Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh sau ch\u1ea5n th\u01b0\u01a1ng chi\u1ebfm kho\u1ea3ng 12% – 18,8% c\u00e1c tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh n\u00f3i chung. Ch\u1ea5n th\u01b0\u01a1ng m\u1eaft l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh \u1edf ng\u01b0\u1eddi tr\u1ebb. Ngu\u1ed3n ch\u1ea3y m\u00e1u v\u00e0o khoang d\u1ecbch k\u00ednh c\u00f3 th\u1ec3 xu\u1ea5t ph\u00e1t t\u1eeb c\u00e1c m\u1ea1ch m\u00e1u c\u1ee7a h\u1eafc m\u1ea1c, c\u1ee7a v\u00f5ng m\u1ea1c, m\u1ed1ng m\u1eaft, th\u1ec3 mi. Trong tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh do h\u1ed9i ch\u1ee9ng terson, m\u00e1u trong s\u1ecd n\u00e3o \u0111i theo m\u00e0ng m\u1ec1m bao b\u1ecdc th\u1ecb th\u1ea7n kinh v\u00e0o trong khoang d\u1ecbch k\u00ednh. Theo m\u1ed9t s\u1ed1 t\u00e0i li\u1ec7u nghi\u00ean c\u1ee9u, 33% c\u00e1c tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft m\u00e0ng m\u1ec1m (g\u1eb7p trong ch\u1ea5n th\u01b0\u01a1ng s\u1ecd n\u00e3o) c\u00f3 k\u00e8m theo xu\u1ea5t huy\u1ebft n\u1ed9i nh\u00e3n, trong \u0111\u00f3 kho\u1ea3ng 6% b\u1ec7nh nh\u00e2n b\u1ecb xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh.<\/p>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p khi b\u1ecb xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh: <\/strong>V\u1ec1 l\u00e2m s\u00e0ng, sau ch\u1ea5n th\u01b0\u01a1ng t\u00f9y theo m\u1ee9c \u0111\u1ed9 xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh m\u00e0 b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng sau:<\/p>\n – C\u1ea3m gi\u00e1c \u0111au c\u00f3 th\u1ec3 g\u1eb7p ngay sau ch\u1ea5n th\u01b0\u01a1ng v\u00e0 k\u00e9o d\u00e0i m\u1ed9t v\u00e0i ng\u00e0y sau ch\u1ea5n th\u01b0\u01a1ng. \u0110au c\u00f3 th\u1ec3 do b\u1ea3n th\u00e2n t\u00ecnh tr\u1ea1ng ch\u1ea5n th\u01b0\u01a1ng m\u1eaft ho\u1eb7c do t\u0103ng nh\u00e3n \u00e1p. T\u0103ng nh\u00e3n \u00e1p s\u1edbm sau ch\u1ea5n th\u01b0\u01a1ng l\u00fac n\u00e0y c\u00f3 th\u1ec3 do th\u1ec3 mi t\u0103ng ti\u1ebft th\u1ee7y d\u1ecbch ho\u1eb7c kh\u1ed1i l\u01b0\u1ee3ng th\u1ee7y d\u1ecbch t\u0103ng do m\u00e1u n\u1ed9i nh\u00e3n. \u0110au xu\u1ea5t hi\u1ec7n mu\u1ed9n (m\u1ed9t v\u00e0i tu\u1ea7n) sau xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh th\u01b0\u1eddng l\u00e0 do gl\u00f4c\u00f4m do t\u1ebf b\u00e0o ma (ghost-cell, b\u1ea3n ch\u1ea5t l\u00e0 c\u00e1c t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u b\u1ecb tho\u00e1i h\u00f3a) ho\u1eb7c gl\u00f4c\u00f4m do tan m\u00e1u (hemolytic glaucoma).<\/p>\n – Trong tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh nh\u1eb9, b\u1ec7nh nh\u00e2n nh\u00ecn th\u1ea5y nh\u01b0 c\u00f3 kh\u00f3i, c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng “m\u01b0a b\u1ed3 h\u00f3ng” ho\u1eb7c m\u1ea1ng nh\u1ec7n bay tr\u01b0\u1edbc m\u1eaft. \u0110\u1ed1i v\u1edbi xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh trung b\u00ecnh v\u00e0 n\u1eb7ng, b\u1ec7nh nh\u00e2n b\u1ecb gi\u1ea3m th\u1ecb l\u1ef1c th\u1eadm ch\u00ed \u0111\u1ebfn m\u1ee9c ch\u1ec9 c\u00f2n kh\u1ea3 n\u0103ng nh\u1eadn th\u1ee9c s\u00e1ng t\u1ed1i.<\/p>\n – M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u1ea3m gi\u00e1c c\u00f3 ch\u1edbp s\u00e1ng tr\u01b0\u1edbc m\u1eaft, th\u01b0\u1eddng g\u1eb7p trong tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh c\u00f3 k\u00e8m theo c\u00e1c r\u00e1ch c\u1ee7a v\u00f5ng m\u1ea1c.<\/p>\n Th\u0103m kh\u00e1m l\u00e2m s\u00e0ng cho th\u1ea5y, b\u00ean c\u1ea1nh c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a ch\u1ea5n th\u01b0\u01a1ng xuy\u00ean nh\u00e3n c\u1ea7u v\u00e0 ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ee5ng d\u1eadp nh\u00e3n c\u1ea7u n\u00f3i chung (s\u1eb9o gi\u00e1c m\u1ea1c, s\u1eb9o c\u1ee7ng m\u1ea1c, \u0111\u1ee5c v\u1ee1 th\u1ee7y tinh th\u1ec3, l\u1ec7ch th\u1ee7y tinh th\u1ec3, m\u00e1u ti\u1ec1n ph\u00f2ng…), c\u00f3 th\u1ec3 th\u1ea5y s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a m\u00e1u trong bu\u1ed3ng d\u1ecbch k\u00ednh. T\u00f9y theo m\u1ee9c \u0111\u1ed9 m\u00e1u trong bu\u1ed3ng d\u1ecbch k\u00ednh, c\u00f3 th\u1ec3 th\u1ea5y m\u00e1u trong bu\u1ed3ng d\u1ecbch k\u00ednh ch\u1ec9 l\u00e0 m\u1ed9t d\u1ea3i ho\u1eb7c t\u1eebng \u0111\u00e1m tr\u00f4i n\u1ed5i hay to\u00e0n b\u1ed9 bu\u1ed3ng d\u1ecbch k\u00ednh l\u00e0 m\u00e1u. Trong tr\u01b0\u1eddng h\u1ee3p c\u00f2n quan s\u00e1t \u0111\u01b0\u1ee3c \u0111\u00e1y m\u1eaft, c\u00f3 th\u1ec3 th\u1ea5y m\u1ed9t s\u1ed1 t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p c\u1ee7a h\u1eafc v\u00f5ng m\u1ea1c nh\u01b0 xu\u1ea5t huy\u1ebft h\u1eafc – v\u00f5ng m\u1ea1c, r\u1ea1n m\u00e0ng Bruch, r\u00e1ch v\u00f5ng m\u1ea1c…<\/p>\n Th\u0103m kh\u00e1m c\u1eadn l\u00e2m s\u00e0ng bao g\u1ed3m si\u00eau \u00e2m B \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 t\u00ecnh tr\u1ea1ng v\u00f5ng m\u1ea1c (c\u00f3 bong v\u00f5ng m\u1ea1c kh\u00f4ng?…). Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ea7n thi\u1ebft, CT scanner gi\u00fap ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh d\u1ecb v\u1eadt n\u1ed9i nh\u00e3n, nh\u1ed5 gi\u1eadt c\u1ee7a th\u1ecb th\u1ea7n kinh ho\u1eb7c m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p v\u1ee1 c\u1ee7ng m\u1ea1c \u1edf ph\u00eda sau…<\/p>\n \u0110i\u1ec1u tr\u1ecb xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh sau ch\u1ea5n th\u01b0\u01a1ng<\/strong><\/p>\n \u0110i\u1ec1u tr\u1ecb n\u1ed9i khoa bao g\u1ed3m:<\/p>\n – N\u1eb1m ngh\u1ec9 ng\u01a1i tuy\u1ec7t \u0111\u1ed1i t\u1ea1i gi\u01b0\u1eddng, \u0111\u1ea7u cao 30oC – 45oC, b\u0103ng k\u00edn 2 m\u1eaft nh\u1eb1m tr\u00e1nh ch\u1ea3y m\u00e1u t\u00e1i ph\u00e1t v\u00e0 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho h\u1ed3ng c\u1ea7u l\u1eafng \u0111\u1ecdng xu\u1ed1ng d\u01b0\u1edbi.<\/p>\n – B\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00e1c ch\u1ea5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p b\u1eb1ng kh\u00e1ng sinh (trong tr\u01b0\u1eddng h\u1ee3p ch\u1ea5n th\u01b0\u01a1ng xuy\u00ean nh\u00e3n c\u1ea7u), ch\u1ed1ng vi\u00eam t\u00edch c\u1ef1c b\u1eb1ng corticoid, ch\u1ed1ng d\u00ednh \u0111\u1ed3ng t\u1eed b\u1eb1ng tra m\u1eaft dung d\u1ecbch atropin.<\/p>\n – Ngo\u00e0i ra, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 d\u00f9ng th\u00eam tam th\u1ea5t b\u1ed9t 10g\/ng\u00e0y, u\u1ed1ng nhi\u1ec1u n\u01b0\u1edbc (0,5l\/l\u1ea7n l\u00fac \u0111\u00f3i, ch\u00fa \u00fd ng\u01b0\u1eddi t\u0103ng huy\u1ebft \u00e1p ho\u1eb7c c\u00f3 b\u1ec7nh tim m\u1ea1ch c\u1ea7n th\u1eadn tr\u1ecdng khi u\u1ed1ng nhi\u1ec1u n\u01b0\u1edbc).<\/p>\n – B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i \u0111\u1ecbnh k\u1ef3 2-5 ng\u00e0y m\u1ed9t l\u1ea7n nh\u1eb1m lo\u1ea1i tr\u1eeb bong v\u00f5ng m\u1ea1c. Sau \u0111\u00f3, th\u1eddi gian theo d\u00f5i c\u00f3 th\u1ec3 th\u01b0a d\u1ea7n 1-2 tu\u1ea7n cho \u0111\u1ebfn khi m\u00e1u d\u1ecbch k\u00ednh ti\u00eau h\u1ebft.<\/p>\n \u0110i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt b\u1eb1ng c\u1eaft d\u1ecbch k\u00ednh xu\u1ea5t huy\u1ebft \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p:<\/p>\n – Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh d\u00e0y \u0111\u1eb7c, k\u00e9o d\u00e0i kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng ti\u00eau m\u00e1u.<\/p>\n – Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh c\u00f3 k\u00e8m theo bong v\u00f5ng m\u1ea1c.<\/p>\n – Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh k\u00e8m theo gl\u00f4c\u00f4m do tan m\u00e1u ho\u1eb7c gl\u00f4c\u00f4m do t\u1ebf b\u00e0o ma.<\/p>\n Bi\u1ebfn ch\u1ee9ng do xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh: <\/strong>Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh n\u1ebfu kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ed9t s\u1ed1 bi\u1ebfn ch\u1ee9ng nh\u01b0:<\/p>\n – Hi\u1ec7n t\u01b0\u1ee3ng nhi\u1ec5m s\u1eaft c\u1ee7a nh\u00e3n c\u1ea7u (hemosiderois bulbi) k\u00e8m theo nhi\u1ec5m \u0111\u1ed9c c\u1ee7a t\u1ebf b\u00e0o c\u1ea3m th\u1ee5 \u00e1nh s\u00e1ng.<\/p>\n – Hi\u1ec7n t\u01b0\u1ee3ng t\u0103ng nh\u00e3n \u00e1p do s\u1ef1 l\u1eafng \u0111\u1ecdng c\u1ee7a c\u00e1c t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u b\u1ecb tho\u00e1i h\u00f3a (ghost cell glaucoma) ho\u1eb7c s\u1ef1 l\u1eafng \u0111\u1ecdng c\u1ee7a c\u00e1c m\u1ea3nh v\u1ee5n t\u1ebf b\u00e0o h\u1ed3ng c\u1ea7u, c\u00e1c \u0111\u1ea1i th\u1ef1c b\u00e0o ch\u1ee9a \u0111\u1ea7y hemoglobin (hemolytic glaucoma)…<\/p>\n – M\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh \u1edf ng\u01b0\u1eddi tr\u1ebb v\u00e0 \u0111\u1eb7c bi\u1ec7t l\u00e0 tr\u1ebb em d\u01b0\u1edbi 2 tu\u1ed5i c\u00f3 th\u1ec3 b\u1ecb c\u1eadn th\u1ecb h\u00f3a ho\u1eb7c nh\u01b0\u1ee3c th\u1ecb.<\/p>\n TS. ThS. <\/em>TH\u1ea8M TR\u01af\u01a0NG KH\u00c1NH V\u00c2N<\/p>\n Theo SK&\u0110S<\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh sau ch\u1ea5n th\u01b0\u01a1ng chi\u1ebfm kho\u1ea3ng 12% – 18,8% c\u00e1c tr\u01b0\u1eddng h\u1ee3p xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh n\u00f3i chung. Ch\u1ea5n th\u01b0\u01a1ng m\u1eaft l\u00e0 nguy\u00ean nh\u00e2n h\u00e0ng \u0111\u1ea7u g\u00e2y xu\u1ea5t huy\u1ebft d\u1ecbch k\u00ednh \u1edf ng\u01b0\u1eddi tr\u1ebb. Ngu\u1ed3n ch\u1ea3y m\u00e1u v\u00e0o khoang d\u1ecbch k\u00ednh c\u00f3 th\u1ec3 xu\u1ea5t ph\u00e1t t\u1eeb c\u00e1c m\u1ea1ch m\u00e1u c\u1ee7a h\u1eafc m\u1ea1c, […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1249],"tags":[],"class_list":["post-273898","post","type-post","status-publish","format-standard","hentry","category-tin-tuc-y-te"],"acf":[],"_links":{"self":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273898","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/comments?post=273898"}],"version-history":[{"count":1,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273898\/revisions"}],"predecessor-version":[{"id":311094,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273898\/revisions\/311094"}],"wp:attachment":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/media?parent=273898"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/categories?post=273898"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/tags?post=273898"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}