm cơ tim toàn bộ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Bệnh cơ tim thể giãn.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Bệnh gây suy tim cung lượng cao (như: cường giáp, thiếu máu nặng, thiếu vitamin B<sub>1</sub>...).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><em>4.3.2. Triệu chứng:</em></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Là sự kết hợp cả các triệu chứng cơ năng, thực thể, cận lâm sàng của suy tim trái và suy tim phải: </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Cơ năng: bệnh nhân khó thở nhiều, thường xuyên.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Phù to toàn thân và phù thanh mạc.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Phổi ứ huyết: có nhiều ran ẩm, ran nổ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Gan to, xung huyết, có thể có xơ gan-tim; tĩnh mạch cổ nổi to.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Huyết áp tâm thu giảm, huyết áp tâm trương tăng.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Mạch và nhịp tim nhanh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Áp lực tĩnh mạch ngoại vi tăng cao.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ X quang tim-phổi: tim to toàn bộ, ứ huyết tiểu tuần hoàn .</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Siêu âm: thất trái và thất phải đều phì đại, giãn rộng; giảm chức năng tâm thu, tâm trương cả hai thất, cung lượng tim giảm, hở van 2 lá, hở van 3 lá, hở van động mạch phổi (cơ năng).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ Điện tim: dày 2 thất.</span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><em>Tóm lại: </em></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Suy tim là một hội chứng bệnh lý do nhiều nguyên nhân gây nên, có biểu hiện lâm sàng phong phú. Người thầy thuốc phải xác định sự có mặt hay không của hội chứng này để có biện pháp điều trị kịp thời.</span>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-20521764566418174232011-04-29T05:15:00.000-07:002011-04-29T05:15:28.014-07:00- HỞ VAN HAI LÁ<span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">Hở van hai lá </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Hở van hai lá (HoHL) là bệnh khá thường gặp. HoHL thường chia thành hai loại: HoHL thực tổn (do thấp tim, viêm nội tâm mạc, biến chứng của NMCT...) hoặc HoHL cơ năng…<br />
<span style="font-weight: bold;">I.</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> Triệu chứng lâm sàng<br />
A. Triệu chứng cơ năng<br />
1. Phù phổi </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">(khó thở khi nghỉ, khi nằm) hoặc sốc tim (do giảm thể tích tống máu) là triệu chứng chính của hở van hai lá (HoHL) nặng, cấp, mới xuất hiện.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
2. </span>HoHL mạn tính thường không biểu hiện triệu chứng cơ năng gì trong nhiều năm ngoài một tiếng thổi ở tim. Đợt tiến triển của HoHL thường xuất hiện khó thở khi gắng sức hay giảm dung nạp khi gắng sức, nặng hơn sẽ xuất hiện khó thở khi nằm và cơn khó thở kịch phát về đêm. Lâu ngày sẽ xuất hiện triệu chứng suy tim trái, cũng </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> các triệu chứng suy tim phải do tăng áp động mạch phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
3. Loạn nhịp hoàn toàn </span>(rung nhĩ) thường gặp do hậu quả của giãn nhĩ trái. Triệu chứng hay gặp khác là mệt (do giảm thể tích tống máu và cung lượng tim).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
B. Triệu chứng thực thể<br />
1. Sờ: </span>Mỏm tim đập mạnh và ngắn nếu chức năng thất trái còn tốt. Mỏm tim đập lệch trái khi thất trái giãn. Có thể cảm thấy hiện tượng đổ đầy thất nhanh và giãn nhanh nhĩ trái.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> <br />
2. Nghe tim: </span>a. Tiếng tim: <br />
- Âm sắc T<sub>1</sub> thường giảm (HoHL mạn) nhưng cũng có thể bình thường nếu do sa van hai lá hoặc rối loạn hoạt động dây chằng. <br />
- T<sub>2 </sub>thường tách đôi rộng (do phần chủ của T<sub>2</sub> đến sớm), âm sắc sẽ mạnh khi có tăng áp động mạch phổi.<br />
- Xuất hiện tiếng T<sub>3</sub> khi tăng dòng chảy tâm trương cho dù đó không phải luôn luôn là biểu hiện rối loạn chức năng thất trái. Đôi khi có thể nghe thấy tiếng T<sub>4</sub> nhất là trong đợt HoHL cấp.<br />
<span style="font-weight: bold;">b. Tiếng thổi tâm thu:</span> toàn thì tâm thu, âm sắc cao, kiểu tống máu, nghe rõ nhất ở mỏm, lan ra nách (xuất hiện giữa thì tâm thu nếu do sa va hai lá hoặc rối loạn chức năng cơ nhú). Tiếng thổi tâm thu này có thể ngắn, đến sớm khi HoHL cấp/ nặng phản ánh tình trạng tăng áp lực nhĩ trái. Tuy vậy nếu áp lực nhĩ trái tăng quá nhiều sẽ không còn nghe rõ thổi tâm thu nữa. Cần chẩn đoán phân biệt tiếng thổi toàn tâm thu của HoHL với hở ba lá (HoBL) và thông liên thất (TLT): tất cả đều có âm sắc cao, nhưng tiếng thổi của TLT thường thô ráp hơn, nghe rõ ở bờ trái xương ức và lan ra vùng trước tim; tiếng thổi của HoBL nghe rõ nhất ở bờ dưới trái xương ức, lan về bờ phải xương ức và đường giữa đòn trái, tăng lên khi hít sâu trong khi thổi tâm thu HoHL nghe rõ nhất ở mỏm và lan ra nách (cũng có thể lan ra đáy tim do dòng chảy hướng ra trước). <br />
c. Các triệu chứng thực thể của suy tim trái và suy tim phải (tĩnh mạch cổ nổi, gan to, cổ chướng, phù chi dưới) xuất hiện khi bệnh tiến triển nặng. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">II. Nguyên nhân và cơ chế bệnh sinh <br />
A. Nguyên nhân gây ra HoHL<br />
1. Bệnh lý lá van: </span>a. Di chứng thấp tim: xơ hoá, dầy, vôi, co rút lá van.<br />
b. Thoái hoá nhầy: làm di động quá mức lá van.<br />
c. Viêm nội tâm mạc nhiễm khuẩn (VNTMNK) gây thủng lá van, co rút lá van khi lành bệnh. <br />
d. Phình lá van do dòng hở van ĐMC (do VNTMNK) tác động lên van hai lá.<br />
e. Bẩm sinh: <br />
- Xẻ (nứt) van hai lá: đơn thuần hoặc phối hợp (thông sàn nhĩ thất). <br />
- Van hai lá có hai lỗ van.<br />
f. Bệnh cơ tim phì đại: van hai lá di động ra trước trong kỳ tâm thu. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">2. Bệnh lý vòng van hai lá: </span>a. Giãn vòng van: <br />
- Giãn thất trái do bệnh cơ tim giãn, bệnh tim thiếu máu cục bộ, tăng huyết áp.<br />
b. Vôi hoá vòng van:<br />
- Thoái hoá ở người già, thúc đẩy do tăng huyết áp, đái đường, suy thận.<br />
- Do bệnh tim do thấp, hội chứng Marfan, hội chứng Hurler. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">3. Bệnh lý dây chằng: </span>a. Thoái hoá nhầy gây đứt dây chằng. <br />
b. Di chứng thấp tim: dày, dính, vôi hoá dây chằng. </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">4. Bệnh lý cột cơ: </span>a. Nhồi máu cơ tim gây đứt cột cơ nhú.<br />
b. Rối loạn hoạt động cơ nhú:<br />
- Thiếu máu cơ tim: cụm cơ nhú trước được cấp máu từ nhánh mũ và nhánh liên thất trước, cụm cơ nhú sau từ nhánh xuống sau (PDA). <br />
- Bệnh lý thâm nhiễm cơ tim: amyloid, sarcoid.<br />
c. Bẩm sinh: dị dạng, van hình dù... </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">B. Cơ chế bệnh sinh<br />
1. </span>HoHL cấp tính: gây tăng thể tích cuối tâm trương thất trái (vì thêm một lợng máu do HoHL từ nhĩ trái đổ về), tăng độ dài sợi cơ (tiền gánh) và tăng co bóp cơ tim theo định luật Frank-Starling dù hậu quả là tăng áp lực đổ đầy thất trái và gây ứ huyết ở phổi. Hậu gánh giảm do máu thoát về nhĩ trái vì thế càng làm thất trái bóp khỏe, tăng động tuy thể tích tống máu vẫn giảm. Nếu dung nạp được, bệnh nhân sẽ tiến triển thành HoHL mạn tính.<br />
<span style="font-weight: bold;">2. </span>Trong trường hợp <span style="font-weight: bold;">HoHL mạn tính</span>, thất trái giãn và phì đại lệch tâm. Sức ép lên thành cơ tim sẽ trở lại bình thường do phì đại cơ tim, đồng thời mức độ giảm hậu gánh do thoát máu về nhĩ trái không còn nhiều </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">như trong pha cấp. Tiền gánh vẫn ở mức cao làm nhĩ trái giãn. Thất trái không co bóp tăng động như trong pha cấp song vẫn ở ngưỡng bình thường cao. Rối loạn chức năng thất trái sẽ tiến triển âm thầm trong nhiều năm dù không có hoặc có rất ít triệu chứng. Những thông số truyền thống đánh giá co bóp cơ tim (như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> phân số tống máu) sẽ vẫn ở ngưỡng bình thường trong thời gian dài do tăng tiền gánh và giảm/bình thường hoá hậu gánh. Lâu dần rối loạn chức năng kèm với giãn tiến triển buồng thất trái và tăng sức ép lên thành tim càng làm HoHL tăng lên, thành một vòng xoắn tiếp tục gây giảm chức năng thất trái, gây mất bù. Khi các triệu chứng cơ năng đã rõ thì có khi rối loạn chức năng thất trái đã không hồi phục, làm tăng nguy cơ suy tim, tăng tỷ lệ biến chứng và tử vong dù đã phẫu thuật giải quyết bệnh van hai lá.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
III. Các xét nghiệm chẩn đoán<br />
A. Điện tim: </span>các biểu hiện không đặc hiệu </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> dày nhĩ trái, dày thất trái, rung nhĩ đều có thể gặp ở bất kỳ giai đoạn nào của HoHL.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> <br />
B. X quang ngực: </span>thường có giãn thất trái và nhĩ trái nếu HoHL mạn tính. Hình ảnh phù khoảng kẽ và phù phế nang gặp khi HoHL cấp hoặc khi đã suy thất trái nặng.<br />
<span style="font-weight: bold;">C. Siêu âm Doppler tim: </span>(qua thành ngực và qua thực quản) đóng vai trò rất quan trọng, được sử dụng rộng rãi để chẩn đoán xác định và đánh giá mức độ hở van hai lá. Mức độ hở hai lá trên siêu âm Doppler tim thường chia làm 4 độ (từ 1/4 đến 4/4) hoặc các mức độ: nhẹ (1+), vừa (2+), nhiều (3+) và rất nhiều (4+).<br />
<span style="font-weight: bold;">1. Siêu âm Doppler màu:</span> chẩn đoán HoHL bằng hình ảnh dòng màu phụt ngược về nhĩ trái. Độ HoHL có thể ước tính dựa vào sự lan của dòng màu phụt ngược trong nhĩ trái. Lượng giá mức độ hở hai lá: dựa vào các thông số </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">: </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><b></b><span style="font-weight: bold;">a. Độ dài tối đa của dòng màu (hở) phụt ngược trong nhĩ trái hoặc % diện tích dòng hở so với diện tích nhĩ trái.</span> Rất đáng tin cậy nếu HoHL kiểu trung tâm, song thường đánh giá thấp mức độ hở van nếu dòng hở lệch tâm. Với những dòng hở lệch tâm lớn, HoHL đưuợc ước tính tăng thêm 1 độ. Hướng của dòng hở cho phép đánh giá nguyên nhân gây HoHL. <br />
<span style="font-weight: bold;">Bảng 13-1.</span> Lượng giá mức độ hở van hai lá.</span></span><br />
<table border="1" cellpadding="0" cellspacing="0" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><tbody>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="60"><span style="font-weight: bold;"><span class="Apple-style-span" style="font-size: large;">Độ HoHL</span></span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="156"><span style="font-weight: bold;"><span class="Apple-style-span" style="font-size: large;">Chiều dài tối đa của dòng hở (cm) phụt ngợc vào nhĩ trái</span></span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="132"><span style="font-weight: bold;"><span class="Apple-style-span" style="font-size: large;">Diện tích dòng hở so với diện tích nhĩ trái (%)</span></span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="60"><span class="Apple-style-span" style="font-size: large;">Độ 1</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="156"><span class="Apple-style-span" style="font-size: large;">< 1,5</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="132"><span class="Apple-style-span" style="font-size: large;">< 20</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="60"><span class="Apple-style-span" style="font-size: large;">Độ 2</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="156"><span class="Apple-style-span" style="font-size: large;">1,5 – 2,9</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="132"><span class="Apple-style-span" style="font-size: large;">20 – 40</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="60"><span class="Apple-style-span" style="font-size: large;">Độ 3</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="156"><span class="Apple-style-span" style="font-size: large;">3,0 – 4,4</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="132"><span class="Apple-style-span" style="font-size: large;">-</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="60"><span class="Apple-style-span" style="font-size: large;">Độ 4</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="156"><span class="Apple-style-span" style="font-size: large;">> 4,4</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" valign="top" width="132"><span class="Apple-style-span" style="font-size: large;">> 40</span></td></tr>
</tbody></table><span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Cần chú ý: với phương pháp này, khi dùng siêu âm qua thực quản để đánh giá HoHL, nếu dùng an thần (giảm hậu gánh) sẽ làm giảm mức HoHL so với bình thường. Tương tự, nếu đánh giá HoHL ngay trong mổ, độ hở thay đổi nhiều phụ thuộc vào tiền gánh và hậu gánh cơ tim. Do vậy, người ta thường phối hợp thêm nhiều phương pháp khác để đánh giá mức độ HoHL. <br />
b. Độ rộng dòng hở (chỗ hẹp nhất) khi qua lỗ hở (vena contracta): là một chỉ số đáng tin cậy. Nếu rộng > 0,5 cm là bằng chứng của HoHL nặng. Tuy nhiên phương pháp này đòi hỏi máy siêu âm phải có độ phân giải cao và phải phóng hình to, nên dễ có xu hướng đánh giá quá mức độ hở.<br />
c. Diện tích lỗ hở hiệu dụng (ERO) tính theo phương pháp PISA (Proximal Isovelocity Surface Area): dựa trên hiện tượng dòng chảy qua lỗ hẹp hình phễu: khi tới gần lỗ hở, vận tốc của dòng hở gia tăng hội tụ có dạng bán cầu, tại phần rìa vùng hội tụ vận tốc dòng chảy chậm, dạng cầu lớn trong khi tại vùng sát lỗ hở vận tốc dòng chảy nhanh, dạng cầu nhỏ. Có thể đo chính xác vận tốc dòng chảy và đường kính vùng cầu tại điểm đầu tiên có hiện tượng aliasing của phổ Doppler (tần số giới hạn Nyquist), từ đó tính diện tích lỗ hở hiệu dụng (ERO = 2pr2V/Vmr) và thể tích dòng hở (RV = ERO </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">x VTImr) trong đó r là chiều dài từ bờ ngoài vùng cầu hội tụ đến mặt phẳng van hai lá, V là vận tốc tại vùng aliasing, Vmr là vận tốc tối đa dòng hở xác định bằng Doppler liên tục, VTImr là tích phân vận tốc thời gian của dòng hở. Diện tích lỗ hở hiệu dụng (ERO) là thông số đánh giá chính xác độ hở: nhẹ (ERO: 0-10 mm2), vừa (10-25 mm2), nặng (25-50 mm2), rất nặng (> 50 mm2). Tuy nhiên thực tế lại có một vài sai số khi chọn vùng hội tụ dạng cầu dẹt, xác định mặt phẳng lỗ hở, khi dòng hở lại không đồng nhất, lệch tâm... và làm tăng giả tạo độ hở. Dù vậy hiện tượng PISA</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> thường báo hiệu mức độ hở hai lá vừa nhất là khi sử dụng Doppler xung (PRF).<br />
2. Siêu âm Doppler xung: có thể giúp đánh giá mức độ hở van hai lá, nhất là trong những trường hợp HoHL nặng, có thể dựa vào dòng chảy tĩnh mạch phổi. Hiện tượng giảm phổ tâm thu của dòng chảy tĩnh mạch phổi khi chức năng thất trái bình thường báo hiệu HoHL nặng, tuy nhiên không chính xác nếu rung nhĩ hoặc đã rối loạn chức năng thất trái nặng. Hiện tượng đảo ngược phổ tâm thu dòng chảy tĩnh mạch phổi báo hiệu HoHL rất nặng.<br />
D. Thông tim<br />
1. Sóng v trên đường cong áp lực nhĩ trái (tương ứng giai đoạn đổ đầy nhĩ trái từ các tĩnh mạch phổi trong thời kỳ tâm thu) cho phép ước lợng mức độ HoHL, đặc biệt là HoHL cấp tính. Biên độ sóng v gấp 2-3 lần áp lực trung bình nhĩ trái gợi ý HoHL nặng. Tuy nhiên nếu HoHL mạn tính hoặc khi giảm hậu gánh, có thể không thấy bất thường sóng v. Không có sóng v cũng không thể loại trừ HoHL nặng. Mặt khác sóng v cao cũng có thể gặp trong những trường hợp như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> rối loạn chức năng thất trái mà nhĩ trái kém giãn, thông liên thất sau nhồi máu cơ tim hoặc những tình trạng tăng lưu lượng phổi. <br />
2. Chụp buồng thất trái: cho phép ước lượng mức độ HoHL theo phân độ của Seller: <br />
- 1/4: Chỉ có vệt cản quang mờ vào nhĩ trái, không đủ viền rõ hình nhĩ trái.<br />
- 2/4: Cản quang tràn khắp nhĩ trái nhưng đậm độ không bằng thất trái, mất đi nhanh chóng sau 2-3 nhát bóp.<br />
- 3/4: Đậm độ cản quang ở nhĩ trái và thất trái bằng nhau.<br />
- 4/4: Cản quang ở nhĩ trái đậm hơn ở thất trái, xuất hiện cả cản quang ở tĩnh mạch phổi.<br />
3. Thông tim cũng dùng để khảo sát đồng thời bệnh động mạch vành khi HoHL: bệnh nhân nam tuổi >= 40, nữ tuổi >= 50 dù không có triệu chứng hoặc yếu tố nguy cơ của bệnh mạch vành cũng nên chụp động mạch vành trớc mổ. Chỉ định thông tim gồm: <br />
a. Khi không tơng xứng giữa triệu chứng lâm sàng và kết quả thăm dò không chảy máu, <br />
b. Khi dự định phẫu thuật ở những bệnh nhân còn nghi ngờ về mức độ nặng của hở van hai lá hoặc bệnh mạch vành, <br />
c. Bệnh nhân hở van hai lá có nguy cơ mắc bệnh mạch vành hoặc nghi ngờ bệnh mạch vành là căn nguyên gây hở van hai lá.<br />
IV. Điều trị<br />
Nắm bắt cơ chế sinh bệnh là việc rất cần thiết để lựa chọn biện pháp điều trị phù hợp.<br />
A. Hở van hai lá cấp tính<br />
1. Điều trị nội khoa: nếu huyết áp trung bình động mạch vẫn trong giới hạn bình thường, sử dụng các thuốc hạ hậu gánh có thể làm ổn định tình trạng HoHL cấp. Truyền tĩnh mạch Nitroprusside và Nitroglycerin làm giảm áp lực mạch phổi và tăng cường thể tích tống máu. Nếu chưa cần phẫu thuật ngay, có thể chuyển sang dạng thuốc uống, phối hợp thuốc ức chế men chuyển và Hydralazin. Trong những trường hợp HoHL nặng, cấp (mà thất trái chưa kịp giãn, phì đại như</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> HoHL do đứt cột cơ nhú sau nhồi máu cơ tim) nếu xuất hiện triệu chứng phù phổi, sốc tim thì nên đặt bóng trong động mạch chủ để ổn định tình trạng huyết động trước khi gửi đi mổ. <br />
2. Điều trị ngoại khoa: đa số bệnh nhân HoHL nặng, cấp tính đều phải mổ cấp cứu. <br />
B. Hở van hai lá mạn tính<br />
1. Chọn phương pháp và thời điểm điều trị phù hợp:<br />
a. Bệnh nhân HoHL từ vừa đến nặng nếu có triệu chứng thì có chỉ định mổ.<br />
b. Bệnh nhân HoHL nặng không có hoặc có rất ít triệu chứng thì chỉ định phức tạp hơn. Vấn đề mấu chốt là xác định được thời điểm can thiệp trước khi chức năng thất trái giảm đến mức không hồi phục. Nếu chỉ theo dõi sát tới khi xuất hiện triệu chứng thì vẫn có nguy cơ bỏ qua rối loạn nặng chức năng thất trái và tiên lượng sẽ kém đi hẳn. Ưu thế của sửa van đối với tình trạng suy tim và tỷ lệ tử vong sau mổ khiến cho ngày càng có khuynh hướng chỉ định mổ sửa van hai lá sớm hơn nếu thương tổn giải phẫu cho phép.<br />
c. Rất nhiều phương tiện và thông số được đề xuất để dự báo tiến triển của rối loạn chức năng thất trái, suy tim và tử vong sau mổ ở bệnh nhân HoHL nặng. Song lựa chọn thời điểm và biện pháp điều trị cần phối hợp tuỳ từng cá nhân:<br />
- Triệu chứng lâm sàng: bệnh nhân tuổi trên 75, có kèm bệnh lý mạch vành hoặc rối loạn chức năng thận có tiên lượng kém hẳn sau mổ vì thế nên gửi đi mổ trước khi biểu hiện rõ triệu chứng các bệnh kèm theo. Rung nhĩ cũng là một lý do để cân nhắc chỉ định mổ sớm. <br />
- Thông số đo bằng siêu âm tim: rất có ích để đánh giá xem bệnh nhân đã cần gửi đi mổ hay chưa. Thông thường phân số tống máu (EF) ở trên ngưỡng bình thường. Vì thế EF < 50% cho thấy tình trạng rối loạn chức năng thất trái nặng nên gửi đi mổ sớm cho dù chưa có triệu chứng. Ngay cả khi EF từ 50-60% cũng đã làm tăng nguy cơ suy tim và tỷ lệ tử vong sau mổ. Các thông số dự báo nguy cơ khác bao gồm: đường kính cuối tâm thu thất trái (LVESD, Ds) </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 45 mm, phân suất co ngắn sợi cơ thất trái FS </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≤</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;"></span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: symbol;"></span> 31%, thay đổi áp lực thất trái theo thời gian dp/dt < 1343.<br />
(a) Khi lâm sàng và siêu âm tim không lộ rõ, nên làm siêu âm tim gắng sức: giảm đáp ứng với gắng sức, EF thất trái không tăng khi gắng sức, chỉ số thể tích cuối tâm thu thất trái (LVESVI) </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 25 cm3/m2 là những chỉ số gợi ý cần chỉ định mổ sớm.<br />
(b) Bệnh nhân có sa lá van hai lá gây HoHL nặng nên chỉ định mổ sớm dù không có hoặc có rất ít triệu chứng. <br />
- Thông số đo bằng thông tim: <br />
(a) Áp lực trung bình động mạch phổi </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 20 mmHg, chỉ số tim (CI) < 2 l/phút, áp lực cuối tâm trương thất trái </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 12 mmHg là các dấu hiệu dự báo tiên lượng tồi sau mổ.<br />
(b) Cung lượng tim không tăng hoặc áp lực mao mạch phổi bít tăng khi gắng sức là dấu hiệu cho biết đã có rối loạn chức năng thất trái ẩn.<br />
(c) Độ giãn (elastance) thất trái (đường cong tương quan giữa thể tích và áp lực) là thông số đánh giá chức năng co bóp thất trái tốt nhất song ít được ứng dụng rộng rãi vì phải dùng các thiết bị đặc biệt. <br />
2. Điều trị nội khoa:<br />
a. HoHL do rối loạn chức năng thất trái (có giãn vòng van) được điều trị bằng các thuốc chữa suy tim nh</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">ư:<br />
- Các thuốc giảm hậu gánh, đặc biệt là ức chế men chuyển, làm giảm thể tích dòng hở và tăng thể tích tống máu. Nhóm này cũng có tác dụng với bệnh nhân HoHL do bệnh lý van tim có triệu chứng đang chờ mổ.<br />
- Thuốc lợi tiểu và nhóm Nitrate có tác dụng tốt trong điều trị ứ huyết phổi.<br />
- Rung nhĩ phải được điều trị kiểm soát tần số thất bằng các thuốc chống loạn nhịp, nhất là Digitalis và thuốc chẹn <span style="font-family: tahoma, arial, helvetica, sans-serif;">ß</span> giao cảm.<br />
b. Vai trò của thuốc với bệnh nhân HoHL mạn tính do bệnh van tim, chưa có triệu chứng, nói chung còn cần nhiều thử nghiệm chứng minh nhất là về khả năng làm chậm tiến triển của HoHL hoặc phòng rối loạn chức năng thất trái. Điều trị các thuốc giảm hậu gánh quá tích cực có thể che bớt các triệu chứng, từ đó đưa ra các quyết định sai lầm về thời điểm và biện pháp can thiệp.<br />
c. Phải dự phòng viêm nội tâm mạc nhiễm khuẩn cho tất cả trường hợp HoHL do bệnh van tim ngoại trừ hở do giãn thất trái mà các van tim bình thường.<br />
3. Điều trị phẫu thuật:<br />
a. Kinh điển là cắt bỏ bộ máy van hai lá rồi thay bằng van hai lá nhân tạo. Tuy nhiên, sau mổ thường có giảm chức năng thất trái và suy tim ứ huyết. Các kỹ thuật mới có xu hướng bảo tồn tổ chức dưới van nhằm giảm thể tích thất trái và sức ép trên cơ tim sau mổ (thất trái càng có dạng elíp thì càng cải thiện EF sau mổ).<br />
b. Kỹ thuật sửa van làm giảm đáng kể tỷ lệ tử vong và biến chứng: tỷ lệ sống còn sau 5 năm > 85% và chỉ có 10% bệnh nhân phải mổ lại trong 5 năm. Các kỹ thuật bộc lộ tối thiểu càng làm giảm hơn nữa tỷ lệ biến chứng và tử vong. Tuy chưa có thử nghiệm nào so sánh mổ sửa và thay van song các nghiên cứu đều cho thấy ưu thế của mổ sửa van (phần nào do sự lựa chọn bệnh nhân): <br />
- Tử vong của mổ sửa van là 2% so với 5-8% của thay van.<br />
- Phân số tống máu sau mổ thường cao hơn ở nhóm bệnh nhân sửa được van. <br />
- Nguy cơ tắc mạch ở bệnh nhân sửa van thấp hơn (5% trong 5-10 năm so với 10-35% nếu thay van). Nguy cơ viêm nội tâm mạc cũng giảm hẳn (0,4% so với 2,2%). Sau mổ sửa van không cần dùng thuốc chống đông kéo dài (chỉ 3 tháng) nên đã giảm nguy cơ khi dùng thuốc chống đông. <br />
- Tỷ lệ phải mổ lại tương tự giữa hai nhóm bệnh nhân mổ sửa và thay van.<br />
- Một số bệnh nhân rối loạn chức năng thất trái nặng hoặc hở van hai lá thứ phát có thể áp dụng thủ thuật Batista (tái cấu trúc thất trái kết hợp với mổ sửa van) cho kết quả sớm rất tốt trong khi không thể mổ thay van.<br />
Tuy nhiên chỉ định mổ sớm (nhất là sửa van) ở những bệnh nhân HoHL nặng mà chưa có triệu chứng còn gây nhiều tranh cãi.<br />
c. Khả năng sửa van thường phụ thuộc vào nguyên nhân gây HoHL, dễ đánh giá trước mổ bằng siêu âm tim qua thành ngực hoặc qua thực quản. Thành công và các biến chứng của mổ sửa van/thay van có thể đánh giá bằng siêu âm tim ngay trong mổ. HoHL tồn dư là biến chứng hay gặp nhất sau khi ngừng máy tim phổi nhân tạo. Nếu HoHL còn </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> 2/4 nên chạy lại tim phổi nhân tạo để sửa tiếp hoặc thay van hai lá. Chạy máy tim phổi nhân tạo lần thứ hai không tăng thêm tỷ lệ tử vong tại viện. <br />
d. Cần loại trừ một biến chứng sau mổ là hẹp đường ra thất trái do thừa mô lá van sau (> 1,5 cm) đẩy vùng đóng hai lá van ra trước di chuyển vào đường ra thất trái trong thời kỳ tâm thu. Biến chứng này rất hay gặp ở những bệnh nhân có thừa mô lá van và thất trái nhỏ và tăng động. Kỹ thuật sẻ bớt mô lá van sau được áp dụng để hạn chế biến chứng này, tuy nhiên nếu có cản trở đường ra thất trái quá nhiều thì nên mổ thay van hai lá.<br />
4. Theo dõi sau mổ: <br />
Siêu âm tim sau mổ 4-6 tuần được dùng làm mốc theo dõi. HoHL tái phát do sửa không tốt hoặc do nguyên nhân gây bệnh tiếp tục tiến triển. Bệnh nhân nên được theo dõi lâm sàng và siêu âm tim (đánh giá kết quả mổ sửa van, cơ chế và mức độ hở van, chức năng thất trái, huyết khối hay viêm nội tâm mạc) ít nhất 1 năm/1 lần. </span></span>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-48806880978265090352011-04-29T05:11:00.001-07:002011-04-29T05:11:55.087-07:00- HẸP LỖ VAN ĐỘNG MẠCH CHỦ<div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">Hẹp <span style="letter-spacing: 0.1pt;"><span> </span></span>lỗ<span style="letter-spacing: -3pt;"> </span>van<span style="letter-spacing: 2pt;"> </span>động<span style="letter-spacing: -0.4pt;"> </span>mạch<span style="letter-spacing: -2.15pt;"> </span>chủ</span><span lang="EN"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">(Aortic<span style="letter-spacing: 1.75pt;"> </span>valvular <span style="letter-spacing: 0.15pt;"><span> </span></span>stenosis)</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: right;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">1.<span style="letter-spacing: -0.1pt;"> </span>Đại<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: -0.05pt;">c</span></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 0.5pt;">ư</span><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">ơng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: -1pt;"> </span>lỗ<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>động<span style="letter-spacing: 0.65pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>chủ<span style="letter-spacing: -0.3pt;"> </span>là<span style="letter-spacing: -0.6pt;"> </span>tình <span style="letter-spacing: 0.05pt;"><span> </span></span>trạng<span style="letter-spacing: 2.3pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>động<span style="letter-spacing: 0.65pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>chủ<span style="letter-spacing: -0.3pt;"> </span>không<span style="letter-spacing: 0.3pt;"> </span>mở<span style="letter-spacing: -0.1pt;"> </span>hết<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.3pt;">r</span><span style="letter-spacing: 0.25pt;">o</span><span style="letter-spacing: 0.3pt;">n</span>g<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.3pt;">hờ</span>i<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">k</span>ỳ<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">tâ</span>m <span style="letter-spacing: 0.3pt;">th</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">gâ</span>y<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: 0.25pt;">ác</span>h<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">tắ</span>c<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">đườn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">tốn</span>g<span style="letter-spacing: 1.2pt;"></span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.3pt;">t</span>ừ<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">thấ</span>t<span style="letter-spacing: 2.5pt;"> </span><span style="letter-spacing: 0.25pt;">trá</span>i<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">và</span>o<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 2.5pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.3pt;">chủ.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bình<span style="letter-spacing: 0.55pt;"> </span>thường,<span style="letter-spacing: 0.2pt;"> </span>diện<span style="letter-spacing: -0.65pt;"> </span>tích<span style="letter-spacing: 0.5pt;"> </span>lỗ<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.1pt;">m</span>ạch<span style="letter-spacing: 0.4pt;"> </span>chủ<span style="letter-spacing: -0.15pt;"> </span>từ<span style="letter-spacing: 0.1pt;"> </span>3-4,<span style="letter-spacing: 0.2pt;"></span>5<span style="letter-spacing: 0.2pt;"> </span>cm<span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">2</span>,<span style="letter-spacing: 0.05pt;"> </span>các<span style="letter-spacing: 1.85pt;"> </span>lá<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>mỏng,<span style="letter-spacing: 0.8pt;"> </span>mềm<span style="letter-spacing: -0.55pt;"> </span>mại.<span style="letter-spacing: 0.65pt;"> </span>Khi các lá<span style="letter-spacing: 1.75pt;"> </span>van<span style="letter-spacing: 0.4pt;"> </span>bị<span style="letter-spacing: 1.6pt;"> </span>dày,<span style="letter-spacing: 2.4pt;"> </span>xơ<span style="letter-spacing: 1.6pt;"> </span>và<span style="letter-spacing: 0.3pt;"></span>vôi<span style="letter-spacing: 1.75pt;"> </span>hoá,<span style="letter-spacing: 2.4pt;"> </span>dính<span style="letter-spacing: -1.2pt;"> </span><span style="letter-spacing: 0.05pt;">s</span>ẽ<span style="letter-spacing: 0.2pt;"> </span>làm<span style="letter-spacing: 1.4pt;"> </span>giảm<span> </span>độ<span style="letter-spacing: 1.1pt;"> </span>mở<span style="letter-spacing: 0.75pt;"> </span>của<span style="letter-spacing: 0.55pt;"> </span>các <span style="letter-spacing: 0.25pt;"><span> </span></span>lá<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: 0.4pt;"> </span>g<span style="letter-spacing: 0.05pt;">â</span>y<span style="letter-spacing: 1.25pt;"> </span>nên<span style="letter-spacing: 1.25pt;"> </span>hẹp van<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch chủ,<span style="letter-spacing: -0.4pt;"> </span>lúc<span style="letter-spacing: -0.3pt;"> </span>đó<span style="letter-spacing: 0.45pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>mở<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ong<span style="letter-spacing: -0.25pt;"> </span>thời<span style="letter-spacing: -0.2pt;"></span>kỳ tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: 2.85pt;"> </span>chỉ<span style="letter-spacing: 0.35pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>2 c<span style="letter-spacing: -0.1pt;">m</span><span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.3pt;">Bện</span><span lang="EN">h<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">ha</span>y<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">gặ</span>p<span style="letter-spacing: -0.55pt;"> </span>ở<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">ngườ</span>i<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">lớ</span>n<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">tuổi</span>,<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.3pt;">na</span>m<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">giới</span>,<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">chi</span><span style="letter-spacing: -0.35pt;">ế</span>m<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">25</span>%<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.3pt;">bện</span>h<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.35pt;"> </span>ở<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">n</span><span style="letter-spacing: -0.4pt;">g</span><span style="letter-spacing: -0.3pt;">ườ</span>i<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">lớn</span>.<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">Điề</span>u<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">tr</span>ị<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">nộ</span>i<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span><span style="letter-spacing: -0.4pt;">o</span>a <span style="letter-spacing: -0.3pt;">cò</span>n<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>ó<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.25pt;">khăn</span>,<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span>ủ<span style="letter-spacing: -0.95pt;"></span><span style="letter-spacing: -0.3pt;">yế</span>u<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>à<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">phả</span>i<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: -0.3pt;">phẫ</span>u<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.3pt;">thuậ</span>t<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ỉ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">định.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.<span style="letter-spacing: -0.1pt;"> </span>Nguy<span style="letter-spacing: 0.05pt;">ê</span>n<span style="letter-spacing: -1.95pt;"> </span>nhân<span style="letter-spacing: 0.8pt;"> </span>của<span style="letter-spacing: 2.6pt;"> </span>hẹp<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: 0.1pt;">l</span>ỗ<span style="letter-spacing: -2.85pt;"> </span>van<span style="letter-spacing: 2pt;"> </span>đ<span style="letter-spacing: 0.15pt;">ộ</span>ng<span style="letter-spacing: -0.4pt;"> </span>mạch<span style="letter-spacing: -2.15pt;"> </span>chủ.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.1.<span style="letter-spacing: -0.2pt;"> </span>Do<span style="letter-spacing: -0.15pt;"> </span>thấp<span style="letter-spacing: -0.7pt;"> </span>ti<span style="letter-spacing: 0.05pt;">m</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hiện<span style="letter-spacing: -0.2pt;"> </span>nay,<span style="letter-spacing: 0.3pt;"> </span>hẹp<span style="letter-spacing: -0.4pt;"> </span>lỗ<span style="letter-spacing: 1.1pt;"> </span>van động<span style="letter-spacing: 1.1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ủ<span style="letter-spacing: 0.2pt;"> </span>do<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>h<span style="letter-spacing: -0.05pt;">ấ</span>p<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">ti</span>m<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>xu<span style="letter-spacing: 0.55pt;"> </span>hướng<span style="letter-spacing: 0.45pt;"> </span>giảm<span style="letter-spacing: 0.9pt;"> </span>rõ<span style="letter-spacing: 1.1pt;"> </span>rệt.<span style="letter-spacing: -0.35pt;"> </span>Có<span style="letter-spacing: 0.6pt;"> </span>khoảng<span style="letter-spacing: 0.75pt;"> </span>20%<span style="letter-spacing: 0.45pt;"> </span>các bệnh<span style="letter-spacing: 0.3pt;"> </span>nhân<span style="letter-spacing: -1.05pt;"> </span>bị<span style="letter-spacing: 1.55pt;"> </span>hẹp<span style="letter-spacing: 0.1pt;"> </span>lỗ<span style="letter-spacing: 1.6pt;"></span>van<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.6pt;"> </span>mạch<span style="letter-spacing: 1.05pt;"> </span>chủ<span style="letter-spacing: 0.7pt;"> </span>đơn<span style="letter-spacing: 1.7pt;"> </span>thuần,<span style="letter-spacing: 0.7pt;"> </span>còn<span style="letter-spacing: 1.65pt;"> </span>đa<span style="letter-spacing: 1.6pt;"> </span>số<span style="letter-spacing: 1.6pt;"> </span>là<span style="letter-spacing: 1.85pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>tổn<span style="letter-spacing: 1.6pt;"> </span>thương<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.85pt;"> </span>phối<span style="letter-spacing: 1.4pt;"> </span>h<span style="letter-spacing: -0.05pt;">ợ</span><span style="letter-spacing: 0.05pt;">p</span>, nhất<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>kèm<span style="letter-spacing: 1.85pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ,<span style="letter-spacing: -0.4pt;"></span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tổn<span style="letter-spacing: 0.2pt;"> </span>thương tại<span style="letter-spacing: 0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>là<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: 1.9pt;"> </span>mép<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>dính<span style="letter-spacing: 0.25pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>nhau,<span style="letter-spacing: -0.25pt;"> </span>xơ<span style="letter-spacing: 0.55pt;"> </span>cứng,<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>vôi<span style="letter-spacing: 0.75pt;"> </span>hoá<span style="letter-spacing: 1pt;"> </span>trên<span style="letter-spacing: 2.45pt;"> </span>các<span style="letter-spacing: 0.75pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.2.<span style="letter-spacing: -0.2pt;"> </span>Do<span style="letter-spacing: -0.15pt;"> </span>thoái<span style="letter-spacing: 0.2pt;"> </span>hoá:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thường<span style="letter-spacing: 0.4pt;"> </span>gặp<span style="letter-spacing: 0.05pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span>người<span style="letter-spacing: 0.45pt;"> </span>cao<span style="letter-spacing: 0.3pt;"> </span>tuổi,<span style="letter-spacing: 1.1pt;"> </span>các<span style="letter-spacing: 1pt;"> </span>mép<span style="letter-spacing: -0.6pt;"> </span>van<span style="letter-spacing: -0.05pt;"> </span>không<span style="letter-spacing: 2.5pt;"> </span>bị<span style="letter-spacing: 0.4pt;"> </span>tổn<span style="letter-spacing: 1.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 0.45pt;"> </span>mà<span style="letter-spacing: 0.6pt;"> </span>chỉ<span style="letter-spacing: 1.8pt;"> </span>bị<span style="letter-spacing: 0.85pt;"> </span>tổn<span style="letter-spacing: 1.05pt;"> </span>thương<span style="letter-spacing: 0.45pt;"> </span>vôi<span style="letter-spacing: 1pt;"> </span>hoá<span style="letter-spacing: 1.2pt;"> </span>ở nền<span style="letter-spacing: -0.4pt;"> </span>van,<span style="letter-spacing: -0.3pt;"> </span>chỗ<span style="letter-spacing: 0.95pt;"> </span>sát<span style="letter-spacing: 0.9pt;"> </span>với<span style="letter-spacing: -0.15pt;"></span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>chủ,<span style="letter-spacing: -0.1pt;"> </span>làm<span style="letter-spacing: 0.8pt;"> </span>cho<span style="letter-spacing: 0.15pt;"> </span>v<span style="letter-spacing: 0.1pt;">a</span>n<span style="letter-spacing: -0.15pt;"> </span>mở<span style="letter-spacing: 0.15pt;"> </span>hạn<span style="letter-spacing: 0.8pt;"> </span>chế.<span style="letter-spacing: -0.5pt;"> </span>Thường<span style="letter-spacing: 0.3pt;"> </span>không<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>hở<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.1pt;">m</span>ạch chủ<span style="letter-spacing: 0.15pt;"> </span>kèm<span style="letter-spacing: 2.35pt;"> </span>theo.<span style="letter-spacing: 0.25pt;"> </span>Quá<span style="letter-spacing: 1.15pt;"> </span>trình <span style="letter-spacing: 0.2pt;"><span> </span></span>vôi<span style="letter-spacing: 0.6pt;"> </span>hoá,<span style="letter-spacing: 1.15pt;"> </span>xơ<span style="letter-spacing: 0.65pt;"></span>hoá<span style="letter-spacing: 0.7pt;"> </span>lan<span style="letter-spacing: 0.35pt;"> </span>rộng<span style="letter-spacing: 0.5pt;"> </span>đến<span style="letter-spacing: 1pt;"> </span>diện<span style="letter-spacing: -0.35pt;"> </span>van và<span style="letter-spacing: 1.3pt;"> </span>cả<span style="letter-spacing: 1.6pt;"> </span>lá<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước<span style="letter-spacing: 0.45pt;"> </span>van 2<span style="letter-spacing: 0.45pt;"> </span>l<span style="letter-spacing: -0.1pt;">á</span>,<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>thể<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>cả loét,<span style="letter-spacing: -0.85pt;"> </span>mủn<span style="letter-spacing: -0.45pt;"> </span>nên<span style="letter-spacing: 0.35pt;"> </span>dễ<span style="letter-spacing: -0.7pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>(gọi<span style="letter-spacing: 0.55pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"></span>Monckeberg).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.3.<span style="letter-spacing: -0.2pt;"> </span>Do<span style="letter-spacing: -0.15pt;"> </span>vữa<span style="letter-spacing: 1.2pt;"> </span>xơ<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 2.25pt;"> </span>mạch:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thường<span style="letter-spacing: 0.1pt;"> </span>gặp<span style="letter-spacing: -0.25pt;"> </span>ở<span style="letter-spacing: 0.1pt;"> </span>những<span style="letter-spacing: 0.1pt;"> </span>người<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>yếu<span style="letter-spacing: -0.55pt;"> </span>tố<span style="letter-spacing: 0.75pt;"> </span>nguy<span style="letter-spacing: 0.15pt;"> </span>cơ<span style="letter-spacing: 0.75pt;"> </span>cao của<span style="letter-spacing: -0.2pt;"> </span>vữa<span style="letter-spacing: -0.35pt;"> </span>xơ<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 1.35pt;"> </span>mạch,<span style="letter-spacing: 1.2pt;"> </span>nhất<span style="letter-spacing: 2pt;"> </span>là<span style="letter-spacing: 1pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>rối<span style="letter-spacing: 0.8pt;"> </span>loạn<span style="letter-spacing: 0.6pt;"> </span>mỡ máu<span style="letter-spacing: 0.4pt;"> </span>nặng,<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"></span>chủ<span style="letter-spacing: -0.35pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>xơ<span style="letter-spacing: 0.55pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.4pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>xơ mạch<span style="letter-spacing: 1.35pt;"> </span>máu<span style="letter-spacing: 0.7pt;"> </span>ở các<span style="letter-spacing: 0.3pt;"> </span>nơi<span style="letter-spacing: 0.85pt;"> </span>khác.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.4.<span style="letter-spacing: -0.2pt;"> </span>Do<span style="letter-spacing: -0.15pt;"> </span>viêm<span style="letter-spacing: 0.2pt;"> </span>khớp<span style="letter-spacing: 1.9pt;"> </span>dạng<span style="letter-spacing: 0.2pt;"> </span>thấp</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.25pt;">Nguyê</span><span lang="EN">n <span style="letter-spacing: 0.65pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">nhâ</span>n<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.25pt;">nà</span>y<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">hiế</span>m <span style="letter-spacing: 0.15pt;"><span> </span></span><span style="letter-spacing: -0.3pt;">gặp</span>,<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>á<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.2pt;">v</span>à<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">gố</span>c<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span>ủ<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">cũn</span>g<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">dà</span>y<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">lên.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.5.<span style="letter-spacing: -0.2pt;"> </span>Do<span style="letter-spacing: -0.15pt;"> </span>bẩm<span style="letter-spacing: 1.1pt;"> </span>sinh</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: 0.45pt;"> </span>nhân<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>dị<span style="letter-spacing: 0.55pt;"> </span>tật<span style="letter-spacing: 2pt;"> </span>tại<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>lúc<span style="letter-spacing: -0.3pt;"> </span>mới<span style="letter-spacing: -0.2pt;"> </span>sinh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">Va</span>n<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span>ủ<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ỉ<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.3pt;">van</span>:<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.3pt;">lú</span>c<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ó<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>a<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ỉ<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">l</span>ỗ<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">nh</span>ỏ<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">giữ</span>a<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">du</span>y<span style="letter-spacing: -0.3pt;"> nhất</span>.<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: -0.3pt;">Bệnh nặng</span>,<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">gâ</span>y<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>ử<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">von</span>g<span style="letter-spacing: -0.3pt;">sớ</span>m<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">tron</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">nhữn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">nă</span>m<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.25pt;">đầ</span>u<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">củ</span>a<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">trẻ.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">-<span style="letter-spacing: 0.15pt;"> </span>Van<span style="letter-spacing: 0.15pt;"> </span>động<span style="letter-spacing: 0.75pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>chủ<span style="letter-spacing: -0.2pt;"> </span>chỉ<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>2<span style="letter-spacing: 0.15pt;"> </span>lá:<span style="letter-spacing: 0.8pt;"> </span>th<span style="letter-spacing: -0.05pt;">ư</span>ờng<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>một<span style="letter-spacing: -0.05pt;"> </span>lá<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>to<span style="letter-spacing: -0.05pt;"> </span>và<span style="letter-spacing: 0.95pt;"> </span>m<span style="letter-spacing: -0.05pt;">ộ</span>t<span style="letter-spacing: -0.05pt;"> </span>lá<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>nhỏ.<span style="letter-spacing: 0.75pt;"> </span>Khi<span style="letter-spacing: -0.05pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>đóng,<span style="letter-spacing: 0.35pt;"> </span>chỗ tiếp<span style="letter-spacing: -0.55pt;"> </span>xúc<span style="letter-spacing: 0.05pt;"> </span>của<span style="letter-spacing: 0.05pt;"> </span>2<span style="letter-spacing: 0.4pt;"> </span>mép<span style="letter-spacing: -0.65pt;"></span>van<span style="letter-spacing: -0.1pt;"> </span>không<span style="letter-spacing: 0.65pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span>chính<span style="letter-spacing: 0.6pt;"> </span>giữa<span style="letter-spacing: 0.2pt;"> </span>gốc<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>chủ; khi<span style="letter-spacing: 0.25pt;"> </span>mở<span style="letter-spacing: 0.25pt;"> </span>thì<span style="letter-spacing: 1.9pt;"> </span>các<span style="letter-spacing: 1.4pt;"> </span>lá<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.05pt;"> </span>không<span style="letter-spacing: 1.4pt;"><span> </span></span>áp<span style="letter-spacing: 0.05pt;"> </span>sát<o:p></o:p></span><span lang="EN" style="position: relative; top: 0.5pt;"> được<span style="letter-spacing: 0.9pt;"> </span>đến<span style="letter-spacing: 1.35pt;"> </span>gốc<span style="letter-spacing: 1pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>chủ gây<span style="letter-spacing: 0.7pt;"> </span>nên<span style="letter-spacing: 0.7pt;"></span>hẹp<span style="letter-spacing: -0.55pt;"> </span>lỗ<span style="letter-spacing: 0.95pt;"> </span>van<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>chủ.<span style="letter-spacing: -0.05pt;"> </span>Lâu<span style="letter-spacing: 1.6pt;"> </span>dài,<span style="letter-spacing: 0.15pt;"> </span>do<span style="letter-spacing: 0.25pt;"> </span>tốc<span style="letter-spacing: 0.9pt;"> </span>độ<span style="letter-spacing: 0.9pt;"> </span>dòng<span style="letter-spacing: 0.8pt;"> </span>máu<span style="letter-spacing: 0.75pt;"> </span>qua </span><span lang="EN">van<span style="letter-spacing: -0.5pt;"> </span>mạnh<span style="letter-spacing: 1.35pt;"> </span>làm mép<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>dày<span style="letter-spacing: 1pt;"> </span>lên,<span style="letter-spacing: 2.15pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>cũng<span style="letter-spacing: -0.45pt;"> </span>dày<span style="letter-spacing: -0.7pt;"> </span>lên.<span style="letter-spacing: 0.55pt;"></span>Bệnh<span style="letter-spacing: 1.9pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường có<span style="letter-spacing: 0.65pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>đi<span style="letter-spacing: 0.7pt;"> </span>kèm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.4pt;"> </span>Ba<span style="letter-spacing: -0.55pt;"> </span>lá<span style="letter-spacing: 1.25pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>chủ<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>kích<span style="letter-spacing: 0.65pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ước<span style="letter-spacing: 0.4pt;"> </span>không<span style="letter-spacing: 2.1pt;"> </span>đều<span style="letter-spacing: -0.05pt;"> </span>nhau,<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>thể<span style="letter-spacing: -0.35pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>dính<span style="letter-spacing: 0.65pt;"> </span>một<span style="letter-spacing: 0.2pt;"> </span>ít<span style="letter-spacing: 1.1pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span>mép<span style="letter-spacing: -0.65pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>gây mở<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hạn<span style="letter-spacing: 0.5pt;"> </span>chế,<span style="letter-spacing: -0.8pt;"> </span>lâu<span style="letter-spacing: 1pt;"> </span>dài<span style="letter-spacing: -0.05pt;"></span>cũng<span style="letter-spacing: -0.45pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>xơ<span style="letter-spacing: 0.35pt;"> </span>hoá,<span style="letter-spacing: 1pt;"> </span>vôi<span style="letter-spacing: 0.35pt;"> </span>hoá<span style="letter-spacing: 0.5pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.<span style="letter-spacing: -0.1pt;"> </span>Sinh<span style="letter-spacing: -1pt;"> </span>lý<span style="letter-spacing: 0.25pt;"> </span>bệnh.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trừ<span style="letter-spacing: 0.6pt;"> </span>nguyên<span style="letter-spacing: 1.15pt;"> </span>nhân<span style="letter-spacing: -1.1pt;"> </span>do<span style="letter-spacing: 0.85pt;"> </span>bẩm<span style="letter-spacing: 2.8pt;"> </span>sinh,<span style="letter-spacing: 0.7pt;"> </span>còn<span style="letter-spacing: 1.65pt;"> </span>lại<span style="letter-spacing: 1.65pt;"> </span>hẹp<span style="letter-spacing: 0.05pt;"> </span>lỗ<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>chủ<span style="letter-spacing: 0.6pt;"> </span>thường<span style="letter-spacing: 0.95pt;"> </span>tiến<span style="letter-spacing: 0.2pt;"> </span>triển<span style="letter-spacing: 0.25pt;"> </span>từ<span style="letter-spacing: 0.85pt;"> </span>từ,<span style="letter-spacing: 0.85pt;"> </span>tăng dần<span style="letter-spacing: -0.15pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>đến<span style="letter-spacing: 0.75pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>biến<span style="letter-spacing: -0.85pt;"></span>đổi<span style="letter-spacing: 0.35pt;"> </span>về<span style="letter-spacing: -1.2pt;"> </span>giải<span style="letter-spacing: 0.55pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>lý<span style="letter-spacing: -0.1pt;"> </span>bệnh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Do<span style="letter-spacing: 0.4pt;"> </span>hẹp<span style="letter-spacing: -0.2pt;"> </span>lỗ<span style="letter-spacing: 1.3pt;"> </span>van<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.8pt;"> </span>chủ<span style="letter-spacing: 0.35pt;"> </span>làm<span style="letter-spacing: 2.25pt;"> </span>áp<span style="letter-spacing: 0.9pt;"> </span>lực<span style="letter-spacing: 0.55pt;"> </span>thất<span style="letter-spacing: 2.65pt;"> </span>trái<span style="letter-spacing: 0.4pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>lên<span style="letter-spacing: 1.35pt;"> </span>trong<span style="letter-spacing: 0.45pt;"> </span>thời<span style="letter-spacing: 0.55pt;"> </span>kỳ<span style="letter-spacing: 0.7pt;"> </span>tâm<span style="letter-spacing: 1.1pt;"> </span>thất<span style="letter-spacing: 2.65pt;"> </span>thu,<span style="letter-spacing: 0.5pt;"> </span>dần<span style="letter-spacing: 0.55pt;"> </span>dần làm<span style="letter-spacing: 0.4pt;"> </span>thành<span style="letter-spacing: 1.75pt;"> </span>thất<span style="letter-spacing: 2.3pt;"> </span>trái<span style="letter-spacing: 0.5pt;"> </span>dày<span style="letter-spacing: 0.65pt;"></span>lên.<span style="letter-spacing: 1.85pt;"> </span>Tuy nhiên,<span style="letter-spacing: 0.75pt;"> </span>trong<span style="letter-spacing: 0.15pt;"> </span>một<span style="letter-spacing: 0.2pt;"> </span>thời<span style="letter-spacing: 0.2pt;"> </span>gian<span style="letter-spacing: 0.2pt;"> </span>dài,<span style="letter-spacing: 0.9pt;"> </span>cung<span style="letter-spacing: 0.15pt;"> </span>l<span style="letter-spacing: -0.05pt;">ư</span>ợng<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>vẫn<span style="letter-spacing: 1.85pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>mức<span style="letter-spacing: 0.25pt;"> </span>độ<span style="letter-spacing: 1pt;"> </span>bình <span style="letter-spacing: 0.05pt;">t</span>hường,<span style="letter-spacing: 0.4pt;"> </span>huyết<span style="letter-spacing: -0.4pt;"> </span>áp<span style="letter-spacing: -0.1pt;"> </span>bình <span style="letter-spacing: 0.3pt;"><span> </span></span>t<span style="letter-spacing: -0.1pt;">h</span>ường<span style="letter-spacing: 0.4pt;"> </span>và<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ương<span style="letter-spacing: 0.4pt;"> </span>lực<span style="letter-spacing: 0.25pt;"></span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>ng<span style="letter-spacing: -0.05pt;">o</span>ại<span style="letter-spacing: 0.4pt;"> </span>vi<span style="letter-spacing: -0.05pt;"> </span>vẫn<span style="letter-spacing: 1.95pt;"> </span>bình<span style="letter-spacing: 0.65pt;"> </span>thường,<span style="letter-spacing: 0.4pt;"> </span>nhất<span style="letter-spacing: 2.25pt;"> </span>là<span style="letter-spacing: 1.25pt;"> </span>khi<span style="letter-spacing: 0.25pt;"> </span>hẹp<span style="letter-spacing: -0.5pt;"> </span>lỗ van<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>chủ<span style="letter-spacing: -0.1pt;"> </span>mức<span style="letter-spacing: 0.05pt;"> </span>độ<span style="letter-spacing: 0.8pt;"> </span>nhẹ<span style="letter-spacing: -0.45pt;"> </span>(diện<span style="letter-spacing: -0.5pt;"> </span>tích<span style="letter-spacing: 0.55pt;"> </span>lỗ<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>bằng<span style="letter-spacing: 0.65pt;"> </span>1,1-2,0cm<span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>).<span style="letter-spacing: -0.25pt;"> </span>Nếu<span style="letter-spacing: -0.6pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>2<span style="letter-spacing: 0.25pt;"> </span>lá<span style="letter-spacing: -0.25pt;"> </span>bình <span style="letter-spacing: 0.7pt;"><span> </span></span>thường,<span style="letter-spacing: 0.25pt;"> </span>sẽ<span style="letter-spacing: -0.5pt;"> </span>có một<span style="letter-spacing: 0.05pt;"> </span>cơ<span style="letter-spacing: 0.85pt;"> </span>chế<span style="letter-spacing: -0.45pt;"> </span>bù đắp<span style="letter-spacing: 0.45pt;"> </span>làm<span style="letter-spacing: 0.05pt;"> </span>tăng<span style="letter-spacing: 1.8pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>tích<span style="letter-spacing: 0.55pt;"> </span>thất<span style="letter-spacing: 2.15pt;"> </span>trái<span style="letter-spacing: 0.8pt;"> </span>cu<span style="letter-spacing: -0.05pt;">ố</span>i<span style="letter-spacing: 0.85pt;"> </span>tâm<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ương<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">gâ</span>y<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.25pt;">t</span><span style="letter-spacing: -0.3pt;">ăn</span>g<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>o<span style="letter-spacing: -0.35pt;"></span><span style="letter-spacing: -0.3pt;">bó</span>p<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">tốn</span>g<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.25pt;">m</span><span style="letter-spacing: -0.35pt;">á</span>u<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">củ</span>a<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>t<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: -0.25pt;">tr</span><span style="letter-spacing: -0.3pt;">á</span>i<span style="letter-spacing: 0.5pt;"> </span>ở <span style="letter-spacing: -0.25pt;">th</span>ì<span style="letter-spacing: -0.25pt;"> tâ</span>m<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">thu</span>,<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">ké</span>o<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.25pt;">dà</span>i<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">thờ</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">gia</span>n<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">tốn</span>g <span style="letter-spacing: -0.3pt;">máu.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Khi<span style="letter-spacing: 1.2pt;"> </span>hẹp<span style="letter-spacing: 0.5pt;"> </span>lỗ<span style="letter-spacing: 2pt;"> </span>van<span style="letter-spacing: 0.9pt;"> </span>động<span style="letter-spacing: 2pt;"> </span>mạch<span style="letter-spacing: 1.45pt;"> </span>chủ<span style="letter-spacing: 1.05pt;"> </span>mức<span style="letter-spacing: 1.2pt;"> </span>độ<span style="letter-spacing: 1.95pt;"> </span>vừa<span style="letter-spacing: 0.9pt;"> </span>(diện<span style="letter-spacing: 0.65pt;"> </span>tích<span style="letter-spacing: -0.6pt;"> </span>van<span style="letter-spacing: 0.9pt;"> </span>0,8-1,0<span style="letter-spacing: 1.4pt;"> </span>c<span style="letter-spacing: -0.05pt;">m</span><span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>)<span style="letter-spacing: 1.25pt;"> </span>và<span> </span>hẹp<span style="letter-spacing: 0.5pt;"> </span>mức<span style="letter-spacing: 1.2pt;"> </span>độ<span style="letter-spacing: 1.95pt;"> </span>nặng<o:p></o:p> (diện<span style="letter-spacing: 0.35pt;"> </span>tích<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: 0.6pt;"> </span><<span style="letter-spacing: 1pt;"> </span>0,8<span style="letter-spacing: 1.05pt;"></span>cm<span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">2</span>)<span style="letter-spacing: 0.95pt;"> </span>thì<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>ẽ<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 1.75pt;"> </span>ảnh<span style="letter-spacing: 1.6pt;"> </span>hưởng<span style="letter-spacing: 1.05pt;"> </span>đến<span style="letter-spacing: 1.55pt;"> </span>huyết<span style="letter-spacing: 0.25pt;"> </span>động <span style="letter-spacing: 0.6pt;"><span></span></span>đáng<span style="letter-spacing: 0.05pt;"> </span>kể,<span style="letter-spacing: 0.3pt;"> </span>chênh<span style="letter-spacing: -1.1pt;"> </span>áp<span style="letter-spacing: 1.75pt;"> </span>giữa<span style="letter-spacing: 0.85pt;"> </span>thất<span style="letter-spacing: 2.95pt;"> </span>trái<span style="letter-spacing: 0.4pt;"><span> </span></span>và động<span style="letter-spacing: 1.1pt;"> </span>mạch<span style="letter-spacing: 0.55pt;"> </span>chủ<span style="letter-spacing: 0.15pt;"> </span>tăng<span style="letter-spacing: 1.3pt;"> </span>lên<span style="letter-spacing: 0.5pt;"> </span>rõ<span style="letter-spacing: 1.15pt;"> </span>rệt<span style="letter-spacing: -0.3pt;"> </span>hơn.<span style="letter-spacing: 0.85pt;"> </span>Do<span style="letter-spacing: 0.25pt;"></span>phì <span style="letter-spacing: 0.45pt;"><span> </span></span>đại<span style="letter-spacing: -0.45pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>trái,<span style="letter-spacing: 1.25pt;"> </span>làm<span style="letter-spacing: 0.8pt;"> </span>cho<span style="letter-spacing: 0.4pt;"> </span>thất<span style="letter-spacing: 2.4pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span>i<span style="letter-spacing: 0.95pt;"> </span>giãn<span style="letter-spacing: 1.55pt;"> </span>khó<span style="letter-spacing: 1.05pt;"> </span>khăn,<span style="letter-spacing: 0.8pt;"> </span>lúc<span style="letter-spacing: 0.25pt;"> </span>đó<span style="letter-spacing: 1pt;"> </span>nhĩ trái<span style="letter-spacing: 0.35pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ả</span>i<span style="letter-spacing: 0.8pt;"> </span>tă<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 2.2pt;"> </span>cường<span style="letter-spacing: 0.5pt;"> </span>co<span style="letter-spacing: 0.4pt;"> </span>bóp<span style="letter-spacing: 0.85pt;"> </span>nhưng<span style="letter-spacing: 0.5pt;"> </span>chưa<span style="letter-spacing: 0.5pt;"> </span>làm<span style="letter-spacing: 1pt;"> </span>tă<span style="letter-spacing: -0.05pt;">n</span>g <span style="letter-spacing: 0.2pt;"><span> </span></span>áp lực<span style="letter-spacing: 0.35pt;"></span>tr<span style="letter-spacing: -0.05pt;">u</span>ng<span style="letter-spacing: 0.35pt;"> </span>bình<span style="letter-spacing: 0.75pt;"> </span>tro<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.3pt;"> </span>nhĩ<span style="letter-spacing: 1.25pt;"> </span>trái,<span style="letter-spacing: 0.7pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ong<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: 0.35pt;"> </span>và<span style="letter-spacing: 1.3pt;"> </span>mao mạch<span style="letter-spacing: 0.35pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổ</span><span style="letter-spacing: 0.05pt;">i</span>,<span style="letter-spacing: 0.3pt;"> </span>chưa thấy<span style="letter-spacing: 1.85pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tình<span style="letter-spacing: 0.75pt;"> </span>trạng<span style="letter-spacing: 0.1pt;"> </span>ứ huyết<span style="letter-spacing: -0.8pt;"> </span>ở phổi<span style="letter-spacing: 0.4pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>giai<span style="letter-spacing: -0.2pt;"> </span>đoạn<span style="letter-spacing: 0.65pt;"> </span>đầu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Lâu<span style="letter-spacing: 1.4pt;"> </span>dài,<span style="letter-spacing: -0.05pt;"> </span>ở<span style="letter-spacing: 0.15pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ười<span style="letter-spacing: 0.15pt;"> </span>bị<span style="letter-spacing: 0.7pt;"> </span>hẹp<span style="letter-spacing: -0.75pt;"> </span>lỗ<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>động<span style="letter-spacing: 0.75pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>c<span style="letter-spacing: 0.05pt;">h</span>ủ<span style="letter-spacing: -0.2pt;"> </span>mức<span style="letter-spacing: -0.05pt;"> </span>độ<span style="letter-spacing: 0.7pt;"> </span>nặng<span style="letter-spacing: -0.1pt;"> </span>sẽ<span style="letter-spacing: -0.6pt;"> </span>thấy<span style="letter-spacing: 2pt;"> </span>cung<span style="letter-spacing: -0.1pt;"> </span>lượng<span style="letter-spacing: 0.15pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span>giảm,<span style="letter-spacing: 0.55pt;"> </span>chênh<o:p></o:p> áp<span style="letter-spacing: 1.05pt;"> </span>giữa<span style="letter-spacing: 0.15pt;"> </span>thất<span style="letter-spacing: 2.25pt;"> </span>trái<span style="letter-spacing: 0.65pt;"> </span>và<span style="letter-spacing: -0.6pt;"></span>động <span style="letter-spacing: 0.2pt;"><span> </span></span>mạch<span style="letter-spacing: 2.35pt;"> </span>chủ cũng<span style="letter-spacing: -0.1pt;"> </span>giảm<span style="letter-spacing: 0.75pt;"> </span>bớt.<span style="letter-spacing: 0.15pt;"> </span>N<span style="letter-spacing: -0.05pt;">g</span>ược<span style="letter-spacing: 0.35pt;"> </span>l<span style="letter-spacing: -0.05pt;">ạ</span>i,<span style="letter-spacing: 1.05pt;"> </span>áp<span style="letter-spacing: 0.35pt;"> </span>lực<span style="letter-spacing: 0.2pt;"> </span>nhĩ<span style="letter-spacing: 1.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ái,<span style="letter-spacing: 1.35pt;"> </span>áp lực<span style="letter-spacing: 0.2pt;"> </span>tĩ<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 0.9pt;"> </span>mạch,<span style="letter-spacing: 0.7pt;"> </span>m<span style="letter-spacing: -0.05pt;">a</span>o mạch<span style="letter-spacing: 0.65pt;"> </span>phổi<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.3pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.7pt;"> </span>tăng<span style="letter-spacing: 0.8pt;"></span>lên.<span style="letter-spacing: 0.4pt;"> </span>Hậu<span style="letter-spacing: 2.3pt;"> </span>quả<span style="letter-spacing: 1.5pt;"> </span>là<span style="letter-spacing: -0.2pt;"> </span>làm<span style="letter-spacing: 1.55pt;"> </span>tăng <span style="letter-spacing: 1pt;"><span> </span></span>áp<span style="letter-spacing: 0.3pt;"> </span>lực<span style="letter-spacing: 0.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: 0.05pt;"> </span>phải<span style="letter-spacing: 0.8pt;"> </span>rồi<span style="letter-spacing: 0.95pt;"> </span>nhĩ<span style="letter-spacing: 0.85pt;"> </span>phải,<span style="letter-spacing: 0.4pt;"> </span>cuối<span style="letter-spacing: 0.9pt;"> </span>cùng gây<span style="letter-spacing: 1.05pt;"> </span>suy<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>phải.<span style="letter-spacing: 1.1pt;"> </span>Sau<span style="letter-spacing: -0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ời<span style="letter-spacing: 0.5pt;"> </span>gian<span style="letter-spacing: 0.5pt;"> </span>dài,<span style="letter-spacing: 1.2pt;"> </span>thất<span style="letter-spacing: 2.6pt;"> </span>trái<span style="letter-spacing: 1pt;"> </span>giãn<span style="letter-spacing: 1.7pt;"> </span>ra<span style="letter-spacing: 0.6pt;"></span>gây<span style="letter-spacing: 1.5pt;"> </span>giãn<span style="letter-spacing: 0.6pt;"> </span>vòng<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>2<span style="letter-spacing: 0.75pt;"> </span>lá<span style="letter-spacing: 0.4pt;"> </span>tạo<span style="letter-spacing: 1.35pt;"> </span>nên <span style="letter-spacing: 0.7pt;"><span> </span></span>hở<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>2<span style="letter-spacing: 0.75pt;"> </span>lá<span style="letter-spacing: 0.4pt;"> </span>cơ năng.<span style="letter-spacing: 0.85pt;"> </span>Do<span style="letter-spacing: 0.3pt;"> </span>áp<span style="letter-spacing: 1.35pt;"> </span>lực<span style="letter-spacing: 0.45pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>trái<span style="letter-spacing: 0.25pt;"> </span>tăng<span style="letter-spacing: 2.15pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>thời<span style="letter-spacing: 0.4pt;"> </span>kỳ<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>thu<span style="letter-spacing: 0.35pt;"> </span>nên<span style="letter-spacing: 0.95pt;"> </span>dòng<span style="letter-spacing: 1.05pt;"> </span>máu<span style="letter-spacing: 1.3pt;"> </span>lên<span style="letter-spacing: 1.4pt;"> </span>nhĩ<span style="letter-spacing: 1.55pt;"></span>trái<span style="letter-spacing: 0.45pt;"> </span>do<span style="letter-spacing: 0.5pt;"> </span>hở<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>2<span style="letter-spacing: 0.6pt;"> </span>lá<span style="letter-spacing: 1.45pt;"> </span>sẽ<span style="letter-spacing: -0.15pt;"> </span>nhiều, càng<span style="letter-spacing: 1.5pt;"> </span>làm<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.05pt;">ă</span>ng <span style="letter-spacing: 0.05pt;"><span> </span></span>áp<span style="letter-spacing: -0.2pt;"> </span>lực<span style="letter-spacing: 0.35pt;"> </span>tĩnh<span style="letter-spacing: 1.05pt;"> </span>mạch,<span style="letter-spacing: 0.85pt;"> </span>m<span style="letter-spacing: -0.05pt;">a</span>o<span style="letter-spacing: 0.25pt;"> </span>mạch<span style="letter-spacing: 0.85pt;"> </span>phổi<span style="letter-spacing: 0.9pt;"> </span>gây<span style="letter-spacing: 0.85pt;"> </span>ứ<span style="letter-spacing: 0.5pt;"> </span>trệ<span style="letter-spacing: -0.3pt;"> </span>máu<span style="letter-spacing: 0.9pt;"> </span>ở<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 0.9pt;"> </span>tăng<span style="letter-spacing: 1.05pt;"> </span>lên,<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>thể<span style="letter-spacing: -0.25pt;"> </span>gây<span style="letter-spacing: 0.85pt;"></span>hen<span style="letter-spacing: 0.35pt;"> </span>tim, phù phổi.<span style="letter-spacing: 0.8pt;"> </span>ở<span style="letter-spacing: -0.75pt;"> </span>bệnh<span style="letter-spacing: -0.15pt;"> </span>nhân<span style="letter-spacing: 2.2pt;"> </span>bị<span style="letter-spacing: 0.35pt;"> </span>hẹp<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 1.15pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>chủ<span style="letter-spacing: 0.2pt;"> </span>mức<span style="letter-spacing: 0.35pt;"> </span>độ<span style="letter-spacing: 1.1pt;"> </span>nặng,<span style="letter-spacing: 0.3pt;"> </span>phì <span style="letter-spacing: 0.45pt;"><span> </span></span>đại<span style="letter-spacing: -0.45pt;"> </span>thất<span style="letter-spacing: 2.45pt;"> </span>trái<span style="letter-spacing: 1.1pt;"> </span>làm<span style="letter-spacing: 1.3pt;"> </span>khối<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.1pt;">l</span>ượng cơ<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>tăng<span style="letter-spacing: 1.2pt;"></span>lên;<span style="letter-spacing: 0.75pt;"> </span>tăng<span style="letter-spacing: 1.2pt;"> </span>co<span style="letter-spacing: 0.55pt;"> </span>bóp<span style="letter-spacing: 1pt;"> </span>cơ<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>làm<span style="letter-spacing: 1.15pt;"> </span>nhu<span style="letter-spacing: 0.65pt;"> </span>cầu<span style="letter-spacing: 0.5pt;"> </span>o<span style="letter-spacing: -0.05pt;">x</span>y<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: 0.3pt;"> </span>cơ<span style="letter-spacing: 1.25pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>cũng<span style="letter-spacing: 0.2pt;"> </span>tă<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 2.35pt;"> </span>lên;<span style="letter-spacing: 1.9pt;"> </span>áp<span style="letter-spacing: -0.25pt;"> </span>lực<span style="letter-spacing: 0.5pt;"> </span>trong<span style="letter-spacing: 0.4pt;"> </span>buồng thất <span style="letter-spacing: 0.1pt;"><span> </span></span>tăng<span style="letter-spacing: -0.85pt;"> </span>làm<span style="letter-spacing: 1.7pt;"> </span>ép<span style="letter-spacing: 0.25pt;"> </span>c<span style="letter-spacing: -0.05pt;">á</span>c<span style="letter-spacing: 0.9pt;"> </span>nhánh<span> </span>động <span style="letter-spacing: 0.1pt;"><span> </span></span>mạch<span style="letter-spacing: 2.2pt;"> </span>vành<span style="letter-spacing: 1.35pt;"> </span>nhỏ<span style="letter-spacing: 1.7pt;"> </span>lại<span style="letter-spacing: 1.9pt;"> </span>cộng<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ới<span style="letter-spacing: 0.75pt;"> </span>lưu<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ượng<span style="letter-spacing: 1.2pt;"> </span>máu<span style="letter-spacing: 1.6pt;"> </span>vào<span style="letter-spacing: 0.6pt;"> </span>động <span style="letter-spacing: 0.1pt;"><span> </span></span>mạch<span style="letter-spacing: 2.2pt;"> </span>chủ giảm<span style="letter-spacing: 1.05pt;"> </span>do<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.25pt;"> </span>lỗ<span style="letter-spacing: 1.25pt;"> </span>van<span style="letter-spacing: 0.15pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>chủ<span style="letter-spacing: 0.3pt;"> </span>(<span style="letter-spacing: 0.1pt;">l</span>ượng<span style="letter-spacing: 0.65pt;"> </span>máu<span style="letter-spacing: 1.05pt;"></span><span style="letter-spacing: -0.05pt;">v</span>ào<span style="letter-spacing: 0.65pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>chủ<span style="letter-spacing: 0.25pt;"> </span>ít)<span style="letter-spacing: 1.15pt;"> </span>sẽ<span style="letter-spacing: -0.1pt;"> </span>làm<span style="letter-spacing: 0.65pt;"> </span>giảm<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: -0.1pt;">l</span>ưu<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ượng<span style="letter-spacing: 0.6pt;"> </span>máu <span style="position: relative; top: 0.5pt;">đến<span style="letter-spacing: -0.45pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>vành<span style="letter-spacing: -0.15pt;"> </span>gây<span style="letter-spacing: 0.8pt;"> </span>nên<span style="letter-spacing: 0.8pt;"> </span>đau<span style="letter-spacing: 0.2pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>mà<span style="letter-spacing: -0.5pt;"> </span>không<span style="letter-spacing: 2.05pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>thực<span style="letter-spacing: -0.2pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>vành.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Vì<span style="letter-spacing: -1.05pt;"> </span>hẹp lỗ<span style="letter-spacing: 1.5pt;"> </span>van<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>chủ,<span style="letter-spacing: 0.5pt;"> </span>lượng<span style="letter-spacing: 0.9pt;"> </span>máu<span style="letter-spacing: 1.3pt;"> </span>vào<span style="letter-spacing: 0.3pt;"> </span>động<span style="letter-spacing: 2.4pt;"> </span>mạch<span style="letter-spacing: 1.9pt;"> </span>chủ<span style="letter-spacing: 0.55pt;"> </span>thời<span style="letter-spacing: 0.7pt;"> </span>kỳ<span style="letter-spacing: 0.9pt;"> </span>tâm<span style="letter-spacing: 1.25pt;"> </span>thu<span style="letter-spacing: 0.75pt;"> </span>giảm<span style="letter-spacing: 1pt;"> </span>gây<span style="letter-spacing: 1.45pt;"> </span>thiếu máu<span style="letter-spacing: 0.7pt;"> </span>não,<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>ngất<span style="letter-spacing: 1.85pt;"></span>ở người bị<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng,<span style="letter-spacing: -0.25pt;"> </span>nhất<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Do<span style="letter-spacing: 0.45pt;"> </span>dòng<span style="letter-spacing: 1.2pt;"> </span>máu<span style="letter-spacing: 1.15pt;"> </span>qua<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>lỗ<span style="letter-spacing: 1.35pt;"> </span>động<span style="letter-spacing: 1.35pt;"> </span>mạch<span style="letter-spacing: 0.8pt;"> </span>chủ<span style="letter-spacing: 0.45pt;"> </span>bị<span style="letter-spacing: 1.3pt;"> </span>hẹp<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>tốc<span style="letter-spacing: 1.3pt;"> </span>độ<span style="letter-spacing: 1.3pt;"> </span>rất<span style="letter-spacing: 2.65pt;"> </span>lớn<span style="letter-spacing: 0.6pt;"> </span>nên<span style="letter-spacing: 1.1pt;"> </span>t<span style="letter-spacing: 0.05pt;">h</span><span style="letter-spacing: -0.05pt;">ư</span>ờng<span style="letter-spacing: 0.8pt;"> </span>các <span style="letter-spacing: 0.15pt;"><span> </span></span>lá<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: 0.35pt;"> </span>bị<span style="letter-spacing: 1.35pt;"> </span>vôi hoá,<span style="letter-spacing: 0.45pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>nguy cơ<span style="letter-spacing: 0.6pt;"></span>tắc<span style="letter-spacing: -0.15pt;"> </span>các<span style="letter-spacing: -0.8pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>(động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>vành,<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>vi...).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.<span style="letter-spacing: -0.1pt;"> </span>Lâm<span style="letter-spacing: -0.5pt;"> </span>sàng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.1.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>n<span style="letter-spacing: 0.05pt;">ă</span>ng:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.1pt;"> </span>một<span style="letter-spacing: 0.3pt;"> </span>thời<span style="letter-spacing: 0.3pt;"> </span>gian<span style="letter-spacing: 0.3pt;"> </span>dài,<span style="letter-spacing: 1pt;"> </span>bệnh<span style="letter-spacing: -0.2pt;"> </span>tiến<span style="letter-spacing: -0.25pt;"> </span>triển<span style="letter-spacing: -0.2pt;"> </span>âm<span style="letter-spacing: 0.85pt;"> </span>thầm<span style="letter-spacing: 0.25pt;"> </span>không<span style="letter-spacing: 0.75pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>triệu<span style="letter-spacing: -0.2pt;"> </span>chứng<span style="letter-spacing: 0.2pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>năng. <span style="letter-spacing: 0.05pt;"><span> </span></span>Vì<span style="letter-spacing: 0.9pt;"> </span>vậy,<span style="letter-spacing: 1.95pt;"> </span>hẹp<span style="letter-spacing: -0.4pt;"> </span>lỗ van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"></span>thường được<span style="letter-spacing: 0.2pt;"> </span>phát<span style="letter-spacing: 1.25pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>tình<span style="letter-spacing: 0.3pt;"> </span>cờ<span style="letter-spacing: -0.1pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>dịp<span style="letter-spacing: 0.4pt;"> </span>khám<span style="letter-spacing: 0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường qui.<o:p></o:p> </span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Ở<span style="letter-spacing: -1.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng,<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>cơ<span style="letter-spacing: -0.4pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gặp<span style="letter-spacing: -0.35pt;"> </span>là:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.5pt;"> </span>Cơn<span style="letter-spacing: 0.95pt;"> </span>đau<span style="letter-spacing: 0.95pt;"> </span>ngực<span style="letter-spacing: 0.3pt;"> </span>khi<span style="letter-spacing: 0.4pt;"> </span>gắng<span style="letter-spacing: 0.25pt;"> </span>sức<span style="letter-spacing: 0.55pt;"> </span>là<span style="letter-spacing: 1.4pt;"> </span>triệu<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: 0.25pt;"> </span>rất<span style="letter-spacing: 2.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.5pt;"> </span>gặp.<span style="letter-spacing: 0.3pt;"> </span>Thường<span style="letter-spacing: 0.55pt;"> </span>đau<span style="letter-spacing: 0.95pt;"> </span>lan<span style="letter-spacing: 0.4pt;"> </span>lên<span style="letter-spacing: 0.95pt;"> </span>cổ<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.55pt;"> </span>cánh<span style="letter-spacing: 0.95pt;"> </span>tay trái.<span style="letter-spacing: 0.45pt;"> </span>Triệu<span style="letter-spacing: -1.05pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>đau<span style="letter-spacing: 0.4pt;"></span>ngực<span style="letter-spacing: -0.25pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>theo<span style="letter-spacing: -0.3pt;"> </span>tuổi<span style="letter-spacing: 0.55pt;"> </span>vì<span style="letter-spacing: -0.05pt;"> </span>quá<span style="letter-spacing: 0.5pt;"> </span>trình<span style="letter-spacing: 2.5pt;"> </span>xơ<span style="letter-spacing: 0.35pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>vành<span style="letter-spacing: -0.45pt;"> </span>tăng<span style="letter-spacing: 1.05pt;"> </span>lên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.4pt;"> </span>Ngất<span style="letter-spacing: 2.15pt;"> </span>khi<span style="letter-spacing: 0.3pt;"> </span>gắng<span style="letter-spacing: 0.2pt;"> </span>sức,<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>đi<span style="letter-spacing: 1.15pt;"> </span>sau<span style="letter-spacing: 0.45pt;"> </span>một<span style="letter-spacing: 0.25pt;"> </span>cơn<span style="letter-spacing: 0.85pt;"> </span>đau<span style="letter-spacing: 0.85pt;"> </span>thắt<span style="letter-spacing: 0.25pt;"> </span>ngực.<span style="letter-spacing: 0.2pt;"> </span>Có<span style="letter-spacing: 0.6pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>co<span style="letter-spacing: 0.35pt;"> </span>giật,<span style="letter-spacing: 2.35pt;"> </span>đôi<span style="letter-spacing: 1.25pt;"> </span>khi<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.25pt;"> </span>nhân chỉ<span style="letter-spacing: 0.75pt;"> </span>cảm<span style="letter-spacing: 0.2pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>xỉu<span style="letter-spacing: 0.95pt;"> </span>đi, cảm<span style="letter-spacing: 0.45pt;"> </span>giác<span style="letter-spacing: 0.45pt;"> </span>sương mù<span style="letter-spacing: -0.3pt;"> </span>trước<span style="letter-spacing: -0.05pt;"> </span>m<span style="letter-spacing: -0.05pt;">ặ</span>t.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Lâu<span style="letter-spacing: 1.5pt;"> </span>dài<span style="letter-spacing: -0.25pt;"> </span>sẽ<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>cơ<span style="letter-spacing: -0.4pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>như khó<span style="letter-spacing: 0.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức, có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở kịch<span style="letter-spacing: 1.05pt;"> </span>phát,<span style="letter-spacing: -0.2pt;"> </span>ho,<span style="letter-spacing: -0.15pt;"> </span>phù...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; letter-spacing: 0.3pt;">4.2</span><span lang="EN" style="font-weight: bold;">.<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">Triệ</span>u<span style="letter-spacing: 2.45pt;"> </span><span style="letter-spacing: 0.3pt;">chứn</span>g<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: 0.3pt;">thự</span>c<span style="letter-spacing: 2.45pt;"> </span><span style="letter-spacing: 0.3pt;">th</span><span style="letter-spacing: 0.35pt;">ể</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: 0.3pt;">Tron</span><span lang="EN">g<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.3pt;">hẹ</span>p<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>ỗ<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">chủ</span>,<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">triệ</span>u<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">chứn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.3pt;">thự</span>c<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>ể<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.2pt;">l</span>à <span style="letter-spacing: 0.1pt;"><span> </span></span><span style="letter-spacing: 0.3pt;">triệ</span>u<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">chứn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.3pt;">qua</span>n<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">trọn</span>g<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: 0.3pt;">giú</span>p<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">ích ch</span>o<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">chẩ</span>n<span style="letter-spacing: 2.45pt;"> </span><span style="letter-spacing: 0.3pt;">đoán.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.85pt;"> </span>Triệu<span style="letter-spacing: -0.2pt;"> </span>chứng<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span>giá<span style="letter-spacing: 1.2pt;"> </span>trị<span style="letter-spacing: 1.55pt;"> </span>nhất<span style="letter-spacing: 2.7pt;"> </span>là<span style="letter-spacing: 1.7pt;"> </span>nghe<span style="letter-spacing: 0.6pt;"> </span>thấy<span style="letter-spacing: 2.7pt;"> </span>tiếng<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>hổi<span style="letter-spacing: 1.35pt;"> </span>tâm<span style="letter-spacing: 1.15pt;"> </span>thu<span style="letter-spacing: 0.65pt;"> </span>mạnh<span style="letter-spacing: 1.15pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>liên<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.05pt;">s</span>ườn<span style="letter-spacing: 0.85pt;"> </span>II<span style="letter-spacing: 0.85pt;"> </span>cạnh<span style="letter-spacing: 1.25pt;"> </span>bờ<span style="letter-spacing: 0.85pt;"> </span>phải xương<span style="letter-spacing: 0.3pt;"> </span>ức<span style="letter-spacing: 0.2pt;"> </span>và<span style="letter-spacing: -0.3pt;"> </span>liên <span style="letter-spacing: 0.05pt;"><span> </span>s</span>ườn<span style="letter-spacing: 0.3pt;"></span>III<span style="letter-spacing: 0.3pt;"> </span>cạnh<span style="letter-spacing: 0.7pt;"> </span>bờ<span style="letter-spacing: 0.3pt;"> </span>trái<span style="letter-spacing: 0.85pt;"> </span>xương<span style="letter-spacing: 0.3pt;"> </span>ức.<span style="letter-spacing: 0.15pt;"> </span>Tiếng<span style="letter-spacing: -0.85pt;"> </span>thổi<span style="letter-spacing: 0.85pt;"> </span>này<span style="letter-spacing: 0.8pt;"> </span>lan<span style="letter-spacing: 0.15pt;"> </span>l<span style="letter-spacing: 0.05pt;">ê</span>n<span style="letter-spacing: 0.65pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>c<span style="letter-spacing: -0.05pt;">ả</span>nh,<span style="letter-spacing: 0.6pt;"> </span>nghe<span style="letter-spacing: 0.05pt;"> </span>rõ<span style="letter-spacing: 0.95pt;"> </span>cả ở<span style="letter-spacing: 1.15pt;"> </span>hõm<span style="letter-spacing: 1.75pt;"> </span>trên<span style="letter-spacing: -0.95pt;"> </span>ức;<span style="letter-spacing: 1pt;"> </span>bắt<span style="letter-spacing: 1pt;"> </span>đầu<span style="letter-spacing: 1.5pt;"> </span>sau<span style="letter-spacing: 1.15pt;"> </span>tiếng<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">T</span>1<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">và</span>i<span style="letter-spacing: -1.35pt;"><span> </span></span><span style="letter-spacing: 0.35pt;">m</span><span style="letter-spacing: 0.25pt;">i</span><span style="letter-spacing: 0.35pt;">li</span><span style="letter-spacing: 0.3pt;">g</span><span style="letter-spacing: 0.25pt;">i</span><span style="letter-spacing: 0.3pt;">ây</span>, <span style="letter-spacing: -1.4pt;"><span> </span></span><span style="letter-spacing: 0.35pt;">m</span><span style="letter-spacing: 0.3pt;">ạn</span>h <span style="letter-spacing: -1.45pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">n</span><span style="letter-spacing: 0.3pt;">hấ</span>t <span style="letter-spacing: -1.35pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">l</span>à <span style="letter-spacing: -1.35pt;"><span> </span></span>ở<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.3pt;">g</span><span style="letter-spacing: 0.35pt;">i</span><span style="letter-spacing: 0.25pt;">ữ</span>a<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.3pt;">v</span>à <span style="letter-spacing: -1.35pt;"><span> </span></span><span style="letter-spacing: 0.3pt;">cu</span><span style="letter-spacing: 0.25pt;">ố</span>i<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.25pt;">â</span>m <span style="letter-spacing: -1.35pt;"><span> </span></span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.3pt;">h</span>u<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">r</span><span style="letter-spacing: 0.25pt;">ồ</span>i<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.25pt;">k</span><span style="letter-spacing: 0.3pt;">ế</span>t <span style="letter-spacing: 0.3pt;">thú</span>c<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: 0.3pt;">nga</span>y<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">t</span><span style="letter-spacing: 0.25pt;">r</span><span style="letter-spacing: 0.3pt;">ướ</span>c<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">tiến</span>g<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.3pt;">T2</span>.<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.3pt;">Tiến</span>g<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: 0.3pt;">thổ</span>i<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.25pt;">tâ</span>m<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">nà</span>y<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">cườn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>ộ<span style="letter-spacing: 0.7pt;"></span><span style="letter-spacing: 0.25pt;">giả</span>m<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.3pt;">kh</span>i<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">su</span>y<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">trái</span>,<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.25pt;">kh</span>í<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.3pt;">phế thũng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tiếng<span style="letter-spacing: -0.6pt;"> </span>thổi<span style="letter-spacing: 1.1pt;"> </span>tâm<span style="letter-spacing: 0.9pt;"> </span>thu<span style="letter-spacing: 0.4pt;"> </span>của<span style="letter-spacing: 0.2pt;"> </span>hẹp<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 1.15pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>hủ<span style="letter-spacing: 0.25pt;"> </span>nghe<span style="letter-spacing: 0.3pt;"> </span>rõ<span style="letter-spacing: 1.2pt;"> </span>lên<span style="letter-spacing: 0.95pt;"> </span>sau<span style="letter-spacing: 0.55pt;"> </span>khi<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>gửi<span style="letter-spacing: 0.4pt;"> </span>amylnitrit,<span style="letter-spacing: 0.05pt;"> </span>khi<span style="letter-spacing: 0.4pt;"> </span>ngồi bó<span style="letter-spacing: 0.55pt;"> </span>gối.<span style="letter-spacing: 0.55pt;"> </span>Tiếng<span style="letter-spacing: -1.15pt;"> </span>thổi<span style="letter-spacing: 0.55pt;"> </span>này<span style="letter-spacing: 0.5pt;"> </span>nhỏ<span style="letter-spacing: 0.5pt;"></span>đi<span style="letter-spacing: 0.7pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>nghiệm<span style="letter-spacing: -0.75pt;"> </span>pháp<span style="letter-spacing: 0.4pt;"> </span>Valsal<span style="letter-spacing: -0.05pt;">v</span>a.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Có<span style="letter-spacing: 0.7pt;"> </span>thể<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>tiếng<span style="letter-spacing: -0.2pt;"> </span>clíc<span style="letter-spacing: 1.1pt;"> </span>đầu<span style="letter-spacing: 0.5pt;"> </span>tâm<span style="letter-spacing: 1.1pt;"> </span>thu<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>mở<span style="letter-spacing: 0.4pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>chủ,<span style="letter-spacing: 0.15pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ường<span style="letter-spacing: 0.55pt;"> </span>xuất<span style="letter-spacing: 2.4pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>sau<span style="letter-spacing: 0.55pt;"> </span>tiếng<span style="letter-spacing: -0.2pt;"> </span>T1<span style="letter-spacing: 0.15pt;"> </span>từ<o:p></o:p> 0,04-<span style="letter-spacing: 0.95pt;"></span>0,10<span style="letter-spacing: 0.95pt;"> </span>giây.<span style="letter-spacing: -1.1pt;"> </span>Tiếng<span style="letter-spacing: -0.2pt;"></span>clic<span style="letter-spacing: 0.8pt;"> </span>mất<span style="letter-spacing: 2.85pt;"> </span>đi<span style="letter-spacing: 1.65pt;"> </span>k<span style="letter-spacing: 0.05pt;">h</span>i<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>chủ<span style="letter-spacing: 0.6pt;"> </span>đã<span style="letter-spacing: -0.45pt;"> </span>bị<span style="letter-spacing: 2.2pt;"> </span>xơ <span style="letter-spacing: 0.05pt;"><span></span></span>dày, <span style="letter-spacing: 1.25pt;"><span></span></span>vôi<span style="letter-spacing: 0.25pt;"><span> </span></span>hoá <span style="letter-spacing: 0.55pt;"><span> </span></span>nhiều.<span style="letter-spacing: 0.05pt;"> </span>Tiếng<span style="letter-spacing: -0.2pt;"> </span>thổi tâm<span style="letter-spacing: -1.1pt;"> </span>thu<span style="letter-spacing: 0.95pt;"> </span>ở<span style="letter-spacing: 1.1pt;"> </span>liên<span style="letter-spacing: -1.1pt;"> </span>sườn<span style="letter-spacing: 1.1pt;"> </span>II<span style="letter-spacing: 1.1pt;"> </span>cạnh<span style="letter-spacing: 1.5pt;"> </span>bờ<span style="letter-spacing: 1.1pt;"> </span>phải<span style="letter-spacing: 1.6pt;"> </span>xương<span style="letter-spacing: 1.1pt;"></span>ức<span style="letter-spacing: 1pt;"> </span>bao<span style="letter-spacing: 0.95pt;"> </span>giờ<span style="letter-spacing: 0.95pt;"> </span>cũng<span style="letter-spacing: 0.65pt;"> </span>xuất<span style="letter-spacing: 2.95pt;"> </span>hiện<span style="letter-spacing: 0.25pt;"> </span>sau<span style="letter-spacing: 1.1pt;"> </span>tiếng<span style="letter-spacing: 0.35pt;"> </span>clic<span style="letter-spacing: 0.95pt;"> </span>mở<span style="letter-spacing: 0.95pt;"> </span>van<span style="letter-spacing: 0.6pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>chủ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Khi<span style="letter-spacing: -0.2pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng,<span style="letter-spacing: -0.25pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>T2<span style="letter-spacing: -0.4pt;"> </span>thường mờ<span style="letter-spacing: -0.15pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>mất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>ngựa<span style="letter-spacing: -0.25pt;"> </span>phi<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Thườn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">s</span>ờ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.3pt;">run</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">mi</span>u<span style="letter-spacing: -0.8pt;"> </span>ở<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">liê</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.25pt;">s</span><span style="letter-spacing: -0.3pt;">ườ</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">I</span>I<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">cạn</span>h <span style="letter-spacing: -0.3pt;">b</span>ờ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>i <span style="letter-spacing: -0.3pt;">xươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ức</span>,<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">liê</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">sườ</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">II</span>I<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">c</span><span style="letter-spacing: -0.3pt;">ạn</span>h<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>ờ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i <span style="letter-spacing: -0.3pt;">xươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ứ</span>c<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">và</span><o:p></o:p></span><span lang="EN" style="letter-spacing: -0.3pt;"> h</span><span lang="EN">ố<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">trê</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">xươn</span>g<span style="letter-spacing: -0.6pt;"></span><span style="letter-spacing: -0.3pt;">ức</span>,<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">nhấ</span>t<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>à<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">chuyể</span>n<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>ừ<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">th</span>ế<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">đứn</span>g<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">san</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ngồi.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.1pt;"> </span>Trương<span style="letter-spacing: 1.1pt;"> </span>lực<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 2pt;"> </span>mạch<span style="letter-spacing: 1.45pt;"> </span>ngoại<span style="letter-spacing: 1.45pt;"> </span>vi<span style="letter-spacing: 0.65pt;"> </span>yếu,<span style="letter-spacing: 0.25pt;"> </span>tốc<span style="letter-spacing: 1.65pt;"> </span>độ<span style="letter-spacing: 1.5pt;"> </span>nảy<span style="letter-spacing: 1.85pt;"> </span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 1.45pt;"> </span>rất<span> </span>chậm,<span style="letter-spacing: 3pt;"> </span>sau<span style="letter-spacing: 1.05pt;"> </span>đó<span style="letter-spacing: -1.05pt;"> </span>lại<span style="letter-spacing: 0.85pt;"> </span>giảm <span style="letter-spacing: 0.55pt;"><span> </span></span>nhanh. Huyết<span style="letter-spacing: -0.9pt;"> </span>áp<span style="letter-spacing: -0.35pt;"> </span>tâm<span style="letter-spacing: 1.95pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.9pt;"></span>mạch<span style="letter-spacing: 0.35pt;"> </span>giảm<span style="letter-spacing: 0.1pt;"> </span>nhưng huyết<span style="letter-spacing: -0.8pt;"> </span>áp<span style="letter-spacing: -0.35pt;"> </span>tâm<span style="letter-spacing: 1.95pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ương bình<span style="letter-spacing: 0.25pt;"> </span>thường.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.3.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cận <span style="letter-spacing: 0.2pt;"><span> </span></span>lâm<span style="letter-spacing: -0.8pt;"> </span>sàng:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.5pt;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">4.3.1.<span style="letter-spacing: -0.25pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tim:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+ Dày<span style="letter-spacing: 0.55pt;"> </span>thất<span style="letter-spacing: 1.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ái<span style="letter-spacing: -0.3pt;"> </span>(tăng<span style="letter-spacing: 2.05pt;"> </span>gá<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 0.7pt;"> </span>tâm<span style="letter-spacing: 1.05pt;"> </span>thu<span style="letter-spacing: -0.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: -0.2pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span><span style="letter-spacing: 0.05pt;">i</span>)<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.15pt;">h</span>ường<span style="letter-spacing: 0.05pt;"> </span>rất<span style="letter-spacing: 1.95pt;"> </span>điển<span style="letter-spacing: -0.05pt;"> </span>hình<span style="letter-spacing: 1.1pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>bệnh<span style="letter-spacing: -0.65pt;"> </span>nhân<span style="letter-spacing: 1.7pt;"> </span>bị<span style="letter-spacing: -0.15pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>lỗ<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"></span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Chỉ<span style="letter-spacing: 0.4pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>Sokolow-Lyon<span style="letter-spacing: 0.1pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>35 mm<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">(SV<span style="position: relative; top: 2.5pt;">1</span></span>+<span style="letter-spacing: -0.95pt;"> </span>RV<span style="position: relative; top: 2.5pt;">5<span style="letter-spacing: 1.45pt;"> </span></span>><span style="letter-spacing: -0.05pt;"> </span>35 mm).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Trục<span style="letter-spacing: -0.7pt;"> </span>QRS<span style="letter-spacing: -0.7pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>sang trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">Són</span>g<span style="letter-spacing: 0.35pt;"> </span>T<span style="letter-spacing: 0.25pt;"> â</span>m<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.25pt;">tín</span>h<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.25pt;">v</span>à<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: 0.25pt;">khôn</span>g <span style="letter-spacing: 0.65pt;"><span></span></span><span style="letter-spacing: 0.25pt;">đố</span>i<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.3pt;">xứn</span>g<span style="letter-spacing: 0.6pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">cá</span>c<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.25pt;">đạ</span>o<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: 0.25pt;">trìn</span>h <span style="letter-spacing: 1.45pt;"><span></span></span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">trái</span>:<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.2pt;">D</span><span style="letter-spacing: 0.35pt; position: relative; top: 2.5pt;">1</span>,<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">a</span><span style="letter-spacing: 0.25pt;">V</span><span style="letter-spacing: 0.3pt;">L</span>,<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">V</span><span style="position: relative; top: 2.5pt;">5 <span style="letter-spacing: 0.15pt;"><span> </span></span></span><span style="letter-spacing: 0.2pt;">v</span>à<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.25pt;">V</span><span style="letter-spacing: 0.35pt; position: relative; top: 2.5pt;">6</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thời<span style="letter-spacing: -0.45pt;"> </span>gian<span style="letter-spacing: -0.2pt;"> </span>xuất<span style="letter-spacing: 1.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>nhánh<span style="letter-spacing: 0.35pt;"> </span>nội<span style="letter-spacing: -0.1pt;"> </span>điện<span style="letter-spacing: 0.4pt;"> </span>muộn<span style="letter-spacing: -0.25pt;"> </span>ở các<span style="letter-spacing: 1.45pt;"> </span>đạo<span style="letter-spacing: -0.5pt;"> </span>trình <span style="letter-spacing: 1.55pt;"><span></span></span>trước ngực<span style="letter-spacing: -0.25pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span>i<span style="letter-spacing: 0.6pt;"> </span>(<span style="letter-spacing: -0.05pt;">V</span><span style="position: relative; top: 2.5pt;">5 </span><span style="letter-spacing: 0.2pt;">v</span>à<span style="letter-spacing: 1.5pt;"> </span>V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">6</span>).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Có<span style="letter-spacing: 0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">Kh</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">run</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">th</span>ì<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.3pt;">cầ</span>n<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">ngh</span>ĩ<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span><span style="letter-spacing: -0.3pt;">ế</span>n<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">hẹ</span>p<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.3pt;">l</span>ỗ <span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span>2<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>á<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">kế</span>t <span style="letter-spacing: 0.6pt;"><span> </span></span><span style="letter-spacing: -0.3pt;">hợp</span>;<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">tiê</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">l</span><span style="letter-spacing: -0.35pt;">ư</span><span style="letter-spacing: -0.3pt;">ợn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">xấu.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.3pt;">Ha</span>y<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">blố</span>c <span style="letter-spacing: -0.25pt;">nhán</span>h<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.25pt;">hoà</span>n<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">toà</span>n<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">hoà</span>n <span style="letter-spacing: 0.3pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">toà</span>n<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">blố</span>c <span style="letter-spacing: -0.3pt;">nhĩ-thất.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">4.3.2.<span style="letter-spacing: -0.25pt;"> </span>X<span style="letter-spacing: -0.7pt;"> </span>quang.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Quai<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>giãn<span style="letter-spacing: 0.45pt;"> </span>sau chỗ<span style="letter-spacing: 0.65pt;"> </span>hẹp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Vôi<span style="letter-spacing: 0.85pt;"> </span>hoá<span style="letter-spacing: 0.05pt;"> </span>ở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>động <span style="letter-spacing: 0.55pt;"><span> </span></span>mạch <span style="letter-spacing: 0.2pt;"><span> </span></span>chủ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.85pt;"> </span>t<span style="letter-spacing: -0.1pt;">o</span>:<span style="letter-spacing: 0.1pt;"> </span>cung<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ưới<span style="letter-spacing: 0.3pt;"> </span>trái<span style="letter-spacing: 0.85pt;"> </span>to<span style="letter-spacing: 0.1pt;"> </span>hơn<span style="letter-spacing: 0.7pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>phim<span style="letter-spacing: 0.05pt;"> </span>tim-p<span style="letter-spacing: -0.05pt;">h</span>ổi<span style="letter-spacing: 0.6pt;"> </span>thẳng<span style="letter-spacing: 2.3pt;"> </span>và<span style="letter-spacing: -0.65pt;"> </span>giảm<span style="letter-spacing: 1.9pt;"> </span>khoả<span style="letter-spacing: -0.05pt;">n</span>g <span style="letter-spacing: 1.3pt;"><span> </span></span>sáng<span style="letter-spacing: 1.55pt;"> </span>sau<span style="letter-spacing: 0.3pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>phim nghiêng <span style="letter-spacing: 0.05pt;"><span> </span></span>trái.<span style="letter-spacing: -0.4pt;"> </span>Tuy nhiên,<span style="letter-spacing: 0.6pt;"></span>ở<span style="letter-spacing: 0.4pt;"> </span>b<span style="letter-spacing: 0.05pt;">ệ</span>nh<span style="letter-spacing: -0.3pt;"> </span>nhân<span style="letter-spacing: 2.05pt;"> </span>bị<span style="letter-spacing: 0.2pt;"> </span>hẹp<span style="letter-spacing: -0.5pt;"> </span>lỗ<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>chủ<span style="letter-spacing: 0.05pt;"> </span>thì<span style="letter-spacing: 0.8pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>phì <span style="letter-spacing: 0.5pt;"><span> </span></span>đại<span style="letter-spacing: -0.35pt;"> </span>đồng<span style="letter-spacing: 2.4pt;"> </span>tâm,<span style="letter-spacing: 1.95pt;"> </span>ít<span style="letter-spacing: -0.05pt;"> </span>giãn buồng<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>ở giai<span style="letter-spacing: -0.2pt;"> </span>đoạn<span style="letter-spacing: -0.65pt;"> </span>đầu<span style="letter-spacing: 1.35pt;"> </span>nên<span style="letter-spacing: 1.85pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: -0.15pt;"></span>không<span style="letter-spacing: 2.4pt;"> </span>quá<span style="letter-spacing: 0.05pt;"> </span>to<span style="letter-spacing: -0.2pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>X<span style="letter-spacing: -0.15pt;"> </span>quang.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ứ<span style="letter-spacing: 1.5pt;"> </span>đọng<span style="letter-spacing: 1.1pt;"> </span>máu<span style="letter-spacing: -0.4pt;"> </span>ở phổi<span style="letter-spacing: 0.4pt;"> </span>th<span style="letter-spacing: -0.05pt;">ư</span>ờng xuất<span style="letter-spacing: 1.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>muộn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">4.3.3.<span style="letter-spacing: -0.25pt;"> </span>Tâm<span style="letter-spacing: 0.2pt;"> </span>thanh<span style="letter-spacing: 2.4pt;"> </span>đồ:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tâm<span style="letter-spacing: 1.2pt;"> </span>thanh<span style="letter-spacing: 0.65pt;"> </span>đồ<span style="letter-spacing: -1.2pt;"> </span>ghi<span style="letter-spacing: 0.75pt;"> </span>được<span style="letter-spacing: 1.75pt;"> </span>một<span style="letter-spacing: 0.7pt;"> </span>tiếng<span style="letter-spacing: 0.15pt;"> </span>thổi<span style="letter-spacing: 1.45pt;"> </span>tâm<span style="letter-spacing: 1.25pt;"> </span>thu<span style="letter-spacing: 0.75pt;"> </span>dạng<span style="letter-spacing: 1.3pt;"> </span>tống<span style="letter-spacing: 1.5pt;"> </span>máu<span style="letter-spacing: 1.3pt;"> </span>hình<span style="letter-spacing: -1.2pt;"> </span>thoi,<span style="letter-spacing: 0.7pt;"> </span>bắt<span style="letter-spacing: 0.75pt;"> </span>đầu<span style="letter-spacing: 1.3pt;"> </span>sau<span style="letter-spacing: 0.9pt;"> </span>tiếng<span style="letter-spacing: 0.15pt;"> </span>T1 hoặc<span style="letter-spacing: -0.2pt;"> </span>sau<span style="letter-spacing: 0.05pt;"> </span>tiếng<span style="letter-spacing: -0.65pt;"> </span>clic<span style="letter-spacing: -0.05pt;"> </span>mở<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.4pt;"></span>động<span style="letter-spacing: 0.65pt;"> </span>mạch<span style="letter-spacing: 0.15pt;"> </span>chủ,<span style="letter-spacing: -0.35pt;"> </span>tối<span style="letter-spacing: 0.65pt;"> </span>đa<span style="letter-spacing: 0.45pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>giữa<span style="letter-spacing: -0.15pt;"> </span>thời<span style="letter-spacing: -0.15pt;"> </span>kỳ<span style="letter-spacing: 0.05pt;"> </span>tâm<span style="letter-spacing: 0.45pt;"> </span>thu<span style="letter-spacing: -0.1pt;"> </span>và<span style="letter-spacing: 0.85pt;"> </span>chấm<span style="letter-spacing: 2pt;"> </span>dứt<span style="letter-spacing: -0.1pt;"> </span>t<span style="letter-spacing: -0.25pt;">r</span>ước<span style="letter-spacing: 0.05pt;"> </span>tiếng<span style="letter-spacing: -0.7pt;"> </span>T2. Tiếng<span style="letter-spacing: 1pt;"> </span>thổi<span style="letter-spacing: 2.7pt;"> </span>tâm<span style="letter-spacing: -0.05pt;"> </span>thu<span style="letter-spacing: 2pt;"> </span>này <span style="letter-spacing: 0.7pt;"><span></span></span>được <span style="letter-spacing: 0.25pt;"><span></span></span>tăng<span style="letter-spacing: 0.1pt;"> </span>cường <span style="letter-spacing: -0.85pt;"><span> </span></span>độ<span style="letter-spacing: 0.3pt;"><span> </span></span>khi<span style="letter-spacing: 2pt;"> </span>ngửi<span style="letter-spacing: 1.95pt;"> </span>amylnitrit<span style="letter-spacing: 1.75pt;"> </span>và<span style="letter-spacing: 1.7pt;"> </span>giảm <span style="letter-spacing: 2.25pt;"><span></span></span>khi<span style="letter-spacing: 2pt;"> </span>làm<span style="letter-spacing: 0.15pt;"><span> </span></span>nghiệm<span style="letter-spacing: 1.4pt;"> </span>pháp Valsalva.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">4.3.4.<span style="letter-spacing: -0.25pt;"> </span>Siêu<span style="letter-spacing: 0.7pt;"> </span>âm<span style="letter-spacing: 0.05pt;"> </span>tim:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">+<span style="letter-spacing: 1.3pt;"> </span>Dấu<span style="letter-spacing: 2.5pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>gián<span style="letter-spacing: 0.4pt;"> </span>tiế<span style="letter-spacing: -0.05pt;">p</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hình<span style="letter-spacing: 2.25pt;"> </span>ảnh<span style="letter-spacing: 0.05pt;"> </span>dày<span style="letter-spacing: 0.05pt;"> </span>cơ<span style="letter-spacing: -0.25pt;"> </span>thành<span style="letter-spacing: 1.35pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>siêu<span style="letter-spacing: 0.7pt;"> </span>âm<span style="letter-spacing: 0.2pt;"> </span>TM<span style="letter-spacing: -0.35pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>siêu <span style="letter-spacing: 0.05pt;"><span> </span></span>âm<span style="letter-spacing: 1.55pt;"> </span>2 bình<span style="letter-spacing: 0.25pt;"> </span>diện.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">+<span style="letter-spacing: 1.3pt;"> </span>Dấu<span style="letter-spacing: 2.5pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>trực<span style="letter-spacing: 0.55pt;"> </span>tiếp:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span>Siêu<span style="letter-spacing: 1.3pt;"> </span>âm<span style="letter-spacing: 1.3pt;"> </span>TM:<span style="letter-spacing: 0.45pt;"> </span>tình<span style="letter-spacing: -1.15pt;"> </span>trạng<span style="letter-spacing: 2.2pt;"> </span>vôi<span style="letter-spacing: 1pt;"> </span>hoá<span style="letter-spacing: 1.15pt;"> </span>nặng<span style="letter-spacing: 0.65pt;"> </span>các <span style="letter-spacing: 0.25pt;"><span> </span></span>lá<span style="letter-spacing: 0.9pt;"> </span>van,<span style="letter-spacing: 0.3pt;"> </span>do<span style="letter-spacing: 0.8pt;"> </span>đó<span style="letter-spacing: -1.2pt;"> </span>độ<span style="letter-spacing: 1.45pt;"> </span>mở<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>chủ<span style="letter-spacing: 0.55pt;"> </span>ở<span style="letter-spacing: 0.9pt;"> </span>thời<span style="letter-spacing: 0.7pt;"> </span>kỳ tâm<span style="letter-spacing: 0.65pt;"> </span>thu<span style="letter-spacing: 0.15pt;"> </span>thấy<span style="letter-spacing: 2.1pt;"> </span>giảm<span style="letter-spacing: 0.1pt;"> </span>(bình<span style="letter-spacing: 1.45pt;"></span>thường<span style="letter-spacing: 0.3pt;"> </span>độ<span style="letter-spacing: 0.85pt;"> </span>mở<span style="letter-spacing: 0.15pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>chủ<span style="letter-spacing: -0.05pt;"> </span>là<span style="letter-spacing: 1.15pt;"> </span>16-26<span style="letter-spacing: 0.3pt;"> </span>mm,<span style="letter-spacing: 0.1pt;"> </span>nếu<span style="letter-spacing: -0.4pt;"> </span>độ<span style="letter-spacing: 0.85pt;"> </span>mở<span style="letter-spacing: 0.15pt;"> </span><<span style="letter-spacing: 0.25pt;"> </span>8<span style="letter-spacing: 0.3pt;"> </span>mm<span style="letter-spacing: 0.1pt;"> </span>là<span style="letter-spacing: 1.15pt;"> </span>hẹp lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1pt;"> </span>Siêu<span style="letter-spacing: 1.45pt;"> </span>âm<span style="letter-spacing: -1.15pt;"> </span>hai<span style="letter-spacing: 0.85pt;"> </span>bình<span style="letter-spacing: -1.1pt;"> </span>diện<span style="letter-spacing: 0.15pt;"> </span>theo<span style="letter-spacing: 0.8pt;"> </span>trục<span style="letter-spacing: 0.6pt;"> </span>ngắn,<span style="letter-spacing: 0.75pt;"> </span>ở<span style="letter-spacing: 1pt;"> </span>m<span style="letter-spacing: -0.05pt;">ặ</span>t<span style="letter-spacing: 0.8pt;"> </span>phẳng<span style="letter-spacing: 1.35pt;"> </span>cắt<span style="letter-spacing: 0.9pt;"> </span>ngang<span style="letter-spacing: 0.7pt;"> </span>qua<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.6pt;"> </span>mạch<span style="letter-spacing: 1.1pt;"> </span>chủ<span style="letter-spacing: 0.65pt;"> </span>sẽ<span style="letter-spacing: 0.25pt;"> </span>đo được<span style="letter-spacing: 0.85pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"></span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mở<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thời<span style="letter-spacing: -0.2pt;"> </span>kỳ tâm<span style="letter-spacing: 0.35pt;"> </span>thu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">+ <span style="letter-spacing: 1.3pt;"><span> </span></span>Siêu<span style="letter-spacing: 0.4pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>Doppler:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.8pt;"> </span>Bằng<span style="letter-spacing: 1.25pt;"> </span>Doppler liên<span style="letter-spacing: 1.2pt;"> </span>tục<span style="letter-spacing: 0.55pt;"> </span>(CW)<span style="letter-spacing: 0.3pt;"> </span>sẽ<span style="letter-spacing: 0.05pt;"> </span>đo<span style="letter-spacing: 1.2pt;"> </span>được<span style="letter-spacing: 1.05pt;"> </span>chênh <span style="letter-spacing: 2.3pt;"><span> </span></span>áp<span style="letter-spacing: 0.5pt;"> </span>tâm <span style="letter-spacing: 0.35pt;"><span> </span></span>thu<span style="letter-spacing: 0.7pt;"> </span>tối<span style="letter-spacing: 1.45pt;"> </span>đa<span style="letter-spacing: 1.45pt;"> </span>g<span style="letter-spacing: 0.05pt;">i</span>ữa<span style="letter-spacing: 0.65pt;"> </span>thất<span style="letter-spacing: 2.75pt;"> </span>trái<span style="letter-spacing: 1.6pt;"> </span>và<span style="letter-spacing: 0.25pt;"> </span>động <span style="letter-spacing: 1.4pt;"><span> </span></span>mạch chủ<span style="letter-spacing: -0.35pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ương trình<span style="letter-spacing: 0.25pt;"> </span>Bernouilli:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 12.85pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: -0.5pt;">∆<span style="letter-spacing: -0.55pt;"> </span>p</span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;"><span> </span>t</span><span lang="EN" style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">ố</span><span lang="EN" style="position: relative; top: 2.5pt;">i<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>a <span style="letter-spacing: 0.2pt;"><span> </span></span></span><span lang="EN" style="position: relative; top: -0.5pt;"><span> </span>=<span style="letter-spacing: -0.05pt;"> </span>4V</span><sup><span lang="EN">2</span></sup><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;"> t</span><span lang="EN" style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">ố</span><span lang="EN" style="position: relative; top: 2.5pt;">i<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>a <span style="letter-spacing: 0.2pt;"><span> </span></span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.6pt;"> </span>đó<span style="letter-spacing: 0.45pt;"> </span>V<span style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;">t</span><span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">ố</span><span style="position: relative; top: 2.5pt;">i<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>a <span style="letter-spacing: 0.2pt;"><span> </span></span></span>là<span style="letter-spacing: -0.5pt;"> </span>vận<span style="letter-spacing: 1.55pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>tối<span style="letter-spacing: 0.6pt;"> </span>đa<span style="letter-spacing: 0.6pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.15pt;">N</span><span lang="EN" style="letter-spacing: -0.2pt;">g</span><span lang="EN" style="letter-spacing: -0.25pt;">ư</span><span lang="EN" style="letter-spacing: -0.2pt;">ờ</span><span lang="EN">i<span style="letter-spacing: -0.2pt;"> t</span>a<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.2pt;">cũn</span>g<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.15pt;">đán</span>h<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.15pt;">gi</span>á<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.2pt;">đ</span><span style="letter-spacing: -0.15pt;">ượ</span>c<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.15pt;">chên</span>h <span style="letter-spacing: 1.45pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">á</span>p<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.2pt;">trun</span>g<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.2pt;">bìn</span>h<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.2pt;">giữ</span>a<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">thấ</span>t<span style="letter-spacing: -0.15pt;"> tr</span><span style="letter-spacing: -0.25pt;">á</span>i<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.2pt;"> đ</span><span style="letter-spacing: -0.25pt;">ộ</span><span style="letter-spacing: -0.2pt;">n</span>g<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.15pt;">m</span><span style="letter-spacing: -0.2pt;">ạ</span><span style="letter-spacing: -0.15pt;">c</span>h<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.4pt;">ch</span>ủ<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.35pt;">bằn</span>g<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.35pt;">các</span>h<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.35pt;">đ</span>o<span style="letter-spacing: -0.4pt;"> d</span><span style="letter-spacing: -0.35pt;">iệ</span>n <span style="letter-spacing: -0.35pt;">tíc</span>h<span style="letter-spacing: -0.4pt;"> củ</span>a<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.4pt;">ph</span>ổ<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.4pt;">dòn</span>g<span style="letter-spacing: -0.35pt;">má</span>u<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.4pt;">qu</span>a<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.35pt;">độn</span>g<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.35pt;">mạ</span><span style="letter-spacing: -0.3pt;">c</span>h<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.4pt;">ch</span>ủ<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: -0.4pt;">thờ</span>i<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: -0.4pt;">k</span>ỳ<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.35pt;">t</span><span style="letter-spacing: -0.3pt;">â</span>m<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.4pt;">thu.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Bằng<span style="letter-spacing: 0.75pt;"> </span>kết<span style="letter-spacing: -0.45pt;"> </span>hợp<span style="letter-spacing: -0.05pt;"> </span>Doppler<span style="letter-spacing: -0.55pt;"> </span>xung<span style="letter-spacing: 0.3pt;"> </span>(PW)<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 1.1pt;"> </span>Doppler<span style="letter-spacing: -0.5pt;"> </span>liên<span style="letter-spacing: 0.65pt;"> </span>tục (CW)<span style="letter-spacing: -0.25pt;"> </span>sẽ<span style="letter-spacing: -0.45pt;"> </span>tính <span style="letter-spacing: 0.05pt;"><span> </span></span>được<span style="letter-spacing: 0.5pt;"> </span>diện<span style="letter-spacing: -0.55pt;"> </span>tích<span style="letter-spacing: 0.6pt;"> </span>lỗ<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>động mạch<span style="letter-spacing: 0.95pt;"> </span>chủ<span style="letter-spacing: 0.25pt;"> </span>bằng<span style="letter-spacing: 2.2pt;"> </span>cách<span style="letter-spacing: 1.85pt;"></span>áp<span style="letter-spacing: 0.1pt;"> </span>dụng<span style="letter-spacing: 0.35pt;"> </span>phương<span style="letter-spacing: 0.6pt;"> </span>trình<span style="letter-spacing: 1.15pt;"> </span>liên<span style="letter-spacing: 0.7pt;"> </span>tục<span style="letter-spacing: 0.3pt;"> </span>giữa<span style="letter-spacing: 0.4pt;"> </span>2<span style="letter-spacing: 0.6pt;"> </span>phổ<span style="letter-spacing: 0.95pt;"> </span>Doppler<span style="letter-spacing: -0.2pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>vị<span style="letter-spacing: 0.85pt;"> </span>trí<span style="letter-spacing: 1.55pt;"> </span>đến<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.6pt;"> </span>vị<span style="letter-spacing: 0.85pt;"> </span>trí<span style="letter-spacing: 1.55pt;"> </span>ra<span style="letter-spacing: 0.5pt;"> </span>khỏi van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"><span> </span>TVI<span style="position: relative; top: 2.5pt;">1</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 12px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 2.75pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">A<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 1.2pt;"> </span></span>=<span style="letter-spacing: -0.05pt;"> A</span><span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.2pt;"> x </span></span><span style="letter-spacing: 0.5pt;"><span> </span></span>---------<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 12px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 2.75pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"><span> </span>TVI<span style="position: relative; top: 2.5pt;">2</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 3.3pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.6pt;"> </span>đó:<span style="letter-spacing: 0.35pt;"> </span>A<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 1.1pt;"> </span></span>là<span style="letter-spacing: 0.85pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">A<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.2pt;"> </span></span>là<span style="letter-spacing: 0.85pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>đường<span style="letter-spacing: -0.05pt;"> </span>ra<span style="letter-spacing: -0.15pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 18px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">TVI<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.1pt;"> </span></span>(time<span style="letter-spacing: 0.05pt;"> </span>velocity<span style="letter-spacing: -0.45pt;"> </span>i<span style="letter-spacing: -0.05pt;">n</span>t<span style="letter-spacing: -0.05pt;">e</span>rgral):<span style="letter-spacing: -0.2pt;"> </span>tích<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">p</span>hân<span style="letter-spacing: 0.75pt;"> </span>vận<span style="letter-spacing: 1.85pt;"> </span>tốc<span style="letter-spacing: 0.85pt;"> </span>theo<span style="letter-spacing: 0.1pt;"> </span>thời<span style="letter-spacing: 0.1pt;"> </span>gi<span style="letter-spacing: -0.05pt;">a</span>n<span style="letter-spacing: 0.15pt;"> </span>của<span style="letter-spacing: -0.05pt;"> </span>phổ<span style="letter-spacing: 0.65pt;"> </span>Doppler<span style="letter-spacing: -0.5pt;"> </span>đo tại<span style="letter-spacing: 0.7pt;"> </span>đường<span style="letter-spacing: -0.05pt;"> </span>ra<span style="letter-spacing: -0.15pt;"> </span>của<span style="letter-spacing: -0.4pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 24px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">TVI<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">2</span>:<span style="letter-spacing: -0.45pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>phân<span style="letter-spacing: 0.55pt;"> </span>vận<span style="letter-spacing: 1.55pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>thời<span style="letter-spacing: -0.2pt;"> </span>gian<span style="letter-spacing: -0.2pt;"> </span>của<span style="letter-spacing: -0.4pt;"> </span>phổ<span style="letter-spacing: 0.35pt;"> </span>Doppler<span style="letter-spacing: -0.8pt;"> </span>đo<span style="letter-spacing: 0.9pt;"> </span>tại<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ. Diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.4pt;"> </span>van<span style="letter-spacing: -0.4pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 0.15pt;"> </span>chủ<span style="letter-spacing: -0.25pt;"> </span>tính<span style="letter-spacing: 0.4pt;"></span>theo<span style="letter-spacing: -0.1pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 0.1pt;"> </span>pháp<span style="letter-spacing: 0.8pt;"> </span>này<span style="letter-spacing: 0.15pt;"> </span>khá<span style="letter-spacing: 0.15pt;"> </span>chính <span style="letter-spacing: 0.3pt;"><span> </span></span>xác<span style="letter-spacing: 0.15pt;"> </span>(khi<span style="letter-spacing: -0.1pt;"> </span>so sánh<span style="letter-spacing: 0.5pt;"> </span>với<span style="letter-spacing: -0.35pt;"> </span>cách<span style="letter-spacing: 1.35pt;"> </span>đo <span style="position: relative; top: -0.5pt;">theo<span style="letter-spacing: -0.2pt;"> </span>công<span style="letter-spacing: 0.35pt;"> </span>thức<span style="letter-spacing: -0.2pt;"> </span>Gorlin<span style="letter-spacing: -0.3pt;"> </span>khi<span style="letter-spacing: -0.2pt;"> </span>thông<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>để khảo<span style="letter-spacing: 1.9pt;"> </span>sát<span style="letter-spacing: 0.4pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"></span>động).</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.75pt;"> </span>Bằng<span style="letter-spacing: 0.55pt;"> </span>siêu<span style="letter-spacing: 1.8pt;"> </span>âm<span style="letter-spacing: 1.15pt;"> </span>Doppler<span style="letter-spacing: -0.05pt;"> </span>màu<span style="letter-spacing: 1.25pt;"> </span>thấy<span style="letter-spacing: 2.6pt;"> </span>dòng<span style="letter-spacing: 1.2pt;"> </span>máu<span style="letter-spacing: 1.15pt;"> </span>qua<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>động<span style="letter-spacing: 1.35pt;"> </span>mạch<span style="letter-spacing: 0.8pt;"> </span>chủ<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>màu<span style="letter-spacing: 0.95pt;"> </span>khảm<span style="letter-spacing: 1.75pt;"> </span>(do<span style="letter-spacing: 0.6pt;"> </span>tốc<span style="letter-spacing: 1.3pt;"> </span>độ dòng<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 1.75pt;"> </span>tăng<span style="letter-spacing: 0.4pt;"><span> </span></span>và<span style="letter-spacing: -0.6pt;"> </span>rối).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">+<span style="letter-spacing: 1.3pt;"> </span>Các<span style="letter-spacing: -0.1pt;"> </span>yếu<span style="letter-spacing: 0.85pt;"> </span>tố<span style="letter-spacing: 0.6pt;"> </span>khác<span style="letter-spacing: -0.45pt;"> </span>trên<span style="letter-spacing: 1.15pt;"> </span>siêu<span style="letter-spacing: 0.55pt;"> </span>âm tim:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.2pt;"> </span>Siêu<span style="letter-spacing: 0.6pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span>còn<span style="letter-spacing: 0.85pt;"> </span>đánh<span style="letter-spacing: 0.5pt;"> </span>giá<span style="letter-spacing: 1pt;"> </span>được<span style="letter-spacing: 1.05pt;"> </span>các<span style="letter-spacing: 1.2pt;"> </span>tổn<span style="letter-spacing: 0.8pt;"> </span>thương<span style="letter-spacing: 0.2pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>phối<span style="letter-spacing: 0.6pt;"> </span>hợp<span style="letter-spacing: -0.15pt;"> </span>khác<span style="letter-spacing: 0.6pt;"> </span>như:<span style="letter-spacing: 0.2pt;"> </span>hở<span style="letter-spacing: 0.2pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 0.8pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>chủ, hẹp<span style="letter-spacing: -0.9pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đánh<span style="letter-spacing: 0.9pt;"><span> </span></span>giá<span style="letter-spacing: 0.35pt;"> </span>được<span style="letter-spacing: 0.2pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>năng<span style="letter-spacing: 0.8pt;"> </span>tâm<span style="letter-spacing: 0.1pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à tâm<span style="letter-spacing: 0.35pt;"> </span>trương<span style="letter-spacing: -0.1pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đo<span style="letter-spacing: 1.2pt;"> </span>áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">4.3.5.<span style="letter-spacing: -0.25pt;"> </span>Thông<span style="letter-spacing: 0.15pt;"> </span>tim.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thông<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>rất<span style="letter-spacing: 1.9pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>giá<span style="letter-spacing: 0.8pt;"> </span>trị<span style="letter-spacing: 1.1pt;"> </span>để<span style="letter-spacing: 0.15pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: 0.65pt;"> </span>bệnh:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Đo<span style="letter-spacing: 1.35pt;"> </span>được<span style="letter-spacing: 0.4pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>chênh <span style="letter-spacing: 1.65pt;"><span></span></span>áp<span style="letter-spacing: -0.2pt;"> </span>tâm<span style="letter-spacing: 2.15pt;"> </span>thu<span style="letter-spacing: 0.05pt;"> </span>trung<span style="letter-spacing: -0.05pt;"> </span>bình<span style="letter-spacing: 0.95pt;"><span> </span></span>“đỉnh<span style="letter-spacing: -0.6pt;"> </span>đến<span style="letter-spacing: 1.4pt;"> </span>đỉnh”<span style="letter-spacing: -0.6pt;"> </span>giữa thất<span style="letter-spacing: 2.1pt;"> </span>trái<span style="letter-spacing: 0.75pt;"> </span>và<span style="letter-spacing: -0.65pt;"> </span>động <span style="letter-spacing: 0.35pt;"><span> </span></span>mạch<span style="letter-spacing: 2.45pt;"> </span>chủ.<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.1pt;">K</span><span style="letter-spacing: -0.05pt;">h</span>i<o:p></o:p> độ<span style="letter-spacing: 0.2pt;"> </span>chênh <span style="letter-spacing: 1.1pt;"><span> </span></span>áp<span style="letter-spacing: -0.5pt;"> </span>trung<span style="letter-spacing: -0.25pt;"></span>bình<span style="letter-spacing: 0.25pt;"> </span>≥<span style="letter-spacing: 0.2pt;"> </span>50 mmHg<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>tỏ<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.75pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đo<span style="letter-spacing: 1.2pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>công<span style="letter-spacing: 0.35pt;"> </span>thức<span style="letter-spacing: -0.2pt;"> </span>Gorlin:<span style="letter-spacing: -0.35pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>≤<span style="letter-spacing: 0.25pt;"> </span>0,8 c<span style="letter-spacing: -0.05pt;">m</span><span style="position: relative; top: -5pt;">2<span style="letter-spacing: 1.05pt;"> </span></span>là<span style="letter-spacing: 0.85pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.95pt;"> </span>Đánh <span style="letter-spacing: 0.45pt;"><span> </span></span>giá<span style="letter-spacing: 0.45pt;"> </span>chức<span style="letter-spacing: 0.7pt;"> </span>năng<span style="letter-spacing: -1.1pt;"> </span>thất<span style="letter-spacing: 2.85pt;"> </span>trái<span style="letter-spacing: 1.5pt;"> </span>qua<span style="letter-spacing: 0.8pt;"> </span>đo<span style="letter-spacing: 1.5pt;"> </span>cung<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ư<span style="letter-spacing: -0.05pt;">ợ</span>ng<span style="letter-spacing: 0.95pt;"> </span>tim,<span style="letter-spacing: 0.7pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>lực<span style="letter-spacing: 0.8pt;"> </span>cuối<span style="letter-spacing: 1.55pt;"> </span>tâm<span style="letter-spacing: 1.3pt;"> </span>trương<span style="letter-spacing: 0.9pt;"> </span>thất<span style="letter-spacing: 2.8pt;"> </span>trái, <span style="letter-spacing: 0.2pt;"><span> </span></span>áp<span style="letter-spacing: 0.9pt;"> </span>lực trung<span style="letter-spacing: -0.25pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>mao<span style="letter-spacing: -0.2pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"></span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Chụp<span style="letter-spacing: -0.9pt;"> </span>động<span style="letter-spacing: 0.75pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>chủ<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>thuốc<span style="letter-spacing: 0.65pt;"> </span>cản<span style="letter-spacing: 0.7pt;"> </span>quang:<span style="letter-spacing: -0.2pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>giãn<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.35pt;"> </span>mạch<span style="letter-spacing: 0.85pt;"> </span>chủ<span style="letter-spacing: -0.2pt;"> </span>sau<span style="letter-spacing: 0.15pt;"> </span>chỗ<span style="letter-spacing: 0.8pt;"> </span>hẹp<span style="letter-spacing: -0.8pt;"> </span>của<span style="letter-spacing: -0.2pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>và<span style="letter-spacing: 0.95pt;"> </span>có thể<span style="letter-spacing: -0.75pt;"> </span>phát<span style="letter-spacing: 0.45pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"></span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>đi<span style="letter-spacing: 0.7pt;"> </span>kèm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Chụp<span style="letter-spacing: -1.05pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cản<span style="letter-spacing: 0.65pt;"> </span>quang:<span style="letter-spacing: -0.35pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>nên<span style="letter-spacing: 0.8pt;"> </span>làm<span style="letter-spacing: -0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">hư</span>ờng qui.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Chụp<span style="letter-spacing: -1.05pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>vành<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cản<span style="letter-spacing: 0.55pt;"> </span>quang:<span style="letter-spacing: -0.35pt;"> </span>để<span style="letter-spacing: 0.35pt;"> </span>đánh<span style="letter-spacing: 0.65pt;"> </span>giá<span style="letter-spacing: 1pt;"> </span>các<span style="letter-spacing: 1.2pt;"> </span>tổn<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.15pt;">h</span>ương động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>vành<span style="letter-spacing: -0.15pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Thông<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>được<span style="letter-spacing: 0.2pt;"> </span>chỉ<span style="letter-spacing: 1.55pt;"> </span>định<span style="letter-spacing: 0.55pt;"> </span>khi:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>sự mất<span style="letter-spacing: 1.9pt;"> </span>cân<span style="letter-spacing: 0.35pt;"> </span>xứng giữa<span style="letter-spacing: -0.2pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>lâm<span style="letter-spacing: 2.15pt;"> </span>sàng<span style="letter-spacing: 1.85pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>siêu <span style="letter-spacing: 0.05pt;"><span> </span></span>âm<span style="letter-spacing: 1.55pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>lý<span style="letter-spacing: -0.1pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phối<span style="letter-spacing: 0.4pt;"> </span>hợp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ở<span style="letter-spacing: -1.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>40 tuổi,<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>đau<span style="letter-spacing: 0.4pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>phải<span style="letter-spacing: 0.2pt;"> </span>chụp<span style="letter-spacing: -0.45pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Chuẩn<span style="letter-spacing: 1.45pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>thay<span style="letter-spacing: -0.2pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.<span style="letter-spacing: -0.1pt;"> </span>Chẩn<span style="letter-spacing: 2.4pt;"> </span>đoán.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.1.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>xác<span style="letter-spacing: 0.4pt;"> </span>định:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Cơ<span style="letter-spacing: -0.4pt;"> </span>năng:<span style="letter-spacing: 2.15pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở,<span style="letter-spacing: -0.2pt;"> </span>đau<span style="letter-spacing: 0.4pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>ngất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span>Thực<span style="letter-spacing: 0.1pt;"> </span>thể:<span style="letter-spacing: -0.15pt;"> </span>tiếng<span style="letter-spacing: -0.15pt;"> </span>thổi<span style="letter-spacing: 1.15pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>thu<span style="letter-spacing: 0.45pt;"> </span>tống<span style="letter-spacing: 1.1pt;"> </span>máu<span style="letter-spacing: 1pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>ổ<span style="letter-spacing: 1.25pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>chủ<span style="letter-spacing: 0.25pt;"> </span>lan<span style="letter-spacing: 0.45pt;"> </span>lên<span style="letter-spacing: 1pt;"> </span>cổ,<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.1pt;">c</span>ường<span style="letter-spacing: 0.6pt;"> </span>độ<span style="letter-spacing: 0.45pt;"> </span>mạnh,<span style="letter-spacing: 2.35pt;"> </span>có rung miu,<span style="letter-spacing: -0.2pt;"> </span>T2<span style="letter-spacing: -0.4pt;"> </span>mờ<span style="letter-spacing: -0.15pt;"> </span>(đôi<span style="letter-spacing: 0.65pt;"></span>khi<span style="letter-spacing: -0.15pt;"> </span>mất),<span style="letter-spacing: 1.85pt;"> </span>clic<span style="letter-spacing: -0.15pt;"> </span>mở<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ,<span style="letter-spacing: 2.6pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>ngựa<span style="letter-spacing: -0.25pt;"> </span>phi<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Cận<span style="letter-spacing: 1.55pt;"> </span>l<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.4pt;"> </span>s<span style="letter-spacing: -0.05pt;">à</span>ng:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. X<span style="letter-spacing: -0.15pt;"> </span>quang:<span style="letter-spacing: -0.35pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>to.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Điện<span style="letter-spacing: 0.45pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ày thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.2pt;"> </span>Siêu<span style="letter-spacing: 1.9pt;"> </span>âm:<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ôi<span style="letter-spacing: 0.85pt;"> </span>hoá,<span style="letter-spacing: 1.45pt;"> </span>dày<span style="letter-spacing: 0.95pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 0.8pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>chủ,<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.6pt;"> </span>mở<span style="letter-spacing: 0.05pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>động<span style="letter-spacing: 0.8pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>chủ<span style="letter-spacing: -0.15pt;"> </span>hạn<span style="letter-spacing: 0.7pt;"> </span>chế,<span style="letter-spacing: -0.6pt;"> </span>đo<span style="letter-spacing: 0.75pt;"> </span>độ<span style="letter-spacing: 0.75pt;"> </span>chênh áp<span style="letter-spacing: 1.25pt;"> </span>lực<span style="letter-spacing: 0.4pt;"> </span>tâm<span style="letter-spacing: 0.9pt;"> </span>thu<span style="letter-spacing: 0.4pt;"> </span>giữa<span style="letter-spacing: 0.35pt;"> </span>thất<span style="letter-spacing: 2.45pt;"></span>trái<span style="letter-spacing: 0.85pt;"> </span>và<span style="letter-spacing: -0.4pt;"> </span>động <span style="letter-spacing: 0.45pt;"><span> </span></span>mạch<span style="letter-spacing: 0.05pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">c</span>hủ<span style="letter-spacing: 0.25pt;"> </span>thấy<span style="letter-spacing: 2.4pt;"> </span>tăng,<span style="letter-spacing: 0.8pt;"> </span>dòng<span style="letter-spacing: 1pt;"> </span>máu<span style="letter-spacing: 0.95pt;"> </span>qua<span style="letter-spacing: 0.4pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>chủ<span style="letter-spacing: 0.2pt;"> </span>rối<span style="letter-spacing: 1.2pt;"> </span>và khảm, <span style="letter-spacing: 0.4pt;"><span></span></span>đo<span style="letter-spacing: 0.4pt;"> </span>được<span style="letter-spacing: 0.2pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>s<span style="letter-spacing: 0.05pt;">i</span>êu<span style="letter-spacing: 0.95pt;"></span>âm<span style="letter-spacing: 0.4pt;"> </span>2 bình<span style="letter-spacing: 0.25pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>bằng <span style="letter-spacing: 0.05pt;"><span> </span></span>p<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: -0.05pt;"> </span>trình<span style="letter-spacing: 0.5pt;"> </span>liên<span style="letter-spacing: 0.05pt;"> </span>tục.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Thông<span style="letter-spacing: 0.25pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span>đo<span style="letter-spacing: 0.55pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>p<span style="letter-spacing: 0.1pt;">h</span>ương trình<span style="letter-spacing: 0.25pt;"> </span>Gorlin.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.85pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.2.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>mức<span style="letter-spacing: 1.25pt;"> </span>độ<span style="letter-spacing: 0.4pt;"> </span>hẹp:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hẹp<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.1pt;">h</span>ẹ:<span style="letter-spacing: -0.75pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>1,1-2 cm<span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hẹp<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>v<span style="letter-spacing: -0.05pt;">ừ</span>a:<span style="letter-spacing: -0.55pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>0,8-1 cm<span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hẹp<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.1pt;">ặ</span>ng:<span style="letter-spacing: -0.25pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>0,8 c<span style="letter-spacing: -0.05pt;">m</span><span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.9pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.3.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>phân<span style="letter-spacing: 0.5pt;"> </span>b<span style="letter-spacing: 0.1pt;">i</span>ệt:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Hở<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>lá:<span style="letter-spacing: 0.95pt;"> </span>nhất<span style="letter-spacing: 2.15pt;"> </span>là<span style="letter-spacing: 1.15pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>bị<span style="letter-spacing: 0.85pt;"> </span>hở<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>lá<span style="letter-spacing: 1.15pt;"> </span>do<span style="letter-spacing: 0.2pt;"> </span>đứt<span style="letter-spacing: 0.35pt;"> </span>dây<span style="letter-spacing: 1.1pt;"> </span>chằng<span style="letter-spacing: 1.35pt;"> </span>sau<span style="letter-spacing: 0.3pt;"> </span>sẽ<span style="letter-spacing: -0.45pt;"> </span>gây<span style="letter-spacing: 0.65pt;"> </span>thổi<span style="letter-spacing: 0.85pt;"> </span>tâm<span style="letter-spacing: 0.65pt;"> </span>thu<span style="letter-spacing: 0.15pt;"> </span>mạnh<span style="letter-spacing: 0.65pt;"> </span>lan<span style="letter-spacing: 0.15pt;"> </span>dọc xương ức<span style="letter-spacing: -0.1pt;"> </span>lên<span style="letter-spacing: 0.4pt;"> </span>vùng<span style="letter-spacing: -0.75pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ.<span style="letter-spacing: -0.4pt;"> </span>Chẩn<span style="letter-spacing: 1.4pt;"> </span>đoán<span style="letter-spacing: -0.35pt;"> </span>xác<span style="letter-spacing: 0.75pt;"> </span>định<span style="letter-spacing: 0.55pt;"> </span>được<span style="letter-spacing: 0.2pt;"> </span>bằng<span style="letter-spacing: 1.9pt;"> </span>siêu<span style="letter-spacing: 2.25pt;"> </span>âm<span style="letter-spacing: 1.35pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.2pt;"> </span>Bệnh<span style="letter-spacing: 2.4pt;"> </span>cơ<span style="letter-spacing: -0.4pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span>phì<span style="letter-spacing: 2.2pt;"> </span>đại:<span style="letter-spacing: -0.4pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>tiếng<span style="letter-spacing: -0.55pt;"> </span>thổi<span style="letter-spacing: 0.75pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: 0.05pt;"> </span>tống<span style="letter-spacing: 0.8pt;"> </span>máu<span style="letter-spacing: 0.6pt;"> </span>dọc<span style="letter-spacing: 0.85pt;"> </span>bờ<span style="letter-spacing: 0.2pt;"> </span>trái<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.2pt;"> </span>ức.<span style="letter-spacing: 0.05pt;"> </span>Chẩn<span style="letter-spacing: 1.6pt;"> </span>đoán<span style="letter-spacing: -0.15pt;"> </span>xác<span style="letter-spacing: 0.95pt;"> </span>định bằng<span style="letter-spacing: 0.2pt;"> </span>siêu<span style="letter-spacing: 0.9pt;"> </span>âm<span style="letter-spacing: 0.3pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>và làm<span style="letter-spacing: 1.85pt;"> </span>nghiệm<span style="letter-spacing: -0.65pt;"> </span>pháp<span style="letter-spacing: 0.45pt;"> </span>Valsal<span style="letter-spacing: -0.05pt;">v</span>a<span style="letter-spacing: -0.7pt;"> </span>kết<span style="letter-spacing: -0.65pt;"> </span>hợp<span style="letter-spacing: -0.3pt;"> </span>với<span style="letter-spacing: -0.35pt;"> </span>nghe<span style="letter-spacing: -0.15pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>(ở<span style="letter-spacing: 0.1pt;"> </span>bệnh<span style="letter-spacing: -0.6pt;"> </span>cơ<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>phì <span style="letter-spacing: 0.4pt;"><span> </span></span>đại<span style="letter-spacing: -0.45pt;"> </span>thì<span> </span>tiếng thổi<span style="letter-spacing: 0.55pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>tăng<span style="letter-spacing: 0.55pt;"> </span>lên;<span style="letter-spacing: 0.1pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>ở hẹp<span style="letter-spacing: -0.9pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: -0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>thổi<span style="letter-spacing: 0.55pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>nhỏ<span style="letter-spacing: 0.5pt;"> </span>đi).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Hẹp<span style="letter-spacing: -0.75pt;"> </span>dưới<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>chủ<span style="letter-spacing: -0.05pt;"> </span>cũng<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>tiếng<span style="letter-spacing: -0.45pt;"> </span>thổi<span style="letter-spacing: 0.85pt;"> </span>tâm<span style="letter-spacing: 0.65pt;"> </span>thu<span style="letter-spacing: 0.15pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>bờ<span style="letter-spacing: 0.3pt;"> </span>trái<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.3pt;"> </span>ức,<span style="letter-spacing: 0.15pt;"> </span>không<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>vôi<span style="letter-spacing: 0.65pt;"> </span>hoá van.<span style="letter-spacing: -0.6pt;"> </span>Chẩn<span style="letter-spacing: 1.4pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>xác<span style="letter-spacing: 0.5pt;"></span>định<span style="letter-spacing: 0.25pt;"> </span>bằng<span style="letter-spacing: 1.6pt;"> </span>siêu<span style="letter-spacing: 2pt;"> </span>âm<span style="letter-spacing: 1.2pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.4pt;"> </span>Hẹp<span style="letter-spacing: -0.65pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: -0.05pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.5pt;"> </span>chủ:<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>tiếng<span style="letter-spacing: -0.3pt;"> </span>thổi<span style="letter-spacing: 1pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu<span style="letter-spacing: 0.25pt;"> </span>ở<span style="letter-spacing: 0.4pt;"> </span>bờ<span style="letter-spacing: 0.4pt;"> </span>phải<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.4pt;"> </span>ức,<span style="letter-spacing: 0.25pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.75pt;"> </span>cảnh<span style="letter-spacing: 0.25pt;"> </span>phải đập<span style="letter-spacing: -0.2pt;"> </span>sớm<span style="letter-spacing: 0.5pt;"> </span>hơn<span style="letter-spacing: 1.55pt;"> </span>động<span style="letter-spacing: 2.5pt;"></span>mạch<span style="letter-spacing: 2.1pt;"> </span>cảnh<span style="letter-spacing: 1.45pt;"> </span>bên<span style="letter-spacing: 1.9pt;"> </span>trái,<span style="letter-spacing: 1.15pt;"> </span>áp<span style="letter-spacing: -0.2pt;"> </span>lực<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ộng<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 1.4pt;"> </span>cánh<span style="letter-spacing: 1.1pt;"> </span>tay<span style="letter-spacing: 0.55pt;"> </span>phải<span style="letter-spacing: 1.2pt;"> </span>lớn<span style="letter-spacing: 0.55pt;"> </span>hơn <span style="letter-spacing: 0.1pt;"><span> </span></span>áp<span style="letter-spacing: 0.55pt;"> </span>lực<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch cánh<span style="letter-spacing: 0.4pt;"> </span>tay<span style="letter-spacing: -0.15pt;"> </span>trái.<span style="letter-spacing: 0.45pt;"> </span>Chẩn<span style="letter-spacing: 1.4pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>xác<span style="letter-spacing: 0.5pt;"> </span>định<span style="letter-spacing: 0.25pt;"> </span>bằng<span style="letter-spacing: 1.6pt;"></span>siêu<span style="letter-spacing: 2pt;"> </span>âm<span style="letter-spacing: 1.2pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.<span style="letter-spacing: -0.1pt;"> </span>Tiến<span style="letter-spacing: -0.85pt;"> </span>triển<span style="letter-spacing: -2pt;"> </span>và<span style="letter-spacing: 2.5pt;"> </span>t<span style="letter-spacing: 0.05pt;">i</span>ên <span style="letter-spacing: 0.05pt;">l</span></span><span lang="EN">ư<span style="font-weight: bold;">ợng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: -0.8pt;"> </span>thường<span style="letter-spacing: 0.7pt;"> </span>tiến<span style="letter-spacing: -0.05pt;"> </span>triển từ<span style="letter-spacing: 0.6pt;"> </span>từ,<span style="letter-spacing: 0.6pt;"> </span>chậm<span style="letter-spacing: 2.6pt;"> </span>chạp,<span style="letter-spacing: 1.75pt;"> </span>đ<span style="letter-spacing: 0.1pt;">ế</span>n<span style="letter-spacing: 0.9pt;"> </span>tuổi<span style="letter-spacing: 1.25pt;"> </span>trung<span style="letter-spacing: 0.45pt;"> </span>niên<span style="letter-spacing: 0.95pt;"> </span>mới<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 1.35pt;"> </span>triệu <span style="letter-spacing: 0.35pt;">c</span><span style="letter-spacing: 0.3pt;">hứn</span>g<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>ơ<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.3pt;">năn</span>g<span style="letter-spacing: -0.9pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span><span style="letter-spacing: 0.25pt;">ư</span>:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: 0.25pt;">Đa</span><span lang="EN">u<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.3pt;">ngực</span>,<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">ngất</span>,<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: 0.3pt;">kh</span>ó<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.3pt;">thở</span>.<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">Bện</span>h<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: 0.3pt;">nhâ</span>n<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: 0.3pt;">sốn</span>g<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">đ</span><span style="letter-spacing: 0.25pt;">ượ</span>c<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.25pt;">đế</span>n<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.3pt;">50-6</span>0<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">tuổi.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Suy<span style="letter-spacing: -0.2pt;"> </span>tim<span style="letter-spacing: 0.6pt;"> </span>xuất<span style="letter-spacing: 2.6pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span>là<span style="letter-spacing: 1.6pt;"> </span>biểu<span style="letter-spacing: -0.1pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span>nặng<span style="letter-spacing: 0.5pt;"> </span>của<span style="letter-spacing: 0.4pt;"> </span>bệnh,<span style="letter-spacing: -0.05pt;"> </span>l<span style="letter-spacing: -0.05pt;">ú</span>c<span style="letter-spacing: 0.4pt;"> </span>đó<span style="letter-spacing: 1.2pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>nhân<span style="letter-spacing: 1.55pt;"> </span>chỉ<span style="letter-spacing: 0.7pt;"> </span>số<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.95pt;"> </span>thêm<span style="letter-spacing: 1.45pt;"><span> </span></span>khoảng <span style="letter-spacing: 1.95pt;"><span></span></span>2 năm.<span style="letter-spacing: -1.15pt;"> </span>Khi<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>ngất,<span style="letter-spacing: 2.85pt;"> </span>bệnh<span style="letter-spacing: 0.2pt;"></span>nhân<span style="letter-spacing: -1.15pt;"> </span>chỉ<span style="letter-spacing: -1.1pt;"> </span>sống<span style="letter-spacing: 1.55pt;"> </span>thêm<span style="letter-spacing: -1.2pt;"> </span><span style="letter-spacing: 0.05pt;">đ</span><span style="letter-spacing: -0.05pt;">ư</span>ợc<span style="letter-spacing: 1.75pt;"> </span>3<span style="letter-spacing: 0.9pt;"> </span>năm.<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: -0.1pt;">K</span>hi<span style="letter-spacing: 0.8pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>đau<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>gực<span style="letter-spacing: 0.75pt;"> </span>thì<span style="letter-spacing: -1.15pt;"> </span>bệnh<span style="letter-spacing: 0.2pt;"> </span>nhân<span style="letter-spacing: -1.15pt;"> </span>chỉ<span style="letter-spacing: -1.1pt;"> </span>sống được<span style="letter-spacing: 0.2pt;"> </span>thêm <span style="letter-spacing: 0.7pt;"><span> </span></span>khoảng <span style="letter-spacing: 1.2pt;"><span></span></span>5 năm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Đôi<span style="letter-spacing: -0.6pt;"> </span>khi<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>biểu<span style="letter-spacing: -0.1pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span>tắc<span style="letter-spacing: 0.6pt;"> </span>mạch <span style="letter-spacing: 1.65pt;"><span> </span></span>đại<span style="letter-spacing: -0.45pt;"> </span>tuần<span style="letter-spacing: 0.6pt;"> </span>hoàn<span style="letter-spacing: 1.2pt;"> </span>do<span style="letter-spacing: 0.7pt;"> </span>cục<span style="letter-spacing: 0.45pt;"> </span>vôi<span style="letter-spacing: 1.35pt;"> </span>hoá<span style="letter-spacing: 1.55pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.3pt;"> </span>bong<span style="letter-spacing: 0.55pt;"> </span>ra,<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>thể<span style="letter-spacing: 0.05pt;"> </span>gây<span style="letter-spacing: 1.15pt;"> </span>ra<span style="letter-spacing: 0.7pt;"> </span>nhồi máu<span style="letter-spacing: 1.25pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Viêm<span style="letter-spacing: -0.75pt;"> </span>màng<span style="letter-spacing: 1.6pt;"> </span>trong<span style="letter-spacing: 1pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>nhiễm<span style="letter-spacing: 0.3pt;"> </span>khuẩn <span style="letter-spacing: 0.15pt;"><span> </span></span>là<span style="letter-spacing: 2.1pt;"> </span>một<span style="letter-spacing: 1.05pt;"> </span>biến<span style="letter-spacing: 0.4pt;"> </span>chứng<span style="letter-spacing: 0.95pt;"> </span>khá<span style="letter-spacing: 1.75pt;"> </span>thường<span style="letter-spacing: 1.25pt;"> </span>gặp<span style="letter-spacing: 0.9pt;"> </span>ở<span style="letter-spacing: 1.25pt;"> </span>người<span style="letter-spacing: 1.25pt;"> </span>bị<span style="letter-spacing: 1.8pt;"> </span>hẹp<span style="letter-spacing: 0.35pt;"> </span>lỗ<span style="letter-spacing: 1.85pt;"> </span>van<o:p></o:p> động<span style="letter-spacing: 0.65pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>chủ,<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.4pt;"> </span>đặc<span style="letter-spacing: 1.45pt;"></span>điểm<span style="letter-spacing: 2.25pt;"> </span>là<span style="letter-spacing: -0.6pt;"> </span>cấy<span style="letter-spacing: 1.95pt;"> </span>máu<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.05pt;"> </span>không<span style="letter-spacing: 0.3pt;"> </span>mọc<span style="letter-spacing: 0.65pt;"> </span>vi<span style="letter-spacing: -0.4pt;"> </span>khuẩn,<span style="letter-spacing: 1.85pt;"> </span>hay<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>biến<span style="letter-spacing: -0.8pt;"> </span>chứng<span style="letter-spacing: -0.25pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>nội<span style="letter-spacing: -0.1pt;"> </span>tạng, thiếu<span style="letter-spacing: -0.75pt;"> </span>máu,<span style="letter-spacing: 0.7pt;"> </span>giảm<span style="letter-spacing: 0.7pt;"> </span>bạch<span style="letter-spacing: 0.4pt;"> </span>cầu,<span style="letter-spacing: -0.2pt;"> </span>diễn<span style="letter-spacing: -0.85pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: 0.8pt;"></span>có<span style="letter-spacing: 0.65pt;"> </span>tỷ<span style="letter-spacing: -0.1pt;"> </span>lệ<span style="letter-spacing: -0.75pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>vong<span style="letter-spacing: -0.7pt;"> </span>cao.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Nếu<span style="letter-spacing: -0.3pt;"> </span>hẹp<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 1.15pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>chủ<span style="letter-spacing: 0.2pt;"> </span>kết<span style="letter-spacing: -0.2pt;"> </span>hợp<span style="letter-spacing: 0.2pt;"> </span>với<span style="letter-spacing: 0.1pt;"> </span>hẹp<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 1.15pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>2<span style="letter-spacing: 0.55pt;"> </span>lá<span style="letter-spacing: -0.7pt;"> </span>thì<span style="letter-spacing: 0.95pt;"> </span>nguyên <span style="letter-spacing: 1.4pt;"><span> </span></span>nhân<span style="letter-spacing: 2.5pt;"> </span>hầu<span style="letter-spacing: 0.4pt;"> </span>hết<span style="letter-spacing: -0.2pt;"> </span>là<span style="letter-spacing: 1.4pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>thấp. Trong<span style="letter-spacing: 0.2pt;"> </span>trường<span style="letter-spacing: 0.8pt;"> </span>hợp<span style="letter-spacing: 0.45pt;"> </span>này,<span style="letter-spacing: 1.25pt;"></span>triệu<span style="letter-spacing: 0.1pt;"> </span>chứng<span style="letter-spacing: 0.5pt;"> </span>của<span style="letter-spacing: 0.45pt;"> </span>hẹp<span style="letter-spacing: -0.1pt;"> </span>lỗ<span style="letter-spacing: 1.4pt;"> </span>van<span style="letter-spacing: 0.3pt;"> </span>2<span style="letter-spacing: 0.8pt;"> </span>lá<span style="letter-spacing: 1.65pt;"> </span>và<span style="letter-spacing: 1.8pt;"> </span>h<span style="letter-spacing: 0.05pt;">ẹ</span>p<span style="letter-spacing: -0.15pt;"> </span>lỗ<span style="letter-spacing: 1.4pt;"> </span>van<span style="letter-spacing: 0.3pt;"> </span>động<span style="letter-spacing: 1.4pt;"> </span>mạch<span style="letter-spacing: 0.85pt;"> </span>chủ<span style="letter-spacing: 0.45pt;"> </span>thay<span style="letter-spacing: 0.6pt;"> </span>đổi,<span style="letter-spacing: 1.1pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>chóng,<span style="letter-spacing: 0.65pt;"> </span>đột<span style="letter-spacing: 0.45pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>biến<span style="letter-spacing: -0.85pt;"></span>c<span style="letter-spacing: -0.05pt;">h</span>ứng<span style="letter-spacing: -0.1pt;"> </span>quan<span style="letter-spacing: -0.25pt;"> </span>tr<span style="letter-spacing: -0.05pt;">ọ</span>ng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tuy<span style="letter-spacing: 0.2pt;"> </span>nhiên,<span style="letter-spacing: 1.5pt;"> </span>tiên<span style="letter-spacing: 0.45pt;"> </span>lượng<span style="letter-spacing: 0.6pt;"> </span>còn<span style="letter-spacing: 1.25pt;"> </span>phụ<span style="letter-spacing: 0.05pt;"> </span>thuộc<span style="letter-spacing: 0.35pt;"> </span>vào<span style="letter-spacing: 1.15pt;"> </span>mức<span style="letter-spacing: 0.4pt;"> </span>độ<span style="letter-spacing: 1.15pt;"> </span>hẹp<span style="letter-spacing: -0.3pt;"> </span>lỗ<span style="letter-spacing: 1.2pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>chủ,<span style="letter-spacing: 0.2pt;"> </span>mức<span style="letter-spacing: 0.4pt;"> </span>lao<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 0.9pt;"> </span>thể lực,<span style="letter-spacing: -0.2pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>đẻ,<span style="letter-spacing: 0.55pt;"> </span>cách<span style="letter-spacing: 1.85pt;"> </span>điều<span style="letter-spacing: 1.75pt;"></span>trị<span style="letter-spacing: 0.95pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.<span style="letter-spacing: -0.1pt;"> </span>Điều<span style="letter-spacing: -0.95pt;"> </span>trị.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.1.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>nội<span style="letter-spacing: 0.6pt;"> </span>khoa</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Điều<span style="letter-spacing: 0.8pt;"> </span>trị<span style="letter-spacing: 0.85pt;"> </span>nội<span style="letter-spacing: 0.2pt;"> </span>khoa<span style="letter-spacing: 0.1pt;"> </span>ít<span style="letter-spacing: 1.05pt;"> </span>hiệu<span style="letter-spacing: -0.5pt;"> </span>quả,<span style="letter-spacing: 0.8pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ỉ<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>tác<span style="letter-spacing: 0.95pt;"> </span>dụng<span style="letter-spacing: 0.1pt;"> </span>với<span style="letter-spacing: -0.1pt;"> </span>hẹp<span style="letter-spacing: -0.55pt;"> </span>lỗ<span style="letter-spacing: 0.95pt;"> </span>van<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>chủ mức<span style="letter-spacing: 0.15pt;"> </span>độ<span style="letter-spacing: 0.9pt;"> </span>nhẹ<span style="letter-spacing: -0.35pt;"> </span>và<span style="letter-spacing: 1.15pt;"> </span>vừa khi<span style="letter-spacing: -0.15pt;"> </span>chưa có<span style="letter-spacing: 0.65pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"></span>suy tim,<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>au<span style="letter-spacing: -0.1pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>ngất.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Theo<span style="letter-spacing: -0.5pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>tình<span style="letter-spacing: 0.75pt;"> </span>trạng<span style="letter-spacing: 0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>thường xuyên,<span style="letter-spacing: 0.2pt;"> </span>nhất<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>các<span style="letter-spacing: 1pt;"> </span>chỉ<span style="letter-spacing: 1.95pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>s<span style="letter-spacing: -0.05pt;">i</span>êu<span style="letter-spacing: 0.7pt;"> </span>âm<span style="letter-spacing: 0.2pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>(3- 6 tháng/lần).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tránh<span style="letter-spacing: 0.35pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức đột<span style="letter-spacing: 0.45pt;"> </span>ngột.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.75pt;"> </span>Dùng<span style="letter-spacing: 1.2pt;"> </span>kháng<span style="letter-spacing: 2.1pt;"> </span>sinh<span style="letter-spacing: 1.55pt;"> </span>phòng<span style="letter-spacing: 2.05pt;"> </span>thấp <span style="letter-spacing: 0.45pt;"><span> </span></span>hoặc<span style="letter-spacing: 1.5pt;"> </span>chống<span style="letter-spacing: 2.3pt;"> </span>thấp <span style="letter-spacing: 0.45pt;"><span> </span></span>(nếu<span style="letter-spacing: 0.85pt;"> </span>do<span style="letter-spacing: 1.65pt;"> </span>thấp <span style="letter-spacing: 0.45pt;"><span> </span></span>tim)<span style="letter-spacing: 1.55pt;"> </span>và <span style="letter-spacing: 0.35pt;"><span> </span></span>phòng<span style="letter-spacing: 2.05pt;"> </span>chống<span style="letter-spacing: 2.3pt;"> </span>viêm màng<span style="letter-spacing: 0.35pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"></span>khuẩn,<span style="letter-spacing: 1.8pt;"> </span>loại<span style="letter-spacing: 0.45pt;"> </span>trừ<span style="letter-spacing: -0.15pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>ổ<span style="letter-spacing: 0.65pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>khuẩn<span style="letter-spacing: 1.9pt;"> </span>tiềm<span style="letter-spacing: -0.9pt;"> </span>tàng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.4pt;">Kh</span>i<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.4pt;">c</span>ó<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: 0.4pt;">su</span>y<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.4pt;">tim</span>:<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.4pt;">ng</span><span style="letter-spacing: 0.3pt;">h</span>ỉ<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.35pt;">ngơi</span>,<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.4pt;">ă</span>n<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: 0.35pt;">hạ</span>n<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.4pt;">ch</span>ế<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: 0.4pt;">m</span><span style="letter-spacing: 0.35pt;">u</span><span style="letter-spacing: 0.4pt;">ối</span>,<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.4pt;">dùn</span>g<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.35pt;">cá</span>c<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.4pt;">thuố</span>c<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.45pt;">c</span><span style="letter-spacing: 0.4pt;">ườn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.4pt;">tim</span>,<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.4pt;">lợ</span>i<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.4pt;">tiể</span>u<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: 0.4pt;">từng đợt.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">Khi<span style="letter-spacing: 0.5pt;"> </span>dùng<span style="letter-spacing: 0.45pt;"> </span>thuốc<span style="letter-spacing: 1.2pt;"> </span>lợi<span style="letter-spacing: 0.55pt;"> </span>tiểu<span style="letter-spacing: -0.05pt;"> </span>phải<span style="letter-spacing: 1.2pt;"> </span>chú<span style="letter-spacing: 0.35pt;"> </span>ý<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ì<span style="letter-spacing: 0.7pt;"> </span>lợi<span style="letter-spacing: 0.55pt;"> </span>tiểu<span style="letter-spacing: -0.05pt;"> </span>mạnh<span style="letter-spacing: 1.05pt;"> </span>sẽ<span style="letter-spacing: -0.05pt;"> </span>làm<span style="letter-spacing: 0.7pt;"> </span>giảm<span style="letter-spacing: 1.7pt;"> </span>cung<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.05pt;">l</span>ượng<span style="letter-spacing: 0.7pt;"> </span>tim,<span style="letter-spacing: 0.5pt;"> </span>gây<span style="letter-spacing: 1.05pt;"> </span>tụt<span style="letter-spacing: 0.45pt;"> </span>huyết</span><span lang="EN"><o:p></o:p> áp<span style="letter-spacing: 0.7pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>đứng,<span style="letter-spacing: 0.25pt;"> </span>dễ<span style="letter-spacing: -0.7pt;"> </span>bị<span style="letter-spacing: 0.4pt;"> </span>đột<span style="letter-spacing: 0.85pt;"> </span>tử.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nếu<span style="letter-spacing: -0.85pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>đau<span style="letter-spacing: 0.4pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>dùng<span style="letter-spacing: -0.3pt;"> </span>nitroglycerin<span style="letter-spacing: -0.65pt;"> </span>liều<span style="letter-spacing: -0.8pt;"> </span>thấp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.2.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>ngoại<span style="letter-spacing: 0.25pt;"> </span>khoa:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Chỉ<span style="letter-spacing: 1.05pt;"> </span>định<span style="letter-spacing: -0.05pt;"> </span>thay<span style="letter-spacing: -0.2pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>nhân<span style="letter-spacing: 2.5pt;"> </span>tạo<span style="letter-spacing: -0.25pt;"> </span>cơ<span style="letter-spacing: -0.1pt;"> </span>học<span style="letter-spacing: 0.65pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>vật<span style="letter-spacing: 1.5pt;"> </span>khi:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.85pt;"> </span>Hẹp<span style="letter-spacing: -0.2pt;"> </span>lỗ<span style="letter-spacing: 1.45pt;"> </span>van<span style="letter-spacing: 0.35pt;"> </span>động<span style="letter-spacing: 1.45pt;"> </span>mạch<span style="letter-spacing: 0.9pt;"> </span>chủ<span style="letter-spacing: 0.5pt;"> </span>mức<span style="letter-spacing: 0.65pt;"> </span>độ<span style="letter-spacing: 1.4pt;"> </span>n<span style="letter-spacing: -0.05pt;">ặ</span>ng<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span>triệu<span style="letter-spacing: 0.15pt;"> </span>chứng<span style="letter-spacing: 0.55pt;"> </span>khi<span style="letter-spacing: 0.7pt;"> </span>gắng<span style="letter-spacing: 0.6pt;"> </span>sức.<span style="letter-spacing: 0.8pt;"> </span>N<span style="letter-spacing: 0.05pt;">g</span>ười<span style="letter-spacing: 0.8pt;"> </span>ta<span style="letter-spacing: 0.7pt;"> </span>thường<span style="letter-spacing: 0.85pt;"> </span>chọn van<span style="letter-spacing: -0.25pt;"> </span>sinh<span style="letter-spacing: 0.05pt;"> </span>học<span style="letter-spacing: 0.9pt;"> </span>cho<span style="letter-spacing: 0.1pt;"> </span>người<span style="letter-spacing: 0.25pt;"></span>lớn<span style="letter-spacing: 0.1pt;"> </span>tuổi<span style="letter-spacing: 0.8pt;"> </span>vì<span style="letter-spacing: 0.05pt;"> </span>không <span style="letter-spacing: 0.5pt;"><span> </span></span>phải<span style="letter-spacing: 0.7pt;"> </span>dùng thuốc<span style="letter-spacing: 0.75pt;"> </span>kháng<span style="letter-spacing: 2pt;"> </span>đông<span style="letter-spacing: -0.45pt;"> </span>sau<span style="letter-spacing: 0.25pt;"> </span>mổ,<span style="letter-spacing: 0.8pt;"> </span>nhưng<span style="letter-spacing: 0.2pt;"> </span>sẽ<span style="letter-spacing: -0.55pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>nguy<span style="letter-spacing: 0.2pt;"> </span>cơ lâu<span style="letter-spacing: 1.95pt;"> </span>dài<span style="letter-spacing: 1pt;"> </span>là<span style="letter-spacing: -0.35pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>bị<span style="letter-spacing: 0.25pt;"> </span>thoái<span style="letter-spacing: 1.3pt;"> </span>hoá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.05pt;"> </span>Khi<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1.7pt;"> </span>s<span style="letter-spacing: -0.05pt;">u</span>y<span style="letter-spacing: 1.05pt;"> </span>tim:<span style="letter-spacing: 0.9pt;"> </span>cần<span style="letter-spacing: 0.95pt;"> </span>phẫu<span style="letter-spacing: 2.75pt;"> </span>thuật <span style="letter-spacing: 0.1pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">n</span>gay,<span style="letter-spacing: 0.9pt;"> </span>sớm.<span style="letter-spacing: 0.75pt;"> </span>Chỉ<span style="letter-spacing: 1.05pt;"> </span>định<span style="letter-spacing: 1.6pt;"> </span>phẫu<span style="letter-spacing: 2.75pt;"> </span>thuật <span style="letter-spacing: 0.05pt;"><span> </span></span>lúc<span style="letter-spacing: 0.75pt;"> </span>này<span style="letter-spacing: 1.55pt;"> </span>thì<span style="letter-spacing: -1pt;"> </span>nguy<span style="letter-spacing: 1.05pt;"> </span>cơ<span style="letter-spacing: 1.65pt;"> </span>tử<span style="letter-spacing: 0.95pt;"> </span>vong trong<span style="letter-spacing: -0.25pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>mổ<span style="letter-spacing: 0.6pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>gia<span style="letter-spacing: -0.15pt;"></span>tăng<span style="letter-spacing: 0.25pt;"> </span>nhiều.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 1.15pt;"> </span>màng<span style="letter-spacing: -0.3pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>khuẩn<span style="letter-spacing: 1.9pt;"> </span>kháng<span style="letter-spacing: 0.35pt;"> </span>trị.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Điều<span style="letter-spacing: 1.3pt;"> </span>trị<span style="letter-spacing: -1.2pt;"> </span>bằng<span style="letter-spacing: 1.25pt;"> </span>phẫu<span style="letter-spacing: 2.55pt;"> </span>thuật<span style="letter-spacing: 2.85pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span>tỉ<span style="letter-spacing: 1.55pt;"> </span>lệ<span style="letter-spacing: 0.1pt;"> </span>tử<span style="letter-spacing: 0.75pt;"> </span>vong<span style="letter-spacing: 0.15pt;"> </span>khoảng<span style="letter-spacing: 1.15pt;"> </span>5%,<span style="letter-spacing: 0.85pt;"> </span>tỉ<span style="letter-spacing: 1.55pt;"> </span>lệ<span style="letter-spacing: 0.1pt;"> </span>này<span style="letter-spacing: 1.35pt;"> </span>tăng<span style="letter-spacing: -1.2pt;"> </span>ở<span style="letter-spacing: 0.85pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ười<span style="letter-spacing: 0.85pt;"> </span>lớn<span style="letter-spacing: 0.7pt;"> </span>tuổi,<span style="letter-spacing: 1.5pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ư<span style="letter-spacing: 0.05pt;">ờ</span>i<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.05pt;">có </span>vữa<span style="letter-spacing: -0.2pt;"> </span>xơ<span style="letter-spacing: 0.15pt;"> </span>động<span style="letter-spacing: 1.8pt;"> </span>mạch<span style="letter-spacing: 1.3pt;"></span>vành,<span style="letter-spacing: 1pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span>ười<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ã<span style="letter-spacing: 1.45pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>suy<span style="letter-spacing: 0.3pt;"> </span>tim.<span style="letter-spacing: 0.05pt;"> </span>Sau<span style="letter-spacing: -0.6pt;"> </span>phẫu<span style="letter-spacing: 1.95pt;"> </span>thuật,<span style="letter-spacing: 2.3pt;"> </span>triệu<span style="letter-spacing: -0.4pt;"> </span>chứng<span style="letter-spacing: -0.05pt;"> </span>cơ<span style="letter-spacing: 0.55pt;"> </span>năng<span style="letter-spacing: 0.85pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">đư</span>ợc<span style="letter-spacing: 0.5pt;"> </span>cải<span style="letter-spacing: 0.5pt;"> </span>thiện<span style="letter-spacing: -0.45pt;"> </span>và bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>sống<span style="letter-spacing: 0.65pt;"> </span>khá<span style="letter-spacing: 0.5pt;"> </span>lâu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.3.<span style="letter-spacing: -0.2pt;"> </span>Nong<span style="letter-spacing: 0.55pt;"> </span>van<span style="letter-spacing: 1.2pt;"> </span>động<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>chủ<span style="letter-spacing: 1.05pt;"> </span>bằng<span style="letter-spacing: 0.2pt;"> </span>bóng<span style="letter-spacing: 1.85pt;"> </span>qua<span style="letter-spacing: 1.9pt;"> </span>da:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Kết<span style="letter-spacing: -0.9pt;"> </span>quả<span style="letter-spacing: 0.5pt;"> </span>tr<span style="letter-spacing: -0.05pt;">ư</span>ớc mắt<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>lâu<span style="letter-spacing: 1.55pt;"> </span>dài<span style="letter-spacing: 0.55pt;"> </span>không <span style="letter-spacing: 1.4pt;"><span></span></span>thật<span style="letter-spacing: 1.9pt;"> </span>tốt,<span style="letter-spacing: 0.6pt;"> </span>kh<span style="letter-spacing: -0.1pt;">o</span>ảng 90% bị<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>tái<span style="letter-spacing: 0.1pt;"> </span>phát<span style="letter-spacing: 1.55pt;"> </span>sau một<span style="letter-spacing: -0.2pt;"> </span>năm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Thường<span style="letter-spacing: 0.1pt;"> </span>chỉ<span style="letter-spacing: 1.1pt;"> </span>định<span style="letter-spacing: -0.25pt;"> </span>ở<span style="letter-spacing: 0.1pt;"> </span>n<span style="letter-spacing: -0.05pt;">gư</span>ời<span style="letter-spacing: 0.1pt;"> </span>hẹp<span style="letter-spacing: -0.8pt;"> </span>khít<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 0.15pt;"> </span>chủ<span style="letter-spacing: -0.25pt;"> </span>mà<span style="letter-spacing: 0.65pt;"> </span>tuổi<span style="letter-spacing: 0.7pt;"> </span>đã<span style="letter-spacing: -0.3pt;"> </span>quá <span style="letter-spacing: 1.05pt;"><span></span></span>cao<span style="letter-spacing: -0.05pt;"> </span>hoặc<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>chống<span style="letter-spacing: 0.65pt;"> </span>chỉ<o:p></o:p> định<span style="letter-spacing: 0.55pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật.</span></span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-12853075829181882122011-04-29T05:10:00.001-07:002011-04-30T19:16:59.408-07:00- HẸP LỖ VAN HAI LÁ<div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">Hẹp <span style="letter-spacing: 0.1pt;"> </span>lỗ<span style="letter-spacing: -3pt;"> </span>van<span style="letter-spacing: -1.9pt;"> </span>hai<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>á</span><span lang="EN"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.75pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">(<span style="letter-spacing: -0.05pt;"> </span>Mitralvalve <span style="letter-spacing: 0.3pt;"> </span>stenosis<span style="letter-spacing: 1.15pt;"> </span>)</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: right;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">1.<span style="letter-spacing: -0.1pt;"> </span>Đại<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: -0.05pt;">c</span></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 0.5pt;">ư</span><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">ơng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.1.<span style="letter-spacing: -0.2pt;"> </span>Định<span style="letter-spacing: 0.5pt;"> </span>nghĩa</span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Van hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>nối<span style="letter-spacing: 0.6pt;"> </span>liền<span style="letter-spacing: -0.75pt;"> </span>nhĩ<span style="letter-spacing: 1.8pt;"> </span>trái<span style="letter-spacing: 0.75pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái,<span style="letter-spacing: 0.45pt;"> </span>giúp<span style="letter-spacing: -0.65pt;"> </span>máu<span style="letter-spacing: 1.75pt;"> </span>đi<span style="letter-spacing: 0.1pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: 0.05pt;">h</span>ướng từ<span style="letter-spacing: -0.1pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>xuống<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.05pt;"> </span>Van<span style="letter-spacing: 0.05pt;"> </span>gồm<span style="letter-spacing: 0.65pt;"> </span>hai<span style="letter-spacing: -0.1pt;"> </span>lá:<span style="letter-spacing: 1.25pt;"> </span>lá<span style="letter-spacing: 0.45pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>lớn<span style="letter-spacing: -0.1pt;"> </span>(lá<span style="letter-spacing: 0.7pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước),<span style="letter-spacing: 0.05pt;"> </span>lá<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>nhỏ<span style="letter-spacing: 0.55pt;"> </span>(lá<span style="letter-spacing: 0.7pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>sau).<span style="letter-spacing: 0.05pt;"> D</span>ưới<span style="letter-spacing: 0.05pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>là<span style="letter-spacing: 0.9pt;"> </span>tổ<span style="letter-spacing: 0.65pt;"> </span>chức<span style="letter-spacing: -0.2pt;"> </span>trụ<span style="letter-spacing: -0.2pt;"> </span>cơ<span style="letter-spacing: 1.35pt;"> </span>và dây<span style="letter-spacing: 0.35pt;"> </span>chằng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Bình<span style="letter-spacing: 0.5pt;"> </span>thường<span style="letter-spacing: 0.1pt;"> </span>diện<span style="letter-spacing: -0.75pt;"> </span>tích<span style="letter-spacing: 0.4pt;"> </span>mở<span style="letter-spacing: -0.05pt;"> </span>van<span style="letter-spacing: -0.4pt;"> </span>tru<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.05pt;"> </span>bình<span style="letter-spacing: 1.7pt;"> </span>vào<span style="letter-spacing: -0.5pt;"> </span>thì<span style="letter-spacing: 0.5pt;"> </span>tâm<span style="letter-spacing: 1.1pt;"> </span>trương<span style="letter-spacing: 0.1pt;"> </span>là<span style="letter-spacing: 1pt;"> </span>4-6<span style="letter-spacing: 0.1pt;"> </span>c<span style="letter-spacing: -0.05pt;">m<span style="position: relative; top: -5pt;">2</span></span>,<span style="letter-spacing: -0.05pt;"> </span>khi diện<span style="letter-spacing: -0.7pt;"> </span>tích<span style="letter-spacing: 0.45pt;"> </span>mở van<span style="letter-spacing: -0.35pt;"> </span>< 4 c<span style="letter-spacing: -0.05pt;">m</span><span style="position: relative; top: -5pt;">2<span style="letter-spacing: 1.15pt;"> </span></span>được<span style="letter-spacing: 0.85pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"></span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span>Hẹp<span style="letter-spacing: -0.45pt;"> </span>lỗ<span style="letter-spacing: 1.2pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>hai<span style="letter-spacing: 0.45pt;"> </span>lá<span style="letter-spacing: 1.6pt;"> </span>là<span style="letter-spacing: 1.45pt;"> </span>một<span style="letter-spacing: 0.4pt;"> </span>bệnh<span style="letter-spacing: -0.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.6pt;"> </span>gặp<span style="letter-spacing: 0.25pt;"> </span>trong<span style="letter-spacing: 0.35pt;"> </span>lâm<span style="letter-spacing: 1.4pt;"> </span>sàng<span style="letter-spacing: 0.75pt;"> </span>tim<span style="letter-spacing: 0.45pt;"> </span>mạch,<span style="letter-spacing: 1pt;"> </span>chiếm<span style="letter-spacing: -0.3pt;"> </span>tỷ<span style="letter-spacing: 0.5pt;"> </span>lệ<span style="letter-spacing: -0.15pt;"> </span>khoảng<span style="letter-spacing: 0.9pt;"> </span>40% các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>lý<span style="letter-spacing: -0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.2.<span style="letter-spacing: -0.2pt;"> </span>Nguyên<span style="letter-spacing: -0.8pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>hẹp<span style="letter-spacing: 0.55pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 1.2pt;"> </span>hai<span style="letter-spacing: 1.2pt;"> </span>lá:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Phần<span style="letter-spacing: -0.25pt;"> </span>lớn<span style="letter-spacing: 0.1pt;"> </span>nguyên<span style="letter-spacing: 0.85pt;"> </span>nhân<span style="letter-spacing: 0.2pt;"> </span>là<span style="letter-spacing: 1.1pt;"> </span>do<span style="letter-spacing: 0.15pt;"> </span>thấp<span style="letter-spacing: 1.95pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>nên,<span style="letter-spacing: 0.75pt;"> </span>nhưng<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>nhiều<span style="letter-spacing: -0.55pt;"> </span>trường<span style="letter-spacing: 0.25pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span>lỗ<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.1pt;"> l</span>á mà<span style="letter-spacing: 0.55pt;"> </span>tiền<span style="letter-spacing: -0.75pt;"> </span>sử thấp<span style="letter-spacing: 1.7pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>rõ<span style="letter-spacing: 0.65pt;"></span>ràng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.25pt;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 1.6pt;"> </span>Một<span style="letter-spacing: 1.4pt;"> </span>số<span style="letter-spacing: 2.2pt;"> </span>ít <span style="letter-spacing: 0.05pt;"> </span>hẹp<span style="letter-spacing: 0.7pt;"> </span>lỗ<span style="letter-spacing: 2.2pt;"> </span>van<span style="letter-spacing: 1.05pt;"> </span>hai<span style="letter-spacing: 1.45pt;"> </span>lá <span style="letter-spacing: 0.2pt;"> </span>bẩm <span style="letter-spacing: 0.45pt;"> </span>sinh:<span style="letter-spacing: 1.35pt;"> </span>van<span style="letter-spacing: 1.1pt;"> </span>hai<span style="letter-spacing: 1.45pt;"> </span>lá <span style="letter-spacing: 0.3pt;"> </span>hình<span style="letter-spacing: -0.5pt;"> </span>dù,<span style="letter-spacing: 1.25pt;"> </span>hẹp<span style="letter-spacing: 0.7pt;"> </span>lỗ<span style="letter-spacing: 2.2pt;"> </span>van<span style="letter-spacing: 1.1pt;"> </span>hai<span style="letter-spacing: 1.45pt;"> </span>lá <span style="letter-spacing: 0.3pt;"> </span>trong<span style="letter-spacing: 1.35pt;"> </span>bệnh </span><span lang="EN">Estein.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.3pt; position: relative; top: 0.5pt;">Kh</span><span lang="EN" style="position: relative; top: 0.5pt;">i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">hẹ</span>p<span style="letter-spacing: -0.3pt;"> l</span>ỗ <span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">ha</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">d</span>o<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>p<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ể<span style="letter-spacing: -0.3pt;"> thấ</span>y<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">hìn</span>h<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.3pt;">thứ</span>c<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">tổ</span>n <span style="letter-spacing: -0.3pt;">t</span><span style="letter-spacing: -0.35pt;">h</span><span style="letter-spacing: -0.3pt;">ươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">nh</span>ư<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">sau:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Van dày<span style="letter-spacing: -0.45pt;"> </span>lên,<span style="letter-spacing: 0.8pt;"> </span>dính<span style="letter-spacing: 1.3pt;"> </span>mép<span style="letter-spacing: -1.05pt;"> </span>van,<span style="letter-spacing: -0.6pt;"> </span>sù<span style="letter-spacing: -0.35pt;"> </span>sì,<span style="letter-spacing: 0.5pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>ngắn,<span style="letter-spacing: -0.25pt;"> </span>vôi<span style="letter-spacing: 0.55pt;"> </span>hóa,<span style="letter-spacing: 0.6pt;"> </span>kém<span style="letter-spacing: -0.85pt;"> </span>di<span style="letter-spacing: -0.1pt;"> </span>động.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Dính <span style="letter-spacing: 0.75pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Dính<span style="letter-spacing: 0.55pt;"> </span>dây<span style="letter-spacing: 0.1pt;"> </span>chằng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Phối<span style="letter-spacing: 0.2pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>cả<span style="letter-spacing: 0.75pt;"> </span>ba<span style="letter-spacing: -0.1pt;"> </span>loại<span style="letter-spacing: 0.5pt;"> </span>trên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.3.<span style="letter-spacing: 2.85pt;"> </span>Sinh<span style="letter-spacing: 1.1pt;"> </span>lý<span style="letter-spacing: -0.1pt;"> </span>bệnh:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">Kh</span>i<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.25pt;">h</span><span style="letter-spacing: 0.3pt;">a</span>i<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.2pt;">l</span>á<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.3pt;">bìn</span>h<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: 0.3pt;">thường</span>,<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>ộ<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.3pt;">chên</span>h<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: 0.25pt;">á</span>p<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.3pt;">giữ</span>a<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span>ĩ<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: 0.25pt;">trá</span>i<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: 0.25pt;">v</span>à<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">thấ</span>t<span style="letter-spacing: 2.95pt;"> </span><span style="letter-spacing: 0.25pt;">tr</span><span style="letter-spacing: 0.15pt;">á</span>i<span style="letter-spacing: 2.3pt;"> </span><span style="letter-spacing: 0.25pt;">l</span>à<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">4-</span>5<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.05pt;">mm</span><span style="letter-spacing: -0.1pt;">H</span>g,<span style="letter-spacing: 0.35pt;"> </span>sẽ<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>ạo điều<span style="letter-spacing: 0.4pt;"> </span>kiện<span style="letter-spacing: -0.85pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái<span style="letter-spacing: -0.15pt;"></span>xuống<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Khi<span style="letter-spacing: -0.2pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá,<span style="letter-spacing: -0.05pt;"> </span>máu<span style="letter-spacing: 1.75pt;"> </span>ứ lại<span style="letter-spacing: 0.7pt;"> </span>ở nhĩ<span style="letter-spacing: 1.15pt;"> </span>trái<span style="letter-spacing: 0.1pt;"> </span>gây<span style="letter-spacing: 1.45pt;"> </span>tăng<span style="letter-spacing: 2.05pt;"> </span>áp<span style="letter-spacing: -0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>trái,<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>20-30 mmHg.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.25pt;">Tăn</span>g <span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">á</span>p<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.3pt;">lự</span>c <span style="letter-spacing: -0.25pt;">nh</span>ĩ<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.25pt;">trá</span>i<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.25pt;">gâ</span>y<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.25pt;">tăn</span>g<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">á</span>p<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">lự</span>c <span style="letter-spacing: -0.25pt;">tĩn</span>h<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">phổi</span>,<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">ma</span>o<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.25pt;">p</span><span style="letter-spacing: -0.3pt;">hổ</span>i<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g <span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h <span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">phổi</span>.<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.3pt;">Đ</span>ó<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.3pt;">là nguyê</span>n<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">nhâ</span>n<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">củ</span>a<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>ó<span style="letter-spacing: -0.1pt;"></span><span style="letter-spacing: -0.3pt;">thở</span>,<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">đặ</span>c<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">biệ</span>t<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>à<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>ó<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ở<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">gắn</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">sức.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.35pt;">á</span>p<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">lự</span>c<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">phổ</span>i<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.25pt;">tăn</span>g<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.25pt;">là</span>m<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">ch</span>o<span style="letter-spacing: -0.3pt;"> ti</span>m<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>i<span style="letter-spacing: -0.25pt;"> tă</span><span style="letter-spacing: -0.3pt;">n</span>g<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.3pt;">cườn</span>g<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>o<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">bó</span>p<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ể<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.3pt;">đẩ</span>y<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">má</span>u<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.25pt;">lê</span>n<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.3pt;">phổi</span>,<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">dầ</span>n<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">dần dẫ</span>n<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.25pt;">đế</span>n<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">su</span>y<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>i<span style="letter-spacing: 1.85pt;"></span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">gâ</span>y <span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">h</span>ở<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>a<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.2pt;">l</span>á<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.2pt;">c</span>ơ<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.3pt;">năng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.55pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span>ứ<span style="letter-spacing: 2.4pt;"> </span>máu<span style="letter-spacing: 1.3pt;"> </span>nhĩ<span style="letter-spacing: -1.2pt;"> </span>trái<span style="letter-spacing: 1.45pt;"> </span>l<span style="letter-spacing: -0.05pt;">à</span>m<span style="letter-spacing: 1.7pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ĩ<span style="letter-spacing: 0.9pt;"> </span>trái<span style="letter-spacing: 1.9pt;"> </span>giãn <span style="letter-spacing: 0.3pt;"> </span>và<span style="letter-spacing: 0.45pt;"> </span>dần<span style="letter-spacing: 0.75pt;"> </span>dần<span style="letter-spacing: 0.75pt;"> </span>dẫn<span style="letter-spacing: 2.75pt;"> </span>đến<span style="letter-spacing: 1.4pt;"> </span>thoái <span style="letter-spacing: -0.05pt;">h</span>oá<span style="letter-spacing: 1.4pt;"> </span>cơ<span style="letter-spacing: 1pt;"> </span>nhĩ<span style="letter-spacing: -1.2pt;"> </span>gây<span style="letter-spacing: 1.45pt;"> </span>loạn<span style="letter-spacing: 0.55pt;"> </span>nhịp<span style="letter-spacing: 1.75pt;"> </span>hoàn toàn;<span style="letter-spacing: 1.4pt;"> </span>nhĩ<span style="letter-spacing: -1.15pt;"> </span>tr<span style="letter-spacing: -0.1pt;">á</span>i<span style="letter-spacing: 1.4pt;"> </span>giãn<span style="letter-spacing: 2pt;"> </span>to,<span style="letter-spacing: 0.85pt;"> </span>ứ<span style="letter-spacing: 0.95pt;"></span>máu<span style="letter-spacing: 1.35pt;"> </span>nhĩ<span style="letter-spacing: -1.15pt;"> </span>trái<span style="letter-spacing: 1.7pt;"> </span>và<span style="letter-spacing: 0.4pt;"> </span>loạn <span style="letter-spacing: 0.05pt;"> </span>nh<span style="letter-spacing: 0.05pt;">ị</span>p <span style="letter-spacing: 1.2pt;"> </span>hoàn <span style="letter-spacing: 0.45pt;"> </span>toàn <span style="letter-spacing: 0.05pt;"> </span>là<span style="letter-spacing: 0.3pt;"> </span>cơ<span style="letter-spacing: 1.4pt;"> </span>sở<span style="letter-spacing: 0.95pt;"> </span>hình<span style="letter-spacing: -1.15pt;"> </span>thành<span style="letter-spacing: 1.3pt;"> </span>cục<span style="letter-spacing: 0.6pt;"> </span>máu <span style="letter-spacing: 0.6pt;"> </span>đông<span style="letter-spacing: 1.85pt;"> </span>và nhồi<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>cơ<span style="letter-spacing: 0.05pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">Bảng<span style="letter-spacing: 0.25pt;"> </span>phân<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.1pt;">l</span>oại<span style="letter-spacing: 0.5pt;"> </span>mức<span style="letter-spacing: 0.6pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.2pt;"> </span>lỗvan<span style="letter-spacing: 1.05pt;"> </span>hai<span style="letter-spacing: 1.2pt;"> </span>lá<span style="letter-spacing: 0.7pt;"> </span>theo<span style="letter-spacing: 0.6pt;"> </span>sinh<span style="letter-spacing: 1.2pt;"> </span>lý<span style="letter-spacing: -0.75pt;"> </span>bệnh.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; margin-left: 0.5pt;"><tbody>
<tr style="height: 43pt;"><td style="border-bottom-color: black; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: black; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-color: black; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 43pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 69.25pt;" valign="top" width="106"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.35pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">Mức<span style="letter-spacing: 0.45pt;"> </span>độ</span></span><span lang="EN"><o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 43pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 85pt;" valign="top" width="130"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.4pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 1.8pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">Diện<span style="letter-spacing: -0.25pt;"> </span>tích<span style="letter-spacing: 0.2pt;"> </span>mở van<span style="letter-spacing: -2.45pt;"> </span> hai<span style="letter-spacing: -1.75pt;"> </span> lá</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.4pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">(c<span style="letter-spacing: -0.05pt;">m<span style="position: relative; top: -5pt;">2</span></span>)</span></span><span lang="EN"><o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 43pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 92.15pt;" valign="top" width="141"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13px; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 1.8pt; margin-top: 1.9pt; text-align: justify;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">áp lực<span style="letter-spacing: 1.4pt;"> </span>mao mạch<span style="letter-spacing: 2.4pt;"> </span>phổi lúc nghỉ<span style="letter-spacing: -0.7pt;"> </span>(mmHg)</span></span><span lang="EN"><o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 43pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 70.85pt;" valign="top" width="108"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.4pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 1.8pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">Cung<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: 0.05pt;">l</span></span></span><span lang="EN">ư<span style="font-style: italic; font-weight: bold;"><span style="letter-spacing: 0.05pt;">ợng</span>tim<span style="letter-spacing: -0.15pt;"> </span>lúc<span style="letter-spacing: 0.25pt;"> </span>nghỉ</span><o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 43pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 147pt;" valign="top" width="225"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.35pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: x-small;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>năng</span></span><span lang="EN"><o:p></o:p></span></span></div></td></tr>
<tr style="height: 60.25pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 69.25pt;" valign="top" width="106"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 11.6pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Độ<span style="letter-spacing: 1.35pt;"> </span>I:<span style="letter-spacing: -0.05pt;"> </span>nhẹ<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 85pt;" valign="top" width="130"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 33.95pt; margin-right: 32.95pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;">>2<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 92.15pt;" valign="top" width="141"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 28.4pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;"><10-12<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 70.85pt;" valign="top" width="108"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.7pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Bình<span style="letter-spacing: 0.35pt;"> </span>thường<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 147pt;" valign="top" width="225"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Không<span style="letter-spacing: 1.55pt;"> </span>có <span style="letter-spacing: 2.05pt;"> </span>triệu <span style="letter-spacing: 0.7pt;"> </span>chứng <span style="letter-spacing: 1.1pt;"> </span>cơ<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: x-small;">năng<span style="letter-spacing: 0.6pt;"> </span>hoặc<span style="letter-spacing: 2.4pt;"> </span>có <span style="letter-spacing: 0.3pt;"> </span>khó <span style="letter-spacing: 0.15pt;"> </span>thở<span style="letter-spacing: 2.5pt;"> </span>nhẹ<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: x-small;">khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></div></td></tr>
<tr style="height: 80.1pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 80.1pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 69.25pt;" valign="top" width="106"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 9.8pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Độ<span style="letter-spacing: 1.35pt;"> </span>II:<span style="letter-spacing: -0.1pt;"> </span>vừa<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 80.1pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 85pt;" valign="top" width="130"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 27.8pt; margin-right: 26.8pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;">1,1-2<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 80.1pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 92.15pt;" valign="top" width="141"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 29.85pt; margin-right: 28.9pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;">10-17<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 80.1pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 70.85pt;" valign="top" width="108"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 7.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 0cm; margin-top: 0.35pt;"><span class="Apple-style-span" style="font-size: x-small;"><br />
</span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.7pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Bình<span style="letter-spacing: 0.35pt;"> </span>thường<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 80.1pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 147pt;" valign="top" width="225"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 2.3pt; margin-top: 0cm; text-align: justify;"><span lang="EN" style="font-size: x-small;">Có <span style="letter-spacing: 1.05pt;"> </span>khó <span style="letter-spacing: 1.4pt;"> </span>thở <span style="letter-spacing: 0.75pt;"> </span>khi <span style="letter-spacing: 0.75pt;"> </span>gắng <span style="letter-spacing: 0.65pt;"> </span>sức<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 1.8pt; margin-top: 4.65pt; text-align: justify;"><span lang="EN" style="font-size: x-small;">nhẹ<span style="letter-spacing: 1.25pt;"> </span>đến vừa.<span style="letter-spacing: 1.35pt;"> </span>Khó<span style="letter-spacing: 2.6pt;"> </span>thở<span style="letter-spacing: 1.85pt;"> </span>phải ngồi,<span style="letter-spacing: 1.45pt;"> </span>cơn<span style="letter-spacing: 1.4pt;"> </span>khó<span style="letter-spacing: 1.5pt;"> </span>thở<span style="letter-spacing: 0.85pt;"> </span>kịch<span style="letter-spacing: -1.05pt;"> </span>phát về<span style="letter-spacing: -1.2pt;"></span>đêm,<span style="letter-spacing: 0.2pt;"> </span>khái<span style="letter-spacing: 0.95pt;"> </span>huyết.<o:p></o:p></span></div></td></tr>
<tr style="height: 40.3pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 40.3pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 69.25pt;" valign="top" width="106"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 17.75pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Độ<span style="letter-spacing: 1.35pt;"> </span>III:<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 22.65pt; margin-right: -1pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: x-small;">nặng<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 40.3pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 85pt;" valign="top" width="130"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 32.45pt; margin-right: 31.45pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;"><<span style="letter-spacing: -0.05pt;"> </span>1<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 40.3pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 92.15pt;" valign="top" width="141"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 34.45pt; margin-right: 33.55pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;">>18<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 40.3pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 70.85pt;" valign="top" width="108"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 21.85pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Giảm<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 40.3pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 147pt;" valign="top" width="225"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 5.05pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Khó<span style="letter-spacing: 1.6pt;"> </span>thở<span style="letter-spacing: 0.85pt;"> </span>lúc<span style="letter-spacing: 0.7pt;"> </span>nghỉ,<span style="letter-spacing: -1.1pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>thể<span style="letter-spacing: 0.25pt;"> </span>có<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 4.65pt;"><span lang="EN" style="font-size: x-small;">phù<span style="letter-spacing: -0.55pt;"> </span>phổi.<o:p></o:p></span></div></td></tr>
<tr style="height: 60.25pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 69.25pt;" valign="top" width="106"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 7.65pt; margin-right: 6.75pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;">Độ<span style="letter-spacing: 1.35pt;"> </span>IV: rất<o:p></o:p></span></div><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 20.75pt; margin-right: 19.8pt; margin-top: 4.65pt; text-align: center;"><span lang="EN" style="font-size: x-small;">nặng<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 85pt;" valign="top" width="130"><div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 27.95pt; margin-right: 26.95pt; margin-top: 0cm; text-align: center;"><span lang="EN" style="font-size: x-small;"><<span style="letter-spacing: -0.05pt;"> </span>0,8<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 92.15pt;" valign="top" width="141"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 28.4pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">>20-25<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 70.85pt;" valign="top" width="108"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 8.65pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Giảm<span style="letter-spacing: 0.4pt;"> </span>nặng<o:p></o:p></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 60.25pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 147pt;" valign="top" width="225"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.2pt; margin-bottom: 0.0001pt; margin-left: 5.05pt; margin-right: -1pt; margin-top: 0cm;"><span lang="EN" style="font-size: x-small;">Tăng <span style="letter-spacing: 0.35pt;"> </span>áp<span style="letter-spacing: -0.35pt;"> </span>ĐMP<span style="letter-spacing: 1.15pt;"> </span>nặng,<span style="letter-spacing: -0.05pt;"> </span>suy<span style="letter-spacing: 0.2pt;"> </span>tim<o:p></o:p></span></div><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: 1.9pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: x-small;">phải;<span style="letter-spacing: 1.8pt;"> </span>khó <span style="letter-spacing: 0.15pt;"> </span>thở <span style="letter-spacing: 2.5pt;"> </span>nặng, <span style="letter-spacing: 2.4pt;"> </span>mệt nhiều,<span style="letter-spacing: -0.9pt;"> </span>tím<span style="letter-spacing: 0.35pt;"> </span>t<span style="letter-spacing: -0.1pt;">á</span>i</span><span class="Apple-style-span" style="font-size: large;"><o:p></o:p></span></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.05pt;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">2.<span style="letter-spacing: -0.1pt;"> </span>Lâm<span style="letter-spacing: -0.5pt;"> </span>sàng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Các<span style="letter-spacing: 0.8pt;"> </span>triệu<span style="letter-spacing: -0.4pt;"> </span>chứng lâm<span style="letter-spacing: 1.1pt;"> </span>sàng<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>diễn<span style="letter-spacing: -0.55pt;"> </span>ra<span style="letter-spacing: 0.2pt;"> </span>âm<span style="letter-spacing: 0.7pt;"> </span>thầm<span style="letter-spacing: 0.05pt;"> </span>hay<span style="letter-spacing: 0.15pt;"> </span>rầm<span style="letter-spacing: 0.1pt;"> </span>rộ<span style="letter-spacing: 0.3pt;"> </span>phụ<span style="letter-spacing: -0.25pt;"> </span>thuộc<span style="letter-spacing: 0.05pt;"> </span>vào<span style="letter-spacing: 0.85pt;"> </span>mức<span style="letter-spacing: 0.1pt;"> </span>độ<span style="letter-spacing: 0.85pt;"> </span>hẹp<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à sự tái<span style="letter-spacing: 0.1pt;"> </span>phát<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ủa<span style="letter-spacing: -0.35pt;"> </span>thấp<span style="letter-spacing: 1.7pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Có<span style="letter-spacing: 0.4pt;"> </span>nhiều<span style="letter-spacing: -0.55pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>nhân<span style="letter-spacing: 1.9pt;"> </span>bị<span style="letter-spacing: 0.05pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span>lỗ<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>hai<span style="letter-spacing: 0.1pt;"> </span>lá<span style="letter-spacing: 1.1pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ưng<span style="letter-spacing: 0.25pt;"> </span>triệu<span style="letter-spacing: -0.45pt;"> </span>chứng<span style="letter-spacing: -0.05pt;"> </span>kín<span style="letter-spacing: 2.05pt;"> </span>đáo,<span style="letter-spacing: -0.5pt;"> </span>phát<span style="letter-spacing: 1.8pt;"> </span>hiện<span style="letter-spacing: -0.6pt;"> </span>được<span style="letter-spacing: 1.1pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>là do<span style="letter-spacing: -0.1pt;"> </span>khám<span style="letter-spacing: 0.35pt;"> </span>sức khỏe<span style="letter-spacing: 0.45pt;"> </span>kiểm<span style="letter-spacing: -0.75pt;"></span>tra<span style="letter-spacing: -0.15pt;"> </span>mà<span style="letter-spacing: 0.55pt;"> </span>thôi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.1.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>n<span style="letter-spacing: 0.05pt;">ă</span>ng:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.45pt;"> </span>nhân<span style="letter-spacing: -0.05pt;"> </span>mệt<span style="letter-spacing: -0.75pt;"> </span>mỏi,<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>trạng<span style="letter-spacing: 0.4pt;"> </span>nhỏ<span style="letter-spacing: 0.5pt;"> </span>bé,<span style="letter-spacing: -0.75pt;"> </span>gầy.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Khó<span style="letter-spacing: 0.6pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức và<span style="letter-spacing: 0.8pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>dần<span style="letter-spacing: -0.15pt;"> </span>đến<span style="letter-spacing: 0.5pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cơn<span style="letter-spacing: 0.4pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>về<span style="letter-spacing: -1.2pt;"> </span>đêm,<span style="letter-spacing: 0.5pt;"> </span>khó<span style="letter-spacing: 0.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>ngồi<span style="letter-spacing: 0.6pt;"> </span>dậy<span style="letter-spacing: 2pt;"> </span>để<span style="letter-spacing: 0.7pt;"> </span>thở và<span style="letter-spacing: 0.8pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>xảy<span style="letter-spacing: 0.5pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>phù<span style="letter-spacing: -0.55pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"></span>cấp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ho<span style="letter-spacing: -0.15pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>về<span style="letter-spacing: -1.2pt;"> </span>đêm<span style="letter-spacing: 0.55pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>ho<span style="letter-spacing: -0.1pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>máu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đau<span style="letter-spacing: 1.3pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>hộp<span style="letter-spacing: -0.35pt;"> </span>trống<span style="letter-spacing: 0.5pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>đặc<span style="letter-spacing: 0.4pt;"> </span>biệt<span style="letter-spacing: -0.75pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1pt;"> </span>Nói<span style="letter-spacing: 1.5pt;"> </span>khàn<span style="letter-spacing: 1.4pt;"> </span>do<span style="letter-spacing: 0.9pt;"> </span>nhĩ<span style="letter-spacing: -1.1pt;"> </span>trái<span style="letter-spacing: 1.55pt;"> </span>quá<span style="letter-spacing: 1.75pt;"> </span>lớn<span style="letter-spacing: 0.85pt;"> </span>chèn<span style="letter-spacing: 2.85pt;"> </span>vào<span style="letter-spacing: 1.55pt;"> </span>thần<span style="letter-spacing: 0.8pt;"> </span>kinh<span style="letter-spacing: 0.8pt;"> </span>quặt<span style="letter-spacing: 0.8pt;"> </span>ng<span style="letter-spacing: -0.05pt;">ư</span>ợc,<span style="letter-spacing: 1pt;"> </span>khó<span style="letter-spacing: 1.5pt;"> </span>nuốt<span style="letter-spacing: 1.6pt;"> </span>do<span style="letter-spacing: 0.9pt;"> </span>nhĩ<span style="letter-spacing: -1.1pt;"> </span>trái<span style="letter-spacing: 1.55pt;"> </span>quá<span style="letter-spacing: 1.75pt;"> </span>to chèn<span style="letter-spacing: 1.85pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>thực<span style="letter-spacing: -0.2pt;"> </span>quản.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Triệu<span style="letter-spacing: -0.8pt;"> </span>chứng<span style="letter-spacing: -0.05pt;"> </span>do<span style="letter-spacing: 0.15pt;"> </span>loạn<span style="letter-spacing: 1.5pt;"> </span>nhịp <span style="letter-spacing: 0.2pt;"> </span>hoàn<span style="letter-spacing: 1.85pt;"> </span>toàn<span style="letter-spacing: 1.5pt;"> </span>và<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>ắc<span style="letter-spacing: 0.1pt;"> </span>mạch:<span style="letter-spacing: 0.6pt;"> </span>tắc<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: -0.35pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>não,<span style="letter-spacing: 0.15pt;"> </span>thân,<span style="letter-spacing: 1.9pt;"> </span>động<span style="letter-spacing: 1.45pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>vành; tắc<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>phổi,<span style="letter-spacing: 0.5pt;"> </span>tắc<span style="letter-spacing: 0.1pt;"></span>mạch<span style="letter-spacing: 0.6pt;"> </span>chi;<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>khi<span style="letter-spacing: 0.1pt;"> </span>cục<span style="letter-spacing: -0.1pt;"> </span>m<span style="letter-spacing: -0.1pt;">á</span>u<span style="letter-spacing: 1.4pt;"> </span>đông<span style="letter-spacing: 0.15pt;"> </span>n<span style="letter-spacing: 0.1pt;">ằ</span>m<span style="letter-spacing: 1.25pt;"> </span>sát<span style="letter-spacing: 0.25pt;"> </span>vách<span style="letter-spacing: 1.3pt;"> </span>nhĩ<span style="letter-spacing: 1.65pt;"> </span>hoặc là<span style="letter-spacing: 1.1pt;"> </span>một<span style="letter-spacing: 0.05pt;"> </span>khối<span style="letter-spacing: 0.85pt;"> </span>lớn<span style="letter-spacing: 0.1pt;"> </span>nằm tự<span style="letter-spacing: -0.1pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>nhĩ,<span style="letter-spacing: 0.55pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cuống<span style="letter-spacing: 0.55pt;"> </span>gắn<span style="letter-spacing: -0.15pt;"> </span>vào<span style="letter-spacing: 0.8pt;"></span>vách<span style="letter-spacing: 1.9pt;"> </span>nhĩ, <span style="letter-spacing: 0.25pt;"> </span>đây<span style="letter-spacing: 0.15pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>nguyên<span style="letter-spacing: 1.4pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>gây<span style="letter-spacing: -0.1pt;"> </span>ngất<span style="letter-spacing: 1.85pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>đột<span style="letter-spacing: 0.45pt;"> </span>tử.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.2.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>thực<span style="letter-spacing: 1.85pt;"> </span>thể:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.15pt;"> </span>T<span style="position: relative; top: 2.5pt;">1 <span style="letter-spacing: 0.25pt;"> </span></span>đanh<span style="letter-spacing: 1.5pt;"> </span>ở<span style="letter-spacing: 1.15pt;"> </span>mỏm<span style="letter-spacing: 1.65pt;"> </span>khi<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: 0.65pt;"> </span>còn<span style="letter-spacing: 1.8pt;"> </span>di<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.45pt;"> </span>tốt.<span style="letter-spacing: 1.75pt;"> </span>Khi<span style="letter-spacing: 0.95pt;"> </span>đã <span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>vôi<span style="letter-spacing: 1.7pt;"> </span>hóa<span style="letter-spacing: 1.8pt;"> </span>van,<span style="letter-spacing: 0.55pt;"> </span>van<span style="letter-spacing: 0.65pt;"> </span>kém<span style="letter-spacing: 0.3pt;"> </span>di<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.45pt;"> </span>thì<span style="letter-spacing: -0.9pt;"> </span>T<span style="position: relative; top: 2.5pt;">1 </span>giảm<span style="letter-spacing: 0.4pt;"> </span>đanh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- T<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 0.85pt;"> </span></span>đanh, <span style="letter-spacing: 1.45pt;"> </span>tách<span style="letter-spacing: 2.05pt;"> </span>đôi<span style="letter-spacing: -0.4pt;"> </span>ở liên<span style="letter-spacing: 0.35pt;"> </span>sườn III cạ<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 0.45pt;"> </span>ức<span style="letter-spacing: -0.1pt;"> </span>trái<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>ở động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.4pt;"> </span>Clắc<span style="letter-spacing: -0.05pt;"> </span>mở<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.05pt;"> </span>hai<span style="letter-spacing: 0.25pt;"> </span>lá:<span style="letter-spacing: 1.8pt;"> </span>là<span style="letter-spacing: 0.8pt;"> </span>triệu<span style="letter-spacing: -0.25pt;"> </span>chứng<span style="letter-spacing: 0.1pt;"> </span>quan<span style="letter-spacing: 0.15pt;"> </span>trọng<span style="letter-spacing: 0.9pt;"> </span>khi<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>hẹp<span style="letter-spacing: -0.5pt;"> </span>khít<span style="letter-spacing: 0.7pt;"> </span>lỗ<span style="letter-spacing: 1.05pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>hai<span style="letter-spacing: 0.25pt;"> </span>lá.<span style="letter-spacing: 1.1pt;"> </span>Nếu<span style="letter-spacing: -0.45pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>hở<span style="letter-spacing: 0.4pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>hai lá<span style="letter-spacing: 0.85pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>triệu<span style="letter-spacing: -0.7pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"></span>này<span style="letter-spacing: -0.45pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>nữa.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.65pt;"> </span>Rùng<span style="letter-spacing: 0.4pt;"> </span>tâm<span style="letter-spacing: 1.05pt;"> </span>trương<span style="letter-spacing: 0.65pt;"> </span>ở<span style="letter-spacing: 0.65pt;"> </span>mỏm,<span style="letter-spacing: 1.2pt;"> </span>nghe<span style="letter-spacing: 0.4pt;"> </span>rõ<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 0.5pt;"> </span>nghiêng <span style="letter-spacing: 1.7pt;"> </span>trái.<span style="letter-spacing: 0.6pt;"> </span>Là<span style="letter-spacing: -0.4pt;"> </span>triệu<span style="letter-spacing: -0.05pt;"> </span>chứng<span style="letter-spacing: 0.35pt;"> </span>rất<span style="letter-spacing: 2.55pt;"> </span>hay<span style="letter-spacing: 0.5pt;"> </span>gặp<span style="letter-spacing: 0.3pt;"> </span>trong<span style="letter-spacing: 0.4pt;"> </span>bệnh hẹp<span style="letter-spacing: 0.2pt;"> </span>lỗ<span style="letter-spacing: 1.7pt;"> </span>van<span style="letter-spacing: 0.6pt;"> </span>hai<span style="letter-spacing: 0.95pt;"> </span>lá.<span style="letter-spacing: 1.8pt;"> </span>Tuy<span style="letter-spacing: 0.7pt;"></span>nhiên,<span style="letter-spacing: -1.1pt;"> </span>cũng<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 1.75pt;"> </span>một<span style="letter-spacing: 0.9pt;"> </span>số<span style="letter-spacing: 1.7pt;"> </span>t<span style="letter-spacing: -0.1pt;">r</span>ường<span style="letter-spacing: 1.1pt;"> </span>hợp<span style="letter-spacing: 0.75pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>nghe<span style="letter-spacing: 0.85pt;"> </span>được<span style="letter-spacing: 1.95pt;"> </span>tiếng<span style="letter-spacing: 0.35pt;"> </span>rùng<span style="letter-spacing: 0.65pt;"> </span>tâm<span style="letter-spacing: -1.1pt;"> </span>tr<span style="letter-spacing: -0.05pt;">ư</span>ơng như hẹp<span style="letter-spacing: -0.9pt;"> </span>hình<span style="letter-spacing: 0.25pt;"> </span>phễu<span style="letter-spacing: -0.95pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá,<span style="letter-spacing: 0.35pt;"> </span>vôi<span style="letter-spacing: 1.05pt;"> </span>hóa<span style="letter-spacing: 0.65pt;"> </span>hoàn<span style="letter-spacing: 1.9pt;"></span>toàn<span style="letter-spacing: 1.55pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>vòng<span style="letter-spacing: 0.25pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.7pt;"> </span>Tiếng<span style="letter-spacing: 0.55pt;"> </span>thổi<span style="letter-spacing: 2.25pt;"> </span>tiền<span style="letter-spacing: 0.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 2.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>u:<span style="letter-spacing: 1.5pt;"> </span>ở<span style="letter-spacing: 1.7pt;"> </span>cuối<span style="letter-spacing: 2.3pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ì <span style="letter-spacing: -1.3pt;"> </span>tâm<span style="letter-spacing: -0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ươ<span style="letter-spacing: -0.05pt;">n</span>g <span style="letter-spacing: -1.3pt;"> </span>có<span style="letter-spacing: 2.35pt;"> </span>tiếng<span style="letter-spacing: 0.95pt;"> </span>thổi<span style="letter-spacing: 2.25pt;"> </span>tâm<span style="letter-spacing: -0.5pt;"> </span>thu<span style="letter-spacing: 1.45pt;"> </span>nhẹ<span style="letter-spacing: 1pt;"> </span>làm<span style="letter-spacing: 2.2pt;"> </span>r<span style="letter-spacing: -0.05pt;">ù</span>ng<span style="letter-spacing: 1.4pt;"> </span>tâm <span style="letter-spacing: 0.05pt;">t</span>rương<span style="letter-spacing: 0.9pt;"> </span>mạnh<span style="letter-spacing: 1.6pt;"> </span>lên<span style="letter-spacing: 1.3pt;"> </span>(chỉ<span style="letter-spacing: -1.15pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>khi<span style="letter-spacing: 0.75pt;"></span>còn<span style="letter-spacing: 1.55pt;"> </span>nhịp<span style="letter-spacing: 1.2pt;"> </span>xoang).<span style="letter-spacing: 0.55pt;"> </span>Nếu<span style="letter-spacing: 0.05pt;"> </span>loạn<span style="letter-spacing: 1.1pt;"> </span>nhịp<span style="letter-spacing: 2.25pt;"> </span>hoàn<span style="letter-spacing: 1.3pt;"> </span>toàn<span style="letter-spacing: 1.1pt;"> </span>thì<span style="letter-spacing: -1.15pt;"> </span>m<span style="letter-spacing: -0.1pt;">ấ</span>t<span style="letter-spacing: 2.75pt;"> </span>tiếng<span style="letter-spacing: 0.15pt;"> </span>thổi<span style="letter-spacing: 1.45pt;"> </span>tiền<span style="letter-spacing: 0.15pt;"> </span>tâm thu<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>nhĩ<span style="letter-spacing: 0.15pt;"> </span>không<span style="letter-spacing: 1pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>khả<span style="letter-spacing: -0.45pt;"> </span>năng<span style="letter-spacing: 1.65pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>bóp<span style="letter-spacing: 0.35pt;"> </span>tống<span style="letter-spacing: 0.6pt;"> </span>máu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.25pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Ngoài<span style="letter-spacing: 1.15pt;"> </span>ra,<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>thể<span style="letter-spacing: 0.05pt;"> </span>nghe<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 1.65pt;"> </span>tiếng<span style="letter-spacing: 0.05pt;"> </span>thổi<span style="letter-spacing: 1.35pt;"> </span>tâm<span style="letter-spacing: 1.15pt;"> </span>thu<span style="letter-spacing: 0.65pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>mũi<span style="letter-spacing: 0.4pt;"> </span>ức<span style="letter-spacing: 0.7pt;"> </span>do<span style="letter-spacing: 0.7pt;"> </span>hở<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.3pt;"> </span>3<span style="letter-spacing: 0.8pt;"> </span>lá<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: 0.05pt;">c</span>ơ<span style="letter-spacing: 1.3pt;"> </span>năng, <span style="letter-spacing: 2.05pt;"> </span>hoặc<span style="letter-spacing: 0.55pt;"> </span>tiếng thổi<span style="letter-spacing: 0.55pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>ở liên<span style="letter-spacing: 0.35pt;"> </span>sườn II, III trái<span style="letter-spacing: 0.55pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>(tiếng<span style="letter-spacing: -0.85pt;"> </span>thổi<span style="letter-spacing: 0.55pt;"> </span>Graham-Steell).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.3pt;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.3pt;"> </span>Có<span style="letter-spacing: 0.45pt;"> </span>thể<span style="letter-spacing: -0.45pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>các<span style="letter-spacing: 0.85pt;"> </span>triệu<span style="letter-spacing: -0.4pt;"> </span>chứng của<span style="letter-spacing: -0.1pt;"> </span>loạn<span style="letter-spacing: 0.5pt;"> </span>nhịp<span style="letter-spacing: 1.65pt;"> </span>hoàn<span style="letter-spacing: 0.7pt;"> </span>toàn,<span style="letter-spacing: 0.7pt;"> </span>suy<span style="letter-spacing: 0.3pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải(<span style="letter-spacing: 0.85pt;"> </span>phù,<span style="letter-spacing: -0.35pt;"> </span>gan<span style="letter-spacing: 0.15pt;"> </span>to,<span style="letter-spacing: 0.2pt;"> </span>tĩnh<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>cổ </span><span lang="EN">nổi).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">3.<span style="letter-spacing: 2.9pt;"> </span>Cận<span style="letter-spacing: 0.75pt;"> </span>lâm<span style="letter-spacing: -0.95pt;"> </span>sàng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.1.<span style="letter-spacing: 2.85pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tâm<span style="letter-spacing: -0.2pt;"> </span>đồ:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nếu<span style="letter-spacing: -0.85pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xoang<span style="letter-spacing: -0.3pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>thấy:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Nhĩ<span style="letter-spacing: 1.25pt;"> </span>trái<span style="letter-spacing: -0.15pt;"> </span>giãn<span style="letter-spacing: 0.45pt;"> </span>với:<span style="letter-spacing: -0.55pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>rộng, P<span style="letter-spacing: -0.35pt;"> </span>2 đỉnh<span style="letter-spacing: 0.55pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>0,12" ở <span style="letter-spacing: -0.05pt;">D</span><span style="position: relative; top: 2.5pt;">I<span style="letter-spacing: -0.05pt;">I</span></span>;<span style="letter-spacing: -0.3pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>2 pha,<span style="letter-spacing: -0.2pt;"> </span>pha<span style="letter-spacing: -0.4pt;"> </span>âm<span style="letter-spacing: 0.4pt;"> </span>><span style="letter-spacing: -0.05pt;"> </span>pha<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ương ở V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">1</span>,V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Cũng<span style="letter-spacing: -0.8pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>xo<span style="letter-spacing: -0.05pt;">a</span>ng<span style="letter-spacing: -0.15pt;"> </span>mà<span style="letter-spacing: 0.8pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>loạn<span style="letter-spacing: 1.8pt;"> </span>nhịp <span style="letter-spacing: 0.55pt;"> </span>hoàn<span style="letter-spacing: 2.2pt;"> </span>toàn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.1pt;"> </span>Giai<span style="letter-spacing: -0.3pt;"> </span>đoạn<span style="letter-spacing: 0.75pt;"> </span>sau<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>dày<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>p<span style="letter-spacing: -0.15pt;">h</span>ải.<span style="letter-spacing: 0.3pt;"> </span>Trên<span style="letter-spacing: 1.25pt;"> </span>điện<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>thấy:<span style="letter-spacing: 2.1pt;"> </span>trục<span style="letter-spacing: -0.3pt;"> </span>đ<span style="letter-spacing: -0.05pt;">i</span>ện<span style="letter-spacing: 0.65pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>chuyển<span style="letter-spacing: -0.6pt;"> </span>p<span style="letter-spacing: -0.1pt;">h</span>ải,<span style="letter-spacing: 0.6pt;"> </span>sóng<span style="letter-spacing: 0.75pt;"> </span>R<span style="letter-spacing: 0.15pt;"> </span>cao<span style="letter-spacing: -0.05pt;"> </span>ở<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">1</span>, V<span style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;">2</span>;<span style="letter-spacing: -0.05pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>S<span style="letter-spacing: -0.85pt;"> </span>sâu<span style="letter-spacing: 0.35pt;"> </span>ở <span style="letter-spacing: -0.1pt;">V</span><span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">5</span>, V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">6</span>;<span style="letter-spacing: -0.05pt;"> </span>Sokolow-Lyon<span style="letter-spacing: 0.1pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.05pt;">p</span>hải<span style="letter-spacing: 0.6pt;"> </span>(<span style="letter-spacing: -0.05pt;">+</span>).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.8pt;"> </span>Người<span style="letter-spacing: 0.8pt;"> </span>ta<span style="letter-spacing: 0.7pt;"> </span>nhận<span style="letter-spacing: 2.7pt;"> </span>thấy<span style="letter-spacing: 2.65pt;"> </span>luôn<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>dấu<span style="letter-spacing: 2.65pt;"> </span>hiệu<span style="letter-spacing: -0.05pt;"> </span>dày<span style="letter-spacing: 1.3pt;"> </span>thất<span style="letter-spacing: 2.7pt;"> </span>phải<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 0.65pt;"> </span>áp<span style="letter-spacing: 1.5pt;"> </span>lực<span style="letter-spacing: 0.65pt;"> </span>động<span style="letter-spacing: 1.4pt;"> </span>mạch<span style="letter-spacing: 0.85pt;"> </span>phổi<span style="letter-spacing: 1.2pt;"> </span>tăng<span style="letter-spacing: 1.05pt;"> </span>cao<span style="letter-spacing: 0.65pt;"> </span>> 70-100 mmHg.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.2.<span style="letter-spacing: 2.85pt;"> </span>Hình<span style="letter-spacing: -0.25pt;"> </span>ảnh<span style="letter-spacing: 0.2pt;"> </span>X<span style="letter-spacing: -0.1pt;"> </span>quang<span style="letter-spacing: 2.35pt;"> </span>tim-phổi:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.05pt;"> </span>Nhĩ<span style="letter-spacing: 1.3pt;"> </span>trái<span style="letter-spacing: -0.1pt;"> </span>to<span style="letter-spacing: -0.15pt;"> </span>chèn<span style="letter-spacing: 1.9pt;"> </span>đẩy<span style="letter-spacing: -0.65pt;"> </span>thực<span style="letter-spacing: -0.15pt;"> </span>quản<span style="letter-spacing: 0.4pt;"> </span>về<span style="letter-spacing: -1.15pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ía<span style="letter-spacing: 0.6pt;"> </span>sau, hoặc<span style="letter-spacing: -0.2pt;"> </span>trên<span style="letter-spacing: 0.2pt;"> </span>phim<span style="letter-spacing: -0.25pt;"> </span>thẳng<span style="letter-spacing: 1.05pt;"> </span>tạo<span style="letter-spacing: -0.65pt;"> </span>hình<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: -0.1pt;"> </span>hai<span style="letter-spacing: -0.1pt;"> </span>bờ<span style="letter-spacing: 0.05pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>cung dưới phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Cao<span style="letter-spacing: -0.05pt;"> </span>áp<span style="letter-spacing: -0.2pt;"> </span>động <span style="letter-spacing: 0.1pt;"> </span>mạch<span style="letter-spacing: 2.2pt;"> </span>phổi<span style="letter-spacing: 0.95pt;"> </span>tạo<span style="letter-spacing: 0.3pt;"> </span>h<span style="letter-spacing: 0.05pt;">ì</span>nh <span style="letter-spacing: 0.15pt;"> </span>ảnh<span style="letter-spacing: 0.75pt;"> </span>4<span style="letter-spacing: 0.5pt;"> </span>cung<span style="letter-spacing: 0.25pt;"> </span>ở<span style="letter-spacing: 0.5pt;"> </span>bờ<span style="letter-spacing: 0.5pt;"> </span>trái<span style="letter-spacing: 1.05pt;"> </span>tim,<span style="letter-spacing: 0.35pt;"> </span>cung<span style="letter-spacing: 0.5pt;"> </span>thứ<span style="letter-spacing: 0.4pt;"> </span>hai<span style="letter-spacing: 0.4pt;"> </span>ở<span style="letter-spacing: 0.55pt;"> </span>bờ<span style="letter-spacing: 0.55pt;"> </span>trái<span style="letter-spacing: 1.1pt;"> </span>tim<span style="letter-spacing: 0.4pt;"> </span>to<span style="letter-spacing: 0.35pt;"> </span>và vồng<span style="letter-spacing: 0.25pt;"> </span>ra.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thất<span style="letter-spacing: 1.6pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">g</span><span style="letter-spacing: 0.05pt;">i</span>ãn:<span style="letter-spacing: 1.1pt;"> </span>m<span style="letter-spacing: -0.05pt;">ỏ</span>m<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>tròn<span style="letter-spacing: 0.55pt;"> </span>và<span style="letter-spacing: 0.05pt;"> </span>bị<span style="letter-spacing: 1.25pt;"> </span>đẩy<span style="letter-spacing: -0.7pt;"> </span>lên<span style="letter-spacing: 0.4pt;"> </span>cao,<span style="letter-spacing: -0.2pt;"> </span>khoảng<span style="letter-spacing: 1.15pt;"> </span>sáng<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ước tim<span style="letter-spacing: -0.15pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>hẹp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Tăng <span style="letter-spacing: 0.7pt;"> </span>áp<span style="letter-spacing: 0.05pt;"> </span>lực<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>phổi:<span style="letter-spacing: 0.8pt;"> </span>biểu<span style="letter-spacing: -0.3pt;"> </span>hiện<span style="letter-spacing: -0.3pt;"> </span>hình<span style="letter-spacing: 0.8pt;"> </span>ảnh<span style="letter-spacing: 0.55pt;"> </span>tái<span style="letter-spacing: 0.1pt;"> </span>phân <span style="letter-spacing: 0.3pt;"> </span>phối<span style="letter-spacing: 0.95pt;"> </span>máu<span style="letter-spacing: 0.95pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>phổi,<span style="letter-spacing: 0.8pt;"> </span>hình<span style="letter-spacing: 0.8pt;"> </span>Kerley<span style="letter-spacing: 0.2pt;"> </span>A và<span style="letter-spacing: 0.8pt;"> </span>B;<span style="letter-spacing: -0.9pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>số<span style="letter-spacing: 0.5pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ường hợp<span style="letter-spacing: -0.35pt;"></span>nặng<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>ứ phù<span style="letter-spacing: -0.55pt;"> </span>mô<span style="letter-spacing: 0.45pt;"> </span>kẽ<span style="letter-spacing: -0.65pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>tràn<span style="letter-spacing: -0.25pt;"> </span>dịch<span style="letter-spacing: 1.3pt;"> </span>màng<span style="letter-spacing: 0.7pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Còn<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>hình<span style="letter-spacing: 1.85pt;"> </span>ảnh<span style="letter-spacing: 0.05pt;"> </span>vôi<span style="letter-spacing: -0.1pt;"> </span>hóa<span style="letter-spacing: 0.65pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>vòng<span style="letter-spacing: 0.25pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.3.<span style="letter-spacing: 2.85pt;"> </span>Siêu<span style="letter-spacing: 0.2pt;"> </span>âm<span style="letter-spacing: -0.85pt;"> </span>tim:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Siêu<span style="letter-spacing: 0.8pt;"> </span>âm<span style="letter-spacing: 0.8pt;"> </span>tim<span style="letter-spacing: 0.25pt;"> </span>là<span style="letter-spacing: 1.25pt;"> </span>phương<span style="letter-spacing: 0.35pt;"> </span>pháp<span style="letter-spacing: 0.8pt;"> </span>cần<span style="letter-spacing: 0.25pt;"> </span>thiết<span style="letter-spacing: -0.5pt;"> </span>gi<span style="letter-spacing: -0.05pt;">ú</span>p<span style="letter-spacing: -0.15pt;"> </span>chẩn<span style="letter-spacing: 2.2pt;"> </span>đoán<span style="letter-spacing: -0.6pt;"> </span>chính <span style="letter-spacing: 0.95pt;"> </span>xác<span style="letter-spacing: 0.7pt;"> </span>bệnh<span style="letter-spacing: -0.3pt;"> </span>hẹp<span style="letter-spacing: -0.5pt;"> </span>lỗ<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>hai<span style="letter-spacing: 0.25pt;"> </span>lá,<span style="letter-spacing: 1.1pt;"> </span>mức độ<span style="letter-spacing: 1.45pt;"> </span>hẹp van<span style="letter-spacing: 0.4pt;"> </span>và<span style="letter-spacing: 1.7pt;"> </span>tình<span style="letter-spacing: -1.15pt;"> </span>trạng<span style="letter-spacing: 1.3pt;"></span>tổn<span style="letter-spacing: 1.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: 0.4pt;"> </span>để<span style="letter-spacing: 1.6pt;"> </span>giúp<span style="letter-spacing: 0.25pt;"> </span>cho<span style="letter-spacing: 0.75pt;"> </span>người<span style="letter-spacing: 0.9pt;"> </span>thầy<span style="letter-spacing: 0.7pt;"> </span>thuốc<span style="letter-spacing: 1.4pt;"> </span>lâm<span style="letter-spacing: 1.7pt;"> </span>sàng<span style="letter-spacing: 1.05pt;"> </span>điều<span style="letter-spacing: 1.05pt;"> </span>trị<span style="letter-spacing: -1.15pt;"> </span>thích<span style="letter-spacing: -1.2pt;"> </span>hợp cho<span style="letter-spacing: 0.35pt;"> </span>từng<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.2pt;"> </span>nhân<span style="letter-spacing: 0.75pt;"> </span>cụ<span style="letter-spacing: 0.15pt;"> </span>thể.<span style="letter-spacing: -0.25pt;"> </span>Có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.25pt;"> </span>điều<span style="letter-spacing: 1.2pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span>n<span style="letter-spacing: -0.05pt;">ộ</span>i<span style="letter-spacing: 0.45pt;"></span>khoa<span style="letter-spacing: 0.25pt;"> </span>hay<span style="letter-spacing: 0.35pt;"> </span>ngoại<span style="letter-spacing: 0.85pt;"> </span>khoa.<span style="letter-spacing: 0.25pt;"> </span>Siêu<span style="letter-spacing: 0.9pt;"> </span>âm<span style="letter-spacing: 0.9pt;"> </span>tim<span style="letter-spacing: 0.35pt;"> </span>c<span style="letter-spacing: -0.05pt;">ò</span>n<span style="letter-spacing: 1.15pt;"> </span>giúp<span style="letter-spacing: -0.15pt;"> </span>theo<span style="letter-spacing: 0.3pt;"> </span>dõi đánh<span style="letter-spacing: 0.3pt;"> </span>giá<span style="letter-spacing: 0.8pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>quả<span style="letter-spacing: 0.5pt;"> </span>sau phẫu<span style="letter-spacing: 1.7pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>nong<span style="letter-spacing: -0.25pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Siêu<span style="letter-spacing: 0.4pt;"> </span>âm<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">T</span>M<span style="letter-spacing: -0.35pt;"> </span>(T-<span style="letter-spacing: -0.45pt;"> </span>motion):<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1.1pt;"> </span>Giảm<span style="letter-spacing: 1.5pt;"> </span>biên<span style="letter-spacing: -0.95pt;"> </span>độ<span style="letter-spacing: 1.65pt;"> </span>chuyển<span style="letter-spacing: 0.4pt;"> </span>động <span style="letter-spacing: 1.65pt;"> </span>lá<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.6pt;"> </span>trước<span style="letter-spacing: 1.1pt;"> </span>trong<span style="letter-spacing: 0.75pt;"> </span>thì<span style="letter-spacing: -0.95pt;"> </span>tâm<span style="letter-spacing: -1.1pt;"> </span>tr<span style="letter-spacing: -0.05pt;">ư</span>ơng,<span style="letter-spacing: 1.1pt;"> </span>lá<span style="letter-spacing: 1.95pt;"> </span>trước<span style="letter-spacing: 1.1pt;"> </span>van<span style="letter-spacing: 0.6pt;"> </span>hai<span style="letter-spacing: 0.95pt;"> </span>lá<span style="letter-spacing: 1.95pt;"> </span>có<span style="letter-spacing: 1.75pt;"> </span>hình dạng<span style="letter-spacing: 0.1pt;"> </span>“cao<span style="letter-spacing: -0.15pt;"> </span>nguyên”<span style="letter-spacing: 0.35pt;"> </span>(hì<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 1.5pt;"></span>doming).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Giảm<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>mất<span style="letter-spacing: 1.9pt;"> </span>biên<span style="letter-spacing: 1.55pt;"> </span>độ<span style="letter-spacing: -0.3pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>A.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Giảm<span style="letter-spacing: 0.4pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: -0.3pt;"> </span>đóng<span style="letter-spacing: 2pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá,<span style="letter-spacing: 0.7pt;"> </span>dốc<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">E</span>F<span style="letter-spacing: -0.05pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>35mm/s.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Lá<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>sau chuyển<span style="letter-spacing: -0.7pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>song<span style="letter-spacing: -0.25pt;"> </span>song<span style="letter-spacing: -0.25pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Hình<span style="letter-spacing: 2.25pt;"> </span>ảnh<span style="letter-spacing: 0.05pt;"> </span>vôi<span style="letter-spacing: -0.1pt;"> </span>hóa<span style="letter-spacing: 0.65pt;"> </span>ở van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Siêu<span style="letter-spacing: 0.6pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>2<span style="letter-spacing: 0.15pt;"> </span>bình<span style="letter-spacing: 0.4pt;"> </span>diện<span style="letter-spacing: -0.65pt;"> </span>(2D:<span style="letter-spacing: -0.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">w</span>o<span style="letter-spacing: -0.35pt;"> </span>dimention):<span style="letter-spacing: -0.4pt;"> </span>cho hình<span style="letter-spacing: 1.45pt;"> </span>ảnh<span style="letter-spacing: -0.3pt;"> </span>hai<span style="letter-spacing: 0.05pt;"> </span>lá<span style="letter-spacing: 1pt;"> </span>van,<span style="letter-spacing: -0.45pt;"> </span>hệ<span style="letter-spacing: -0.55pt;"> </span>thống<span style="letter-spacing: 0.7pt;"> </span>dây<span style="letter-spacing: 0.95pt;"> </span>chằng,<span style="letter-spacing: 1.6pt;"> </span>các góc<span style="letter-spacing: 0.65pt;"> </span>mép<span style="letter-spacing: -1.05pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>để<span style="letter-spacing: 0.7pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>đó<span style="letter-spacing: 0.45pt;"> </span>giúp<span style="letter-spacing: -0.65pt;"></span>cho<span style="letter-spacing: -0.15pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: 1.6pt;"> </span>và<span style="letter-spacing: 0.3pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.05pt;">hư</span>ớng điều<span style="letter-spacing: 0.15pt;"> </span>trị thích<span style="letter-spacing: 1.7pt;"> </span>hợp:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 26px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Đo<span style="letter-spacing: 1.2pt;"> </span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 2.35pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>chu<span style="letter-spacing: -0.15pt;"> </span>vi<span style="letter-spacing: -0.45pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá: Hẹp<span style="letter-spacing: -1.05pt;"> </span>nhẹ:<span style="letter-spacing: -0.85pt;"> </span>2,5 - 4 c<span style="letter-spacing: -0.1pt;">m</span><span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">Hẹp<span style="letter-spacing: -1.05pt;"> </span>vừa:<span style="letter-spacing: -0.6pt;"> </span>2,5 - 1,5 c<span style="letter-spacing: -0.1pt;">m</span></span><span lang="EN" style="letter-spacing: -0.05pt; position: relative; top: -4.5pt;">2</span><span lang="EN" style="position: relative; top: 0.5pt;">.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: -1.05pt;"> </span>khít:<span style="letter-spacing: 0.25pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>1,5 c<span style="letter-spacing: -0.05pt;">m</span><span style="letter-spacing: 0.05pt; position: relative; top: -5pt;">2</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.15pt;"> </span>Tình<span style="letter-spacing: 1.05pt;"> </span>trạng<span style="letter-spacing: 0.3pt;"> </span>tổn<span style="letter-spacing: 0.75pt;"> </span>thương<span style="letter-spacing: 0.2pt;"> </span>của<span style="letter-spacing: -0.15pt;"> </span>hai<span style="letter-spacing: 0.05pt;"> </span>lá<span style="letter-spacing: 1.05pt;"> </span>van,<span style="letter-spacing: -0.4pt;"> </span>dây<span style="letter-spacing: 2.1pt;"> </span>chằng <span style="letter-spacing: 0.5pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>tổ<span style="letter-spacing: 0.8pt;"> </span>chức<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.1pt;">d</span>ưới<span style="letter-spacing: 0.2pt;"> </span>van;<span style="letter-spacing: -0.4pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>t<span style="letter-spacing: 0.75pt;"> </span>hiện<span style="letter-spacing: -0.65pt;"> </span>vôi<span style="letter-spacing: 0.75pt;"> </span>h<span style="letter-spacing: -0.1pt;">o</span>á<span style="letter-spacing: 0.2pt;"> </span>ở<span style="letter-spacing: 0.2pt;"> </span>lá van,<span style="letter-spacing: -0.6pt;"> </span>mép<span style="letter-spacing: -1.05pt;"> </span>van.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Phát<span style="letter-spacing: 0.45pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>quẩn,<span style="letter-spacing: 1.95pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>đông<span style="letter-spacing: -0.1pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>nhĩ<span style="letter-spacing: 1.8pt;"> </span>trái<span style="letter-spacing: 0.75pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span>Siêu<span style="letter-spacing: 1.3pt;"> </span>âm<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.05pt;">Do</span>ppler<span style="letter-spacing: 0.05pt;"> </span>màu:<span style="letter-spacing: 1.3pt;"> </span>bằng<span style="letter-spacing: 1.3pt;"> </span>siêu<span style="letter-spacing: 1.95pt;"> </span>âm<span style="letter-spacing: 1.3pt;"> </span>Doppler<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>thể<span style="letter-spacing: 0.15pt;"> </span>đánh<span style="letter-spacing: 1.2pt;"> </span>giá<span style="letter-spacing: 1.7pt;"> </span>được<span style="letter-spacing: 1.75pt;"> </span>tình<span style="letter-spacing: -1.15pt;"> </span>trạng<span style="letter-spacing: 1.3pt;"> </span>huyết<span style="letter-spacing: 0.1pt;"> </span>động qua<span style="letter-spacing: -0.15pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá,<span style="letter-spacing: 0.15pt;"> </span>đo<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.85pt;"></span>diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>mở<span style="letter-spacing: -0.15pt;"> </span>van:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.25pt;">Bìn</span>h<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">thường</span>,<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.3pt;">vậ</span>n<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: 0.3pt;">tố</span>c<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.3pt;">đ</span>ổ<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: 0.25pt;">đầ</span>y<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">nhan</span>h<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.25pt;">đầ</span>u<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">tâ</span>m<span style="letter-spacing: -1.2pt;"> </span><span style="letter-spacing: 0.3pt;">trươn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.25pt;">khôn</span>g<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.3pt;">vượ</span>t<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">qu</span>á<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.3pt;">1,</span>4<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">m/s</span>.<span style="letter-spacing: 0.05pt;"> </span>Khi<span style="letter-spacing: 0.45pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>h<span style="letter-spacing: -0.05pt;">ẹ</span>p lỗ<span style="letter-spacing: 0.6pt;"> </span>van,<span style="letter-spacing: -0.6pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>qua<span style="letter-spacing: -0.15pt;"></span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: -0.5pt;"> </span>tăng <span style="letter-spacing: 0.4pt;"> </span>lên<span style="letter-spacing: 1.55pt;"> </span>rất<span style="letter-spacing: 1.9pt;"> </span>nhiều.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">Dự</span>a<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">và</span>o<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>ộ<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.25pt;">chên</span>h <span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: 0.25pt;">á</span>p<span style="letter-spacing: 0.3pt;"> tố</span>i<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>a<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">qu</span>a<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>ể<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.25pt;">đán</span>h<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: 0.25pt;">gi</span>á<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.25pt;">đượ</span>c<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.3pt;">mứ</span>c<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>ộ<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">hẹ</span>p<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>ỗ<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.3pt;">ha</span>i<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.3pt;">lá:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 4pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.3pt;"><br />
</div><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif; margin-left: 0.5pt;"><tbody>
<tr style="height: 26.4pt;"><td style="border-bottom-color: black; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: black; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-color: black; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 195.75pt;" valign="top" width="299"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 42.5pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Mức độ<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá<o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: solid; border-top-width: 1pt; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 173.65pt;" valign="top" width="265"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 17.4pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Mức chênh <span style="letter-spacing: 0.7pt;"> </span>áp<span style="letter-spacing: -0.7pt;"> </span>tối<span style="letter-spacing: 0.6pt;"> </span>đa<span style="letter-spacing: 0.6pt;"> </span>qua<span style="letter-spacing: -0.15pt;"> </span>van<o:p></o:p></span></span></div></td></tr>
<tr style="height: 26.4pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 195.75pt;" valign="top" width="299"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: -1.05pt;"> </span>nhẹ<o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 173.65pt;" valign="top" width="265"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 54.35pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">5 - 10 mm<span style="letter-spacing: -0.1pt;">H</span>g<o:p></o:p></span></span></div></td></tr>
<tr style="height: 26.4pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 195.75pt;" valign="top" width="299"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: -1.05pt;"> </span>trung<span style="letter-spacing: -0.25pt;"> </span>bình<o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.4pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 173.65pt;" valign="top" width="265"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 51.3pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">10 - 15 mmHg<o:p></o:p></span></span></div></td></tr>
<tr style="height: 26.45pt;"><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: solid; border-left-width: 1pt; border-right-color: black; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.45pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 195.75pt;" valign="top" width="299"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 5.1pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: -1.05pt;"> </span>nặng<o:p></o:p></span></span></div></td><td style="border-bottom-style: solid; border-bottom-width: 1pt; border-left-style: none; border-left-width: medium; border-right-style: solid; border-right-width: 1pt; border-top-style: none; border-top-width: medium; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; height: 26.45pt; padding-bottom: 0cm; padding-left: 0.5pt; padding-right: 0.5pt; padding-top: 0cm; width: 173.65pt;" valign="top" width="265"><div class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 57.4pt; margin-right: -1pt; margin-top: 3.9pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">><span style="letter-spacing: -0.05pt;"> </span>15 mmHg<o:p></o:p></span></span></div></td></tr>
</tbody></table><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 3.7pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">Tín</span>h<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">diệ</span>n<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.25pt;">tíc</span>h<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">l</span>ỗ <span style="letter-spacing: -0.3pt;">va</span>n<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">ha</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>á<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">bằn</span>g <span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.3pt;">p</span><span style="letter-spacing: -0.35pt;">h</span><span style="letter-spacing: -0.3pt;">ươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">phá</span>p<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">thờ</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">gia</span>n<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">giả</span>m<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">á</span>p<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">mộ</span>t<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">nửa:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"> 220<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.3pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">MVA = -------- <o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"> T<span style="letter-spacing: -0.35pt;"> </span>1/2<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">MVA: diện<span style="letter-spacing: -0.85pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 13.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">T<span style="letter-spacing: -0.35pt;"> </span>1/2:<span style="letter-spacing: -0.2pt;"> </span>thời<span style="letter-spacing: -0.2pt;"> </span>gian<span style="letter-spacing: -0.2pt;"> </span>giảm<span style="letter-spacing: 2.2pt;"> </span>áp<span style="letter-spacing: -0.15pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>nửa.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 3.95pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Phát<span style="letter-spacing: 0.45pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phối<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ợp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Đo<span style="letter-spacing: 1.2pt;"> </span>áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>đây<span style="letter-spacing: 1.65pt;"> </span>là<span style="letter-spacing: 0.4pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>chỉ<span style="letter-spacing: 0.35pt;"> </span>số<span style="letter-spacing: 0.7pt;"> </span>quan<span style="letter-spacing: -0.25pt;"> </span>trọng<span style="letter-spacing: 0.5pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>bác<span style="letter-spacing: 0.3pt;"> </span>sĩ<span style="letter-spacing: 0.1pt;"> </span>lâm<span style="letter-spacing: 1.5pt;"> </span>sàng<span style="letter-spacing: 1pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.<span style="letter-spacing: -0.1pt;"> </span>Chẩn<span style="letter-spacing: -1.55pt;"> </span>đoán<span style="letter-spacing: -1.85pt;"> </span>phân<span style="letter-spacing: 1.85pt;"> </span>biệ<span style="letter-spacing: 0.05pt;">t</span></span><span lang="EN">.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Khi<span style="letter-spacing: 0.05pt;"> </span>các<span style="letter-spacing: 0.8pt;"> </span>triệu<span style="letter-spacing: -0.45pt;"> </span>chứng<span style="letter-spacing: -0.05pt;"> </span>lâm<span style="letter-spacing: 0.8pt;"> </span>sàng<span style="letter-spacing: 0.1pt;"> </span>không<span style="letter-spacing: 1.6pt;"> </span>rõ<span style="letter-spacing: 0.9pt;"> </span>và<span style="letter-spacing: 1.05pt;"> </span>chưa<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>siêu<span style="letter-spacing: 1.05pt;"> </span>âm<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>p<span style="letter-spacing: -0.1pt;">h</span>ải<span style="letter-spacing: 0.8pt;"> </span>chẩn<span style="letter-spacing: 2.1pt;"> </span>đoán<span style="letter-spacing: -0.4pt;"> </span>phân <span style="letter-spacing: 0.3pt;"> </span>biệt với<span style="letter-spacing: -0.45pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">b</span>ệnh<span style="letter-spacing: -0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"></span>sau:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- U<span style="letter-spacing: -0.1pt;"> </span>nhầy<span style="letter-spacing: -0.25pt;"> </span>nhĩ<span style="letter-spacing: 0.35pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>chủ<span style="letter-spacing: -0.35pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hẹp<span style="letter-spacing: -1.05pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>3 lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 2.2pt;"> </span>cơ<span style="letter-spacing: -0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phì<span style="letter-spacing: 1.8pt;"> </span>đại.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Để<span style="letter-spacing: 0.55pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>phân <span style="letter-spacing: 0.05pt;"> </span>biệt<span style="letter-spacing: -0.75pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.95pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>trên<span style="letter-spacing: 1pt;"> </span>phải<span style="letter-spacing: -0.35pt;"> </span>dựa<span style="letter-spacing: -0.15pt;"> </span>vào<span style="letter-spacing: -0.6pt;"> </span>siêu<span style="letter-spacing: 1.2pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; letter-spacing: 0.3pt;">5</span><span lang="EN" style="font-weight: bold;">.<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.35pt;">Biế</span>n<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.4pt;">chứn</span>g<span style="letter-spacing: 1.8pt;"> </span><span style="letter-spacing: 0.4pt;">củ</span>a<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.4pt;">hẹ</span>p<span style="letter-spacing: -2.3pt;"> </span><span style="letter-spacing: 0.6pt;">l</span>ỗ<span style="letter-spacing: -2.2pt;"> </span><span style="letter-spacing: 0.45pt;">va</span>n<span style="letter-spacing: -0.75pt;"> </span>2<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">lá:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: 0.25pt;">Cá</span><span lang="EN">c<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">biế</span>n<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.3pt;">chứn</span>g<span style="letter-spacing: 0.3pt;"> củ</span>a<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.3pt;">bện</span>h<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.3pt;">hẹ</span>p<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>ỗ<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">v</span><span style="letter-spacing: 0.3pt;">a</span>n<span style="letter-spacing: 0.15pt;"> </span>2<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.2pt;">l</span>á<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">th</span>ể<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.3pt;">xế</span>p<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: 0.25pt;">và</span>o<span style="letter-spacing: 1.3pt;"> </span>4<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">nhó</span>m<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.3pt;">biế</span>n<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.3pt;">chứn</span>g<span style="letter-spacing: 0.3pt;"> sa</span>u<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">đây:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Biến<span style="letter-spacing: 0.5pt;"> </span>chứng cấp<span style="letter-spacing: 2.05pt;"> </span>tính,<span style="letter-spacing: 0.85pt;"> </span>liên<span style="letter-spacing: 0.4pt;"> </span>quan<span style="letter-spacing: 0.05pt;"> </span>đến<span style="letter-spacing: 0.8pt;"> </span>rối<span style="letter-spacing: 0.95pt;"> </span>loạn<span style="letter-spacing: 0.75pt;"> </span>huyết<span style="letter-spacing: -0.45pt;"> </span>động:<span style="letter-spacing: 0.55pt;"> </span>ho<span style="letter-spacing: 0.1pt;"> </span>ra<span style="letter-spacing: 0.2pt;"> </span>máu,<span style="letter-spacing: 0.7pt;"> </span>hen<span style="letter-spacing: 0.15pt;"> </span>tim,<span style="letter-spacing: 0.1pt;"> </span>phù<span style="letter-spacing: -0.25pt;"> </span>phổi<span style="letter-spacing: 0.7pt;"> </span>cấp,<span style="letter-spacing: 2.05pt;"> </span>suy tim<span style="letter-spacing: -0.2pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Biến<span style="letter-spacing: 0.2pt;"> </span>chứng<span style="letter-spacing: -0.35pt;"> </span>liên<span style="letter-spacing: 0.35pt;"> </span>quan<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ến rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hịp<span style="letter-spacing: 1.15pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span>ng<span style="letter-spacing: -0.1pt;">o</span>ại tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ất,<span style="letter-spacing: 1.85pt;"> </span>ngoại<span style="letter-spacing: 0.35pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>nhĩ,<span style="letter-spacing: 0.3pt;"> </span>rung nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.5pt;"> </span>Biến<span style="letter-spacing: -1.15pt;"> </span>chứng<span style="letter-spacing: 0.2pt;"> </span>liên<span style="letter-spacing: 0.85pt;"> </span>quan<span style="letter-spacing: 0.25pt;"> </span>đến<span style="letter-spacing: 1pt;"> </span>tắc<span style="letter-spacing: 0.35pt;"> </span>mạch:<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>máu<span style="letter-spacing: 0.9pt;"> </span>quẩn,<span style="letter-spacing: 2.35pt;"> </span>máu<span style="letter-spacing: 1.75pt;"> </span>đông<span style="letter-spacing: 0.4pt;"> </span>trong<span style="letter-spacing: 0.25pt;"> </span>nhĩ<span style="letter-spacing: 2.3pt;"> </span>trái<span style="letter-spacing: 1.25pt;"> </span>và<span style="letter-spacing: -0.1pt;"> </span>tiểu<span style="letter-spacing: -0.25pt;"> </span>nhĩ<span style="letter-spacing: 1.25pt;"> </span>trái,<span style="letter-spacing: 0.7pt;"> </span>có thể<span style="letter-spacing: -0.75pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>não,<span style="letter-spacing: 0.2pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"></span>mạch<span style="letter-spacing: 0.35pt;"> </span>chi,<span style="letter-spacing: -0.25pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>vành,<span style="letter-spacing: 0.4pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>thân.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 2.65pt;"> </span>Biến<span style="letter-spacing: 1pt;"> </span>chứng<span style="letter-spacing: 2.35pt;"> </span>liên<span style="letter-spacing: 0.45pt;"> </span>quan<span style="letter-spacing: 2.4pt;"> </span>đến <span style="letter-spacing: 0.65pt;"> </span>nhiễm<span style="letter-spacing: 1.75pt;"> </span>khuẩn: <span style="letter-spacing: 1.5pt;"> </span>viêm màng<span style="letter-spacing: -0.95pt;"> </span>tr<span style="letter-spacing: -0.1pt;">o</span>ng<span style="letter-spacing: 2.5pt;"> </span>tim<span style="letter-spacing: 2.5pt;"> </span>nhiễm<span style="letter-spacing: 1.75pt;"> </span>khuẩn <span style="letter-spacing: 1.55pt;"> </span>b<span style="letter-spacing: -0.1pt;">á</span>n <span style="letter-spacing: 0.8pt;"> </span>cấp<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">(Osler), bội<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>phổ<span style="letter-spacing: 0.15pt;">i</span>,<span style="letter-spacing: 0.35pt;"> </span>thấp<span style="letter-spacing: 1.65pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>tái<span style="letter-spacing: 0.6pt;"> </span>phát.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.<span style="letter-spacing: -0.1pt;"> </span>Điều<span style="letter-spacing: -0.95pt;"> </span>trị.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: -1.05pt;"> </span>hẹp<span style="letter-spacing: -0.4pt;"> </span>lỗ<span style="letter-spacing: 1.1pt;"> </span>van hai<span style="letter-spacing: 0.35pt;"> </span>lá,<span style="letter-spacing: 1.2pt;"> </span>dù<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.7pt;"> </span>điều<span style="letter-spacing: 2pt;"> </span>trị<span style="letter-spacing: 1.3pt;"> </span>hay<span style="letter-spacing: 0.35pt;"> </span>không <span style="letter-spacing: 1.5pt;"> </span>được<span style="letter-spacing: 0.7pt;"> </span>điều<span style="letter-spacing: 2pt;"> </span>trị,<span style="letter-spacing: 1.8pt;"> </span>vẫn<span style="letter-spacing: 2.05pt;"> </span>tiến<span style="letter-spacing: -0.25pt;"> </span>triển<span style="letter-spacing: -0.2pt;"> </span>nặng<span style="letter-spacing: 0.25pt;"> </span>dần,<span style="letter-spacing: 0.3pt;"> </span>vì vậy<span style="letter-spacing: 1.55pt;"> </span>cần<span style="letter-spacing: -0.15pt;"> </span>được<span style="letter-spacing: 0.85pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: 0.65pt;"></span>sớm,<span style="letter-spacing: -0.25pt;"> </span>điều<span style="letter-spacing: -0.1pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>đúng<span style="letter-spacing: 0.65pt;"> </span>nguyên<span style="letter-spacing: 2.6pt;"> </span>tắc.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.55pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.1.<span style="letter-spacing: -0.2pt;"> </span>Nguyên<span style="letter-spacing: -0.8pt;"> </span>tắc:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: -0.3pt;"> </span>nguyên<span style="letter-spacing: 2.2pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ấp<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.75pt;"> </span>dự<span style="letter-spacing: -0.1pt;"> </span>phòng<span style="letter-spacing: 0.3pt;"> </span>thấp<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>tái<span style="letter-spacing: 0.65pt;"> </span>phát.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.05pt;"> </span>Điều<span style="letter-spacing: 0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị<span style="letter-spacing: 0.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">ạ</span>i<span style="letter-spacing: 0.05pt;"> </span>chỗ<span style="letter-spacing: 0.7pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>lỗ<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>hai<span style="letter-spacing: -0.1pt;"> </span>lá<span style="letter-spacing: -0.3pt;"> </span>đối<span style="letter-spacing: 2.05pt;"> </span>với<span style="letter-spacing: -0.4pt;"> </span>t<span style="letter-spacing: -0.15pt;">r</span>ường<span style="letter-spacing: 0.05pt;"> </span>hợp<span style="letter-spacing: -0.3pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>khít<span style="letter-spacing: 2.25pt;"> </span>đơn<span style="letter-spacing: -0.6pt;"> </span>thuần.<span style="letter-spacing: -0.25pt;"> </span>Nếu<span style="letter-spacing: -0.8pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>lỗ<span style="letter-spacing: 0.65pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>2<span style="letter-spacing: 0.05pt;"> </span>lá kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>2 lá<span style="letter-spacing: 0.85pt;"></span>nặng<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>x<span style="letter-spacing: -0.05pt;">e</span>m<span style="letter-spacing: -0.1pt;"> </span>xét<span style="letter-spacing: -0.6pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ỉ định<span style="letter-spacing: 0.55pt;"> </span>thay<span style="letter-spacing: -0.2pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>nội<span style="letter-spacing: -0.15pt;"> </span>khoa<span style="letter-spacing: -0.25pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ường<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu,<span style="letter-spacing: -0.85pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">b</span><span style="letter-spacing: 0.05pt;">i</span>ến<span style="letter-spacing: -0.75pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>(<span style="letter-spacing: -0.05pt;">n</span>ếu<span style="letter-spacing: -0.7pt;"> </span>có).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.65pt;"> </span>c<span style="letter-spacing: -0.1pt;">á</span>c<span style="letter-spacing: 0.35pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>an<span style="letter-spacing: -0.45pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"> </span>(nếu<span style="letter-spacing: -0.9pt;"> </span>có).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">C</span>ó<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ế<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ộ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">s</span><span style="letter-spacing: -0.25pt;">i</span><span style="letter-spacing: -0.3pt;">n</span>h<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">hoạt</span>,<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">la</span>o<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">ph</span>ù<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: -0.3pt;">hợ</span>p<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">vớ</span>i<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.3pt;">mứ</span>c<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ộ<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">su</span>y<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">củ</span>a<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">bện</span>h<span style="letter-spacing: -0.3pt;"> nhân.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.2.<span style="letter-spacing: 2.85pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>nội<span style="letter-spacing: 0.6pt;"> </span>khoa:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị s<span style="letter-spacing: -0.05pt;">u</span>y tim<span style="letter-spacing: -0.15pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>c<span style="letter-spacing: -0.05pt;">ó</span>:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Hạn<span style="letter-spacing: 0.45pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>lao<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. <span style="letter-spacing: -0.05pt;">ă</span>n<span style="letter-spacing: 1.3pt;"> </span>nhạt:<span style="letter-spacing: 1pt;"> </span>hạn<span style="letter-spacing: 0.05pt;"> </span>chế<span style="letter-spacing: -0.7pt;"> </span>muối,<span style="letter-spacing: 0.55pt;"> </span>ăn<span style="letter-spacing: 0.5pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>1-2g/ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.2pt;"> </span>Thuốc<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ường<span style="letter-spacing: 0.15pt;"> </span>tim: digitalis<span style="letter-spacing: -0.2pt;"> </span>không <span style="letter-spacing: 1.55pt;"> </span>phải<span style="letter-spacing: 1.45pt;"> </span>là<span style="letter-spacing: -0.55pt;"> </span>thuốc<span style="letter-spacing: 0.65pt;"> </span>tốt<span style="letter-spacing: 0.75pt;"> </span>trong<span style="letter-spacing: -0.1pt;"> </span>điều<span style="letter-spacing: 0.85pt;"> </span>trị<span style="letter-spacing: 0.45pt;"> </span>hẹp<span style="letter-spacing: -0.75pt;"> </span>lỗ<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>hai<span style="letter-spacing: 0.05pt;"> </span>lá. Chỉ<span style="letter-spacing: 1.7pt;"> </span>dùng khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 2.1pt;"> </span>và<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"></span>loạn<span style="letter-spacing: 0.2pt;"> </span>nhịp<span style="letter-spacing: 1.35pt;"> </span>hoàn<span style="letter-spacing: 0.4pt;"> </span>toàn<span style="letter-spacing: 0.2pt;"> </span>nhanh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 16px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.25pt;"> </span>Nếu<span style="letter-spacing: -0.6pt;"> </span>suy<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>phải,<span style="letter-spacing: 0.65pt;"> </span>huyết<span style="letter-spacing: -0.55pt;"> </span>áp<span style="letter-spacing: 0.95pt;"> </span>thấp<span style="letter-spacing: 1.95pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>kết<span style="letter-spacing: -0.5pt;"> </span>hợp<span style="letter-spacing: -0.1pt;"> </span>nhóm<span style="letter-spacing: 0.8pt;"> </span>amyl <span style="letter-spacing: 0.25pt;"> </span>cường<span style="letter-spacing: 0.25pt;"> </span>tim:<span style="letter-spacing: 0.05pt;"> </span>heptamyl,<span style="letter-spacing: -0.25pt;"> </span>dopamin. Có<span style="letter-spacing: 0.3pt;"> </span>thể<span style="letter-spacing: -0.6pt;"> </span>dùng<span style="letter-spacing: -0.1pt;"> </span>thuốc<span style="letter-spacing: 0.65pt;"> </span>chẹn<span style="letter-spacing: -0.6pt;"> </span>β<span style="letter-spacing: -1.6pt;"></span>giao<span style="letter-spacing: -0.05pt;"> </span>cảm<span style="letter-spacing: 0.85pt;"> </span>để<span style="letter-spacing: -0.4pt;"> </span>điều<span style="letter-spacing: 1.1pt;"> </span>trị<span style="letter-spacing: 0.65pt;"> </span>nhịp<span style="letter-spacing: 2pt;"> </span>tim nhanh<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: -0.1pt;"> </span>hẹp<span style="letter-spacing: -0.8pt;"> </span>lỗ<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>hai lá<span style="letter-spacing: 1pt;"> </span>(nếu<span style="letter-spacing: -0.75pt;"> </span>không<span style="letter-spacing: 0.4pt;"> </span>có chống<span style="letter-spacing: 0.55pt;"> </span>chỉ<span style="letter-spacing: 0.35pt;"> </span>định).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1.6pt;"> </span>Thuốc<span style="letter-spacing: 1.9pt;"> </span>lợi<span style="letter-spacing: 1.45pt;"> </span>tiểu<span style="letter-spacing: 0.85pt;"> </span>và <span style="letter-spacing: 0.2pt;"> </span>nitrates<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược <span style="letter-spacing: 0.05pt;"> </span>d<span style="letter-spacing: -0.05pt;">ù</span>ng<span style="letter-spacing: 1.35pt;"> </span>khi<span style="letter-spacing: 1.45pt;"> </span>có<span style="letter-spacing: 2.25pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>uy<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 1.5pt;"> </span>phải,<span style="letter-spacing: 1.95pt;"> </span>tăng<span style="letter-spacing: -0.45pt;"> </span>áp <span style="letter-spacing: 0.05pt;"> </span>lực<span style="letter-spacing: 1.45pt;"> </span>động<span style="letter-spacing: -1.05pt;"> </span>mạch<span style="letter-spacing: 1.9pt;"> </span>phổi. Thuốc<span style="letter-spacing: 0.3pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>nên<span style="letter-spacing: 0.35pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>là<span style="letter-spacing: 0.85pt;"></span>lasix, h<span style="letter-spacing: -0.1pt;">y</span>pothyazit.<span style="letter-spacing: -0.95pt;"> </span>Chú<span style="letter-spacing: -0.8pt;"> </span>ý bồi<span style="letter-spacing: 0.6pt;"> </span>phụ<span style="letter-spacing: -0.55pt;"> </span>đủ<span style="letter-spacing: 0.6pt;"> </span>K<span style="position: relative; top: -5pt;">+<span style="letter-spacing: 1.15pt;"> </span></span>để<span style="letter-spacing: 0.15pt;"> </span>tránh <span style="letter-spacing: 0.45pt;"> </span>hạ K<span style="position: relative; top: -5pt;">+<span style="letter-spacing: 1.15pt;"> </span></span>máu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ị t<span style="letter-spacing: -0.05pt;">ắ</span>c<span style="letter-spacing: -0.2pt;"> </span>mạch:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Hẹp<span style="letter-spacing: 0.3pt;"> </span>lỗ<span style="letter-spacing: 1.95pt;"> </span>van<span style="letter-spacing: 0.8pt;"> </span>2<span style="letter-spacing: 1.3pt;"> </span>lá hay<span style="letter-spacing: 1.15pt;"> </span>gặp<span style="letter-spacing: 0.95pt;"> </span>c<span style="letter-spacing: -0.05pt;">á</span>c<span style="letter-spacing: 1.9pt;"> </span>biến<span style="letter-spacing: 0.45pt;"> </span>chứng<span style="letter-spacing: 1.05pt;"> </span>tắc<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 1.7pt;"> </span>ở<span style="letter-spacing: 1.25pt;"> </span>động<span style="letter-spacing: 2.15pt;"> </span>mạch<span style="letter-spacing: 1.65pt;"> </span>não,<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 2.2pt;"> </span>mạch<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ành,<span style="letter-spacing: 1.3pt;"> </span>động mạch<span style="letter-spacing: 0.85pt;"> </span>phổi.<span style="letter-spacing: 0.75pt;"> </span>Nhất<span style="letter-spacing: 2.2pt;"> </span>là<span style="letter-spacing: 1.35pt;"></span>trong<span style="letter-spacing: 0.25pt;"> </span>hẹp<span style="letter-spacing: -0.4pt;"> </span>lỗ<span style="letter-spacing: 1.1pt;"> </span>van 2<span style="letter-spacing: 0.5pt;"> </span>lá<span style="letter-spacing: 1.35pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>loạn<span style="letter-spacing: 0.7pt;"> </span>nhịp<span style="letter-spacing: 1.85pt;"> </span>hoàn<span style="letter-spacing: 0.9pt;"> </span>toàn<span style="letter-spacing: 0.7pt;"> </span>thì<span style="letter-spacing: 0.9pt;"> </span>cần<span style="letter-spacing: 0.35pt;"> </span>điều<span style="letter-spacing: 1.2pt;"> </span>trị<span style="letter-spacing: 0.8pt;"> </span>dự<span style="letter-spacing: 0.5pt;"> </span>phòng<span style="letter-spacing: 0.8pt;"> </span>tắc<span style="letter-spacing: 0.35pt;"> </span>mạch bằng<span style="letter-spacing: 0.4pt;"> </span>heparin,<span style="letter-spacing: -0.4pt;"> </span>fraxiparin,<span style="letter-spacing: -0.5pt;"> </span>sintrom,<span style="letter-spacing: -0.4pt;"></span>aspegic.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.1pt;"> </span>Điều<span style="letter-spacing: 1.55pt;"> </span>trị<span style="letter-spacing: -0.95pt;"> </span>l<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 0.9pt;"> </span>nhịp<span style="letter-spacing: 2.2pt;"> </span>bằng<span style="letter-spacing: 1.5pt;"> </span>thuốc<span style="letter-spacing: 1.6pt;"> </span>hay<span style="letter-spacing: 0.95pt;"> </span>bằng<span style="letter-spacing: 1.5pt;"> </span>sốc<span style="letter-spacing: 1.7pt;"> </span>điện <span style="letter-spacing: 0.45pt;"> </span>để<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ưa<span style="letter-spacing: 1.1pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.95pt;"> </span>về<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 1.4pt;"> </span>xoang,<span style="letter-spacing: 0.8pt;"> </span>từ<span style="letter-spacing: 1pt;"> </span>đó<span style="letter-spacing: -1pt;"> </span>giúp giảm<span style="letter-spacing: 0.4pt;"> </span>bớt<span style="letter-spacing: -0.15pt;"> </span>đi<span style="letter-spacing: 0.7pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>nguy cơ<span style="letter-spacing: -0.1pt;"></span>gây<span style="letter-spacing: 1.45pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.3.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>ngoại<span style="letter-spacing: 0.25pt;"> </span>kho<span style="letter-spacing: 0.05pt;">a</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Đã<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>tiến<span style="letter-spacing: -0.75pt;"> </span>bộ và<span style="letter-spacing: 0.8pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>p<span style="letter-spacing: 0.05pt;">h</span>ương pháp<span style="letter-spacing: 0.4pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị<span style="letter-spacing: 0.15pt;"> </span>ngoại<span style="letter-spacing: 1pt;"> </span>khoa<span style="letter-spacing: -0.25pt;"> </span>đối<span style="letter-spacing: 0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.05pt;"> </span>Nong<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.55pt;"> </span>hai<span style="letter-spacing: 0.9pt;"> </span>lá<span style="letter-spacing: 0.8pt;"> </span>bằng <span style="letter-spacing: 1.45pt;"> </span>bóng<span style="letter-spacing: 1.5pt;"> </span>qua<span style="letter-spacing: 0.9pt;"> </span>da:<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: 1.9pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 1.05pt;"> </span>pháp<span style="letter-spacing: 1.45pt;"> </span>có<span style="letter-spacing: 1.7pt;"> </span>nhiều<span style="letter-spacing: 0.3pt;"> </span>ưu<span style="letter-spacing: 1.55pt;"> </span>điểm, <span style="letter-spacing: 0.95pt;"> </span>bệnh<span style="letter-spacing: 0.35pt;"> </span>nhân<span style="letter-spacing: -1pt;"> </span>không phải<span style="letter-spacing: 0.45pt;"> </span>chịu<span style="letter-spacing: 2.1pt;"> </span>phẫu<span style="letter-spacing: 2.5pt;"> </span>thuật<span style="letter-spacing: 2.8pt;"> </span>lớn<span style="letter-spacing: 0.65pt;"></span>và<span style="letter-spacing: 1.6pt;"> </span>nhanh<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 1.7pt;"> </span>ra<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">v</span><span style="letter-spacing: 0.05pt;">i</span>ện;<span style="letter-spacing: -0.35pt;"> </span>bớt<span style="letter-spacing: 0.7pt;"> </span>tốn<span style="letter-spacing: 1.45pt;"> </span>kém về<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>huốc<span style="letter-spacing: 1.2pt;"> </span>men<span style="letter-spacing: 0.65pt;"> </span>và<span style="letter-spacing: 0.25pt;"> </span>ngày <span style="letter-spacing: 0.55pt;"> </span>nằm<span style="letter-spacing: 2.4pt;"> </span>viện.<span style="letter-spacing: -0.35pt;"> </span>Kết quả<span style="letter-spacing: 0.5pt;"> </span>khá<span style="letter-spacing: 0.5pt;"> </span>tốt<span style="letter-spacing: 0.6pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>mềm<span style="letter-spacing: -0.75pt;"> </span>mại,<span style="letter-spacing: 1.55pt;"> </span>ít<span style="letter-spacing: 0.15pt;"> </span>vôi<span style="letter-spacing: 0.9pt;"> </span>hóa,<span style="letter-spacing: 0.6pt;"></span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>đông<span style="letter-spacing: -0.1pt;"> </span>ở nhĩ<span style="letter-spacing: 0.35pt;"> </span>trái.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Nong<span style="letter-spacing: 0.05pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>hai<span style="letter-spacing: 0.15pt;"> </span>lá<span style="letter-spacing: -0.35pt;"> </span>kín<span style="letter-spacing: 1.9pt;"> </span>bằng<span style="letter-spacing: 2.2pt;"> </span>tay<span style="letter-spacing: 0.15pt;"> </span>h<span style="letter-spacing: -0.05pt;">a</span>y<span style="letter-spacing: 0.2pt;"> </span>dụng<span style="letter-spacing: 0.05pt;"> </span>cụ: phải<span style="letter-spacing: 0.8pt;"> </span>lựa<span style="letter-spacing: 0.15pt;"> </span>chọn<span style="letter-spacing: 0.75pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>nhân<span style="letter-spacing: 1.95pt;"> </span>bị<span style="letter-spacing: 0.1pt;"> </span>hẹp<span style="letter-spacing: -0.6pt;"> </span>lỗ<span style="letter-spacing: 0.9pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>lá<span style="letter-spacing: 1.15pt;"> </span>mức độ<span style="letter-spacing: 0.75pt;"> </span>trung<span style="letter-spacing: -0.05pt;"> </span>bình <span style="letter-spacing: 0.4pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>nặng,<span style="letter-spacing: -0.05pt;"></span>không<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>hở<span style="letter-spacing: 0.2pt;"> </span>lỗ<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: -0.3pt;"> </span>2<span style="letter-spacing: 0.2pt;"> </span>lá<span style="letter-spacing: 1.05pt;"> </span>kết<span style="letter-spacing: -0.55pt;"> </span>hợp, van<span style="letter-spacing: -0.3pt;"> </span>còn<span style="letter-spacing: 0.85pt;"> </span>mềm<span style="letter-spacing: -0.55pt;"> </span>mại,<span style="letter-spacing: 0.35pt;"> </span>không<span style="letter-spacing: 2.25pt;"> </span>vôi<span style="letter-spacing: -0.1pt;"> </span>hóa,<span style="letter-spacing: 0.8pt;"> </span>không<span style="letter-spacing: 0.45pt;"> </span>có cục<span style="letter-spacing: 0.65pt;"> </span>máu<span style="letter-spacing: 2.25pt;"> </span>đông<span style="letter-spacing: 0.9pt;"> </span>ở<span style="letter-spacing: 1pt;"> </span>nhĩ<span style="letter-spacing: -1.1pt;"> </span>trái,<span style="letter-spacing: 0.7pt;"> </span>không<span style="letter-spacing: 2.35pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>tiền<span style="letter-spacing: 0.25pt;"></span>sử<span style="letter-spacing: 1pt;"> </span>tắc<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 1.35pt;"> </span>mới<span style="letter-spacing: 0.8pt;"> </span>(trong<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>òng<span style="letter-spacing: 1.1pt;"> </span>3<span style="letter-spacing: 1pt;"> </span>tháng),<span style="letter-spacing: 1.25pt;"> </span>không<span style="letter-spacing: 1.25pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>Osler<span style="letter-spacing: 1pt;"> </span>và thấp<span style="letter-spacing: 1.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>ổn<span style="letter-spacing: 0.55pt;"> </span>định.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Sửa<span style="letter-spacing: -0.75pt;"> </span>chữa<span style="letter-spacing: -0.1pt;"> </span>tạo<span style="letter-spacing: -0.3pt;"> </span>hình<span style="letter-spacing: 2pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>hai lá:<span style="letter-spacing: 0.8pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ẫu<span style="letter-spacing: 1.85pt;"> </span>thuật<span style="letter-spacing: 2.15pt;"> </span>mở c<span style="letter-spacing: -0.05pt;">ầ</span>n<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>tim-p<span style="letter-spacing: -0.05pt;">h</span>ổi<span style="letter-spacing: 0.45pt;"> </span>nhân<span style="letter-spacing: 1.8pt;"> </span>tạo.<span style="letter-spacing: -0.3pt;"> </span>Có<span style="letter-spacing: 0.3pt;"> </span>thể<span style="letter-spacing: -0.6pt;"> </span>nong<span style="letter-spacing: -0.1pt;"> </span>chỗ<span style="letter-spacing: 0.8pt;"> </span>hẹp van, sửa<span style="letter-spacing: 0.6pt;"> </span>chữa<span style="letter-spacing: 0.35pt;"> </span>lá<span style="letter-spacing: 1.45pt;"> </span>van, mép<span style="letter-spacing: -0.45pt;"> </span>van, cắt<span style="letter-spacing: 0.45pt;"> </span>cục<span style="letter-spacing: 0.25pt;"> </span>sùi,<span style="letter-spacing: 0.25pt;"> </span>lấy<span style="letter-spacing: 2.5pt;"> </span>m<span style="letter-spacing: -0.05pt;">á</span>u<span style="letter-spacing: 1.75pt;"> </span>đông<span style="letter-spacing: 0.5pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span>nhĩ<span style="letter-spacing: 0.95pt;"> </span>trái,<span style="letter-spacing: 0.3pt;"> </span>khâu<span style="letter-spacing: 1.95pt;"> </span>lỗ<span style="letter-spacing: 1.2pt;"> </span>thủng<span style="letter-spacing: 0.3pt;"> </span>trên<span style="letter-spacing: 0.9pt;"> </span>van, nối<span style="letter-spacing: 1.2pt;"> </span>trụ cơ-dây<span style="letter-spacing: 0.8pt;"> </span>chằng<span style="letter-spacing: 1.4pt;"> </span>bị<span style="letter-spacing: -0.05pt;"> </span>đứt.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Thay<span style="letter-spacing: -0.2pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>hai<span style="letter-spacing: 0.15pt;"> </span>lá:<span style="letter-spacing: 0.2pt;"> </span>chỉ<span style="letter-spacing: 1.85pt;"> </span>định<span style="letter-spacing: 0.85pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>tổn<span style="letter-spacing: 0.9pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ương<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>kết<span style="letter-spacing: -0.45pt;"> </span>hợp<span style="letter-spacing: -0.05pt;"> </span>như<span style="letter-spacing: 0.3pt;"> </span>hẹp<span style="letter-spacing: -0.6pt;"> </span>và<span style="letter-spacing: 1.1pt;"> </span>hở<span style="letter-spacing: 0.3pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>lá,<span style="letter-spacing: 1pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>2<span style="letter-spacing: 0.3pt;"> </span>lá<span style="letter-spacing: -0.35pt;"> </span>bị vôi<span style="letter-spacing: 0.9pt;"> </span>hóa,<span style="letter-spacing: 0.95pt;"> </span>xơ<span style="letter-spacing: 0.7pt;"> </span>dày,<span style="letter-spacing: 1.35pt;"> </span>biến<span style="letter-spacing: -0.5pt;"></span>dạng.<span style="letter-spacing: 0.7pt;"> </span>Có<span style="letter-spacing: 0.5pt;"> </span>n<span style="letter-spacing: -0.1pt;">h</span>iều<span style="letter-spacing: -0.4pt;"> </span>loại<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.15pt;"> </span>để<span style="letter-spacing: 1.05pt;"> </span>thay<span style="letter-spacing: 0.15pt;"> </span>thế<span style="letter-spacing: -0.4pt;"> </span>n<span style="letter-spacing: 0.1pt;">h</span>ưng<span style="letter-spacing: 0.35pt;"> </span>tốt<span style="letter-spacing: 0.95pt;"> </span>nhất<span style="letter-spacing: 2.2pt;"> </span>là<span style="letter-spacing: 1.2pt;"> </span>thay<span style="letter-spacing: 0.15pt;"> </span>van<span style="letter-spacing: -0.15pt;"> </span>đồng <span style="letter-spacing: 0.4pt;"> </span>loại<span style="letter-spacing: 0.6pt;"> </span>vì<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: 0.1pt;">c</span>ó nhiều<span style="letter-spacing: -0.75pt;"> </span>ưu<span style="letter-spacing: 0.55pt;"> </span>điểm<span style="letter-spacing: 1.95pt;"> </span>hơn<span style="letter-spacing: 1.6pt;"> </span>van<span style="letter-spacing: -0.45pt;"> </span>nhân<span style="letter-spacing: 2.25pt;"> </span>tạo,<span style="letter-spacing: 0.1pt;"> </span>ít<span style="letter-spacing: -0.3pt;"> </span>gây<span style="letter-spacing: 1pt;"></span>biến<span style="letter-spacing: -0.8pt;"> </span>chứng<span style="letter-spacing: -0.25pt;"> </span>tắc<span style="letter-spacing: -0.1pt;"> </span>mạch <span style="letter-spacing: 0.25pt;"> </span>hơn,<span style="letter-spacing: 2.3pt;"> </span>đây<span style="letter-spacing: -0.05pt;"> </span>là<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ướng<span style="letter-spacing: 0.05pt;"> </span>đang<span style="letter-spacing: 0.95pt;"> </span>phát<span style="letter-spacing: -0.05pt;"> </span>triển<span style="letter-spacing: -0.65pt;"> </span>trong <span style="letter-spacing: 0.05pt;">t</span>ương lai.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Dù<span style="letter-spacing: -0.15pt;"> </span>nong<span style="letter-spacing: 0.05pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>hay<span style="letter-spacing: 0.15pt;"> </span>thay<span style="letter-spacing: 0.1pt;"> </span>van<span style="letter-spacing: -0.2pt;"> </span>thì<span style="letter-spacing: 0.7pt;"> </span>vẫn<span style="letter-spacing: 1.85pt;"> </span>cần<span style="letter-spacing: 0.15pt;"> </span>phối<span style="letter-spacing: 0.65pt;"> </span>hợp<span style="letter-spacing: -0.05pt;"> </span>tốt<span style="letter-spacing: 0.9pt;"> </span>giữa<span style="letter-spacing: 0.1pt;"> </span>nội-ngoại<span style="letter-spacing: 0.55pt;"> </span>khoa,<span style="letter-spacing: 0.05pt;"> </span>dự<span style="letter-spacing: 0.3pt;"> </span>phòng<span style="letter-spacing: 0.6pt;"> </span>thấp<span style="letter-spacing: 2pt;"> </span>tim tái<span style="letter-spacing: -0.1pt;"> </span>phát,<span style="letter-spacing: 1.6pt;"> </span>dự phòng<span style="letter-spacing: 0.3pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>điều<span style="letter-spacing: 1.75pt;"></span>trị<span style="letter-spacing: 0.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">ố</span>t<span style="letter-spacing: 0.55pt;"> </span>viêm<span style="letter-spacing: 0.6pt;"> </span>màng<span style="letter-spacing: 0.05pt;"> </span>trong<span style="letter-spacing: -0.3pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>khuẩn<span style="letter-spacing: 1.9pt;"> </span>bán<span style="letter-spacing: 0.5pt;"> </span>cấp,<span style="letter-spacing: 1.75pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>uy tim,<span style="letter-spacing: -0.2pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>trị chống<span style="letter-spacing: 1.25pt;"> </span>đông máu,<span style="letter-spacing: 1.7pt;"> </span>điều<span style="letter-spacing: 1.4pt;"> </span>trị<span style="letter-spacing: 1pt;"> </span>loạn<span style="letter-spacing: 1.15pt;"> </span>nhịp<span style="letter-spacing: 2.3pt;"> </span>tim<span style="letter-spacing: 0.55pt;"> </span>để<span style="letter-spacing: 1.4pt;"> </span>kéo<span style="letter-spacing: -0.2pt;"></span>dài<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.1pt;">c</span>uộc<span style="letter-spacing: 0.45pt;"> </span>sống<span style="letter-spacing: 1.35pt;"> </span>cho<span style="letter-spacing: 0.55pt;"> </span>bệnh nhân <span style="letter-spacing: 0.35pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>nâng <span style="letter-spacing: 0.35pt;"> </span>cao<span style="letter-spacing: 0.55pt;"> </span>hiệu<span style="letter-spacing: -0.15pt;"> </span>quả điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá.</span></span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-50179918774110451602011-04-29T05:09:00.000-07:002011-04-29T05:09:29.743-07:00- BIẾN CHỨNG NHỒI MÁU CƠ TIM<span class="Apple-style-span" style="font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><span style="font-family: Tahoma;"><span class="Apple-style-span" style="color: #e06666;">BIẾN CHỨNG NHỒI MÁU CƠ TIM </span></span></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"><br />
</span></span><br />
<span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">Bệnh nhân NMCT thờng chết chủ yếu là do các biến chứng cấp và nếu qua khỏi giai đoạn cấp cũng thờng để lại một số biến chứng đôi khi rất nặng nếu không đợc điều trị một cách thoả đáng. Các biến chứng của NMCT rất phong phú và có thể chia làm các nhóm: biến chứng cơ học, biến chứng rối loạn nhịp, biến chứng thiếu máu cơ tim, tắc mạch…<span> </span><br />
<strong>I. Biến chứng cơ học</strong>Các biến chứng cơ học có thể đe doạ tính mạng bệnh nhân là: thông liên thất, hở van hai lá cấp do đứt dây chằng, vỡ thành tim tự do, phình thành tim...<span> </span><br />
<strong>A. Thông liên thất (TLT) do thủng vách liên thất<br />
1. Triệu chứng lâm sàng:</strong>a. TLT xảy ra ở khoảng 0,5 – 2% số bệnh nhân NMCT cấp. Tỷ lệ gặp ngang nhau giữa các nhóm NMCT phía trớc và sau dới. TLT thờng xảy ra ở những bệnh nhân bị NMCT diện rộng, tắc một mạch mà tuần hoàn bàng hệ kém. TLT có thể xảy ra sớm ngay sau 24 giờ của NMCT nhng thờng xảy ra sau khoảng 3-7 ngày.<br />
b. Bệnh nhân có biến chứng TLT thờng có dấu hiệu lâm sàng nặng nề hơn. Các bệnh cảnh lâm sàng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> đau ngực tăng, phù phổi cấp, tụt huyết áp, sốc tim có thể xảy ra đột ngột trong qua trình đang diễn biến bình thờng của bệnh.<br />
c. Khi nghe tim thấy một tiếng thổi tâm thu mới xuất hiện vùng trớc tim, tiếng thổi rõ nhất ở phía thấp bên trái xơng ức. Khi bệnh nhân có lỗ thủng lớn ở vách liên thất và tình trạng suy tim nặng thì có thể không nghe thấy tiếng thổi nữa.<br />
d. Cần phân biệt với hở van hai lá hoặc hở van ba lá.<br />
<strong>2. Giải phẫu bệnh:</strong>Lỗ TLT là hậu quả của lỗ thủng vùng cơ tim bị hoại tử do NMCT và xảy ra chỗ ranh giới giữa vùng không hoại tử và vùng bị nhồi máu. Lỗ này thờng ở vùng gần<span> </span>mỏm tim đối với những bệnh nhân NMCT vùng trớc và vùng vách sau với NMCT phía sau.<br />
<strong>3. Các xét nghiệm chẩn đoán:<br />
a. Điện tâm đồ:</strong> có thể thấy bất thờng về dẫn truyền ở nút nhĩ thất hoặc đờng dẫn truyền từ nhĩ xuống thất.<br />
<strong>b. Siêu âm tim:</strong> là thăm dò có giá trị trong chẩn đoán bệnh đặc biệt là siêu âm màu. Đối với thủng vùng gần mỏm, mặt cắt 4 buồng từ mỏm là mặt cắt tốt nhất để quan sát. Đối với thủng vùng vách sau, mặt cắt trục dọc có lái góc đôi chút hoặc mặt cắt trục dọc dới mũi ức cho phép đánh giá rõ nhất. Trong một số trờng hợp cần phải dùng đến siêu âm qua đuờng thực quản để đánh giá rõ hơn về bản chất thơng tổn. Siêu âm tim có thể giúp đánh giá đợc kích thớc lỗ thông, mức độ lớn của shunt. Siêu âm tim cũng có thể giúp đánh giá chức năng thất trái và thất phải, từ đó góp phần tiên lợng bệnh.<span> </span><br />
<strong>c. Thông tim phải:</strong> khi có chỉ định chụp ĐMV thờng nên thông tim phải để đánh giá đợc luồng thông và lu lợng shunt cũng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">áp lực động mạch phổi, cung lợng tim... giúp có thái độ điều trị và tiên lợng bệnh tốt hơn.<br />
<strong>4. Điều trị:<br />
a. Thái độ: </strong>Tỷ lệ tử vong khi có biến chứng TLT đợc điều trị nội khoa là khoảng 24% sau 24 giờ, 46% sau 1 tuần và 67-82% sau 2 tháng. Do vậy, cần nhanh chóng xác định và có kế hoạch mổ sớm để đóng lỗ thông ngay khi tình trạng bệnh nhân không đợc ổn định.<br />
<strong>b. Điều trị nội khoa:</strong> Điều trị nội khoa là biện pháp cơ bản và là cầu nối cho điều trị ngoại khoa. Các thuốc giãn mạch làm giảm lu lợng shunt và làm tăng cung lợng hệ thống do làm giảm sức cản hệ thống; tuy nhiên, nếu làm giảm sức cản động mạch phổi quá lại dẫn đến làm tăng lu lợng shunt. Thuốc thờng dùng là Nitroprusside truyền TM, bắt đầu bằng liều 0,5-3 mcg/kg/ph và theo dõi huyết áp trung bình ở mức 70-80mmHg.<br />
<strong>c. Đặt bóng bơm ngợc dòng trong động mạch chủ</strong> (IABP): là biện pháp nên đợc thực hiện càng sớm càng tốt trớc khi gửi đi mổ. IABP làm giảm sức cản hệ thống, giảm lu lợng shunt, tăng tới máu ĐMV và duy trì đuợc huyết áp động mạch.<br />
<strong>d. Phẫu thuật:</strong> Là biện pháp lựa chọn mặc dù tình trạng huyết động không đợc ổn định. Phẫu thuật ở bệnh nhân có biến chứng TLT làm giảm đáng kể tỷ lệ tử vong so với điều trị bảo tồn. Tuy nhiên, tỷ lệ tử vong vẫn còn cao đặc biệt ở nhóm bệnh nhân có sốc tim, suy đa phủ tạng, NMCT vùng sau dới gây lỗ thủng vùng vách sau do kỹ thuật khó khăn hơn nhiều so với vùng mỏm...<br />
<strong>B. Hở van hai lá (HoHL) cấp</strong>HoHL cấp do đứt dây chằng cột cơ là một biến chứng nặng nề và báo hiệu tiên lợng rất xấu trong NMCT. Đứt dây chằng cột cơ thờng xảy ra trong vòng 2-7 ngày sau NMCT cấp và chiếm tỷ lệ khoảng 1% trong số NMCT cấp.<br />
<strong>1. Triệu chứng lâm sàng:</strong>a. HoHL cấp do đứt dây chằng cột cơ thờng xảy ra ở bệnh nhân bị NMCT cấp thành sau.<br />
b. Nếu tình trạng đứt hoàn toàn một cột cơ gây HoHL cấp sẽ dẫn đến tình trạng sốc tim nhanh chóng hoặc đột tử. Những trờng hợp nhẹ hơn có thể biểu hiện bằng khó thở tăng lên nhiều, phù phổi cấp hoặc đi vào sốc tim.<br />
<strong>c. Nghe tim:</strong> có thể thấy xuất hiện một tiếng thổi tâm thu mới ở vùng mỏm lan lên nách hoặc lên vùng đáy tim. Trong trờng hợp NMCT vùng thành sau gây đứt dây chằng sau có thể nghe thấy tiếng thổi tâm thu phía cạnh xơng ức dễ nhầm lẫn với thông liên thất hoặc hẹp van động mạch chủ. Cờng độ tiếng thổi không có ý nghĩa dự đoán mức độ nặng nhẹ của HoHL. Đôi khi tiếng thổi rất nhẹ hoặc không thấy do bệnh nhân bị suy tim quá mức hoặc giảm cung lợng tim quá.<br />
<strong>d. Chú ý:</strong> Đứt dây chằng thờng xảy ra ở NMCT vùng dới. NMCT vùng này (tắc nhánh liên thất sau – PDA) gây hoại tử cột cơ phía sau và gây sa van hai lá và HoHL.<br />
<strong>2. Các xét nghiệm chẩn đoán:<br />
a. Điện tâm đồ:</strong> cho thấy hình ảnh của NMCT cấp thờng là phía sau dới.<br />
<strong>b. Xquang tim phổi</strong> có thể cho thấy hình ảnh của phù phổi tuỳ mức độ. Một số bệnh nhân có hình ảnh phù phổi nhiều ở thuỳ trên phải vì dòng HoHL phụt trực tiếp nhiều về phía tĩnh mạch phổi phải phía trên.<br />
<strong>c. Siêu âm Doppler tim:</strong> là phơng pháp rất có giá trị trong chẩn đoán cũng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> tiên lợng bệnh.<br />
ã Hình ảnh sa lá van hai lá.<br />
ã Hình ảnh dòng màu của HoHL và cho phép đánh giá mức độ HoHL.<br />
ã Cho phép chẩn đoán phân biệt với tiếng thổi do biến chứng thông liên thất hoặc các biến chứng khác.<br />
ã Giúp đánh giá chức năng tim và áp lực động mạch phổi.<br />
<strong>d. Thăm dò huyết động:</strong> Thông thờng đối với những bệnh nhân này cần theo dõi huyết động chặt chẽ bằng một ống thông Swan-Ganz để theo dõi áp lực động mạch phổi, cung lợng tim và áp lực mao mạch phổi bít (PCW). Trên đờng cong áp lực của PCW có thể thấy hình ảnh sóng V cao một cách bất ngờ.<span> </span><br />
<strong>3. Điều trị:<br />
a. Các u tiên trong điều trị</strong>: Cần thiết phải phát hiện đợc nhanh chóng biến chứng HoHL cấp để kịp thời đối phó. Bệnh nhân cần đợc điều trị nội khoa một cách hết sức tích cực và cân nhắc điều trị ngoại khoa sớm nếu có thể.<br />
<strong>b. Điều trị nội khoa: </strong>ã Các thuốc giãn mạch đóng vai trò quan trọng. Thuốc đợc u tiên dùng là Nitroprusside, thuốc này làm giảm sức cản hệ thống một cách có ý nghĩa, làm giảm phân số hở van hai lá và có thể làm tăng cung lợng tim. Thuốc này đợc dùng bằng đờng truyền tĩnh mạch liên tục với liều khởi đầu là 0,5-3 mcg/kg/phút và điều chỉnh theo huyết áp trung bình trong khoảng 70-80 mmHg.<br />
ã Thuốc giãn mạch không nên dùng cho bệnh nhân đã bị tụt huyết áp. Trong trờng hợp này, giải pháp tốt nhất là nên đặt bóng bơm ngợc dòng trong động mạch chủ (IABP). IABP làm giảm hậu gánh của thất trái và tăng lu lợng đến mạch vành. Sau khi đặt IABP có thể cân nhắc cho tiếp thuốc giãn mạch.<br />
<strong>c. Biện pháp can thiệp động mạch vành cấp cứu:</strong> Nong ĐMV hoặc đặt Stent cấp cứu làm cải thiện đợc tình trạng huyết động và mức độ HoHL ở những bệnh nhân HoHL mới do thiếu máu cục bộ. Tuy nhiên, khi đã bị đứt hẳn cột cơ thì can thiệp ĐMV đơn thuần cũng không cải thiện đợc tình trạng bệnh.<br />
<strong>d. Điều trị ngoại khoa:</strong> Là biện pháp cần đợc tiến hành sớm khi có đứt hoàn toàn cột cơ.<br />
ã Tỷ lệ tử vong khi mổ khá cao (20-25% ở các nớc phát triển) tuy nhiên vẫn là biện pháp hiệu quả nhất và cần đợc chỉ định sớm.<br />
ã Nên tiến hành can thiệp ĐMV trớc khi tiến hành phẫu thuật can thiệp van hai lá.<br />
ã Có thể tiến hành sửa van hai lá ở những bệnh nhân HoHL mức độ vừa mà không cần phải thay van hai lá.<br />
<strong>C. Vỡ thành tự do của tim<br />
1. Triệu chứng lâm sàng: </strong>a. Vỡ thành tự do tim có thể gặp ở khoảng 3% số bệnh nhân NMCT cấp và là một trong những nguyên nhân dẫn đến tử vong đột ngột. Vỡ thành tim cũng chỉ xảy ra ở những bệnh nhân có NMCT xuyên thành. Những yếu tố nguy cơ dễ xảy ra vỡ thành tim là: tuổi già, nữ giới, tăng huyết áp quá nhiều, NMCT lần đầu và hệ thống mạch vành không phong phú.<br />
b. Triệu chứng của thể cấp: có thể thấy biểu hiện của phân ly điện cơ trên ĐTĐ và đột tử. Một số bệnh nhân kêu đau ngực dữ dội hơn, ho và nấc.<br />
c. Thể bán cấp: gặp ở số ít bệnh nhân mà bệnh cảnh dễ nhầm với viêm màng ngoài tim cấp, nôn, tụt huyết áp.<br />
d. Khám thấy các dấu hiệu của ép tim cấp đột ngột: giãn tĩnh mạch cảnh, mạch đảo, tiếng tim mờ..<br />
<strong>2. Các xét nghiệm chẩn đoán:<br />
a. Điện tâm đồ:</strong> có hình ảnh nhịp bộ nối hoặc tự thất, điện thế ngoại vi thấp, sóng T cao nhọn ở các chuyển đạo trớc tim. Một số bệnh nhân biểu hiện nhịp chậm trớc khi vỡ thành tự do.<br />
<strong>b. Siêu âm tim:</strong> cho phép nhìn thấy hình ảnh ép tim cấp và có thể cho phép nhìn thấy chỗ vỡ.<br />
<strong>3. Điều trị: </strong>a. Biện pháp điều trị tái tới máu làm giảm bớt tỷ lệ bị vỡ thành tim.<br />
b. Mục đích là phải nhanh chóng nhận biết đợc tình trạng vỡ tim và tiến hành mổ cấp cứu.<br />
c. Điều trị nội khoa chỉ đóng vai trò tạm thời khi hồi sức và trong lúc đa đến phòng mổ. Dùng thuốc vận mạch và truyền dịch để duy trì huyết áp.<br />
d. Nhanh chóng chọc dịch màng tim nếu xác định là có ép tim cấp trong lúc thu xếp cuộc mổ.<br />
e. Phẫu thuật tối cấp cứu là biện pháp duy nhất có thể cứu sống đợc bệnh nhân trong trờng hợp bị vỡ thành tự do tim.<br />
<strong>D. Giả phình thành tim<br />
1. Triệu chứng lâm sàng:</strong>a. Giả phình thành thất thờng có tiến triển thầm lặng và thờng đợc phát hiện tình cờ khi làm các thăm dò chẩn đoán. Tuy nhiên, một số bệnh nhân có biểu hiện của các cơn tim nhanh tái phát và suy tim.<br />
b. Thăm khám có thể thấy tiếng thổi tâm thu hoặc tâm trơng hoặc tiếng thổi theo t thế do dòng máu xoáy qua lỗ thủng vào chỗ phình.<br />
c. Bản chất bệnh lý của giả phình thành thất là do vỡ một chỗ nhỏ của thành tự do thất và đợc màng ngoài tim cùng huyết khối thành bao bọc lại. Giữa túi phình và thất vẫn còn liên hệ với nhau nhờ lỗ thủng.<br />
<strong>2. Các xét nghiệm chẩn đoán:<br />
a. Xquang tim phổi</strong>: thẳng có thể thấy hình ảnh bóng tim bất thờng với một chỗ lồi tơng ứng với túi phình.<br />
<strong>b. Điện tâm đồ</strong>: có thể cho thấy hình ảnh ST chênh vòm cố định giống trờng hợp bị phình thất.<br />
<strong>c. Siêu âm tim:</strong> có thể giúp chẩn đoán xác định bệnh. Chụp cộng hởng từ (MRI) cũng là một biện pháp khá chính xác để chẩn đoán bệnh.<br />
<strong>3. Điều trị:</strong> Phẫu thuật là chỉ định bắt buộc bất kể kích cỡ hoặc triệu chứng của túi giả phình này </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> thế nào để ngăn ngừa việc vỡ thứ phát của túi giả phình này<strong>.<br />
E. Phình vách thất<br />
1. Triệu chứng lâm sàng:<br />
a. Thể cấp:</strong> Khi một vùng cơ tim rộng bị giãn ra thì nhanh chóng dẫn đến suy tim hoặc sốc tim. Những bệnh nhân bị NMCT ở vị trí có ảnh hởng đến vùng mỏm thờng là có nguy cơ cao nhất.<br />
<strong>b. Thể mạn tính:</strong> Là những thể phình vách thất tiến triển từ từ sau hơn 6 tuần. Chúng xảy ra ở 10-30% các trờng hợp NMCT. Những bệnh nhân này thờng có các triệu chứng của suy tim, rối loạn nhịp thất, tắc mạch đại tuần hoàn..<br />
<strong>c. Khám tim:</strong> Đôi khi có thể phát hiện đợc vùng bị phình của thất thông qua sờ mỏm tim hoặc gõ tim. Còn phần lớn các trờng hợp là có thể thấy tiếng ngựa phi ở những bệnh nhân đã suy giảm nhiều chức năng thất trái.<br />
<strong>2. Sinh lý bệnh:</strong>Phình vách thất là một vùng cơ thất bị giãn ra do vùng đó bị hoại tử do động mạch vành nuôi dỡng tơng ứng bị tắc. Nếu ĐMV bị tắc đợc giải phóng càng sớm thì nguy cơ bị phình vách thất càng thấp. Quá trình phình vách thất là phối hợp nhiều cơ chế trong đó quá trình tái cấu trúc (remodeling) cơ tim là rất quan trọng.<br />
<strong>3. Các thăm dò cận lâm sàng:<br />
a. Điện tâm đồ:</strong>ã Nếu phình vách thất xảy ra cấp tính thì sóng ST chênh lên cố định mặc dù ĐMV có đợc tái tới máu.<br />
ã Nếu phình vách thất xảy ra từ từ thì ST chênh lên tồn tại khoảng hơn 6 tuần.<br />
<strong>b. Xquang tim phổi:</strong> thấy hình ảnh một vùng bóng tim phình ra tơng ứng với vùng cơ thất bị phình.<br />
<strong>c. Siêu âm tim:</strong> là một thăm dò có giá trị giúp chẩn đoàn xác định bệnh, định khu, đánh gía<span> </span>các biến chứng, chức năng thất, huyết khối. Đặc biệt siêu âm giúp chẩn đoán với gỉa phình thất (trong phình vách thất thật thì cổ vào rộng còn giả phình thì cổ vào hẹp).<br />
<strong>d. Chụp cộng hởng từ</strong>: cũng giúp xác định phình vách thất.<br />
<strong>4. Điều trị:<br />
a. Điều trị nội khoa:</strong>ã <strong>Phình cấp:</strong> Nên nhanh chóng điều trị tình trạng suy tim bằng các thuốc giãn mạch truyền tĩnh mạch và đặt bóng bơm ngợc dòng trong ĐMC. Cho thuốc ức chế men chuyển sớm là một biện pháp quan trọng ngăn ngừa đợc quá trình tái cấu trúc và lan rộng của vùng nhồi máu. Vì quá trình lan rộng của nhồi máu xảy ra rất sớm nên cần cho thuốc ức chế men chuyển sớm trong vòng 24 giờ của NMCT cấp (nếu huyết áp không quá thấp).<br />
ã <strong>Phình mạn tính:</strong> Các thuốc dùng để điều trị suy tim do phình mạn tính vách thất là: ức chế men chuyển, lợi tiểu hoặc có thể cho Digoxin.<br />
ã <strong>Chống đông:</strong> Các thuốc kháng vitamin K đờng uống đợc chỉ định ở những bệnh nhân có phình vách thất mà có huyết khối bám thành. Trớc tiên nên cho Heparin trong vòng vài ngày và cũng bắt đầu luôn bằng các thuốc chống đông dạng uống loại kháng vitamin K. Khi điều trị, nên chỉnh liều sao cho INR từ khoảng 2-3 trong vòng 3-6 tháng. Đối với những phình vách thất dù lớn mà không thấy hình ảnh huyết khối bám thành thì ngời ta cũng cha rõ lợi ích và chỉ định của kháng vitamin K. Đối với những bệnh nhân có phình vách thất mà chức năng thất trái rất kém thì nên cho thuốc chống đông đờng uống trong ít nhất 3 tháng sau NMCT cấp.<br />
<strong>b. Điều trị can thiệp: </strong>ã Những bệnh nhân bị nhồi máu thì can thiệp ĐMV càng sớm càng tốt giúp ngăn chặn quá trình giãn thành thất và tái cấu trúc. Can thiệp muộn sau 12 giờ vẫn có thể có ích nhng sau 24 giờ thì có thể không cải thiện đợc tình hình phình vách thất.<br />
ã Đối với những bệnh nhân có phình vách thất mà có rối loạn nhịp thất nguy hiểm thì có thể cân nhắc việc cấy máy phá rung tự động trong buồng tim (ICD).<br />
<strong>c. Ngoại khoa:</strong> Đối với những bệnh nhân phình vách thất có suy tim dai dẳng hoặc rối loạn nhịp tim nặng nề thì có thể cân nhắc điều trị ngoại khoa. Điều trị ngoại khoa có thể cắt đóng đoạn phình hoặc làm một miếng vá ở đó để duy trì đợc thể tích thất trái. Cũng nên cân nhắc việc điều trị tái tới máu động mạch vành trớc đó.<br />
<strong>II. Các rối loạn nhịp</strong>Trong NMCT, biến chứng rối loạn nhịp tim là rất thờng gặp ở các mức độ khác nhau (90% các trờng hợp). Có thể gặp tất cả các loại rối loạn nhịp khác nhau (xin tham khảo chi tiết ở phần các rối loạn nhịp tim).<br />
<strong>A. Rối loạn nhịp thất<br />
1. Ngoại tâm thu thất: </strong>hay gặp, cần theo dõi tốt, điều chỉnh các rối loạn điện giải. Thuốc chẹn bêta giao cảm có thể có tác dụng tốt. Một số tác giả a dùng Amiodarone.<strong><br />
2. Nhịp tự thất gia tốc: </strong>hay gặp ở bệnh nhân có hội chứng tái tới máu, đề phòng cơn nhanh thất hoặc rung thất.<br />
<strong>3. Nhịp nhanh thất và rung thất: </strong>là tình trạng cấp cứu và cần xử trí theo đúng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> phác đồ ngừng tuần hoàn.<strong><br />
B. Rối loạn nhịp trên thất: </strong>có thể gặp các rối loạn </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">:<strong><br />
1. Nhịp nhanh xoang.<br />
2. Cơn nhịp nhanh kịch phát trên thất.<br />
3. Rung nhĩ.<br />
4. Nhịp bộ nối.<br />
C. Các rối loạn nhịp chậm<br />
1. Nhịp chậm xoang: </strong>hay gặp ở bệnh nhân NMCT sau dới, cần điều trị khi có ảnh hởng đến huyết động.<strong><br />
2. Bloc nhĩ thất từ cấp I đến cấp III: </strong>Nếu bloc độ cao ảnh hởng đến huyết động thì cần cấp cứu theo phác đồ và chú ý đặt máy tạo nhịp tạm thời sớm. Chỉ định đặt máy tạo nhịp tạm thời: <strong><br />
</strong>a. Vô tâm thu;<br />
b. Bloc nhĩ thất cấp III;<br />
c. Nhịp chậm xoang hoặc bloc nhĩ thất độ thấp nhng có ảnh hởng đến huyết động.<br />
<strong>III. Suy chức năng thất trái và sốc tim</strong>Rối loạn chức năng thất trái là diễn biến khó tránh khỏi sau NMCT, chỉ tuỳ theo mức độ nhẹ hay nặng. Mức độ suy chức năng thất trái liên quan đến vùng tổn thơng nhiều hay ít. Bệnh nhân NMCT với vùng tổn thơng nhỏ có thể gây rối loạn vận động một vùng cơ tim nhng không gây giảm chức năng đáng kể toàn bộ thất trái. Tuy nhiên, khi nhồi máu diện rộng, đặc biệt là vùng trớc hoặc ở nữ giới, ngời cao tuổi, tiểu đờng… là những yếu tố dự báo nguy cơ cao của suy tim trái nặng và sốc tim.<br />
<strong>A. Phân loại</strong>Hiện nay phân loại của Killip và Kimban (bảng 4-1) là phân loại đợc sử dụng rộng rãi nhất trên lâm sàng để phân loại mức độ nặng nhẹ và có giá trị tiên lợng bệnh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"><strong></strong></span></span><br />
<div style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;"><strong><span>Bảng 4-1. Mối liên quan giữa độ Killip và tử vong trong 30 ngày.</span></strong></div><table border="1" cellpadding="0" cellspacing="0"><tbody>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="60"><div align="center" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;"><span><strong>Độ Killip</strong></span></div></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="168"><strong><span><br />
Đặc điểm lâm sàng</span></strong></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><strong><span><br />
%</span></strong></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><strong><span>Tỷ lệ tử vong trong 30 ngày (%)</span></strong></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="60"><span>I</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="168"><span>Không có triệu chứng của suy tim trái</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>85</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>5,1</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="60"><span>II</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="168"><span>Có ran ẩm < 1/2 phổi, tĩnh mạch cổ nổi, có thể có tiếng T<sub>3</sub> ngựa phi</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>13</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>13,6</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="60"><span>III</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="168"><span>Phù phổi cấp</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>1</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>32,2</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="60"><span>IV</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="168"><span>Sốc tim</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>1</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>57,8</span></td></tr>
</tbody></table><strong><span>Một phân loại khác của Forrester dựa trên các thông số huyết động cũng có giá trị tiên lợng bệnh rất tốt (bảng 4-2).<br />
Bảng 4-2. Phân loại của Forrester trong NMCT cấp.</span><table border="1" cellpadding="0" cellspacing="0"><tbody>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><div align="center" style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;"><span><br />
<strong>Độ</strong></span></div></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="144"><strong><span>Áp lực mao mạch phổi bít (mmHg)</span></strong></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="84"><strong><span>Chỉ số tim<br />
l/phút/m<sup>2</sup></span></strong></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><strong><span>Tỷ lệ tử vong trong 30 ngày (%)</span></strong></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>I</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="144"><span>< 18</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="84"><span>> 2,2</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>3</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>II</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="144"><span>> 18</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="84"><span>> 2,2</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>9</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>III</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="144"><span>< 18</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="84"><span>< 2,2</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>23</span></td></tr>
<tr><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="36"><span>IV</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="144"><span>> 18</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="84"><span>< 2,2</span></td><td style="font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif;" width="132"><span>51</span></td></tr>
</tbody></table><strong><span>B. Triệu chứng lâm sàng</span></strong></strong><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><strong><span style="font-family: Tahoma;">1. Triệu chứng cơ năng:</span></strong></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">a. Bệnh nhân có thể có các dấu hiệu của suy hô hấp, khó thở, cảm giác lạnh... bên cạnh các dấu hiệu kinh điển của NMCT.<br />
b. Bệnh nhân sốc tim có các dấu hiệu trầm trọng hơn </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> khó thở nhiều, tiểu ít, rét run, rối loạn tâm thần…<br />
<strong>2. Triệu chứng thực thể:</strong>a. Hạ huyết áp do giảm cung lợng tim, giảm thể tích tuần hoàn.<br />
B. Ứ trệ tuần hoàn phổi, với ran ở phổi.<br />
c. Giảm tới máu ngoại vi: da lạnh, đầu chi lạnh, vã mồ hôi.<br />
d. Nghe tim: thấy nhịp tim nhanh, tiếng ngựa phi..<br />
<strong>3. Nguyên nhân dễ dẫn đến sốc tim ở bệnh nhân NMCT cấp:</strong>a. NMCT diện rộng.<br />
b. Nhồi máu thất phải diện rộng.<br />
c. Vỡ thành thất.<br />
d. Hở van hai lá cấp.<br />
E. Ép tim cấp có kèm hoặc không kèm vỡ thành tim.<br />
<strong>C. Các xét nghiệm thăm dò<br />
1. Xét nghiệm máu: </strong>Tăng acid lactic trong máu, tăng creatinin và thiếu ôxy máu động mạch.<strong><br />
2. Xquang tim phổi: </strong>thấy hình ảnh ứ huyết phổi các mức độ.<strong><br />
3. Điện tâm đồ (ĐTĐ): </strong>thờng chỉ ra dấu hiệu của NMCT lan rộng. Có thể thấy hình ảnh ST chênh xuống (do thiếu máu cơ tim) lan rộng ở nhiều chuyển đạo. Nếu ĐTĐ không biến động đặc hiệu khi sốc tim thì phải nghĩ tới nguyên nhân khác gây sốc tim </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">tách thành ĐMC hoặc các biến chứng cơ học trầm trọng của NMCT cấp.<br />
<strong>4. Siêu âm tim: </strong>giúp đánh giá mức độ lan rộng của vùng nhồi máu, chức năng thất và tìm hiểu thêm các biến chứng có thể gây ra sốc tim.<strong><br />
5. Các thăm dò chảy máu: </strong>giúp theo dõi về huyết động chính xác. Thờng thì nên đặt một ống thông Swan Ganz để theo dõi áp lực động mạch phổi và áp lực mao mạch phổi bít cũng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> cung lợng tim (xem thêm phần sốc tim).<strong><br />
D. Điều trị<br />
1. Các u tiên trong điều trị: </strong>Nếu bệnh nhân có sốc tim nên đặt bóng ngợc dòng trong ĐMC (IABP) trớc nếu có thể, sau đó tìm cách giải quyết nguyên nhân và các biện pháp điều trị nội khoa thích hợp.<strong><br />
2. Các thuốc:</strong>a. Các thuốc giãn mạch đóng vai trò cực kỳ quan trọng trong điều trị bệnh nhân suy tim trái sau NMCT. Cần theo dõi huyết áp chặt chẽ khi cho các thuốc giãn mạch.<br />
b. Nitroglycerin dạng truyền tĩnh mạch là thuốc nên đợc lựa chọn hàng đầu. Liều dùng bắt đầu từ 10 – 20 mcg/phút và có thể tăng mỗi 10 mcg/phút sau vài phút tuỳ theo đáp ứng và huyết áp. Nên điều chỉnh sao cho huyết áp trung bình động mạch khoảng 70 mmHg.<br />
c. Nitropruside có thể thêm vào để có tác dụng làm giảm hậu gánh vì nếu dùng Nitroglycerin một mình chủ yếu làm giảm tiền gánh do giãn hệ tĩnh mạch. Nitroprusside đợc dùng bắt đầu bằng liều 0,3-5 mcg/kg/phút và chỉnh liều theo huyết áp động mạch.<br />
d. Thuốc ức chế men chuyển (ƯCMC) cải thiện đợc chức năng thất trái ở bệnh nhân sau NMCT. ƯCMC nên đợc cho sớm trong NMCT nếu huyết áp không thấp quá. Chú ý tác dụng gây tụt áp liều đầu của ƯCMC, do vậy nên cho bệnh nhân dạng truyền TM với liều bắt đầu thấp và không dùng khi có sốc tim.<br />
e. Thuốc lợi tiểu có tác dụng tốt ở những bệnh nhân có phù phổi sau NMCT. Furosemide là thuốc nên đợc lựa chọn.<br />
f. Digitalis trợ tim không nên cho rộng rãi trong NMCT, nhng có tác dụng tốt ở bệnh nhân suy tim trái nhiều kèm rung nhĩ hoặc cuồng nhĩ hoặc các thuốc khác điều trị suy tim kém hiệu quả.<br />
g. Các thuốc giống giao cảm (Dopamine và Dobutamine) đợc chỉ định cho những bệnh nhân suy tim nặng có tụt áp hoặc sốc tim.<br />
h. Thuốc vận mạch khác (Norepinephrine) có thể phải dùng khi cần thiết để duy trì huyết áp trong sốc tim (xem bài sốc tim).<br />
<strong>3. Điều trị can thiệp động mạch vành:</strong>a. Đặt ngay bóng bơm ngợc dòng động mạch chủ nếu có thể ở bệnh nhân sốc tim. Biện pháp này rất hữu ích giúp làm giảm hậu gánh, tăng cung lợng tim, giảm nhu cầu tiêu thụ ôxy cơ tim.<br />
b. Can thiệp động mạch vành tức thì giúp cải thiện đợc tiên lợng ở những bệnh nhân đã có sốc tim đặc biệt ở ngời không quá già.<br />
<strong>4. Phẫu thuật:</strong>a. Phẫu thuật làm cầu nối chủ-vành trong sốc tim ở bệnh nhân NMCT đợc chỉ định ở những bệnh nhân bị bệnh nhiều ĐMV, hoặc tổn thơng thân chung ĐMV trái mà không thích hợp cho can thiệp ĐMV.<br />
b. Có khi phẫu thuật đợc chỉ định để cấy ghép những thiết bị hỗ trợ thất trong khi chờ ghép tim.<br />
<strong>IV. Nhồi máu cơ tim thất phải</strong>Rối loạn chức năng thất phải nhẹ thờng gặp ở những bệnh nhân bị NMCT vùng sau dới, tuy nhiên có khoảng 10% số bệnh nhân này có suy thất phải cấp và điều trị cần chú ý một số đặc điểm khác biệt.<br />
<strong>A. Giải phẫu bệnh</strong>Thành thất phải bình thờng mỏng hơn và ít nhu cầu tiêu thụ ôxy hơn buồng thất trái, do vậy thông thờng thì thất phải có thể chịu đựng và hồi phục sau khi đợc điều trị kịp thời. Việc suy chức năng thất phải nặng xảy ra phụ thuộc vào mức độ tắc nhánh động mạch vành nuôi dỡng thất phải và mức độ tuần hoàn bàng hệ từ bên trái sang khi nhánh nuôi thất phải bị tắc (nhánh này thông thờng bắt nguồn từ động mạch vành bên phải).<br />
<strong>B. Triệu chứng lâm sàng</strong>1. Bệnh nhân NMCT thất phải thờng có triệu chứng của ứ trệ tuần hoàn ngoại vi nhng không khó thở.<strong><br />
</strong>2. Bệnh nhân có suy thất phải nặng có thể có biểu hiện của giảm cung lợng tim nặng </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> rét run, chân tay lạnh, rối loạn tâm thần, huyết áp tụt và thiểu niệu.<strong><br />
</strong>3. Thăm khám thực thể ở bệnh nhân NMCT thất phải thờng thấy tĩnh mạch cổ nổi, gan to, huyết áp thấp nhng phổi không có ran. Dấu hiệu Kussmaul (tĩnh mạch cổ nổi to hơn trong thời kỳ hít vào) là khá đặc hiệu và báo hiệu có suy thất phải nặng.<strong><br />
C. Các xét nghiệm chẩn đoán<br />
1. Điện tâm đồ: </strong>thờng cho thấy hình ảnh NMCT vùng sau dới kèm </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">theo ST</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> chênh lên ở V1 và đặc biệt là V3R và V4R<strong>.<br />
2. Xquang tim phổi: </strong>không có dấu hiệu của ứ trệ tuần hoàn phổi<strong>.<br />
3. Siêu âm tim:</strong> là một thăm dò có giá trị trong NMCT thất phải. Trên siêu âm tim thờng cho thấy hình ảnh thất phải giãn, suy chức năng thất phải, rối loạn vận động vùng sau dới, và đặc biệt giúp loại trừ tràn dịch màng tim gây ép thất phải (dễ nhầm với NMCT thất phải)<strong>.<br />
4. Các thông số về huyết động </strong>trên thăm dò chảy máu cho thấy tăng áp lực của nhĩ phải nhng không tăng áp lực mao mạch phổi bít (PCWP). NMCT thất phải cũng làm giảm cung lợng tim do giảm lợng máu về thất trái. Khi áp lực nhĩ phải trên 10 mmHg và tỷ lệ áp lực nhĩ phải/PCWP trên 0,8 là một dấu hiệu huyết động quan trọng gợi ý NMCT thất phải<strong>.<br />
D. Điều trị<br />
1. Điều trị nội khoa:</strong>a. Truyền đủ dịch là một biện pháp quan trọng hàng đầu vì trong NMCT thất phải có sự giảm cung lợng tim do giảm thể tích đổ đầy thất trái. Một số bệnh nhân nặng cần cho truyền tới 1 lít dịch trong giờ đầu. Khi truyền dịch cần phải theo dõi chặt chẽ các thông số huyết động vì nếu truyền quá nhiều dịch đôi khi lại dẫn đến suy giảm chức năng thất trái (hiện tợng này là do vách liên thất bị ép quá về phía thất trái gây giảm cung lợng tim). Mục tiêu điều trị là đa áp lực tĩnh mạch trung tâm đến khoảng 15 mmHg.<br />
b. Thuốc tăng co bóp cơ tim: Khi truyền dịch vẫn không đủ làm tăng cung lợng tim thì có chỉ định dùng các thuốc tăng co bóp cơm tim. Dobutamine là thuốc đợc lựa chọn hàng đầu làm tăng cung lợng tim và phân số tống máu của thất phải.<br />
c. Một lu ý rất quan trọng là không đợc dùng các thuốc giãn mạch (Nitrates, ức chế men chuyển...) và lợi tiểu khi có suy thất phải vì các thuốc này càng làm giảm cung lợng tim.<br />
<strong>2. Điều trị can thiệp:</strong>a. Nong hoặc đặt Stent động mạch vành sớm sẽ giúp cải thiện rõ rệt tỷ lệ tử vong ở bệnh nhân NMCT thất phải. Việc tái tới máu ĐMV thất phải giúp cải thiện chức năng thất phải.<br />
b. Một số trờng hợp NMCT thất phải thờng kèm theo nhịp chậm hoặc bloc nhĩ thất cấp III cần đợc đặt máy tạo nhịp tạm thời sớm và đại đa số phục hồi tốt sau khi đã can thiệp tốt ĐMV.<br />
c. Một số trờng hợp huyết áp thấp quá có thể cần phải đặt bóng bơm ngợc dòng động mạch chủ.<br />
<strong>3. Phẫu thuật:</strong>a. Một số trờng hợp mà tình trạng sốc tim kéo dài không đáp ứng các biện pháp điều trị thông thờng có thể có chỉ định mổ cắt màng ngoài tim.<br />
b. Phẫu thuật cấy thiết bị hỗ trợ tim khi tình trạng sốc tim quá nặng.<br />
c. Mổ làm cầu nối chủ-vành cấp khi tổn thơng không thể can thiệp đợc hoặc khi can thiệp có biến chứng hoặc khi có các biến chứng cơ học.<br />
<strong>V. Đau ngực tái phát sau NMCT</strong>Biến chứng thiếu máu cơ tim (đau ngực) xảy ra sau NMCT cấp có thể do vùng tổn thơng lan rộng, thiếu máu cơ tim tái phát, tái NMCT...<br />
<strong>A. Vùng tổn thơng lan rộng: </strong>Bệnh nhân vẫn đau ngực liên tục hoặc tái phát, trên điện tâm đồ có thay đổi mới (chênh hơn và lan rộng), men tim vẫn tăng kéo dài. Thăm dò siêu âm tim hoặc phóng xạ đồ giúp xác định đợc vùng cơ tim tổn thơng.<strong><br />
B. Thiếu máu cơ tim tái phát: </strong>Bệnh nhân đau ngực sau giai đoạn cấp từ vài giờ đến 30 ngày với sự thay đổi trên điện tim chứng tỏ có thiếu máu cơ tim. Thiếu máu cơ tim tái phát thờng hay xảy ra hơn ở bệnh nhân NMCT không có sóng Q. Đau ngực tái phát sau NMCT thờng có tiên lợng xấu và cơ chế bệnh sinh đợc coi nh là đau thắt ngực không ổn định. Việc điều trị do đó đợc coi </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> là điều trị đau thắt ngực không ổn<span> </span>định<strong>.<br />
C. Nhồi máu cơ tim tái phát: </strong>Bệnh nhân đau ngực lại với thay đổi mới điện tim đồ và men tim. Nếu bệnh nhân nhồi máu lại sau khi đã dùng thuốc tiêu huyết khối cần tiến hành can thiệp động mạch vành ngay<strong>.<br />
Vấn đề điều trị:</strong> Cần chỉ định chụp và can thiệp ĐMV sớm ở các bệnh nhân này. Các thuốc Heparin, Aspirin, Nitrates, chẹn Beta giao cảm cần đợc cho một cách tích cực hơn.<br />
<strong>VI. Các biến chứng tắc mạch</strong>Các biến chứng tắc mạch ở bệnh nhân NMCT cấp xảy ra trong khoảng 20% số bệnh nhân. Những bệnh nhân bị NMCT trớc rộng là có nguy cơ cao dễ bị biến chứng này.<br />
<strong>A. Triệu chứng lâm sàng</strong>Các biểu hiện lâm sàng hay gặp nhất là của tai biến mạch não, một số bệnh nhân bị tắc mạch chi, tắc mạch thận, tắc mạch mạc treo… Hầu hết các tai biến tắc mạch thờng xảy ra trong 10 ngày đầu của NMCT cấp. Đối với những bệnh nhân nằm bất động lâu, có thể có các biến chứng huyết khối tĩnh mạch sâu chi dới và tắc mạch phổi. Tuỳ theo thể bệnh mà có các triệu chứng tơng ứng trên lâm sàng.<br />
<strong>B. Điều trị</strong>1. Truyền Heparin tĩnh mạch liên tục trong 3-4 ngày sao cho thời gian aPTT ở khoảng 50-65 giây.<strong><br />
</strong>2. Với những bệnh nhân bị NMCT thành trớc mà có dấu hiệu huyết khối bám thành cần cho thuốc chống đông đờng uống (kháng vitamin K) ít nhất trong 3 tháng, gối đầu với Heparin.<strong><br />
</strong>3. Heparin trọng lợng phân tử thấp có tác dụng phòng ngừa tốt huyết khối tĩnh mạch chi dới và nhồi máu phổi đối với những bệnh nhân nằm lâu.<strong><br />
VII. Biến chứng viêm màng ngoài tim<br />
A. Viêm màng ngoài tim cấp<br />
1. Triệu chứng lâm sàng:</strong>a. Biến chứng viêm màng ngoài tim cấp xảy ra ở khoảng 10% số bệnh nhân NMCT cấp và là một trong những nguyên nhân gây đau ngực. Biến chứng này thờng xảy ra trong vòng 24-96 giờ sau NMCT cấp.<br />
b. Viêm màng ngoài tim cấp thờng xảy ra ở bệnh nhân có NMCT xuyên thành. Một số không có triệu chứng lâm sàng mà chỉ nghe thấy tiếng cọ màng tim.<br />
c. Đa số các bệnh nhân thờng có dấu hiệu đau ngực kéo dài và cảm giác rát bỏng. Đau ngực tăng lên khi bệnh nhân ngồi và cúi ra phía trớc hoặc hít thở sâu, ho hay nuốt. Đau thờng không lan và quanh quẩn trớc ngực.<br />
d. Nghe tim cho thấy dấu hiệu quan trọng nhất là tiếng cọ màng ngoài tim. Một số trờng hợp có thể không thấy tiếng cọ này. Tiếng cọ màng tim thờng nghe rõ nhất ở cạnh ức trái vùng thấp. Tiếng cọ màng tim tiến triển theo thời gian, giảm hoặc mất đi khi lợng dịch màng tim nhiều.<br />
e. Cơ chế của viêm màng ngoài tim cấp là do phản ứng viêm vùng màng tim tơng ứng với vùng bị nhồi máu. Sự tiến triển của phản ứng viêm có thể liên quan đến mức độ và diện rộng của NMCT.<br />
<strong>2. Các xét nghiệm chẩn đoán:<br />
a. Điện tâm đồ:</strong> là một thăm dò có giá trị trong chẩn đoán viêm màng tim cấp. Tuy nhiên khi<span> </span>bệnh nhân bị viêm màng ngoài tim cấp sau NMCT cấp thì các dấu hiệu viêm màng ngoài tim có thể bị che lấp mất. Nhìn chung, dấu hiệu đặc hiệu của viêm màng ngoài tim trên ĐTĐ là đoạn ST chênh lên đồng hớng ở các chuyển đạo và kiểu chênh lên hình yên ngựa. Các dấu hiệu thay đổi đoạn ST cũng thay đổi theo thời gian, đầu tiên là ST và T chênh lên, sau đó T dẹt rồi ST về đờng đẳng điện và sóng T thì âm rồi cũng dơng trở lại.<br />
<strong>b. Xquang tim phổi:</strong> ít có giá trị chẩn đoán viêm màng ngoài tim cấp.<br />
<strong>c. Siêu âm tim:</strong> có thể cho thấy dịch màng ngoài tim, nhng cũng không thể hoàn toàn loại trừ chẩn đoán đợc.<br />
<strong>3. Điều trị: </strong>a. Aspirin là thuốc đợc lựa chọn với liều khoảng 2,5g đến 4g trong một ngày chia làm 4-6 lần.<br />
b. Các thuốc giảm viêm chống đau không steroid và steroid không nên dùng để điều trị trong trờng hợp này vì nó có thể ảnh hởng quá trình liền sẹo của cơ tim và làm lan rộng vùng nhồi máu một cách âm thầm. Một số bệnh nhân mà có đau ngực tái phát nhiều không đáp ứng với Aspirin thì có thể cho Colchicine.<br />
<strong>B. Hội chứng Dressler</strong>Hội chứng Dressler<span> </span>(viêm màng ngoài tim muộn) xảy ra ở khoảng 1-3% số bệnh nhân NMCT. Hội chứng này thờng xảy ra sau từ 1-8 tuần sau NMCT cấp. Hiện cơ chế bệnh sinh của bệnh cha đợc rõ hoàn toàn, nhng ngời ta thấy có nhiều bằng chứng liên quan đến cơ chế tự miễn dịch của cơ thể.<br />
Bệnh nhân thờng có biểu hiện đau ngực kiểu viêm màng ngoài tim, có thể sốt, đau khớp, đau cơ, tăng bạch cầu máu, tốc độ lắng máu tăng. Nghe tim có tiếng cọ màng ngoài tim. Siêu âm tim cho thấy có dịch màng ngoài tim.<br />
Về điều trị thì giống </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;">nh</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Tahoma;"> trong điều trị viêm màng tim cấp sau NMCT. Tuy nhiên, nếu sau quá 4 tuần của NMCT thì có thể cho bệnh nhân đợc các thuốc kháng viêm không phải steroid thậm chí có thể cho cả steroid.</span></span>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-83505988708200310062011-04-29T05:07:00.000-07:002011-04-29T05:07:33.874-07:00- BỆNH VAN ĐỘNG MẠCH PHỔI<span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><span class="Apple-style-span" style="color: blue;">BỆNH VAN ĐỘNG MẠCH PHỔI</span></span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
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<span class="Apple-style-span" style="font-size: large;"><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Van động mạch phổi là van tổ chim ngăn cách động mạch phổi với thất phải. Rối loạn hoạt động van động mạch phổi sẽ gây tác</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: tahoma, arial, helvetica, sans-serif;"> động có hại lên chức năng của thất phải. Bình thường, tỷ lệ hở van động mạch phổi phát hiện bằng siêu âm Doppler tim ở người bình thường khá cao, song chỉ có một số ít bệnh lý van động mạch phổi (hở hoặc hẹp) thực sự gây ảnh hưởng đến tình trạng huyết động của tim phải và gây rối loạn chức năng thất phải.</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">I. Hẹp van động mạch phổi đơn thuần (HP)<br />
A. Triệu chứng lâm sàng</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Các triệu chứng suy tim phải và khó thở khi gắng sức thường xuất hiện ở tuổi 30-40 nếu bệnh không được phát hiện và điều trị từ trước.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Triệu chứng điển hình là tiếng thổi tâm thu tống máu ở khoang liên sườn 3-4 trái, giảm cường độ khi hít vào (do giảm chênh áp qua van động mạch phổi) đồng thời giảm cường độ hoặc mất hẳn tiếng T</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>2</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">3. Triệu chứng suy tim phải biểu hiện ở giai đoạn muộn.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
B. Điện tâm đồ</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Hình ảnh điện tim bình thường nếu HP nhẹ.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Trục phải, dày thất phải khi HP mức độ từ vừa-nặng. Mức độ dày thất phải trên điện tim có liên quan khá chặt với mức độ nặng của HP. Trường hợp hẹp khít van ĐMP, có thể gặp hình ảnh dày nhĩ phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
C. Chụp tim phổi: </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">bóng tim không to, cung động mạch phổi phồng rõ (giãn ĐMP sau hẹp), máu lên phổi ít. Bóng tim sẽ to khi đã có suy tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
D. Nguyên nhân</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Hẹp van động mạch phổi bẩm sinh là dạng bệnh lý hay gặp nhất (chiếm tỷ lệ 10% trong số các bệnh tim bẩm sinh).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Di chứng thấp tim: dính mép van gây hẹp van. Cần lưu ý rằng van động mạch phổi là van ít bị ảnh hưởng nhất do bệnh thấp tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">3. Hẹp thứ phát do hội chứng u carcinoid gây thâm nhiễm lá van ĐMP.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">4. Giả hẹp van động mạch phổi trong trường hợp tắc nghẽn đường tống máu thất phải do u trong tim hoặc túi phình xoang Valsalva.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">E. Chẩn</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> đoán: </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Siêu âm Doppler tim rất có giá trị để chẩn đoán xác định và lượng giá mức độ hẹp van động mạch phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">a. Van động mạch phổi thấy rõ nhất ở mặt cắt trục ngắn cạnh ức trái hoặc dưới sườn. Nếu hình ảnh qua thành ngực có chất lượng kém, có thể dùng siêu âm tim qua thực quản.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">b. Siêu âm Doppler tim cho phép đánh giá tình trạng van động mạch phổi (van dày, vôi, hạn chế vận động ở người lớn; lá van không vôi, mở dạng vòm ở trẻ con) và thất phải (bình thường hoặc phì đại phụ thuộc vào mức độ hẹp van động mạch phổi và thời gian bị bệnh).</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Mức độ hẹp van động mạch phổi được phân loại dựa trên chênh áp tối đa đỉnh-đỉnh qua van động mạch phổi đo bằng phổ Doppler liên tục (tính theo công thức của Bernoulli). Hiện tại, siêu âm Doppler tim đã được xem như một phương pháp chuẩn để đánh giá mức độ hẹp van (tương quan rất chặt so với tiêu chuẩn vàng là thông tim). Hẹp van ĐMP chia thành các mức độ như sau:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">a. Hẹp nhẹ: khi chênh áp tối đa qua van ĐMP < 40 mmHg</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">b. Hẹp vừa: khi chênh áp tối đa từ 40 đến 80 mmHg</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">c. Hẹp khít (nặng): khi chênh áp tối đa</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">80 mmHg.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">F. Điều trị</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Hẹp van động mạch phổi mức độ từ nhẹ đến vừa có tiên lượng rất tốt và rất ít khi cần can thiệp.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Hẹp van động mạch phổi nặng hoặc suy tim phải thứ phát thường biểu hiện sau tuổi 40 hoặc 50 dù có nhiều dạng bệnh biểu hiện ngay từ nhỏ. Phương pháp điều trị chính là nong van động mạch phổi bằng bóng qua da, có kết quả khả quan, nói chung giảm được 75% chênh áp qua van. Tiên lượng lâu dài và tỷ lệ sống còn sau can thiệp hoàn toàn phụ thuộc vào tình trạng chức năng thất phải khi nong van.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">3. Hẹp van động mạch phổi thứ phát do hội chứng carcinoid có tiên lượng rất xấu (thời gian sống sót trung bình sau khi chẩn đoán bệnh chỉ được 1,6 năm), hầu như không đáp ứng với nong van bằng bóng nên nói chung phải thay van.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
II. Hở van động mạch phổi (HoP)<br />
A. Triệu chứng lâm sàng</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Thường có biểu hiện khó thở khi gắng sức và triệu chứng của suy tim phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
2. Nghe tim:</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">a. Thổi tâm trương âm sắc thấp, nghe rõ nhất ở khoang liên sườn 3-4 trái kèm T</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>2</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">tách đôi, tăng lên khi hít vào và nếu có tăng áp động mạch phổi thì T</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>2</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">mạnh.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">b. Tiếng thổi của Graham Steell là tiếng thổi tâm trương giảm dần về cường độ, có âm sắc cao, xuất hiện ngay sau tiếng T</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>2</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">, là tiếng thổi điển hình khi áp lực động mạch phổi vượt quá 70 mmHg đồng thời có hở van ĐMP.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">3. Ngoài ra có thể phát hiện được các triệu chứng của suy tim phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
B. Nguyên nhân</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Khác với hẹp van, hở van động mạch phổi rất ít khi do nguyên nhân bẩm sinh như không có lá van, thiểu sản hay thủng lá van ĐMP.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Thường gặp là các bệnh tim mắc phải gây hở van động mạch phổi: hàng đầu là hẹp van hai lá, u nhầy nhĩ trái gây tăng áp lực động mạch phổi, sau đó là do viêm nội tâm mạc nhiễm khuẩn. U carcinoid hoặc thấp tim cũng có thể gây HoP song thường gây hẹp van nhiều hơn. Còn gặp HoP thứ phát trong hội chứng Marfan do giãn động mạch phổi.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
C. Chẩn đoán: </span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">chủ yếu bằng siêu âm Doppler tim.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Van động mạch phổi nhìn thấy rõ nhất ở mặt cắt trục ngắn cạnh ức trái hoặc dưới sườn. Đa số người bình thường đều có một dòng phụt ngược nhỏ do hở van động mạch phổi rất nhẹ. Dòng HoP này chỉ được coi là đáng kể khi phụt sâu vào thất phải 1-2 cm và kéo dài</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-family: Arial;">≥</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">75% thời kỳ tâm trương. Doppler xung cũng có thể dùng để thăm dò dòng phụt ngược trong thời kỳ tâm trương.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Không giảm vận tốc dòng hở trong thời kỳ tâm trương là dấu hiệu gợi ý tăng áp lực động mạch phổi gây ra hở van. Biểu hiện khác của tăng áp lực động mạch phổi trên siêu âm tim là hiện tượng mất sóng a và sự đóng nhẹ van ĐMP giữa tâm thu trên siêu âm TM cũng như trên phổ Doppler dòng chảy qua van</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;">.</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">3. Áp lực ĐMP tâm thu có thể ước tính dựa trên phổ Doppler của dòng hở van ba lá. Áp lực ĐMP cuối tâm trương (ALĐMPCTTr) có thể tính được khi ghi được phổ của hở van động mạch phổi, dựa theo công thức:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">ALĐMPCTTr = 4 (V</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>PR-E</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">)</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sup>2</sup></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ ALTP</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Trong đó ALTP là áp lực thất phải và thường = 10 mmHg; V</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>PR-E</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">là vận tốc dòng HoP cuối tâm trương.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Tơng tự như vậy, ta cũng có thể tính được áp lực trung bình của ĐMP (ALĐMPTB) căn cứ vào vận tốc đầu tâm trương của dòng hở phổi dựa theo công thức sau:</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">ALĐMPTB = 4(V</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>PR-P</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">)</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sup>2</sup></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">+ ALTP</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">Trong đó ALTP là áp lực thất phải và thường = 10 mmHg; V</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><sub>PR-P</sub></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"> </span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">là vận tốc dòng HoP đầu tâm trương.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><br />
</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">4. Hiện tượng giảm vận tốc dòng hở phổi ở kỳ tâm trương thường gợi ý có dị dạng của van ĐMP.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
D. Điều trị</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">1. Hở van động mạch phổi tiên phát có tiên lượng rất tốt, ít khi cần xử trí trừ phi gây ra suy thất phải.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"><br />
</span></span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;">2. Hở van ĐMP thứ phát: tiên lượng hoàn toàn phụ thuộc vào diễn biến của bệnh chính như hẹp van hai lá khít, viêm nội tâm mạc nhiễm khuẩn, u carcinoid, tăng áp lực động mạch phổi... Điều trị ngoại khoa bằng thay van hoặc sửa vòng van động mạch phổi chỉ được áp dụng trong một số trường hợp rất hãn hữu.</span><span class="Apple-style-span" style="color: #333333; font-family: Geneva, Arial, Helvetica, sans-serif;"><span style="font-weight: bold;"> </span></span></span>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-59695165378789314042011-04-29T05:05:00.000-07:002011-04-29T05:05:06.426-07:00- BỆNH TIM- PHỔI MẠN TÍNH<div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">Bệnh<span style="letter-spacing: -2.05pt;"> </span>tim<span style="letter-spacing: 1.45pt;"> </span>-<span style="letter-spacing: -0.05pt;"> </span>phổi<span style="letter-spacing: -1.45pt;"> </span>mạn<span style="letter-spacing: -0.55pt;"> </span>tính</span><span lang="EN"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.75pt; text-align: center;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">(Chronic<span style="letter-spacing: 3pt;"> </span>cor-pulmonale)</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: right;"><span class="Apple-style-span" style="font-size: large;"><br />
</span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">1.<span style="letter-spacing: -0.1pt;"> </span>Đại<span style="letter-spacing: 2.55pt;"> </span><span style="letter-spacing: -0.05pt;">c</span></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 0.5pt;">ư</span><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">ơng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>tim-phổi<span style="letter-spacing: 0.4pt;"> </span>mạn<span style="letter-spacing: 1.8pt;"> </span>tính <span style="letter-spacing: 0.25pt;"><span> </span></span>là<span style="letter-spacing: -0.5pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>phì<span style="letter-spacing: 2pt;"> </span>đại,<span style="letter-spacing: -0.55pt;"> </span>giãn<span style="letter-spacing: 2.1pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>thứ<span style="letter-spacing: -0.15pt;"> </span>phát<span style="letter-spacing: 0.45pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi, gây<span style="letter-spacing: 0.35pt;"> </span>nên<span style="letter-spacing: 0.35pt;"> </span>bởi<span style="letter-spacing: -0.15pt;"> </span>những bệnh<span style="letter-spacing: -0.7pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>qu<span style="letter-spacing: 0.05pt;">ả</span>n,<span style="letter-spacing: 0.75pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>thần<span style="letter-spacing: -0.2pt;"> </span>kinh<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>xương lồng<span style="letter-spacing: 0.6pt;"> </span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Loại<span style="letter-spacing: 0.45pt;"> </span>trừ<span style="letter-spacing: -0.15pt;"> </span>những trường h<span style="letter-spacing: -0.05pt;">ợ</span>p<span style="letter-spacing: -0.25pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>l<span style="letter-spacing: -0.05pt;">ự</span>c<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2 lá,<span style="letter-spacing: 0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">bẩ</span>m sinh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Bệnh<span style="letter-spacing: -1.05pt;"> </span>thường<span style="letter-spacing: 0.55pt;"> </span>gặp<span style="letter-spacing: 0.2pt;"> </span>ở<span style="letter-spacing: 0.55pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span>ười<span style="letter-spacing: 0.55pt;"> </span>trên<span style="letter-spacing: 0.85pt;"> </span>50<span style="letter-spacing: 0.55pt;"> </span>tuổi,<span style="letter-spacing: 1.2pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>nghiện<span style="letter-spacing: -0.45pt;"> </span>thuốc<span style="letter-spacing: 1.05pt;"> </span>l<span style="letter-spacing: -0.1pt;">á</span>.<span style="letter-spacing: 0.55pt;"> </span><st1:country-region w:st="on"><st1:place w:st="on">Nam</st1:place></st1:country-region><span style="letter-spacing: 0.3pt;"> </span>bị<span style="letter-spacing: 1.1pt;"> </span>nhiều<span style="letter-spacing: -0.25pt;"> </span>hơn<span style="letter-spacing: 0.95pt;"> </span>nữ,<span style="letter-spacing: 0.55pt;"> </span>với<span style="letter-spacing: 0.1pt;"> </span>tỉ<span style="letter-spacing: 1.25pt;"> </span>lệ<span style="letter-spacing: -0.2pt;"> </span>5:1. Ở<span style="letter-spacing: 1.95pt;"> </span>Mỹ,<span style="letter-spacing: 0.7pt;"> </span>bệnh tim-phổi<span style="letter-spacing: 1.1pt;"></span>mạn<span style="letter-spacing: 0.6pt;"> </span>tính<span style="letter-spacing: 1.7pt;"> </span>chiếm<span style="letter-spacing: -0.15pt;"> </span>từ<span style="letter-spacing: 0.6pt;"> </span>10-30%<span style="letter-spacing: 0.7pt;"> </span>số<span style="letter-spacing: 1.3pt;"> </span>bệnh <span style="letter-spacing: 0.4pt;">nhâ</span>n<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.35pt;">v</span><span style="letter-spacing: 0.45pt;">à</span>o<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.35pt;">đi</span><span style="letter-spacing: 0.4pt;">ề</span>u<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.4pt;">tr</span>ị<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: 0.3pt;">v</span>ì<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: 0.4pt;">su</span>y<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.4pt;">ti</span>m<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.35pt;">mạ</span>n<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: 0.4pt;">tính </span><span style="letter-spacing: 0.3pt;">v</span>à<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: 0.3pt;">l</span>à<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: 0.4pt;">mộ</span>t<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.35pt;">nguyê</span>n<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.35pt;">nhâ</span>n<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.4pt;">q</span><span style="letter-spacing: 0.45pt;">u</span><span style="letter-spacing: 0.4pt;">a</span>n<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.4pt;">trọn</span>g<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.35pt;">gâ</span>y<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.4pt;">t</span>ử<span style="letter-spacing: 0.7pt;"></span><span style="letter-spacing: 0.4pt;">v</span><span style="letter-spacing: 0.35pt;">o</span><span style="letter-spacing: 0.4pt;">ng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.<span style="letter-spacing: -0.1pt;"> </span>Nguy<span style="letter-spacing: 0.05pt;">ê</span>n<span style="letter-spacing: -0.65pt;"> </span>nhân.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.1.<span style="letter-spacing: -0.2pt;"> </span>Theo<span style="letter-spacing: 1.25pt;"> </span>Rubin<span style="letter-spacing: 2.35pt;"> </span>L.<span style="letter-spacing: 0.6pt;"> </span>J.<span style="letter-spacing: 1.3pt;"> </span>(1984):</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">2.1.1.<span style="letter-spacing: -0.25pt;"> </span>Bệnh<span style="letter-spacing: 0.5pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>đ</span></span><span lang="EN">ư<span style="font-style: italic; font-weight: bold;">ờng hô<span style="letter-spacing: 0.4pt;"> </span>hấp<span style="letter-spacing: 0.2pt;"><span> </span></span>và<span style="letter-spacing: 0.7pt;"> </span>phế<span style="letter-spacing: -0.2pt;"> </span>nang:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 2.95pt;"> </span>Bệnh<span style="letter-spacing: 0.2pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạn<span style="letter-spacing: -0.1pt;"> </span>tính<span style="letter-spacing: 1pt;"> </span>(COPD).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 2.95pt;"> </span>Khuyết<span style="letter-spacing: -1.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">ậ</span>t bẩm<span style="letter-spacing: 1.85pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 2.95pt;"> </span>Bệnh<span style="letter-spacing: 0.45pt;"> </span>thâm<span style="letter-spacing: -0.05pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>u hạt<span style="letter-spacing: 0.55pt;"> </span>ở phổi:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Xơ<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>vô<span style="letter-spacing: 0.65pt;"> </span>căn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.25pt;"> </span>Sarcoidosis<span style="letter-spacing: 0.15pt;"> </span>(bệnh<span style="letter-spacing: 0.4pt;"> </span>Bernier-B<span style="letter-spacing: -0.05pt;">o</span>ck-Schaumann)<span style="letter-spacing: 1.55pt;"> </span>là<span style="letter-spacing: 2.1pt;"> </span>bệnh<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: 0.9pt;"> </span>hệ<span style="letter-spacing: 0.55pt;"> </span>thống<span style="letter-spacing: 1.8pt;"> </span>liên<span style="letter-spacing: -0.95pt;"> </span>võng<span style="letter-spacing: 1.5pt;"> </span>nội<span style="letter-spacing: 1.1pt;"> </span>mạc,<span style="letter-spacing: 1.65pt;"> </span>có nhiều<span style="letter-spacing: -0.8pt;"> </span>hạch<span style="letter-spacing: 0.4pt;"> </span>ở 2 rốn<span style="letter-spacing: 0.6pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>bụi<span style="letter-spacing: -0.3pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Xơ<span style="letter-spacing: 0.5pt;"> </span>cứng<span style="letter-spacing: -0.25pt;"> </span>bì.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Lupus<span style="letter-spacing: -0.3pt;"> </span>ban<span style="letter-spacing: -0.15pt;"> </span>đỏ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 0.2pt;"> </span>khớp<span style="letter-spacing: -0.25pt;"> </span>dạng<span style="letter-spacing: 0.4pt;"> </span>thấp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>a-<span style="letter-spacing: -0.05pt;">c</span>ơ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.85pt;"> </span>Bệnh<span style="letter-spacing: -0.7pt;"> </span>u<span style="letter-spacing: 0.85pt;"> </span>hạt<span style="letter-spacing: 1.4pt;"> </span>tế<span style="letter-spacing: 0.1pt;"> </span>bào<span style="letter-spacing: 0.45pt;"><span> </span></span>ái<span style="letter-spacing: 0.95pt;"> </span>toan<span style="letter-spacing: 0.65pt;"> </span>(eosino<span style="letter-spacing: -0.05pt;">p</span>hilic<span style="letter-spacing: 0.2pt;"> </span>g<span style="letter-spacing: -0.05pt;">r</span>anuloma):<span style="letter-spacing: 0.35pt;"> </span>bệnh<span style="letter-spacing: 0.15pt;"> </span>biểu hiện cả<span style="letter-spacing: 1.55pt;"> </span>ở<span style="letter-spacing: 0.85pt;"> </span>xương<span style="letter-spacing: 0.85pt;"> </span>sọ,<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ư<span style="letter-spacing: 0.05pt;">ơng </span>hàm<span style="letter-spacing: 2.1pt;"> </span>và<span style="letter-spacing: -0.25pt;"> </span>xương đùi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.45pt;"> </span>thâm<span style="letter-spacing: -0.05pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>ác<span style="letter-spacing: 0.7pt;"> </span>tính.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Do<span style="letter-spacing: -0.3pt;"> </span>tia<span style="letter-spacing: -0.1pt;"> </span>xạ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Tắc<span style="letter-spacing: -0.35pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>đường hô<span style="letter-spacing: 0.55pt;"> </span>hấp<span style="letter-spacing: 1.7pt;"> </span>trên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Cắt<span style="letter-spacing: -0.5pt;"> </span>bỏ<span style="letter-spacing: 0.55pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Bệnh<span style="letter-spacing: 0.2pt;"> </span>thiếu<span style="letter-spacing: -0.75pt;"> </span>ôxy<span style="letter-spacing: 0.4pt;"> </span>ở độ<span style="letter-spacing: 0.55pt;"> </span>cao.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">2.1.2.<span style="letter-spacing: -0.25pt;"> </span>Bệnh<span style="letter-spacing: 0.5pt;"> </span>làm<span style="letter-spacing: 0.4pt;"> </span>tổn<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span></span><span lang="EN" style="letter-spacing: -0.05pt;">ư</span><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">ơng<span style="letter-spacing: 0.65pt;"> </span>bộ<span style="letter-spacing: -0.1pt;"> </span>phận<span style="letter-spacing: -0.55pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>học<span style="letter-spacing: 1.15pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>quan<span style="letter-spacing: 1.85pt;"> </span>hô<span style="letter-spacing: 0.4pt;"> </span>hấp:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Dị<span style="letter-spacing: 0.3pt;"> </span>dạng<span style="letter-spacing: 1pt;"> </span>lồng<span style="letter-spacing: 0.6pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>gù<span style="letter-spacing: -0.25pt;"> </span>vẹo<span style="letter-spacing: 0.2pt;"> </span>cột<span style="letter-spacing: -0.15pt;"> </span>sống.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Cắt<span style="letter-spacing: -0.5pt;"> </span>ép<span style="letter-spacing: -0.95pt;"> </span>xương sườn (đánh<span style="letter-spacing: 0.55pt;"> </span>xẹp<span style="letter-spacing: -0.9pt;"> </span>lồng<span style="letter-spacing: 0.6pt;"> </span>ngực).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Xơ<span style="letter-spacing: 0.1pt;"> </span>màng<span style="letter-spacing: 1.35pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>dày<span style="letter-spacing: -0.45pt;"> </span>dính<span style="letter-spacing: 1.3pt;"> </span>màng<span style="letter-spacing: 0.7pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Xơ<span style="letter-spacing: 0.5pt;"> </span>cứng<span style="letter-spacing: -0.25pt;"> </span>bì.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>nhược cơ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hội chứng<span style="letter-spacing: -0.3pt;"> </span>ngừng thở<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>ngủ,<span style="letter-spacing: -0.4pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>ở người béo<span style="letter-spacing: -0.9pt;"> </span>bệu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 1.35pt;"> </span>giảm<span style="letter-spacing: -0.5pt;"> </span>thông<span style="letter-spacing: 0.6pt;"> </span>khí<span style="letter-spacing: -0.05pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>nang<span style="letter-spacing: -0.25pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>rõ<span style="letter-spacing: 0.65pt;"> </span>nguyên<span style="letter-spacing: 0.2pt;"> </span>nhân.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">2.1.3.<span style="letter-spacing: -0.25pt;"> </span>Bệnh<span style="letter-spacing: 0.5pt;"> </span>làm<span style="letter-spacing: 0.4pt;"> </span>tổn<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span></span></span><span lang="EN" style="letter-spacing: -0.05pt;">ư</span><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">ơng<span style="letter-spacing: 0.25pt;"> </span>mạch<span style="letter-spacing: 0.55pt;"> </span>máu<span style="letter-spacing: 0.25pt;"> </span>ở<span style="letter-spacing: -0.05pt;"> </span>phổi:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Các<span style="letter-spacing: 0.5pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tiên<span style="letter-spacing: 0.8pt;"> </span>phát<span style="letter-spacing: -0.1pt;"> </span>ở thành<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tăng<span style="letter-spacing: 0.15pt;"><span> </span></span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>tiên<span style="letter-spacing: 0.35pt;"> </span>phát.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 1.15pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>mạch<span style="letter-spacing: -0.3pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hạt.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tăng <span style="letter-spacing: 0.15pt;"><span></span></span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>độc<span style="letter-spacing: 0.4pt;"> </span>tố.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>gan<span style="letter-spacing: -0.15pt;"> </span>mạn<span style="letter-spacing: 0.45pt;"> </span>tính.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Hẹp<span style="letter-spacing: -1.05pt;"> </span>các<span style="letter-spacing: -0.6pt;"> </span>nhánh<span style="letter-spacing: 1.05pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Các<span style="letter-spacing: 0.5pt;"> </span>cục<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>ghẽn:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nghẽn<span style="letter-spacing: -1pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>tế<span style="letter-spacing: -0.75pt;"> </span>bào<span style="letter-spacing: 0.5pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>lý.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Các<span style="letter-spacing: 0.5pt;"> </span>vi<span style="letter-spacing: -0.45pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>ở phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Viêm<span style="letter-spacing: 0.2pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>mạch:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tắc<span style="letter-spacing: -0.35pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tắc<span style="letter-spacing: -0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>nguồn<span style="letter-spacing: 0.6pt;"> </span>gốc<span style="letter-spacing: 0.65pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>khối<span style="letter-spacing: 0.6pt;"> </span>u.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tắc<span style="letter-spacing: -0.35pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>khác<span style="letter-spacing: 0.4pt;"> </span>(do<span style="letter-spacing: -0.15pt;"> </span>khí,<span style="letter-spacing: 0.3pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>nước ối...).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tắc<span style="letter-spacing: -0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>sán<span style="letter-spacing: -0.15pt;"> </span>máng<span style="letter-spacing: 1.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>ký sinh<span style="letter-spacing: -0.2pt;"> </span>trùng<span style="letter-spacing: -0.25pt;"> </span>khác.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Chèn<span style="letter-spacing: 1.4pt;"> </span>ép<span style="letter-spacing: -0.95pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>u trung<span style="letter-spacing: -0.25pt;"> </span>thất,<span style="letter-spacing: 1.9pt;"> </span>phình<span style="letter-spacing: 0.9pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>mạch, tổ<span style="letter-spacing: 0.6pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>u hạt,<span style="letter-spacing: 0.5pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>xơ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.2.<span style="letter-spacing: -0.2pt;"> </span>Theo<span style="letter-spacing: 1.25pt;"> </span>chức<span style="letter-spacing: 1.15pt;"> </span>năng<span style="letter-spacing: -0.25pt;"> </span>hô<span style="letter-spacing: 0.4pt;"> </span>hấp</span><span lang="EN">: người ta<span style="letter-spacing: -0.1pt;"> </span>chia<span style="letter-spacing: -0.2pt;"> </span>thành<span style="letter-spacing: 0.35pt;"> </span>4 nhóm<span style="letter-spacing: 0.55pt;"> </span>nguyên<span style="letter-spacing: 0.2pt;"> </span>nhân:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: -0.35pt;"> </span>thông<span style="letter-spacing: 1.25pt;"> </span>khí<span style="letter-spacing: 0.35pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>nang<span style="letter-spacing: -0.25pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>phân<span style="letter-spacing: 0.65pt;"><span> </span></span>bố<span style="letter-spacing: 0.55pt;"> </span>khí-<span style="letter-spacing: 1.05pt;"> </span>m<span style="letter-spacing: -0.1pt;">á</span>u<span style="letter-spacing: 0.05pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>khuếch<span style="letter-spacing: -0.85pt;"> </span>tán<span style="letter-spacing: 0.55pt;"> </span>khí.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>tuần<span style="letter-spacing: -0.2pt;"> </span>hoàn<span style="letter-spacing: 0.4pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Phối<span style="letter-spacing: 0.2pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>1 và<span style="letter-spacing: 0.8pt;"> </span>3.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.3.<span style="letter-spacing: -0.2pt;"> </span>Ở<span style="letter-spacing: -1.65pt;"> </span>Việt<span style="letter-spacing: -0.2pt;"> </span>Nam,<span style="letter-spacing: 1.05pt;"> </span>các<span style="letter-spacing: 0.45pt;"> </span>nguyên<span style="letter-spacing: -0.35pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>hay<span style="letter-spacing: 1.2pt;"> </span>gặp<span style="letter-spacing: 1.2pt;"> </span>là:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạn<span style="letter-spacing: -0.35pt;"> </span>tính<span style="letter-spacing: 0.75pt;"> </span>(<span style="letter-spacing: -0.05pt;">v</span>iêm<span style="letter-spacing: 1.25pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>quản<span style="letter-spacing: 0.4pt;"> </span>mạn,<span style="letter-spacing: 0.4pt;"> </span>hen<span style="letter-spacing: -0.15pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>quản).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Lao<span style="letter-spacing: -0.2pt;"> </span>xơ<span style="letter-spacing: 0.55pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Giãn<span style="letter-spacing: 0.4pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ế<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.05pt;">q</span>uản.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 1.15pt;"> </span>màng<span style="letter-spacing: -0.3pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Dị<span style="letter-spacing: 0.3pt;"> </span>dạng<span style="letter-spacing: 1pt;"> </span>lồng<span style="letter-spacing: 0.6pt;"> </span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.<span style="letter-spacing: -0.1pt;"> </span>Cơ<span style="letter-spacing: 1.15pt;"> </span>chế<span style="letter-spacing: -0.25pt;"> </span>bệnh<span style="letter-spacing: -1.8pt;"> </span>sinh.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tùy<span style="letter-spacing: -0.05pt;"> </span>theo<span style="letter-spacing: 0.35pt;"> </span>nguyên<span style="letter-spacing: 1.95pt;"> </span>nhân<span style="letter-spacing: 1.05pt;"> </span>gây<span style="letter-spacing: 0.45pt;"> </span>bệnh<span style="letter-spacing: -0.15pt;"> </span>mà<span style="letter-spacing: 1.35pt;"> </span>cơ<span style="letter-spacing: 1.15pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>phần<span style="letter-spacing: 0.3pt;"> </span>khác<span style="letter-spacing: 0.95pt;"> </span>nhau<span style="letter-spacing: 0.3pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ưng<span style="letter-spacing: 0.55pt;"> </span>tất<span style="letter-spacing: 2.45pt;"> </span>cả<span style="letter-spacing: 0.6pt;"> </span>đều<span style="letter-spacing: 2pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>chung<span style="letter-spacing: 0.25pt;"> </span>một đặc<span style="letter-spacing: 1.75pt;"> </span>điểm <span style="letter-spacing: 0.1pt;"><span> </span></span>là<span style="letter-spacing: -0.5pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 2.4pt;"> </span>áp<span style="letter-spacing: -0.5pt;"></span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bình<span style="letter-spacing: 1.1pt;"> </span>thường,<span style="letter-spacing: 0.7pt;"> </span>áp<span style="letter-spacing: 1.4pt;"> </span>lực<span style="letter-spacing: 0.55pt;"> </span>động<span style="letter-spacing: 1.3pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>phổi<span style="letter-spacing: 1.1pt;"> </span>thì<span style="letter-spacing: 0.95pt;"> </span>tâm<span style="letter-spacing: 1.5pt;"> </span>thu<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 1.55pt;"> </span>đo<span style="letter-spacing: 1.45pt;"> </span>khi<span style="letter-spacing: 0.55pt;"> </span>thông<span style="letter-spacing: 0.95pt;"> </span>tim<span style="letter-spacing: 0.6pt;"> </span>phải <span style="letter-spacing: 0.75pt;"><span> </span></span>là<span style="letter-spacing: 0.65pt;"> </span>23<span style="letter-spacing: 0.7pt;"> </span>mmHg.<span style="letter-spacing: 0.35pt;"> </span>Khi áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>này<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ượt quá<span style="letter-spacing: 0.5pt;"> </span>23 mmHg<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.2pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.35pt;"> </span>tăng<span style="letter-spacing: 1pt;"><span> </span></span>áp<span style="letter-spacing: 0.2pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.1.<span style="letter-spacing: -0.2pt;"> </span>Cơ<span style="letter-spacing: 0.4pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>làm<span style="letter-spacing: 0.3pt;"> </span>tăng<span style="letter-spacing: -0.25pt;"> </span>áp<span style="letter-spacing: 0.35pt;"> </span>lực<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>phổi:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">3.1.1.<span style="letter-spacing: -0.25pt;"> </span>Cơ<span style="letter-spacing: 0.5pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>thắt<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.55pt;"> </span>máu<span style="letter-spacing: 0.25pt;"> </span>phổi:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Các<span style="letter-spacing: 0.8pt;"> </span>bệnh<span style="letter-spacing: -0.4pt;"> </span>phổi<span style="letter-spacing: 0.7pt;"> </span>mạn<span style="letter-spacing: 0.2pt;"> </span>tính<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>suy<span style="letter-spacing: 0.3pt;"> </span>hô<span style="letter-spacing: 0.85pt;"> </span>hấp<span style="letter-spacing: 2pt;"> </span>từng<span style="letter-spacing: 0.1pt;"> </span>phần<span style="letter-spacing: 0.05pt;"> </span>gây<span style="letter-spacing: 0.65pt;"> </span>thi<span style="letter-spacing: 0.05pt;">ế</span>u<span style="letter-spacing: -0.45pt;"> </span>ôxy<span style="letter-spacing: 0.7pt;"> </span>máu,<span style="letter-spacing: 0.7pt;"> </span>thiếu<span style="letter-spacing: -0.45pt;"> </span>ôxy<span style="letter-spacing: 0.7pt;"> </span>tổ<span style="letter-spacing: 0.9pt;"> </span>chức làm<span style="letter-spacing: 1.45pt;"> </span>cho<span style="letter-spacing: 0.8pt;"> </span>toan<span style="letter-spacing: 0.75pt;"> </span>chuyển<span style="letter-spacing: 0.25pt;"> </span>h<span style="letter-spacing: -0.1pt;">o</span>á.<span style="letter-spacing: 1.4pt;"></span>Suy hô<span style="letter-spacing: 1.5pt;"> </span>hấp<span style="letter-spacing: 2.65pt;"> </span>toàn<span style="letter-spacing: 1.4pt;"> </span>phần<span style="letter-spacing: 0.7pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>ứ<span style="letter-spacing: 0.95pt;"> </span>trệ<span style="letter-spacing: 0.15pt;"> </span>CO<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 1.7pt;"> </span></span>gây<span style="letter-spacing: -1.2pt;"> </span>toan<span style="letter-spacing: 0.75pt;"> </span>hô<span style="letter-spacing: 1.5pt;"> </span>hấp.<span style="letter-spacing: 2.6pt;"> </span>Thiếu<span style="letter-spacing: -0.2pt;"> </span>oxy<span style="letter-spacing: 0.75pt;"> </span>tổ<span style="letter-spacing: 1.55pt;"> </span>chức gây<span style="letter-spacing: -0.85pt;"> </span>co<span style="letter-spacing: 1.2pt;"> </span>thắt<span style="letter-spacing: 1.15pt;"> </span>động<span style="letter-spacing: 1.9pt;"> </span>mạch<span style="letter-spacing: 1.4pt;"> </span>phổi,<span style="letter-spacing: 1.55pt;"> </span>toan<span style="letter-spacing: 1.1pt;"> </span>máu<span style="letter-spacing: 1.7pt;"> </span>gây<span style="letter-spacing: -0.85pt;"></span>co<span style="letter-spacing: 1.2pt;"> </span>thắt<span style="letter-spacing: 1.15pt;"> </span>tĩnh<span style="letter-spacing: -0.7pt;"> </span>mạch<span style="letter-spacing: 1.7pt;"> </span>phổi.<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: -0.05pt;">V</span>ì<span style="letter-spacing: 1.35pt;"> </span>vậy<span style="letter-spacing: 2.9pt;"> </span>làm<span style="letter-spacing: 1.85pt;"> </span>tăng<span style="letter-spacing: -0.7pt;"> </span>áp<span style="letter-spacing: 2pt;"> </span>lực<span style="letter-spacing: 1.2pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổ</span><span style="letter-spacing: 0.05pt;">i</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Co<span style="letter-spacing: 0.45pt;"> </span>thắt<span style="letter-spacing: 0.85pt;"> </span>tĩnh<span style="letter-spacing: -1pt;"> </span>mạch<span style="letter-spacing: 1.4pt;"> </span>phổi<span style="letter-spacing: 1.4pt;"> </span>gây<span style="letter-spacing: -1.15pt;"> </span>ra<span style="letter-spacing: 0.9pt;"> </span>dòng<span style="letter-spacing: 1.45pt;"> </span>thông<span style="letter-spacing: 1.25pt;"> </span>ở<span style="letter-spacing: 1pt;"> </span>phổi<span style="letter-spacing: 1.4pt;"> </span>từ<span style="letter-spacing: 0.9pt;"> </span>động<span style="letter-spacing: 1.6pt;"> </span>mạch<span style="letter-spacing: 1.05pt;"> </span>phổi<span style="letter-spacing: 1.4pt;"> </span>sang<span style="letter-spacing: 1pt;"> </span>tĩnh<span style="letter-spacing: -1.05pt;"> </span>mạch<span style="letter-spacing: 1.35pt;"> </span>phổi, máu<span style="letter-spacing: 2.15pt;"> </span>được<span style="letter-spacing: 0.85pt;"> </span>trở<span style="letter-spacing: 0.5pt;"> </span>về<span style="letter-spacing: -0.55pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>trái<span style="letter-spacing: 1.2pt;"> </span>mà<span style="letter-spacing: 1pt;"></span>không <span style="letter-spacing: 1.65pt;"><span></span></span>được<span style="letter-spacing: 0.85pt;"> </span>ti<span style="letter-spacing: -0.05pt;">ế</span>p<span style="letter-spacing: -0.35pt;"> </span>x<span style="letter-spacing: -0.05pt;">ú</span>c<span style="letter-spacing: 0.35pt;"> </span>với<span style="letter-spacing: 0.2pt;"> </span>phế<span style="letter-spacing: -0.25pt;"> </span>n<span style="letter-spacing: -0.05pt;">a</span>ng<span style="letter-spacing: 0.55pt;"> </span>và<span style="letter-spacing: 1.45pt;"> </span>hậu<span style="letter-spacing: 2.65pt;"> </span>quả<span style="letter-spacing: 1.85pt;"> </span>là<span style="letter-spacing: 0.15pt;"> </span>máu<span style="letter-spacing: 0.3pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">v</span>ề<span style="letter-spacing: -0.5pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>trái<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.05pt;">gi</span>ảm bão<span style="letter-spacing: 1.15pt;"> </span>hoà<span style="letter-spacing: 1.15pt;"> </span>oxy.<span style="letter-spacing: 0.45pt;"> </span>Từ<span style="letter-spacing: 0.25pt;"> </span>đó<span style="letter-spacing: 1.45pt;"> </span>lại<span style="letter-spacing: 0.25pt;"> </span>gây<span style="letter-spacing: 2.3pt;"> </span>co<span style="letter-spacing: 0.55pt;"> </span>thắt<span style="letter-spacing: 0.45pt;"> </span>mạch<span style="letter-spacing: 1.35pt;"> </span>máu<span style="letter-spacing: 0.8pt;"></span>phổi<span style="letter-spacing: 1pt;"> </span>và<span style="letter-spacing: -0.15pt;"> </span>gây<span style="letter-spacing: 0.1pt;"><span> </span></span>tăng<span style="letter-spacing: 0.75pt;"><span> </span></span>áp<span style="letter-spacing: 0.3pt;"> </span>lực<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ổi<span style="letter-spacing: 1pt;"> </span>theo<span style="letter-spacing: 0.45pt;"> </span>cơ<span style="letter-spacing: 1.2pt;"> </span>chế như trên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.35pt;"> </span>Các<span style="letter-spacing: 0.85pt;"> </span>bệnh<span style="letter-spacing: -0.35pt;"> </span>của cơ<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.35pt;"> </span>lồng<span style="letter-spacing: 0.95pt;"> </span>ngực<span style="letter-spacing: 0.1pt;"> </span>gây<span style="letter-spacing: 0.9pt;"> </span>giảm<span style="letter-spacing: 0.4pt;"> </span>thông<span style="letter-spacing: 1.6pt;"> </span>khí<span style="letter-spacing: 0.7pt;"> </span>phổi<span style="letter-spacing: 0.75pt;"> </span>(như<span style="letter-spacing: 0.35pt;"> </span>gù<span style="letter-spacing: 0.1pt;"> </span>vẹo<span style="letter-spacing: -0.9pt;"> </span>cột<span style="letter-spacing: 0.2pt;"> </span>sống,<span style="letter-spacing: 0.85pt;"> </span>béo<span style="letter-spacing: -0.55pt;"> </span>bệu, giảm<span style="letter-spacing: 0.5pt;"> </span>thông<span style="letter-spacing: 1.65pt;"> </span>khí<span style="letter-spacing: 0.75pt;"> </span>phế<span style="letter-spacing: -0.5pt;"> </span>nang<span style="letter-spacing: 0.15pt;"></span>tiên<span style="letter-spacing: 1.65pt;"> </span>phát,<span style="letter-spacing: 1.1pt;"> </span>xơ<span style="letter-spacing: 0.4pt;"> </span>cứng<span style="letter-spacing: 0.15pt;"> </span>bì,<span style="letter-spacing: 0.8pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span>ược<span style="letter-spacing: 0.4pt;"> </span>cơ...)<span style="letter-spacing: 0.7pt;"> </span>cũng<span style="letter-spacing: -0.05pt;"> </span>gây<span style="letter-spacing: 0.75pt;"> </span>suy<span style="letter-spacing: 0.4pt;"> </span>hô<span style="letter-spacing: 0.95pt;"> </span>hấp,<span style="letter-spacing: 2.05pt;"> </span>thiếu<span style="letter-spacing: -0.35pt;"> </span>ôxy<span style="letter-spacing: 0.05pt;"><span> </span></span>và<span style="letter-spacing: -0.05pt;"> </span>toan máu<span style="letter-spacing: 0.15pt;"> </span>gây<span style="letter-spacing: 0.8pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>làm<span style="letter-spacing: 1.25pt;"> </span>tăng<span style="letter-spacing: 0.7pt;"><span></span></span>áp lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">3.1.2.<span style="letter-spacing: -0.25pt;"> </span>Các<span style="letter-spacing: 1.4pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>khác<span style="letter-spacing: 1.15pt;"> </span>làm<span style="letter-spacing: -0.05pt;"> </span>tăng<span style="letter-spacing: -0.9pt;"> </span>áp<span style="letter-spacing: 0.55pt;"> </span>lực<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.25pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>phổi:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Các<span style="letter-spacing: 0.5pt;"> </span>tổn<span style="letter-spacing: 0.6pt;"> </span>thương giải<span style="letter-spacing: 0.5pt;"> </span>phẫu<span style="letter-spacing: 1.7pt;"> </span>ở mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>(giảm<span style="letter-spacing: 0.35pt;"> </span>lưới mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>xơ hoá,<span style="letter-spacing: 1.55pt;"> </span>bị<span style="letter-spacing: 0.95pt;"> </span>ngh<span style="letter-spacing: 0.1pt;">ẽ</span>n<span style="letter-spacing: -0.15pt;"> </span>tắc,<span style="letter-spacing: 0.4pt;"> </span>bị<span style="letter-spacing: 1.1pt;"> </span>phá<span style="letter-spacing: 1pt;"></span>hủy)<span style="letter-spacing: 0.1pt;"> </span>như<span style="letter-spacing: 0.55pt;"> </span>ở<span style="letter-spacing: 0.55pt;"> </span>các<span style="letter-spacing: 1.1pt;"> </span>bệnh<span style="letter-spacing: -0.15pt;"> </span>tăng<span style="letter-spacing: 0.4pt;"><span> </span></span>áp<span style="letter-spacing: 0.05pt;"> </span>lực<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>phổi<span style="letter-spacing: 0.95pt;"> </span>tiên<span style="letter-spacing: 0.05pt;"><span> </span></span>phát,<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ơ<span style="letter-spacing: 1.1pt;"> </span>phổi,<span style="letter-spacing: 0.8pt;"> </span>viêm phế<span style="letter-spacing: -0.9pt;"> </span>nang,<span style="letter-spacing: -0.25pt;"> </span>bụi<span style="letter-spacing: -0.3pt;"> </span>phổi...<span style="letter-spacing: 0.3pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">D</span>o<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.3pt;">tăn</span>g<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: 0.4pt;">c</span><span style="letter-spacing: 0.3pt;">huyể</span>n<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: 0.25pt;">hoá</span>,<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.3pt;">nhiễ</span>m<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">khuẩ</span>n <span style="letter-spacing: 0.15pt;"><span> </span></span><span style="letter-spacing: 0.3pt;">phổi</span>,<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.3pt;">thiế</span>u<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">ôx</span>y<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: 0.25pt;">là</span>m<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.3pt;">tăn</span>g<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: 0.3pt;">lư</span>u<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.35pt;">l</span><span style="letter-spacing: 0.3pt;">ượn</span>g<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">tim</span>,<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">t</span>ừ<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.3pt;">đ</span>ó<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: 0.3pt;">gây </span><span style="letter-spacing: 0.25pt;">tăn</span>g<span style="letter-spacing: 0.6pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">á</span>p<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.3pt;">lự</span>c<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">phổi.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.95pt;"> </span>Bệnh<span style="letter-spacing: -0.6pt;"> </span>nhân<span style="letter-spacing: -1.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.95pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>tăng<span style="letter-spacing: -1.1pt;"> </span>số<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ượng<span style="letter-spacing: 0.95pt;"> </span>hồng<span style="letter-spacing: 1.4pt;"> </span>cầu<span style="letter-spacing: 0.8pt;"> </span>và<span style="letter-spacing: 1.75pt;"> </span>hematocrit,<span style="letter-spacing: 0.35pt;"> </span>làm<span style="letter-spacing: 1.45pt;"> </span>tăng<span style="letter-spacing: -1.1pt;"> </span>độ<span style="letter-spacing: 1.5pt;"> </span>nhớt<span style="letter-spacing: 0.75pt;"> </span>qu<span style="letter-spacing: -0.1pt;">á</span>nh<span style="letter-spacing: 1.35pt;"> </span>của máu<span style="letter-spacing: 0.4pt;"> </span>cũng<span style="letter-spacing: -0.45pt;"> </span>góp<span style="letter-spacing: 0.35pt;"> </span>phần<span style="letter-spacing: -0.25pt;"> </span>làm<span style="letter-spacing: 0.5pt;"></span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 18px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.4pt;"> </span>Trong<span style="letter-spacing: -0.2pt;"> </span>hoàn<span style="letter-spacing: 0.8pt;"> </span>cảnh<span style="letter-spacing: 0.8pt;"> </span>thiếu<span style="letter-spacing: -0.35pt;"> </span>ôxy,<span style="letter-spacing: 0.45pt;"> </span>tăng<span style="letter-spacing: 0.95pt;"> </span>CO<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: -0.5pt;"> </span></span><span style="letter-spacing: 0.05pt;">m</span><span style="letter-spacing: -0.05pt;">á</span>u<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.05pt;">t</span><span style="letter-spacing: -0.05pt;">i</span>m<span style="letter-spacing: 0.3pt;"> </span>phải<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">b</span>ị<span style="letter-spacing: 1.1pt;"> </span>s<span style="letter-spacing: -0.05pt;">u</span>y<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>àm<span style="letter-spacing: 0.45pt;"> </span>cho<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.05pt;">nh</span><span style="letter-spacing: 0.05pt;">ị</span>p<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">t</span><span style="letter-spacing: 0.05pt;">i</span>m<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">nhan</span>h<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.05pt;">cũng </span>góp<span style="letter-spacing: 0.35pt;"> </span>phần<span style="letter-spacing: -0.25pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"></span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.2.<span style="letter-spacing: -0.2pt;"> </span>Cơ<span style="letter-spacing: 0.4pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>gây<span style="letter-spacing: 0.25pt;"> </span>suy<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>phải:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Khi<span style="letter-spacing: -0.15pt;"> </span>tăng<span style="letter-spacing: 2.35pt;"> </span>áp<span style="letter-spacing: -0.45pt;"> </span>lực<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 0.65pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>phổi,<span style="letter-spacing: 0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải<span style="letter-spacing: 0.55pt;"> </span>sẽ<span style="letter-spacing: -0.7pt;"> </span>phải<span style="letter-spacing: 0.55pt;"> </span>co<span style="letter-spacing: -0.05pt;"> </span>bóp<span style="letter-spacing: 0.4pt;"> </span>mạnh<span style="letter-spacing: 0.75pt;"> </span>g<span style="letter-spacing: -0.2pt;">â</span>y<span style="letter-spacing: 0.8pt;"> </span>phì<span style="letter-spacing: 0.45pt;"> </span>đại<span style="letter-spacing: 0.95pt;"> </span>thất<span style="letter-spacing: 1.95pt;"> </span>phải,<span style="letter-spacing: 0.45pt;"> </span>sau<span style="letter-spacing: 0.05pt;"> </span>đó<span style="letter-spacing: 0.5pt;"> </span>thất phải<span style="letter-spacing: 0.5pt;"> </span>giãn<span style="letter-spacing: 0.7pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>hậu<span style="letter-spacing: 2pt;"></span>quả<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.05pt;">c</span>uối<span style="letter-spacing: 0.55pt;"> </span>cùng<span style="letter-spacing: -0.45pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 0.75pt;"> </span>bị<span style="letter-spacing: 0.4pt;"> </span>suy.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.4pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.15pt;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><o:p><span class="Apple-style-span" style="font-size: large;"> <img align="" alt="" border="0px" src="http://www.benhhoc.com/images.php?do=view&id=1391" /></span></o:p></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.75pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic; position: relative; top: 0.5pt;">Sơ<span style="letter-spacing: 0.35pt;"> </span>đồ<span style="letter-spacing: 0.8pt;"> </span>về<span style="letter-spacing: 1.1pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>chế<span style="letter-spacing: -0.15pt;"> </span>sinh<span style="letter-spacing: 1.2pt;"> </span>b<span style="letter-spacing: -0.05pt;">ệ</span>nh<span style="letter-spacing: 0.6pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>bệnh<span style="letter-spacing: 0.5pt;"> </span>tim-ph<span style="letter-spacing: -0.05pt;">ổ</span>i<span style="letter-spacing: 1.1pt;"> </span>mạn<span style="letter-spacing: 0.25pt;"> </span>tính.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 12pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.55pt;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.<span style="letter-spacing: -0.1pt;"> </span>Giải <span style="letter-spacing: 0.15pt;"><span> </span></span>phẫu<span style="letter-spacing: -1.75pt;"> </span><span style="letter-spacing: 0.05pt;">b</span>ệnh.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bao<span style="letter-spacing: -0.85pt;"> </span>giờ<span style="letter-spacing: -0.05pt;"> </span>cũ<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: -0.25pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>phì<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ại<span style="letter-spacing: 0.1pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>phải,<span style="letter-spacing: 0.2pt;"> </span>thành<span style="letter-spacing: 0.8pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>phải <span style="letter-spacing: 0.75pt;"><span> </span></span>dày <span style="letter-spacing: 0.2pt;"><span> </span></span>≥<span style="letter-spacing: -0.6pt;"> </span>10<span style="letter-spacing: 0.1pt;"> </span>mm.<span style="letter-spacing: -0.1pt;"> </span>Giãn<span style="letter-spacing: 0.5pt;"> </span>buồng<span style="letter-spacing: 0.7pt;"> </span>thất<span style="letter-spacing: 2pt;"> </span>phải<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">(</span>≥ 25mm); giãn<span style="letter-spacing: 1pt;"> </span>vòng<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>3<span style="letter-spacing: 0.55pt;"> </span>lá<span style="letter-spacing: 0.2pt;"></span>gây<span style="letter-spacing: 0.5pt;"><span> </span></span>hở<span style="letter-spacing: 0.55pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>3<span style="letter-spacing: 0.55pt;"> </span>lá<span style="letter-spacing: -0.1pt;"> </span>cơ<span style="letter-spacing: 0.8pt;"> </span>năng; <span style="letter-spacing: 1.5pt;"><span></span></span>giãn<span style="letter-spacing: 1.8pt;"> </span>vòng<span style="letter-spacing: 0.8pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>phổi<span style="letter-spacing: 0.9pt;"> </span>gây<span style="letter-spacing: 0.9pt;"> </span>hở<span style="letter-spacing: 0.55pt;"> </span>van<span style="letter-spacing: 0.05pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>mạch phổi<span style="letter-spacing: 0.4pt;"> </span>cơ<span style="letter-spacing: -0.6pt;"> </span>năng;<span style="letter-spacing: 1.8pt;"> </span>giãn<span style="letter-spacing: -0.1pt;"> </span>thân<span style="letter-spacing: 1.3pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.5pt;"></span>phổi;<span style="letter-spacing: 0.25pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>xơ<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tùy<span style="letter-spacing: 0.85pt;"> </span>theo<span style="letter-spacing: 1.25pt;"> </span>nguyên<span style="letter-spacing: -0.8pt;"> </span>nhân<span style="letter-spacing: -0.6pt;"> </span>gây<span style="letter-spacing: -0.7pt;"> </span>bệnh<span style="letter-spacing: 0.75pt;"> </span>mà<span style="letter-spacing: 2pt;"> </span>có<span style="letter-spacing: 2.1pt;"> </span>những<span style="letter-spacing: 1.45pt;"> </span>tổn<span style="letter-spacing: 2.05pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 1.4pt;"> </span>giải<span style="letter-spacing: 1.9pt;"> </span>phẫu<span style="letter-spacing: 0.1pt;"><span> </span></span>bệnh<span style="letter-spacing: 0.7pt;"> </span>lý<span style="letter-spacing: 1.3pt;"> </span>khác<span style="letter-spacing: 1.8pt;"> </span>nhau.<span style="letter-spacing: 1.15pt;"> </span>Nếu nguyên<span style="letter-spacing: 0.95pt;"> </span>nhân<span style="letter-spacing: 0.3pt;"> </span>là<span style="letter-spacing: 1.2pt;"> </span>do<span style="letter-spacing: 0.25pt;"> </span>tắc<span style="letter-spacing: 0.2pt;"></span>mạch<span style="letter-spacing: 0.8pt;"> </span>phổi<span style="letter-spacing: 0.75pt;"> </span>thì<span style="letter-spacing: 0.75pt;"> </span>thấy<span style="letter-spacing: 2.2pt;"> </span>phì<span style="letter-spacing: 0.45pt;"><span> </span></span>đại<span style="letter-spacing: -0.4pt;"> </span>lớp<span style="letter-spacing: 0.1pt;"> </span>áo<span style="letter-spacing: 1.05pt;"> </span>giữa<span style="letter-spacing: 0.15pt;"> </span>của động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>phổi,<span style="letter-spacing: 0.6pt;"> </span>cục tắc<span style="letter-spacing: 0.2pt;"> </span>bị<span style="letter-spacing: 0.9pt;"> </span>tổ<span style="letter-spacing: 0.95pt;"> </span>chức hoá<span style="letter-spacing: 0.1pt;"> </span>gây<span style="letter-spacing: 1.35pt;"> </span>nên<span style="letter-spacing: 1.35pt;"> </span>hẹp<span style="letter-spacing: -0.35pt;"> </span>hoặc<span style="letter-spacing: 0.3pt;"> </span>tắc<span style="letter-spacing: 0.4pt;"> </span>lòng<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 1.25pt;"></span>máu.<span style="letter-spacing: 0.95pt;"> </span>N<span style="letter-spacing: -0.05pt;">ế</span>u<span style="letter-spacing: -0.35pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>giãn<span style="letter-spacing: 1pt;"> </span>phế<span style="letter-spacing: -0.35pt;"> </span>nang<span style="letter-spacing: 0.3pt;"> </span>thì<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 1.9pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>bị<span style="letter-spacing: 0.65pt;"> </span>t<span style="letter-spacing: -0.15pt;">h</span>ưa<span style="letter-spacing: 0.55pt;"> </span>thớt,<span style="letter-spacing: 0.35pt;"> </span>lớp<span style="letter-spacing: 0.2pt;"> </span>áo giữa<span style="letter-spacing: -0.2pt;"> </span>dày<span style="letter-spacing: 0.5pt;"> </span>lên...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.<span style="letter-spacing: -0.1pt;"> </span>Triệu<span style="letter-spacing: -1.25pt;"> </span>chứng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.1.<span style="letter-spacing: -0.2pt;"> </span>Giai<span style="letter-spacing: 1.25pt;"> </span>đoạn<span style="letter-spacing: 0.4pt;"> </span>đầ<span style="letter-spacing: -0.05pt;">u</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Chỉ<span style="letter-spacing: 0.9pt;"> </span>thấy<span style="letter-spacing: 2.35pt;"> </span>triệu<span style="letter-spacing: -0.2pt;"> </span>chứng<span style="letter-spacing: 0.2pt;"> </span>của<span style="letter-spacing: 0.15pt;"> </span>các<span style="letter-spacing: 1.05pt;"> </span>bệnh<span style="letter-spacing: -0.2pt;"> </span>phổi,<span style="letter-spacing: 0.75pt;"> </span>phế<span style="letter-spacing: -0.4pt;"> </span>quản,<span style="letter-spacing: 2.15pt;"> </span>cơ<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.5pt;"> </span>lồng<span style="letter-spacing: 1.1pt;"> </span>ngực<span style="letter-spacing: 0.25pt;"> </span>mạn<span style="letter-spacing: 1.5pt;"> </span>tính<span style="letter-spacing: 2.45pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>tăng <span style="letter-spacing: 0.35pt;"><span> </span></span>áp lực động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.1.1.<span style="letter-spacing: -0.25pt;"> </span>Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>nhóm<span style="letter-spacing: 1.85pt;"> </span>bệnh<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 1.25pt;"> </span>tắc<span style="letter-spacing: 0.55pt;"> </span>nghẽn</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thường<span style="letter-spacing: 0.9pt;"> </span>là<span style="letter-spacing: 1.75pt;"> </span>do<span style="letter-spacing: 0.8pt;"> </span>các<span style="letter-spacing: 1.45pt;"> </span>bệnh<span style="letter-spacing: 0.2pt;"> </span>của<span style="letter-spacing: 0.55pt;"> </span>phế quản<span style="letter-spacing: 1.3pt;"> </span>như:<span style="letter-spacing: 0.9pt;"> </span>viêm<span style="letter-spacing: 1.2pt;"> </span>phế quản<span style="letter-spacing: 1.3pt;"> </span>mạn,<span style="letter-spacing: 1.3pt;"> </span>hen<span style="letter-spacing: 0.75pt;"> </span>phế quản,<span style="letter-spacing: 1.9pt;"> </span>giãn<span style="letter-spacing: 1.1pt;"> </span>phế quản, giãn<span style="letter-spacing: 0.85pt;"> </span>phế<span style="letter-spacing: -0.5pt;"> </span>nang<span style="letter-spacing: 0.15pt;"> </span>tắc<span style="letter-spacing: 0.25pt;"> </span>nghẽn.<span style="letter-spacing: -0.6pt;"></span>Bệnh<span style="letter-spacing: -1.15pt;"> </span>nhân<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>từng<span style="letter-spacing: 0.2pt;"> </span>đợt<span style="letter-spacing: 0.85pt;"> </span>bùng<span style="letter-spacing: 0.15pt;"> </span>phát<span style="letter-spacing: 0.85pt;"> </span>của<span style="letter-spacing: 0.05pt;"> </span>bệnh,<span style="letter-spacing: -0.4pt;"> </span>ho<span style="letter-spacing: 0.3pt;"> </span>nhiều,<span style="letter-spacing: -0.5pt;"> </span>khạc<span style="letter-spacing: 0.55pt;"> </span>đờm<span style="letter-spacing: 1.05pt;"> </span>mủ<span style="letter-spacing: 0.1pt;"> </span>(đờm màu<span style="letter-spacing: 1.4pt;"> </span>xanh,<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>àng).<span style="letter-spacing: 0.95pt;"> </span>Có<span style="letter-spacing: 1.1pt;"> </span>thể<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>những<span style="letter-spacing: 0.95pt;"> </span>cơn<span style="letter-spacing: 1.35pt;"> </span>khó<span style="letter-spacing: 1.45pt;"></span>thở<span style="letter-spacing: 0.8pt;"> </span>kịch<span style="letter-spacing: -1.05pt;"> </span>phát.<span style="letter-spacing: 1.35pt;"> </span>Bệnh<span style="letter-spacing: -0.6pt;"> </span>nặng<span style="letter-spacing: 0.7pt;"> </span>dần<span style="letter-spacing: 0.8pt;"> </span>lên<span style="letter-spacing: 1.35pt;"> </span>sau<span style="letter-spacing: 0.95pt;"> </span>những<span style="letter-spacing: 0.95pt;"> </span>đợt<span style="letter-spacing: 1.4pt;"> </span>bùng phát.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thay<span style="letter-spacing: -0.5pt;"> </span>đổi<span style="letter-spacing: 0.35pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>hô<span style="letter-spacing: -0.3pt;"> </span>hấp<span style="letter-spacing: 1.7pt;"> </span>đặc<span style="letter-spacing: 0.4pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>n<span style="letter-spacing: -0.05pt;">à</span>y<span style="letter-spacing: 1.2pt;"> </span>là<span style="letter-spacing: -0.5pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>tích<span style="letter-spacing: 0.3pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>tối<span style="letter-spacing: 0.6pt;"> </span>đa<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>giây<span style="letter-spacing: 0.25pt;"> </span>đầu (VEMS)<span style="letter-spacing: -0.85pt;"> </span>bị<span style="letter-spacing: 0.1pt;"> </span>giảm,<span style="letter-spacing: 1.35pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>tích<span style="letter-spacing: 0.3pt;"> </span>cặn<span style="letter-spacing: -0.15pt;"> </span>(RV) tăng<span style="letter-spacing: 0.25pt;"> </span>lên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.1.2.<span style="letter-spacing: -0.25pt;"> </span>Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>nhóm<span style="letter-spacing: 1.85pt;"> </span>bệnh<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 1.25pt;"> </span>hạn<span style="letter-spacing: 0.2pt;"> </span>ch<span style="letter-spacing: 0.05pt;">ế</span></span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thường<span style="letter-spacing: 1.45pt;"> </span>do<span style="letter-spacing: 1.35pt;"> </span>béo<span style="letter-spacing: 0.55pt;"> </span>bệu,<span style="letter-spacing: 0.6pt;"> </span>gù<span style="letter-spacing: 1.2pt;"> </span>vẹo<span style="letter-spacing: 0.2pt;"> </span>dị<span style="letter-spacing: 1.7pt;"> </span>dạng <span style="letter-spacing: 0.2pt;"><span> </span></span>cột<span style="letter-spacing: 1.3pt;"> </span>sống<span style="letter-spacing: 2.1pt;"> </span>và <span style="letter-spacing: 0.05pt;"><span> </span></span>lồng<span style="letter-spacing: 2.05pt;"> </span>ngực,<span style="letter-spacing: 1.2pt;"> </span>xơ<span style="letter-spacing: 2pt;"> </span>phổi<span style="letter-spacing: 1.85pt;"> </span>lan<span style="letter-spacing: 1.3pt;"> </span>toả,<span style="letter-spacing: 1.95pt;"> </span>dày<span style="letter-spacing: 1.95pt;"> </span>dính<span style="letter-spacing: -0.65pt;"> </span>màng phổi,<span style="letter-spacing: 0.25pt;"> </span>nhược cơ,<span style="letter-spacing: 0.7pt;"> </span>xơ<span style="letter-spacing: 0.35pt;"> </span>cứng<span style="letter-spacing: -0.25pt;"></span>bì,<span style="letter-spacing: 0.75pt;"> </span>các<span style="letter-spacing: 0.1pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ưới mạch<span style="letter-spacing: 0.7pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>giãn<span style="letter-spacing: 0.45pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>nang.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thay<span style="letter-spacing: 0.3pt;"> </span>đổi<span style="letter-spacing: 1.15pt;"> </span>chức<span style="letter-spacing: 0.55pt;"> </span>năng <span style="letter-spacing: 0.15pt;"><span> </span></span>hô<span style="letter-spacing: 0.5pt;"> </span>hấp<span style="letter-spacing: 2.5pt;"> </span>đặc<span style="letter-spacing: 1.2pt;"> </span>hiệu<span style="letter-spacing: -0.05pt;"> </span>trong<span style="letter-spacing: 0.55pt;"> </span>nhóm<span style="letter-spacing: 1.35pt;"> </span>bệnh<span style="letter-spacing: 0.1pt;"> </span>này<span style="letter-spacing: 0.4pt;"><span> </span></span>là<span style="letter-spacing: 0.75pt;"> </span>dung<span style="letter-spacing: 0.8pt;"> </span>tích<span style="letter-spacing: -1.2pt;"> </span>sống<span style="letter-spacing: 1.45pt;"> </span>(VC)<span style="letter-spacing: 0.3pt;"> </span>giảm<span style="letter-spacing: 1.2pt;"> </span>nặng, chứng<span style="letter-spacing: -0.3pt;"> </span>tỏ<span style="letter-spacing: 0.6pt;"> </span>khả<span style="letter-spacing: -0.2pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"></span>nở của<span style="letter-spacing: -0.35pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>rất<span style="letter-spacing: 1.9pt;"> </span>kém.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Khuếch<span style="letter-spacing: -0.7pt;"> </span>tán<span style="letter-spacing: 0.15pt;"> </span>khí<span style="letter-spacing: 1.35pt;"> </span>của<span style="letter-spacing: -0.15pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>giảm<span style="letter-spacing: 0.6pt;"> </span>nói<span style="letter-spacing: 0.8pt;"> </span>lên<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>tổn<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ương<span style="letter-spacing: 0.2pt;"> </span>màng<span style="letter-spacing: 0.55pt;"> </span>mao mạch-phế<span style="letter-spacing: 0.45pt;"> </span>nang.<span style="letter-spacing: -0.05pt;"> </span>Có<span style="letter-spacing: 0.35pt;"> </span>rối<span style="letter-spacing: 0.85pt;"> </span>loạn<span style="letter-spacing: 0.65pt;"> </span>về tỉ<span style="letter-spacing: 0.7pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>phân<span style="letter-spacing: 0.25pt;"> </span>bố<span style="letter-spacing: 0.55pt;"> </span>khí<span style="letter-spacing: 1.8pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>máu<span style="letter-spacing: 1.75pt;"></span>trong<span style="letter-spacing: -0.25pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.1.3.<span style="letter-spacing: -0.25pt;"> </span>Phối<span style="letter-spacing: 1.9pt;"> </span>hợp<span style="letter-spacing: 0.55pt;"> </span>triệu<span style="letter-spacing: 0.45pt;"> </span>c<span style="letter-spacing: -0.1pt;">h</span>ứng<span style="letter-spacing: 1.85pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>2<span style="letter-spacing: -0.05pt;"> </span>nhóm<span style="letter-spacing: 1.85pt;"> </span>bệnh<span style="letter-spacing: 0.5pt;"> </span>trên</span></span><span lang="EN">.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.1.4.<span style="letter-spacing: -0.25pt;"> </span>Các<span style="letter-spacing: 0.4pt;"> </span>biểu<span style="letter-spacing: -0.2pt;"> </span>hiện<span style="letter-spacing: 0.45pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>tăng<span style="letter-spacing: -0.9pt;"> </span>áp<span style="letter-spacing: 0.55pt;"> </span>lực<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.25pt;"> </span>mạch<span style="letter-spacing: 0.25pt;"> </span>phổi:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: -1.15pt;"> </span>mạn<span style="letter-spacing: 0.35pt;"> </span>tính<span style="letter-spacing: 1.45pt;"> </span>của<span style="letter-spacing: 0.1pt;"> </span>phổi,<span style="letter-spacing: 0.65pt;"> </span>phế<span style="letter-spacing: -0.5pt;"> </span>quản<span style="letter-spacing: 0.8pt;"> </span>hoặc<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: -0.3pt;"> </span>cơ-xương<span style="letter-spacing: 0.4pt;"> </span>lồng<span style="letter-spacing: 1pt;"> </span>ngực<span style="letter-spacing: 0.15pt;"> </span>kéo<span style="letter-spacing: -0.5pt;"> </span>dài<span style="letter-spacing: 0.15pt;"> </span>khoảng <span style="letter-spacing: 0.25pt;"><span></span></span>5-10<span style="letter-spacing: 0.4pt;"> </span>năm<span style="letter-spacing: 0.7pt;"> </span>thì xuất<span style="letter-spacing: 2.3pt;"> </span>hiện<span style="letter-spacing: -0.35pt;"> </span>tăng<span style="letter-spacing: 0.35pt;"><span> </span></span>áp<span style="letter-spacing: -0.05pt;"> </span>lực<span style="letter-spacing: 0.35pt;"></span>động<span style="letter-spacing: 1.1pt;"> </span>mạch<span style="letter-spacing: 0.55pt;"> </span>phổi.<span style="letter-spacing: 0.7pt;"> </span>Triệu<span style="letter-spacing: -0.55pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ứng<span style="letter-spacing: 0.35pt;"> </span>tăng<span style="letter-spacing: 0.35pt;"><span> </span></span>áp<span style="letter-spacing: -0.05pt;"> </span>lực<span style="letter-spacing: 0.35pt;"> </span>động<span style="letter-spacing: 1.05pt;"> </span>mạch<span style="letter-spacing: 0.55pt;"> </span>phổi<span style="letter-spacing: 0.8pt;"> </span>lúc<span style="letter-spacing: 0.15pt;"> </span>đầu<span style="letter-spacing: 0.85pt;"> </span>rất<span style="letter-spacing: 2.35pt;"> </span>kín<span style="letter-spacing: 0.05pt;"><span> </span></span>đáo nên<span style="letter-spacing: 1.1pt;"> </span>khó<span style="letter-spacing: 1.25pt;"> </span>phát<span style="letter-spacing: 1.15pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span>được<span style="letter-spacing: 0.95pt;"> </span>trên <span style="letter-spacing: 0.5pt;"><span> </span></span>lâm <span style="letter-spacing: 0.25pt;"><span> </span></span>sàng<span style="letter-spacing: 2.3pt;"></span>nếu<span style="letter-spacing: 0.05pt;"> </span>không<span style="letter-spacing: 1.75pt;"> </span>khám<span style="letter-spacing: 0.8pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>nhân<span style="letter-spacing: 1pt;"> </span>kỹ<span style="letter-spacing: 0.75pt;"> </span>lưỡng.<span style="letter-spacing: 0.7pt;"> </span>Bệnh<span style="letter-spacing: -0.8pt;"> </span>nhân<span style="letter-spacing: 1pt;"> </span>thường<span style="letter-spacing: 0.75pt;"> </span>có khó<span style="letter-spacing: 0.55pt;"> </span>thở<span style="letter-spacing: -0.1pt;"> </span>khi<span style="letter-spacing: -0.1pt;"> </span>gắng<span style="letter-spacing: -0.2pt;"> </span>sức,<span style="letter-spacing: 0.05pt;"> </span>móng<span style="letter-spacing: 0.6pt;"> </span>tay<span style="letter-spacing: -0.1pt;"> </span>khum,<span style="letter-spacing: -0.25pt;"> </span>ngón<span style="letter-spacing: 0.5pt;"> </span>tay<span style="letter-spacing: -0.1pt;"> </span>dùi<span style="letter-spacing: -0.25pt;"> </span>t<span style="letter-spacing: -0.1pt;">r</span>ống.<span style="letter-spacing: 0.6pt;"></span>Suy<span style="letter-spacing: -0.9pt;"> </span>hô<span style="letter-spacing: 0.6pt;"> </span>hấp<span style="letter-spacing: 1.75pt;"> </span>bắt<span style="letter-spacing: -0.1pt;"> </span>đầu<span style="letter-spacing: 0.45pt;"> </span>xuất<span style="letter-spacing: 1.9pt;"> </span>hiện,<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: 0.3pt;">nhấ</span>t<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.35pt;">l</span>à<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">s</span><span style="letter-spacing: 0.25pt;">a</span>u <span style="letter-spacing: 0.3pt;">gắn</span>g<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.3pt;">sứ</span>c<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">biể</span>u<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.3pt;">hiệ</span>n<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: 0.25pt;">bằn</span>g<span style="letter-spacing: 0.5pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">á</span>p<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.3pt;">lự</span>c<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">ô</span><span style="letter-spacing: 0.2pt;">x</span>y<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">(Pa</span><span style="letter-spacing: 0.2pt;">O</span><span style="letter-spacing: 0.35pt; position: relative; top: 2.5pt;">2</span>)<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.25pt;">giả</span>m<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: 0.25pt;">đế</span>n<span style="letter-spacing: 0.45pt;"> </span>70<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: 0.05pt;">mm</span><span style="letter-spacing: -0.05pt;">H</span>g.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.15pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tăng<span style="letter-spacing: 0.5pt;"><span> </span></span>áp<span style="letter-spacing: -0.15pt;"> </span>lực<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>phổi<span style="letter-spacing: 0.75pt;"> </span>lúc<span style="letter-spacing: 0.05pt;"> </span>đầu<span style="letter-spacing: 1.25pt;"> </span>xảy<span style="letter-spacing: 0.6pt;"> </span>ra<span style="letter-spacing: 0.25pt;"> </span>không<span style="letter-spacing: 0.6pt;"> </span>thường<span style="letter-spacing: 0.35pt;"> </span>xuyên,<span style="letter-spacing: 0.55pt;"> </span>thường<span style="letter-spacing: 0.35pt;"> </span>chỉ<span style="letter-spacing: 0.7pt;"> </span>khi<span style="letter-spacing: 0.2pt;"> </span>gắng<span style="letter-spacing: 0.1pt;"> </span>sức<span style="letter-spacing: 0.35pt;"> </span>hoặc sau<span style="letter-spacing: 0.95pt;"> </span>các<span style="letter-spacing: 1.25pt;"> </span>đợt<span style="letter-spacing: 1.8pt;"> </span>bùng<span style="letter-spacing: 0.7pt;"> </span>phát<span style="letter-spacing: 1.4pt;"></span>của<span style="letter-spacing: 0.6pt;"> </span>bệnh<span style="letter-spacing: 0.25pt;"> </span>phổi-phế<span style="letter-spacing: 0.5pt;"> </span>quản<span style="letter-spacing: 1.35pt;"> </span>mạn<span style="letter-spacing: 0.85pt;"> </span>tính.<span style="letter-spacing: 2.35pt;"> </span>Nếu<span style="letter-spacing: 0.1pt;"> </span>lúc<span style="letter-spacing: 0.65pt;"> </span>này<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">đ</span><span style="letter-spacing: 0.35pt;">i</span><span style="letter-spacing: 0.3pt;">ề</span>u<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.25pt;">r</span>ị<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: 0.3pt;">s</span>ẽ<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.3pt;">hồ</span>i<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: 0.3pt;">phụ</span>c<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.3pt;">rấ</span>t <span style="letter-spacing: 0.3pt;">tốt</span>.<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.3pt;">Sa</span>u<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: 0.25pt;">này</span>,<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.25pt;">tăn</span>g <span style="letter-spacing: 0.3pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">á</span>p<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: 0.3pt;">lự</span>c<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">phổ</span>i<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">s</span>ẽ<span style="letter-spacing: -0.15pt;"></span><span style="letter-spacing: 0.3pt;">tr</span>ở<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">nê</span>n<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">t</span><span style="letter-spacing: 0.35pt;">h</span><span style="letter-spacing: 0.3pt;">ườn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">xuyên.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">X<span style="letter-spacing: -0.15pt;"> </span>quang<span style="letter-spacing: -0.3pt;"> </span>tim-phổi<span style="letter-spacing: 0.4pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>cung<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.1pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>nổi<span style="letter-spacing: 0.6pt;"> </span>vồng, đập<span style="letter-spacing: -0.9pt;"> </span>mạnh,<span style="letter-spacing: 0.35pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ường có<span style="letter-spacing: 0.65pt;"> </span>hình<span style="letter-spacing: 0.25pt;"> </span>giọt<span style="letter-spacing: 0.55pt;"> </span>nư<span style="letter-spacing: -0.05pt;">ớc.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Chẩn<span style="letter-spacing: 2.05pt;"> </span>đoán<span style="letter-spacing: 0.3pt;"> </span>xác<span style="letter-spacing: 1.4pt;"> </span>định<span style="letter-spacing: 1.2pt;"> </span>tăng<span style="letter-spacing: 0.75pt;"><span> </span></span>áp<span style="letter-spacing: 0.3pt;"> </span>lực<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>phổi<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>2<span style="letter-spacing: 0.65pt;"> </span>phương<span style="letter-spacing: 0.65pt;"> </span>pháp:<span style="letter-spacing: 2.05pt;"> </span>đo<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.65pt;"> </span>lực<span style="letter-spacing: 0.5pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>ph<span style="letter-spacing: -0.1pt;">ổ</span>i trong<span style="letter-spacing: -0.25pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ông<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: -0.15pt;"></span>phải<span style="letter-spacing: 1.3pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>siêu <span style="letter-spacing: 0.05pt;"><span> </span></span>âm<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>ước <span style="letter-spacing: 0.05pt;">l</span>ượng áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.25pt;"> </span>Thông<span style="letter-spacing: 0.55pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>bằng<span style="letter-spacing: 1.3pt;"> </span>ống<span style="letter-spacing: 0.75pt;"> </span>thông<span style="letter-spacing: -0.45pt;"> </span>Swan-Gans,<span style="letter-spacing: 2.2pt;"> </span>đo<span style="letter-spacing: 0.9pt;"> </span>được<span style="letter-spacing: 1.15pt;"> </span>áp<span style="letter-spacing: 0.25pt;"> </span>lực<span style="letter-spacing: 0.15pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>phổi<span style="letter-spacing: 0.7pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>thì<span style="letter-spacing: 0.55pt;"> </span>tâm<span style="letter-spacing: 1.1pt;"> </span>thu, tâm<span style="letter-spacing: -1.2pt;"> </span>trương<span style="letter-spacing: 0.95pt;"> </span>và<span style="letter-spacing: 1.6pt;"> </span>áp<span style="letter-spacing: 2pt;"> </span>lực<span style="letter-spacing: 0.8pt;"></span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>phổi<span style="letter-spacing: 1.35pt;"> </span>trung<span style="letter-spacing: 0.7pt;"> </span>bình.<span style="letter-spacing: -1.15pt;"> </span>K<span style="letter-spacing: 0.05pt;">h</span>i<span style="letter-spacing: 0.8pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>lực<span style="letter-spacing: 0.85pt;"> </span>động<span style="letter-spacing: 1.6pt;"> </span>mạch<span style="letter-spacing: 1.05pt;"> </span>phổi<span style="letter-spacing: 1.35pt;"> </span>tâm<span style="letter-spacing: -1.2pt;"> </span>thu<span style="letter-spacing: 0.85pt;"> </span>cao<span style="letter-spacing: 0.85pt;"> </span>hơn<span style="letter-spacing: 1.4pt;"> </span>23 mmHg<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.2pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: -0.35pt;"> </span>tăng<span style="letter-spacing: 1pt;"><span> </span></span>áp<span style="letter-spacing: 0.2pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.8pt;"> </span>Ước<span style="letter-spacing: -0.5pt;"> </span>lượng<span style="letter-spacing: 0.8pt;"> </span>áp<span style="letter-spacing: 1.5pt;"> </span>lực<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 1.4pt;"> </span>mạch<span style="letter-spacing: 0.9pt;"> </span>phổi<span style="letter-spacing: 1.2pt;"> </span>bằng<span style="letter-spacing: 1.25pt;"> </span>phươ<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.85pt;"> </span>pháp<span style="letter-spacing: 0.9pt;"> </span>siêu<span style="letter-spacing: 1.9pt;"> </span>âm<span style="letter-spacing: 1.25pt;"> </span>Doppler.<span style="letter-spacing: -0.1pt;"> </span>Các<span style="letter-spacing: 1.35pt;"> </span>phương<span style="letter-spacing: 0.85pt;"> </span>pháp ước <span style="letter-spacing: 0.05pt;">l</span>ượng áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>bằng<span style="letter-spacing: 0.1pt;"> </span>siêu<span style="letter-spacing: 0.8pt;"> </span>âm<span style="letter-spacing: 0.2pt;"> </span>t<span style="letter-spacing: 0.05pt;">h</span>ường được<span style="letter-spacing: 0.85pt;"> </span>sử dụng<span style="letter-spacing: -0.25pt;"> </span>trên<span style="letter-spacing: 1.05pt;"><span> </span></span>lâm<span style="letter-spacing: 0.8pt;"><span> </span></span>sàng<span style="letter-spacing: 0.65pt;"><span> </span></span>là:<o:p></o:p><span style="letter-spacing: 1pt;"> </span></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"> - Ước<span style="letter-spacing: -0.4pt;"> </span>lượng<span style="letter-spacing: 0.95pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>lực<span style="letter-spacing: 0.8pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>phổi<span style="letter-spacing: 1.35pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 1.35pt;"> </span>thu<span style="letter-spacing: 0.8pt;"> </span>thông<span style="letter-spacing: 1.2pt;"> </span>qua<span style="letter-spacing: 0.8pt;"> </span>chênh<span style="letter-spacing: -1.2pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>giữa<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.05pt;">t</span><span style="letter-spacing: -0.05pt;">h</span>ất<span style="letter-spacing: 1pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ả</span>i<span style="letter-spacing: 1pt;"> </span>và<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>hĩ<span style="letter-spacing: 1pt;"> </span>phải dựa<span style="letter-spacing: -0.15pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>phổ<span style="letter-spacing: 0.35pt;"> </span>Doppler<span style="letter-spacing: -0.8pt;"></span>của<span style="letter-spacing: -0.35pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>3 lá:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">Áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span>=<span style="letter-spacing: 1.3pt;"> </span>4V<span style="position: relative; top: -5pt;">2<span style="letter-spacing: -0.1pt;"> </span></span>+<span style="letter-spacing: 1.3pt;"> </span>10 mmHg</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.6pt;"> </span>đó:<span> </span></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"><span></span>V là<span style="letter-spacing: 0.85pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>tối<span style="letter-spacing: 0.6pt;"> </span>đa<span style="letter-spacing: 0.6pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>3 lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">4V<span style="position: relative; top: -5pt;">2<span style="letter-spacing: 1.2pt;"> </span></span>là<span style="letter-spacing: 0.85pt;"> </span>chênh <span style="letter-spacing: 0.7pt;"><span> </span></span>áp<span style="letter-spacing: -0.7pt;"> </span>giữa<span style="letter-spacing: -0.2pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 1.4pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>nhĩ<span style="letter-spacing: 1.8pt;"> </span>phải<span style="letter-spacing: 1.3pt;"> </span>thì<span style="letter-spacing: 1.3pt;"> </span>tâm<span style="letter-spacing: 2.15pt;"> </span>thu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">10 mmHg<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.55pt;"> </span>áp<span style="letter-spacing: 1.25pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>nhĩ<span style="letter-spacing: 0.75pt;"> </span>phải<span style="letter-spacing: -0.05pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.25pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"><span style="letter-spacing: 1pt;"></span> - Ước<span style="letter-spacing: -0.45pt;"> </span>lượng<span style="letter-spacing: 0.95pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>lực<span style="letter-spacing: 0.8pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>phổi<span style="letter-spacing: 1.35pt;"> </span>tâm<span style="letter-spacing: 1.3pt;"> </span>trương<span style="letter-spacing: 0.95pt;"> </span>thông<span style="letter-spacing: 1.2pt;"> </span>qua<span style="letter-spacing: 0.8pt;"> </span>chênh<span style="letter-spacing: -1.2pt;"> </span>áp<span style="letter-spacing: 1.65pt;"> </span>giữa<span style="letter-spacing: 0.75pt;"> </span>thất<span style="letter-spacing: 2.85pt;"> </span>phải<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.95pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổ</span>i<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>uối<span style="letter-spacing: 0.55pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"></span>t<span style="letter-spacing: 0.05pt;">r</span>ương dựa<span style="letter-spacing: -0.15pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>phổ<span style="letter-spacing: 0.35pt;"> </span>Doppler<span style="letter-spacing: -0.8pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">Áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>tr</span><span lang="EN">ư<span style="font-style: italic;">ơng =<span style="letter-spacing: 1.3pt;"> </span>4V<span style="position: relative; top: -5pt;">2<span style="letter-spacing: -0.1pt;"> </span></span>+<span style="letter-spacing: 1.3pt;"> </span>10 mmHg</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.6pt;"> </span>đó:<span> </span></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">V là<span style="letter-spacing: 0.85pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>ở cuối<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>t<span style="letter-spacing: 0.1pt;">r</span>ương.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.4pt;">4V</span><span lang="EN" style="position: relative; top: -5pt;">2<span style="letter-spacing: 0.45pt;"> </span></span><span lang="EN" style="letter-spacing: -0.3pt;">l</span><span lang="EN">à<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.35pt;">c</span><span style="letter-spacing: -0.4pt;">h</span><span style="letter-spacing: -0.35pt;">ê</span><span style="letter-spacing: -0.4pt;">n</span>h<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">á</span>p<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.4pt;">g</span><span style="letter-spacing: -0.35pt;">i</span><span style="letter-spacing: -0.4pt;">ữ</span>a<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: -0.35pt;">độn</span>g<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.35pt;">mạ</span><span style="letter-spacing: -0.3pt;">c</span>h<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.4pt;">phổ</span>i<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">v</span>à<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.4pt;">t</span><span style="letter-spacing: -0.45pt;">hấ</span>t<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.35pt;">phả</span>i<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.35pt;">c</span><span style="letter-spacing: -0.4pt;">uố</span>i<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.35pt;">tâ</span>m<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.4pt;">t</span><span style="letter-spacing: -0.3pt;">r</span><span style="letter-spacing: -0.35pt;">ư</span><span style="letter-spacing: -0.4pt;">ơng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">10 mmHg<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.55pt;"> </span>áp<span style="letter-spacing: 1.25pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>buồng<span style="letter-spacing: 0.6pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải<span style="letter-spacing: -0.05pt;"> </span>thì<span style="letter-spacing: 0.4pt;"> </span>tâm<span style="letter-spacing: 1pt;"> </span>t<span style="letter-spacing: -0.1pt;">r</span>ương.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"> -<span style="letter-spacing: 1.1pt;"> </span>Ước<span style="letter-spacing: -0.25pt;"> </span>lượng<span style="letter-spacing: 1.1pt;"> </span>áp<span style="letter-spacing: 1.75pt;"> </span>lực<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.7pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"> </span>phổi<span style="letter-spacing: 1.45pt;"> </span>trung<span style="letter-spacing: 0.85pt;"> </span>bình<span style="letter-spacing: -1pt;"> </span>thông<span style="letter-spacing: 1.35pt;"> </span>qua<span style="letter-spacing: 0.9pt;"> </span>chênh<span style="letter-spacing: -1.05pt;"> </span>áp<span style="letter-spacing: 1.75pt;"> </span>giữa<span style="letter-spacing: 0.9pt;"> </span>thất<span> </span>phải<span style="letter-spacing: 0.85pt;"><span> </span></span>và<span style="letter-spacing: 1pt;"> </span>động <span style="letter-spacing: 0.05pt;">m</span>ạch ph<span style="letter-spacing: -0.05pt;">ổ</span>i<span style="letter-spacing: 0.35pt;"> </span>ở<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.25pt;">đầ</span>u<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.25pt;">th</span>ì<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: 0.25pt;">tâ</span>m<span style="letter-spacing: 1.45pt;"></span><span style="letter-spacing: 0.3pt;">trươn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">dự</span>a<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">trê</span>n<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">ph</span>ổ<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.3pt;">D</span><span style="letter-spacing: 0.2pt;">o</span><span style="letter-spacing: 0.3pt;">pple</span>r<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: 0.3pt;">c</span><span style="letter-spacing: 0.4pt;">ủ</span>a<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: 0.3pt;">dòn</span>g<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">h</span>ở<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">va</span>n<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">phổi.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">Áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>trung<span style="letter-spacing: 0.25pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>=<span style="letter-spacing: 1.3pt;"> </span>4V<span style="position: relative; top: -5pt;">2<span style="letter-spacing: -0.1pt;"> </span></span>+<span style="letter-spacing: 1.3pt;"> </span>10 mmHg</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: -0.6pt;"> </span>đó:<span style="letter-spacing: 0.35pt;"> </span>V là<span style="letter-spacing: 0.85pt;"> </span>tốc<span style="letter-spacing: 0.55pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>dòng<span style="letter-spacing: 0.45pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>ở đầu<span style="letter-spacing: 0.2pt;"> </span>thì<span style="letter-spacing: 0.25pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ương.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="letter-spacing: -0.3pt;">4V</span><span lang="EN" style="position: relative; top: -5pt;">2<span style="letter-spacing: 0.65pt;"> </span></span><span lang="EN" style="letter-spacing: -0.2pt;">l</span><span lang="EN">à<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.3pt;">chên</span>h<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.2pt;">á</span>p<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">giữ</span>a<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.25pt;">p</span><span style="letter-spacing: -0.3pt;">hổ</span>i<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.2pt;">v</span>à<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>t<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.25pt;">phả</span>i<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.25pt;">đầ</span>u<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.3pt;">t</span><span style="letter-spacing: -0.35pt;">r</span><span style="letter-spacing: -0.3pt;">ương.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">10 mmHg<span style="letter-spacing: -0.35pt;"> </span>là<span style="letter-spacing: 0.55pt;"> </span>áp<span style="letter-spacing: 1.25pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>bu<span style="letter-spacing: -0.05pt;">ồ</span>ng<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 0.3pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 1.3pt;"> </span>trương.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span>Khi<span style="letter-spacing: 0.4pt;"> </span>không<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>hở<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>3<span style="letter-spacing: 0.6pt;"> </span>lá<span style="letter-spacing: 1.45pt;"> </span>và<span style="letter-spacing: 1.65pt;"> </span>hở<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: 0.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>phổi<span style="letter-spacing: 1pt;"> </span>trên<span style="letter-spacing: 1.15pt;"> </span>siêu<span style="letter-spacing: 1.15pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>Doppler,<span style="letter-spacing: -0.25pt;"> </span>n<span style="letter-spacing: -0.05pt;">g</span>ười<span style="letter-spacing: 0.6pt;"> </span>ta<span style="letter-spacing: 0.5pt;"> </span>có thể<span style="letter-spacing: -0.75pt;"> </span>ước <span style="letter-spacing: 0.05pt;">l</span>ượng áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>bằng<span style="letter-spacing: 1.3pt;"> </span>các<span style="letter-spacing: 0.1pt;"> </span>p<span style="letter-spacing: -0.15pt;">h</span>ương pháp<span style="letter-spacing: 0.4pt;"> </span>sau:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Phương pháp<span style="letter-spacing: 0.4pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>Kitabatake<span style="letter-spacing: -0.5pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>cộng<span style="letter-spacing: -0.25pt;"> </span>sự:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">Log<span style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;">1</span><span style="position: relative; top: 2.5pt;">0<span style="letter-spacing: 0.05pt;"> </span></span>(áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>trung<span style="letter-spacing: 0.2pt;"> </span>bình)<span style="letter-spacing: 0.25pt;"> </span>=<span style="letter-spacing: 1.3pt;"> </span>- 0,0068 (AcT)<span style="letter-spacing: 0.2pt;"> </span>+<span style="letter-spacing: 1.3pt;"> </span>2,1</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: 0.45pt;"> </span>đó:<span style="letter-spacing: -1pt;"> </span><span style="letter-spacing: -0.05pt;">A</span>cT<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 1.95pt;"> </span>thời<span style="letter-spacing: 0.9pt;"> </span>gian<span style="letter-spacing: 0.9pt;"> </span>tăng<span style="letter-spacing: -0.95pt;"> </span>tốc<span style="letter-spacing: 1.65pt;"> </span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: 0.65pt;"> </span>phổ<span style="letter-spacing: 1.4pt;"> </span>Doppler<span style="letter-spacing: 0.25pt;"> </span>dòng<span style="letter-spacing: 1.5pt;"> </span>vào<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 2.55pt;"> </span>mạch<span style="letter-spacing: 2.1pt;"> </span>phổi.<span style="letter-spacing: 1.3pt;"> </span>Bình<span style="letter-spacing: 1.4pt;"> </span>thường<o:p></o:p> AcT<span style="letter-spacing: -0.45pt;"> </span>≥<span style="letter-spacing: 0.25pt;"> </span>120 msec.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Phương pháp<span style="letter-spacing: 0.4pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>Mahan<span style="letter-spacing: -0.35pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>cộng<span style="letter-spacing: -0.25pt;"> </span>sự:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">Áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.35pt;"> </span>phổi<span style="letter-spacing: 0.6pt;"> </span>trung<span style="letter-spacing: 0.25pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>=<span style="letter-spacing: 1.3pt;"> </span>79 - 0,45 (<span style="letter-spacing: -0.05pt;">A</span>cT)</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Trong<span style="letter-spacing: 0.25pt;"> </span>đó:<span style="letter-spacing: 1.2pt;"> </span>AcT<span style="letter-spacing: 0.4pt;"> </span>là<span style="letter-spacing: 1.7pt;"> </span>thời<span style="letter-spacing: 0.65pt;"> </span>gian<span style="letter-spacing: 0.65pt;"> </span>tăng<span style="letter-spacing: -1.2pt;"> </span>tốc<span style="letter-spacing: 1.4pt;"> </span>của<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">p</span>hổ<span style="letter-spacing: 1.2pt;"> </span>Doppler dòng<span style="letter-spacing: 1.3pt;"> </span>vào<span style="letter-spacing: 0.25pt;"> </span>động<span style="letter-spacing: 2.35pt;"> </span>mạch<span style="letter-spacing: 1.85pt;"> </span>phổi.<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.1pt;">K</span>hi<span style="letter-spacing: 0.75pt;"> </span>nhịp<span style="letter-spacing: 1.15pt;"> </span>tim<o:p></o:p> 60-100<span style="letter-spacing: 0.2pt;"> </span>chu<span style="letter-spacing: 0.05pt;"> </span>kì/phút<span style="letter-spacing: 1.6pt;"> </span>thì<span style="letter-spacing: -0.1pt;"></span>không<span style="letter-spacing: 0.85pt;"> </span>cần<span style="letter-spacing: 0.05pt;"> </span>hiệu<span style="letter-spacing: -0.75pt;"> </span>chỉnh,<span style="letter-spacing: 0.4pt;"> </span>khi<span style="letter-spacing: 0.05pt;"> </span>nhịp<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: 0.05pt;"> </span><<span style="letter-spacing: 0.15pt;"> </span>60<span style="letter-spacing: 0.2pt;"> </span>hoặc<span style="letter-spacing: -0.05pt;"> ></span>100<span style="letter-spacing: 0.15pt;"> </span>chu<span style="letter-spacing: 0.05pt;"> </span>kỳ/phút<span style="letter-spacing: -0.55pt;"> </span>thì<span style="letter-spacing: 0.8pt;"> </span>phải<span style="letter-spacing: 0.4pt;"> </span>hiệu chỉnh<span style="letter-spacing: 0.2pt;"> </span>AcT<span style="letter-spacing: -0.45pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Ngoài<span style="letter-spacing: 0.9pt;"> </span>ra,<span style="letter-spacing: 0.45pt;"> </span>siêu<span style="letter-spacing: 1.35pt;"> </span>âm<span style="letter-spacing: 0.75pt;"> </span>kiểu<span style="letter-spacing: -0.3pt;"> </span>TM<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>thể<span style="letter-spacing: -0.2pt;"> </span>cho<span style="letter-spacing: 0.35pt;"> </span>thấy<span style="letter-spacing: 2.4pt;"> </span>hình<span style="letter-spacing: 2.4pt;"> </span>ảnh<span style="letter-spacing: 0.6pt;"> </span>tăng<span style="letter-spacing: 2.35pt;"> </span>áp<span style="letter-spacing: -0.35pt;"> </span>lực<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.05pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>phổi<span style="letter-spacing: 0.95pt;"> </span>thông<span style="letter-spacing: 0.8pt;"> </span>qua hình<span style="letter-spacing: 1.7pt;"> </span>ảnh<span style="letter-spacing: -0.05pt;"> </span>vận<span style="letter-spacing: 1.95pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>của<span style="letter-spacing: 0.05pt;"></span>van<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>phổi<span style="letter-spacing: 0.8pt;"> </span>(mất<span style="letter-spacing: 2.2pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>óng<span style="letter-spacing: 0.9pt;"> </span>a,<span style="letter-spacing: 0.3pt;"> </span>đóng<span style="letter-spacing: 0.65pt;"> </span>sớm<span style="letter-spacing: 0.2pt;"> </span>van<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.45pt;"> </span>phổi),<span style="letter-spacing: 0.7pt;"> </span>vách<span style="letter-spacing: 0.85pt;"> </span>liên thất<span style="letter-spacing: 2.5pt;"> </span>vận<span style="letter-spacing: 2.15pt;"> </span>động <span style="letter-spacing: 1.45pt;"><span> </span></span>đảo<span style="letter-spacing: -0.45pt;"> </span>ngược;<span style="letter-spacing: 0.6pt;"> </span>siêu<span style="letter-spacing: 1.4pt;"> </span>âm<span style="letter-spacing: 0.8pt;"> </span>hai<span style="letter-spacing: 0.45pt;"></span>bình<span style="letter-spacing: 0.85pt;"> </span>diện<span style="letter-spacing: -0.25pt;"> </span>thấy<span style="letter-spacing: 2.45pt;"> </span>thất<span style="letter-spacing: 2.5pt;"> </span>trái<span style="letter-spacing: 0.2pt;"> </span>trên<span style="letter-spacing: 1.85pt;"> </span>trục<span style="letter-spacing: 0.2pt;"> </span>ngắn<span style="letter-spacing: 0.35pt;"> </span>của<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: 0.45pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>hình<span style="letter-spacing: 0.85pt;"> </span>chữ<span style="letter-spacing: 0.45pt;"> </span>D trong<span style="letter-spacing: -0.25pt;"> </span>thì<span style="letter-spacing: 0.25pt;"> </span>t<span style="letter-spacing: -0.05pt;">â</span>m<span style="letter-spacing: 0.85pt;"> </span>trương cũng<span style="letter-spacing: -0.45pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>biểu<span style="letter-spacing: -0.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"></span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.2.<span style="letter-spacing: -0.2pt;"> </span>Giai<span style="letter-spacing: 1.25pt;"> </span>đoạn<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>suy<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>phải:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.2.1.<span style="letter-spacing: -0.25pt;"> </span>Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>năng:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Khó<span style="letter-spacing: 0.9pt;"> </span>thở:<span style="letter-spacing: 0.1pt;"> </span>khó<span style="letter-spacing: 0.8pt;"> </span>thở<span style="letter-spacing: 0.15pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>gắng<span style="letter-spacing: 0.05pt;"> </span>sức<span style="letter-spacing: 0.3pt;"> </span>nhiều,<span style="letter-spacing: -0.6pt;"> </span>sau<span style="letter-spacing: 0.3pt;"> </span>đó<span style="letter-spacing: 0.75pt;"> </span>khó<span style="letter-spacing: 0.8pt;"> </span>thở<span style="letter-spacing: 0.15pt;"> </span>xuất<span style="letter-spacing: 2.15pt;"> </span>hiện<span style="letter-spacing: -0.55pt;"> </span>cả<span style="letter-spacing: 1.05pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>làm<span style="letter-spacing: 0.8pt;"> </span>việc<span style="letter-spacing: -0.95pt;"> </span>nhẹ<span style="letter-spacing: -0.4pt;"> </span>và<span style="letter-spacing: 1.1pt;"> </span>nghỉ ngơi;<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>thể<span style="letter-spacing: -0.2pt;"> </span>có<span style="letter-spacing: 1.2pt;"> </span>cơn<span style="letter-spacing: 0.95pt;"> </span>phù phổi<span style="letter-spacing: 0.95pt;"> </span>c<span style="letter-spacing: -0.05pt;">ấ</span>p<span style="letter-spacing: 2.15pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>tăng<span style="letter-spacing: 1.1pt;"> </span>tính<span style="letter-spacing: 0.85pt;"> </span>th<span style="letter-spacing: -0.05pt;">ấ</span>m<span style="letter-spacing: 2.35pt;"> </span>của<span style="letter-spacing: 0.2pt;"> </span>mao<span style="letter-spacing: 0.35pt;"> </span>mạch<span style="letter-spacing: 0.95pt;"> </span>phổi,<span style="letter-spacing: 0.8pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>thiếu<span style="letter-spacing: -0.2pt;"> </span>ôxy,<span style="letter-spacing: 0.9pt;"> </span>ứ<span style="letter-spacing: 0.55pt;"> </span>trệ<span style="letter-spacing: -0.25pt;"> </span>C<span style="letter-spacing: -0.1pt;">O</span><span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 1.25pt;"> </span></span><span style="letter-spacing: 0.05pt;">và </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<span style="letter-spacing: 0.25pt;"> </span>Khó<span style="letter-spacing: 0.6pt;"> </span>thở<span style="letter-spacing: -0.15pt;"></span>còn<span style="letter-spacing: 0.5pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>phổi-phế<span style="letter-spacing: -0.45pt;"> </span>quản<span style="letter-spacing: 0.4pt;"> </span>mạn<span style="letter-spacing: -0.1pt;"> </span>tính<span style="letter-spacing: 1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>sẵn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.2pt;"> </span>Đau<span style="letter-spacing: 1.5pt;"> </span>tức<span style="letter-spacing: 0.05pt;"> </span>vùng<span style="letter-spacing: -0.55pt;"> </span>gan: t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.2pt;"> </span>xuất<span style="letter-spacing: 2.05pt;"> </span>hiện<span style="letter-spacing: -0.65pt;"> </span>muộn.<span style="letter-spacing: -0.1pt;"> </span>Bệnh<span style="letter-spacing: 0.65pt;"> </span>nhân<span style="letter-spacing: 0.15pt;"> </span>thấy<span style="letter-spacing: 2pt;"> </span>tức nặng<span style="letter-spacing: -0.1pt;"> </span>vùng<span style="letter-spacing: -0.6pt;"> </span>gan,<span style="letter-spacing: -0.05pt;"> </span>tăng<span style="letter-spacing: 0.95pt;"> </span>lên<span style="letter-spacing: 0.15pt;"> </span>khi gắng<span style="letter-spacing: -0.25pt;"> </span>sức và<span style="letter-spacing: -0.25pt;"> </span>giảm <span style="letter-spacing: 0.45pt;"><span> </span></span>đi<span style="letter-spacing: 0.4pt;"> </span>khi<span style="letter-spacing: -0.15pt;"></span>nghỉ<span style="letter-spacing: 0.25pt;"> </span>ngơi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tím<span style="letter-spacing: 1.35pt;"> </span>tái<span style="letter-spacing: -0.65pt;"> </span>tă<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 1.7pt;"> </span>dần,<span style="letter-spacing: -0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ườ<span style="letter-spacing: -0.05pt;">n</span>g tím<span style="letter-spacing: 0.35pt;"> </span>ở môi,<span style="letter-spacing: 0.3pt;"> </span>mũi<span style="letter-spacing: -0.4pt;"> </span>và<span style="letter-spacing: -0.25pt;"> </span>đầu<span style="letter-spacing: 2.05pt;"> </span>chi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Choáng<span style="letter-spacing: 1.15pt;"> </span>váng<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>thiếu<span style="letter-spacing: -0.75pt;"> </span>ôxy<span style="letter-spacing: 0.65pt;"> </span>não,<span style="letter-spacing: 0.2pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>quên,<span style="letter-spacing: 0.25pt;"> </span>bực<span style="letter-spacing: -0.15pt;"> </span>bội,<span style="letter-spacing: -0.2pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>giấc<span style="letter-spacing: 2pt;"> </span>ngủ,<span style="letter-spacing: -0.4pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>hộp<span style="letter-spacing: -0.35pt;"> </span>trống<span style="letter-spacing: 0.5pt;"> </span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.2.2.<span style="letter-spacing: -0.25pt;"> </span>Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>thực<span style="letter-spacing: 1.25pt;"> </span>thể:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.2.1. Tim<span style="letter-spacing: 0.2pt;"> </span>mạch:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nhịp<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nhanh,<span style="letter-spacing: -0.3pt;"> </span>đôi<span style="letter-spacing: 0.8pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: -0.35pt;"> </span>nhịp,<span style="letter-spacing: 1.15pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>gặp<span style="letter-spacing: -0.35pt;"> </span>rung nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Sờ<span style="letter-spacing: -0.9pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>ở t<span style="letter-spacing: -0.05pt;">hư</span>ợng vị<span style="letter-spacing: 0.65pt;"> </span>(do<span style="letter-spacing: -0.15pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>to,<span style="letter-spacing: -0.1pt;"> </span>gọi<span style="letter-spacing: 0.6pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>dấu<span style="letter-spacing: 1.85pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>Hartzer<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">dư</span>ơng tính).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tiếng<span style="letter-spacing: -1.15pt;"> </span>T2<span style="letter-spacing: -0.4pt;"> </span>đanh,<span style="letter-spacing: 1.45pt;"><span> </span></span>tách<span style="letter-spacing: 2.05pt;"> </span>đôi<span style="letter-spacing: -0.4pt;"> </span>ở liên<span style="letter-spacing: 0.35pt;"> </span>sườn II trái<span style="letter-spacing: 0.1pt;"> </span>cạnh<span style="letter-spacing: 1pt;"> </span>ức<span style="letter-spacing: -0.1pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>tiếng<span style="letter-spacing: -0.75pt;"> </span>ngựa<span style="letter-spacing: -0.25pt;"> </span>phi<span style="letter-spacing: -0.3pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">-<span style="letter-spacing: 0.35pt;"> </span>Tiếng<span style="letter-spacing: -0.8pt;"> </span>thổi<span style="letter-spacing: 0.9pt;"> </span>tâm<span style="letter-spacing: 0.7pt;"> </span>thu<span style="letter-spacing: 0.2pt;"> </span>ở<span style="letter-spacing: 0.35pt;"> </span>mũi<span style="letter-spacing: -0.05pt;"> </span>ức<span style="letter-spacing: 0.2pt;"> </span>(tăng<span style="letter-spacing: 1.5pt;"> </span>lên<span style="letter-spacing: 0.35pt;"> </span>khi<span style="letter-spacing: 0.2pt;"> </span>hít<span style="letter-spacing: 1.3pt;"> </span>sâu<span style="letter-spacing: 1.75pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>nín<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>hở,<span style="letter-spacing: 0.3pt;"> </span>nghiệm<span style="letter-spacing: -0.4pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.8pt;"> </span>Rivero-Carvalho dương<span style="letter-spacing: 0.75pt;"> </span>tính)<span style="letter-spacing: 1pt;"> </span>do<span style="letter-spacing: 0.65pt;"> </span>hở<span style="letter-spacing: 0.75pt;"> </span>van<span style="letter-spacing: 0.25pt;"> </span>3<span style="letter-spacing: 0.75pt;"> </span>lá<span style="letter-spacing: 0.25pt;"></span>cơ<span style="letter-spacing: 1.25pt;"> </span>năng;<span style="letter-spacing: 2.05pt;"><span> </span></span>có<span style="letter-spacing: 1.4pt;"> </span>tiếng thổi<span style="letter-spacing: 1.3pt;"> </span>tâm<span style="letter-spacing: 1.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ương<span style="letter-spacing: 0.8pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>liên<span style="letter-spacing: 1.15pt;"> </span>sườn<span style="letter-spacing: 0.75pt;"> </span>II<span style="letter-spacing: 0.75pt;"> </span>trái<span style="letter-spacing: 0.85pt;"> </span>cạnh<span style="letter-spacing: 1.75pt;"> </span>ức<span style="letter-spacing: 0.65pt;"> </span>do<span style="letter-spacing: 0.65pt;"> </span>hở<span style="letter-spacing: 0.75pt;"> </span>van<o:p></o:p></span><span lang="EN" style="position: relative; top: 0.5pt;"> động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>năng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tĩnh<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>cổ<span style="letter-spacing: 0.65pt;"> </span>nổi<span style="letter-spacing: 0.6pt;"> </span>to,<span style="letter-spacing: -0.2pt;"> </span>đập<span style="letter-spacing: -0.9pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>nhịp<span style="letter-spacing: 0.3pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.2.2. Triệu<span style="letter-spacing: -0.8pt;"> </span>chứng<span style="letter-spacing: -0.6pt;"> </span>khác:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.2pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">-<span style="letter-spacing: 0.15pt;"> </span>Gan<span style="letter-spacing: -0.25pt;"> </span>to,<span style="letter-spacing: 0.05pt;"> </span>mặt<span style="letter-spacing: -0.05pt;"> </span>nhẵn,<span style="letter-spacing: -0.65pt;"> </span>đau<span style="letter-spacing: 0.55pt;"> </span>khi sờ<span style="letter-spacing: 0.15pt;"> </span>nắn,<span style="letter-spacing: -0.05pt;"> </span>mật<span style="letter-spacing: 2.05pt;"> </span>độ<span style="letter-spacing: 0.7pt;"> </span>mềm,<span style="letter-spacing: -0.75pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>thể<span style="letter-spacing: -0.65pt;"> </span>đập<span style="letter-spacing: -0.8pt;"> </span>theo<span style="letter-spacing: -0.1pt;"> </span>nhịp<span style="letter-spacing: 0.4pt;"> </span>tim,<span style="letter-spacing: -0.1pt;"> </span>phản<span style="letter-spacing: 0.5pt;"> </span>hồi<span style="letter-spacing: 0.7pt;"> </span>gan-tĩnh mạch<span style="letter-spacing: 0.85pt;"> </span>cổ<span style="letter-spacing: 1.15pt;"> </span>(+).<span style="letter-spacing: 0.3pt;"> </span>Giai<span style="letter-spacing: 0.1pt;"> </span>đoạn<span style="letter-spacing: 1.15pt;"></span>sau,<span style="letter-spacing: 0.5pt;"> </span>khi<span style="letter-spacing: 0.35pt;"> </span>đã<span style="letter-spacing: 1.55pt;"> </span>có<span style="letter-spacing: 1.15pt;"> </span>xơ<span style="letter-spacing: 1.05pt;"> </span>gan-tim<span style="letter-spacing: 0.15pt;"> </span>thì<span style="letter-spacing: 0.9pt;"> </span>gan<span style="letter-spacing: 0.35pt;"> </span>chắc,<span style="letter-spacing: 0.25pt;"> </span>bờ<span style="letter-spacing: 0.5pt;"> </span>tù,<span style="letter-spacing: 0.25pt;"> </span>phản<span style="letter-spacing: 0.9pt;"> </span>hồi<span style="letter-spacing: 1.1pt;"> </span>gan-tĩnh<span style="letter-spacing: 2.45pt;"> </span>mạch<span style="letter-spacing: -0.1pt;"> </span>cảnh<o:p></o:p></span><span lang="EN" style="position: relative; top: 0.5pt;"> (-).</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN"><o:p></o:p></span><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: -0.05pt;">Phù</span>:<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ầu<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: -0.05pt;">t</span><span style="letter-spacing: 0.05pt;">i</span>ên<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.05pt;">l</span>à <span style="letter-spacing: 0.25pt;"><span> </span></span>phù<span style="letter-spacing: 0.8pt;"> </span>2<span style="letter-spacing: 1.3pt;"> </span>chi<span style="letter-spacing: 1.25pt;"> </span>dưới,<span style="letter-spacing: 1.3pt;"> </span>sau<span style="letter-spacing: 1.3pt;"> </span>phù<span style="letter-spacing: 0.75pt;"> </span>toàn<span style="letter-spacing: 1.75pt;"> </span>thân,<span style="letter-spacing: -0.85pt;"> </span>có<span style="letter-spacing: 1.95pt;"> </span>k<span style="letter-spacing: -0.05pt;">h</span>i<span style="letter-spacing: 1.25pt;"> </span>có<span style="letter-spacing: 1.95pt;"> </span>cổ<span style="letter-spacing: 1.95pt;"> </span>trướng,<span style="letter-spacing: 1.3pt;"> </span>tràn<span style="letter-spacing: 1.8pt;"> </span>dịch<span style="letter-spacing: -0.75pt;"> </span>màng </span><span lang="EN">phổi...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">- Tím:<span style="letter-spacing: 0.3pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hemoglobin<span style="letter-spacing: -0.55pt;"> </span>khử ><span style="letter-spacing: -0.05pt;"> </span>5 g%. T<span style="letter-spacing: -0.05pt;">h</span>ường tím<span style="letter-spacing: 0.35pt;"> </span>ở môi,<span style="letter-spacing: 0.9pt;"> </span>đầu<span style="letter-spacing: 0.2pt;"> </span>mũi<span style="letter-spacing: -0.4pt;"> </span>và<span style="letter-spacing: -0.25pt;"> </span>đầu<span style="letter-spacing: 2.05pt;"> </span>chi.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">Mắ</span>t<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">lồ</span>i<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">v</span>à<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">đ</span>ỏ<span style="letter-spacing: 2.15pt;"> </span><span style="letter-spacing: 0.3pt;">d</span>o<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">tăn</span>g<span style="letter-spacing: 1.75pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.25pt;">màn</span>g<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.3pt;">tiế</span>p<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: 0.3pt;">hợ</span>p<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.3pt;">gọ</span>i<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.2pt;">l</span>à<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.3pt;">mắ</span>t<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>á<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">chà</span>y<span style="letter-spacing: 0.2pt;"><span> </span></span><span style="letter-spacing: 0.25pt;">h</span><span style="letter-spacing: 0.3pt;">a</span>y<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">mắ</span>t<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.25pt;">ế</span><span style="letter-spacing: 0.3pt;">ch.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ngón<span style="letter-spacing: 0.5pt;"> </span>tay<span style="letter-spacing: -0.15pt;"> </span>dùi<span style="letter-spacing: -0.3pt;"> </span>trống.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- <span style="letter-spacing: -0.05pt;">Á</span>p<span style="letter-spacing: -0.4pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>tăng<span style="letter-spacing: 0.8pt;"> </span>trên<span style="letter-spacing: 0.55pt;"> </span>25 mm<span style="letter-spacing: -0.1pt;">H</span><span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">2</span>O.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Lượng nước tiểu<span style="letter-spacing: -0.75pt;"> </span>ít,<span style="letter-spacing: 1pt;"> </span>tỉ<span style="letter-spacing: 0.35pt;"> </span>trọng<span style="letter-spacing: 0.5pt;"> </span>nước tiểu<span style="letter-spacing: -0.75pt;"> </span>tăng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">5.2.3.<span style="letter-spacing: -0.25pt;"> </span>Triệu<span style="letter-spacing: 0.55pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>cận<span style="letter-spacing: 0.2pt;"><span> </span></span>lâm<span style="letter-spacing: 0.2pt;"> </span>sàng:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.1. X<span style="letter-spacing: 1pt;"> </span>quang tim-phổi:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.65pt;"> </span>Giai<span style="letter-spacing: 0.25pt;"> </span>đoạn<span style="letter-spacing: -0.3pt;"> </span>đầu:<span style="letter-spacing: 2.35pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>không<span style="letter-spacing: 0.9pt;"> </span>to,<span style="letter-spacing: 0.55pt;"> </span>hình<span style="letter-spacing: 0.9pt;"> </span>giọt<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.05pt;">n</span>ước<span style="letter-spacing: 0.65pt;"> </span>hoặc<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>thể<span style="letter-spacing: -0.1pt;"> </span>hơi<span style="letter-spacing: 1.1pt;"> </span>to;<span style="letter-spacing: 0.5pt;"> </span>cung<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>phổi<span style="letter-spacing: 1.05pt;"> </span>nổi vồng; <span style="letter-spacing: 0.05pt;">t</span>ư thế<span style="letter-spacing: -0.75pt;"> </span>chếch<span style="letter-spacing: -0.85pt;"> </span>trước phải<span style="letter-spacing: 0.5pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>bờ trước tim<span style="letter-spacing: -0.15pt;"> </span>vồng<span style="letter-spacing: 0.25pt;"> </span>lên.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 2.65pt;"> </span>Giai<span style="letter-spacing: 2.25pt;"> </span>đoạn<span style="letter-spacing: 0.95pt;"><span> </span></span>sau:<span style="letter-spacing: 2.45pt;"> </span>các<span style="letter-spacing: 0.75pt;"><span> </span></span>cung<span style="letter-spacing: 2.4pt;"> </span>tim<span style="letter-spacing: 2.5pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải <span style="letter-spacing: 0.7pt;"><span> </span></span>to,<span style="letter-spacing: 2.55pt;"> </span>mất<span style="letter-spacing: 1.55pt;"><span> </span></span>khoảng<span style="letter-spacing: 0.25pt;"><span> </span></span>sáng<span style="letter-spacing: -0.9pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ước <span style="letter-spacing: -0.35pt;"><span> </span></span>tim<span style="letter-spacing: 2.5pt;"> </span>trên<span style="letter-spacing: 0.6pt;"> </span>phim<span style="letter-spacing: 2.4pt;"> </span>tim-phổi nghiêng.<span style="letter-spacing: 0.4pt;"> </span>Sau<span style="letter-spacing: -0.65pt;"> </span>đó<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: 0.1pt;"> </span>to<span style="letter-spacing: 0.05pt;"> </span>toàn<span style="letter-spacing: 0.7pt;"></span>bộ,<span style="letter-spacing: 0.25pt;"> </span>cung động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>phổi<span style="letter-spacing: 0.55pt;"> </span>to<span style="letter-spacing: 0.05pt;"> </span>vồng,<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>hình<span style="letter-spacing: 1.55pt;"> </span>ảnh<span style="letter-spacing: -0.2pt;"> </span>phù<span style="letter-spacing: -0.35pt;"> </span>tổ<span style="letter-spacing: 0.85pt;"> </span>chức kẽ<span style="letter-spacing: -0.45pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>phổi, tăng<span style="letter-spacing: 0.25pt;"> </span>đậm<span style="letter-spacing: -0.85pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ướng đi<span style="letter-spacing: 0.7pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"></span>phổi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Ngoài<span style="letter-spacing: 1.15pt;"> </span>ra<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>thể thấy<span style="letter-spacing: 2.65pt;"> </span>hình<span style="letter-spacing: 2.1pt;"> </span>ảnh<span style="letter-spacing: 0.35pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>lý<span style="letter-spacing: 0.65pt;"> </span>của<span style="letter-spacing: 0.45pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>phổi-phế<span style="letter-spacing: 0.35pt;"> </span>quản,<span style="letter-spacing: 1.15pt;"> </span>cơ-<span style="letter-spacing: -0.1pt;">x</span>ương<span style="letter-spacing: 0.75pt;"> </span>lồng<span style="letter-spacing: 1.4pt;"> </span>ngực<span style="letter-spacing: 0.55pt;"> </span>gây<span style="letter-spacing: 1.1pt;"> </span>ra bệnh<span style="letter-spacing: -0.7pt;"> </span>tim-phổi<span style="letter-spacing: 0.4pt;"> </span>mạn<span style="letter-spacing: 0.45pt;"> </span>tính.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.2. Điện<span style="letter-spacing: 0.45pt;"> </span>ti<span style="letter-spacing: -0.05pt;">m</span></span><span lang="EN">:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thấy<span style="letter-spacing: 1.6pt;"> </span>biểu<span style="letter-spacing: -0.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>dày<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải<span style="letter-spacing: 1.3pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>giãn<span style="letter-spacing: 1.55pt;"> </span>nhĩ<span style="letter-spacing: 1.8pt;"> </span>phải:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Trục<span style="letter-spacing: -0.7pt;"> </span>phải,<span style="letter-spacing: 0.4pt;"> </span>góc<span style="letter-spacing: 0.65pt;"> </span>α<span style="letter-spacing: -0.85pt;"> </span>≥<span style="letter-spacing: 0.25pt;"> </span>110<span style="letter-spacing: -0.05pt; position: relative; top: -5pt;">o</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- P<span style="letter-spacing: -0.35pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>ở D<span style="position: relative; top: 2.5pt;">I<span style="letter-spacing: -0.05pt;">I</span></span>,<span style="letter-spacing: -0.25pt;"> </span>D<span style="position: relative; top: 2.5pt;">III</span>,<span style="letter-spacing: -0.25pt;"> </span>aVF.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tỉ<span style="letter-spacing: 0.55pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>R/S<span style="letter-spacing: -0.7pt;"> </span>ở V<span style="position: relative; top: 2.5pt;">6<span style="letter-spacing: 1.2pt;"> </span></span>≤<span style="letter-spacing: 0.25pt;"> </span>1.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ở<span style="letter-spacing: -1.3pt;"> </span>V<span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.2pt;"> </span></span>và<span style="letter-spacing: 0.8pt;"> </span>V<span style="position: relative; top: 2.5pt;">2<span style="letter-spacing: 1.2pt;"> </span></span>thấy<span style="letter-spacing: 1.85pt;"> </span>R<span style="letter-spacing: 0.15pt;"> </span>cao,<span style="letter-spacing: -0.2pt;"> </span>S<span style="letter-spacing: -0.85pt;"> </span>sâu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Blốc<span style="letter-spacing: -0.2pt;"> </span>nhánh<span style="letter-spacing: 1.4pt;"> </span>phải<span style="letter-spacing: -0.05pt;"> </span>bó<span style="letter-spacing: 0.55pt;"> </span>His<span> </span>h<span style="letter-spacing: -0.05pt;">o</span>àn<span style="letter-spacing: 0.8pt;"> </span>toàn<span style="letter-spacing: 0.45pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>không<span style="letter-spacing: 1.35pt;"> </span>hoàn<span style="letter-spacing: -0.15pt;"> </span>toàn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đôi<span style="letter-spacing: 0.2pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>hình<span style="letter-spacing: 1.3pt;"> </span>ảnh<span style="letter-spacing: -0.45pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>S<span style="letter-spacing: -0.85pt;"> </span>sâu<span style="letter-spacing: 0.35pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.05pt;">V</span><span style="position: relative; top: 2.5pt;">1<span style="letter-spacing: 1.2pt;"> </span></span>đến<span style="letter-spacing: 0.5pt;"> </span>V<span style="letter-spacing: -0.05pt; position: relative; top: 2.5pt;">6</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.3. Thông<span style="letter-spacing: 0.35pt;"> </span>tim<span style="letter-spacing: -0.8pt;"> </span>phải:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Đo<span style="letter-spacing: 1.6pt;"> </span>áp<span style="letter-spacing: 1.1pt;"> </span>lực<span style="letter-spacing: 0.3pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 0.8pt;"> </span>khi<span style="letter-spacing: 0.25pt;"> </span>thô<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: 0.8pt;"> </span>tim<span style="letter-spacing: 0.3pt;"> </span>phải<span style="letter-spacing: 0.9pt;"> </span>thấy<span style="letter-spacing: 2.35pt;"> </span>áp<span style="letter-spacing: 1.1pt;"> </span>lực<span style="letter-spacing: 0.3pt;"> </span>động<span style="letter-spacing: 1pt;"> </span>mạch<span style="letter-spacing: 0.5pt;"> </span>phổi<span style="letter-spacing: 0.8pt;"> </span>tâm<span style="letter-spacing: 0.8pt;"> </span>thu<span style="letter-spacing: 0.25pt;"> </span>tăng<span style="letter-spacing: 1pt;"> </span>trên<span style="letter-spacing: 0.75pt;"> </span>23 mmHg.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Khi<span style="letter-spacing: -0.1pt;"> </span>bệnh<span style="letter-spacing: -0.6pt;"> </span>nặng,<span style="letter-spacing: -0.15pt;"> </span>áp<span style="letter-spacing: 0.8pt;"> </span>lực<span style="letter-spacing: -0.05pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.1pt;">p</span>hổi<span style="letter-spacing: 0.45pt;"> </span>tâm<span style="letter-spacing: 0.45pt;"> </span>thu<span style="letter-spacing: -0.05pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>thể<span style="letter-spacing: -0.65pt;"> </span>đến<span style="letter-spacing: 0.6pt;"> </span>60-70<span style="letter-spacing: 0.1pt;"> </span>mmHg.<span style="letter-spacing: -0.25pt;"> </span>Ngoài<span style="letter-spacing: 0.45pt;"> </span>ra còn<span style="letter-spacing: 0.75pt;"> </span>thấy<span style="letter-spacing: 1.95pt;"> </span>tăng áp<span style="letter-spacing: 0.7pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>cuối<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>trương<span style="letter-spacing: -0.05pt;"></span>của<span style="letter-spacing: -0.4pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải,<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: 0.1pt;">l</span>ưu <span style="letter-spacing: 0.05pt;">l</span>ượng tim<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường hoặc<span style="letter-spacing: -0.25pt;"> </span>tăng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.4. Siêu<span style="letter-spacing: 0.4pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>tim:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Thất<span style="letter-spacing: 1.8pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ả</span>i<span style="letter-spacing: 1.3pt;"> </span>và<span style="letter-spacing: -0.65pt;"> </span>nhĩ<span style="letter-spacing: 1.8pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: -0.05pt;">g</span><span style="letter-spacing: 0.05pt;">i</span><span style="letter-spacing: -0.05pt;">ã</span>n<span style="letter-spacing: 0.2pt;"> </span>to;<span style="letter-spacing: 0.05pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ành<span style="letter-spacing: 0.85pt;"> </span>thất<span style="letter-spacing: 2.1pt;"> </span>phải<span style="letter-spacing: 0.95pt;"> </span>dày<span style="letter-spacing: 0.7pt;"> </span>từ<span style="letter-spacing: 0.1pt;"> </span>10-15<span style="letter-spacing: 0.2pt;"> </span>mm; thường<span style="letter-spacing: 0.15pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>hở<span style="letter-spacing: 0.15pt;"> </span>van<span style="letter-spacing: -0.35pt;"> </span>3<span style="letter-spacing: 0.15pt;"> </span>lá<span style="letter-spacing: 1pt;"> </span>và<span style="letter-spacing: 1.15pt;"> </span>hở<span style="letter-spacing: 0.15pt;"> </span>van động<span style="letter-spacing: 0.45pt;"> </span>mach<span style="letter-spacing: -0.1pt;"> </span>phổi,<span style="letter-spacing: 0.35pt;"> </span>thấy<span style="letter-spacing: 2pt;"></span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.35pt;"> </span>trên<span style="letter-spacing: 2.35pt;"> </span>siêu<span style="letter-spacing: 2.4pt;"> </span>âm<span style="letter-spacing: 1.5pt;"> </span>Doppler<span style="letter-spacing: -0.7pt;"> </span>màu.<span style="letter-spacing: -0.05pt;"> </span>Thông<span style="letter-spacing: 1.15pt;"> </span>qua các<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.05pt;">p</span>hổ<span style="letter-spacing: 0.5pt;"> </span>hở<span style="letter-spacing: 0.15pt;"> </span>của<span style="letter-spacing: -0.2pt;"> </span>v<span style="letter-spacing: 0.1pt;">a</span>n<span style="letter-spacing: -0.3pt;"> </span>3<span style="letter-spacing: 0.15pt;"> </span>lá<span style="letter-spacing: 1pt;"> </span>và<span style="letter-spacing: 1.15pt;"> </span>hở<span style="letter-spacing: 0.15pt;"> </span>van<o:p></o:p> động<span style="letter-spacing: 1.7pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"> </span>phổi<span style="letter-spacing: 1.5pt;"> </span>có<span style="letter-spacing: 1.75pt;"> </span>thể<span style="letter-spacing: 0.3pt;"> </span>ước<span style="letter-spacing: 1.1pt;"> </span>lượng<span style="letter-spacing: 1.1pt;"> </span>khá<span style="letter-spacing: 1.6pt;"></span>chính<span style="letter-spacing: -0.9pt;"> </span>xác<span style="letter-spacing: 0.15pt;"><span> </span></span>áp<span style="letter-spacing: 1.3pt;"> </span>lực<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.7pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"> </span>phổi<span style="letter-spacing: 1.5pt;"> </span>của<span style="letter-spacing: 0.75pt;"> </span>bệnh<span style="letter-spacing: 0.4pt;"> </span>nhân<span style="letter-spacing: -0.95pt;"> </span>(theo<span style="letter-spacing: 0.85pt;"> </span>các phương pháp<span style="letter-spacing: 0.4pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>nêu<span style="letter-spacing: 0.35pt;"> </span>ở trên).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.5. Đo<span style="letter-spacing: 1.35pt;"> </span>chức<span style="letter-spacing: -0.25pt;"> </span>năng<span style="letter-spacing: 1.9pt;"> </span>hô<span style="letter-spacing: -0.5pt;"> </span>hấp<span style="letter-spacing: 2.6pt;"> </span>và đo<span style="letter-spacing: 0.75pt;"> </span>khí<span style="letter-spacing: 1.3pt;"> </span>máu:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 12.85pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">Có<span style="letter-spacing: 0.75pt;"> </span>thể<span style="letter-spacing: -0.15pt;"> </span>thấy<span style="letter-spacing: 2.45pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 0.25pt;"> </span>thông<span style="letter-spacing: 1.85pt;"> </span>khí<span style="letter-spacing: 0.95pt;"> </span>thể<span style="letter-spacing: -0.15pt;"> </span>tắc<span style="letter-spacing: 0.45pt;"> </span>nghẽn<span style="letter-spacing: -0.3pt;"> </span>(<span style="letter-spacing: -0.05pt;">V</span>EMS<span style="letter-spacing: -0.4pt;"> </span>giảm<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ể<span style="letter-spacing: -0.2pt;"> </span>tích<span style="letter-spacing: 0.9pt;"> </span>cặn<span style="letter-spacing: 0.45pt;"> </span>tăng),<span style="letter-spacing: 0.8pt;"> </span>rối<span style="letter-spacing: 1.25pt;"> </span>loạn<span style="letter-spacing: 1.05pt;"> </span>thông khí<span style="letter-spacing: -0.95pt;"> </span>thể<span style="letter-spacing: 0.4pt;"> </span>hạn<span style="letter-spacing: 1.65pt;"> </span>chế<span style="letter-spacing: 0.45pt;"> </span>(dung<span style="letter-spacing: 1.15pt;"></span>tích<span style="letter-spacing: -0.85pt;"> </span>sống<span style="letter-spacing: 1.8pt;"> </span>giảm<span style="letter-spacing: 1.55pt;"> </span>nặng)<span style="letter-spacing: 0.9pt;"> </span>hoặc<span style="letter-spacing: 0.9pt;"> </span>rối<span style="letter-spacing: 1.8pt;"> </span>loạn<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.45pt;">t</span><span style="letter-spacing: -0.35pt;">hôn</span>g<span style="letter-spacing: 1.9pt;"> </span><span style="letter-spacing: -0.35pt;">kh</span>í<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.4pt;">th</span>ể<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.4pt;">hỗ</span>n<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.4pt;">hợp</span>.<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.4pt;">á</span>p<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.4pt;">suấ</span>t<span style="letter-spacing: 2.5pt;"> </span><span style="letter-spacing: -0.35pt;">ôx</span>y<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.4pt;">động </span><span style="letter-spacing: -0.35pt;">mạc</span>h<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.4pt;">(Pa</span><span style="letter-spacing: -0.5pt;">O</span><span style="letter-spacing: -0.4pt; position: relative; top: 2.5pt;">2</span>)<span style="letter-spacing: -0.35pt;"> giả</span>m<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.4pt;">(</span><span style="letter-spacing: -0.45pt;">d</span><span style="letter-spacing: -0.4pt;">ướ</span>i<span style="letter-spacing: 0.15pt;"> </span><<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: -0.4pt;">7</span>0<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.4pt;">mm</span><span style="letter-spacing: -0.45pt;">H</span><span style="letter-spacing: -0.4pt;">g</span><span style="letter-spacing: -0.35pt;">)</span>,<span style="letter-spacing: 0.1pt;"></span>nhất<span style="letter-spacing: 2.6pt;"> </span>là<span style="letter-spacing: 1.6pt;"> </span>sau<span style="letter-spacing: 0.75pt;"> </span>gắng<span style="letter-spacing: 0.5pt;"> </span>sức<span style="letter-spacing: 0.75pt;"> </span>biểu<span style="letter-spacing: -0.1pt;"> </span>hiện<span style="letter-spacing: -0.1pt;"> </span>suy<span style="letter-spacing: 0.7pt;"> </span>hô<span style="letter-spacing: 1.3pt;"> </span>hấp<span style="letter-spacing: 2.4pt;"> </span>từng<span style="letter-spacing: 0.55pt;"> </span>phần.<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.05pt;">Á</span>p<span style="letter-spacing: 0.35pt;"> </span>suất<o:p></o:p></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: -1.5pt;"> C</span><span lang="EN" style="letter-spacing: -0.05pt; position: relative; top: -1.5pt;">O</span><span lang="EN" style="position: relative; top: 1pt;">2<span style="letter-spacing: 1.5pt;"> </span></span><span lang="EN" style="position: relative; top: -1.5pt;">động<span style="letter-spacing: 1.4pt;"> </span>mạch<span style="letter-spacing: 0.85pt;"> </span>(PaC<span style="letter-spacing: -0.05pt;">O</span></span><span lang="EN" style="letter-spacing: -0.05pt; position: relative; top: 1pt;">2</span><span lang="EN" style="position: relative; top: -1.5pt;">)<span style="letter-spacing: -0.2pt;"> </span>tăng<span style="letter-spacing: 1.05pt;"> </span>ở<span style="letter-spacing: 0.8pt;"> </span>giai<span style="letter-spacing: 0.6pt;"> </span>đoạn<span style="letter-spacing: 1.45pt;"> </span>cuối<span style="letter-spacing: 1.4pt;"> </span>(tăng<span style="letter-spacing: 1.35pt;"></span>trên<span style="letter-spacing: 0.85pt;"> </span>50-80<span style="letter-spacing: 0.8pt;"> </span>mmHg),<span style="letter-spacing: 0.4pt;"> </span>biểu<span style="letter-spacing: -0.05pt;"> </span>hiện<span style="letter-spacing: -0.05pt;"> </span>của<span style="letter-spacing: 0.45pt;"> </span>suy<span style="letter-spacing: 0.8pt;"> </span>hô<span style="letter-spacing: 1.35pt;"> </span>hấp </span><span lang="EN">toàn<span style="letter-spacing: 1.45pt;"> </span>bộ.<span style="letter-spacing: 1pt;"> </span>Độ<span style="letter-spacing: 2.35pt;"> </span>bão<span style="letter-spacing: 0.8pt;"> </span>hoà<span style="letter-spacing: 0.8pt;"> </span>ô<span style="letter-spacing: -0.05pt;">x</span>y<span style="letter-spacing: 1.65pt;"> </span>động<span style="letter-spacing: 2.5pt;"> </span>mạch<span style="letter-spacing: 2pt;"> </span>giảm,<span style="letter-spacing: 2.05pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>khi<span style="letter-spacing: 0.9pt;"> </span><<span style="letter-spacing: 0.95pt;"> </span>75%.<span style="letter-spacing: 1pt;"> </span>Khi<span style="letter-spacing: 0.8pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>suy<span style="letter-spacing: 1pt;"></span>hô<span style="letter-spacing: 1.55pt;"> </span>h<span style="letter-spacing: -0.05pt;">ấ</span>p<span style="letter-spacing: 2.7pt;"> </span>toàn<span style="letter-spacing: 1.45pt;"> </span>bộ<span style="letter-spacing: 1pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ì<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.05pt;">p</span>H<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.05pt;">máu </span>giảm<span style="letter-spacing: 0.4pt;"> </span><<span style="letter-spacing: -0.05pt;"> </span>7,2.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">5.2.3.6. Các<span style="letter-spacing: -0.1pt;"> </span>xét nghiệm<span style="letter-spacing: 2.55pt;"> </span>khác:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tăng<span style="letter-spacing: 0.25pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>l<span style="letter-spacing: -0.05pt;">ư</span>ợng hồng<span style="letter-spacing: 0.45pt;"> </span>cầu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tăng<span style="letter-spacing: 0.25pt;"> </span>hematocrit.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tốc<span style="letter-spacing: 0.2pt;"> </span>độ<span style="letter-spacing: 0.2pt;"> </span>m<span style="letter-spacing: -0.1pt;">á</span>u<span style="letter-spacing: 1.15pt;"> </span>lắng<span style="letter-spacing: -0.2pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>bội<span style="letter-spacing: -0.15pt;"> </span>nhiễm.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.<span style="letter-spacing: -0.1pt;"> </span>Chẩn<span style="letter-spacing: 2.4pt;"> </span>đoán.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.1.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>xác<span style="letter-spacing: 0.4pt;"> </span>định:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Có<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>phổi-phế<span style="letter-spacing: -0.45pt;"> </span>quản<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>ương lồng<span style="letter-spacing: 0.6pt;"> </span>ngực<span style="letter-spacing: -0.25pt;"> </span>mạn<span style="letter-spacing: 0.45pt;"> </span>tính.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Suy<span style="letter-spacing: -0.95pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phải:<span style="letter-spacing: 0.4pt;"> </span>gan<span style="letter-spacing: -0.15pt;"> </span>to,<span style="letter-spacing: -0.15pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>cổ<span style="letter-spacing: 0.65pt;"> </span>nổi,<span style="letter-spacing: 0.55pt;"> </span>phù...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- X<span style="letter-spacing: -0.15pt;"> </span>quang:<span style="letter-spacing: -0.35pt;"> </span>cung<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>nổi<span style="letter-spacing: 0.6pt;"> </span>vồng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điện<span style="letter-spacing: 0.45pt;"> </span>tim:<span style="letter-spacing: -0.2pt;"> </span>sóng<span style="letter-spacing: 0.65pt;"> </span>P<span style="letter-spacing: -0.35pt;"> </span>phế,<span style="letter-spacing: -1.05pt;"> </span>dày<span style="letter-spacing: 0.5pt;"> </span>thất<span style="letter-spacing: 1.9pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- <span style="letter-spacing: -0.05pt;">á</span>p<span style="letter-spacing: -0.4pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>tăng:<span style="letter-spacing: 1.1pt;"> </span>trên<span style="letter-spacing: 0.55pt;"> </span>siêu<span style="letter-spacing: 0.55pt;"> </span>âm tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>à thông<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.2.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>phân<span style="letter-spacing: 0.5pt;"> </span>b<span style="letter-spacing: 0.1pt;">i</span>ệt:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Chẩn<span style="letter-spacing: 1.4pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>phân <span style="letter-spacing: 0.05pt;"><span> </span></span>biệt<span style="letter-spacing: -0.75pt;"> </span>với:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.05pt;"> </span>Các<span style="letter-spacing: 0.55pt;"> </span>bệ<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: -0.65pt;"> </span>có<span style="letter-spacing: 0.7pt;"> </span>suy<span style="letter-spacing: 0.05pt;"> </span>tim<span style="letter-spacing: -0.1pt;"> </span>phải:<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ẹp<span style="letter-spacing: -0.9pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>2<span style="letter-spacing: 0.05pt;"> </span>lá,<span style="letter-spacing: 0.75pt;"> </span>bệnh<span style="letter-spacing: -0.65pt;"> </span>tim<span style="letter-spacing: -0.1pt;"> </span>bẩm<span style="letter-spacing: 1.9pt;"> </span>sinh,<span style="letter-spacing: -0.2pt;"> </span>viêm<span style="letter-spacing: 1.75pt;"> </span>cơ<span style="letter-spacing: -0.2pt;"> </span>tim,<span style="letter-spacing: -0.15pt;"> </span>bệnh<span style="letter-spacing: -0.65pt;"> </span>cơ<span style="letter-spacing: 0.65pt;"> </span>tim,<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">h</span>ẹp lỗ<span style="letter-spacing: 0.6pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi,<span style="letter-spacing: 0.25pt;"> </span>hở van<span style="letter-spacing: -0.5pt;"> </span>3 lá...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.2pt;"> </span>Viêm<span style="letter-spacing: -0.8pt;"> </span>màng<span style="letter-spacing: 1.55pt;"> </span>ngoài<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: 1.05pt;"> </span>co<span style="letter-spacing: 1.05pt;"> </span>thắt<span style="letter-spacing: 1pt;"> </span>(hội<span style="letter-spacing: 1pt;"> </span>chứng<span style="letter-spacing: 0.9pt;"> </span>Pick):<span style="letter-spacing: 0.65pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.85pt;"> </span>hình<span style="letter-spacing: -0.9pt;"> </span>ảnh<span style="letter-spacing: 1.45pt;"> </span>vôi<span style="letter-spacing: 1.3pt;"> </span>hoá<span style="letter-spacing: 1.4pt;"> </span>màng <span style="letter-spacing: 0.35pt;"><span> </span></span>ngoài tim,<span style="letter-spacing: -0.2pt;"> </span>tràn<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: -0.05pt;">d</span><span style="letter-spacing: 0.05pt;">ị</span>ch đa<span style="letter-spacing: -0.1pt;"> </span>màng,<span style="letter-spacing: 2.15pt;"> </span>gan<span style="letter-spacing: -0.15pt;"></span>to<span style="letter-spacing: -0.2pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>chắc.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">Thiế</span>u<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: 0.25pt;">m</span><span style="letter-spacing: 0.15pt;">á</span>u<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>ơ<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">tim</span>:<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">cũn</span>g<span style="letter-spacing: 0.15pt;"> </span>ở<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">n</span><span style="letter-spacing: 0.25pt;">g</span><span style="letter-spacing: 0.3pt;">ườ</span>i<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">gi</span>à<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.3pt;">nhưn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">khôn</span>g<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">bện</span>h<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.3pt;">phổ</span>i<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.25pt;">mạ</span>n<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.3pt;">tính.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">6.3.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>giai<span style="letter-spacing: 0.55pt;"> </span>đoạn:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Giai<span style="letter-spacing: -0.15pt;"> </span>đoạn<span style="letter-spacing: -0.4pt;"> </span>đầu:<span style="letter-spacing: 2.2pt;"> </span>chỉ<span style="letter-spacing: 1.8pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>c<span style="letter-spacing: -0.05pt;">ủ</span>a<span style="letter-spacing: -0.15pt;"> </span>phổi-phế<span style="letter-spacing: -0.2pt;"> </span>quản<span style="letter-spacing: 0.65pt;"> </span>hoặc bệnh<span style="letter-spacing: -0.45pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>cơ-<span style="letter-spacing: -0.05pt;">x</span>ương<span style="letter-spacing: 0.25pt;"> </span>lồng<span style="letter-spacing: 0.85pt;"> </span>ngực mạn<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.2pt;">t</span><span style="letter-spacing: -0.15pt;">í</span><span style="letter-spacing: -0.25pt;">n</span>h <span style="letter-spacing: -0.15pt;">v</span>à<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.2pt;">nhữn</span>g<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.15pt;">đợ</span>t<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.15pt;">kịc</span>h<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.15pt;">phát</span>,<span style="letter-spacing: -0.4pt;"></span><span style="letter-spacing: -0.15pt;">t</span><span style="letter-spacing: -0.25pt;">ă</span><span style="letter-spacing: -0.15pt;">n</span>g<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.2pt;">nh</span>ẹ<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.15pt;">á</span>p<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.2pt;">lự</span>c<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.15pt;">độn</span>g<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.15pt;">mạc</span>h<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">p</span><span style="letter-spacing: -0.35pt;">h</span><span style="letter-spacing: -0.2pt;">ổi</span>.<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.2pt;">Bện</span>h <span style="letter-spacing: -0.2pt;">cầ</span>n<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.15pt;">điề</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.15pt;">tr</span>ị <span style="letter-spacing: -0.2pt;">sớm.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Giai<span style="letter-spacing: -0.4pt;"> </span>đoạn<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>uy tim<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ụ</span>c:<span style="letter-spacing: -0.65pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>c<span style="letter-spacing: -0.05pt;">ò</span>n<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>quả.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Giai<span style="letter-spacing: -0.4pt;"> </span>đoạn<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>uy tim<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: -0.35pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>phục:<span style="letter-spacing: -0.55pt;"> </span>điều<span style="letter-spacing: 0.15pt;"> </span>trị không<span style="letter-spacing: 1.7pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>quả.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">7.<span style="letter-spacing: -0.1pt;"> </span>Tiến<span style="letter-spacing: -0.85pt;"> </span>triển<span style="letter-spacing: -2pt;"> </span>và<span style="letter-spacing: 2.5pt;"> </span>t<span style="letter-spacing: 0.05pt;">i</span>ên <span style="letter-spacing: 0.05pt;">l</span></span><span lang="EN">ư<span style="font-weight: bold;">ợng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Bệnh<span style="letter-spacing: -1pt;"> </span>phổi-phế<span style="letter-spacing: 0.1pt;"> </span>quản<span style="letter-spacing: 0.6pt;"><span> </span></span>và<span style="letter-spacing: 0.1pt;"> </span>bệnh<span style="letter-spacing: -0.15pt;"> </span>cơ-<span style="letter-spacing: -0.05pt;">xư</span>ơng<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: 0.2pt;"> </span>lồng<span style="letter-spacing: 1.15pt;"> </span>ngực<span style="letter-spacing: 0.3pt;"> </span>tiến<span style="letter-spacing: -0.2pt;"> </span>triển<span style="letter-spacing: -0.15pt;"> </span>từ<span style="letter-spacing: 0.45pt;"> </span>từ,<span style="letter-spacing: 0.45pt;"> </span>nặng<span style="letter-spacing: 0.3pt;"> </span>dần<span style="letter-spacing: 0.4pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>tổn<span style="letter-spacing: 1.15pt;"> </span>thương phổi<span style="letter-spacing: 0.5pt;"> </span>tăng<span style="letter-spacing: 0.35pt;"> </span>dần<span style="letter-spacing: -0.05pt;"> </span>dẫn<span style="letter-spacing: 1.95pt;"> </span>đến<span style="letter-spacing: 0.6pt;"></span>suy<span style="letter-spacing: 0.1pt;"> </span>hô<span style="letter-spacing: 0.65pt;"> </span>hấp<span style="letter-spacing: 1.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">ừ</span>ng phần<span style="letter-spacing: -0.15pt;"> </span>rồi<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.1pt;">o</span>àn<span style="letter-spacing: 0.7pt;"> </span>bộ,<span style="letter-spacing: 0.1pt;"> </span>gây<span style="letter-spacing: 1.55pt;"> </span>nên<span style="letter-spacing: 1.55pt;"> </span>tăng<span style="letter-spacing: 2.1pt;"> </span>áp<span style="letter-spacing: -0.6pt;"> </span>lực<span style="letter-spacing: -0.05pt;"> </span>động<span style="letter-spacing: 0.7pt;"> </span>mạch<span style="letter-spacing: 0.15pt;"> </span>phổi<span style="letter-spacing: 0.5pt;"> </span>và<span style="letter-spacing: 0.9pt;"> </span>hậu quả<span style="letter-spacing: 1.95pt;"> </span>là<span style="letter-spacing: -0.05pt;"> </span>suy tim<span style="letter-spacing: -0.15pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Nếu<span style="letter-spacing: -0.1pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>phổi-phế<span style="letter-spacing: 0.25pt;"> </span>quản<span style="letter-spacing: 0.8pt;"><span> </span></span>và<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: 0.1pt;">c</span>ủa<span style="letter-spacing: 0.4pt;"> </span>cơ-xương<span style="letter-spacing: 0.75pt;"> </span>của<span style="letter-spacing: 0.4pt;"> </span>lồng<span style="letter-spacing: 1.35pt;"> </span>ngực<span style="letter-spacing: 0.5pt;"> </span>được<span style="letter-spacing: 0.95pt;"> </span>phát<span style="letter-spacing: 2pt;"> </span>hiện, điều<span style="letter-spacing: 1.45pt;"> </span>trị<span style="letter-spacing: 1.05pt;"> </span>sớm<span style="letter-spacing: 0.55pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ì tăng<span style="letter-spacing: -0.95pt;"> </span>áp<span style="letter-spacing: 1.75pt;"> </span>lực<span style="letter-spacing: 0.95pt;"> </span>động<span style="letter-spacing: 1.65pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"></span>phổi<span style="letter-spacing: 1.45pt;"> </span>và<span style="letter-spacing: 1.9pt;"> </span>suy<span style="letter-spacing: 1.05pt;"> </span>tim<span style="letter-spacing: 0.95pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 1.7pt;"> </span>c<span style="letter-spacing: -0.05pt;">hậ</span>m<span style="letter-spacing: 1.1pt;"> </span>phát<span style="letter-spacing: 1.55pt;"> </span>triển<span style="letter-spacing: 0.35pt;"> </span>hơn.<span style="letter-spacing: 1.45pt;"> </span>Bệnh<span style="letter-spacing: -0.45pt;"> </span>nhân<span style="letter-spacing: -0.95pt;"> </span>viêm<span style="letter-spacing: 1.4pt;"> </span>phế<span style="letter-spacing: 0.2pt;"> </span>quản<span style="letter-spacing: 1.5pt;"> </span>mạn tính<span style="letter-spacing: 0.3pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>nhiều<span style="letter-spacing: -0.8pt;"> </span>đợt<span style="letter-spacing: 0.45pt;"> </span>bùng<span style="letter-spacing: -0.25pt;"> </span>phát<span style="letter-spacing: 0.45pt;"> </span>thì<span style="letter-spacing: 0.6pt;"> </span>nhanh<span style="letter-spacing: -0.3pt;"> </span>bị<span style="letter-spacing: 0.55pt;"></span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tim-phổi<span style="letter-spacing: 0.1pt;"> </span>mạn<span style="letter-spacing: -0.1pt;"> </span>tính<span style="letter-spacing: 1pt;"> </span>(có<span style="letter-spacing: 0.6pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>chỉ<span style="letter-spacing: 0.35pt;"> </span>sau 1-3 năm<span style="letter-spacing: 1.55pt;"> </span>bị<span style="letter-spacing: -0.05pt;"> </span>viêm phế<span style="letter-spacing: -0.9pt;"> </span>quản<span style="letter-spacing: 0.7pt;"> </span>mạn<span style="letter-spacing: 0.2pt;"> </span>tính).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 28px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Ở<span style="letter-spacing: -1.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 1.65pt;"> </span>bị<span style="letter-spacing: -0.2pt;"> </span>hen<span style="letter-spacing: -0.15pt;"> </span>dị<span style="letter-spacing: 0.55pt;"> </span>ứng, tăng<span style="letter-spacing: 2.3pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>xuất<span style="letter-spacing: 1.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>muộn. Bệnh<span style="letter-spacing: 1.65pt;"> </span>nhân<span style="letter-spacing: 1.1pt;"> </span>bị<span style="letter-spacing: -0.45pt;"> </span>hen<span style="letter-spacing: -0.15pt;"> </span>nhiễm<span style="letter-spacing: -0.9pt;"> </span>khuẩn,<span style="letter-spacing: 1.8pt;"> </span>thư<span style="letter-spacing: -0.05pt;">ờ</span>ng sau 5-10 năm <span style="letter-spacing: 0.7pt;"><span> </span></span>là<span style="letter-spacing: -0.5pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>s<span style="letter-spacing: -0.05pt;">u</span>y tim<span style="letter-spacing: -0.15pt;"> </span>phải.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: -0.4pt;"> </span>cơ-x<span style="letter-spacing: -0.05pt;">ư</span>ơng<span style="letter-spacing: 1.15pt;"> </span>của<span style="letter-spacing: 0.8pt;"> </span>lồng<span style="letter-spacing: 1.75pt;"> </span>ngực<span style="letter-spacing: 0.9pt;"> </span>nếu<span style="letter-spacing: 0.45pt;"> </span>không<span style="letter-spacing: 1.4pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>bội<span style="letter-spacing: 1pt;"> </span>nhiễm<span style="letter-spacing: 0.25pt;"> </span>phổi<span style="letter-spacing: 1.55pt;"> </span>thì<span style="letter-spacing: -0.9pt;"> </span>cũng<span style="letter-spacing: 0.7pt;"> </span>lâu<span style="letter-spacing: -1pt;"> </span>bị<span style="letter-spacing: 1.7pt;"> </span>tăng<span style="letter-spacing: -0.9pt;"> </span>áp<span style="letter-spacing: 1.85pt;"> </span>lực<span style="letter-spacing: 1pt;"> </span>động mạch<span style="letter-spacing: 0.35pt;"> </span>ph<span style="letter-spacing: -0.05pt;">ổ</span><span style="letter-spacing: 0.05pt;">i</span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.2pt;">Bện</span>h<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.2pt;">ha</span>y<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.2pt;">c</span>ó<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.2pt;">biế</span>n<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">chứn</span>g<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.2pt;">nhi</span><span style="letter-spacing: -0.3pt;">ễ</span>m<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.2pt;">khuẩ</span>n<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.15pt;">h</span>ô<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.2pt;">hấp</span>,<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.2pt;">rố</span>i<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.15pt;">loạ</span>n<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.15pt;">nhị</span>p<span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: -0.2pt;">tim</span>,<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.2pt;">toa</span>n<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.15pt;">ho</span>á<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.2pt;">máu.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tăng<span style="letter-spacing: 0.25pt;"> </span>hồng<span style="letter-spacing: 0.45pt;"> </span>cầu<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>hem<span style="letter-spacing: -0.1pt;">o</span>globin<span style="letter-spacing: -0.55pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gây<span style="letter-spacing: 0.35pt;"> </span>biến<span style="letter-spacing: -0.85pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">8.<span style="letter-spacing: -0.1pt;"> </span>Điều<span style="letter-spacing: -0.95pt;"> </span>trị.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">8.1.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>các<span style="letter-spacing: 0.45pt;"> </span>bệnh<span style="letter-spacing: 1.2pt;"> </span>phổi-phế<span style="letter-spacing: 2.55pt;"> </span>quản<span style="letter-spacing: -0.8pt;"> </span>và<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: 1.2pt;"> </span>của<span style="letter-spacing: 1pt;"> </span>cơ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: 0.05pt;">x</span></span><span lang="EN">ư<span style="font-weight: bold;">ơng<span style="letter-spacing: 2.05pt;"> </span>lồng<span style="letter-spacing: 1.25pt;"> </span>ngực:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Tùy<span style="letter-spacing: 0.15pt;"> </span>theo<span style="letter-spacing: 0.55pt;"> </span>nguyên<span style="letter-spacing: 2.15pt;"> </span>nhân<span style="letter-spacing: 1.25pt;"> </span>gây<span style="letter-spacing: 0.65pt;"> </span>bệnh<span style="letter-spacing: 0.05pt;"> </span>mà<span style="letter-spacing: 0.9pt;"> </span>điều<span style="letter-spacing: 2pt;"> </span>trị<span style="letter-spacing: 1.4pt;"> </span>có<span style="letter-spacing: 1.4pt;"> </span>khác<span style="letter-spacing: 1.1pt;"> </span>nhau.<span style="letter-spacing: 0.5pt;"> </span>Sau<span style="letter-spacing: -0.15pt;"> </span>đây <span style="letter-spacing: 0.2pt;"><span> </span></span>là<span style="letter-spacing: 1.15pt;"> </span>biện<span style="letter-spacing: -0.1pt;"> </span>pháp<span style="letter-spacing: 1.1pt;"> </span>hay<span style="letter-spacing: 0.6pt;"> </span>dùng<span style="letter-spacing: 0.45pt;"> </span>cho<o:p></o:p> điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"></span>nghẽn<span style="letter-spacing: -0.9pt;"> </span>mạn<span style="letter-spacing: -0.1pt;"> </span>tính<span style="letter-spacing: 1pt;"> </span>(COPD):<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.75pt;"> </span>Kháng<span style="letter-spacing: 1pt;"> </span>sinh:<span style="letter-spacing: 0.5pt;"> </span>để<span style="letter-spacing: 0.55pt;"> </span>điều<span style="letter-spacing: 2.25pt;"> </span>trị<span style="letter-spacing: 1.55pt;"> </span>các<span style="letter-spacing: 1.3pt;"> </span>đợt<span style="letter-spacing: 1.85pt;"> </span>bội<span style="letter-spacing: 0.6pt;"> </span>nhiễm<span style="letter-spacing: -0.15pt;"> </span>bùng<span style="letter-spacing: 0.5pt;"> </span>phát.<span style="letter-spacing: 0.55pt;"> </span>Nên<span style="letter-spacing: 1.55pt;"> </span>lấy<span style="letter-spacing: 2.65pt;"> </span>đờm<span style="letter-spacing: 1.1pt;"> </span>cấy<span style="letter-spacing: 2.65pt;"> </span>khuẩn,<span style="letter-spacing: 2.55pt;"> </span>làm<span style="letter-spacing: 1.25pt;"> </span>kháng sinh<span style="letter-spacing: 0.7pt;"> </span>đồ<span style="letter-spacing: -1.2pt;"> </span>để<span style="letter-spacing: 1.6pt;"> </span>chọn<span style="letter-spacing: 1.35pt;"> </span>kháng<span style="letter-spacing: 1.25pt;"></span><span style="letter-spacing: 0.05pt;">si</span>nh.<span style="letter-spacing: 0.85pt;"> </span>Phải<span style="letter-spacing: 1.4pt;"> </span>dùng<span style="letter-spacing: 0.65pt;"> </span>kháng<span style="letter-spacing: 1.25pt;"> </span>sinh<span style="letter-spacing: 0.7pt;"> </span>kéo dài<span> </span>và<span style="letter-spacing: 1pt;"> </span>liều<span style="letter-spacing: 0.15pt;"> </span>cao<span style="letter-spacing: 0.75pt;"> </span>(2-3<span style="letter-spacing: 0.9pt;"> </span>tuần)<span style="letter-spacing: 0.65pt;"> </span>qua<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ường<span style="letter-spacing: 0.9pt;"> </span>tiêm, uống<span style="letter-spacing: 1.75pt;"> </span>và<span style="letter-spacing: 2.1pt;"> </span>khí<span style="letter-spacing: -0.8pt;"> </span>dung<span style="letter-spacing: 1.3pt;"> </span>khi<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.95pt;"> </span>nhiễm<span style="letter-spacing: 0.45pt;"> </span>khuẩn, <span style="letter-spacing: 0.1pt;"><span> </span></span>máu<span style="letter-spacing: 1.7pt;"></span>lắng<span style="letter-spacing: 1.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">ă</span>ng,<span style="letter-spacing: 2.4pt;"> </span>bạch<span style="letter-spacing: 0.85pt;"> </span>cầu<span style="letter-spacing: 1.15pt;"> </span>tăng.<span style="letter-spacing: -0.75pt;"> </span>Có<span style="letter-spacing: 1.45pt;"> </span>tác<span style="letter-spacing: 1.9pt;"> </span>giả<span style="letter-spacing: 2.1pt;"> </span>còn<span style="letter-spacing: 1.95pt;"> </span>chủ<span style="letter-spacing: 0.95pt;"> </span>t<span style="letter-spacing: -0.05pt;">r</span>ương dùng<span style="letter-spacing: -0.25pt;"> </span>kháng<span style="letter-spacing: 0.35pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>dự phòng<span style="letter-spacing: 0.3pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>thời<span style="letter-spacing: -0.2pt;"> </span>tiết<span style="letter-spacing: -0.8pt;"> </span>lạnh<span style="letter-spacing: 0.5pt;"> </span>(uống<span style="letter-spacing: 0.55pt;"> </span>kháng<span style="letter-spacing: 0.35pt;"> </span>sinh<span style="letter-spacing: -0.2pt;"> </span>10 ngày<span style="letter-spacing: 0.4pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>1 tháng).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span>Thuốc<span style="letter-spacing: 0.6pt;"> </span>giãn<span style="letter-spacing: 0.75pt;"> </span>phế<span style="letter-spacing: -0.6pt;"> </span>quản:<span style="letter-spacing: 0.65pt;"> </span>sử<span style="letter-spacing: 0.3pt;"> </span>dụng<span style="letter-spacing: 0.05pt;"> </span>khi<span style="letter-spacing: 0.15pt;"> </span>bệnh<span style="letter-spacing: -0.4pt;"> </span>nhân<span style="letter-spacing: 0.55pt;"> </span>có<span style="letter-spacing: 0.95pt;"> </span>co<span style="letter-spacing: 0.2pt;"> </span>thắt<span style="letter-spacing: 0.1pt;"> </span>phế<span style="letter-spacing: -0.6pt;"> </span>quản<span style="letter-spacing: 0.7pt;"> </span>(n<span style="letter-spacing: -0.05pt;">h</span>ư<span style="letter-spacing: 0.35pt;"> </span>hen<span style="letter-spacing: 0.2pt;"> </span>phế<span style="letter-spacing: -0.55pt;"> </span>quản,<span style="letter-spacing: 0.7pt;"> </span>viêm phế<span style="letter-spacing: -0.9pt;"> </span>quản<span style="letter-spacing: -0.2pt;"> </span>mạn...);<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>dùng<span style="letter-spacing: -0.25pt;"> </span>theophylin,<span style="letter-spacing: -0.55pt;"> </span>theos<span style="letter-spacing: 0.05pt;">t</span>at,<span style="letter-spacing: -0.4pt;"> </span>aminophylin,<span style="letter-spacing: -0.65pt;"> </span>ventolin,<span style="letter-spacing: -0.7pt;"> </span>salbutamol...<span style="letter-spacing: -0.6pt;"> </span>đường uống, tiêm<span style="letter-spacing: 0.8pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>khí<span style="letter-spacing: 0.35pt;"> </span>dung.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.1pt;"> </span>Corticoid:<span style="letter-spacing: -0.85pt;"> </span>là<span style="letter-spacing: 0.95pt;"> </span>thuốc<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>t<span style="letter-spacing: -0.1pt;">á</span>c<span style="letter-spacing: 0.7pt;"> </span>dụng<span style="letter-spacing: -0.15pt;"> </span>rất<span style="letter-spacing: 2pt;"> </span>tốt<span style="letter-spacing: 0.7pt;"> </span>trong<span style="letter-spacing: -0.15pt;"> </span>các<span style="letter-spacing: 0.4pt;"> </span>đợt<span style="letter-spacing: 0.95pt;"> </span>cấp<span style="letter-spacing: 1.8pt;"> </span>của<span style="letter-spacing: -0.25pt;"> </span>bệnh.<span style="letter-spacing: -0.7pt;"> </span>Thuốc<span style="letter-spacing: 0.4pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>tác<span style="letter-spacing: 0.7pt;"> </span>dụng<span style="letter-spacing: -0.15pt;"> </span>chống viêm,<span style="letter-spacing: 0.25pt;"> </span>chống<span style="letter-spacing: 0.55pt;"> </span>dị<span style="letter-spacing: 0.55pt;"> </span>ứng và<span style="letter-spacing: -0.45pt;"></span>giảm <span style="letter-spacing: 0.1pt;"><span> </span></span>tiết.<span style="letter-spacing: -0.75pt;"> </span>Có<span style="letter-spacing: 0.15pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ường uống,<span style="letter-spacing: 0.55pt;"> </span>tiêm<span style="letter-spacing: 0.25pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>khí<span style="letter-spacing: 0.35pt;"> </span>dung.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Các<span></span><span style="letter-spacing: 0.3pt;"><span> </span></span>thuốc <span style="letter-spacing: 2.25pt;"><span></span></span>hay<span style="letter-spacing: 1.6pt;"><span> </span></span>dùng<span style="letter-spacing: 1.5pt;"><span> </span></span>là<span> </span><span style="letter-spacing: 1.35pt;"><span></span></span>prednisolon, <span style="letter-spacing: 1.1pt;"><span></span></span>medrol,<span style="letter-spacing: 1.45pt;"><span> </span></span>depersolon,<span style="letter-spacing: 1.2pt;"><span> </span></span>hydrocort<span style="letter-spacing: -0.05pt;">i</span>son,<span style="letter-spacing: 1.05pt;"><span> </span></span>solu-medrol, pulmicort...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.8pt;"> </span>Thuốc<span style="letter-spacing: 2.1pt;"> </span>kháng<span style="letter-spacing: 2.15pt;"> </span>histamin,<span style="letter-spacing: 1.35pt;"> </span>chống<span style="letter-spacing: 2.35pt;"> </span>dị<span style="letter-spacing: 2.35pt;"> </span>ứng:<span style="letter-spacing: 1.6pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span>ư <span style="letter-spacing: -1.2pt;"><span> </span></span>telfast,<span style="letter-spacing: 1.5pt;"> </span>clarytin,<span style="letter-spacing: 1.4pt;"> </span>peritol...<span style="letter-spacing: 1.4pt;"> </span>dùng<span style="letter-spacing: 1.55pt;"> </span>cho<span style="letter-spacing: 1.65pt;"> </span>các<span style="letter-spacing: 2.35pt;"> </span>bệnh nhân<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cơ<span style="letter-spacing: 0.75pt;"> </span>địa<span style="letter-spacing: -0.15pt;"> </span>dị<span style="letter-spacing: 0.95pt;"> </span>ứng, nhất<span style="letter-spacing: 1.85pt;"></span>là<span style="letter-spacing: 0.85pt;"> </span>người hen<span style="letter-spacing: -0.15pt;"> </span>dị<span style="letter-spacing: 0.55pt;"> </span>ứng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.75pt;"> </span>Thuốc<span style="letter-spacing: 2.05pt;"> </span>long<span style="letter-spacing: 1.55pt;"> </span>đờm:<span style="letter-spacing: -1pt;"> </span>để <span style="letter-spacing: 0.15pt;"><span> </span></span>giúp<span style="letter-spacing: 1.1pt;"> </span>bệnh<span style="letter-spacing: 1.05pt;"> </span>nhân<span style="letter-spacing: -0.3pt;"> </span>dễ<span style="letter-spacing: 1.05pt;"> </span>khạc <span style="letter-spacing: 0.85pt;"><span> </span></span>được<span style="letter-spacing: 1.95pt;"> </span>đờm<span style="letter-spacing: -1.15pt;"> </span>mủ.Các<span style="letter-spacing: 2.05pt;"> </span>thuốc<span style="letter-spacing: 2.25pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ường <span style="letter-spacing: -1.25pt;"><span> </span></span>dùng<span style="letter-spacing: 1.5pt;"> </span>là:<o:p></o:p> mucomyst,<span style="letter-spacing: -0.55pt;"> </span>natribenzoat,<span style="letter-spacing: -0.6pt;"></span>mucitux...<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bỏ<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>lá,<span style="letter-spacing: -0.2pt;"> </span>tránh<span style="letter-spacing: 2.2pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>dị<span style="letter-spacing: 0.55pt;"> </span>nguy<span style="letter-spacing: 0.05pt;">ê</span>n,<span style="letter-spacing: 2.6pt;"> </span>tránh<span style="letter-spacing: 0.05pt;"> </span>nơi<span style="letter-spacing: -0.4pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>ẩm<span style="letter-spacing: 1.9pt;"> </span>cao<span style="letter-spacing: -0.15pt;"> </span>(như tắm<span style="letter-spacing: -0.2pt;"> </span>hơi...).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">8.2.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>tăng<span style="letter-spacing: -0.25pt;"> </span>áp<span style="letter-spacing: 0.45pt;"> </span>lực<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>phổi:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Các<span style="letter-spacing: 0.5pt;"> </span>phương pháp<span style="letter-spacing: 1.3pt;"> </span>làm<span style="letter-spacing: 0.5pt;"> </span>giảm<span style="letter-spacing: 1.6pt;"> </span>áp<span style="letter-spacing: -0.5pt;"> </span>lực<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường <span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.85pt;"> </span>áp dụng:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tập<span style="letter-spacing: 1.5pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>bụng,<span style="letter-spacing: -0.25pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>ôxy.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Liệu<span style="letter-spacing: 0.5pt;"> </span>pháp<span style="letter-spacing: 1.8pt;"> </span>ôxy<span style="letter-spacing: 2.05pt;"> </span>có<span style="letter-spacing: 2.05pt;"> </span>vai<span style="letter-spacing: 0.95pt;"> </span>trò<span style="letter-spacing: 2.05pt;"> </span>cực<span style="letter-spacing: 1.25pt;"> </span>kỳ<span style="letter-spacing: 1.4pt;"> </span>quan<span style="letter-spacing: 1.15pt;"> </span>trọng,<span style="letter-spacing: 1.95pt;"> </span>là <span style="letter-spacing: 0.1pt;"><span> </span></span>một<span style="letter-spacing: 1.2pt;"> </span>trong<span style="letter-spacing: 1.15pt;"> </span>các<span style="letter-spacing: 1.95pt;"> </span>biện<span style="letter-spacing: 0.55pt;"> </span>pháp <span style="letter-spacing: 0.15pt;"><span> </span></span>làm<span style="letter-spacing: 1.9pt;"> </span>giảm <span style="letter-spacing: 0.5pt;"><span> </span></span>áp<span style="letter-spacing: 0.9pt;"> </span>lực<o:p></o:p> động<span style="letter-spacing: 1.45pt;"> </span>mạch<span style="letter-spacing: 0.9pt;"> </span>phổi<span style="letter-spacing: 1.25pt;"> </span>rất<span style="letter-spacing: 2.75pt;"> </span>hiệu quả..<span style="letter-spacing: 1.25pt;"> </span>Thở<span style="letter-spacing: 0.45pt;"> </span>oxy<span style="letter-spacing: 0.65pt;"> </span>qua<span style="letter-spacing: 0.7pt;"> </span>mũi,<span style="letter-spacing: 0.4pt;"> </span>qua<span style="letter-spacing: 0.7pt;"> </span>m<span style="letter-spacing: -0.1pt;">ặ</span>t<span style="letter-spacing: 0.65pt;"> </span>nạ<span style="letter-spacing: 1.9pt;"> </span>và<span style="letter-spacing: 1.5pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span>thể<span style="letter-spacing: 0.1pt;"> </span>điều<span style="letter-spacing: 1.25pt;"> </span>trị<span style="letter-spacing: -1.2pt;"> </span>bằng<span style="letter-spacing: 1.25pt;"> </span>liệu<span style="letter-spacing: 0.1pt;"> </span>pháp<span style="letter-spacing: 1.2pt;"> </span>ôxy cao<span style="letter-spacing: -0.15pt;"> </span>áp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thuốc<span style="letter-spacing: 0.3pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>nitrat:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Imdur<span style="letter-spacing: -0.3pt;"> </span>60 mg<span style="letter-spacing: -0.1pt;"> x </span>1viên/ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 22.1pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN">.<span style="letter-spacing: 0.55pt;"> </span>Hoặc<span style="letter-spacing: 0.3pt;"> </span>nitromint<span style="letter-spacing: 0.1pt;"> </span>2,6<span style="letter-spacing: 0.55pt;"> </span>mg<span style="letter-spacing: 0.3pt;"> x </span>2-4<span style="letter-spacing: -0.05pt;">v</span>iên/ngày<span style="letter-spacing: 0.95pt;"> </span>hoặc<span style="letter-spacing: 0.3pt;"> </span>lenitral<span style="letter-spacing: 0.2pt;"> </span>2,5<span style="letter-spacing: 0.55pt;"> </span>mg<span style="letter-spacing: 0.35pt;"> x </span>1-2viên/ngày<span style="letter-spacing: 0.8pt;"> </span>hoặc<span style="letter-spacing: 0.3pt;"> </span>risordan<o:p></o:p></span><span lang="EN" style="position: relative; top: -1pt;"> 5 mg<span style="letter-spacing: -0.15pt;"> x </span>1-2<span style="letter-spacing: -0.05pt;">v</span>iên/ngày...</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">8.3.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>suy<span style="letter-spacing: 0.5pt;"> </span>tim:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Ăn nhạt<span style="letter-spacing: 0.45pt;"> </span>t<span style="letter-spacing: -0.05pt;">ư</span>ơng đối,<span style="letter-spacing: 0.75pt;"> </span>làm<span style="letter-spacing: -0.7pt;"> </span>việc<span style="letter-spacing: 1.6pt;"> </span>nhẹ,<span style="letter-spacing: -0.85pt;"> </span>tránh<span style="letter-spacing: 0.35pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức;<span style="letter-spacing: -0.2pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>bị<span style="letter-spacing: 0.55pt;"> </span>suy<span style="letter-spacing: -0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>p<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 0.6pt;"> </span>miễn<span style="letter-spacing: -0.75pt;"> </span>lao<span style="letter-spacing: -0.15pt;"> </span>động.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu:<span style="letter-spacing: -0.9pt;"> </span>từng<span style="letter-spacing: -0.2pt;"> </span>đợt<span style="letter-spacing: 0.45pt;"> </span>3-4 ngày.<span style="letter-spacing: 1.65pt;"> </span>Các<span style="letter-spacing: 0.25pt;"> </span>loại<span style="letter-spacing: 0.25pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>là:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 18px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.5pt;"> </span>Nhóm<span style="letter-spacing: 0.8pt;"> </span>lợi<span style="letter-spacing: 0.35pt;"> </span>tiểu<span style="letter-spacing: -0.25pt;"> </span>ức<span style="letter-spacing: 0.4pt;"> </span>chế<span style="letter-spacing: -0.35pt;"> </span>men<span style="letter-spacing: 0.3pt;"> </span>anhydrase carbonic<span style="letter-spacing: 0.1pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ư:<span style="letter-spacing: 0.5pt;"> </span>di<span style="letter-spacing: -0.05pt;">a</span><span style="letter-spacing: 0.05pt;">m</span>ox<span style="letter-spacing: 0.1pt;"> </span>để<span style="letter-spacing: 0.15pt;"> </span>tăng <span style="letter-spacing: 0.35pt;"><span> </span></span>t<span style="letter-spacing: -0.05pt;">h</span>ải<span style="letter-spacing: 1.05pt;"> </span>C<span style="letter-spacing: -0.15pt;">O</span><span style="letter-spacing: 0.05pt; position: relative; top: 2.5pt;">2</span>,<span style="letter-spacing: -0.05pt;"> </span>liều<span style="letter-spacing: -0.3pt;"> </span>thường dùng<span style="letter-spacing: -0.25pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>10 mg/kg/ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Nhóm<span style="letter-spacing: 0.3pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>thải<span style="letter-spacing: 0.5pt;"> </span>muối<span style="letter-spacing: 0.5pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span>ư:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Lasix 40 mg<span style="letter-spacing: -0.15pt;"> x </span>1-2 viên/ngày,<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>hypothiazid<span style="letter-spacing: -0.55pt;"> </span>50-100 mg/ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.75pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Chú<span style="letter-spacing: -0.8pt;"> </span>ý bồi<span style="letter-spacing: 0.6pt;"> </span>phụ<span style="letter-spacing: -0.55pt;"> </span>kali<span style="letter-spacing: -0.2pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>kaleorid<span style="letter-spacing: -0.4pt;"> </span>0,6g<span style="letter-spacing: -0.05pt;"> x </span>1-2 viên/ngày<span style="letter-spacing: 0.35pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>panangin<span style="letter-spacing: -0.45pt;"> x </span>4-6 viên/ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Nhóm<span style="letter-spacing: 0.3pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu<span style="letter-spacing: -0.75pt;"> </span>kháng<span style="letter-spacing: 0.35pt;"> </span>aldosteron:<span style="letter-spacing: -0.55pt;"> </span>aldacton<span style="letter-spacing: -0.4pt;"> </span>25-50 mg/<span style="letter-spacing: -0.2pt;"> </span>ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thuốc<span style="letter-spacing: 0.3pt;"> </span>cư<span style="letter-spacing: -0.05pt;">ờ</span>ng tim:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: -1.5pt;">Nên<span style="letter-spacing: -1.1pt;"> </span>dùng<span style="letter-spacing: 0.85pt;"> </span>thuốc<span style="letter-spacing: 1.6pt;"> </span>tác<span style="letter-spacing: 1.7pt;"> </span>dụng<span style="letter-spacing: 0.85pt;"> </span>nhanh,<span style="letter-spacing: 0.8pt;"> </span>thải<span style="letter-spacing: 1.6pt;"> </span>nhanh<span style="letter-spacing: 0.8pt;"> </span>như<span style="letter-spacing: 1pt;"> </span>ouabain<span style="letter-spacing: 0.7pt;"> </span>0,25<span style="letter-spacing: 1.1pt;"> </span>mg<span style="letter-spacing: 0.95pt;"> x </span>1<span style="letter-spacing: 1.1pt;"> </span>ống/ngày,<span style="letter-spacing: 1.3pt;"> </span>tiêm<span style="letter-spacing: -1pt;"> </span>tĩnh</span><span lang="EN"><o:p></o:p> mạch<span style="letter-spacing: 0.5pt;"> </span>chậm.<span style="letter-spacing: 2.05pt;"> </span>Thân<span style="letter-spacing: 0.4pt;"> </span>trọng<span style="letter-spacing: 0.65pt;"> </span>khi dùng<span style="letter-spacing: -0.1pt;"> </span>digoxin,<span style="letter-spacing: -0.1pt;"> </span>digit<span style="letter-spacing: -0.1pt;">o</span>xin<span style="letter-spacing: -0.1pt;"> </span>vì<span style="letter-spacing: 0.85pt;"> </span>rất<span style="letter-spacing: 2.1pt;"> </span>dễ<span style="letter-spacing: -0.5pt;"> </span>ngộ<span style="letter-spacing: 0.2pt;"> </span>độc<span style="letter-spacing: 0.6pt;"> </span>trong<span style="letter-spacing: -0.1pt;"> </span>điều<span style="letter-spacing: 0.55pt;"> </span>kiện<span style="letter-spacing: -0.7pt;"> </span>thiếu<span style="letter-spacing: -0.55pt;"> </span>ôxy<span style="letter-spacing: 0.55pt;"> </span>ở<span style="letter-spacing: 0.15pt;"> </span>cơ<o:p></o:p> tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">8.4.<span style="letter-spacing: -0.2pt;"> </span>Các<span style="letter-spacing: 0.3pt;"> </span>biện<span style="letter-spacing: 0.45pt;"> </span>pháp<span style="letter-spacing: -0.8pt;"> </span>khác:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nên<span style="letter-spacing: 0.3pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>chống<span style="letter-spacing: 0.55pt;"> </span>độc<span style="letter-spacing: 1.8pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>bảo<span style="letter-spacing: 1.2pt;"> </span>vệ<span style="letter-spacing: -1.2pt;"> </span>tế<span style="letter-spacing: -0.75pt;"> </span>bào<span style="letter-spacing: 0.5pt;"> </span>gan<span style="letter-spacing: -0.15pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span>ư: eganin,<span style="letter-spacing: -0.35pt;"> </span>fortec.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 19.5pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.35pt;"> </span>Không<span style="letter-spacing: 0.6pt;"> </span>dùng<span style="letter-spacing: 0.1pt;"> </span>các<span style="letter-spacing: 0.9pt;"> </span>thuốc<span style="letter-spacing: 0.85pt;"> </span>gây<span style="letter-spacing: 0.7pt;"> </span>ức<span style="letter-spacing: 0.25pt;"> </span>chế<span style="letter-spacing: -0.35pt;"> </span>hô<span style="letter-spacing: 0.9pt;"> </span>hấp<span style="letter-spacing: 2.05pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ư:<span style="letter-spacing: 0.35pt;"> </span>seduxen,<span style="letter-spacing: 0.35pt;"> </span>gardenan,<span style="letter-spacing: -0.1pt;"> </span>thuốc<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>á<span style="letter-spacing: 1.5pt;"> </span>phiện<span style="letter-spacing: -0.75pt;"> </span>(thuốc ho<span style="letter-spacing: -0.1pt;"> </span>codein,<span style="letter-spacing: -0.35pt;"> </span>morphin).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 1.6pt;"> </span><span style="letter-spacing: 0.5pt;">Chốn</span>g <span style="letter-spacing: 0.2pt;"><span> </span></span><span style="letter-spacing: 0.4pt;">đôn</span>g<span style="letter-spacing: 1.6pt;"><span> </span></span><span style="letter-spacing: 0.5pt;">má</span>u<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.45pt;">b</span><span style="letter-spacing: 0.5pt;">ằ</span><span style="letter-spacing: 0.45pt;">ng</span>:<span style="letter-spacing: 1.1pt;"><span> </span></span><span style="letter-spacing: 0.5pt;">hepar</span><span style="letter-spacing: 0.55pt;">i</span><span style="letter-spacing: 0.5pt;">n</span>,<span style="letter-spacing: 2.9pt;"> </span><span style="letter-spacing: 0.5pt;">thuố</span>c <span style="letter-spacing: 0.7pt;"><span> </span></span><span style="letter-spacing: 0.45pt;">khán</span>g<span style="letter-spacing: 1.15pt;"><span> </span></span><span style="letter-spacing: 0.5pt;">vita</span><span style="letter-spacing: 0.6pt;">m</span><span style="letter-spacing: 0.5pt;">i</span>n<span style="letter-spacing: 2.6pt;"> </span>K<span style="letter-spacing: 0.1pt;"><span> </span></span><span style="letter-spacing: 0.5pt;">kh</span>i <span style="letter-spacing: 0.05pt;"><span></span></span><span style="letter-spacing: 0.55pt;">c</span>ó<span style="letter-spacing: 0.8pt;"><span> </span></span><span style="letter-spacing: 0.5pt;">ngu</span>y <span style="letter-spacing: 0.2pt;"><span></span></span><span style="letter-spacing: 0.4pt;">c</span>ơ <span style="letter-spacing: 1.5pt;"><span></span></span><span style="letter-spacing: 0.5pt;">nghẽn mạch.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.35pt;">C</span><span style="letter-spacing: 0.3pt;">h</span><span style="letter-spacing: 0.35pt;">íc</span>h<span style="letter-spacing: 1.15pt;"> </span><span style="letter-spacing: 0.35pt;">h</span><span style="letter-spacing: 0.4pt;">u</span><span style="letter-spacing: 0.35pt;">y</span><span style="letter-spacing: 0.45pt;">ế</span>t<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: 0.4pt;">k</span><span style="letter-spacing: 0.35pt;">h</span>i<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.4pt;">hematocri</span>t<span style="letter-spacing: 0.35pt;"> </span>><span style="letter-spacing: 0.7pt;"> </span><span style="letter-spacing: 0.4pt;">6</span><span style="letter-spacing: 0.35pt;">5</span><span style="letter-spacing: 0.4pt;">%</span>,<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.45pt;">lấ</span>y<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.4pt;">30</span>0<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: 0.4pt;">m</span>l<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.35pt;">má</span>u<span style="letter-spacing: 1.35pt;"> </span><span style="letter-spacing: 0.4pt;">tr</span><span style="letter-spacing: 0.35pt;">o</span><span style="letter-spacing: 0.4pt;">n</span>g<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.4pt;">kh</span>i<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: 0.4pt;">c</span>ó<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.4pt;">ph</span>ù<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: 0.4pt;">phổi.</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Phẫu<span style="letter-spacing: 1.55pt;"> </span>thuật<span style="letter-spacing: 2pt;"> </span>chỉnh<span style="letter-spacing: 0.55pt;"> </span>hình ở người có<span style="letter-spacing: 0.65pt;"> </span>dị<span style="letter-spacing: 0.25pt;"> </span>dạng<span style="letter-spacing: 1.3pt;"> </span>lồng<span style="letter-spacing: 0.6pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>cột<span style="letter-spacing: -0.15pt;"> </span>sống.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.95pt;"> </span>Phẫu<span style="letter-spacing: 2.5pt;"> </span>thuật<span style="letter-spacing: 2.95pt;"> </span>lấy<span style="letter-spacing: 2.85pt;"> </span>cục<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 2.2pt;"> </span>đông<span style="letter-spacing: 0.85pt;"> </span>nếu<span style="letter-spacing: 0.25pt;"> </span>do<span style="letter-spacing: 0.85pt;"> </span>tắc<span style="letter-spacing: 0.8pt;"> </span>mạch<span style="letter-spacing: 1.2pt;"> </span>phổi<span style="letter-spacing: 1.35pt;"> </span>lớn<span style="letter-spacing: 0.8pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>dùng<span style="letter-spacing: 0.7pt;"> </span>liệu<span style="letter-spacing: 0.2pt;"> </span>pháp<span style="letter-spacing: 1.95pt;"> </span>làm<span style="letter-spacing: 1.2pt;"> </span>cho<span style="letter-spacing: 0.8pt;"> </span>tan cục<span style="letter-spacing: -0.35pt;"> </span>máu<span style="letter-spacing: 0.95pt;"> </span>đông.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Giáo<span style="letter-spacing: 0.4pt;"> </span>dục<span style="letter-spacing: -0.35pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>biết<span style="letter-spacing: -0.75pt;"> </span>dự phòng<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>tật,<span style="letter-spacing: 1.95pt;"> </span>điều<span style="letter-spacing: 0.55pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>kịp<span style="letter-spacing: 0.8pt;"> </span>thời<span style="letter-spacing: -0.2pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>phổi<span style="letter-spacing: 0.4pt;"> </span>phế<span style="letter-spacing: -0.9pt;"> </span>quản.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.3pt;"> </span><span style="letter-spacing: -0.05pt;">Đ</span>ưa<span style="letter-spacing: 0.3pt;"> </span>thể<span style="letter-spacing: -0.45pt;"> </span>trọng<span style="letter-spacing: 0.8pt;"> </span>về<span style="letter-spacing: -0.9pt;"> </span>mức<span style="letter-spacing: 0.1pt;"> </span>lý<span style="letter-spacing: 0.2pt;"> </span>tư<span style="letter-spacing: -0.05pt;">ởn</span>g<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.05pt;">[</span><span style="letter-spacing: 0.05pt;">t</span><span style="letter-spacing: -0.05pt;">ư</span>ơng<span style="letter-spacing: 0.3pt;"> </span>đương<span style="letter-spacing: -0.4pt;"> </span>bình <span style="letter-spacing: 0.5pt;"><span> </span></span>phương<span style="letter-spacing: 0.2pt;"> </span>chiều<span style="letter-spacing: -0.5pt;"> </span>cao<span style="letter-spacing: 0.15pt;"> </span>cơ<span style="letter-spacing: 0.8pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>(tính<span style="letter-spacing: 1.1pt;"> </span>bằng<span style="letter-spacing: 0.1pt;"> </span>mét)<o:p></o:p> nhân<span style="letter-spacing: 0.25pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>22] nếu<span style="letter-spacing: -0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt; letter-spacing: -0.7pt;"></span>nhân<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>béo<span style="letter-spacing: -0.9pt;"> </span>bệu<span style="letter-spacing: -0.7pt;"> </span>bằng<span style="letter-spacing: 1.3pt;"> </span>các<span style="letter-spacing: 0.1pt;"> </span>phương pháp<span style="letter-spacing: 0.7pt;"> </span>ăn<span style="letter-spacing: 0.3pt;"> </span>uống,<span style="letter-spacing: 0.55pt;"> </span>tập<span style="letter-spacing: 1.75pt;"> </span>luyện<span style="letter-spacing: -0.8pt;"> </span>thích<span style="letter-spacing: 0.25pt;"> </span>hợp.</span></span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-23775120620463390462011-04-29T05:02:00.000-07:002011-04-29T05:02:55.488-07:00- CƠN ĐAU THẮT NGỰC<div align="center" class="MsoNormal" style="font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15.25pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt; text-align: center;"><span class="Apple-style-span" style="color: red; font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">Cơn<span style="letter-spacing: -1.8pt;"> </span>đau<span style="letter-spacing: 0.75pt;"> </span>thắt<span style="letter-spacing: -2.65pt;"> </span>n<span style="letter-spacing: 0.1pt;">g</span>ực</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 10pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: right;"><br />
</div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 15pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">1.<span style="letter-spacing: -0.1pt;"> </span>Đạ<span style="letter-spacing: -0.05pt;">i c</span></span><span lang="EN" style="letter-spacing: 0.05pt; position: relative; top: 0.5pt;">ư</span><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">ơng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.1.<span style="letter-spacing: -0.2pt;"> </span>Định<span style="letter-spacing: 0.5pt;"> </span>nghĩa:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Đau<span style="letter-spacing: 1.6pt;"> </span>thắt<span style="letter-spacing: 0.1pt;"> </span>ngực<span style="letter-spacing: 0.05pt;"> </span>là<span style="letter-spacing: -0.35pt;"> </span>cơn<span style="letter-spacing: 1.85pt;"> </span>đau<span style="letter-spacing: 1.85pt;"> </span>thắt<span style="letter-spacing: 0.1pt;"> </span>từng<span style="letter-spacing: 0.1pt;"> </span>cơn<span style="letter-spacing: 0.7pt;"> </span>ở<span style="letter-spacing: 0.3pt;"> </span>vùng<span style="letter-spacing: -0.45pt;"> </span>tim<span style="letter-spacing: 0.15pt;"> </span>do<span style="letter-spacing: 0.2pt;"> </span>thiếu<span style="letter-spacing: -0.45pt;"> </span>máu<span style="letter-spacing: 1.55pt;"> </span>cơ<span style="letter-spacing: 0.4pt;"> </span>tim;<span style="letter-spacing: 0.1pt;"> </span>là<span style="letter-spacing: 1.15pt;"> </span>hậu<span style="letter-spacing: 2.3pt;"> </span>quả<span style="letter-spacing: 0.8pt;"> </span>của<span style="letter-spacing: -0.05pt;"> </span>một tình<span style="letter-spacing: 1.4pt;"> </span>trạng<span style="letter-spacing: 0.75pt;"> </span>mất<span style="letter-spacing: 2.55pt;"> </span>cân<span style="letter-spacing: 1.65pt;"> </span>bằng<span style="letter-spacing: 1.35pt;"></span>tạm<span style="letter-spacing: 0.45pt;"> </span>thời<span style="letter-spacing: 0.45pt;"> </span>giữa<span style="letter-spacing: 0.45pt;"> </span>sự<span style="letter-spacing: 0.65pt;"> </span>cung<span style="letter-spacing: 0.4pt;"> </span>c<span style="letter-spacing: -0.1pt;">ấ</span>p<span style="letter-spacing: 2.3pt;"> </span>và<span style="letter-spacing: 1.45pt;"> </span>nhu<span style="letter-spacing: 0.65pt;"> </span>cầu<span style="letter-spacing: 0.5pt;"> </span>ôxy.<span style="letter-spacing: 1.5pt;"> </span>Tình<span style="letter-spacing: 1.8pt;"> </span>trạng<span style="letter-spacing: 1.05pt;"> </span>này<span style="letter-spacing: 0.2pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>thể<span style="letter-spacing: -0.1pt;"> </span>hồi<span style="letter-spacing: 1.25pt;"> </span>phục <span style="position: relative; top: 0.5pt;">được.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.2.<span style="letter-spacing: 2.85pt;"> </span>Nguyên<span style="letter-spacing: -0.8pt;"> </span>nhân<span style="letter-spacing: 0.5pt;"> </span>bệnh<span style="letter-spacing: 1.2pt;"> </span>sinh:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 21px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">+<span style="letter-spacing: 0.55pt;"> </span></span><span lang="EN">Khi<span style="letter-spacing: 0.65pt;"> </span>lưu<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: 0.05pt;">l</span><span style="letter-spacing: -0.05pt;">ư</span>ợng<span style="letter-spacing: 0.85pt;"> </span>tuần<span style="letter-spacing: 0.65pt;"> </span>hoàn<span style="letter-spacing: 1.25pt;"> </span>mạch<span style="letter-spacing: 1.85pt;"> </span>vành<span style="letter-spacing: 1pt;"> </span>giảm<span style="letter-spacing: 1.55pt;"> </span>dưới<span style="letter-spacing: 0.85pt;"> </span>50%<span style="letter-spacing: 0.85pt;"> </span>mức<span style="letter-spacing: 0.65pt;"> </span>bình<span style="letter-spacing: 1.1pt;"> </span>t<span style="letter-spacing: 0.05pt;">h</span>ường<span style="letter-spacing: 0.85pt;"> </span>thì<span style="letter-spacing: 1.25pt;"> </span>xuất<span style="letter-spacing: 2.7pt;"> </span>hiện cơn<span style="letter-spacing: 1.25pt;"> </span>đau thắt<span style="letter-spacing: -0.2pt;"> </span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: 0.2pt;"> </span>Đa<span style="letter-spacing: 1.5pt;"> </span>số<span style="letter-spacing: 0.85pt;"> </span>nguyên<span style="letter-spacing: 0.85pt;"> </span>nhân<span style="letter-spacing: 0.2pt;"> </span>là<span style="letter-spacing: 1.1pt;"> </span>do<span style="letter-spacing: 0.15pt;"> </span>vữa<span style="letter-spacing: -0.25pt;"> </span>xơ<span style="letter-spacing: 0.8pt;"> </span>làm<span style="letter-spacing: 1pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.05pt;">l</span>òng<span style="letter-spacing: 0.75pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>vành<span style="letter-spacing: -0.2pt;"> </span>(khoảng<span style="letter-spacing: 1.9pt;"> </span>90%).<span style="letter-spacing: 0.25pt;"> </span>Vữa<span style="letter-spacing: 0.25pt;"> </span>xơ<span style="letter-spacing: 0.2pt;"> </span>gây<span style="letter-spacing: 1.45pt;"> </span>ra các<span style="letter-spacing: 0.6pt;"> </span>tổn<span style="letter-spacing: 0.65pt;"> </span>thương<span style="letter-spacing: 0.05pt;"> </span>ở<span style="letter-spacing: 0.05pt;"></span>thành<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>vành,<span style="letter-spacing: 0.1pt;"> </span>g<span style="letter-spacing: -0.05pt;">â</span>y<span style="letter-spacing: 0.6pt;"> </span>hẹp<span style="letter-spacing: -0.85pt;"> </span>ở<span style="letter-spacing: 0.05pt;"> </span>các<span style="letter-spacing: -0.3pt;"> </span>thân<span style="letter-spacing: 1.6pt;"> </span>động<span style="letter-spacing: 1.55pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.2pt;"> </span>(động<span style="letter-spacing: 2pt;"> </span>mạch<span style="letter-spacing: 1.05pt;"> </span>vành<span style="letter-spacing: 0.2pt;"> </span>đoạn <span style="letter-spacing: 0.05pt;">t</span>hượng<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 2.1pt;"> </span>mạc<span style="letter-spacing: 1.3pt;"> </span>và<span style="letter-spacing: -0.55pt;"> </span>động <span style="letter-spacing: 0.15pt;"><span> </span></span>mạch<span style="letter-spacing: 2.25pt;"></span>vành<span style="letter-spacing: 1.35pt;"> </span>đoạn<span style="letter-spacing: -0.7pt;"> </span>gần).<span style="letter-spacing: 0.35pt;"> </span>Các<span style="letter-spacing: 1.1pt;"> </span>tổn<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">hư</span>ơng<span style="letter-spacing: 0.6pt;"> </span>này<span style="letter-spacing: 1.1pt;"> </span>diễn<span style="letter-spacing: -0.25pt;"> </span>tiến<span style="letter-spacing: -0.15pt;"> </span>thành<span style="letter-spacing: 0.95pt;"> </span>từng<span style="letter-spacing: 0.4pt;"> </span>đợt.<span style="letter-spacing: 1pt;"> </span>Bệnh có<span style="letter-spacing: 1.25pt;"> </span>thể<span style="letter-spacing: -0.15pt;"> </span>trầm<span style="letter-spacing: 0.4pt;"> </span>trọng<span style="letter-spacing: 1.1pt;"> </span>hơn<span style="letter-spacing: 1pt;"> </span>nếu<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 1.25pt;"> </span>hiện<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>ượng<span style="letter-spacing: 0.6pt;"> </span>co<span style="letter-spacing: 0.5pt;"> </span>thắt<span style="letter-spacing: 0.4pt;"></span>mạch<span style="letter-spacing: 1.3pt;"> </span>vành,<span style="letter-spacing: 1pt;"> </span>loét<span style="letter-spacing: -0.35pt;"> </span>mảng<span style="letter-spacing: 1.95pt;"> </span>xơ<span style="letter-spacing: 0.6pt;"> </span>vữa, cục<span style="letter-spacing: 0.25pt;"> </span>máu<span style="letter-spacing: 1.85pt;"> </span>đông<span style="letter-spacing: 0.5pt;"> </span>hoặc xuất<span style="letter-spacing: 1.85pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>thành<span style="letter-spacing: 0.35pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 9pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0.3pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span>Một<span style="letter-spacing: -0.2pt;"> </span>số<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span><span style="letter-spacing: -0.05pt;">ư</span>ờng hợp<span style="letter-spacing: -0.35pt;"> </span>không<span style="letter-spacing: 0.25pt;"> </span>do<span style="letter-spacing: -0.1pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>xơ<span style="letter-spacing: -0.15pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: -1pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>:<o:p> </o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.6pt;"> </span>Viêm<span style="letter-spacing: 2.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span>vành,<span style="letter-spacing: 0.35pt;"> </span>viêm<span style="letter-spacing: 1.15pt;"> </span>lỗ<span style="letter-spacing: 1.2pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ành<span style="letter-spacing: 0.6pt;"> </span>do<span style="letter-spacing: 0.45pt;"> </span>giang<span style="letter-spacing: 0.35pt;"> </span>mai,<span style="letter-spacing: 0.4pt;"> </span>bệnh<span style="letter-spacing: -0.2pt;"> </span>viêm<span style="letter-spacing: 0.9pt;"> </span>nút<span style="letter-spacing: 0.3pt;"> </span>quanh<span style="letter-spacing: 0.3pt;"> </span>động </span><span lang="EN">mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.6pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">- Dị<span style="letter-spacing: 0.3pt;"> </span>dạng<span style="letter-spacing: 1pt;"> </span>bẩm<span style="letter-spacing: 1.85pt;"> </span>sinh<span style="letter-spacing: 2.8pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Co<span style="letter-spacing: -0.55pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: 0.3pt;">Mộ</span>t<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: 0.3pt;">s</span>ố<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">nguyê</span>n<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: 0.25pt;">nhâ</span>n<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: 0.25pt;">gâ</span>y<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.3pt;">thiế</span>u<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: 0.25pt;">má</span>u<span style="letter-spacing: 1.95pt;"> </span><span style="letter-spacing: 0.25pt;">c</span>ơ<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">n</span><span style="letter-spacing: 0.3pt;">hưn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">khôn</span>g<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.3pt;">d</span>o<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.25pt;">độn</span>g<span style="letter-spacing: 1.3pt;"> </span><span style="letter-spacing: 0.25pt;">mạc</span>h<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: 0.3pt;">vành:</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.25pt;"> </span>Một<span style="letter-spacing: 0.05pt;"> </span>số<span style="letter-spacing: 0.8pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>tim:<span style="letter-spacing: 0.05pt;"> </span>bệnh<span style="letter-spacing: -0.55pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>chủ,<span style="letter-spacing: -0.15pt;"> </span>bệnh<span style="letter-spacing: -0.45pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span>kh<span style="letter-spacing: -0.05pt;">í</span>t<span style="letter-spacing: 0.7pt;"> </span>lỗ<span style="letter-spacing: 0.85pt;"> </span>van<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.2pt;">ha</span>i<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.15pt;">l</span><span style="letter-spacing: -0.2pt;">á</span>,<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.2pt;">bện</span>h<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.15pt;">s</span>a<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.25pt;">v</span><span style="letter-spacing: -0.15pt;">a</span>n<span style="letter-spacing: -0.55pt;"> </span>2 <span style="letter-spacing: -0.15pt;">lá</span>,<span style="letter-spacing: 0.4pt;"> </span><span style="letter-spacing: -0.2pt;">bện</span>h<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.15pt;">c</span>ơ<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.2pt;">ti</span>m<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.15pt;">ph</span>ì<span style="letter-spacing: 0.55pt;"><span> </span></span><span style="letter-spacing: -0.15pt;">đạ</span>i<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.2pt;">h</span><span style="letter-spacing: -0.25pt;">o</span><span style="letter-spacing: -0.2pt;">ặ</span>c<span style="letter-spacing: -0.65pt;"></span><span style="letter-spacing: -0.2pt;">bện</span>h<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.15pt;">c</span>ơ<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.2pt;">ti</span>m<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.2pt;">t</span><span style="letter-spacing: -0.25pt;">h</span>ể<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.25pt;">g</span><span style="letter-spacing: -0.2pt;">iãn.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thiếu<span style="letter-spacing: -1.15pt;"> </span>máu<span style="letter-spacing: 0.4pt;"> </span>nặng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">+<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">Bằn</span>g <span style="letter-spacing: -0.3pt;">phươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">phá</span>p <span style="letter-spacing: -0.3pt;">chụ</span>p<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">độn</span>g<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.25pt;">vành</span>,<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">ngườ</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">t</span>a<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">nhữn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">t</span><span style="letter-spacing: -0.2pt;">r</span><span style="letter-spacing: -0.3pt;">ườn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">hợ</span>p<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">tổ</span>n <span style="letter-spacing: -0.3pt;">t</span><span style="letter-spacing: -0.25pt;">h</span><span style="letter-spacing: -0.3pt;">ươn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">h</span>ệ<span style="letter-spacing: -0.3pt;"> động </span><span style="letter-spacing: -0.25pt;">mạc</span>h<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.25pt;">vàn</span>h<span style="letter-spacing: -0.05pt;"></span><span style="letter-spacing: -0.3pt;">nhưn</span>g<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">bện</span>h<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">nhâ</span>n<span style="letter-spacing: 0.4pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">lạ</span>i<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g <span style="letter-spacing: 0.85pt;"><span> </span></span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: -0.25pt;">đa</span>u<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">ngực</span>,<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ó<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.25pt;">l</span>à<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ể<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.25pt;">đặ</span>c<span style="letter-spacing: 0.2pt;"> </span><span style="letter-spacing: -0.3pt;">biệ</span>t<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.3pt;">củ</span>a<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">thiế</span>u<span style="letter-spacing: -1.1pt;"> </span><span style="letter-spacing: -0.25pt;">má</span>u<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: -0.25pt;">c</span>ơ<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">cụ</span>c<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>ộ<span style="letter-spacing: -0.35pt;"></span>:<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.3pt;">thể </span><span style="letter-spacing: -0.25pt;">khôn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.25pt;">đa</span>u<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.3pt;">ngực.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">1.3.<span style="letter-spacing: -0.2pt;"> </span>Yếu<span style="letter-spacing: -0.2pt;"> </span>tố<span style="letter-spacing: 1.3pt;"> </span>thuận<span style="letter-spacing: -0.65pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>xuất<span style="letter-spacing: -0.65pt;"> </span>hiện<span style="letter-spacing: 0.45pt;"> </span>cơn<span style="letter-spacing: 0.35pt;"> </span>đau<span style="letter-spacing: -0.8pt;"> </span>ngực:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Xúc<span style="letter-spacing: -0.4pt;"> </span>cảm<span style="letter-spacing: -0.1pt;"> </span>mạnh,<span style="letter-spacing: 1.05pt;"> </span>chấn<span style="letter-spacing: 1.85pt;"> </span>t<span style="letter-spacing: 0.05pt;">h</span>ương tâm<span style="letter-spacing: 0.35pt;"> </span>lý.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- <span style="letter-spacing: 0.05pt;">C</span>ường gi<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.65pt;"> </span>trạng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Cảm<span style="letter-spacing: 0.45pt;"> </span>lạnh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nhịp<span style="letter-spacing: 0.25pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>nhanh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Sốc.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Sau<span style="letter-spacing: -0.9pt;"> </span>ăn<span style="letter-spacing: 0.5pt;"> </span>no.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Những<span style="letter-spacing: 0.2pt;"> </span>yếu<span style="letter-spacing: -0.15pt;"> </span>tố<span style="letter-spacing: 1.15pt;"> </span>này<span style="letter-spacing: 1.3pt;"> </span>chỉ<span style="letter-spacing: 2.1pt;"> </span>gây<span style="letter-spacing: 2.45pt;"> </span>được<span style="letter-spacing: 0.75pt;"> </span>cơn<span style="letter-spacing: 1.9pt;"> </span>đau<span style="letter-spacing: 1.9pt;"> </span>thắt<span style="letter-spacing: 0.35pt;"> </span>ngực<span style="letter-spacing: 0.3pt;"> </span>khi<span style="letter-spacing: 0.4pt;"> </span>động<span style="letter-spacing: 1.15pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">vàn</span>h<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.2pt;">đ</span>ã <span style="letter-spacing: 0.15pt;"><span></span></span><span style="letter-spacing: 0.3pt;">c</span>ó<span style="letter-spacing: 1.55pt;"> </span><span style="letter-spacing: 0.35pt;">í</span>t<span style="letter-spacing: 1.05pt;"> </span><span style="letter-spacing: 0.25pt;">n</span><span style="letter-spacing: 0.3pt;">h</span><span style="letter-spacing: 0.35pt;">i</span><span style="letter-spacing: 0.3pt;">ề</span>u<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: 0.3pt;">b</span>ị<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.25pt;">ổ</span>n <span style="letter-spacing: 0.35pt;">t</span><span style="letter-spacing: 0.3pt;">hươn</span>g<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.25pt;">m</span>à<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">nh</span>u<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.3pt;">cầ</span>u<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">ôx</span>y<span style="letter-spacing: 1.05pt;"></span><span style="letter-spacing: 0.3pt;">củ</span>a<span style="letter-spacing: 0.25pt;"> c</span>ơ<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: 0.3pt;">ti</span>m<span style="letter-spacing: 0.45pt;"> </span><span style="letter-spacing: 0.25pt;">lạ</span>i<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.25pt;">tăn</span>g<span style="letter-spacing: 0.3pt;"><span> </span>hơn.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Cơ<span style="letter-spacing: 1.6pt;"> </span>tim<span style="letter-spacing: 0.9pt;"> </span>bị<span style="letter-spacing: 1.6pt;"> </span>thiếu<span style="letter-spacing: 0.3pt;"> </span>máu,<span style="letter-spacing: 1.45pt;"> </span>chuyển<span style="letter-spacing: 0.35pt;"> </span>hoá<span style="letter-spacing: 1.55pt;"> </span>yếm<span style="letter-spacing: 0.2pt;"> </span>khí,<span style="letter-spacing: -1pt;"> </span>gây<span style="letter-spacing: -1.15pt;"> </span>ứ<span style="letter-spacing: 1.05pt;"> </span>đọng<span style="letter-spacing: -1.05pt;"> </span>axít<span style="letter-spacing: -0.95pt;"> </span>lactic<span style="letter-spacing: 0.75pt;"> </span>làm<span style="letter-spacing: 1.55pt;"> </span>toan<span style="letter-spacing: 0.85pt;"> </span>hoá<span style="letter-spacing: 1.55pt;"> </span>nội<span style="letter-spacing: 0.9pt;"> </span>bào,<span style="letter-spacing: 1.5pt;"> </span>dẫn đến<span style="letter-spacing: 0.5pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: 0.45pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>hoá<span style="letter-spacing: 0.5pt;"> </span>tế<span style="letter-spacing: -0.75pt;"></span>bào<span style="letter-spacing: 1.7pt;"> </span>và<span style="letter-spacing: -0.1pt;"> </span>rối<span style="letter-spacing: 0.65pt;"> </span>loạn<span style="letter-spacing: 0.2pt;"> </span>hoạt<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>dẫn<span style="letter-spacing: 1.85pt;"> </span>truyền<span style="letter-spacing: -0.95pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.<span style="letter-spacing: -0.1pt;"> </span>Triệu<span style="letter-spacing: -2.45pt;"> </span>chứng<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: 0.05pt;">l</span><span style="letter-spacing: -0.05pt;">â</span>m sàng<span style="letter-spacing: -0.75pt;"> </span>và<span style="letter-spacing: 2.5pt;"> </span>cận<span style="letter-spacing: -2.3pt;"> </span><span style="letter-spacing: 0.05pt;">l</span><span style="letter-spacing: -0.05pt;">â</span>m sàng.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.1.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>đau:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">Cơ</span>n <span style="letter-spacing: -0.25pt;">đa</span>u<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.3pt;">khở</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">phá</span>t <span style="letter-spacing: -0.3pt;">ch</span>ủ<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">yế</span>u<span style="letter-spacing: -0.3pt;"> d</span>o<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">gắn</span>g<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">sức</span>,<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">thờ</span>i<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">tiế</span>t<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.25pt;">lạn</span>h<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">sa</span>u<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">ă</span>n <span style="letter-spacing: -0.3pt;">no.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span>Vị<span style="letter-spacing: 0.85pt;"> </span>trí<span style="letter-spacing: 1.8pt;"> </span>đau<span style="letter-spacing: 0.85pt;"> </span>ở<span style="letter-spacing: 0.45pt;"> </span>giữa<span style="letter-spacing: 0.25pt;"> </span>phía<span style="letter-spacing: 0.75pt;"> </span>sau<span style="letter-spacing: 0.45pt;"> </span>xương<span style="letter-spacing: 0.45pt;"> </span>ức;<span style="letter-spacing: 0.3pt;"> </span>đau<span style="letter-spacing: 0.85pt;"> </span>kiểu<span style="letter-spacing: -0.4pt;"> </span>co<span style="letter-spacing: 0.35pt;"> </span>thắt<span style="letter-spacing: 0.25pt;"> </span>đè<span style="letter-spacing: -0.25pt;"> </span>nặng<span style="letter-spacing: 0.2pt;"> </span>hay<span style="letter-spacing: 0.3pt;"> </span>cảm<span style="letter-spacing: 1.15pt;"> </span>giác<span style="letter-spacing: 1.15pt;"> </span>bị<span style="letter-spacing: 0.7pt;"> </span>ép,<span style="letter-spacing: -0.5pt;"> </span>có<span style="letter-spacing: 1.1pt;"> </span>khi<span style="letter-spacing: 0.3pt;"> </span>đau rát,<span style="letter-spacing: 1.45pt;"> </span>đôi<span style="letter-spacing: -0.1pt;"> </span>khi<span style="letter-spacing: -0.1pt;"> </span>gây<span style="letter-spacing: 0.4pt;"> </span>nghẹt<span style="letter-spacing: -0.75pt;"></span>thở.<span style="letter-spacing: -0.15pt;"> </span>Đau<span style="letter-spacing: 1.35pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ường<span style="letter-spacing: 0.05pt;"> </span>lan<span style="letter-spacing: -0.1pt;"> </span>lên<span style="letter-spacing: 0.45pt;"> </span>cổ,<span style="letter-spacing: 0.6pt;"> </span><span style="letter-spacing: 0.05pt;">x</span>ương<span style="letter-spacing: 0.05pt;"> </span>hàm,<span style="letter-spacing: 0.45pt;"> </span>vai;<span style="letter-spacing: -0.5pt;"> </span>hoặc<span style="letter-spacing: -0.2pt;"> </span>lan<span style="letter-spacing: -0.1pt;"> </span>ra<span style="letter-spacing: -0.25pt;"> </span>cánh<span style="letter-spacing: 0.45pt;"> </span>tay,<span style="letter-spacing: -0.15pt;"> </span>bờ<span style="letter-spacing: 0.05pt;"> </span>trong<span style="letter-spacing: -0.2pt;"> </span>của cẳng<span style="letter-spacing: 1.25pt;"> </span>tay<span style="letter-spacing: 0.7pt;"> </span>đến<span style="letter-spacing: 1.35pt;"> </span>tận<span style="letter-spacing: 2.75pt;"> </span>ngón<span style="letter-spacing: 1.3pt;"> </span>4,<span style="letter-spacing: 0.85pt;"> </span>5<span style="letter-spacing: 0.85pt;"> </span>ở<span style="letter-spacing: 0.85pt;"> </span>một<span style="letter-spacing: 0.65pt;"> </span>hoặc<span style="letter-spacing: 0.6pt;"></span>cả<span style="letter-spacing: 1.55pt;"> </span>2<span style="letter-spacing: 0.85pt;"> </span>bên;<span style="letter-spacing: -1.2pt;"> </span>thời<span style="letter-spacing: 0.65pt;"> </span>gian<span style="letter-spacing: 0.65pt;"> </span>của<span style="letter-spacing: 0.5pt;"> </span>cơn<span style="letter-spacing: 1.25pt;"> </span>đau<span style="letter-spacing: 1.25pt;"> </span>thường<span style="letter-spacing: 0.5pt;"> </span>ngắn<span style="letter-spacing: 0.6pt;"> </span>2-5<span style="letter-spacing: 0.5pt;"> </span>phút,<span style="letter-spacing: -0.1pt;"> </span>mất dần<span style="letter-spacing: -0.15pt;"> </span>sau khi<span style="letter-spacing: -0.15pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ưng gắng<span style="letter-spacing: -0.25pt;"> </span>sức hoặc<span style="letter-spacing: -0.25pt;"> </span>dùng<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 1pt;"></span>vành<span style="letter-spacing: 0.15pt;"> </span>(trinitrine).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.2.<span style="letter-spacing: -0.2pt;"> </span>Các<span style="letter-spacing: 0.3pt;"> </span>triệu<span style="letter-spacing: 1.8pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>đi<span style="letter-spacing: 0.5pt;"> </span>kèm<span style="letter-spacing: 0.15pt;"><span> </span></span>với<span style="letter-spacing: -0.15pt;"> </span>cơn<span style="letter-spacing: 0.35pt;"> </span>đau:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Khó<span style="letter-spacing: 0.6pt;"> </span>thở<span style="letter-spacing: -0.15pt;"> </span>nhanh,<span style="letter-spacing: -0.3pt;"> </span>nông.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đánh<span style="letter-spacing: 0.25pt;"> </span>trống<span style="letter-spacing: 0.5pt;"> </span>ngực,<span style="letter-spacing: -0.25pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>hộp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Buồn<span style="letter-spacing: -0.25pt;"> </span>nôn,<span style="letter-spacing: 0.35pt;"> </span>chóng<span style="letter-spacing: 0.55pt;"> </span>mặt,<span style="letter-spacing: -0.2pt;"> </span>vã<span style="letter-spacing: 0.8pt;"> </span>mồ<span style="letter-spacing: 0.6pt;"> </span>hôi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Có<span style="letter-spacing: 0.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ường hợp<span style="letter-spacing: -0.35pt;"> </span>xuất<span style="letter-spacing: 1.85pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>đái<span style="letter-spacing: 0.85pt;"> </span>nhiều.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.3.<span style="letter-spacing: -0.2pt;"> </span>Triệu<span style="letter-spacing: 1.85pt;"> </span>chứng<span style="letter-spacing: 1.75pt;"> </span>về<span style="letter-spacing: -0.7pt;"> </span>điện<span style="letter-spacing: 0.25pt;"> </span>tim.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">2.3.1.<span style="letter-spacing: -0.25pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>ngoài<span style="letter-spacing: 0.9pt;"> </span>c<span style="letter-spacing: -0.05pt;">ơ</span>n<span style="letter-spacing: 0.15pt;"> </span>đau:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-style: italic;">-</span><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;"><span style="letter-spacing: -0.05pt;"> </span></span></span><span lang="EN">Điện<span style="letter-spacing: 0.45pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ó<span style="letter-spacing: 0.6pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>bình<span style="letter-spacing: 0.25pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ường nhưng cũng<span style="letter-spacing: -0.45pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>loại<span style="letter-spacing: -0.45pt;"> </span>trừ<span style="letter-spacing: -0.15pt;"> </span>chẩn<span style="letter-spacing: 1.85pt;"> </span>đoán<span style="letter-spacing: -0.65pt;"> </span>cơn<span style="letter-spacing: 1.1pt;"> </span>đau<span style="letter-spacing: 1.1pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: -0.3pt;">Điệ</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">ti</span>m<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">n</span><span style="letter-spacing: -0.25pt;">goà</span>i<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.25pt;">cơ</span>n<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.3pt;">c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">th</span>ể<span style="letter-spacing: -0.3pt;"> c</span>ó<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">dấ</span>u<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.3pt;">hiệ</span>u<span style="letter-spacing: -0.3pt;"> gợ</span>i<span style="letter-spacing: -0.75pt;"> </span>ý<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: -0.25pt;">tìn</span>h<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.25pt;">trạn</span>g<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.25pt;">thiế</span>u <span style="letter-spacing: 0.65pt;"><span> </span></span><span style="letter-spacing: -0.25pt;">má</span>u<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.25pt;">c</span>ơ<span style="letter-spacing: -0.55pt;"> </span><span style="letter-spacing: -0.3pt;">tim.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đoạn<span style="letter-spacing: 0.25pt;"> </span>ST<span style="letter-spacing: 0.1pt;"> </span>chênh<span style="letter-spacing: 0.55pt;"> </span>xuống<span style="letter-spacing: 0.6pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>>1mm<span style="letter-spacing: -0.3pt;"> </span>ở ít<span style="letter-spacing: 0.7pt;"> </span>nhất<span style="letter-spacing: 1.85pt;"> </span>2 chuyển<span style="letter-spacing: -0.7pt;"> </span>đạo<span style="letter-spacing: 0.8pt;"> </span>3 nhịp<span style="letter-spacing: 0.55pt;"> </span>liên<span style="letter-spacing: 0.35pt;"> </span>tiếp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Són</span>g<span style="letter-spacing: -0.85pt;"> </span>T<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.25pt;">âm</span>,<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">nhọ</span>n<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.25pt;">v</span>à<span style="letter-spacing: -0.4pt;"> </span><span style="letter-spacing: -0.25pt;">đố</span>i<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.3pt;">xứn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">gợ</span>i<span style="letter-spacing: -0.75pt;"> </span>ý<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">thiế</span>u<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: -0.25pt;">má</span>u<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">cụ</span>c<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>ộ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">dướ</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">nộ</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">mạc.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span>Ngoài<span style="letter-spacing: 0.35pt;"> </span>ra,<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>tìm<span style="letter-spacing: 0.35pt;"> </span>thấy<span style="letter-spacing: 1.85pt;"> </span>hình<span style="letter-spacing: 1.3pt;"> </span>ảnh<span style="letter-spacing: -0.45pt;"> </span><span style="letter-spacing: -0.05pt;">s</span>óng<span style="letter-spacing: 0.45pt;"> </span>Q là<span style="letter-spacing: -0.35pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"><span> </span></span>chứng<span style="letter-spacing: -0.3pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>một<span style="letter-spacing: -0.2pt;"> </span>nhồi<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>cũ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic;">2.3.2.<span style="letter-spacing: -0.25pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: 1.25pt;"> </span>lúc<span style="letter-spacing: 0.3pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>cơn<span style="letter-spacing: -0.15pt;"> </span>đau<span style="letter-spacing: 0.65pt;"> </span>thắt<span style="letter-spacing: 1.25pt;"> </span>ngực:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.2pt;"> </span>Hay<span style="letter-spacing: 1.15pt;"> </span>gặp<span style="letter-spacing: 0.8pt;"> </span>nhất<span> </span>là<span style="letter-spacing: 2pt;"> </span>có<span style="letter-spacing: 1.8pt;"> </span>đ<span style="letter-spacing: -0.1pt;">o</span>ạn<span style="letter-spacing: 1.95pt;"> </span>ST<span style="letter-spacing: -0.1pt;"> </span>chênh<span style="letter-spacing: -1pt;"> </span>xuống<span style="letter-spacing: 1.75pt;"> </span>hoặc<span style="letter-spacing: 0.9pt;"> </span>sóng<span style="letter-spacing: 1.8pt;"> </span>T<span style="letter-spacing: 0.8pt;"> </span>đảo<span style="letter-spacing: 1.95pt;"> </span>n<span style="letter-spacing: 0.05pt;">g</span>ược<span style="letter-spacing: 1.15pt;"> </span>(thiếu<span style="letter-spacing: 0.3pt;"> </span>máu<span style="letter-spacing: 1.55pt;"> </span>dưới<span> </span><span style="letter-spacing: -0.7pt;"><span></span></span>nội<span style="letter-spacing: 1pt;"> </span>tâm mạc).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- <span style="letter-spacing: -0.3pt;">Đô</span>i<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.3pt;">kh</span>i<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">kế</span>t<span style="letter-spacing: -0.3pt;"> hợ</span>p<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">vớ</span>i<span style="letter-spacing: -1.05pt;"> </span><span style="letter-spacing: -0.25pt;">tìn</span>h<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">trạn</span>g<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">thiế</span>u<span style="letter-spacing: 1.85pt;"> </span><span style="letter-spacing: -0.25pt;">má</span>u<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.3pt;">cụ</span>c<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">b</span>ộ<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.35pt;">d</span><span style="letter-spacing: -0.3pt;">ướ</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">thượn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">mạc.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.1pt;"> </span>Điện<span style="letter-spacing: 0.8pt;"> </span>tim<span style="letter-spacing: 0.2pt;"> </span>trong<span style="letter-spacing: 0.1pt;"> </span>lúc<span style="letter-spacing: 0.05pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>cơn<span style="letter-spacing: 0.75pt;"> </span>đau<span style="letter-spacing: 0.75pt;"> </span>thắt<span style="letter-spacing: 0.15pt;"> </span>ngực<span style="letter-spacing: 0.1pt;"> </span>còn<span style="letter-spacing: 1pt;"> </span>g<span style="letter-spacing: -0.1pt;">i</span>úp<span style="letter-spacing: -0.25pt;"> </span>xác<span style="letter-spacing: 1.3pt;"> </span>định<span style="letter-spacing: 1.2pt;"> </span>vị<span style="letter-spacing: 0.6pt;"> </span>trí<span style="letter-spacing: 1.3pt;"> </span>vùng<span style="letter-spacing: -0.4pt;"> </span>cơ<span style="letter-spacing: 0.95pt;"> </span>tim<span style="letter-spacing: 0.2pt;"> </span>bị<span style="letter-spacing: 0.9pt;"> </span>thiếu<span style="letter-spacing: -0.4pt;"> </span>máu<span style="letter-spacing: 0.75pt;"> </span>cục bộ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.75pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span style="font-weight: bold;"><span lang="EN" style="font-style: italic; position: relative; top: 0.5pt;">2.3.3.<span style="letter-spacing: -0.25pt;"> </span>Điện<span style="letter-spacing: 1.15pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>gắng<span style="letter-spacing: 1.15pt;"> </span>sức:</span></span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.65pt;"> </span><span style="letter-spacing: -0.05pt;">Đ</span>ược <span style="letter-spacing: -1.35pt;"><span> </span></span>thực<span style="letter-spacing: 1.45pt;"> </span>hiện<span style="letter-spacing: 0.8pt;"> </span>trên<span style="letter-spacing: -0.4pt;"> </span>xe<span style="letter-spacing: 1.65pt;"> </span>đạp, <span style="letter-spacing: 0.1pt;"><span></span></span>có<span style="letter-spacing: 2.3pt;"> </span>gắn<span style="letter-spacing: 1.5pt;"> </span>lực<span style="letter-spacing: 1.5pt;"> </span>kế<span style="letter-spacing: 0.95pt;"> </span>hoặc<span style="letter-spacing: 1.4pt;"> </span>thảm<span style="letter-spacing: 2.05pt;"> </span>lăn;<span style="letter-spacing: -0.55pt;"> </span>chỉ<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.1pt;"><span> </span></span>tiến<span style="letter-spacing: 0.9pt;"> </span>hành<span style="letter-spacing: 2.05pt;"> </span>ở<span style="letter-spacing: 1.65pt;"> </span>các<span style="letter-spacing: 2.4pt;"> </span>cơ<span style="letter-spacing: 2.1pt;"> </span><span style="letter-spacing: 0.05pt;">s</span>ở chuyên<span style="letter-spacing: 1.3pt;"> </span>khoa, dưới<span style="letter-spacing: 0.25pt;"> </span>sự<span style="letter-spacing: 0.25pt;"></span>theo<span style="letter-spacing: 0.05pt;"> </span>dõi<span style="letter-spacing: 0.85pt;"> </span>chặt<span style="letter-spacing: 0.05pt;"> </span>chẽ<span style="letter-spacing: -0.45pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>một<span style="letter-spacing: 0.05pt;"> </span>bác<span style="letter-spacing: 1.2pt;"> </span>sĩ<span style="letter-spacing: 0.7pt;"> </span>nội<span style="letter-spacing: 0.1pt;"> </span>tim-<span style="letter-spacing: 0.05pt;"> </span>mạch<span style="letter-spacing: 0.6pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>kinh<span style="letter-spacing: 0.05pt;"> </span>nghiệm<span style="letter-spacing: -0.5pt;"> </span>và<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>sẵn<span style="letter-spacing: -0.6pt;"> </span>các phương tiện<span style="letter-spacing: -0.75pt;"> </span>cấp<span style="letter-spacing: 1.75pt;"> </span>cứu<span style="letter-spacing: -0.15pt;"> </span>hồi<span style="letter-spacing: 0.6pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.1pt;"> </span>Nghiệm<span style="letter-spacing: -0.65pt;"> </span>pháp<span style="letter-spacing: 0.5pt;"> </span>ghi<span style="letter-spacing: -0.05pt;"> </span>điện<span style="letter-spacing: 0.5pt;"> </span>tim<span style="letter-spacing: -0.05pt;"> </span>gắng<span style="letter-spacing: -0.15pt;"> </span>sức<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.95pt;"> </span>gọi<span style="letter-spacing: 0.7pt;"> </span>là<span style="letter-spacing: 0.05pt;"> </span>“<span style="letter-spacing: -0.05pt;">d</span>ương<span style="letter-spacing: 2.15pt;"> </span>tính”<span style="letter-spacing: 2pt;"> </span>khi thấy<span style="letter-spacing: 2pt;"> </span><span style="letter-spacing: -0.05pt;">x</span>uất hiện<span style="letter-spacing: -0.7pt;"> </span>dòng<span style="letter-spacing: 0.55pt;"> </span>điện<span style="letter-spacing: 0.55pt;"> </span>của thiếu<span style="letter-spacing: -0.15pt;"> </span>máu<span style="letter-spacing: 1pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ưới<span style="letter-spacing: 0.6pt;"> </span>nội<span style="letter-spacing: 0.45pt;"> </span>tâm<span style="letter-spacing: 1.4pt;"></span>mạc,<span style="letter-spacing: 0.7pt;"> </span>với<span style="letter-spacing: 0.15pt;"> </span>sự<span style="letter-spacing: 0.6pt;"> </span>chênh<span style="letter-spacing: 0.8pt;"> </span>xuống<span style="letter-spacing: 1.2pt;"> </span>trên<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">1</span>mm<span style="letter-spacing: 0.4pt;"> </span>của<span style="letter-spacing: 0.25pt;"> </span>đoạn<span> </span><span style="letter-spacing: 0.15pt;"><span></span></span>ST;<span style="letter-spacing: -0.6pt;"> </span>đoạn<span style="letter-spacing: 1.25pt;"> </span>ST<span style="letter-spacing: -0.65pt;"> </span>chênh<span style="letter-spacing: 1.8pt;"> </span>lên<span style="letter-spacing: 0.4pt;"> </span>hiếm gặp<span style="letter-spacing: -0.35pt;"> </span>hơn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.3pt;"> </span>Nghiệm<span style="letter-spacing: 0.55pt;"> </span>pháp<span style="letter-spacing: 0.8pt;"><span> </span></span>“âm<span style="letter-spacing: 1.15pt;"> </span>tính”<span style="letter-spacing: 1.9pt;"> </span>khi<span style="letter-spacing: 1.15pt;"> </span>không<span></span><span style="letter-spacing: 0.7pt;"><span> </span></span>đạt<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.1pt;">đ</span>ược<span style="letter-spacing: 2.15pt;"> </span>các<span style="letter-spacing: 2.3pt;"> </span>tiêu<span style="letter-spacing: -0.9pt;"> </span>chuẩn<span style="letter-spacing: 0.15pt;"><span> </span></span>dương<span style="letter-spacing: 1.3pt;"> </span>tính<span style="letter-spacing: -0.7pt;"> </span>về<span style="letter-spacing: 0.15pt;"> </span>điện<span style="letter-spacing: 1.75pt;"> </span>tâm<span style="letter-spacing: -0.85pt;"> </span>đồ<span style="letter-spacing: -0.8pt;"> </span>như trên,<span style="letter-spacing: -1.15pt;"> </span>mặc<span style="letter-spacing: 0.8pt;"> </span>dù<span style="letter-spacing: 0.7pt;"> </span>tần<span style="letter-spacing: 0.85pt;"> </span>số<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: 0.85pt;"></span>bệnh<span style="letter-spacing: 0.3pt;"> </span>nhân<span style="letter-spacing: -1.05pt;"> </span>đã<span style="letter-spacing: 1.65pt;"> </span>đạt <span style="letter-spacing: 0.6pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 1.8pt;"> </span>tần<span style="letter-spacing: 0.8pt;"> </span>số<span style="letter-spacing: 1.55pt;"> </span>tim<span style="letter-spacing: 0.85pt;"> </span>tối<span style="letter-spacing: 1.55pt;"> </span>đa<span style="letter-spacing: 1.55pt;"> </span>theo<span style="letter-spacing: 0.75pt;"> </span>lý<span style="letter-spacing: 0.85pt;"> </span>thuyết<span style="letter-spacing: 0.1pt;"> </span>(2<span style="letter-spacing: -0.05pt;">2</span>0<span style="letter-spacing: 0.95pt;"> </span>trừ<span style="letter-spacing: 0.8pt;"> </span>đi<span style="letter-spacing: 1.65pt;"> </span>số<span style="letter-spacing: 1.2pt;"> </span>tuổi bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.4.<span style="letter-spacing: -0.2pt;"> </span>Chụp<span style="letter-spacing: 2.35pt;"> </span>X<span style="letter-spacing: -0.1pt;"> </span>quang<span style="letter-spacing: 2.35pt;"> </span>động<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 0.2pt;"> </span>vành:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.55pt;"> </span>Đây<span style="letter-spacing: 0.05pt;"> </span>là<span style="letter-spacing: 1.75pt;"> </span>p<span style="letter-spacing: -0.1pt;">h</span>ương<span style="letter-spacing: 0.9pt;"> </span>pháp<span style="letter-spacing: 1.25pt;"> </span>rất<span style="letter-spacing: 2.8pt;"> </span>có<span style="letter-spacing: 1.55pt;"> </span>giá<span style="letter-spacing: 1.45pt;"> </span>trị<span style="letter-spacing: -1.15pt;"> </span>t<span style="letter-spacing: 0.05pt;">r</span>ong<span style="letter-spacing: 0.65pt;"> </span>chẩn<span style="letter-spacing: 2.75pt;"> </span>đoán<span style="letter-spacing: 1.55pt;"> </span>bệnh<span style="letter-spacing: 0.2pt;"> </span>động<span style="letter-spacing: 1.8pt;"> </span>mạch<span style="letter-spacing: 1.2pt;"> </span>vành.<span style="letter-spacing: 0.95pt;"> </span>Kỹ<span style="letter-spacing: 0.75pt;"> </span>thuật<span style="letter-spacing: 2.9pt;"> </span>này<span style="letter-spacing: 1.4pt;"> </span>giúp đánh<span style="letter-spacing: -0.65pt;"> </span>giá<span style="letter-spacing: 0.15pt;"> </span>tiên<span style="letter-spacing: 1.7pt;"> </span><span style="letter-spacing: 0.05pt;">l</span>ượng và<span style="letter-spacing: 0.8pt;"></span>nguy cơ<span style="letter-spacing: 0.6pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>thiếu<span style="letter-spacing: -0.75pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>cơ<span style="letter-spacing: 0.05pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>gi<span style="letter-spacing: -0.05pt;">ú</span>p<span style="letter-spacing: -0.55pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ỉ định<span style="letter-spacing: -0.35pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>bằng<span style="letter-spacing: 1pt;"> </span>ngoại<span style="letter-spacing: 1.35pt;"> </span>khoa<span style="letter-spacing: -0.25pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>tiến hành<span style="letter-spacing: 0.4pt;"> </span>nong<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.65pt;"> </span>Kết<span style="letter-spacing: -0.25pt;"> </span>quả<span style="letter-spacing: 1.15pt;"> </span>chụp<span style="letter-spacing: 0.2pt;"> </span>X<span style="letter-spacing: 0.5pt;"> </span>quang<span style="letter-spacing: 0.35pt;"> </span>động<span style="letter-spacing: 1.85pt;"> </span>mạch<span style="letter-spacing: 1.4pt;"> </span>vành<span style="letter-spacing: 0.5pt;"> </span>còn<span style="letter-spacing: 1.3pt;"> </span>cho<span style="letter-spacing: 0.5pt;"> </span>thấy<span style="letter-spacing: 2.55pt;"> </span>đặc<span style="letter-spacing: 0.65pt;"> </span>tính<span style="letter-spacing: 1.45pt;"> </span>của<span style="letter-spacing: 0.35pt;"> </span>chỗ<span style="letter-spacing: 1.35pt;"> </span>hẹp:<span style="letter-spacing: -0.4pt;"> </span>hẹp<span style="letter-spacing: -0.25pt;"> </span>một<span style="letter-spacing: 0.5pt;"> </span>chỗ<span style="letter-spacing: 1.35pt;"> </span>hay nhiều<span style="letter-spacing: -0.55pt;"> </span>chỗ;<span style="letter-spacing: 0.85pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span>một,<span style="letter-spacing: 0.05pt;"> </span>hai,<span style="letter-spacing: 0.05pt;"></span>hay<span style="letter-spacing: 0.1pt;"> </span>ba<span style="letter-spacing: 0.15pt;"> </span>thân<span style="letter-spacing: 1.8pt;"> </span>động<span style="letter-spacing: 1.75pt;"> </span>mạch<span style="letter-spacing: 1.15pt;"> </span>vành,<span style="letter-spacing: 0.95pt;"> </span>độ<span style="letter-spacing: -0.05pt;"> </span>dài<span style="letter-spacing: -0.25pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>chỗ<span style="letter-spacing: 0.9pt;"> </span>hẹp,<span style="letter-spacing: -0.8pt;"> </span>chỗ<span style="letter-spacing: 0.9pt;"> </span>hẹp<span style="letter-spacing: -0.65pt;"> </span>có<span style="letter-spacing: 0.9pt;"> </span>gấp<span style="letter-spacing: 1.95pt;"> </span>khúc<span style="letter-spacing: -0.2pt;"> </span>hay không,<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>vôi<span style="letter-spacing: 0.55pt;"> </span>hoá<span style="letter-spacing: 0.75pt;"> </span>hay<span style="letter-spacing: -0.15pt;"> </span>không <span style="letter-spacing: 1.4pt;"><span></span></span>và<span style="letter-spacing: -0.6pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"></span>phát<span style="letter-spacing: 0.45pt;"> </span>hiện<span style="letter-spacing: -0.85pt;"> </span>những t<span style="letter-spacing: -0.05pt;">r</span>ường hợp<span style="letter-spacing: -0.35pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.15pt;"> </span>phối<span style="letter-spacing: 0.4pt;"> </span>hợp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">2.5.<span style="letter-spacing: -0.25pt;"> </span>Một<span style="letter-spacing: 1.15pt;"> </span>số<span style="letter-spacing: 0.55pt;"> </span>xét<span style="letter-spacing: -0.2pt;"> </span>nghiệm<span style="letter-spacing: 1.05pt;"> </span>khác:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Xét<span style="letter-spacing: -0.1pt;"> </span>nghiệm<span style="letter-spacing: 0.05pt;"> </span>enzym<span style="letter-spacing: 0.5pt;"> </span>(SGOT,<span style="letter-spacing: -0.75pt;"> </span>LDH,<span style="letter-spacing: 0.5pt;"> </span><st1:place w:st="on"><st1:city w:st="on">CPK</st1:city>, <st1:state w:st="on">MB</st1:state></st1:place>),<span style="letter-spacing: -0.3pt;"> </span>chụp<span style="letter-spacing: 0.35pt;"> </span>xạ<span style="letter-spacing: 0.6pt;"> </span>hình<span style="letter-spacing: 1pt;"><span> </span></span>cơ<span style="letter-spacing: 1.05pt;"> </span>tim,<span style="letter-spacing: 0.6pt;"> </span>chụp<span style="letter-spacing: 0.35pt;"> </span>buồng<span style="letter-spacing: 1.4pt;"> </span>tim<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 1.45pt;"> </span>đồng<span style="letter-spacing: 0.5pt;"><span> </span></span>vị<o:p></o:p> phóng<span style="letter-spacing: 0.3pt;"> </span>xạ;<span style="letter-spacing: -0.5pt;"> </span>siêu<span style="letter-spacing: 1.25pt;"> </span>âm<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"></span>hai<span style="letter-spacing: -0.15pt;"> </span>chiều<span style="letter-spacing: -0.8pt;"> </span>để<span style="letter-spacing: 0.35pt;"> </span>đánh<span style="letter-spacing: 0.65pt;"> </span>giá<span style="letter-spacing: 1pt;"> </span>mức<span style="letter-spacing: -0.2pt;"> </span>độ<span style="letter-spacing: 0.55pt;"> </span>tổn<span style="letter-spacing: 0.6pt;"> </span>t<span style="letter-spacing: -0.1pt;">h</span>ư<span style="letter-spacing: -0.05pt;">ơ</span>ng cơ<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>do<span style="letter-spacing: -0.2pt;"> </span>thiếu<span style="letter-spacing: -0.75pt;"> </span>máu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.<span style="letter-spacing: -0.1pt;"> </span>Các<span style="letter-spacing: -1.2pt;"> </span>thể<span style="letter-spacing: -1.8pt;"> </span>lâm <span style="letter-spacing: 0.05pt;">sà</span>ng của<span style="letter-spacing: 2pt;"> </span>đau<span style="letter-spacing: -2.25pt;"> </span>thắt<span style="letter-spacing: 1.55pt;"> </span>ngực:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.1.<span style="letter-spacing: -0.2pt;"> </span>Đau<span style="letter-spacing: 2.6pt;"> </span>thắt<span style="letter-spacing: 2.55pt;"> </span>ngực<span style="letter-spacing: 1.15pt;"> </span>ổn<span style="letter-spacing: 1.25pt;"> </span>định<span style="letter-spacing: 0.35pt;"> </span>(<span style="letter-spacing: -0.05pt;"></span>Stable<span style="letter-spacing: 1.8pt;"> </span>angina):</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Cơn<span style="letter-spacing: 1.35pt;"> </span>điển<span style="letter-spacing: 1.35pt;"> </span>hình<span style="letter-spacing: -1.15pt;"> </span>như<span style="letter-spacing: 0.95pt;"> </span>đã<span style="letter-spacing: 0.35pt;"> </span>mô<span style="letter-spacing: 1.75pt;"><span> </span></span>tả<span style="letter-spacing: 1.45pt;"> </span>ở<span style="letter-spacing: 0.95pt;"> </span>trê<span style="letter-spacing: -0.05pt;">n</span>:<span style="letter-spacing: -1.15pt;"> </span>đau<span style="letter-spacing: 1.35pt;"> </span>x<span style="letter-spacing: -0.05pt;">u</span>ất<span style="letter-spacing: 0.75pt;"> </span>hiện<span style="letter-spacing: 0.1pt;"> </span>khi<span style="letter-spacing: 0.8pt;"> </span>gắng<span style="letter-spacing: 0.7pt;"> </span>sức,<span style="letter-spacing: 0.95pt;"> </span>đau<span style="letter-spacing: 1.35pt;"> </span>sau<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: 0.05pt;">x</span>ương<span style="letter-spacing: 0.95pt;"> </span>ức,<span style="letter-spacing: 0.8pt;"> </span>đau<span style="letter-spacing: 1.35pt;"> </span>vùng ngực<span style="letter-spacing: 1.25pt;"> </span>trái<span style="letter-spacing: 2.05pt;"> </span>có<span style="letter-spacing: 2.15pt;"> </span>lan<span style="letter-spacing: 1.35pt;"> </span>ra<span style="letter-spacing: 1.4pt;"> </span>cánh<span style="letter-spacing: 1.9pt;"></span>tay,<span style="letter-spacing: 1.25pt;"> </span>cẳng<span style="letter-spacing: 1.9pt;"> </span>tay;<span style="letter-spacing: 1.3pt;"> </span>hết<span style="letter-spacing: 0.75pt;"> </span>đau<span style="letter-spacing: 1.9pt;"> </span>khi<span style="letter-spacing: 1.35pt;"> </span>ngừng<span style="letter-spacing: 1.5pt;"> </span>gắng<span style="letter-spacing: 1.25pt;"> </span>sức<span style="letter-spacing: 1.45pt;"> </span>hoặc<span style="letter-spacing: 1.25pt;"> </span>dùng<span style="letter-spacing: 1.25pt;"> </span>thuốc<span style="letter-spacing: 2pt;"> </span>giãn<span style="letter-spacing: 1.95pt;"> </span>mạch vành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.2.<span style="letter-spacing: -0.2pt;"> </span>Đau<span style="letter-spacing: 2.6pt;"> </span>thắt<span style="letter-spacing: 2.55pt;"> </span>ngực<span style="letter-spacing: 1.15pt;"> </span>không<span style="letter-spacing: -1pt;"> </span>ổn<span style="letter-spacing: 1.25pt;"> </span>định<span style="letter-spacing: 0.35pt;"> </span>(<span style="letter-spacing: -0.05pt;"></span>Instable <span style="letter-spacing: 0.05pt;"><span> </span></span>angina):</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.5pt;"> </span>Đau<span style="letter-spacing: 1.8pt;"> </span>xuất<span style="letter-spacing: 2.35pt;"> </span>hiện<span style="letter-spacing: -0.35pt;"> </span>khi<span style="letter-spacing: 0.35pt;"> </span>nghỉ<span style="letter-spacing: 1.05pt;"> </span>ngơi,<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.5pt;"> </span>xảy<span style="letter-spacing: 1pt;"> </span>ra<span style="letter-spacing: 0.4pt;"> </span>vào<span style="letter-spacing: 1.05pt;"> </span>ban<span style="letter-spacing: 0.35pt;"> </span>đêm;<span style="letter-spacing: 1pt;"> </span>thời<span style="letter-spacing: 0.3pt;"> </span>gian<span style="letter-spacing: 0.3pt;"> </span>mỗi<span style="letter-spacing: 1.05pt;"> </span>cơn<span style="letter-spacing: 0.9pt;"> </span>đau<span style="letter-spacing: 0.9pt;"> </span>kéo<span style="letter-spacing: -0.4pt;"> </span>dài<span style="letter-spacing: 1.05pt;"> </span>từ<span style="letter-spacing: 0.4pt;"> </span>5-<o:p></o:p>30<span style="letter-spacing: 0.65pt;"> </span>phút,<span style="letter-spacing: 0.15pt;"> </span>mức<span style="letter-spacing: 0.45pt;"> </span>độ<span style="letter-spacing: 1.2pt;"> </span>nặng<span style="letter-spacing: 0.4pt;"></span>của<span style="letter-spacing: 0.3pt;"> </span>bệnh<span style="letter-spacing: -0.05pt;"> </span>tăng<span style="letter-spacing: 0.9pt;"> </span>dần<span style="letter-spacing: 0.5pt;"> </span>lên,<span style="letter-spacing: 1.2pt;"> </span>khả<span style="letter-spacing: -0.05pt;"> </span>năng<span style="letter-spacing: 1.95pt;"> </span>gắng<span style="letter-spacing: 0.4pt;"> </span>sức<span style="letter-spacing: 0.65pt;"> </span>giảm,<span style="letter-spacing: 1pt;"> </span>thời<span style="letter-spacing: 0.45pt;"> </span>gian<span style="letter-spacing: 0.45pt;"> </span>và<span style="letter-spacing: 1.45pt;"> </span>tần<span style="letter-spacing: 0.5pt;"> </span>số<span style="letter-spacing: 1.25pt;"> </span>cơn<span style="letter-spacing: 1.05pt;"> </span>đau cũng<span style="letter-spacing: -0.45pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>dần,<span style="letter-spacing: -0.2pt;"> </span>đáp<span style="letter-spacing: 0.8pt;"> </span>ứng với<span style="letter-spacing: -0.45pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>giãn<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 0.35pt;"></span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.15pt;"> </span>giảm<span style="letter-spacing: 0.7pt;"> </span>dần.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Điện<span style="letter-spacing: 0.6pt;"> </span>tâm<span style="letter-spacing: 0.95pt;"> </span>đồ<span style="letter-spacing: 0.25pt;"> </span>ghi trong<span style="letter-spacing: -0.1pt;"> </span>lúc<span style="letter-spacing: -0.15pt;"> </span>đau<span style="letter-spacing: 0.55pt;"> </span>ngực<span style="letter-spacing: -0.1pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.1pt;"> </span>có<span style="letter-spacing: 0.8pt;"> </span>dấu<span style="letter-spacing: 2pt;"> </span>hiệu<span style="letter-spacing: -0.7pt;"> </span>thiếu<span style="letter-spacing: -0.6pt;"> </span>máu<span style="letter-spacing: 0.55pt;"> </span>nội tâm<span style="letter-spacing: 0.7pt;"> </span>mạc, không<span style="letter-spacing: 1.45pt;"> </span>thấy<span style="letter-spacing: 2pt;"> </span>có dấu<span style="letter-spacing: 1.85pt;"> </span>hiệu<span style="letter-spacing: -0.85pt;"> </span>hoại<span style="letter-spacing: 0.45pt;"> </span>tử<span style="letter-spacing: -0.1pt;"> </span>cơ<span style="letter-spacing: 0.6pt;"> </span>tim<span style="letter-spacing: -0.15pt;"></span>trên<span style="letter-spacing: 0.75pt;"> </span>điện<span style="letter-spacing: -0.1pt;"> </span>tâm<span style="letter-spacing: 0.55pt;"> </span>đồ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span> </span>Xét<span style="letter-spacing: -0.9pt;"> </span>nghiệm<span style="letter-spacing: -0.75pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>enzym<span style="letter-spacing: -0.3pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>giới<span style="letter-spacing: -0.2pt;"> </span>hạn<span style="letter-spacing: -0.45pt;"> </span>bình<span style="letter-spacing: 1.3pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Đây<span style="letter-spacing: -0.85pt;"> </span>là<span style="letter-spacing: 0.85pt;"> </span>hội<span style="letter-spacing: -0.15pt;"> </span>chứng<span style="letter-spacing: -0.3pt;"> </span>đe<span style="letter-spacing: 0.45pt;"> </span>doạ<span style="letter-spacing: 1pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>thà<span style="letter-spacing: -0.05pt;">n</span>h<span style="letter-spacing: 0.7pt;"> </span>nhồi<span style="letter-spacing: 0.6pt;"> </span>máu<span style="letter-spacing: 1.25pt;"> </span>cơ<span style="letter-spacing: 0.1pt;"> </span>tim,<span style="letter-spacing: -0.2pt;"> </span>cần<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 1.3pt;"> </span>được<span style="letter-spacing: 0.55pt;"> </span>điều<span style="letter-spacing: 1.75pt;"> </span>trị<span style="letter-spacing: 0.95pt;"> </span>và<span style="letter-spacing: -0.6pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>dõi<span style="letter-spacing: 0.6pt;"> </span>sát.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">3.3.<span style="letter-spacing: -0.2pt;"> </span>Cơn<span style="letter-spacing: 0.2pt;"> </span>đau<span style="letter-spacing: -0.8pt;"> </span>thắt<span style="letter-spacing: 2.55pt;"> </span>ngực<span style="letter-spacing: 1.15pt;"> </span>kiểu<span style="letter-spacing: 0.45pt;"> </span>Prinzmetal:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Là<span style="letter-spacing: 1pt;"> </span>một<span style="letter-spacing: 0.15pt;"> </span>dạng<span style="letter-spacing: 1.05pt;"> </span>đặc<span style="letter-spacing: 0.75pt;"> </span>biệt<span style="letter-spacing: -0.4pt;"> </span>của cơn<span style="letter-spacing: 0.75pt;"> </span>đau<span style="letter-spacing: 0.75pt;"> </span>thắt<span style="letter-spacing: 0.15pt;"> </span>ngực<span style="letter-spacing: 0.15pt;"> </span>không<span style="letter-spacing: 0.6pt;"> </span>ổn<span style="letter-spacing: 0.9pt;"> </span>định.<span style="letter-spacing: 0.85pt;"> </span>Đau<span style="letter-spacing: 1.65pt;"> </span>tự<span style="letter-spacing: 0.25pt;"> </span>phát,<span style="letter-spacing: 0.15pt;"> </span>không<span style="letter-spacing: 1.7pt;"> </span>liên<span style="letter-spacing: 0.9pt;"> </span>quan<span style="letter-spacing: 0.1pt;"> </span>đến gắng<span style="letter-spacing: 0.5pt;"> </span>sức,<span style="letter-spacing: 0.75pt;"> </span>đau<span style="letter-spacing: 1.15pt;"> </span>dữ<span style="letter-spacing: 0.75pt;"> </span>dội<span style="letter-spacing: 0.6pt;"></span>có<span style="letter-spacing: 1.4pt;"> </span>thể<span style="letter-spacing: 0.05pt;"> </span>gây<span style="letter-spacing: 1.1pt;"> </span>ng<span style="letter-spacing: -0.05pt;">ấ</span>t.<span style="letter-spacing: 2.55pt;"> </span>Cơn<span style="letter-spacing: 1.15pt;"> </span>đau<span style="letter-spacing: 1.15pt;"> </span>kéo<span style="letter-spacing: -0.15pt;"> </span>dài<span style="letter-spacing: 1.35pt;"> </span>5-15<span style="letter-spacing: 0.75pt;"> </span>phút,<span style="letter-spacing: 0.25pt;"> </span>thường<span style="letter-spacing: 0.75pt;"> </span>xảy<span style="letter-spacing: 1.25pt;"> </span>ra<span style="letter-spacing: 0.7pt;"> </span>vào<span style="letter-spacing: 1.35pt;"> </span>những<span style="letter-spacing: 0.75pt;"> </span>giờ<span style="letter-spacing: 0.65pt;"> </span>cố<o:p></o:p> định,<span style="letter-spacing: 0.5pt;"> </span>diễn<span style="letter-spacing: -0.85pt;"> </span>tiến<span style="letter-spacing: -0.75pt;"> </span>theo<span style="letter-spacing: -0.2pt;"> </span>chu<span style="letter-spacing: -0.15pt;"> </span>kỳ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">Đ</span><span style="letter-spacing: 0.05pt;">i</span>ện<span style="letter-spacing: 1.45pt;"> </span><span style="letter-spacing: 0.05pt;">t</span><span style="letter-spacing: -0.05pt;">i</span>m<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>r<span style="letter-spacing: -0.05pt;">o</span>ng<span style="letter-spacing: 0.75pt;"> </span>cơn<span style="letter-spacing: 0.9pt;"> </span>đau<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: 0.05pt;">t</span>hấy<span style="letter-spacing: 0.9pt;"> </span>đ<span style="letter-spacing: -0.05pt;">o</span>ạn<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: 0.05pt;">S</span>T<span style="letter-spacing: -0.35pt;"> </span>chênh<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.05pt;">l</span>ên<span style="letter-spacing: 0.9pt;"> </span>rõ<span style="letter-spacing: 1.55pt;"> </span>r<span style="letter-spacing: -0.05pt;">ệ</span><span style="letter-spacing: 0.05pt;">t</span>,<span style="letter-spacing: 0.15pt;"> </span><span style="letter-spacing: 0.05pt;">í</span>t<span style="letter-spacing: 0.9pt;"> </span>khi<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 1.5pt;"> </span><span style="letter-spacing: 0.05pt;">S</span>T<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>hênh<span style="letter-spacing: 0.9pt;"> </span><span style="letter-spacing: -0.3pt;">xuống</span>,<span style="letter-spacing: 1.1pt;"> </span><span style="letter-spacing: -0.25pt;">khôn</span>g<span style="letter-spacing: 0.95pt;"> </span><span style="letter-spacing: -0.3pt;">thấy són</span>g<span style="letter-spacing: 0.05pt;"> </span>Q<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">hoạ</span>i <span style="letter-spacing: -0.3pt;">tử</span>.<span style="letter-spacing: -0.7pt;"> </span><span style="letter-spacing: -0.25pt;">Ngoà</span>i<span style="letter-spacing: 0.3pt;"></span><span style="letter-spacing: -0.25pt;">cơ</span>n<span style="letter-spacing: -0.25pt;"> đa</span>u<span style="letter-spacing: -0.25pt;"> th</span>ì<span style="letter-spacing: -0.25pt;"> điệ</span>n<span style="letter-spacing: -0.3pt;"> </span><span style="letter-spacing: -0.25pt;">tâ</span>m<span style="letter-spacing: 0.35pt;"> </span><span style="letter-spacing: -0.25pt;">đ</span>ồ<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.25pt;">bìn</span>h<span style="letter-spacing: 0.85pt;"> </span><span style="letter-spacing: -0.3pt;">thườn</span>g<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">hoặ</span>c<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.25pt;">ch</span>ỉ<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">tha</span>y<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">đổ</span>i<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">ít.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">Khôn</span>g<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.3pt;">thấ</span>y<span style="letter-spacing: 1.2pt;"> </span><span style="letter-spacing: -0.25pt;">cá</span>c<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">dấ</span>u<span style="letter-spacing: 1.25pt;"> </span><span style="letter-spacing: -0.3pt;">hiệ</span>u<span style="letter-spacing: -0.35pt;"> </span><span style="letter-spacing: -0.3pt;">sin</span>h<span style="letter-spacing: -0.8pt;"> </span><span style="letter-spacing: -0.25pt;">ho</span>á<span style="letter-spacing: -0.65pt;"> </span><span style="letter-spacing: -0.25pt;">biể</span>u<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">hiệ</span>n<span style="letter-spacing: 2.05pt;"> </span><span style="letter-spacing: -0.25pt;">hoạ</span>i<span style="letter-spacing: -0.3pt;"> t</span>ử<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.25pt;">c</span>ơ<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.3pt;">tim.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="position: relative; top: 0.5pt;">-<span style="letter-spacing: 0.2pt;"> </span>Nguyên<span style="letter-spacing: 0.8pt;"> </span>nhân:<span style="letter-spacing: 0.1pt;"> </span>do<span style="letter-spacing: 0.1pt;"> </span>co<span style="letter-spacing: 0.1pt;"> </span>thắt <span style="letter-spacing: -0.05pt;">m</span>ạch<span style="letter-spacing: 0.7pt;"> </span>vành.<span style="letter-spacing: 0.6pt;"> </span>Diễn<span style="letter-spacing: -0.75pt;"> </span>biến<span style="letter-spacing: -0.65pt;"> </span>bệnh<span style="letter-spacing: -0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ường<span style="letter-spacing: 0.2pt;"> </span>nặng,<span style="letter-spacing: -0.05pt;"> </span>cần<span style="letter-spacing: 0.05pt;"> </span>phải<span style="letter-spacing: 1.2pt;"> </span>được<span style="letter-spacing: 0.4pt;"> </span>điều<span style="letter-spacing: 1.7pt;"> </span>trị<span style="letter-spacing: 1pt;"> </span>khẩn </span><span lang="EN">cấp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 14.7pt; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold; position: relative; top: 0.5pt;">3.4.<span style="letter-spacing: -0.2pt;"> </span>Thiếu<span style="letter-spacing: 1.15pt;"> </span>máu<span style="letter-spacing: 2.1pt;"> </span>cơ<span style="letter-spacing: -0.4pt;"> </span>tim<span style="letter-spacing: 1.1pt;"> </span>cục<span style="letter-spacing: 0.35pt;"> </span>bộ<span style="letter-spacing: 0.6pt;"> </span>thể<span style="letter-spacing: 0.6pt;"> </span>câm:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Bệnh<span style="letter-spacing: -0.6pt;"> </span>nhân<span style="letter-spacing: -1.1pt;"> </span>không<span style="letter-spacing: 1.2pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>triệu<span style="letter-spacing: 0.25pt;"> </span>chứng<span style="letter-spacing: 0.65pt;"> </span>đau<span style="letter-spacing: 1.35pt;"> </span>ngực<span style="letter-spacing: 0.7pt;"> </span>hoặc<span style="letter-spacing: 0.7pt;"> </span>chỉ<span style="letter-spacing: -1.05pt;"> </span>đau<span style="letter-spacing: 1.35pt;"> </span>rất<span style="letter-spacing: 2.85pt;"> </span>nhẹ.<span style="letter-spacing: 0.1pt;"> </span>Nhờ<span style="letter-spacing: 0.75pt;"> </span>có<span style="letter-spacing: 1.6pt;"> </span>ghi<span style="letter-spacing: 0.8pt;"> </span>điện<span style="letter-spacing: 1.35pt;"> </span>tim<span style="letter-spacing: 0.8pt;"> </span>liên<span style="letter-spacing: 1.3pt;"> </span>tục (holte<span style="letter-spacing: -0.05pt;">r</span>)<span style="letter-spacing: 1.15pt;"> </span>m<span style="letter-spacing: -0.05pt;">ớ</span>i<span style="letter-spacing: 1.25pt;"> </span>phát<span style="letter-spacing: 1.9pt;"> </span>hiện<span style="letter-spacing: 0.6pt;"></span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 2.3pt;"> </span>những<span style="letter-spacing: 1.45pt;"> </span>thay<span style="letter-spacing: 1.25pt;"> </span>đổi<span style="letter-spacing: -0.65pt;"> </span>của<span style="letter-spacing: 1.1pt;"> </span>đoạn<span style="letter-spacing: 2.1pt;"> </span>ST;<span style="letter-spacing: 0.25pt;"> </span>một<span style="letter-spacing: 1.25pt;"> </span>số<span style="letter-spacing: 2.05pt;"> </span>được<span style="letter-spacing: 2.3pt;"> </span>chẩn <span style="letter-spacing: 0.3pt;"><span> </span></span>đoán<span style="letter-spacing: 2.1pt;"> </span>nhờ<span style="letter-spacing: 1.45pt;"> </span>biện<span style="letter-spacing: 0.6pt;"> </span>pháp gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.<span style="letter-spacing: -0.1pt;"> </span>Chẩn<span style="letter-spacing: -1.55pt;"> </span>đoán<span style="letter-spacing: -0.55pt;"> </span>và<span style="letter-spacing: 2.5pt;"> </span>chẩn<span style="letter-spacing: -2.1pt;"> </span>đ<span style="letter-spacing: 0.1pt;">o</span>án<span style="letter-spacing: -1.75pt;"> </span>phân<span style="letter-spacing: 1.85pt;"> </span>b<span style="letter-spacing: 0.05pt;">i</span>ệt.</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.1.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: -0.25pt;"> </span>xác<span style="letter-spacing: -0.05pt;"> </span>định:<span style="letter-spacing: 1.85pt;"> </span></span><span lang="EN">dựa<span style="letter-spacing: -0.15pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>các<span style="letter-spacing: 0.75pt;"> </span>yếu<span style="letter-spacing: -0.7pt;"> </span>tố<span style="letter-spacing: 0.6pt;"> </span>sau.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Đặc<span style="letter-spacing: 1.25pt;"> </span>tính<span style="letter-spacing: 0.3pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>cơn<span style="letter-spacing: 0.4pt;"> </span>đau.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.45pt;"> </span>Thay<span style="letter-spacing: 0.95pt;"> </span>đổi<span style="letter-spacing: -0.65pt;"> </span>của<span style="letter-spacing: 1.1pt;"> </span>điện<span style="letter-spacing: 1.85pt;"> </span>tim,<span style="letter-spacing: 1.25pt;"> </span>chủ<span style="letter-spacing: 1.1pt;"> </span>yếu<span style="letter-spacing: 0.75pt;"> </span>đoạn<span style="letter-spacing: 2.1pt;"> </span>ST<span style="letter-spacing: 0.2pt;"> </span>chênh<span style="letter-spacing: -0.8pt;"> </span>xuống<span style="letter-spacing: 2.05pt;"> </span>trong<span style="letter-spacing: 1.2pt;"> </span>lúc<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 2.1pt;"> </span>đau<span style="letter-spacing: 1.85pt;"> </span>ngực<span style="letter-spacing: 1.2pt;"> </span>hoặc<span style="letter-spacing: 1.2pt;"> </span>khi<span style="letter-spacing: 1.3pt;"> </span>làm nghiệm<span style="letter-spacing: -0.75pt;"> </span>ph<span style="letter-spacing: -0.1pt;">á</span>p<span style="letter-spacing: 0.45pt;"> </span>gắng<span style="letter-spacing: -0.25pt;"> </span>sức.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Điều<span style="letter-spacing: 0.45pt;"> </span>trị<span style="letter-spacing: 0.5pt;"> </span>t<span style="letter-spacing: -0.05pt;">h</span>ử<span style="letter-spacing: -0.1pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>thu<span style="letter-spacing: -0.05pt;">ố</span>c<span style="letter-spacing: 0.55pt;"> </span>giãn<span style="letter-spacing: -0.1pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>vành<span style="letter-spacing: -0.2pt;"> </span><span style="letter-spacing: -0.05pt;">ho</span>ặc<span style="letter-spacing: -0.25pt;"> </span>chụp<span style="letter-spacing: -0.45pt;"> </span>xạ<span style="letter-spacing: 0.7pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>đồ<span style="letter-spacing: 0.45pt;"> </span>(nếu<span style="letter-spacing: -0.9pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>điều<span style="letter-spacing: 0.4pt;"> </span>kiệ<span style="letter-spacing: -0.05pt;">n</span>).<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">4.2.<span style="letter-spacing: -0.2pt;"> </span>Chẩn<span style="letter-spacing: -0.55pt;"> </span>đoán<span style="letter-spacing: 0.4pt;"> </span>phân<span style="letter-spacing: 0.5pt;"> </span>b<span style="letter-spacing: 0.1pt;">i</span>ệt<span style="letter-spacing: 0.45pt;"> </span>với<span style="letter-spacing: -0.15pt;"> </span>tất<span style="letter-spacing: -1.15pt;"> </span>cả<span style="letter-spacing: 0.25pt;"> </span>các<span style="letter-spacing: 1.15pt;"> </span>bệnh<span style="letter-spacing: 1.2pt;"> </span>gây<span style="letter-spacing: 0.25pt;"> </span>đau<span style="letter-spacing: -0.8pt;"> </span>vùng<span style="letter-spacing: 0.95pt;"> </span>tim:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Sa<span style="letter-spacing: -0.85pt;"> </span>van<span style="letter-spacing: -0.5pt;"> </span>hai<span style="letter-spacing: -0.15pt;"> </span>lá<span style="letter-spacing: 0.85pt;"></span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 0.2pt;"> </span>mà<span style="letter-spacing: -0.05pt;">n</span>g<span style="letter-spacing: -0.6pt;"> </span>ngoài<span style="letter-spacing: 0.35pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Phình<span style="letter-spacing: 0.25pt;"> </span>bóc<span style="letter-spacing: 0.65pt;"> </span>tách<span style="letter-spacing: -0.1pt;"> </span>thành<span style="letter-spacing: 0.7pt;"> </span>động<span style="letter-spacing: 1.2pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>chủ.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Viêm<span style="letter-spacing: 0.2pt;"> </span>co<span style="letter-spacing: -0.1pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"> </span>thực<span style="letter-spacing: -0.2pt;"> </span>quản.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">ú</span>i<span style="letter-spacing: -0.3pt;"> </span>mật.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thoát<span style="letter-spacing: 2.4pt;"> </span>vị<span style="letter-spacing: 0.1pt;"> </span>cơ<span style="letter-spacing: 0.25pt;"> </span>hành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">Viê</span>m<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.3pt;">sụ</span>n<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">sườn</span>;<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">vô</span>i<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">ho</span>á<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.3pt;">sụ</span>n<span style="letter-spacing: -0.95pt;"> </span><span style="letter-spacing: -0.3pt;">sườn</span>;<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.3pt;">th</span><span style="letter-spacing: -0.4pt;">o</span><span style="letter-spacing: -0.35pt;">á</span>i<span style="letter-spacing: -0.6pt;"> </span><span style="letter-spacing: -0.25pt;">ho</span>á<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.3pt;">khớ</span>p<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">vai</span>;<span style="letter-spacing: -1.15pt;"> </span><span style="letter-spacing: -0.3pt;">khớ</span>p<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.3pt;">cộ</span>t<span style="letter-spacing: -0.75pt;"> </span><span style="letter-spacing: -0.3pt;">sốn</span>g<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.25pt;">l</span><span style="letter-spacing: -0.3pt;">ưng.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.6pt;"> </span>Cũng<span style="letter-spacing: -0.8pt;"> </span>cần<span style="letter-spacing: -0.15pt;"> </span>phân<span style="letter-spacing: 0.25pt;"> </span>biệt<span style="letter-spacing: -0.75pt;"> </span>c<span style="letter-spacing: -0.05pt;">ơ</span>n<span style="letter-spacing: 0.65pt;"> </span>đau<span style="letter-spacing: 0.65pt;"> </span>vùng<span style="letter-spacing: -0.75pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>thuộc<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.05pt;">bệ</span>nh<span style="letter-spacing: -0.7pt;"> </span>tâm<span style="letter-spacing: 0.35pt;"> </span>căn.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.45pt;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.<span style="letter-spacing: -0.1pt;"> </span>Điều<span style="letter-spacing: -0.85pt;"> </span>trị<span style="letter-spacing: -2.05pt;"> </span>và <span style="letter-spacing: 2.5pt;"><span></span></span>dự<span style="letter-spacing: -1.65pt;"> </span>phòng:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.1.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>cắt<span style="letter-spacing: 1.25pt;"> </span>cơn<span style="letter-spacing: 0.35pt;"> </span>đau<span style="letter-spacing: -0.8pt;"> </span>thắt<span style="letter-spacing: 2.55pt;"> </span>ngực:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Để<span style="letter-spacing: 0.55pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>ở tư thế<span style="letter-spacing: -0.75pt;"> </span>nửa<span style="letter-spacing: -0.15pt;"> </span>nằm<span style="letter-spacing: 0.45pt;"> </span>nửa<span style="letter-spacing: -0.15pt;"> </span>ngồi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Tránh<span style="letter-spacing: 0.35pt;"> </span>di<span style="letter-spacing: -0.1pt;"> </span>chuyển<span style="letter-spacing: -0.7pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>cơn<span style="letter-spacing: 0.4pt;"> </span>đau<span style="font-weight: bold;">.</span><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Thuốc<span style="letter-spacing: 0.3pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.15pt;"> </span>nhóm<span style="letter-spacing: 0.55pt;"> </span>nitrit<span style="letter-spacing: -0.25pt;"> </span>:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.15pt;"> </span>Nitrogl<span style="letter-spacing: -0.05pt;">y</span>ce<span style="letter-spacing: -0.05pt;">r</span>in<span style="letter-spacing: -0.5pt;"> </span>đặt<span style="letter-spacing: 0.65pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ư<span style="letter-spacing: 0.05pt;">ớ</span>i<span style="letter-spacing: 0.1pt;"> </span><span style="letter-spacing: -0.05pt;">l</span>ưỡi<span style="letter-spacing: 0.1pt;"> </span>0,15-0,6 mg<span style="letter-spacing: -0.45pt;"> </span>để<span style="letter-spacing: 0.8pt;"> </span>cắt<span style="letter-spacing: -0.05pt;"> </span>cơn<span style="letter-spacing: 0.5pt;"> </span>đau<span style="letter-spacing: 0.5pt;"> </span>ngay<span style="letter-spacing: -0.15pt;"> </span>sau<span style="letter-spacing: 0.1pt;"> </span>1-2<span style="letter-spacing: 0.1pt;"> </span>phút,<span style="letter-spacing: -0.4pt;"> </span>có<span style="letter-spacing: 0.75pt;"> </span>thể<span style="letter-spacing: -0.65pt;"> </span>dùng<span style="letter-spacing: -0.15pt;"> </span>lại<span style="letter-spacing: 0.8pt;"> </span>nhiều lần<span style="letter-spacing: -0.15pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>ngày.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Loại<span style="letter-spacing: 0.45pt;"> </span>dung dịch<span style="letter-spacing: 0.25pt;"> </span>nitroglycerin<span style="letter-spacing: -0.6pt;"> </span>1% cho<span style="letter-spacing: -0.15pt;"> </span>1- 3 giọt<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: 0.05pt;">d</span>ưới <span style="letter-spacing: 0.05pt;">l</span>ưỡi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Loại<span style="letter-spacing: 0.45pt;"> </span>ống<span style="letter-spacing: 0.5pt;"> </span>nitrit<span style="letter-spacing: -0.25pt;"> </span>amyl:<span style="letter-spacing: -0.25pt;"> </span>bẻ<span style="letter-spacing: -0.7pt;"> </span>vỡ<span style="letter-spacing: -0.5pt;"> </span>ống<span style="letter-spacing: 0.5pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>cho<span style="letter-spacing: -0.15pt;"> </span>bệnh<span style="letter-spacing: -0.7pt;"> </span>nhân<span style="letter-spacing: 0.25pt;"> </span>ngửi.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Ngoài<span style="letter-spacing: 0.35pt;"> </span>ra<span style="letter-spacing: -0.1pt;"> </span>còn<span style="letter-spacing: 0.65pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>dạng<span style="letter-spacing: 0.4pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>bơm<span style="letter-spacing: 0.65pt;"> </span>xịt<span style="letter-spacing: 0.25pt;"> </span>hoặc<span style="letter-spacing: -0.25pt;"> </span>dạng<span style="letter-spacing: 0.4pt;"> </span>cao<span style="letter-spacing: -0.15pt;"> </span>dán<span style="letter-spacing: 0.05pt;"> </span>ngoài<span style="letter-spacing: 1.35pt;"> </span>da.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1pt;"> </span>Các<span style="letter-spacing: 1.5pt;"> </span>bệnh<span style="letter-spacing: 0.3pt;"> </span>nhân<span style="letter-spacing: -1.05pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>triệu<span style="letter-spacing: 0.35pt;"> </span>chứng<span style="letter-spacing: 0.7pt;"> </span>đau<span style="letter-spacing: 1.4pt;"> </span>thắt<span style="letter-spacing: 0.85pt;"> </span>ngực<span style="letter-spacing: 0.75pt;"> </span>phải<span style="letter-spacing: 1.55pt;"> </span>có<span style="letter-spacing: 1.65pt;"> </span>sẵn<span style="letter-spacing: 0.15pt;"> </span>bên<span style="letter-spacing: -1.15pt;"> </span>mình<span style="letter-spacing: -1.1pt;"> </span>loại<span style="letter-spacing: 1.55pt;"> </span>thuốc<span style="letter-spacing: 1.55pt;"> </span>nitrit<span style="letter-spacing: 0.8pt;"> </span>tác<span style="letter-spacing: 1.6pt;"> </span>dụng nhanh.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">. Chú<span style="letter-spacing: -0.8pt;"> </span>ý thuốc<span style="letter-spacing: 0.5pt;"> </span>này<span style="letter-spacing: 0.75pt;"> </span>gây<span style="letter-spacing: 1.9pt;"> </span>hạ<span style="letter-spacing: -0.35pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp,<span style="letter-spacing: 0.6pt;"> </span>nếu<span style="letter-spacing: -0.7pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp<span style="letter-spacing: -0.35pt;"> </span>tâm<span style="letter-spacing: 1.95pt;"> </span>thu<span style="letter-spacing: -0.15pt;"> </span><span style="letter-spacing: -0.1pt;">d</span>ưới 90 mmHg<span style="letter-spacing: -0.35pt;"> </span>thì<span style="letter-spacing: 1.15pt;"> </span>không <span style="letter-spacing: 1pt;"><span> </span></span><span style="letter-spacing: 0.05pt;">đ</span>ược<span style="letter-spacing: 0.2pt;"> </span>dùng.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.15pt;"> </span>Thuốc<span style="letter-spacing: 0.5pt;"> </span>chẹn<span style="letter-spacing: -0.5pt;"> </span>dòng<span style="letter-spacing: 0.6pt;"> </span>can<span style="letter-spacing: -0.05pt;">x</span>i:<span style="letter-spacing: 0.15pt;"> </span>nifedipine<span style="letter-spacing: 2.85pt;"> </span>với<span style="letter-spacing: -0.25pt;"> </span>10<span style="letter-spacing: 0.15pt;"> </span>mg có<span style="letter-spacing: 0.8pt;"> </span>thể<span style="letter-spacing: 2.6pt;"> </span>cắt<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.1pt;">đ</span>ược<span style="letter-spacing: 0.4pt;"> </span>cơn<span style="letter-spacing: 1.55pt;"> </span>đau,<span style="letter-spacing: 2.1pt;"> </span>thuốc<span style="letter-spacing: 0.7pt;"> </span>còn<span style="letter-spacing: 0.85pt;"> </span>có<span style="letter-spacing: 0.85pt;"> </span>tác<span style="letter-spacing: 0.8pt;"> </span>dụng hạ<span style="letter-spacing: 0.7pt;"> </span>huyết<span style="letter-spacing: -0.8pt;"> </span>áp.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.2.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>khi<span style="letter-spacing: 1.25pt;"> </span>hết<span style="letter-spacing: 0.6pt;"> </span>cơn<span style="letter-spacing: 0.35pt;"> </span>đau:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Bệnh<span style="letter-spacing: 0.45pt;"> </span>nhân<span style="letter-spacing: -0.05pt;"> </span>vẫn<span style="letter-spacing: 1.55pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>ng<span style="letter-spacing: -0.05pt;">h</span>ỉ ngơi<span style="letter-spacing: 1.15pt;"> </span>hoàn<span style="letter-spacing: 0.7pt;"> </span>toàn<span style="letter-spacing: 0.45pt;"> </span>để<span style="letter-spacing: -0.7pt;"> </span>giảm<span style="letter-spacing: 1pt;"> </span>hoạt<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 1.8pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>tim.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.25pt;"> </span>Loại<span style="letter-spacing: 1.7pt;"> </span>bỏ<span style="letter-spacing: 1.8pt;"> </span>những<span style="letter-spacing: 1.25pt;"> </span>yếu<span style="letter-spacing: 0.55pt;"> </span>tố<span style="letter-spacing: 1.8pt;"> </span>làm<span style="letter-spacing: 1.75pt;"> </span>khởi<span style="letter-spacing: 1.05pt;"> </span>phát<span style="letter-spacing: 1.45pt;"> </span>cơn<span style="letter-spacing: 1.65pt;"> </span>đau,<span style="letter-spacing: 2.15pt;"> </span>hoạt<span style="letter-spacing: 1.45pt;"> </span>động <span style="letter-spacing: 0.1pt;"><span> </span></span>nhẹ<span style="letter-spacing: 0.55pt;"> </span>nhàng,<span style="letter-spacing: 1.55pt;"> </span>ăn<span style="letter-spacing: -0.9pt;"> </span>ít<span style="letter-spacing: 1.95pt;"> </span>muối,<span style="letter-spacing: 1.8pt;"> </span>tránh<span style="letter-spacing: 1.6pt;"> </span>lạnh, tránh<span style="letter-spacing: 1.3pt;"> </span>các<span style="letter-spacing: -0.15pt;"> </span>xúc<span style="letter-spacing: -0.35pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>quá<span style="letter-spacing: -0.2pt;"></span>mức,<span style="letter-spacing: -0.25pt;"> </span>bỏ<span style="letter-spacing: 0.55pt;"> </span>hút<span style="letter-spacing: -0.3pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>lá.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.05pt;"> </span>Điều<span style="letter-spacing: 1.5pt;"> </span>trị<span style="letter-spacing: -1pt;"> </span>bệnh<span style="letter-spacing: 0.35pt;"> </span>thiếu<span style="letter-spacing: 0.35pt;"> </span>máu,<span style="letter-spacing: 1.45pt;"> </span>bệnh<span style="letter-spacing: 0.35pt;"> </span>tăng<span style="letter-spacing: -1pt;"> </span>huyết<span style="letter-spacing: 0.25pt;"> </span>áp,<span style="letter-spacing: 1.65pt;"> </span>bệnh<span style="letter-spacing: 0.35pt;"> </span>đái th<span style="letter-spacing: -0.1pt;">á</span>o <span style="letter-spacing: 0.8pt;"><span> </span></span><span style="letter-spacing: -0.05pt;">đ</span>ường;<span style="letter-spacing: 1.05pt;"> </span>dùng<span style="letter-spacing: 0.8pt;"> </span>các<span style="letter-spacing: 1.6pt;"> </span>biện<span style="letter-spacing: 0.2pt;"> </span>pháp<span style="letter-spacing: 2.05pt;"> </span>làm giảm<span style="letter-spacing: 0.1pt;"> </span>cân<span style="letter-spacing: 0.55pt;"> </span>nặng<span style="letter-spacing: -0.25pt;"> </span>đối<span style="letter-spacing: 0.35pt;"> </span>với<span style="letter-spacing: -0.45pt;"></span>người béo<span style="letter-spacing: -0.9pt;"> </span>và<span style="letter-spacing: -0.45pt;"> </span>giảm <span style="letter-spacing: 0.1pt;"><span> </span></span>mỡ<span style="letter-spacing: -0.15pt;"> </span>máu<span style="letter-spacing: 0.15pt;"> </span>đối<span style="letter-spacing: 0.55pt;"> </span>với<span style="letter-spacing: -0.45pt;"> </span>người có<span style="letter-spacing: 0.65pt;"> </span>tăng<span style="letter-spacing: 0.25pt;"> </span>lipit<span style="letter-spacing: -0.4pt;"> </span>máu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nếu<span style="letter-spacing: -0.85pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>suy<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>phải<span style="letter-spacing: 0.5pt;"> </span>d<span style="letter-spacing: -0.05pt;">ù</span>ng<span style="letter-spacing: -0.25pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span><span style="letter-spacing: 0.05pt;">c</span><span style="letter-spacing: -0.05pt;">ư</span>ờng tim<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.8pt;"> </span>lợi<span style="letter-spacing: -0.15pt;"> </span>tiểu.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Dùng<span style="letter-spacing: -0.55pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>giãn<span style="letter-spacing: 0.2pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.15pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ư:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 1.9pt;"> </span>Nhóm<span style="letter-spacing: 2.25pt;"> </span>nitrat<span style="letter-spacing: 1.7pt;"> </span>và <span style="letter-spacing: 0.55pt;"><span></span></span>dẫn <span style="letter-spacing: 0.75pt;"><span></span></span>chất:<span style="letter-spacing: 0.85pt;"><span> </span></span>Có<span style="letter-spacing: 2.05pt;"> </span>thể<span style="letter-spacing: 1.2pt;"> </span>dùng<span style="letter-spacing: 1.65pt;"> </span>loại <span style="letter-spacing: 0.5pt;"><span> </span></span>tác<span style="letter-spacing: 2.3pt;"> </span>dụng<span style="letter-spacing: 1.65pt;"> </span>chậm<span style="letter-spacing: 0.85pt;"><span> </span></span>n<span style="letter-spacing: -0.05pt;">h</span>ư <span style="letter-spacing: -1.1pt;"><span></span></span>:<span style="letter-spacing: 1.9pt;"> </span>lenitr<span style="letter-spacing: -0.05pt;">a</span>l<span style="letter-spacing: 1.6pt;"> </span>(nitroglyceri<span style="letter-spacing: -0.05pt;">n</span>)<o:p></o:p> 2,5mg,<span style="letter-spacing: -0.05pt;"> </span>2-<span style="letter-spacing: 0.3pt;"> </span>4<span style="letter-spacing: 0.3pt;"> </span>viên<span style="letter-spacing: 0.65pt;"> </span>một<span style="letter-spacing: 0.1pt;"> </span>ngày,<span style="letter-spacing: 0.65pt;"></span>thuốc<span style="letter-spacing: 0.8pt;"> </span>t<span style="letter-spacing: -0.1pt;">á</span>c<span style="letter-spacing: 0.9pt;"> </span>dụng chậm<span style="letter-spacing: 2.2pt;"> </span>hơn<span style="letter-spacing: 0.7pt;"> </span>so<span style="letter-spacing: 0.2pt;"> </span>với<span style="letter-spacing: -0.15pt;"> </span>nitroglycerin<span style="letter-spacing: -0.3pt;"> </span>dạng<span style="letter-spacing: 0.7pt;"> </span>nhỏ<span style="letter-spacing: 0.8pt;"> </span><span style="letter-spacing: -0.05pt;">d</span>ưới<span style="letter-spacing: 0.3pt;"> </span>lưỡi<span style="letter-spacing: 0.3pt;"> </span>n<span style="letter-spacing: -0.05pt;">h</span>ưng tác<span style="letter-spacing: 0.6pt;"> </span>dụng<span style="letter-spacing: -0.25pt;"> </span>kéo<span style="letter-spacing: -0.9pt;"> </span>dài.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: -0.1pt;"> </span><span style="letter-spacing: -0.7pt;">Nhó</span>m<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.65pt;">c</span><span style="letter-spacing: -0.7pt;">hẹ</span>n<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.7pt;">th</span>ụ<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.6pt;">cả</span>m<span style="letter-spacing: 0.75pt;"> </span><span style="letter-spacing: -0.7pt;">th</span>ể<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.65pt;">bêta</span>:<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.7pt;">proprano</span><span style="letter-spacing: -0.65pt;">l</span><span style="letter-spacing: -0.75pt;">o</span>l<span style="letter-spacing: -0.85pt;"> </span><span style="letter-spacing: -0.7pt;">40</span><span style="letter-spacing: -0.65pt;">m</span><span style="letter-spacing: -0.7pt;">g</span>,<span style="letter-spacing: 0.05pt;"> </span><span style="letter-spacing: -0.7pt;">liề</span>u<span style="letter-spacing: -0.5pt;"> </span><span style="letter-spacing: -0.7pt;">dùn</span>g <span style="letter-spacing: -0.7pt;">80-12</span>0<span style="letter-spacing: 0.25pt;"> </span><span style="letter-spacing: -0.7pt;">mg/2</span>4<span style="letter-spacing: -0.05pt;"> </span><span style="letter-spacing: -0.7pt;">g</span><span style="letter-spacing: -0.65pt;">i</span><span style="letter-spacing: -0.7pt;">ờ</span>.<span style="letter-spacing: 0.55pt;"> </span>L<span style="letter-spacing: -0.05pt;">o</span>ại<span style="letter-spacing: 1.35pt;"> </span>thuốc<span style="letter-spacing: 1.7pt;"> </span>này<span style="letter-spacing: 1.8pt;"> </span>làm giảm<span style="letter-spacing: 1pt;"> </span>tiêu<span style="letter-spacing: 1.45pt;"> </span>thụ<span style="letter-spacing: 0.6pt;"> </span>ôxy<span style="letter-spacing: 1.3pt;"></span>của<span style="letter-spacing: 0.55pt;"> </span>cơ<span style="letter-spacing: 1.5pt;"> </span>tim,<span style="letter-spacing: 0.7pt;"> </span>làm<span style="letter-spacing: 1.4pt;"> </span>chậm<span style="letter-spacing: 2.8pt;"> </span>nhịp<span style="letter-spacing: 1.2pt;"> </span>t<span style="letter-spacing: -0.05pt;">i</span>m<span style="letter-spacing: 0.75pt;"> </span>và<span style="letter-spacing: 1.55pt;"> </span>hạ<span style="letter-spacing: 1.95pt;"> </span>huyết<span style="letter-spacing: 0.1pt;"> </span>áp.<span style="letter-spacing: 0.25pt;"> </span>Khô<span style="letter-spacing: -0.1pt;">n</span>g <span style="letter-spacing: 0.75pt;"><span> </span></span>nên<span style="letter-spacing: 1.9pt;"> </span>dừng<span style="letter-spacing: 0.9pt;"> </span>đột<span style="letter-spacing: 1.35pt;"> </span>ngột<span style="letter-spacing: 0.7pt;"> </span>thuốc này<span style="letter-spacing: 1.2pt;"> </span>vì<span style="letter-spacing: 0.35pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>gây<span style="letter-spacing: 1.45pt;"> </span>tái<span style="letter-spacing: -0.45pt;"> </span>phát<span style="letter-spacing: 0.7pt;"> </span>cơn<span style="letter-spacing: 0.9pt;"> </span>đau<span style="letter-spacing: 0.9pt;"> </span>thắt<span style="letter-spacing: -0.2pt;"></span>ngực.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 1.35pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">.<span style="letter-spacing: 0.9pt;"> </span>Nhóm<span style="letter-spacing: 1.15pt;"> </span>c<span style="letter-spacing: -0.05pt;">h</span>ẹn<span style="letter-spacing: 0.05pt;"> </span>dòng<span style="letter-spacing: 1.35pt;"> </span>ca<span style="letter-spacing: -0.05pt;">n</span>xi:<span style="letter-spacing: 0.7pt;"> </span>nifedipin<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: 0.65pt;"> </span>các<span style="letter-spacing: 1.4pt;"> </span><span style="letter-spacing: -0.05pt;">t</span>huốc<span style="letter-spacing: 1.3pt;"> </span>diltia<span style="letter-spacing: -0.05pt;">z</span>em,<span style="letter-spacing: 0.4pt;"> </span>verap<span style="letter-spacing: -0.1pt;">a</span>mil, amlodipine.<span style="letter-spacing: 0.25pt;"> </span>Các thuốc<span style="letter-spacing: 0.9pt;"> </span>này<span style="letter-spacing: 0.9pt;"> </span>có<span style="letter-spacing: 1.05pt;"> </span>tác<span style="letter-spacing: 1pt;"> </span>dụng<span style="letter-spacing: 0.15pt;"> </span>làm<span style="letter-spacing: 0.4pt;"></span>g<span style="letter-spacing: -0.05pt;">i</span>ảm<span style="letter-spacing: 1.4pt;"> </span>tần<span style="letter-spacing: 0.25pt;"> </span>suất<span style="letter-spacing: 2.25pt;"> </span>cơn<span style="letter-spacing: 0.8pt;"> </span>đau<span style="letter-spacing: 0.8pt;"> </span>n<span style="letter-spacing: 0.05pt;">h</span>ưng<span style="letter-spacing: 0.45pt;"> </span>ch<span style="letter-spacing: -0.05pt;">ư</span>a<span style="letter-spacing: 0.4pt;"> </span>rõ<span style="letter-spacing: 1.05pt;"> </span>có<span style="letter-spacing: 1pt;"> </span>thể<span style="letter-spacing: -0.3pt;"> </span>thay<span style="letter-spacing: 0.25pt;"> </span>đổi<span style="letter-spacing: 2pt;"> </span>đư<span style="letter-spacing: -0.05pt;">ợ</span>c<span style="letter-spacing: 0.65pt;"> </span>tiến<span style="letter-spacing: -0.4pt;"> </span>triển<span style="letter-spacing: -0.25pt;"> </span><span style="letter-spacing: -0.05pt;">c</span>ủa bệnh<span style="letter-spacing: -0.05pt;"> </span>tim<span style="letter-spacing: 0.5pt;"> </span>do<span style="letter-spacing: 0.55pt;"> </span>thiếu<span style="letter-spacing: -0.1pt;"> </span>máu<span style="letter-spacing: 1.05pt;"> </span>cục<span style="letter-spacing: 0.3pt;"> </span>bộ<span style="letter-spacing: 0.65pt;"> </span>hay<span style="letter-spacing: 0.45pt;"> </span>không?<span style="letter-spacing: 0.9pt;"></span>thuốc<span style="letter-spacing: 1.15pt;"> </span>này<span style="letter-spacing: 1.15pt;"> </span>có<span style="letter-spacing: 1.3pt;"> </span>thể<span style="letter-spacing: -0.1pt;"> </span>dùng<span style="letter-spacing: 0.4pt;"> </span>thay<span style="letter-spacing: 0.45pt;"> </span>thế<span style="letter-spacing: -0.1pt;"> </span>cho<span style="letter-spacing: 0.5pt;"> </span>thuốc<span style="letter-spacing: 1.15pt;"> </span>chẹn<span style="letter-spacing: -0.05pt;"> </span>thụ<span style="letter-spacing: 0.35pt;"> </span>cảm thể<span style="letter-spacing: -0.75pt;"> </span>bêta<span style="letter-spacing: 0.3pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>các<span style="letter-spacing: 0.55pt;"> </span>chống<span style="letter-spacing: 0.55pt;"> </span>chỉ<span style="letter-spacing: 0.55pt;"> </span>định:<span style="letter-spacing: -0.55pt;"> </span>nhịp<span style="letter-spacing: 1.1pt;"> </span>tim<span style="letter-spacing: -0.15pt;"> </span>ch<span style="letter-spacing: -0.05pt;">ậ</span><span style="letter-spacing: 0.05pt;">m</span>,<span style="letter-spacing: 1.8pt;"> </span>hen<span style="letter-spacing: -0.15pt;"> </span>phế<span style="letter-spacing: -0.9pt;"></span>quản.v.v.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">Người ta<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>phối<span style="letter-spacing: 0.4pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>2 hoặc<span style="letter-spacing: -0.25pt;"> </span>3 l<span style="letter-spacing: 0.05pt;">o</span>ại<span style="letter-spacing: 0.7pt;"> </span>thuốc<span style="letter-spacing: 0.5pt;"> </span>trên<span style="letter-spacing: 0.3pt;"> </span>trong<span style="letter-spacing: -0.25pt;"> </span>điều<span style="letter-spacing: 0.7pt;"> </span>trị<span style="letter-spacing: 0.3pt;"> </span>.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.9pt;"> </span>Nhóm<span style="letter-spacing: 1.2pt;"> </span>thuốc<span style="letter-spacing: 1.4pt;"> </span>ức<span style="letter-spacing: 0.8pt;"> </span>chế<span style="letter-spacing: 0.2pt;"> </span>kết<span style="letter-spacing: 0.15pt;"> </span>dính<span style="letter-spacing: -1.2pt;"> </span>tiểu<span style="letter-spacing: 0.15pt;"> </span>cầu<span style="letter-spacing: 0.75pt;"></span>:<span style="letter-spacing: 0.85pt;"> </span>asp<span style="letter-spacing: -0.05pt;">i</span>rin<span style="letter-spacing: 0.4pt;"> </span>hoặc<span style="letter-spacing: 0.65pt;"> </span>aspegic<span style="letter-spacing: 0.55pt;"> </span>với<span style="letter-spacing: 0.45pt;"> </span>liều<span style="letter-spacing: 0.15pt;"> </span>100-<span style="letter-spacing: 0.9pt;"></span>250<span style="letter-spacing: 0.9pt;"> </span>mg<span style="letter-spacing: 0.75pt;"> </span>một<span style="letter-spacing: 0.7pt;"> </span>ngày, uống<span style="letter-spacing: 0.45pt;"> </span>sau khi<span style="letter-spacing: -0.15pt;"> </span>ăn<span style="letter-spacing: 0.5pt;"> </span>no.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 1.45pt;"> </span>Nhóm<span style="letter-spacing: 1.75pt;"> </span>thuốc<span style="letter-spacing: 1.95pt;"> </span>ức<span style="letter-spacing: 1.35pt;"> </span>chế<span style="letter-spacing: 0.75pt;"> </span>men<span style="letter-spacing: 1.25pt;"> </span>chuyển<span style="letter-spacing: 0.8pt;"> </span>dạng<span style="letter-spacing: 1.85pt;"> </span>angi<span style="letter-spacing: -0.1pt;">o</span><span style="letter-spacing: 0.05pt;">t</span>ensin:<span style="letter-spacing: 0.85pt;"> </span>perindopin;<span style="letter-spacing: 0.9pt;"> </span>e<span style="letter-spacing: -0.1pt;">n</span>alapril.<span style="letter-spacing: 0.95pt;"> </span>Ví<span style="letter-spacing: -0.55pt;"> </span>dụ:<span style="letter-spacing: 1.1pt;"> </span>coversyl<span style="letter-spacing: 0.6pt;"> </span>4 mg/ngày,<span style="letter-spacing: 0.25pt;"> </span>ednyt<span style="letter-spacing: -0.25pt;"> </span>5 mg/ngày.v.v.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span class="Apple-style-span" style="font-size: large;"><span lang="EN" style="font-weight: bold;">5.3.<span style="letter-spacing: -0.2pt;"> </span>Điều<span style="letter-spacing: 1.15pt;"> </span>trị<span style="letter-spacing: -0.15pt;"> </span>bằng<span style="letter-spacing: 1.65pt;"> </span>các<span style="letter-spacing: -0.45pt;"> </span>biện<span style="letter-spacing: 0.45pt;"> </span>pháp<span style="letter-spacing: -0.8pt;"> </span>can<span style="letter-spacing: 1.15pt;"> </span>thiệp:</span><span lang="EN"><o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;"><o:p> </o:p>Sau<span style="letter-spacing: -0.9pt;"> </span>khi<span style="letter-spacing: -0.15pt;"> </span>đã<span style="letter-spacing: 1.05pt;"> </span>chụp<span style="letter-spacing: -0.45pt;"> </span>động <span style="letter-spacing: 0.2pt;"><span> </span></span>mạch<span style="letter-spacing: 2.3pt;"> </span>vành,<span style="letter-spacing: 2.05pt;"> </span>xác<span style="letter-spacing: 0.75pt;"> </span>định<span style="letter-spacing: 0.55pt;"> </span><span style="letter-spacing: -0.05pt;">đ</span>ược<span style="letter-spacing: 0.2pt;"> </span>vị<span style="letter-spacing: 0.1pt;"> </span>trí<span style="letter-spacing: 0.8pt;"> </span>hẹp,<span style="letter-spacing: -1.05pt;"> </span>người ta<span style="letter-spacing: -0.1pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>thể<span style="letter-spacing: -0.75pt;"> </span>tiến<span style="letter-spacing: -0.75pt;"> </span>hành:<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; line-height: 20px; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.6pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">-<span style="letter-spacing: 0.8pt;"> </span>Phẫu<span style="letter-spacing: 2.35pt;"> </span>thuật<span style="letter-spacing: 2.8pt;"> </span>bắc<span style="letter-spacing: 0.65pt;"> </span>cầu<span style="letter-spacing: 0.65pt;"> </span>nối<span style="letter-spacing: 1.4pt;"> </span>qua<span style="letter-spacing: 0.65pt;"> </span>chỗ<span style="letter-spacing: 1.45pt;"> </span>hẹp<span style="letter-spacing: -0.1pt;"> </span>của<span style="letter-spacing: 0.45pt;"> </span>động<span style="letter-spacing: 1.9pt;"> </span>mạch<span style="letter-spacing: 1.5pt;"> </span>vành<span style="letter-spacing: 0.6pt;"> </span>(bypass).<span style="letter-spacing: 0.3pt;"> </span>Thủ<span style="letter-spacing: 0.15pt;"> </span>thuật<span style="letter-spacing: 2.8pt;"> </span>này<span style="letter-spacing: 0.8pt;"> </span>nhằm<span style="letter-spacing: 2.1pt;"> </span>mục<o:p></o:p> đích<span style="letter-spacing: 1.2pt;"> </span>tạo<span style="letter-spacing: 0.95pt;"> </span>một<span style="letter-spacing: 0.15pt;"> </span>hoặc<span style="letter-spacing: 0.1pt;"></span>nhiều<span style="letter-spacing: -0.45pt;"> </span>mạch<span style="letter-spacing: 0.7pt;"> </span>nối<span style="letter-spacing: 0.95pt;"> </span>g<span style="letter-spacing: 0.05pt;">i</span>ữa<span style="letter-spacing: 0.15pt;"> </span>động<span style="letter-spacing: 0.95pt;"> </span>mạch<span style="letter-spacing: 0.4pt;"> </span>chủ và<span style="letter-spacing: -0.6pt;"> </span>động <span style="letter-spacing: 0.25pt;"><span> </span></span>mạch<span style="letter-spacing: 2.35pt;"> </span><span style="letter-spacing: -0.05pt;">v</span>ành<span style="letter-spacing: 0.35pt;"> </span>dưới<span style="letter-spacing: 0.35pt;"> </span>chỗ<span style="letter-spacing: 1pt;"> </span>hẹp.<span style="letter-spacing: -0.7pt;"> </span>Mạch<span style="letter-spacing: 0.7pt;"> </span>nối có<span style="letter-spacing: 0.9pt;"> </span>thể<span style="letter-spacing: -0.5pt;"> </span>là<span style="letter-spacing: 1.1pt;"> </span>một<span style="letter-spacing: 0.05pt;"> </span>đoạn<span style="letter-spacing: 0.9pt;"> </span>của<span style="letter-spacing: -0.1pt;"> </span>tĩnh<span style="letter-spacing: 0.55pt;"> </span>mạch<span style="letter-spacing: -0.05pt;"></span>hiển<span style="letter-spacing: -0.6pt;"> </span>trong h<span style="letter-spacing: -0.1pt;">o</span>ặc động<span style="letter-spacing: 0.85pt;"> </span>mạch<span style="letter-spacing: 0.3pt;"> </span>vú<span style="letter-spacing: -0.5pt;"> </span>trong.<span style="letter-spacing: -0.05pt;"> </span>Tỷ<span style="letter-spacing: -0.15pt;"> </span>lệ<span style="letter-spacing: -0.5pt;"> </span>tử<span style="letter-spacing: 0.15pt;"> </span>vong<span style="letter-spacing: -0.45pt;"> </span>do<span style="letter-spacing: 0.15pt;"> </span>phẫu<span style="letter-spacing: 1.95pt;"> </span>thuật này<span style="letter-spacing: -0.2pt;"> </span>khoảng<span style="letter-spacing: 1.95pt;"> </span>từ<span style="letter-spacing: -0.1pt;"> </span>1%-5%.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 4.65pt; text-align: justify;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Nong<span style="letter-spacing: -0.25pt;"> </span>động<span style="letter-spacing: 1.5pt;"> </span>mạch<span style="letter-spacing: 1pt;"> </span>vành<span style="letter-spacing: 0.15pt;"> </span>làm<span style="letter-spacing: -0.2pt;"> </span>rộng chỗ<span style="letter-spacing: 0.65pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>bằng<span style="letter-spacing: 0.4pt;"> </span>ống<span style="letter-spacing: 0.5pt;"> </span>thông<span style="letter-spacing: 0.25pt;"> </span>có<span style="letter-spacing: 0.65pt;"> </span>bóng,<span style="letter-spacing: 0.55pt;"> </span>kết<span style="letter-spacing: -0.75pt;"> </span>hợp<span style="letter-spacing: -0.35pt;"> </span>đặt<span style="letter-spacing: 0.9pt;"> </span>giá<span style="letter-spacing: 0.35pt;"> </span>đỡ<span style="letter-spacing: 0.4pt;"> </span>(stent)<span style="letter-spacing: -0.3pt;"> </span>để<o:p></o:p> chống<span style="letter-spacing: 0.55pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>lại.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Khoan<span style="letter-spacing: -0.3pt;"> </span>xoáy<span style="letter-spacing: 1pt;"> </span>phá<span style="letter-spacing: -0.15pt;"> </span>mảng<span style="letter-spacing: 1.35pt;"> </span>vữa<span style="letter-spacing: -0.5pt;"> </span>để<span style="letter-spacing: 0.5pt;"> </span>tái<span style="letter-spacing: 0.65pt;"> </span>tạo<span style="letter-spacing: 1pt;"> </span>lòng<span style="letter-spacing: 0.6pt;"> </span>mạch.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Lấy<span style="letter-spacing: 1.85pt;"> </span>bỏ<span style="letter-spacing: 0.55pt;"> </span>cục<span style="letter-spacing: -0.35pt;"> </span>tắc<span style="letter-spacing: -0.15pt;"> </span>và<span style="letter-spacing: 0.1pt;"> </span>tái<span style="letter-spacing: 0.85pt;"> </span>tạo<span style="letter-spacing: 1.25pt;"> </span>lòng<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.3pt;"> </span>vành.<o:p></o:p></span></span></div><div class="MsoNormal" style="color: #333333; font-family: 'Times New Roman'; font: normal normal normal 13px/normal Geneva, Arial, Helvetica, sans-serif; margin-bottom: 0.0001pt; margin-left: 0cm; margin-right: 6pt; margin-top: 0cm;"><span lang="EN"><span class="Apple-style-span" style="font-size: large;">- Giải<span style="letter-spacing: 0.5pt;"> </span>phóng<span style="letter-spacing: 0.3pt;"> </span>chỗ<span style="letter-spacing: 0.65pt;"> </span>hẹp<span style="letter-spacing: -0.9pt;"> </span>ở cửa<span style="letter-spacing: -0.15pt;"> </span>vào<span style="letter-spacing: 0.55pt;"> </span>của<span style="letter-spacing: -0.35pt;"> </span>lỗ<span style="letter-spacing: 0.6pt;"> </span>động<span style="letter-spacing: 0.6pt;"> </span>mạch<span style="letter-spacing: 0.05pt;"> </span>vành.</span></span></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-59678964533133749772011-04-23T06:00:00.000-07:002011-05-01T06:29:14.176-07:00- Sử dụng Unikey toolkit chuyển đổi bảng mã tiếng Việt<div class="postmeta left"><h2 class="posttitle"><span class="Apple-style-span" style="color: red; font-size: x-large;">Sử dụng Unikey toolkit chuyển đổi bảng mã tiếng Việt</span><br />
<br />
Sử dụng công cụ miễn phí của tác giả Phạm Kim Long để gõ tiếng Việt có dấu đã trở thành một điều cần phải có trên các máy tính cá nhân, thế nhưng trong Unikey có chương trình Unikey Toolkit thì hầu hết là không rành lắm (vì có dịp nào phải dùng đâu), tuy vậy nó là một công cụ có ý nghĩa hết sức quan trọng đối với người thường làm việc với nhiều tài liệu tiếng Việt có bảng mã khác nhau (như mình trước đây), xin giới thiệu mọi người bài viết hướng dẫn chi tiết từ từ Tinhte.com.<br />
Đôi khi trong công việc văn phòng, chúng ta cần chuyển đổi một đoạn hoặc một văn bản qua lại giữa các font thuộc các bảng mã khác nhau. Có một cách chuyển đổi rất nhanh là dùng công cụ đi kèm theo các bộ gõ như Unikey hay Vietkey, thế nhưng không có nhiều người biết được công cụ này. Trong bài viết này mình sẽ hướng dẫn các bạn cách chuyển đổi font với công cụ của Unikey.<br />
Hãy làm theo các bước sau nhé.<br />
Bước 1: Đánh dấu (bôi đen) đoạn văn bản cần chuyển đổi font.<br />
Bước 2: Sao chép (copy) đoạn văn bản vừa đánh dấu. Nhấp chuột phải vào đoạn văn bản đó và chọn Copy hoặc dùng tổ hợp phím CTRL + C.<br />
<div style="text-align: center;"><a href="http://tip4pc.com/wp-content/uploads/2010/04/unikey.png" rel="nofollow"><img alt="" class="aligncenter size-full wp-image-4473" height="268" src="http://tip4pc.com/wp-content/uploads/2010/04/unikey.png" title="unikey" width="640" /></a></div>Bước 3: Chạy công cụ chuyển đổi font của Unikey bằng tổ hợp phím CTRL + SHIFT + F6.<br />
<div style="text-align: center;"><a href="http://tip4pc.com/wp-content/uploads/2010/04/unikey2.png" rel="nofollow"><img alt="" class="aligncenter size-full wp-image-4474" height="408" src="http://tip4pc.com/wp-content/uploads/2010/04/unikey2.png" title="unikey2" width="582" /></a></div>Bước 4: Lúc này sẽ hiển thị ra một hộp thoại Công cụ chuyển đổi font là Unikey Toolkit.<br />
- Ở phần Nguồn, các bạn chọn Bảng mã font gốc của đoạn văn bản cần chuyển đổi.<br />
- Ở phần Đích, các bạn chọn Bảng mã font cần chuyển.<br />
- Có một số tùy chọn bên phải để các bạn tùy chỉnh.<br />
* Lưu ý:<br />
+ Những font bắt đầu bằng .Vn thì có bảng mã là TCVN3<br />
+ Những font bắt đầu bằng VNI thì có bảng mã là VNI Windows<br />
+ Những font như Times New Roman hay Arial thì có bảng mã là Unicode<br />
+ Ngoài ra còn có một số bảng mã khác nhưng không thông dụng bằng 3 bảng mã trên.<br />
<div style="text-align: center;"><a href="http://tip4pc.com/wp-content/uploads/2010/04/unikey3.png" rel="nofollow"><img alt="" class="aligncenter size-full wp-image-4475" height="408" src="http://tip4pc.com/wp-content/uploads/2010/04/unikey3.png" title="unikey3" width="582" /></a></div><div style="text-align: center;"><a href="http://tip4pc.com/wp-content/uploads/2010/04/unikey4.png" rel="nofollow"><img alt="" class="aligncenter size-full wp-image-4476" height="403" src="http://tip4pc.com/wp-content/uploads/2010/04/unikey4.png" title="unikey4" width="574" /></a></div>Bước 5: Sau khi đã chọn xong các thông số cần thiết thì bấm vào nút Chuyển mã và chờ quá trình chuyển đổi Bảng mã font hoàn tất.<br />
<div style="text-align: center;"><a href="http://tip4pc.com/wp-content/uploads/2010/04/unikey5.png" rel="nofollow"><img alt="" class="aligncenter size-full wp-image-4477" height="407" src="http://tip4pc.com/wp-content/uploads/2010/04/unikey5.png" title="unikey5" width="574" /></a></div>Bước 6: Bấm OK để hoàn tất quá trình.<br />
Bước 7: Bấm nút Đóng để kết thúc Công cụ Unikey Toolkit.<br />
Bước 8: Mở một trang soạn thảo mới và dán (paste) đoạn văn bản vừa chuyển bảng mã font vào đó. Có thể dùng tổ hợp phím tắt là CTRL + V.<br />
Lúc này bạn đã có một đoạn văn bản mới với Bảng mã font phù hợp với mục đích công việc.<br />
<strong>Tips: </strong>nếu đã chọn như các bước ở trên lần đầu, ở các lần sau bạn có thể thực hiện nhanh bằng cách<br />
1. Chọn đoạn văn bản, nhấp Ctrl + X để cắt.<br />
2. Nhấp Ctrl + Shift + F9, đây là phím tắt dùng chuyển mã văn bản theo bảng mã đã chọn trước đó, khi đó máy tính sẽ phát tiếng kêu báo hiệu đã chuyển mã xong.<br />
3. Nhấp Ctrl + V để dán đoạn văn bản đã được chuyển mã tở lại.<br />
Chúc bạn thành công!<br />
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</script> <a href="http://www.linkwithin.com/" rel="nofollow"><img alt="Related Posts with Thumbnails" src="http://www.linkwithin.com/pixel.png" style="border: 0pt none;" /></a></h2></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-49762252262156466862011-04-07T23:20:00.001-07:002011-05-01T06:29:51.697-07:00- CHỮA BỆNH VIÊM XOANG BẰNG Y HỌC CỔ TRUYỀN<table class="contentpaneopen" style="background-attachment: initial; background-clip: initial; background-color: transparent; background-image: initial; background-origin: initial; border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial; font-family: Tahoma, Arial, Helvetica, sans-serif; padding-bottom: 2px; padding-left: 2px; padding-right: 2px; padding-top: 2px; text-align: left;"><tbody>
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<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><em>Theo y học cổ truyền, <b>Bệnh xoang</b> mãn tính là một dạng hư hỏa. Do đó, điều trị <b>Bệnh xoang</b> không chỉ nhằm giải quyết việc viêm nhiễm tại chỗ mà chủ yếu là phải bổ âm để tàng dương.</em></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">TRIỆU CHỨNG</span></div><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><img align="LEFT" height="200" src="http://www.ykhoanet.com/yhoccotruyen/voha/images/Image349.gif" style="border-bottom-style: none; border-color: initial; border-left-style: none; border-right-style: none; border-top-style: none; border-width: initial;" width="185" /><b>Bệnh xoang</b> là tình trạng viêm nhiễm ở một hoặc nhiều khoang rỗng nằm trong khối xương mặt có liên quan chặt chẽ đến hốc mũi. Về mặt bệnh học, người ta phân biệt các xoang làm hai nhóm. Nhóm xoang trước gồm xoang trán, xoang hàm và xoang sàng trước, có các lỗ thông đổ ra khe mũi giữa. Nhóm xoang sau gồm các xoang sàng sau và xoang bướm, có lỗ thông ra khe mũi trên. Mặt trước của xoang bướm còn có hai lỗ nhỏ thông xuống vòm họng.</span><br />
<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span class="Apple-style-span" style="font-size: large;"><span style="font-family: arial, helvetica, sans-serif;">Bình thường, những chất xuất tiết sinh lý hoặc bệnh lý trong xoang được tháo ra ngoài thông qua lỗ thông mũi xoang. Khi ta bị cảm cúm, các xoang trở nên viêm tắc, phù nề và ngăn trở khả năng thông tháo dịch nhầy ra mũi. Điều này dẫn đến sung huyết mạch máu xoang và nhiễm trùng xoang. Do đó cảm cúm hoặc viêm mũi dị ứng kéo dài nếu không được điều trị thích hợp sẽ dễ dẫn đến <b>Bệnh xoang</b>, nhất là những trường hợp mũi có cấu tạo bất thường.</span><span style="font-family: arial, helvetica, sans-serif;"></span></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Hai dấu hiệu chủ yếu của <b>Bệnh xoang</b> là đau nhức và tăng tiết dịch mũi. Nhức đầu, căng nặng đầu từng cơn hoặc thường xuyên xảy ra ở vùng xoang bị viêm. Dịch tiết chạy xuống họng hoặc ra mũi. Dịch mũi thường đặc, vàng hoặc xanh, đôi khi có cả máu, chứ không trong và loãng như dịch mũi ở chứng cảm cúm thông thường.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">ĐIỀU TRỊ</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Việc điều trị viêm xoang mãn tính phải nhằm vào hai yêu cầu: Bổ thận âm và Nạp khí về thận. Đối với những trường hợp viêm xoang cấp, hoặc khi có những triệu chứng sưng nhức khó chịu hay bội nhiễm do phong nhiệt cần giải tỏa gấp, có thể dùng thêm các biện pháp tiêu viêm, tiêu độc hoặc khu phong bài nùng. Tuy nhiên, những phương dược điều trị triệu chứng chỉ là phụ và tạm thời. Bệnh kéo dài chừng nào thì âm hư càng nặng, càng phải chú trọng đến gốc ở thận. Khi sự cân bằng âm dương đã được thiết lập, hỏa sẽ tự yên vị. Mặt khác khi chính khí đã vững, sức đề kháng vươn lên, tà khí sẽ tự lui.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">CÁC BÀI THUỐC</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Lục vị địa hoàng</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Lục vị là một cổ phương căn bản và thông dụng trong y học cổ truyền để bổ Thận âm. Gọi là lục vị vì bài thuốc gồm sáu vị. Để nạp khí về thận, Hải Thượng Lãn Ông thường dùng thêm ba vị: Mạch môn, ngũ vị; Ngưu tất. Mạch môn làm mát phế vị; Ngũ vị liễm phế, cố thận; Ngưu tất giáng khí, dẫn thuốc về thận. Ngoài ra, vì là bệnh lâu ngày nên dùng thêm cao Ban long, là loài huyết nhục hữu tình để tăng hiệu quả. Cao Ban long là một vị thuốc bổ âm mạnh được chế từ sừng hươu nai. Như vậy, một bài thuốc lục vị gia giảm để trị viêm xoang có thể bao gồm:</span></div><span class="Apple-style-span" style="font-size: large;"><br />
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<dir style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px;"><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Thục địa 16g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">cao Ban long 8g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">hoài sơn 8g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">mạch môn 8g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">sơn thù 8g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">ngũ vị 6g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">đơn bì 6g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">ngưu tất 8g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">trạch tả 4g</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">bạch phục linh 4g</span></div></dir><br />
<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Lần thứ nhất, đổ ba chén nước, sắc còn một chén. Lần thứ hai, đổ hai chén nước, sắc còn nửa chén. Hòa chung hai lần nước thuốc lại, chia uống hai hoặc ba lần trong ngày. Hâm nóng trước khi uống. Có thể dùng liên tục từ 10-15 thang.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Một số người không tiện "sắc thuốc" thì có thể dùng lục vị hoàn mua sẵn ở thị trường Đông dược. Trường hợp này dùng thêm cao Ban long bằng cách cắt nhỏ nấu cháo hoặc hấp cơm để ăn.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Bổ âm tiếp dương</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Ở những người lớn tuổi, viêm xoang thường phối hợp với nhiều chứng bệnh mãn tính khác khiến cơ thể suy nhược, ăn kém, thở yếu, hay mệt..., biểu hiện của cả khí huyết âm dương đều kém. Những trường hợp này nếu bổ khí không khéo có thể làm tăng khí nghịch, nếu bổ âm đơn thuần có thể làm ngưng trệ Tỳ Vị; Mà khi Tỳ Vị đã trệ thì thuốc gì cũng khó được chuyển hóa. Do đó cần sử dụng thêm các vị thuốc cam, ôn như nhân sâm, hoàng kỳ, bạch truật, can khương để tiếp dương xen kẽ với bổ âm. Với cách điều trị này, khi âm đã vượng lên một phần thì dương cũng tiến được nửa phần. Từng bước nâng lên mà vẫn bảo đảm không làm chênh lệch thái quá sự cân bằng giữa âm và dương. Bàn về cách tiếp dương trong bổ âm, Hải Thượng Lãn Ông đã ghi lại một phương thuốc rất có giá trị là "Bổ âm tiếp phương dương".</span></div><span class="Apple-style-span" style="font-size: large;"><br />
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<dir style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px;"><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Thục địa 120g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">bố chính sâm 60g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">bạch truật 40g.</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">can khương 12g (sao đen tẩm đồng tiện),</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">bạch thược 20g (sao đen tẩm đồng tiện),</span></div></dir><br />
<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Đây là một thang đại dược, phân lượng lớn, sắc đặc chia làm nhiều lần uống trong ngày. Thục địa là vị chủ lực để bổ âm. Điểm đặc biệt của phương thang bổ âm này là gồm cả Sâm, Khương, Truật để bổ Tỳ Vị bằng cách sao đen và tẩm đồng tiện 2 vị can khương và bạch thược. Cách bào chế này vừa làm dịu sức nóng của can khương, vừa giáng hư hỏa và dẫn thuốc về thận nhằm tiếp dương khí cho Tỳ Vị đủ sức chuyển hóa thục địa, mà lại không kích động hư hỏa.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Với những đợt viêm mũi và viêm xoang cấp tính hoặc viêm mũi phát triển do phong nhiệt, có thể dùng những bài thuốc sau, thiên về khu phong tiêu độc:</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Hoàng liên giải độc thang</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Hoàng liên 12g, bạc hà 8g, hoàng cầm 12g, hoàng bá 12g, chi tử 4g. Đổ ba chén nước, sắc còn một chén, chia làm hai lần uống trong ngày.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Ma hoàng thương nhĩ tử thang</strong></span></div><span class="Apple-style-span" style="font-size: large;"><br />
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<dir style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px;"><dir><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Ma hoàng 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">tân di hoa 8g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">khương hoạt 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">thương nhĩ tử 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">kinh giới 6g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">phòng phong 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">cam thảo 4g.</span></div></dir></dir><br />
<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Đổ ba chén nước, sắc còn một chén, chia làm hai lần uống trong ngày.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Thanh không cao</strong></span></div><span class="Apple-style-span" style="font-size: large;"><br />
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<dir style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px;"><dir><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Khương hoạt 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">xuyên khung 4g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">phòng phong 12g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">bạc hà 4g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">hoàng cầm 8g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">cam thảo 6g,</span></div><div style="margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">hoàng liên 4g.</span></div></dir></dir><br />
<div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Đổ 3 chén nước, sắc còn một chén, chia làm hai lần uống trong ngày.</span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;"><strong style="font-family: Tahoma, Arial, Helvetica, sans-serif;">Điều trị không dùng thuốc</strong></span></div><div style="font-family: Tahoma, Arial, Helvetica, sans-serif; font-size: 12px; margin-bottom: 5px; margin-top: 0px;"><span style="font-family: arial, helvetica, sans-serif; font-size: large;">Có không ít trường hợp viêm xoang dai dẳng nhiều năm, tái đi tái lại sau nhiều lần điều trị khiến người bệnh nghĩ mình sẽ phải sống chung với bệnh suốt đời. Sau đó, vì những lý do khác nhau (chẳng hạn để điều trị một bệnh khác hoặc để tăng cường sức khỏe), người bệnh gia nhập một nhóm tập dưỡng sinh. Điều không ngờ là sau vài tháng, người bệnh chợt nhận ra những triệu chứng khó chịu của viêm xoang đã tự biến mất. Kết quả này không có gì lạ nếu ta hiểu rằng, tất cả những phương pháp dưỡng sinh, ngoài tác dụng nâng cao thể trạng, tăng cường sức đề kháng - thì hiệu ứng sớm nhất, trực tiếp nhất mà người tập đạt được là sự thư giãn, an tĩnh. Y học hiện đại cho rằng sự an tĩnh có thể điều hòa được thần kinh giao cảm, phục hồi tính tự điều chỉnh vốn có của hệ thần kinh trung ương, qua đó điều hòa nội tiết và cải thiện hoạt động của cơ quan. Điều hòa thần kinh giao cảm cũng có vai trò cân bằng hai yếu tố âm và dương trong cơ thể. Hơn nữa, theo quy luật "Thần tĩnh tất âm sinh", sự thư giãn và nhập tĩnh có tác dụng sinh âm và bổ âm. Ngoài ra, hầu hết các bài tập dưỡng sinh từ tư thế, động tác đến ý thức như thượng hư hạ thực, hư kỳ tâm thực kỳ phúc... giúp cứng chắc phần hạ bộ, buông lỏng phần vai, mang trung tâm lực của cơ thể dồn xuống hạ tiêu đều nhằm làm cho khí trầm Đan điền, chính là yêu cầu dẫn hỏa quy nguyên hoặc nạp khí về Thận để trừ hư Hỏa trong việc điều trị viêm xoang. Do đó, việc kiên trì tập luyện đúng phương pháp các bài tập dưỡng sinh, thái cực quyền, khí công, ngồi thiền... cũng là những cách điều trị hiệu quả đối với bệnh viêm xoang mãn tính.</span></div></td></tr>
</tbody></table>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-55379564555888614162011-04-07T23:12:00.000-07:002011-05-01T06:30:08.974-07:00- CÁC PHƯƠNG PHÁP ĐIỀU TRỊ CHỐNG LOẠN NHỊP<div class="tieude" style="color: black; display: block; font-family: Arial; font-size: 13px; font-weight: bold; margin-bottom: 5px; padding-left: 20px; padding-top: 20px; text-align: left;"><span id="ctl03_lblNewsTitle" style="color: #033e97; font-size: 16px; font-weight: bold;">CÁC PHƯƠNG PHÁP ĐIỀU TRỊ CHỐNG LOẠN NHỊP</span> </div><div style="float: left; font-family: Tahoma, Verdana; font-size: 12px;"><div style="display: block; text-align: center;"></div></div><div style="font-family: Tahoma, Verdana; font-size: 12px; margin-top: 0px; padding-bottom: 0px; padding-left: 20px; padding-right: 20px; padding-top: 0px; text-align: left;"><span id="ctl03_lblNewsBody"></span><br />
<div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">Khuyến cáo số 07-1998 của Hội Tim học quốc gia Việt Nam</span></b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">.<o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">(Management of Cardiac Arrhythmias – Recommendation No7 (1998) of the Vietnam National Heart Association)</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðã thông qua Hội đồng khoa học Hội Tim mạch học Quốc gia Việt <st1:place w:st="on"><st1:country-region w:st="on">Nam</st1:country-region></st1:place>. Báo cáo tại Ðại học Tim mạch học Quốc gia Việt <st1:place w:st="on"><st1:country-region w:st="on">Nam</st1:country-region></st1:place> lần thứ VII, Ðà Lạt, tháng 11 – 1998.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Tiểu ban biên soạn chuyên đề:</span></i><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">GS. Trần Ðỗ Trinh (Trưởng tiểu ban)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">GS. Vũ Ðình Hải</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">TS. Nguyễn Ngọc Tước</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">PGS.TS. Nguyễn Phú Kháng</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 437px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 422px;" valign="top" width="100%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><b><span style="font-family: Verdana; font-size: 9pt;">Khuyến cáo này gồm có 2 phần:</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">1.</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">Các phương pháp chống loạn nhịp (LN)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">2.</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">Chọn phương pháp điều trị cho từng loại loạn nhịp tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các phương pháp điều trị chống loạn nhịp bao gồm các thuốc và các thủ thuật được sử dụng nhằm 2 mục đích chủ yếu:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Cắt cơn loạn nhịp cấp tính</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Ngăn chặn lâu dài sự tái phát loạn nhịp.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">A. Các thuốc chống loạn nhịp<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các thuốc nói chung thường vừa có thể dùng để tấn công cắt cơn loạn nhịp cấp tính (bằng tiêm tĩnh mạch hoặc uống liều trung bình), trừ một vài ngoại lệ (như lidocain, adenosin</span><span style="font-family: Verdana; font-size: 9pt;">) có thời gian bán thải</span><span style="font-family: Verdana; font-size: 9pt;"> quá ngắn chỉ dùng cấp.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các thuốc đó bao gồm những loại có thể xếp vào Bảng phân loại Vaughan-Williams và những loại không thể xếp vào đó.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1.Các thuốc xếp trong Bảng phân loại Vaughan-Williams được chia ra làm 4 nhóm, trong đó nhóm 1 lại chia ra IA, IB, IC.<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Bảng phân loại này còn nhiều nhược điểm. Trong thực tế, trong cùng một nhóm không phải tất cả các thuốc đều có tác dụng giống hệt nhau, thí dụ trong nhóm III; bretylium, sotalol và amiodaron khác nhau quá nhiều; trong khi đó một số thuốc của các nhóm khác nhau thì lại có những tác dụng chồng chéo lên nhau, thí dụ các thuốc Nhóm IA và Nhóm IC. Bảng Vaughan-Williams hiện vẫn được sử dụng rộng rãi nhất, coi như một cách "tốc ký" thông tin rất có lợi, có điều phải luôn nhớ rằng tác dụng của các thuốc phức tạp hơn là mô tả trong bảng.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span id="ctl03_lblNewsBody"><b><span style="font-family: Verdana; font-size: 9pt;">Bảng phân loại thuốc chống loạn nhịp</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span id="ctl03_lblNewsBody"><b><i><span style="font-family: Verdana; font-size: 9pt;">(Theo Singh - <st1:place w:st="on"><st1:city w:st="on">Vaughan</st1:city></st1:place> – Williams) 1972*</span></i></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 645px;"><tbody>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 43px;" valign="top" width="9%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><br />
</div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 215px;" valign="top" width="35%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Nhóm I</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Nhóm II</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 126px;" valign="top" width="21%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Nhóm III</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 87px;" valign="top" width="15%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Nhóm IV</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 43px;" valign="top" width="9%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Cơ chế tác dụng</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 215px;" valign="top" width="35%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Làm chậm dẫn truyền do ức chế kênh Na+ nhanh vào tế bào</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Chẹn giao cảm beta</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 126px;" valign="top" width="21%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Kéo dàI AP và ERP do ức chế kênh K+ ra ngoài tế bào</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 87px;" valign="top" width="15%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Ức chế kênh Ca<sup>2+</sup> chậm vào tế bào</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 43px;" width="9%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><b><span style="font-family: Verdana; font-size: 9pt;">Thuốc</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 215px;" valign="top" width="35%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">I.A: Kéo dài AP và ERP</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Quinidin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Procainamid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Disopyramid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">I.B: Rút ngắn AP và ERP</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Lidocain</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Mexiletin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tocainid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Phenytoin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">I.C: ít tác động lên AP và ERP</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Flecainid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Propafenon</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bucainid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Lorcainid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Cibenzolin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Acebutolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Esmolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Propranolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Atenolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Metoprolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Nadolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Timolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Sotalol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Bisoprolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Betaxolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Carvedilol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Buncindolol</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="ES" style="font-family: Verdana; font-size: 9pt;">Và các chẹn beta khác</span><span lang="ES" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 126px;" valign="top" width="21%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Amiodaron</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Bretylium Sotalol</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">N-Acetylpro-cainamid</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Dofetilid</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Azimilid</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Ambasilid</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Và các thuốc khác</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><br />
</div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><br />
</div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 87px;" valign="top" width="15%"><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Verapamil</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Diltiazem</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Bepridil</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">và các thuốc khác</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><br />
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</tbody></table></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">* David L. Brown. Cardiac Intensive Care. W.B.Saunders Co. 1998, p64 [2]</span></i><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">* Braunwald E., Heart Disease, 5<sup>th</sup> Edition, 1997, p.598 [1]</span></i><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">AP = điện thế hoạt động. ERP = thời kỳ trơ hiệu quả.</span></i><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Các thuốc không thể xếp vào bảng Vaughan-Williams, bao gồm:<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Digitalis: dùng cho các loạn nhịp trên thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Adenosin: dùng cho nhịp nhanh vào loại nút nhĩ thất (đã có tác giả xếp thuốc này vào nhóm IV B trong bảng xếp loại).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Magiê: dùng cho xoắn đỉnh, ngoại tâm thu thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Kali: dùng cho loạn nhịp do giảm kali huyết, xoắn đỉnh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Isoprenalin (Isuprel), orciprenalin (Alupent, theophyllin và atropin) dùng cho nhịp chậm.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Nguyên tắc chung khi chọn thuốc<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Cho đến nay, các thứ thuốc chống loạn nhịp tim đã phát triển ồ ạt nhiều loại. Thuốc chống LN lại có nhiều đặc điểm khác hẳn các thứ thuốc tim mạch khác. Một thứ thuốc có thể có hiệu quả trên nhiều loại bệnh khác nhau nhưng ranh giới giữa liều lượng có hiệu quả và liều độc nhiều khi lại rất hẹp và đặc biệt là các ứng tác bất lợi (ƯTBL=adverse effect) có khi khá nặng nề và rất khác nhau, nhiều khi lại là yếu tố chỉ đạo quyết định cho việc chọn thuốc, quan trọng hơn cả hiệu quả của thuốc.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðặc biệt là những kết luận báo động của các công trình Thử nghiệm xóa bỏ Loạn nhịp tim I (1989) và II (1991) (Cardiac Arrhythimia Suppresion Trial: CAST I và CAST II) đã gây một cú choáng trong cộng đồng y giới và biến đổi hẳn các quan điểm của họ về cách dùng thuốc cũng như về nhiều lĩnh vực khác của y khoa. Cơ quan Quản lý thuốc và thực phẩm Mỹ (Food and Drug Administration = FDA) cũng phải khuyến cáo thu hẹp chỉ định một số thuốc chống LN vào một số ca bệnh có đe dọa tính mạng bệnh nhân. Riêng các thuốc Nhóm I nói chung đều có dấu hiệu làm tăng tử vong nên có khuynh hướng chỉ sử dụng để giảm nhẹ triệu chứng khó chịu ở những bệnh nhân không có bệnh tim thực tổn (chứ không để giảm tử vong) thí dụ: Flecainid và propafenon dùng để xóa bỏ rung hay cuồng nhĩ kịch phát ở người không có hay có bệnh tim rất nhẹ.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ngoài ra còn cần chú ý đến tương tác giữa các thuốc cho cùng một lúc.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">B. Các thủ thuật cắt cơn loạn nhịp cấp<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Các thủ thuật cường phế vị:</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i></b><span style="font-family: Verdana; font-size: 9pt;">ấn nhãn cầu, xoa xoang cảnh, uống nước đá lạnh, úp mặt vào nước lạnh, động tác Valsalva; đột ngột đảo ngược tư thế cơ thể như chổng mông, nâng cao 2 chân lên tường (để dồn máu tĩnh mạch về tim làm đột ngột tăng thể tích nhát bóp).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Sốc điện chuyển nhịp hoặc phá rung:</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i></b><span style="font-family: Verdana; font-size: 9pt;">là phương pháp đáng tin cậy nhất. Hãn hữu, nó có thể gây biến chứng rung thất, nhất là khi dùng liều điện nhỏ (25W/sec) khi đó hoặc khi sốc thất bại, phải sốc lại với các liều điện cao nhất của máy (320-400W/sec). Ðặc biệt cần chỉ định sốc điện kịp thời khi nhịp nhanh gây ra tụt huyết áp, thiếu máu cục bộ cơ tim hoặc suy tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Tạo nhịp tạm thời chủ yếu là để chống các cơn Adams Stokes do nhịp chậm:</span></i></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Tạo nhịp ngoài lồng ngực: dùng một điện cực ngực và một điện cực lưng. Thường chỉ tiến hành được trong 5-15 phút vì nếu lâu hơn bệnh nhân bị đau do giật cơ; bỏng rát và hiệu quả cũng giảm dần. Thường chỉ dùng cấp cứu ngừng tim hay cơn <st1:place w:st="on">Adams</st1:place> Stokes nặng, quá cấp bách.<b><i></i></b></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Tạo nhịp xuyên lồng ngực: dùng một kim cắm qua thành ngực trước vào cơ tim làm một điện cực kích thích. Thường cũng chỉ dùng khi cấp cứ ngừng tim hay cơn <st1:place w:st="on">Adams</st1:place> Stokes nặng trong chốc lát chờ tiến hành xong tạo nhịp bằng dây thông điện cực trong buồng tim.<b><i></i></b></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Tạo nhịp qua thực quản: bằng một dây điện cực đưa vào thực quản. Không bị các nhược điểm của các phương pháp trên nhưng đòi hỏi quen tay đưa điện cực vào đúng vị trí để tạo nhịp có hiệu quả và cũng chỉ giữ được một thời gian ngắn và phải làm tiếp tạo nhịp trong buồng tim.<b><i></i></b></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Tạo nhịp trong buồng tim: bằng một dây thông điện cực đưa vào thất phải qua tĩnh mạch dưới đòn hay tĩnh mạch đùi. Hiệu quả rất cao và có thể đặt nhiều ngày, hàng tuần, nên được dùng rất rộng rãi.<b><i></i></b></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Chú ý:</span></i><b><span style="font-family: Verdana; font-size: 9pt;"> </span></b><span style="font-family: Verdana; font-size: 9pt;">Khi có chống chỉ định của sốc điện, đôi khi có thể dùng dây thông tạo nhịp thực quản hay buồng tim tạm thời để tạo nhịp vượt tần số cắt cơn nhịp nhanh cấp với nguyên lý giống như khi cấy máy.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">C. Các thủ thuật điều trị lâu dài<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Máy tạo nhịp cấy (Implantable pacemakers):</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i></b><span style="font-family: Verdana; font-size: 9pt;">Ngoài máy tạo nhịp cấy chống nhịp chậm đã được dùng rất phổ biến từ lâu, ngày nay người ta còn cấy các loại máy tạo xung chống nhịp nhanh với nguyên lý là đưa được xung tạo nhịp lọt vào đúng lúc làm trơ được một đoạn của vòng vào lại làm cho xung động bệnh lý khi đi vòng tới đó thì không dẫn truyền qua được và bị chặn đứng lại, kết thúc cơn nhịp nhanh. Các máy này thường chỉ dùng khi dùng thuốc đã thất bại và bao giờ cũng phải làm các thăm dò điện sinh lý học chứng minh cho tính hiệu quả và độ tin cậy của máy trước khi cấy.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðể chống lại các loạn nhịp nhanh trên thất, máy tạo nhịp cấy có thể sử dụng nhiều kỹ thuật như sử dụng một xung điện đơn độc sớm (single premature stimulus), nhiều xung đơn độc (single extrastimul), tạo nhịp dưới tần số (underdrive pacing), nhiều xung đặt giờ (timed stimuli), tạo nhịp có chương trình (programmed pacing). Nhưng cho đến nay các kỹ thuật đó đã bị lỗi thời, lạc hậu so với phương pháp triệt bỏ bằng tần số radio qua dây thông (radiofrequency catheter ablation).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Tạo nhịp tim đôi khi còn dùng để dự phòng nhịp nhanh thất, đặc biệt là xoắn đỉnh, nói chung người ta có thể phát xung vào nhĩ và/hoặc vào thất với tần số 90-120c/phút, làm tăng tính đồng nhất của sự hồi phục điện học và qua đó làm giảm rõ rệt sự tái phát các cơn nhịp nhanh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các máy tạo nhịp có loại tự chứa đựng năng lượng, có loại nạp năng lượng bằng một nguồn tần số radio bên ngoài. Loại tự chứa đựng có thể hoạt động tự động do có một mạch điện làm chương trình nhận biết loạn nhịp, hoặc có thể được phát động bởi một nam châm ngoài.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Tuy nhiên, các máy tạo nhịp đó có những nhược điểm sau:</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Khi các tính chất của loạn nhịp qua một thời gian bị thay đổi đi thì các thông số đã được đặt vào chương trình của máy không còn cắt được cơn nhịp nhanh nữa.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Máy có thể gây ra rung nhĩ (khi tạo nhịp nhĩ) hoặc nhịp nhanh thất tần số cao hoặc rung thất (khi tạo nhịp thất).</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Bộ phận nhạy cảm của máy bị nhận lầm một cơn loạn nhịp trên thất ra một cơn nhịp nhanh thất, dẫn đến sự phát xung điều trị không cần thiết và còn có thể gây ra nhịp nhanh thất hay rung thất.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Máy chuyển nhịp phá rung tự động cấy (Automatic Implantable Cardioverter/Defibrillator = AICD)</span></i></b><i><span style="font-family: Verdana; font-size: 9pt;"> là</span></i><span style="font-family: Verdana; font-size: 9pt;"> một tiến bộ khoa học lớn khắc phục được các nhược điểm trên. Máy có thể nhận cảm tức thời cơn loạn nhịp thất nguy hiểm và có khả năng phóng ra các dòng điện tử dưới 1W/s cho tới 40W/s (tùy theo chương trình ta đặt vào máy) để cắt cơn.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- Khi tim lên cơn nhịp nhanh thất (NN/T) thông thường thì máy sẽ tự động tạo nhịp chống nhịp nhanh, cơn sẽ được cắt (chuyển nhịp) mà bệnh nhân không cảm thấy một cú sốc đau.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- Khi là cơn NN/T nặng, tần số tăng vọt lên gây tụt huyết áp, hoặc đã tạo nhịp không cắt được cơn, hoặc bị rung thất thì máy sẽ phóng một nhát sốc điện mạnh để cắt cơn (phá rung).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các thử nghiệm lâm sàng cho biết, đối với bệnh nhân đã trơ với thuốc chống LN dùng máy sau một năm có thể tránh được chết đột ngột ở 92-100%. Nhược điểm của máy là ngưỡng điện phá rung có thể cao lên hoặc tần số cơ nhịp nhanh có thể hạ xuống (do dùng kèm thuốc chống LN) dưới ngưỡng phát động của máy làm cho máy kém hiệu quả. Ðặc biệt hay gặp là máy bị phát động nhầm lẫn đối với cả các loạn nhịp thất không bền bỉ có thể tự ngừng cơn, tuy nhiên các máy mới gần đây đã được cải tiến, có bộ phận "nhìn lần 2" để nhận biết được chúng và không phát động máy nữa. Do đó điện cấy máy được mở rộng hơn và còn phát minh ra loại máy cấy qua đường tĩnh mạch, không cần mở lồng ngực.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Triệt bỏ cấu trúc gây loạn nhịp qua dây thông (catheter ablation)</span></i></b><i><span style="font-family: Verdana; font-size: 9pt;"> bằng cách phóng vào đó một tần số</span></i><span style="font-family: Verdana; font-size: 9pt;"> radio (radiofrequency) (tốt nhất) hoặc tia chớp điện (fulguration), hay tia lazer, hiện nay được coi là một phương pháp hàng đầu cực kỳ hiệu quả mà lại rẻ tiền (cost-effective) có thể chữa khỏi hẳn:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Chứng nhịp nhanh, vào lại nhĩ thất bằng cách tác động phá hủy cầu dẫn truyền phụ nhĩ thất ẩn giấu hay không ẩn giấu (hội chứng W-P-W).<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Hầu hết các ca nhịp nhanh nhĩ vào lại hoặc không vào lại bằng cách phá hủy ổ ngoại vị nhĩ.<o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Rung nhĩ, cuồng nhĩ, một số lớn ca nhịp nhanh nhĩ và một vài ca nhịp nhanh vào lại nút nhĩ thất bằng cách phá hủy bộ nối nhĩ thất, tạo ra một block nhĩ-thất hoàn toàn rồi đặt máy tạo nhịp thất vĩnh viễn.<o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">4. Phẫu thuật<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Phẫu thuật điều trị các LN thất thường chỉ tiến hành cho các trường hợp mà các phương pháp khác không giải quyết được; trước và trong khi phẫu thuật cần phải làm thăm dò điện sinh lý học. Có 4 trường hợp phẫu thuật:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Cắt bỏ cầu nối phụ ẩn giấu hoặc do W-P-W là một phẫu thuật tuyệt vời với hiệu quả rất cao mà rất ít nguy hiểm.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Cắt hoặc hủy bỏ ổ phát bệnh lý bằng phương pháp đông lạnh -600C (cryosurgery), ngăn chặn vòng vào lại trong cơ nhĩ có thể chữa khỏi rất tốt bệnh nhịp nhanh nhĩ. Thủ thuật khía nhiều đường rạch vào tâm nhĩ để cắt các vòng vào lại của rung nhĩ. Kết quả đạt được của Cox và Boineau, 1987 là tốt tới 98%.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Cắt hoặc hủy bằng đông lạnh nút nhĩ-thất-His, tạo ra một block nhĩ thất hoàn toàn rồi cấy máy tạo nhịp thất nhân tạo để điều trị các bệnh rung nhĩ, cuồng nhĩ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Cắt bỏ, khía khoanh vùng nội tâm mạc, hoặc làm đông lạnh ổ bệnh lý ở thất, nhất là chỗ bờ rìa vùng nhồi máu cũ để chứa các loạn nhịp thất nguy hiểm.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><br />
</span></div></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-65168409189608173802011-04-07T23:10:00.001-07:002011-05-01T06:30:34.424-07:00- CHỌN PHƯƠNG PHÁP ĐIỀU TRỊ CHO TỪNG LOẠI LOẠN NHỊP<div class="tieude" style="color: black; display: block; font-family: Arial; font-size: 13px; font-weight: bold; margin-bottom: 5px; padding-left: 20px; padding-top: 20px; text-align: left;"><span id="ctl03_lblNewsTitle" style="color: #033e97; font-size: 16px; font-weight: bold;">CHỌN PHƯƠNG PHÁP ĐIỀU TRỊ CHO TỪNG LOẠI LOẠN NHỊP</span> </div><div style="float: left; font-family: Tahoma, Verdana; font-size: 12px;"><div style="display: block; text-align: center;"></div></div><div style="font-family: Tahoma, Verdana; font-size: 12px; margin-top: 0px; padding-bottom: 0px; padding-left: 20px; padding-right: 20px; padding-top: 0px; text-align: left;"><span id="ctl03_lblNewsBody"></span><br />
<div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">A. Nguyên tắc chung</span></b><span style="color: #003366; font-family: Verdana; font-size: 10pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðể điều trị các loạn nhịp cho đúng cần phải có chẩn đoán đúng. Vì thế cần nhắc lại một số kiến thức về bệnh lý và chẩn đoán.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Cơ chế các loạn nhịp<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Có 2 loại:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">1.1. Rối loạn dẫn truyền cục bộ tại một cấu trúc tim như một thớ Purkinje, nút nhĩ-thất: đảo lộn thời kỳ trơ, sinh ra các vòng vào lại phát xung nhanh gây loạn nhịp tim, chiếm đến 80% các ca.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">1.2. Rối loạn hình thành xung động chỉ chiếm 20% bao gồm:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">a. Tăng tính tự động sẵn có của một điểm nào đó trong hệ xoang His-Purkinje thường không thể phát động hoặc chặn đứng bằng tạo nhịp.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">b. Hoạt động nẩy cò (triggered activities) không thể tự phát cơn mà phải do một đột biến tần số tim (thí dụ một ngoại tâm thu) dùng làm cò nẩy, cò nẩy này làm ứ calci lại trong tế bào, do đó gây ra một hậu khử cực với biên độ lớn tới mức vượt ngưỡng khử cực và sinh ra hoạt động lặp lại tức cơn nhịp nhanh. Nó có thể xảy ra ở nhĩ, thất, ở His-Purkinje:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Vào pha 2 hay pha 3 của điện thế hoạt động (hậu khử cực sớm = early afterdepolarisation) thường do nhịp chậm, giảm kali huyết, gây ra xoắn đỉnh.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Vào sau pha 3 (hậu khử cực muộn = delayed afterdepolarisation) thường do tăng catecholamin, tăng kali hay calci-huyết, ngộ độc digitalis, gây ra nhịp nhanh thất khi gắng sức, nhịp tự thất gia tốc trong nhồi máu cơ tim.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Thăm dò điện sinh lý học (DSLH)<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðể biết rõ những cơ chế trên, ưu việt hơn cả là làm thăm dò điện sinh lý học (electrophysiologic studies = EPS) bằng cách đưa vào những vùng cần thiết trong nhĩ và/hoặc thất những dây thông có gắn nhiều điện cực để ghi ra đồ bản điện hoạt hóa nội tâm mạc (endocardial activation mapping), do đó biết rõ cơ chế và vị trí chính xác của ổ phát sinh các loạn nhịp hoặc của cầu Kent hay cầu nối ẩn giấu. Ðồng thời dùng các điện cực đó kích thích theo chương trình (programmed stimulation) để phát động hoặc chặn đứng các cơn nhịp nhanh có tần số và hình dạng giống như cơn đã xảy ra trong lâm sàng. Sau đó lần lượt cho các thuốc chống loạn nhịp và nhận xét hiệu quả cản phá của thuốc đối với cơn hoặc đối với triệu chứng và huyết động của cơn, do đó mà tìm ra được thứ thuốc hay thủ thuật thích hợp nhất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nếu không có điều kiện làm như vậy thì có thể tạm thay thế bằng phương pháp Holter, theo dõi loạn nhịp 24h để đánh giá loạn nhịp, nhất là ngoại tâm thu và tác dụng của thuốc chống loạn nhịp. Nếu không có máy Holter thì dựa vào lâm sàng. Kinh nghiệm cho biết, đối với một số ca nhịp nhanh kịch phát hay ngoại tâm thu thất (NTT/T) gây trống ngực, nghẹn thở, có thể cho bệnh nhân tự theo dõi và ghi lại số lượng, thời gian các cơn trong ngày và tác dụng của các loại thuốc. Ðương nhiên là các phương pháp này có một số hạn chế:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">a. NTT hay có những đợt thay đổi tần suất lên xuống tự phát dễ lầm tưởng là do tác dụng của thuốc.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">b. 25-30% bệnh nhân bị nhịp nhanh thất hay rung thất nguy hiểm nhưng lại có rất ít NTT/T.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">c. Phân kỳ rõ ràng giữa hiệu quả của thuốc chống loạn nhịp đối với NTT/T tự phát và NTT/T.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Về liều lượng thuốc, cần cho thử thăm dò từ thấp lên cao sao cho đạt hiệu quả với liều thấp nhất cho khỏi tới liều độc, nghĩa là đạt tỷ lệ độc tính/hiệu quả tương đối thấp. Kể cả khi có điều kiện đo nồng độ thuốc trong huyết thanh cũng vậy. Vì tất cả các thuốc chống loạn nhịp đều có độc tính, gây tương tác bất lợi, nhất là làm gia tăng loạn nhịp, thậm chí gây ra một loạn nhịp khác (proarrhythimia).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Ðiều trị nguyên nhân<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Mặt khác, cũng phải chú ý tìm và điều trị kết hợp các nguyên nhân gây ra loạn nhịp (nếu có) như: suy tim, giảm thông khí, thiếu oxy, sốt, nhiễm trùng, mất nước, mất máu, thiếu máu, tụt HA, choáng, rối loạn điện giải (kali, magiê, calci</span><span style="font-family: Verdana; font-size: 9pt;">) kích thích giao cảm, rượu, thuốc lá, lo lắng, bồn chồn, cường giáp, gắng</span><span style="font-family: Verdana; font-size: 9pt;"> sức, bệnh tim thiếu máu cục bộ, đau thắt ngực biến thể Prinzmetal (variant angina pectoris), sa van hai lá, các bệnh về cấu trúc tim (hội chứng QT kéo dài, loạn sản thất phải sinh loạn nhịp (arrhythmogenic right ventricular dysplasia), bệnh cơ tim phì đại và các bệnh tim khác</span><span style="font-family: Verdana; font-size: 9pt;">) hoặc dùng thuốc quá liều nhất là</span><span style="font-family: Verdana; font-size: 9pt;"> thuốc chống loạn nhịp nhóm 1C, 1A, digitalis, thuốc chống trầm cảm, theophylin…</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Dưới đây chỉ khuyến cáo cách chọn phương pháp điều trị theo thứ tự ưu tiên cho từng loại loạn nhịp còn mỗi khi sử dụng một thứ thuốc nào đó cho bệnh nhân, cần chú ý thêm đến các chống chỉ định, tương tác bất lợi và tương tác thuốc thích hợp.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị trực tiếp loạn nhịp bao gồm:</span></i><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 45pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">1. Các loạn nhịp trên thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 45pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">2. Các loạn nhịp thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Riêng về các rối loạn dẫn truyền (Block xoang-nhĩ, blốc nhĩ-thất) và các kỹ thuật tạo nhịp sẽ là đề tài trong 1 khuyến cáo sau.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">B. Ðiều trị các rối loạn nhịp trên thất<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Danh từ "Loạn nhịp trên thất" bao gồm nhiều loại loạn nhịp xuất phát từ nút xoang, cơ nhĩ, bộ nối nhĩ thất, cầu dẫn truyền phụ…kịch phát hay trường diễn, nhưng hay gặp và quan trọng hơn cả vẫn là bệnh rung nhĩ trường diễn rồi đến các nhịp nhanh trên thất kịch phát (NNTTKP).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các nhịp nhanh trên thất kịch thích phát đại đa số là do cơ chế vào lại xảy ra trong nút nhĩ-thất (N/T) (nhịp nhanh vào lại nút nhĩ thất) hay trong nút N/T kèm với một cầu nối phụ có dẫn truyền chiều xuôi nhĩ-thất (hội chứng tiền kích thích) hoặc trong nút N/T kèm với một cầu nối phụ chỉ dẫn truyền theo chiều ngược thất-nhĩ (nhịp nhanh vào lại nhĩ-thất, với cầu nối bị ẩn giấu), loại này cùng với nhịp nhanh vào lại nút nhĩ thất chiếm tới 90% các ca nhịp nhanh trên thất kịch phát nhưng lại là một khái niệm ít biết đến.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Các loại loạn nhịp ở xoang hoặc ở nhĩ ít quan trọng hoặc ít gặp bao gồm:<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">1.1. Các ngoại tâm thu nhĩ (NTT/N) (đôi khi xoang) và các NTT bộ nối (xuất phát từ bó His vì nút nhĩ</span></i><span style="font-family: Verdana; font-size: 9pt;"> thất không có tính tự động) thường lành tính và không cần điều trị gì.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðôi khi chúng gây triệu chứng (trống ngực) khó chịu hoặc làm cò nẩy cho cơn nhịp nhanh kịch phát trên thất thì có thể cho an thần, thuốc chẹn beta, đôi khi quinidin và nhóm I. Có khi chúng báo hiệu suy tim (ứ máu lên nhĩ) cần điều trị suy tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">1.2. Các nhịp nhanh vào lại xoang hoặc nhĩ (không bao gồm nhịp nhanh xoang thông thường do</span></i><span style="font-family: Verdana; font-size: 9pt;"> tăng tính tự động nút xoang chỉ cần điều trị nguyên nhân) bao giờ cũng bị phát động bởi một NTT/N và thường hay do một bệnh tim thực tổn. Chẩn đoán ÐTÐ:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Đối với Nhịp nhanh vào lại xoang dựa vào một dạng tim nhanh với sóng P hình dạng xoang nhưng PR dài ra, trái hẳn với nhịp nhanh xoang thông thường có PR ngắn lại. Khác với block nhĩ thất cấp 1 nó không kèm nhịp nhanh, không do một NTT/N phát động và ít khi có kèm bệnh tim thực tổn.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Đối với nhịp nhanh vào lại nhĩ: có P hình dạng khác P xoang và PR dài ra. Ðiều trị giống như các nhịp nhanh vào lại trên thất khác, trừ thủ thuật triệt bỏ qua dây thông ít kết quả vì có thể có nhiều ổ vào lại.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">1.3. Các nhịp nhanh nhĩ không vào lại (mà do hoạt động nẩy cò) có thể do ngộ độc</span></i><span style="font-family: Verdana; font-size: 9pt;"> digitalis hoặc một bệnh tim hay phổi nặng với giảm kali huyết hoặc dùng theophylin hay các thuốc cường giao cảm. Hinh thái ÐTÐ hay gặp nhất là dạng nhịp nhanh nhĩ nhiều ổ (multifocal atrial tachycardias = MAT) với những loạt từ 3 sóng P liên tiếp trở lên có hình dạng khác nhau cách nhau bởi những khoảng đồng điện với tần số trên 100/phút. Nhịp thất cũng không đều vì dẫn truyền nhĩ thất thay đổi; 50-70% số ca đố bị biến thành rung nhĩ. Ðiều trị chủ yếu là hướng về nguyên nhân gây loạn nhịp như suy tim, tâm phế mạn, nghiện rượu. Ðặc biệt, metoprolol và esmolol có tác dụng tốt.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Loạn nhịp do digitalis có thể do cơ chế nẩy cò và hoặc tăng tính tự động, hay kèm Block nhĩ/thất với tần số nhĩ ít khi vượt quá 180C/phút, thường khỏi bệnh khi ngừng digitalis.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh nhĩ với cơ chế tăng tính tự động và không do digitalis rất khó chữa khỏi. Ở đây chữa chủ yếu là khống chế tần số thất ở mức bình thường bằng thuốc ức chế dẫn truyền ở nút nhĩ-thất như digitalis, chẹn beta, chặn dòng calci hoặc triệt bỏ thân bó His qua dây thông hay bằng phẫu thuật (rồi cấy máy tạo nhịp thất). Phương án triệt bỏ ổ gây loạn nhịp ở nhĩ sau khi làm đồ bản điện học nhĩ khó thành công vì hay có nhiều ổ phát xung.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Rung nhĩ (RN)<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Rung nhĩ là do có rất nhiều vòng vào lại nhỏ rải rác khắp cơ nhĩ, hình thành nhiều ổ phát xung với tần số 350-600C/phút làm nhĩ "rung" và mất nhát bóp đồng thời dẫn truyền một phần xuống thất làm nhịp thất cũng nhanh và không đều.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Bệnh viện Bạch Mai đã tiến hành điều trị rung nhĩ bằng sốc điện (và bằng thuốc) lần đầu tiên ở Việt <st1:place w:st="on"><st1:country-region w:st="on">Nam</st1:country-region></st1:place>năm 1973. Cho tới nay đã thực hiện trên 6000 ca và đã đúc kết được nhiều kinh nghiệm. Có 2 phương án điều trị:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">2.1. Chuyển nhịp rung nhĩ về nhịp xoang dập tắt các ổ vào lại: chỉ định cho các ca rung nhĩ trường diễn</span></i><span style="font-family: Verdana; font-size: 9pt;">(không phải kịch phát) với nguy cơ tái phát thấp và trung bình theo thứ tự ưu tiên như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Sốc điện: an toàn và hiệu quả nhất. Trong 6000 ca nói trên (25 năm) đạt tỷ lệ thành công 90% mà không gây tai biến tử vong hay tàn phế.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Amiodaron tiêm tĩnh mạch hoặc uống liều cao: hiệu quả 65% và an toàn, không bị biến chứng nặng. Chú ý tiêm thẳng vào tĩnh mạch dưới đòn (nếu có thể, qua 1 dây thông) vì thuốc có hàm lượng iốt cao, tiêm ngoại biên có thể gây viêm tĩnh mạch nhất là khi truyền lâu.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Disopyramid tiêm tĩnh mạch: chỉ dùng cho những ca chức năng tim còn tốt và nhịp tim chậm (vì có tác dụng giống atropin). Nếu tim nhanh nên cho trước digitalis.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Thuốc có thể làm rung nhĩ chuyển qua cuồng nhĩ (tần số tim nhanh vọt lên) trước khi về xoang. Ðể tránh tương tác bất lợi nguy hiểm đó ta có thể cho digitalis, chẹn beta hay verapamil trong vài ngày trước để khống chế tần số thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Quinidine chậm</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Disopyramide chậm</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Flecainid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Chẹn giao cảm beta (propranolol, sotalol) nếu rung nhĩ là do cường giao cảm đã được chứng minh bằng nghiệm pháp gắng sức hay phương pháp Holter.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Amiodaron: ít khi phải dùng đến vì dùng lâu dài dễ bị các tương tác bất lợi nặng nề (cường hay suy giáp, xơ phổi, sạm da).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Tất cả các thuốc trên đều có thể phối hợp digitalis để tăng thêm hiệu lực. Riêng quinidin và amiodaron có thể làm tăng độc tính của digitalis, vậy khi phối hợp phải giảm liều digitalis xuống một nửa.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">2.2. Ðiều trị lâu dài giảm tần số thất: chỉ định cho những ca không thể chuyển về xoang hoặc có</span></i><span style="font-family: Verdana; font-size: 9pt;"> nguy cơ tái phát rung nhĩ cao. Chọn lần lượt:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Digitalis dùng ưu tiên số một vì rẻ và đơn giản, nhưng kém tác dụng khống chế tần số khi bệnh nhân ở tư thế đứng hay hoạt động thể lực.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Chẹn giao cảm beta: không bị nhược điểm đó nên sử dụng tốt ở những bệnh nhân cần hoạt động lưu động nhưng phải lưu ý các chống chỉ định.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Verapamil hay diltiazem: cũng như thế.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Triệt bỏ thân bó His qua dây thông bằng tần số radio, hay tia chớp điện, hoặc phẫu thuật rồi cấy máy tạo nhịp thất.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Khi dùng các phương pháp này, nên cho phối hợp lâu dài thuốc chống đông dicoumarol (và Aspirin) vì rung nhĩ vẫn còn, có thể có nguy cơ hình thành cục máu đông di chuyển lên nghẽn mạch não, nhất là khi có cả hẹp van hai lá.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Rung nhĩ có kèm hội chứng tiền kích thích tức là có một cầu dẫn truyền nhĩ-thất phụ, cầu này thường là mô cơ nhĩ nên có thời kỳ trơ ngắn (dẫn truyền dễ) hơn nhiều so với nút nhĩ-thất Tawara. Do đó, dễ có nguy cơ chết đột ngột do các xung rất nhanh của rung nhĩ từ nhĩ đi qua cầu phụ xuống gây rối loạn và rung thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nguy cơ đó càng dễ xảy ra nếu ta cho digitalis vì nó làm rút ngắn thêm thời kỳ trơ của cầu phụ, vì vậy ở đây có chống chỉ định digitalis.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các thuốc verapamil hay diltiazem đôi khi cũng có thể gây nguy hiểm như vậy vì chúng làm chậm dẫn truyền qua nút nhĩ thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Cuồng nhĩ (CN)<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Cuồng nhĩ là một loạn nhịp rất gần rung nhĩ và đồ bản điện học đã cho thấy là do một vòng vào lại ở phần thấp nhĩ phải, gần tĩnh mạch chủ, tạo nên một nhịp nhĩ đập 250-350 C/phút và dẫn truyền xuống thất thường hay gặp nhất là dạng 2/1 nghĩ là tần số thất khoảng 150 C/phút. Cuồng nhĩ thường tồn tại ngắn hạn (trong vòng 1 tuần) rồi chuyển sang rung nhĩ hoặc về xoang.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị: bằng cách chuyển nhịp về xoang với các phương pháp sau đây:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Sốc điện với dòng điện nhẹ (10-50W/s) do đó chỉ cần cho an thần nhẹ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Các thuốc giống như với rung nhĩ (amiodaron, quinidin, disopyramid, flecainid, propafenon) với liều tăng dần. Chúng hạ tần số nhĩ (vào vòng lại) xuống cho đến khi tắt hẳn trả lại quyền chủ nhịp cho nút xoang. Nhưng có trường hợp khi tần số nhĩ hạ tới dưới 220C/phút đồng thời thuốc trên lại có tác dụng cắt phế vị, là các điều kiện làm cho nút nhĩ thất có khả năng dẫn truyền 1/1 do đó làm cho tần số thất tăng vọt lên (thí dụ 220C/phút) rất nguy hiểm. Ðể tránh tác dụng phụ này, có thể cho digitalis, chẹn beta hay chẹn dòng calci (verapamil) trước một vài ngày để chặn bớt dẫn truyền ở nút nhĩ-thất do đó khống chế được tần số thất (giống như trong rung nhĩ). Riêng với digitalis cho như thế, cuồng nhĩ có khi chuyển sang rung nhĩ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Tạo nhịp vượt tần số vào nhĩ với tần số xung khoảng 115-130% của tần số cuồng nhĩ thường cũng về xoang nhưng cũng có khi chuyển sang rung nhĩ, nó dễ khống chế tần số thất hơn cuồng nhĩ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị lâu dài chống tái phát cũng giống như rung nhĩ.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị chống đông thường không cần thiết vì ít khi bị tai biến lấp mạch.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">4. Nhịp nhanh vào lại nút nhĩ thất<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh vào lại nút nhĩ thất (NNVLNNT - AV nodal reentrant tachycardia) trước kia thường gọi là nhịp nhanh bộ nối, hoặc nhịp nhanh nút, là loại nhịp nhanh trên thất kịch phát hay gặp nhất. Nó do một vòng vào lại xảy ra ngay trong lòng nút N/T bao gồm một nhánh alpha dẫn truyền chậm nhưng có thời kỳ trơ ngắn và một nhánh beta dẫn truyền nhanh nhưng có thời kỳ trơ dài. Khi vì một lý do nào đó sự dẫn truyền trong đường alpha bị chậm thêm đủ mức để khi xung động xoang qua đó xuống tới bó His thì thời kỳ trơ của đường beta cũng đã hết: xung động lúc đó sẽ có thể đi ngược lên qua đường beta, rồi "vào lại" đường alpha, tạo nên một kích thích mới (NTT/N) nó có thể tiếp tục vận động vòng tròn như trên nhiều lần (nếu có mối cân giữa tốc độ dẫn truyền và tính trơ của hai nhánh) để sinh ra cơn nhịp nhanh. Cơ chế đó cắt nghĩa hình ảnh ÐTÐ của cơn nhịp nhanh như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Tần số tim từ 120-150 C/phút (trước kia quy định từ 140-240).</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">QRS vẫn hẹp như lúc ngoài cơn (xoang) vì xung động vẫn đi xuống thất qua bó His bình thường (trừ trường hợp dẫn truyền lệch hướng thì QRS giãn rộng).</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Sóng P phần lớn là vắng mặt đôi khi thể hiện thành một chỗ biến dạng ở phần cuối của QRS do xung động đi ngược lên nhĩ (khử cực ngược chiều) cùng đồng thời với đầu kia đi xuống thất nên P nhĩ bị vùi hẳn (hay phần đầu) trong QRS.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Ngoại tâm thu nhĩ khởi phát cho cơn bao giờ cũng có PR dài ra do bị dẫn truyền chậm trong đường alpha. Tất cả các điều kiện đó có thể chứng minh bằng thăm dò và phát xung vào bó His (thấy khoảng AH dài, khử cực nhĩ ngược chiều …)</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị:<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh này hay gặp ở nữ hơn nam và thường gây hồi hộp, trống ngực thậm chí có khi tụt HA, ngất, suy tim; mặt khác nút N/T lại nhận đặc biệt nhiều nhánh phế vị và có cấu trúc tế bào khử cực dựa vào dòng calci chậm (pha 2 của điện thế hoạt động) chứ không phải dòng natri nhanh (pha 0), do đó điều trị hợp lý nhất là dùng các phương pháp cường phế vị (adenosin, digitalis,…) hoặc tác dụng vào kênh calci (verapamil, diltiazem,…) Theo kinh nghiệm nên chọn thuốc theo thứ tự ưu tiên như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">4.1. Cắt cơn nhịp nhanh<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Các thủ thuật cường phế vị như xoa xoang cảnh, động tác Valsalva… có thể cắt cơn 80%.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Verapamil: 2,5-10 mg tiêm tĩnh mạch chậm trong 2-3 phút.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Adenosin: 6-12 mg tiêm tĩnh mạch thật nhanh vì thời gian bán thải rất ngắn. Gây một cường phế vị rất mạnh, có thể làm ngừng tim vài giây nhưng thường bệnh nhân hồi phục ngay. Tuy nhiên, cũng nên chuẩn bị atropin để đối phó (tiêm tĩnh mạch 0,5-1,0 mg) khi cần thiết.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Phenylephrin (neosynephrin) ống 0,1 mg tiêm tĩnh mạch có thể cắt cơn đồng thời làm HA tăng lên. Do đó nên dùng khi bệnh nhân có tụt HA.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Isolanide (digitalis) ống 0,4 tiêm vào tĩnh mạch có thể nhắc lại 2-3 lần cách nhau 3-4 giờ. Cắt cơn chậm hơn. Nên dùng khi có kèm suy tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Propranolol 0,05-0,2 mg/kg hoặc chẹn beta khác, chỉ dùng vào hàng ưu tiên thấp.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Tạo nhịp tạm thời vào nhĩ hoặc thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Sốc điện: nên dùng để cắt cơn nhanh chóng khi bệnh nặng, có thiếu máu cục bộ cơ tim nặng và/hoặc tụt HA.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">4.2. Dự phòng tái phát cơn.<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Thường phải dùng thuốc lâu dài, vậy nên nếu các cơn quá nặng, quá mau mà bệnh nhân không thể tự dùng động tác để tự cắt cơn:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Digitalis hoặc chẹn beta, hoặc chẹn dòng calci nên được chọn ưu tiên hàng đầu vì có tỷ lệ lợi ích/nguy cơ rất tốt. Chúng tác dụng đúng vào nhánh alpha dẫn truyền chậm của vòng vào lại.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Các thuốc nhóm IA (Quinnidin…) hoặc IC (Flecainid…) hoặc amiodaron, hoặc sotalol đều có thể dùng nhưng chỉ có tác dụng gián tiếp (vào nhánh beta) nên kém hơn và nhiều tương tác bất lợi.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Và chính xác hơn cả là thăm dò điện sinh lý học, kích thích có chương trình để chọn được thứ thuốc có khả năng ngăn cản cơn tốt nhất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Tác động lên chức năng nút N/T bằng tần số radio qua dây thông hiện nay là thủ thuật hàng đầu để chữa khỏi hẳn chứng nhịp nhanh này tới trên 90% một cách an toàn. Chỉ có từ 1 đến 5% gây ra block N/T, lúc đó cần cho cấy thêm một máy tạo nhịp thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">5. Nhịp nhanh vào lại nhĩ - thất<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh vào lại nhĩ-thất (NNVLNT) (AV reentrant tachycardia) trước kia được gọi nhầm là nhịp nhanh nút (hay bộ nối) dưới. Do một vòng vào lại bao gồm một đường cho xung động từ nhĩ đi xuống thất là bộ nối nhĩ thất Tawara-His bình thường và một đường đi tiếp ngược lên nhĩ là một cầu dẫn truyền phụ thất/nhĩ (VA accessory pathway) để rồi "vào lại" bộ nối N/T lập nên một vận động tròn liên tục tạo ra cơn nhịp nhanh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Ở đây cầu dẫn truyền phụ không bao giờ dẫn truyền theo chiều xuôi từ nhĩ xuống thất, do đó không bao giờ có hiện tượng tiền kích thích để hiện ra các hình ảnh ÐTÐ kiểu W-P-W hay kiểu PR ngắn (Lown - Ganong - Levine) do đó được gọi là cầu dẫn truyền phụ ẩn giấu (concealed W-P-W).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Vòng vào lại như vậy sẽ tạo ra tình huống thất hoạt hóa trước rồi đến nhĩ hoạt hóa sau theo kiểu ngược dòng làm cho ÐTÐ có một sóng P âm (ở DII, DIII, aVF) đứng hẳn ra sau mỗi QRS, một hình ảnh mà lâu nay vẫn gọi là nhịp nhanh nút dưới.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Cơn nhịp nhanh có thể được phát động (hoặc kết thúc) không những bởi một NTT/N như NNVLNN/T mà có thể bởi một NTT/T xuất phát từ đoạn vòng vào lại đi qua tâm thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Ở 1/3 số ca có luân phiên hình dạng của QRS và/hoặc sóng T.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Thăm dò điện sinh lý học để xác định chẩn đoán NNVLN/T, có thể:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Phát hiện ra cầu nối phụ ẩn giấu dẫn truyền ngược lên nhĩ bằng cách:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">a. Cho kích thích thất vào thời điểm bó His đang trơ, thấy xung động dẫn truyền được lên nhĩ.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">b. Cho kích thích thất vào một thời điểm không dẫn truyền được lên nhĩ nhưng lại cắt được cơn nhịp nhanh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Xác định được vị trí cầu nối phụ ẩn giấu bằng cách ghi đồ bản điện học nhĩ. Đặt một dây thông nhiều điện cực trong nhĩ và sâu trong xoang vành (vùng nhĩ trái) và đa số các ca, ghi được một loạt hoạt động điện học sớm nhất ở vùng nhĩ trái, có nghĩa là cầu dẫn truyền phụ (ẩn giấu) nằm ở mé bên trái. Phương thức hoạt hóa lệch tâm này khác hẳn với thứ thự hoạt hóa ngược chiều thông thường trong đó điểm hoạt hóa sớm nhất là ở vùng bộ nối N/T, nghĩa là đúng tâm.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Vì vòng vào lại ở đây cũng đi qua nút N/T nên cũng có thể dùng các thuốc điều trị giống như với NNVLNN/T.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nhưng tốt hơn cả là nên triệt bỏ cầu dẫn truyền phụ sau khi đã thăm dò điện sinh lý kỹ lưỡng như trên, cũng là để chẩn đoán phân biệt với các LN khác chúng cũng có thể gây ra các triệu chứng khó chịu tương tự. Triệt bỏ có thể bằng:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">a. Tần số radio qua dây thông, hiện nay là ưu việt nhất, với thành công ở trên 90% mà nguy hiểm rất ít.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">b. Phẫu thuật cắt cầu phụ dưới sự hướng dẫn của đồ bản điện học; nên làm ở một số ít ca mà tần số radio thất bại.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">6. Hội chứng tiền kích thích (W-P-W…)<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Hội chứng tiền kích thích bao giờ cũng do một hay nhiều cầu phụ có thể dẫn truyền hai chiều: nhĩ xuống thất và ngược lại. Khi đang ở nhịp xoang, xung động đi xuôi chiều từ nhĩ xuống thất theo cả 2 đường: đường cầu phụ và đường bộ nối N/T bình thường lập nên tình huống hoạt hóa thất hỗn hợp làm hiện ra hình ảnh ÐTÐ hỗn hợp kiểu W-P-W (P ngắn, sóng delta, QRS rộng hay hội chứng P ngắn, trước đây gọi là Lown-Ganong-Levine (L-G-L)… Như vậy, đây là một cầu nối phụ không ẩn giấu (non concealed conduction).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các cầu phụ đó là những dải cơ có cấu trúc như cơ tâm nhĩ và có thể nằm ở bất kỳ chỗ nào quanh vòng cơ nhĩ - thất. Hội chứng có thể đi một mình hoặc kèm với một dị tật bẩm sinh mà hay gặp nhất là bệnh Ebstein.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Khi có điều kiện thuận lợi nào đó (cường giao cảm…) một xung động đi xuống thất bằng đường His sẽ đi ngược lên nhĩ bằng đường cầu phụ rồi "vào lại" đường His để đi xuống lặp lại hoạt hóa tâm thất gây ra một vòng vào lại và cơn nhịp nhanh trên thất kịch phát giống hệt như cơn nhịp nhanh vào lại nhĩ/thất đã tả trên. Chỉ có 5% các ca xung động đi theo chiều ngược lại xuống thất qua cầu nối, hoạt hóa toàn bộ thất (làm QRS dãn rộng) rồi đi ngược lên nhĩ qua đường His để vào lại cầu nối phụ: vòng vào lại ngược này có QRS giãn rộng nên rất khó chẩn đoán phân biệt với nhịp nhanh thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Khi có rung hay cuồng nhĩ phối hợp với tiền kích thích cầu nối (là một dải cơ nhĩ) không có cấu trúc làm giảm chậm dẫn truyền như nút N/T nên có thể dẫn truyền các xung động rất nhanh của rung, cuồng nhĩ xuống thất gây ra nhịp nhanh thất thậm chí gây ra rung thất và chết đột ngột.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Tình trạng này càng dễ xảy ra khi ta cho bệnh nhân dùng digitalis vì nó làm rút ngắn thời kỳ trơ và tăng tính dẫn truyền của các dải cơ cầu phụ.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Thăm dò ÐSLH, rất cần khi can thiệp bằng các thủ thuật, có thể giúp ta:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">1. Xác định chẩn đoán.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">2. Xác định vị trí và số lượng các cầu phụ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">3. Chứng minh vai trò của cầu phụ gây ra loạn nhịp</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">4.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"> </span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Xác định mức điện thế có thể gây ra cơn nhịp nhanh đe dọa tính mạng khi có mặt rung cuồng nhĩ.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">5. Ðánh giá các phương án điều trị</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">1. Ðiều trị ngăn chặn cơn nhịp nhanh<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị thuốc: mục tiêu là tác động lên một hay nhiều thành phần của vòng vào lại để ngăn chặn nó khỏi hoạt động và gây ra nhịp nhanh. Cụ thể như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Hay dùng nhất là beta, verapamil, diltiazem, digitalis… để làm chậm dẫn truyền và tăng tính trơ của nút nhĩ thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ </span><span style="font-family: Verdana; font-size: 9pt;">Rồi đến quinidin, flecainid, propafenon… làm chậm dẫn truyền và tăng tính trở chủ yếu của cầu phụ.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các thuốc khác cũng có tác dụng và đều có thể dùng tùy theo tỷ lệ hiệu quả/nguy cơ của từng ca bệnh như: procainamid, disopyramid, eucainid, sotalol, amiodaron.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Chú ý: Khi có rung, cuồng nhĩ đi kèm với W-P-W thì có chống chỉ định của digitalis và</span></i><span style="font-family: Verdana; font-size: 9pt;"> điều đó càng tuyệt đối cấm đối với đường tiêm tĩnh mạch. Cũng với lý do đó, verapamil cũng không được dùng tiêm tĩnh mạch nhưng có thể điều trị mạn tính theo đường uống. Trong trường hợp các xung động của rung nhĩ được dẫn truyền xuống thất qua cầu phụ thì các chẹn beta cũng không có lợi ích gì vì không khống chế được đáp ứng tăng tần số của thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Triệt bỏ cầu phụ bằng tần số radio qua dây thông thật tuyệt vời vì có thể đạt hiệu quả chữa khỏi bệnh tới trên 90%, lại rất an toàn. Tỷ lệ giá thành/hiệu quả rẻ nên rất được ưa dùng.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Phẫu thuật cắt đứt, triệt bỏ cầu phụ dưới sự hướng dẫn của đồ bản điện học: tuy cũng đạt hiệu quả như vậy nhưng phức tạp hơn nên chỉ còn dùng khi tần số radio thất bại.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">2. Ðiều trị cấp cơn nhịp nhanh<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">a. Nếu là cơn nhịp nhanh trên thất kích phát do W-P-W thì điều trị cũng tương tự như nhịp nhanh có cầu nối ẩn giấu như kích thích phế vị, adenosin… Riêng về máy tạo nhịp nhĩ hoặc thất thì có thể cắt cơn rất tốt nhưng chỉ nên dùng kiểu cấp chứ không nên dùng kiểu mạn tính vì nó có thể gây ra rung nhĩ bất lợi.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">b. Nếu là cơn nhịp nhanh do rung nhĩ trên cơ sở W-P-W thì nên sốc điện ngay vì dễ bị rung thất. Nếu không có máy sốc điện thì có thể làm chậm nhịp thất xuống bằng lidocain (3-5mg/kg) hay procainamid (15mg/kg) tiêm tĩnh mạch trong 15-20 phút.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">7. Nhịp nhanh bộ nối không kịch phát<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Bệnh này là do trong bộ nối nhĩ thất xảy ra hoạt động nẩy cò, hoặc tăng tính tự động, phát ra xung động nhanh đoạt quyền chỉ huy tim của nút xoang.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Cơ chế như vậy thường nhất là do ngộ độc digitalis, nhồi máu cơ tim sau dưới viêm cơ tim, tăng quá mức catecholamin nội sinh hoặc ngoại sinh, thấp khớp cấp hoặc sau một phẫu thuật van tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nhịp nhanh khởi phát không đột ngột mà từ từ với một thời kỳ "ấm dần lên" cho tới khi ổn định ở tần số 70-150C/phút. Nếu nhanh hơn nữa thì thường là do digitalis.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Hình dạng điện tâm đồ là kiểu nhịp bộ nối QRS hẹp giống như lúc nhịp xoang. Có dạng block hay N/T hay phân ly nhĩ thất (do digitalis) hoặc dạng dẫn truyền ngược dòng do tình trạng cường giao cảm xảy ra ngay sau phẫu thuật tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Ðặc biệt, giống như ở nút xoang, tần số nhịp nhanh bộ nối ở đây có thể bị ảnh hưởng của trương lực hệ thần kinh tự động, tăng lên do catecholamin, do các thuốc cắt phế vị, gắng sức, và giảm xuống với một mức độ nào đó khi xoa xoang cảnh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Chủ yếu là loại bỏ nguyên nhân. Với ngộ độc digitalis, phải ngừng thuốc ngay vì nếu xuất hiện những loạn nhịp nhĩ hay thất nặng nề thì phải cho lidocain, chẹn beta và khi cần, cho kháng thể kháng digitalis (Fab fragments).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Tạo nhịp nhĩ, nếu không có block nhĩ thất, có thể bắt được và gối lên ổ ngoại vị bộ nối, tạo ra hoạt hóa đồng bộ nhĩ thất để có thể có được một cung lượng tim tối ưu.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Chú ý</span></i><span style="font-family: Verdana; font-size: 9pt;">: Không nên làm sốc điện, nhất là nếu có ngộ độc digitalis.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Tiên lượng tim nhanh bộ nối không kích phát thường tốt, bệnh không hay tái phát hoặc trở thành mạn tính và thường hay khỏi hẳn nếu ta chú ý điều trị nguyên nhân cấp tính gây ra nó.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">C. Ðiều trị các rối loạn nhịp thất<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><st1:street w:st="on"><st1:address w:st="on"><span style="font-family: Verdana; font-size: 9pt;">Các LN</span></st1:address></st1:street><span style="font-family: Verdana; font-size: 9pt;"> thất thường nguy hiểm hơn và điều trị khó khăn hơn LN trên thất. Chúng bao gồm ngoại tâm thu-thất, nhịp nhanh thất, xoắn đỉnh và nhịp tự thất gia tốc.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Ngoại tâm thu thất<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ngoại tâm thu thất (NTT/T) là loại tim hay gặp nhất bao gồm 2 loại khác hẳn nhau về tiên lượng và điều trị: loại không do một bệnh tim thực tổn và loại do một bệnh tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">1.1.NTT/T không do bệnh tim, nhất là bệnh tim thiếu máu cục bộ;</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i></b><span style="font-family: Verdana; font-size: 9pt;">qua nhiều nghiên cứu<b><i> </i></b>cho thấy rằng chúng không làm tăng tỷ lệ tử vong hoặc tỷ lệ mắc bệnh dù cho chúng xuất hiện rất mau, có hình thái phức tạp, hoặc gây ra nhiều triệu chứng: trống ngực, tức ngực, khó thở, mệt mỏi thậm chí ngất xỉu.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Khi không gây triệu chứng: không cần cho uống thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Khi có triệu chứng khó chịu:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Trước hết làm giảm lo lắng, hoặc cho an thần và nếu không đỡ triệu chứng thì mới cho thuốc chống loạn nhịp.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ </span><span style="font-family: Verdana; font-size: 9pt;">Thuốc chống LN đầu tiên nên cho là các chẹn giao cảm beta như propranolol, atenolol, metoprotol và đặc biệt là sotalol vì nó có tác dụng của Nhóm II và Nhóm III. Các chẹn beta đặc biệt có hiệu quả đối với các NTT/T xảy ra ban ngày hoặc do bị stress, hoặc do cường giáp hay sa van hai lá. Ngược lại, nếu có kèm nhịp chậm (<60C/phút) thì nên cho disopyramid (Rythmodan) vì nó làm nhịp tim nhanh lên.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu không có hiệu quả thì cho các thuốc dạng quinidin (Nhóm 1A).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">1.2. NTT/T do bệnh tim<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðặc biệt nhất là do bệnh tim thiếu máu cục bộ, có tới 80% bệnh nhân nhồi máu cơ tim mới hay cũ bị NTT/T. Trong khung cảnh này, NTT/T càng nặng (theo phân cấp của Lown): xuất hiện mau >30/1h, đa dạng, thành chùm, dạng/T thì tỷ lệ tử vong, đột tử càng cao, nhất là khi kèm suy giảm chức năng thất trái (EF = 40%) hoặc QT kéo dài thì việc điều trị càng cấp thiết hơn, nhằm làm giảm bớt nguy cơ NTT/T nặng lên thành các loạn nhịp thất ác tính (nhịp nhanh thất, rung thất) gây tử vong, đột tử.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị cấp tính đối với các NTT/T nhất thời do ngộ độc digitalis, nhồi máu cơ tim, suy cấp, rối loạn điện</span></i><span style="font-family: Verdana; font-size: 9pt;"> giải… như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu NTT/T là do loạn nhịp chậm: cho atropin, isoproterenol hay tạo nhịp tạm thời có thể hết NTT. Nếu cơ năng còn tốt thì có thể cho disopyramid.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu do nhịp nhanh xoang: cần làm nhịp chậm lại.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Xoá bỏ NTT/T trước tiên nên dùng lidocain tiêm tĩnh mạch với cách cho giống như trong nhịp nhanh thất nếu thất bại thì tiêm tĩnh mạch thử lần lượt cách nhau 15 phút: procainamid (chú ý phản ứng tụt HA), amiodaron, quinidin, propranolol hoặc magiê.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị NTT/T mạn tính do bệnh tim thường chỉ định khi có triệu chứng và thuộc cấp cao (cấp 3,4,5 của</span></i><span style="font-family: Verdana; font-size: 9pt;">Lown). Nhưng khống chế được NTT/T nhiều khi rất khó khăn: chủ yếu điều trị bằng thuốc và thường phải uống lâu dài vì nếu ngừng thuốc thì NTT/T lại tái phát như cũ. Liều lượng thuốc phải theo nguyên tắc giữ ở liều thấp nhất mà đạt hiệu quả. Tiêu chuẩn đạt hiệu quả thường quy ước là số NTT/T giảm bớt từ = 70%. Mặt khác sự sử dụng thuốc phải rất thận trọng và hạn chế, nhất là sau kết luận của nghiên cứu CAST. Nghiên cứu này so sánh ngẫu nhiên và khách quan tiến triển của một nhóm lớn bệnh nhân được dùng thuốc eucainid, Flecainid và moricizin (nhóm IC) để xóa bỏ NTT/T sau NMCT nhằm đề phòng chuyển lên LN ác tính và tử vong với một nhóm chỉ dùng giả dược. Sau 2 năm, nghiên cứu này bị đình chỉ lại vì tỷ lệ tử vong và đột tử của nhóm dùng thuốc đã tăng lên một cách đáng kể so với nhóm giả dược. Hiện nay nên chọn dùng lần lượt các thuốc sau đây:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Sotalol (uống 40-320mg/ngày) có hiệu quả làm giảm tới 75% số NTT/T ở 34-91% các ca tùy theo liều lượng; nhưng có thể gây xoắn đỉnh nếu tần số tim xuống <50 C/phút (nên ngừng uống thuốc).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Amiodaron (uống 200-700mg/ngày) cũng có hiệu quả cao ở 89% các ca. Nó rất ít làm giảm lực co cơ tim hoặc gây xoắn đỉnh nhưng dùng lâu dài thì có nhiều ứng tác bất lợi (tuyến giáp, xơ phổi). Riêng bệnh cơ tim giãn có NTT/T thì rất cần amiodaron vì hay có suy tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Các thuốc khác thuộc các nhóm I, II, hầu hết cũng đều có hiệu quả lên NTT/T. Quinidin chậm có hiệu quả tốt 33-62% các ca) nhưng hay gây xoắn đỉnh. Mexiletin hiệu quả thấp (30%). Flecainid và propafenon làm giảm NTT/T ở tới 60-85% nhưng lại tăng đột tử rất cao. Nhóm IV và digitalis là chống chỉ định.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Propranolol và một số chẹn beta khác có tác dụng tốt lên NTT/T xảy ra trong các bệnh có tình trạng cường giao cảm như:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Hậu nhồi máu cơ tim: ở đây tác dụng kéo dài tuổi thọ đã được chứng minh chắc chắn.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Các bệnh thiếu máu cơ tim cục bộ mạn tính</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Bệnh sa van hai lá</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Bệnh cơ tim phì đại (phải liều cao 200-400 mg/24h)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Hội chứng QT kéo dài</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Riêng bisoprolol làm một thuốc mới có nhiều triển vọng nhưng tác dụng chống loạn nhịp còn cần được chứng minh nhiều hơn nữa.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Ðối với NTT/T do tăng huyết áp nên dùng metoprotol và diltiazem mà không dùng enalapril hay hydrochlorothiazid.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðể chọn thuốc thích hợp nhất, nhất là đối với các NTT/T cấp cao (3,4,5 của Lown) nếu điều kiện cho phép, nên làm thăm dò ÐSLH kích thích có chương trình.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các phương pháp cấy máy tạo nhịp, chuyển nhịp, phá rung, triệt bỏ qua dây thông hay phẫu thuật thường không có chỉ định trong NTT/T.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Nhịp nhanh thất (NN/T)<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">2.1. Bệnh cảnh và chẩn đoán nhịp nhanh/T<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh thất bền bỉ theo định nghĩa là một cơn nhịp nhanh có tần số trên 100 C/phút với QRS dãn rộng và cơn kéo dài trên 30 giây. Ổ phát xung động nằm ở thất nên làm mất thứ tự hoạt hóa bình thường của thất và mất tác dụng của nhát bóp nhĩ, do đó thường gây ra các triệu chứng nặng nề do suy huyết động có thể dẫn dến rung thất, ngừng tim. Ðại đa số các ca nhịp nhanh/T là do một bệnh tim, rối loạn chuyển hóa, hội chứng QT kéo dài với ổ phát xung gắn liền với một cấu trúc giải phẫu bệnh cố định ở thất. Còn nhịp nhanh/T không bền bỉ có cơn ngắn hơn 30 giây và về mọi mặt là nhẹ hơn.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Ðiều trị NN/T có kết quả hay không trước hết dựa trên cơ sở một chẩn đoán chính xác mà đó là một vấn đề khó khăn hạng nhất. Một nhịp nhanh với tần số thất trên 100 C/phút, với QRS giãn rộng, nhiều khi là NN/T nhưng cũng có thể là nhịp nhanh trên thất có kèm block nhánh hoặc có kèm W-P-W với vòng vào lại có xung động đi xuống thất qua đường cầu phụ, cả 2 trường hợp này có thể chẩn đoán phân biệt với NN/T dựa trên ÐTÐ ngoài cơn.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhưng vấn đề quan trọng nhất là chẩn đoán phân biệt với nhịp nhanh trên thất dẫn truyền lệch hướng mà về biến chứng và điều trị nó khác hoàn toàn với NN/T. Có thể dựa vào những gợi ý sau đây để chẩn đoán NN/T:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><i><span style="font-family: Verdana; font-size: 9pt;">ÐTÐ 12 chuyển đạo ghi ngoài cơn nhịp nhanh (lúc nhịp xoang) cho thấy:</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Dấu hiệu của một bệnh tim thực thể, nhất là một bệnh tim thiếu máu cục bộ, nhồi máu cơ tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Những ngoại tâm thu thất có hình dạng giống phức bộ QRS trong cơn (theo từng chuyển đạo).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><i><span style="font-family: Verdana; font-size: 9pt;">ÐTÐ 12 chuyển đạo trong cơn nhịp nhanh cho thấy:</span></i><span style="font-family: Verdana; font-size: 9pt;"></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ QRS rộng tới > 0,14s. Theo kinh nghiệm của chúng tôi thì QRS > 0,12s đã có thể nghi là NN/T. Nhưng nếu lại rộng quá 0,20s thì thường là tiền kích thích chứ không phải là NN/T, miễn là không có tác dụng thêm của thuốc nào.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Phân ly nhĩ thất (thường sóng P không rõ nên phải ghi chuyển đạo thực quản hay trong buồng nhĩ) hay dẫn truyền ngược dòng lên nhĩ (P âm ở D2, D3 a VF và đứng sau QRS).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Nhát bóp hỗn hợp và/hoặc nhát bắt được thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ QRS của NN/T đồng hướng ở tất cả các chuyển đạo trước tim (đều dương hoặc đều âm). theo kinh nghiệm trong rung nhĩ chiếm tới 26,9% và 88% là đồng hướng dương, nhiều gấp 7 lần đồng hướng âm (12%).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Ðại đa số là NN/T xuất phát từ thất trái: QRS có dạng block nhánh phải với V1 có dạng R móc, qR, Rr… (dạng tai thỏ), với trục hướng lên trên, khác hẳn NN/TT dẫn truyền lệch hướng thường V1 có dạng rsR…, hoặc rR….</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Chú ý:</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">- </span><span style="font-family: Verdana; font-size: 9pt;">Nhịp tim trong NN/T thường là đều hoặc chỉ hơi không đều. Nếu thấy rất không đều thì chắc chắn là rung nhĩ có dẫn truyền nhĩ thất qua một cầu phụ: nguy hiểm, phải xử trí ngay.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Tiêm tĩnh mạch adenosin hoặc verapamil có thể giúp chẩn đoán phân biệt nhưng nguy hiểm không nên dùng.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Ghi điện đồ His giúp ích rất nhiều, nhưng chưa làm phổ biến được vì thiếu phương tiện.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Thăm dò ÐSLH: kích thích thất có chương trình làm tái xuất hiện NN/T (90% các ca) hoặc làm kết thúc NN/T (76% các ca) có thể giúp đánh giá tác dụng và lựa chọn từng loại thuốc điều trị NN/T, kể cả tác dụng của máy chuyển nhịp/phá rung.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">2.2. Ðiều trị nhịp nhanh thất <o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">2.2.1. Cắt cơn nhịp nhanh<o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">a. Cơn nhịp nhanh thất không bền bỉ:</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu không kèm bệnh tim thực thể, và không gây triệu chứng đáng kể thì thường tiên lượng tốt và không cần cho thuốc chống LN, chỉ cho an thần.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu có kèm bệnh tim (nhồi máu cơ tim, suy tim, hội chứng QT kéo dài, bệnh tim khác, ngộ độc digitalis,…) nhưng chưa nguy kịch thì có thể lần lượt thử cho các thuốc sau đây, mỗi thuốc cách nhau 15 phút và thường đạt kết quả xóa cơn loạn nhịp ở 50-70%.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Lidocain: được dùng đầu tiên và nhiều nhất vì rất ít độc tính như giảm lực co cơ tim hay giảm dẫn truyền. Vì thời gian bán thải rất ngắn, chỉ 20 phút nên liều tấn công phải tiêm tĩnh mạch nhanh 3 đến 4 lần liên tiếp cách nhau 5 phút, lần đầu 80mg, các lần sau 50mg, tổng liều không quá 230mg. Nếu xóa được NN/T thì chuyển sang liều duy trì từ 1-4mg/phút truyền có thể liên tục nhiều ngày, không quá 4g/ngày. Nếu không xóa được NN/T thì chuyển sang thuốc khác.<o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Mexiletin: là một chất rất gần lidocain. Liều tấn công 250mg tiêm tĩnh mạch trong 15 phút rồi chuyển sang liều duy trì từ 250mg truyền trong 1 giờ sau đó 30-50 mg/h.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Amiodaron: rất ít giảm chức năng cơ tim (chỉ giảm khi tiêm quá nhanh) nên dùng tốt khi tim có chức năng giảm hoặc suy, nghi nhồi máu cơ tim, hay có block nhánh. Cần tiêm thẳng vào tĩnh mạch trung tâm và nếu có thể, qua một dây thông. Ông 150mg = 2ml pha thành 10ml tiêm trong 5 phút. Nếu không cắt cơn, nghỉ 10-30 phút rồi tiêm tăng lên 2 ống cũng trong 5 phút như trên. Nếu cơn còn tái phát có thể làm lại như trên cho đến tổng liều 6-8 ống/24h.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Sotalol: có làm giảm chức năng tim nên chỉ dùng ở các ca chức năng tim bình thường hoặc giảm trung bình. Tiêm tĩnh mạch 0,3-0,5mg/kg (có người dùng tới 2,0mg/kg) với tốc độ 5mg/phút. Tiêm 2-3 lần như thế cách nhau 10 phút.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Diphenylhydantoin (DPH) (nếu là do ngộ độ digitalis) liều 50mg/phút tiêm tĩnh mạch trong 5 phút. Nếu chưa xóa được cơn, có thể tiêm nhắc lại cho tới tổng liều 1000mg/24h. Thường đặt 1 dây điện cực vào buồng tim để tạo nhịp tạm thời khi cần. Nếu không có DPH, có thể thay bằng lidocain.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">b. Cơn nhịp nhanh thất bền bỉ<o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu không kèm bệnh tim thực tổn. NN/T bền bỉ vẫn gây triệu chứng khó chịu nên vẫn phải cho các thuốc để cắt cơn và thường đáp ứng tốt với chẹn beta, verapamil.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> Nếu có kèm bệnh tim thực tổn mà các triệu chứng chưa quá nặng đến mức cấp cứu thì ta có thể lần lượt thử dùng các thuốc tiêm tĩnh mạch theo thứ tự sau đây để cắt cơn:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+ Amiodaron</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Sotalol </span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"> Procainamid: thường có hiệu quả cao nhất. </span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Nó có thể căt cơn hay không cắt cơn NN/T nhưng hầu như bao giờ cũng làm giảm được tần số xuống. Nhưng có chống chỉ định trong suy tim và có thể gây một cơn tụt HA nặng nề do giãn mạch đột ngột. Liều đầu là 100mg tiêm tĩnh mạch trong 1 phút rồi tiếp 20mg/phút trong 20 phút. Tổng liều tấn công như vậy là 400-500 mg sau đó chuyển sang liều duy trì từ 2-6 g/24h.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">+</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Bretylium tosilat (Bretylat): chưa có phổ biến ở nước ta.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">+</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Tạo nhịp vượt tần số qua một dây điện cực vào mỏm thất phải.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: 27pt;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">+ Nếu có kèm bệnh tim mà cơn NN/T lại quá nặng, gây tụt HA nặng nề, suy tim nặng nề, có biểu hiện thiếu máu cục bộ ở tim hay thần kinh trung ương thì phải sốc điện cấp cứu ngay.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="color: maroon; font-family: Verdana; font-size: 10pt;">2.2.2. Ðiều trị dài hạn ngăn chặn tái phát NN/T mạn tính<o:p></o:p></span></i></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">- </span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Ðối với NN/T không bền bỉ mà không kèm bệnh tim thì tiên lượng thường tốt và chỉ cần điều trị khi có triệu chứng bằng các chẹn giao cảm beta và an thần. Nhưng khi là những cơn NN/T bền bỉ gây nhiều triệu chứng nặng nề thì dù không kèm bệnh tim, có thể vẫn phải điều trị như khi có bệnh tim.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">- </span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Ðối với NN/T không bền bỉ mà có kèm bệnh tim thì ta điều trị dài hạn bằng thuốc (sotalol, amiodaron, quinidin, chẹn beta) giống như đối với ngoại tâm thu thất mạn tính có bệnh tim.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">- </span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Ðối với NN/T bền bỉ có kèm bệnh tim là loại nguy hiểm nhất nhưng lại khó ngăn chặn nhất. Thường phải thăm dò kích thích có chương trình: trước hết chứng minh là cơn NN/T (giống cơn tự phát) có thể kích thích phát động thành cơn lặp lại đều đặn, sau đó cho dùng lần lượt từng loại thuốc và chọn ra loại nào có thể ngăn chặn được cơn không cho phát ra dù vẫn kích thích cho bệnh nhân phát động như trên, thuốc đó sẽ dùng điều trị dài hạn và thường đạt hiệu quả ngăn chặn tái phát NN/T ở 90%. Tuy nhiên, thường chỉ tìm ra được loại thuốc có hiệu quả ở 50% các ca đưa vào thăm dò.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Trong trường hợp bệnh nhân không có điều kiện thăm dò ÐSLH như trên, có thể lần lượt thử cho uống dài hạn các thuốc sau đây:</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">- </span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Sotalol, có hiệu quả ở 55-85% các ca.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Amiodaron, hiệu quả ở trên 70%</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Quinidin</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Mexiletin</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Kết hợp với amiodaron với quinidin nếu một thuốc không kết quả.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Khi bệnh nhân trơ với thuốc hoặc không muốn dùng thuốc dài hạn phiền phức thì có thể dùng các thủ thuật sau đây:</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Máy tạo nhịp chống nhịp nhanh kết hợp với máy chuyển nhịp/phá rung cấy. Hiện nay có cả loại máy tạo nhịp dùng tần số radio.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Triệt bỏ bằng tần số radio qua giây thông: chỉ dùng với các loại NN/T không phải do thiếu máu cơ tim cục bộ, thí dụ như nhịp nhanh thất trái đơn độc (thường có QRS tương đối hẹp, với block nhánh phải và trục trái) hoặc nhịp nhanh xuất phát từ phần ra thất phải.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Phẫu thuật cắt bỏ nơi có ổ phát sinh của loạn nhịp có thể chữa khỏi hẳn NN/T ở 90% kể cả các ca có bệnh tim thiếu máu cục bộ, bị nhiều động mạch vành với chức năng thất trái suy giảm nặng nề mà tỷ lệ tử vong phẫu thuật chỉ 8-15%. Sau mổ có 1/3 số bệnh nhân còn phải tiếp tục uống thuốc duy trì, với cả các loại thuốc mà trước mổ đã từng không có hiệu quả trên bệnh nhân đó. Tuy nhiên, phẫu thuật đòi hỏi làm được đồ bản điện học thất bằng điện cực nội tâm mạc hay làm trong khi mổ tim.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Xoắn đỉnh<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Xoắn đỉnh là một loại nhịp nhanh thất đặc biệt không bền bỉ có từng đợt QRS đa hình hay tái phát, cơn có kèm ngất thậm chí có thể chuyển thành rung thất và chết đột ngột. ÐTÐ cơ bản (ngoài cơn) thường có QT dài vượt quá 0,44s, có khi quá 0,60s và nó có thể do rối loạn điện giải (đặc biệt giảm Kali huyết và magiê huyết), do dùng một số thuốc chống loạn nhịp (đặc biệt loại quinidine và sotalol), thuốc chống trầm cảm 3 vòng (tricyclic) và phenothiazines, do chế độ ăn quá kiêng khem hoặc do bệnh sa van hai lá, do một bệnh lý nội sọ cấp, do các nhịp chậm, đặc biệt block nhĩ-thất cấp 3, những cũng có thể là QT dài tự phát đơn độc mắc phải hay bẩm sinh, gia đình (thường phát động bởi cơn cường giao cảm như xúc động, gắng sức…)</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: maroon; font-family: Verdana; font-size: 10pt;">Ðiều trị<o:p></o:p></span></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Cắt cơn cấp tính: dùng mặt dẹt của nắm đấm tay mình đập mấy cái thật mạnh lên xương ức và vùng tim bệnh nhân.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Loại bỏ các nguyên nhân trên nếu có, như phải dừng ngay các thuốc gây xoắn đỉnh, chống bệnh hạ kali huyết: dù chỉ nghi ngờ trên lâm sàng, cần cho kali truyền tĩnh mạch liều cao (tới 10-15g/24h).</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Sulfate magiê 1-2g tiêm tĩnh mạch cả gói bao giờ cũng có tác dụng cắt cơn xoắn đỉnh rất tốt. Nếu sau đó, truyền duy trì magiê 4-8g/24h mà vẫn tái phát thì có thể nhắc lại liều tấn công nói trên.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Nếu magiê thất bại thì cho tạo nhịp tạm thời với tần số tăng dần tới mức vượt lên cản phá được cơn nhịp nhanh, có khi tới 100-120 C/phút. Còn Isuprel thì chỉ nên dùng khi không có điều kiện tạo nhịp và khi xoắn đỉnh do tần số tim chậm.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">-</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"> Nếu là hội chứng QT dài bẩm sinh thì các chẹn beta (trừ sotalol) đóng vai trò chủ chốt rất tốt vì loại bỏ được cơn cường giao cảm. Có thể kết hợp thêm phẫu thuật cắt bỏ các hạch giao cảm cổ - ngực bên trái; hoặc cho các thuốc làm ngắn QT lại như phenytoin. Nếu thất bại có thể cấy máy tạo nhịp hay máy phá rung.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;">Chú ý: Cần phân biệt xoắn đỉnh với loại NN/T đa hình do cơ chế vào lại, có QT bình thường, có bệnh tim thiếu máu cục bộ, phát động bởi một ngoại tâm thu R/T và điều trị khác hẳn xoắn đỉnh. ở đây, các thuốc dạng quinidin có hiệu quả nhất và có thể cho liều đầy đủ, mà nếu do thiếu máu cơ tim cục bộ cấp và nặng nề thì chỉ có cách làm các thủ thuật tái tạo tuần hoàn mới khỏi NN/T.</span><span lang="PT-BR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">4. Nhịp tự thất gia tốc<o:p></o:p></span></i></b></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp tự thất gia tốc còn được gọi là "NN/T chậm" với tần số 60-120 C/phút. QRS dãn rộng và phân ly nhĩ thất, thường do nhồi máu cơ tim cấp, nhất là ở thời kỳ tái tưới máu hoặc hậu phẫu tim, bệnh cơ tim, thấp tim, ngộ độc digitalis hoặc không có bệnh tim.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhịp này thường thoảng qua, ít khi gây rối loạn huyết động hoặc triệu chứng do đó ít khi cần điều trị. Trường hợp có triệu chứng thường chỉ cần cho atropin làm tăng tần số xoang để dẫn nhịp thất.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><br />
</span></div></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-14293703947029691242011-04-07T23:08:00.000-07:002011-05-01T06:30:49.100-07:00- CHỈ ĐỊNH DÙNG THUỐC ĐIỀU TRỊ TĂNG HUYẾT ÁP<div class="tieude" style="color: black; display: block; font-family: Arial; font-size: 13px; font-weight: bold; margin-bottom: 5px; padding-left: 20px; padding-top: 20px; text-align: left;"><span id="ctl03_lblNewsTitle" style="color: #033e97; font-size: 16px; font-weight: bold;">CHỈ ĐỊNH DÙNG THUỐC ĐIỀU TRỊ TĂNG HUYẾT ÁP</span> </div><div style="float: left; font-family: Tahoma, Verdana; font-size: 12px;"><div style="display: block; text-align: center;"></div></div><div style="font-family: Tahoma, Verdana; font-size: 12px; margin-top: 0px; padding-bottom: 0px; padding-left: 20px; padding-right: 20px; padding-top: 0px; text-align: left;"><span id="ctl03_lblNewsBody"></span><br />
<div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các chỉ định dùng thuốc dựa vào giai đoạn THA, yếu tố nguy cơ, tổn thương cơ quan đích và các bệnh kèm theo được trình bày ở bảng dưới đây:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 645px;"><tbody>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 165px;" width="28%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">THA</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">(Phân loại JNC VI/1997)</span></b><b><span style="font-family: Verdana; font-size: 9pt;"></span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Nguy cơ nhóm A</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Nguy cơ nhóm B</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 122px;" width="21%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Nguy cơ nhóm C</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 165px;" width="28%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Bình thường cao</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Ðiều chỉnh lối sống</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Ðiều chỉnh lối sống</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 122px;" width="21%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 165px;" width="28%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Giai đoạn I</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Ðiều chỉnh lối sống</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">(có thể đến 12 tháng)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Ðiều chỉnh lối sống</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">(có thể đến 6 tháng)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 122px;" width="21%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 165px;" width="28%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Giai đoạn II</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 149px;" width="25%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 122px;" width="21%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 165px;" width="28%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Giai đoạn III</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td colspan="3" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 450px;" width="71%"><div align="center" class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Dùng thuốc</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Ghi chú:</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div align="center"><table border="0" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-collapse: collapse; width: 594px;"><tbody>
<tr><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 184px;" valign="top" width="33%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Nguy cơ nhóm A:</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 382px;" valign="top" width="66%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Không có nguy cơ, không tổn thương cơ quan đích</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Không có bệnh lý tim mạch biểu hiện lâm sàng</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"> </span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 184px;" valign="top" width="33%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Nguy cơ nhóm B:</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 382px;" valign="top" width="66%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Có ít nhất một yếu tố nguy cơ (không bao gồm tiểu đường). Không có bệnh lý tim và tổn thương cơ quan đích</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"> </span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 184px;" valign="top" width="33%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Nguy cơ nhóm C:</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: rgb(236, 233, 216); border-bottom-style: initial; border-bottom-width: initial; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: rgb(236, 233, 216); border-right-style: initial; border-right-width: initial; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 382px;" valign="top" width="66%"><div class="MsoNormal" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.25in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Tổn thương cơ quan đích, có bệnh lý tim hoặc tiểu đường, có hoặc không phối hợp với các yếu tố nguy cơ khác.</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"> </span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoNormal" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Nhìn bảng trên ta thấy với nguy cơ nhóm A và nhóm B điều trị THA ở giai đoạn I trước hết là điều chỉnh lối sống nếu không kết quả thì mới dùng thuốc. Còn nguy cơ nhóm C thì phải dùng thuốc rất sớm ngay khi huyết áp chỉ ở mức bình thường cao.</span></span></div></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0tag:blogger.com,1999:blog-372906262880197723.post-66541723435369588652011-04-07T23:05:00.001-07:002011-05-01T06:31:07.608-07:00- CHỌN THUỐC HẠ HUYẾT ÁP TRONG ĐIỀU TRỊ CÁC TÌNH HUỐNG CỤ THỂ<div class="tieude" style="color: black; display: block; font-family: Arial; font-size: 13px; font-weight: bold; margin-bottom: 5px; padding-left: 20px; padding-top: 20px; text-align: left;"><span id="ctl03_lblNewsTitle" style="color: #033e97; font-size: 16px; font-weight: bold;">CHỌN THUỐC HẠ HUYẾT ÁP TRONG ĐIỀU TRỊ CÁC TÌNH HUỐNG CỤ THỂ</span> </div><div style="float: left; font-family: Tahoma, Verdana; font-size: 12px;"><div style="display: block; text-align: center;"></div></div><div style="font-family: Tahoma, Verdana; font-size: 12px; margin-top: 0px; padding-bottom: 0px; padding-left: 20px; padding-right: 20px; padding-top: 0px; text-align: left;"><span id="ctl03_lblNewsBody"></span><br />
<div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">1. Thuốc chọn khởi đầu</span></b><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;"><o:p></o:p></span></b></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">Tăng HA không biến chứng: hai nhóm thuốc sau đây được JNC VI khuyên là nên chọn ưu tiên</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">Lợi tiểu: là thuốc được sử dụng đầu tiên, hiện nay Indapamid và Thiazides là lại được ưa chuộng.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">Chẹn beta giao cảm: là thuốc được chọn điều trị sau lợi tiểu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Các nhóm thuốc khác như đối kháng calci, ức chế men chuyển (UCMC) đều có thể được chọn khi điều trị khởi đầu tùy theo tình trạng của bệnh.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Khi dùng các thuốc này có thể xảy ra các tình huống và nên được xử lý như sau:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">a.</span></i><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i><i><span style="font-family: Verdana; font-size: 9pt;">Thuốc có tác dụng tốt: tiếp tục dùng và tìm liều lượng tối thiểu có tác dụng duy trì HA ở mức độ mong muốn.</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">b.</span></i><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i><i><span style="font-family: Verdana; font-size: 9pt;">Thuốc đáp ứng chưa tốt nhưng dung nạp được: dùng phối hợp thêm thuốc thứ 2 khác nhóm.</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">c.</span></i><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i><i><span style="font-family: Verdana; font-size: 9pt;">Thuốc không đáp ứng hoặc có tác dụng phụ: thay thuốc nhóm khác.</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">d.</span></i><i><span style="font-family: Verdana; font-size: 9pt;"> </span></i><i><span style="font-family: Verdana; font-size: 9pt;">Nếu đã sử dụng như b và c mà không hạ được HA đến mức cần thiết thì phải tiếp tục cho thêm các thuốc nhóm khác.</span></i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Việc chọn được 1 thuốc có tác dụng ngay ban đầu rất quan trọng, người bệnh có thể sử dụng lâu dài thuốc này trong 10, 20 năm.. mà thuốc vẫn có hiệu quả. Bảng dưới đây có thể dùng để tham khảo việc chọn thuốc khởi đầu cho người cao HA có một số bệnh kèm theo:<o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><br />
</span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 659px;"><tbody>
<tr><td rowspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td><td rowspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Lợi tiểu</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td rowspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Ức chế beta</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td rowspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Ức chế </span></b><b><span style="font-family: Symbol; font-size: 9pt;">S</span></b><b><span style="font-family: Verdana; font-size: 9pt;">alpha</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td rowspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Ức chế men chuyển</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td colspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 199px;" width="32%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Ðối kháng calci</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Verapamil và Diltiazem</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Dihydro Pyridin</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Người già</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Ðau thắt ngực</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Sau NMCT</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tai biến mạch não</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh thận</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tiểu đường</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Rối loạn chuyển hóa mỡ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">-</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">+</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh tiền liệt tuyến</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">++</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 74px;" valign="top" width="13%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 99px;" valign="top" width="17%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 85px;" valign="top" width="15%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><br />
</div></td></tr>
</tbody></table></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><i><span style="font-family: Verdana; font-size: 9pt;">Ghi chú: </span></i><span style="font-family: Verdana; font-size: 9pt;">(++: nên chọn; +: dùng được; </span><span style="font-family: Symbol; font-size: 9pt;">±</span><span style="font-family: Verdana; font-size: 9pt;"> </span><span style="font-family: Verdana; font-size: 9pt;">: thận trọng khi dùng; -: không dùng)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Dùng UCMC trong bệnh thận: cần loại trừ hẹp ÐM thận trước khi cho điều trị.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">2. Phối hợp thuốc hạ áp<o:p></o:p></span></b></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Việc lựa chọn thuốc khi điều trị phối hợp cũng cần được cân nhắc kỹ lưỡng. Theo nhiều nghiên cứu thì lợi tiểu liều thấp phối hợp với tất cả các nhóm thuốc khác đều làm tăng hiệu quả hạ HA (Frishman và CS 1994, Andren và CS 1983). Các biệt dược đã được phối hợp sẵn thường là:</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Thiazides + chẹn giao cảm beta: Diac, Lopressor-HCT, Corzid, Inderid, Timolid</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Thiazides + ức chế men chuyển: Capozid, Zestoretic, Vaseretic, Co-Renitec</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Thiazides + Reserpine: Hydropress, Diupres…</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Phối hợp đối kháng calci với thuốc UCMC cũng thường được dùng như: Lotrel, Teczem, Tarka.</span><span style="font-family: Verdana; font-size: 9pt;"> Theo khuyến cáo của JNC Vi (1997) thì liều thấp UCMC và đối kháng calci</span><span style="font-family: Verdana; font-size: 9pt;"> (trừ nhóm dihydropyridina) vừa làm hạ HA và giảm protein hiệu quả hơn là dùng đơn độc từng thứ một (Epstein và Bakris 1996), nếu phối hợp UCMC với dihydropyridin có thể làm giảm tác dụng phụ là phù mắt cá chân (Gradman và CS 1997). Tác dụng lợi tiểu cũng được tăng thêm khi dùng Metolazon với một thuốc lợi tiểu quai trong cao HA có suy thận, hoặc ở bệnh thận do tiểu đường việc phối hợp UCMC và đối kháng calci có tác dụng tốt hơn dùng đơn trị liệu.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Khi phải dùng phối hợp thuốc thứ 3 và thứ 4 cũng phải dựa trên nguyên tắc chọn các thuốc có cơ chế tác động khác nhau. Nhiều tác giả thường dùng lợi tiểu - chẹn beta giao cảm sau đó thêm Nifedipin, Prazonsin hoặc Hydralazin và sự phối hợp của một trong ba thứ trên đều có tác dụng hạ HA tương tự (Ramsay và CS 1987); một số người khác dùng Captopril, Nifedifin và Hydralazin cũng thấy tác dụng hạ áp của các thuốc này gần giống như nhau nhưng UCMC tốt hơn (Bevan và CS 1993).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Có một số trường hợp phải dùng đến trên 3 thứ thuốc mà HA giảm rất ít nên được xếp vào loại: "Tăng HA kháng trị". Theo nhiều tác giả thì có thể do chế độ ăn vẫn còn nhiều muối và liều lợi tiểu chưa thích hợp (Graves và CS 1989) hoặc do không dung nạp thuốc, liều lượng thuốc hạ HA không thích hợp và tăng HA thứ phát (Yakovlevitch và Black 1991) một số khác có liên quan tới rượu và khá nhiều trường hợp việc điều trị hạ HA đúng phương pháp không được theo dõi và thực hiện đầy đủ (Shea và CS 1992, Redom và CS 1997).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;">Một số tác giả cho rằng điều trị "THA kháng trị" với liều lợi tiểu thích hợp cộng với đối kháng calci với UCMC và Minoxidil có thể đạt kết quả tốt (Pontremoli 1991).</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3. Thuốc chọn theo từng tình huống của cao HA<o:p></o:p></span></b></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3.1. Ðiều trị lâu dài:</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"></span></i></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 645px;"><tbody>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Chỉ định</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thuốc</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td colspan="2" style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 630px;" valign="top" width="100%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Chọn bắt buộc (trừ khi có chống chỉ định)</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tiểu đường (týp 2) có protein niệu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UCMC</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UCMC, lợi tiểu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">THA tâm thu đơn độc lớn tuổi</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Lợi tiểu (thích hợp hơn), UC calci (DHP tác dụng dài)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Nhồi máu cơ tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta (non ISA), UCMC (khi rối loạn chức năng tâm thu)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td colspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 630px;" valign="top" width="100%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thuốc có hiệu quả với bệnh cùng xảy ra</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Ðau thắt ngực</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta, UC calci</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Nhanh nhĩ, rung nhĩ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta, UC calci (không phải nhóm DHP)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">THA do cyclosporin (cẩn thận với liều cyclosporin)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC calci</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tiểu đường (týp 1 và 2) có protein niệu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UCMC (thích hợp hơn), UC calci</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tiểu đường (týp 2)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Lợi tiểu liều thấp</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Rối loạn lipid huyết</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC alpha</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Run vẫy (Tremor)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC bêta (không chọn lọc tim)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Caredilol, losartan</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Cường giáp</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Migrain</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta (không chọn lọc tim), UC calci (không phải nhóm DHP)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">NMCT</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Diltiazem, Verapamil</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Loãng xương</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Thiazid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">THA trước mổ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="NL" style="font-family: Verdana; font-size: 9pt;">U xơ tiền liệt tuyến</span><span lang="NL" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC alpha</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy thận (cẩn thận khi THA do động mạch thận và creatinin ( 265,2 mmol/l (3mg/dl)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UCMC</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td colspan="2" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 630px;" valign="top" width="100%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Chú ý đến thuốc có tác dụng không mong muốn với bệnh cùng xảy ra</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh co thắt phế quản</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Trầm cảm</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta, đồng vận alpha trung ương, reserpin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Tiểu đường (týp 1 và 2)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta, lợi tiểu liều cao</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Rối loạn lipid huyết</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta (non ISA), lợi tiểu (liều cao)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Gút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Lợi tiểu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Block tim độ 2, 3</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span lang="FR" style="font-family: Verdana; font-size: 9pt;">UC beta, UC calci (non DHP)</span><span lang="FR" style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta (trừ carvedilol), UC calci (trừ amlodipin, felodipin)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh gan</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Labetalol, methyldopa</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh mạch máu ngoại vi</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC beta</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Thai</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UCMC, UC thụ thể angiotensin II</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Suy thận</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Thuốc giữ potassium UCMC</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 308px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">Bệnh mạch máu thận</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 307px;" valign="top" width="50%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span style="font-family: Verdana; font-size: 9pt;">UC thụ thể angiotensin II</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><b><i><span style="color: #003366; font-family: Verdana; font-size: 10pt;">3.2. Ðiều trị cao HA cấp cứu và khẩn cấp:</span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"></span></i></b><b><i><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></i></b></span></div><div align="center"><table border="1" cellpadding="0" cellspacing="0" class="MsoNormalTable" style="border-bottom-color: initial; border-bottom-style: none; border-bottom-width: medium; border-collapse: collapse; border-left-color: initial; border-left-style: none; border-left-width: medium; border-right-color: initial; border-right-style: none; border-right-width: medium; border-top-color: initial; border-top-style: none; border-top-width: medium; width: 645px;"><tbody>
<tr><td colspan="6" style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: windowtext; border-top-style: solid; border-top-width: 1pt; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 630px;" valign="top" width="100%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thuốc (đường tiêm)</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" width="16%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thuốc</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" width="19%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Liều</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thời gian bắt đầu</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Thời gian kéo dài</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" width="19%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Tương tác bất lợi</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" width="18%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><b><span style="font-family: Verdana; font-size: 9pt;">Chỉ định đặc biệt</span></b><b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></b></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><b><span style="font-family: Verdana; font-size: 9pt;">Giãn mạch</span></b><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Sodium nitroprussid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">0,25-10mg/kg mỗi phút TTM (liều tối đa chỉ 10 phút)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">Tức thì</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">1-2 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Buồn nôn, nôn, giật cơ, đổ mồ hôi, nhiễm độc thiocyanat và cyanid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hầu hết các THA cấp cứu, cẩn thận khi áp lực nội sọ cao hoặc tăng azôt máu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Nicardipin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">5-15mg/giờ TM</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">5-10 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">1-4 giờ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh, nhức đầu, đỏ mặt, viêm tĩnh mạch khu trú</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hầu hết THA cấp cứu trừ suy tim cấp, cẩn thận khi thiểu năng vành</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Fenoldopam mesylat Nitroglycerin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">0,1-0,3mg/kg mỗi phút TM<br />
5-100 mg/phút TTM (**)</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;"><5 phút<br />
<br />
2-5 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">30 phút<br />
<br />
3-5 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh, nhức đầu, buồn nôn, đỏ mặt.<br />
Nhức đầu, ói mửa, MetHb máu, dung nạp thuốc khi dùng lâu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hầu hết THA cấp cứu trừ tăng nhãn áp. Thiếu máu cơ tim</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Enalaprilat</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">1,25-5mg mỗi giờ 6 TM</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">15-30 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">6 giờ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Tụt HA khi renin cao; đáp ứng thay đổi</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Suy thận trái cấp; tránh trong NMCT cấp</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hydralazin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">10-20mg TM<br />
10-50mg TB</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">10-20 phút<br />
20-30 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">3-8 giờ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh, đỏ mặt, nhức đầu, ói mửa, làm nặng đau thắt ngực.<br />
Buồn nôn, đỏ mặt, nhịp nhanh, đau ngực</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Kinh giật</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Diazoxid</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">50-100mg TM nhắc lại hoặc TTM 15-30 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">2-4 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">6-12 giờ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><br />
</div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hiện nay ít dùng: khi không có phương tiện theo dõi chặt chẽ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><b><span style="font-family: Verdana; font-size: 9pt;">Ức chế giao cảm</span></b><span style="font-family: Verdana; font-size: 9pt;">Labetalol<b></b></span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">20-80mg TM mỗi 10 phút<br />
0,5-2mg/phút TTM</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">5-10 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">3-6 giờ</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Ói mửa, ngứa da đầu, nóng cổ họng, chóng mặt, buồn nôn, block tim, tụt HA tư thế</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Hầu hết THA cấp cứu trừ suy tim cấp</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Esmolol</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">250-500mg/kg/phút cho 1 phút sau đó 50-100mg/kg/phút cho 4 phút, có thể tập lại</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">1-2 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">1-2 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Tụt HA, buồn nôn</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-attachment: initial; background-clip: initial; background-color: #eaf1dd; background-image: initial; background-origin: initial; background-position: initial initial; background-repeat: initial initial; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Bóc tách động mạch chủ, quanh phẫu thuật</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
<tr><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: windowtext; border-left-style: solid; border-left-width: 1pt; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 93px;" valign="top" width="16%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Phentolamin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 113px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">5-15mg TM</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 67px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">1-2 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 66px;" valign="top" width="12%"><div align="center" class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: center;"><span style="font-family: Verdana; font-size: 9pt;">3-10 phút</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 112px;" valign="top" width="19%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Nhịp nhanh, đỏ mặt, nhức đầu</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td><td style="background-color: transparent; border-bottom-color: windowtext; border-bottom-style: solid; border-bottom-width: 1pt; border-left-color: rgb(236, 233, 216); border-left-style: initial; border-left-width: initial; border-right-color: windowtext; border-right-style: solid; border-right-width: 1pt; border-top-color: rgb(236, 233, 216); border-top-style: initial; border-top-width: initial; padding-bottom: 0in; padding-left: 5.4pt; padding-right: 5.4pt; padding-top: 0in; width: 104px;" valign="top" width="18%"><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in;"><span style="font-family: Verdana; font-size: 9pt;">Thừa Catecholamin</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></div></td></tr>
</tbody></table></div><div class="MsoBodyText" style="margin-bottom: 0pt; margin-left: 0in; margin-right: 0in; margin-top: 0.1in; text-align: justify;"><span id="ctl03_lblNewsBody"><span style="font-family: Verdana; font-size: 9pt;"><o:p> </o:p></span><span style="font-family: Verdana; font-size: 9pt;">Các thuốc thường dùng đường tĩnh mạch hiện nay là Nicardipin, Nitroglycerin, Enalapril và Labetalol. Trong hoàn cảnh cụ thể của Việt Nam không phải lúc nào cũng có thể nhanh chóng giải quyết các cơn cao HA tối cấp bằng thuốc tiêm, vì vậy có thể sử dụng các loại thuốc sau đây: (với điều kiện là cho liều lượng thích hợp và theo dõi HA liên tục để hạ HA trong 2 giờ đầu không quá 25% mức HA ban đầu (HA trung bình) và 2-6 giờ sau đạt mức HA 160/100mmHg.</span><span style="font-family: Verdana; font-size: 9pt;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Nifedipin (tác dụng nhanh) nhỏ dưới lưỡi: 5mg, 10mg, 15mg, 20mg</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Nitroglycerin: xịt hoặc ngậm dưới lưỡi: 0,4mg, 0,8mg, 0,12mg</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Captopril: 6,5mg - 50mg (tác dụng sau 15')</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Clonidin: 0,2mg - 0,8mg (tác dụng sau 30')</span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;"><o:p></o:p></span></span></div><div class="MsoBodyText" style="line-height: 18px; margin-bottom: 0pt; margin-left: 0.5in; margin-right: 0in; margin-top: 0.1in; text-align: justify; text-indent: -0.25in;"><span id="ctl03_lblNewsBody"><span style="font-family: Symbol; font-size: 9pt; line-height: 18px;">·<span new="" style="font-size: 7pt; font-style: normal; font-variant: normal; font-weight: normal; line-height: normal;" times=""> </span></span><span style="font-family: Verdana; font-size: 9pt; line-height: 18px;">Labetalol: 100 - 200mg (tác dụng sau 30') (Kaplan 1998).</span></span></div></div>Mr Nguyễn Xuân Hàhttp://www.blogger.com/profile/04153838238837197903noreply@blogger.com0