X\u01a1 gan l\u00e0 m\u1ed9t b\u1ec7nh m\u00e3n t\u00ednh trong \u0111\u00f3 t\u1ebf b\u00e0o gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng do vi\u00eam, ho\u1ea1i t\u1eed v\u00e0 ho\u1ea1t t\u00ednh t\u1ebf b\u00e0o lan t\u1ecfa, d\u1ea7n d\u1ea7n c\u00e1c t\u1ebf b\u00e0o gan b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng m\u00f4 x\u01a1, m\u00f4 x\u01a1 n\u00e0y lan t\u1ecfa \u1edf gan l\u00e0m bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac b\u00ecnh th\u01b0\u1eddng c\u1ee7a gan th\u00e0nh c\u1ea5u tr\u00fac d\u1ea1ng n\u1ed1t b\u1ea5t th\u01b0\u1eddng, ng\u01b0\u1eddi ta g\u1ecdi \u0111\u00f3 l\u00e0 x\u01a1 gan.<\/p>\n
<\/p>\n
Nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn gan b\u1ecb x\u01a1<\/strong><\/p>\n 1.<\/strong> Do Di truy\u1ec1n: B\u1ec7nh \u1ee9 s\u1eaft; B\u1ec7nh Wilson; Thi\u1ebfu anpha-1-antitrypsin \u1edf ng\u01b0\u1eddi l\u1edbn.<\/p>\n 2.<\/strong> Kh\u00f4ng do di truy\u1ec1n:<\/p>\n + Si\u00eau vi gan B, C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn x\u01a1 gan<\/p>\n + U\u1ed1ng nhi\u1ec1u R\u01b0\u1ee3u<\/p>\n + Nhi\u1ec5m tr\u00f9ng, thu\u1ed1c, \u0111\u1ed9c ch\u1ea5t.<\/p>\n + X\u01a1 gan \u1ee9 m\u1eadt nguy\u00ean ph\u00e1t.<\/p>\n + X\u01a1 gan \u1ee9 m\u1eadt th\u1ee9 ph\u00e1t: do t\u1eafc ngh\u1ebdn \u0111\u01b0\u1eddng m\u1eadt k\u00e9o d\u00e0i.<\/p>\n + X\u01a1 gan do b\u1ec7nh l\u00fd tim: suy tim ph\u1ea3i, vi\u00eam m\u00e0ng ngo\u00e0i tim co th\u1eaft\u2026<\/p>\n + Do b\u1ec7nh l\u00fd Vi\u00eam gan t\u1ef1 mi\u1ec5n<\/p>\n Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng<\/strong><\/p>\n – Trong giai \u0111o\u1ea1n \u0111\u1ea7u \u2013 x\u01a1 gan giai \u0111o\u1ea1n s\u1edbm (c\u00f2n b\u00f9) th\u00ec b\u1ec7nh nh\u00e2n th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng g\u00ec r\u00f5 r\u1ec7t.<\/p>\n – Khi \u0111\u1ebfn gia \u0111o\u1ea1n X\u01a1 gan m\u1ea5t b\u00f9, \u0111\u00f4i khi ng\u01b0\u1eddi b\u1ec7nh ch\u1ec9 c\u1ea3m th\u1ea5y nh\u1eefng tri\u1ec7u ch\u1ee9ng m\u01a1 h\u1ed3, nh\u01b0ng c\u0169ng c\u00f3 khi xu\u1ea5t hi\u1ec7n v\u1edbi nh\u1eefng tri\u1ec7u ch\u1ee9ng n\u1eb7ng n\u1ec1 do bi\u1ebfn ch\u1ee9ng:<\/p>\n * C\u01a1 n\u0103ng: B\u1ec7nh nh\u00e2n c\u1ea3m th\u1ea5y ng\u01b0\u1eddi M\u1ec7t m\u1ecfi, kh\u00f3 ch\u1ecbu; C\u1ea3m gi\u00e1c Ch\u00e1n \u0103n v\u00e0 Gi\u1ea3m c\u00e2n (t\u0103ng c\u00e2n n\u1ebfu c\u00f3 b\u00e1ng b\u1ee5ng, ph\u00f9 ch\u00e2n).<\/p>\n Ng\u00f2ai ra c\u00f3 th\u1ec3 th\u1ea5y N\u01b0\u1edbc ti\u1ec3u v\u00e0ng nh\u01b0 n\u01b0\u1edbc tr\u00e0 \u0111\u1eadm; \u0110au v\u00f9ng b\u1ee5ng tr\u00ean b\u00ean ph\u1ea3i; V\u00f4 kinh ho\u1eb7c R\u1ed1i lo\u1ea1n kinh nguy\u1ec7t; Gi\u1ea3m ham mu\u1ed1n t\u00ecnh d\u1ee5c, r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng; Ph\u00f9 c\u1eb3ng ch\u00e2n\/ B\u1ee5ng ch\u01b0\u1edbng; D\u1ec5 b\u1ecb b\u1ea7m m\u00e1u\/ N\u00f4n ra m\u00e1u; Ng\u1ee9a da; S\u1ea1m da<\/p>\n <\/p>\n * Th\u1ef1c th\u1ec3<\/p>\n – Thay \u0111\u1ed5i \u1edf da: sao m\u1ea1ch; t\u0103ng s\u1eafc t\u1ed1 da; v\u00e0ng da, v\u00e0ng m\u1eaft; b\u1ea7m m\u00e1u; tr\u1ea7y da; l\u00f2ng b\u00e0n tay son<\/p>\n – L\u1edbn c\u01a1 quan: gan to; l\u00e1ch to, n\u1ebfu t\u0103ng \u00e1p t\u0129nh m\u1ea1ch c\u1eeda; gan x\u01a1 \u0111i\u1ec3n h\u00ecnh gan nh\u1ecf v\u00e0 c\u1ee9ng<\/p>\n – B\u00e9o ph\u00ec trung t\u00e2m\/BIM > 30<\/p>\n – V\u00fa to nam gi\u1edbi<\/p>\n \u0110\u1ec3 ch\u1ea9n \u0111o\u00e1n x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c x\u01a1 gan v\u00e0 m\u1ee9c \u0111\u1ed9 x\u01a1, b\u00e1c s\u0129 c\u00f3 th\u1ec3 cho b\u1ec7nh nh\u00e2n th\u1ef1c hi\u1ec7n m\u1ed9t s\u1ed1 x\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng nh\u01b0 sau<\/p>\n – Sinh h\u00f3a: C\u00f4ng th\u1ee9c m\u00e1u<\/p>\n – Si\u00eau \u00e2m b\u1ee5ng: x\u00e1c \u0111\u1ecbnh Gan to ho\u1eb7c teo, b\u1edd kh\u00f4ng \u0111\u1ec1u; B\u1ee5ng b\u00e1ng; L\u00e1ch to; T\u0129nh m\u1ea1ch c\u1eeda gi\u00e3n.<\/p>\n – N\u1ed9i soi th\u1ef1c qu\u1ea3n: Ph\u00e1t hi\u1ec7n d\u00e3n t\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n, l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y ch\u1ea3y m\u00e1u \u1ed3 \u1ea1t n\u1ebfu c\u00f3 bi\u1ebfn ch\u1ee9ng v\u1ee1.<\/p>\n – Sinh thi\u1ebft gan qua da: \u0110\u00e1nh gi\u00e1 m\u00f4 h\u1ecdc l\u00e0 ti\u00eau chu\u1ea9n v\u00e0ng \u0111\u1ec3 \u0111\u1ecbnh l\u01b0\u1ee3ng m\u1ee9c \u0111\u1ed9 x\u01a1.<\/p>\n – C\u00e1c test chuy\u00ean bi\u1ec7t \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh nguy\u00ean nh\u00e2n: Si\u00eau vi gan B: HBsAg, HBeAg, DNA HBV, genotype HBV; Si\u00eau vi gan C: Anti HCV, RNA HCV, genotype HCV; Feritine; Ceruloplasmin….<\/p>\n <\/p>\n \u0110i\u1ec1u tr\u1ecb C\u1ea7n l\u01b0u \u00fd<\/strong><\/p>\n 1. \u0110i\u1ec1u tr\u1ecb nguy\u00ean nh\u00e2n: <\/em><\/strong>t\u00f9y thu\u1ed9c nguy\u00ean nh\u00e2n g\u00e2y x\u01a1 gan (si\u00eau vi gan B, C; R\u01b0\u1ee3u…) b\u00e1c s\u0129 s\u1ebd c\u00f3 ph\u01b0\u01a1ng \u00e1n \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3<\/p>\n 2. <\/em><\/strong>Ph\u00f2ng v\u00e0 \u0111i\u1ec1u tr\u1ecb bi\u1ebfn ch\u1ee9ng c\u00f3 th\u1ec3 x\u1ea3y ra \u1edf b\u1ec7nh nh\u00e2n x\u01a1 gan<\/strong><\/p>\n – D\u00e3n T\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n: Th\u1eaft T\u0129nh m\u1ea1ch th\u1ef1c qu\u1ea3n ho\u1eb7c d\u00f9ng thu\u1ed1c<\/p>\n – Ph\u00f9-b\u00e1ng b\u1ee5ng: Thu\u1ed1c; Truy\u1ec1n Albumin; Ch\u1ecdc h\u00fat d\u1ecbch \u1ed5 b\u1ee5ng<\/p>\n – Nh\u1eadp vi\u1ec7n \u0111i\u1ec1u tr\u1ecb t\u00edch c\u1ef1c: Vi\u00eam ph\u00fac m\u1ea1c nguy\u00ean ph\u00e1t; B\u1ec7nh n\u00e3o do gan: h\u00f4n m\u00ea do gan; H\u1ed9i ch\u1ee9ng gan th\u1eadn: suy th\u1eadn ch\u1ee9c n\u0103ng do suy gan<\/p>\n 3.<\/strong> Ch\u1ebf \u0111\u1ed9 sinh ho\u1ea1t: <\/strong>m\u1ed9t ch\u1ebf \u0111\u1ed9 sinh ho\u1ea1t, \u0103n u\u1ed1ng h\u1ee3p l\u00fd c\u00f3 th\u1ec3 gi\u00fap b\u1ec7nh nh\u00e2n c\u1ea3i thi\u1ec7n c\u00e1c tri\u1ec7u ch\u1ee9ng v\u00e0 ph\u00f2ng ng\u1eeba bi\u1ebfn ch\u1ee9ng. Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n l\u01b0u \u00fd m\u1ed9t s\u1ed1 nguy\u00ean t\u1eafc sau:<\/p>\n – Ki\u00eang c\u1eed tuy\u1ec7t \u0111\u1ed1i r\u01b0\u1ee3u, bia, thu\u1ed1c l\u00e1.<\/p>\n – Tr\u00e1nh c\u00e1c thu\u1ed1c l\u00e0m n\u1eb7ng th\u00eam t\u00ecnh tr\u1ea1ng gan (d\u00f9ng thu\u1ed1c theo ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u1ef9).<\/p>\n – Luy\u1ec7n t\u1eadp th\u1ec3 d\u1ee5c \u0111\u1ec1u \u0111\u1eb7n, nh\u1eb9 nh\u00e0ng \u0111\u1ec3 duy tr\u00ec s\u1ee9c kh\u1ecfe.<\/p>\n <\/p>\n Ch\u1ebf \u0111\u1ed9 \u0103n:<\/strong><\/p>\n + \u0102n l\u1ea1t (h\u1ea1n ch\u1ebf mu\u1ed1i) n\u1ebfu c\u00f3 ph\u00f9 ch\u00e2n, b\u00e1ng b\u1ee5ng.<\/p>\n + L\u01b0\u1ee3ng \u0111\u1ea1m h\u00e0ng ng\u00e0y: 1-1,5g protein\/kg c\u00e2n n\u1eb7ng (t\u01b0\u01a1ng \u0111\u01b0\u01a1ng 100-150g th\u1ecbt, c\u00e1).<\/p>\n + Th\u1ee9c \u0103n c\u00f3 nhi\u1ec1u ch\u1ea5t x\u01a1. C\u00e2n \u0111\u1ed1i gi\u1eefa c\u00e1c th\u00e0nh ph\u1ea7n nh\u01b0 ch\u1ea5t \u0111\u01b0\u1eddng, ch\u1ea5t b\u00e9o, ch\u1ea5t \u0111\u1ea1m, rau v\u00e0 tr\u00e1i c\u00e2y.<\/p>\n + N\u00ean tr\u00e1nh \u0103n m\u1ee1 \u0111\u1ed9ng v\u1eadt, b\u01a1 m\u00e0 thay b\u1eb1ng d\u1ea7u ho\u1eb7c b\u01a1 th\u1ef1c v\u1eadt.<\/p>\n + C\u00f3 th\u1ec3 b\u1ed5 sung \u0111a sinh t\u1ed1 m\u1ed7i ng\u00e0y (tr\u1eeb s\u1eaft).<\/strong><\/p>\n \u0110\u1ec3 ph\u00f2ng b\u1ec7nh x\u01a1 gan, n\u00ean h\u1ea1n ch\u1ebf u\u1ed1ng r\u01b0\u1ee3u v\u00e0 ti\u00eam ph\u00f2ng vi\u00eam gan B, (c\u1ea7n ti\u00eam s\u1edbm cho tr\u1ebb s\u01a1 sinh v\u00e0 tr\u1ebb nh\u1ecf). \u0110\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 b\u1ecb vi\u00eam gan B ho\u1eb7c C m\u1ea1n t\u00ednh, c\u1ea7n theo d\u00f5i \u0111\u1ecbnh k\u1ef3 3 ho\u1eb7c 6 th\u00e1ng m\u1ed9t l\u1ea7n \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm nh\u1eefng tr\u01b0\u1eddng h\u1ee3p vi\u00eam gan \u0111ang ti\u1ebfn tri\u1ec3n, nh\u1eb1m h\u1ea1n ch\u1ebf c\u00e1c bi\u1ebfn ch\u1ee9ng n\u1eb7ng nh\u01b0 x\u01a1 gan v\u00e0 ung th\u01b0 gan. C\u1ea7n theo d\u00f5i s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3 \u0111\u1ec3 ph\u00e1t hi\u1ec7n v\u00e0 \u0111i\u1ec1u tr\u1ecb s\u1edbm c\u00e1c b\u1ec7nh l\u00fd g\u00e2y vi\u00eam gan do c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nh\u01b0 suy tim, t\u1eafc m\u1eadt.<\/p>\n Ti\u00ean l\u01b0\u1ee3ng<\/strong><\/p>\n *Hi\u1ec7n nay, x\u01a1 gan c\u00f3 th\u1ec3 chia th\u00e0nh 3 giai \u0111o\u1ea1n ( theo ph\u00e2n lo\u1ea1i Child-Pugh)<\/p>\n *Theo nguy\u00ean nh\u00e2n.<\/p>\n BS. L\u00ca TH\u1eca PH\u01af\u01a0NG X\u01a1 gan l\u00e0 m\u1ed9t b\u1ec7nh m\u00e3n t\u00ednh trong \u0111\u00f3 t\u1ebf b\u00e0o gan b\u1ecb t\u1ed5n th\u01b0\u01a1ng do vi\u00eam, ho\u1ea1i t\u1eed v\u00e0 ho\u1ea1t t\u00ednh t\u1ebf b\u00e0o lan t\u1ecfa, d\u1ea7n d\u1ea7n c\u00e1c t\u1ebf b\u00e0o gan b\u00ecnh th\u01b0\u1eddng \u0111\u01b0\u1ee3c thay th\u1ebf b\u1eb1ng m\u00f4 x\u01a1, m\u00f4 x\u01a1 n\u00e0y lan t\u1ecfa \u1edf gan l\u00e0m bi\u1ebfn \u0111\u1ed5i c\u1ea5u tr\u00fac b\u00ecnh th\u01b0\u1eddng c\u1ee7a […]<\/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-273968","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\/273968","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=273968"}],"version-history":[{"count":1,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273968\/revisions"}],"predecessor-version":[{"id":311023,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/273968\/revisions\/311023"}],"wp:attachment":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/media?parent=273968"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/categories?post=273968"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/tags?post=273968"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n\n
\n Child A<\/td>\n M\u1ee9c \u0111\u1ed9 nhe<\/td>\n Th\u1eddi gian s\u1ed1ng trung b\u00ecnh 37 th\u00e1ng<\/td>\n<\/tr>\n \n Child B<\/td>\n M\u1ee9c \u0111\u1ed9 trung b\u00ecnh<\/td>\n Th\u1eddi gian s\u1ed1ng trung b\u00ecnh 16 th\u00e1ng<\/td>\n<\/tr>\n \n Child C<\/td>\n M\u1ee9c \u0111\u1ed9 n\u1eb7ng<\/td>\n Th\u1eddi gian s\u1ed1ng trung b\u00ecnh 7 th\u00e1ng<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\nChuy\u00ean khoa Gan \u2013 BV Ho\u00e0n M\u1ef9 S\u00e0i G\u00f2n<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"