{"id":280596,"date":"2024-02-06T22:45:06","date_gmt":"2024-02-06T15:45:06","guid":{"rendered":"https:\/\/clients-previewhub.com\/hoanmy_wp\/ton-thuong-gan-do-thuoc\/"},"modified":"2025-11-10T11:54:26","modified_gmt":"2025-11-10T04:54:26","slug":"ton-thuong-gan-do-thuoc","status":"publish","type":"post","link":"https:\/\/clients-previewhub.com\/hoanmy_wp\/ton-thuong-gan-do-thuoc\/","title":{"rendered":"T\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><em>V\u1eeba qua, b\u1ec7nh vi\u1ec7n Ho\u00e0n M\u1ef9 Vinh \u0111\u00e3 ti\u1ebfp nh\u1eadn v\u00e0 \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh b\u1ecb t\u1ed5n th\u01b0\u01a1ng gan do d\u00f9ng thu\u1ed1c g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 c\u00f3 nhi\u1ec1u nguy c\u01a1 nguy hi\u1ec3m.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ng\u01b0\u1eddi b\u1ec7nh n\u1eef 73 tu\u1ed5i \u0111\u1ebfn Khoa N\u1ed9i t\u1ed5ng qu\u00e1t B\u1ec7nh vi\u1ec7n Ho\u00e0n M\u1ef9 Vinh trong t\u00ecnh tr\u1ea1ng v\u00e0ng da, ch\u00e1n \u0103n, ti\u1ec3u s\u1eabm m\u00e1u. Sau th\u0103m kh\u00e1m l\u00e2m s\u00e0ng v\u00e0 l\u00e0m x\u00e9t nghi\u1ec7m, b\u00e1c s\u0129 x\u00e1c \u0111\u1ecbnh ng\u01b0\u1eddi b\u1ec7nh c\u00f3 t\u00ecnh tr\u1ea1ng men gan t\u0103ng r\u1ea5t cao so v\u1edbi ch\u1ec9 s\u1ed1 b\u00ecnh th\u01b0\u1eddng GOT: 353.8U\/L, GPT: 444.2 U\/L; Bilirubin to\u00e0n ph\u1ea7n 230.6 \u00b5mol\/L; Bilirubin tr\u1ef1c ti\u1ebfp 230.6 \u00b5mol\/L. Ti\u1ebfp \u0111\u00f3, ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c l\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m t\u00ecm nguy\u00ean nh\u00e2n nh\u01b0 x\u00e9t nghi\u1ec7m vi\u00eam gan A, B, C, E \u0111\u1ec1u \u00e2m t\u00ednh, k\u1ebft qu\u1ea3 ch\u1ee5p c\u1ed9ng h\u01b0\u1edfng t\u1eeb MRI gan m\u1eadt kh\u00f4ng ph\u00e1t hi\u1ec7n kh\u1ed1i u, s\u1ecfi g\u00e2y n\u00ean t\u00ecnh tr\u1ea1ng \u1ee9 m\u1eadt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Qua khai th\u00e1c ti\u1ec1n s\u1eed c\u00e1ch th\u1eddi gian v\u00e0o vi\u1ec7n m\u1ed9t th\u00e1ng, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh zona, \u0111au nhi\u1ec1u v\u00f9ng da t\u1ed5n th\u01b0\u01a1ng n\u00ean \u0111\u00e3 t\u1ef1 mua \u201cthu\u1ed1c Nam\u201d kh\u00f4ng r\u00f5 ngu\u1ed3n g\u1ed1c xu\u1ea5t x\u1ee9 \u0111\u1ec3 u\u1ed1ng. C\u00e1c b\u00e1c s\u0129 \u0111\u00e3 y\u00eau c\u1ea7u ng\u01b0\u1eddi b\u1ec7nh ng\u1eebng ngay lo\u1ea1i thu\u1ed1c n\u00e0y, ngh\u1ec9 ng\u01a1i, h\u1ea1n ch\u1ebf v\u1eadn \u0111\u1ed9ng v\u00e0 \u0111i\u1ec1u tr\u1ecb h\u1ed7 tr\u1ee3 b\u1eb1ng c\u00e1c thu\u1ed1c h\u1ea1 men gan, c\u00f4 l\u1eadp acid m\u1eadt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Sau 6 ng\u00e0y \u0111i\u1ec1u tr\u1ecb, t\u00ecnh tr\u1ea1ng b\u1ec7nh \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n: Ng\u01b0\u1eddi b\u1ec7nh \u0103n u\u1ed1ng ngon mi\u1ec7ng, \u0111\u1ee1 v\u00e0ng da, ti\u1ec3u v\u00e0ng nh\u1ea1t, c\u00e1c ch\u1ec9 s\u1ed1 men gan v\u00e0 bilirubin gi\u1ea3m d\u1ea7n: GOT 161.5U\/L; GPT: 180.5U\/L; Bilirubin tr\u1ef1c ti\u1ebfp 106.8 \u00b5mol\/L. Ng\u01b0\u1eddi b\u1ec7nh \u0111\u01b0\u1ee3c xu\u1ea5t vi\u1ec7n v\u00e0 h\u1eb9n t\u00e1i kh\u00e1m.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-content\/uploads\/2025\/11\/Ton-thuong-gan-do-thuoc-1024x768-1.jpg\" alt=\"T\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c\" class=\"wp-image-166185\"\/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Vi\u00eam gan do thu\u1ed1c (Drug-Induced Hepatitis) hay t\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c (Drug-Induced Liver Injury &#8211; DILI) l\u00e0 t\u00ean g\u1ecdi d\u00e0nh cho cho b\u1ea5t k\u1ef3 t\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c bao g\u1ed3m c\u00e1c lo\u1ea1i thu\u1ed1c \u0111i\u1ec1u tr\u1ecb n\u1ed9i tr\u00fa, ngo\u1ea1i tr\u00fa, th\u1ea3o m\u1ed9c, th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng thu\u1ed1c b\u1ed5,&#8230; Bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh c\u00f3 th\u1ec3 t\u1eeb kh\u00f4ng tri\u1ec7u ch\u1ee9ng \u0111\u1ebfn suy gan c\u1ea5p t\u00ednh, m\u1ea1n t\u00ednh hay th\u1eadm ch\u1ec9 t\u1eed vong.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">D\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m t\u1ed5n th\u01b0\u01a1ng, DILI \u0111\u01b0\u1ee3c chia ra l\u00e0m 3 lo\u1ea1i: Th\u1ec3 ho\u1ea1i t\u1eed t\u1ebf b\u00e0o gan, t\u1ed5n th\u01b0\u01a1ng \u1ee9 m\u1eadt v\u00e0 d\u1ea1ng h\u1ed7n h\u1ee3p. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n vi\u00eam gan do thu\u1ed1c l\u00e0 ch\u1ea9n \u0111o\u00e1n sau khi \u0111\u00e3 lo\u1ea1i tr\u1eeb c\u00e1c nguy\u00ean nh\u00e2n g\u00e2y vi\u00eam gan kh\u00e1c.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-nh\u1eefng-lo\u1ea1i-thu\u1ed1c-nao-co-th\u1ec3-gay-ra-viem-gan\"><strong>Nh\u1eefng lo\u1ea1i thu\u1ed1c n\u00e0o c\u00f3 th\u1ec3 g\u00e2y ra vi\u00eam gan?<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>H\u01a1n 1000 lo\u1ea1i thu\u1ed1c v\u00e0 s\u1ea3n ph\u1ea9m th\u1ea3o d\u01b0\u1ee3c \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u00eam gan do thu\u1ed1c.<\/li>\n\n\n\n<li>Nh\u00f3m thu\u1ed1c gi\u1ea3m \u0111au: T\u1ea1i Hoa K\u1ef3 acetaminophen l\u00e0 nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn nh\u1ea5t do \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn l\u00e0m thu\u1ed1c gi\u1ea3m \u0111au.<\/li>\n\n\n\n<li>NSAID (nh\u00f3m thu\u1ed1c ch\u1ed1ng vi\u00eam kh\u00f4ng steroid): Diclofenac.<\/li>\n\n\n\n<li>Nh\u00f3m thu\u1ed1c kh\u00e1ng sinh v\u00e0 thu\u1ed1c ch\u1ed1ng lao: Trong \u0111\u00f3 amoxicillin &#8211; clavulanate l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n ph\u1ed5 bi\u1ebfn.<\/li>\n\n\n\n<li>Nh\u00f3m thu\u1ed1c statin: Atorvastatin<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh<\/strong><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tri\u1ec7u ch\u1ee9ng trong t\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c kh\u00f4ng \u0111\u1eb7c hi\u1ec7u, ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd khi l\u00e0m x\u00e9t nghi\u1ec7m. C\u00e1c tri\u1ec7u ch\u1ee9ng th\u01b0\u1eddng g\u1eb7p l\u00e0:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>V\u00e0ng da.<\/li>\n\n\n\n<li>Ng\u1ee9a.<\/li>\n\n\n\n<li>\u0110au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i.<\/li>\n\n\n\n<li>Ti\u1ec3u s\u1eabm m\u00e0u.<\/li>\n\n\n\n<li>C\u00f3 th\u1ec3 c\u00f3 s\u1ed1t.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">C\u00e1c tri\u1ec7u ch\u1ee9ng kh\u00e1c nh\u01b0 bu\u1ed3n n\u00f4n, n\u00f4n m\u1eeda, kh\u00f3 ch\u1ecbu v\u00e0 ch\u00e1n \u0103n, ti\u00eau ch\u1ea3y, ch\u01b0\u1edbng b\u1ee5ng c\u0169ng c\u00f3 th\u1ec3 g\u1eb7p. N\u1eb7ng nh\u1ea5t c\u00f3 th\u1ec3 g\u00e2y suy gan c\u1ea5p d\u1eabn \u0111\u1ebfn b\u1ec7nh c\u1ea3nh h\u00f4n m\u00ea gan, r\u1ed1i lo\u1ea1n \u0111\u00f4ng m\u00e1u.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Ch\u1ea9n \u0111o\u00e1n<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>L\u00e0 ch\u1ea9n \u0111o\u00e1n lo\u1ea1i tr\u1eeb sau khi \u0111\u00e3 s\u00e0ng l\u1ecdc h\u1ebft c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c nh\u01b0 t\u1ef1 mi\u1ec5n, virus, r\u1ed1i lo\u1ea1n chuy\u1ec3n h\u00f3a,\u2026<\/li>\n\n\n\n<li>Ng\u01b0\u1eddi b\u1ec7nh c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ec7t m\u1ecfi, ch\u00e1n \u0103n, v\u00e0ng da, ti\u1ec3u s\u1eabm m\u00e0u, ng\u1ee9a,\u2026 c\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n ngay khi d\u00f9ng thu\u1ed1c v\u00e0i ng\u00e0y ho\u1eb7c v\u00e0i th\u00e1ng sau khi d\u00f9ng thu\u1ed1c.<\/li>\n\n\n\n<li>Khai th\u00e1c ti\u1ec1n s\u1eed: C\u00e1c lo\u1ea1i thu\u1ed1c, li\u1ec1u l\u01b0\u1ee3ng, t\u1ea7n su\u1ea5t v\u00e0 th\u1eddi gian s\u1eed d\u1ee5ng.<\/li>\n\n\n\n<li>X\u00e9t nghi\u1ec7m: AST ho\u1eb7c ALT &gt; 5 l\u1ea7n gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng, ho\u1eb7c ALP &gt; 2 l\u1ea7n gi\u00e1 tr\u1ecb b\u00ecnh th\u01b0\u1eddng.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>\u0110i\u1ec1u tr\u1ecb t\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ng\u1eebng ngay c\u00e1c thu\u1ed1c c\u00f3 kh\u1ea3 n\u0103ng g\u00e2y vi\u00eam gan \u0111ang s\u1eed d\u1ee5ng.<\/li>\n\n\n\n<li>Glucocorticoid c\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb, th\u01b0\u1eddng s\u1eed d\u1ee5ng \u1edf ng\u01b0\u1eddi b\u1ec7nh c\u00f3 bi\u1ec3u hi\u1ec7n ngo\u00e0i gan c\u1ee7a ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch.<\/li>\n\n\n\n<li>N-acetylcystein ti\u00eam t\u0129nh m\u1ea1ch \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u c\u1ea3i thi\u1ec7n kh\u1ea3n n\u0103ng s\u1ed1ng s\u00f3t trong suy gan c\u1ea5p t\u00ednh s\u1edbm kh\u00f4ng do acetaminiphen.<\/li>\n\n\n\n<li>\u0110i\u1ec1u tr\u1ecb tri\u1ec7u ch\u1ee9ng: s\u1eed d\u1ee5ng kh\u00e1ng histaimin \u1edf ng\u01b0\u1eddi b\u1ec7nh ng\u1ee9a nhi\u1ec1u.<\/li>\n\n\n\n<li>Ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n \u0111\u01b0\u1ee3c theo d\u00f5i x\u00e9t nghi\u1ec7m sinh h\u00f3a cho \u0111\u1ebfn khi x\u00e9t nghi\u1ec7m tr\u1edf l\u1ea1i b\u00ecnh th\u01b0\u1eddng.<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>D\u1ef1 ph\u00f2ng t\u1ed5n th\u01b0\u01a1ng gan do d\u00f9ng thu\u1ed1c<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u0110\u1ec3 ng\u0103n ng\u1eeba t\u1ed5n th\u01b0\u01a1ng gan do thu\u1ed1c tr\u01b0\u1edbc khi s\u1eed d\u1ee5ng thu\u1ed1c tr\u00ean ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n s\u1eed d\u1ee5ng li\u1ec1u l\u01b0\u1ee3ng th\u00edch h\u1ee3p, \u0111\u00e1ng gi\u00e1 t\u01b0\u01a1ng t\u00e1c v\u1edbi c\u00e1c lo\u1ea1i thu\u1ed1c kh\u00e1c.<\/li>\n\n\n\n<li>\u0110\u1ed1i v\u1edbi ng\u01b0\u1eddi b\u1ec7nh: D\u00f9ng thu\u1ed1c theo \u0111\u00fang h\u01b0\u1edbng d\u1eabn k\u00ea \u0111\u01a1n, kh\u00f4ng t\u1ef1 \u00fd s\u1eed d\u1ee5ng c\u00e1c lo\u1ea1i th\u1ef1c ph\u1ea9m ch\u1ee9c n\u0103ng, th\u1ea3o d\u01b0\u1ee3c kh\u00f4ng r\u00f5 ngu\u1ed3n g\u1ed1c.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u1edbi s\u1ef1 t\u01b0 v\u1ea5n c\u1ee7a B\u00e1c s\u0129 T\u1ea1 Th\u1ecb Xoan \u2013 Khoa N\u1ed9i t\u1ed5ng qu\u00e1t, b\u1ec7nh vi\u1ec7n Ho\u00e0n M\u1ef9 Vinh<\/em><\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u00e0i li\u1ec7u tham kh\u1ea3o: Drug-induced liver injury up-to-date.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Th\u00f4ng tin chi ti\u1ebft, vui l\u00f2ng li\u00ean h\u1ec7:<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>B\u1ec7nh vi\u1ec7n Qu\u1ed1c t\u1ebf Ho\u00e0n M\u1ef9 Vinh \u2013 S\u1ed1 99, Ph\u1ea1m \u0110\u00ecnh To\u00e1i, tp. Vinh, Ngh\u1ec7 An.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Hotline: <a href=\"tel:0238396888\">02383.968.88<\/a><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>V\u1eeba qua, b\u1ec7nh vi\u1ec7n Ho\u00e0n M\u1ef9 Vinh \u0111\u00e3 ti\u1ebfp nh\u1eadn v\u00e0 \u0111i\u1ec1u tr\u1ecb cho m\u1ed9t tr\u01b0\u1eddng h\u1ee3p ng\u01b0\u1eddi b\u1ec7nh b\u1ecb t\u1ed5n th\u01b0\u01a1ng gan do d\u00f9ng thu\u1ed1c g\u00e2y \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe v\u00e0 c\u00f3 nhi\u1ec1u nguy c\u01a1 nguy hi\u1ec3m. Ng\u01b0\u1eddi b\u1ec7nh n\u1eef 73 tu\u1ed5i \u0111\u1ebfn Khoa N\u1ed9i t\u1ed5ng qu\u00e1t B\u1ec7nh vi\u1ec7n Ho\u00e0n M\u1ef9 Vinh trong [&hellip;]<\/p>\n","protected":false},"author":15,"featured_media":280597,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1293],"tags":[],"class_list":["post-280596","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-benh-vien-hoan-my-vinh___vi"],"acf":[],"_links":{"self":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/280596","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\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/comments?post=280596"}],"version-history":[{"count":1,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/280596\/revisions"}],"predecessor-version":[{"id":298482,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/posts\/280596\/revisions\/298482"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/media\/280597"}],"wp:attachment":[{"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/media?parent=280596"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/categories?post=280596"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clients-previewhub.com\/hoanmy_wp\/wp-json\/wp\/v2\/tags?post=280596"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}