Phuong phap moi chua roi loan nhip tim.

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Phuong phap moi chua roi loan nhip tim

Vua qua, Benh vien (BV) Nguyen Trai (TP.HCM) da trien khai mot phuong phap moi trong dieu tri roi loan nhip tim - phuong phap dien sinh ly hoc can thiep..

Phuong phap moi chua roi loan nhip tim - Ban co dau.
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Phuong phap moi chua roi loan nhip tim.

Phuong phap moi chua roi loan nhip tim.


Ky thuat kho 

Vi la ky thuat  kho, lan dau ap dung, nen hai ca chua tri dau tien bang phuong phap dien sinh ly hoc can thiep tai BV Nguyen Trai  (TP.HCM) co su ho tro chuyen mon tu cac bac si cua Vien Tim mach VN (BV Bach Mai, Ha Noi). Hai benh nhan gom: L.T.K.Q (48 tuoi) bi hoi chung W.P.W (Wolf Parkinson White - la mot trong nhung benh ly thuoc roi loan nhip tim). Can benh lam cho ba Q. hay bi hoi hop, danh trong nguc, met..., va benh nhan H.D.V (75 tuoi) bi benh con nhip nhanh kich phat tren that, bieu hien cac trieu chung: tim dap nhanh, thuong bi hoi hop...

Tien si Pham Quoc Khanh - Pho chu tich  Hoi Tim mach can thiep VN - nguoi tham gia ho tro ky thuat  cho cac bac si khoa Tim mach cua BV Nguyen Trai de thuc hien nhung ca dau tien, trinh bay ve phuong phap chua tri nay nhu sau: Phuong phap dien sinh ly hoc can thiep duoc ap dung lan dau tien tai My tren mot benh nhan mac hoi chung W.P.W (W.P.W la hoi chung bam sinh, co the xay ra o moi doi tuong, no gay ra cac con nhip tim rat nhanh, neu de lau co the dan den suy tim, va co the gay dot tu). Sau do phuong phap nay duoc ap dung tai cac nuoc chau  Au, roi qua chau A...

Roi loan nhip tim la benh ly rat pho bien, la mot tinh huong cap cuu tim mach rat thuong gap. Tu vong do roi loan nhip tim chiem khoang 38% trong so nhung truong hop bi tu vong boi cac benh ly ve tim mach. Benh co the xay ra o moi doi tuong, co the gap o tre moi sanh.

Co tinh huong nguoi benh dang o nha bi chet dot ngot - con goi la dot tu, ma nguyen nhan  phan lon la do roi loan nhip tim (dot tu pho bien nhat la do benh mach vanh dan den nhoi mau co tim, ma nhoi mau co tim la nguyen nhan  hang dau gay ra roi loan nhip tim). Cung co nhung truong hop loan nhip nhung khong nguy hiem lam.

Con tai VN, phuong phap nay duoc ap dung lan dau o Vien Tim mach VN (BV Bach Mai, Ha Noi), cung tren mot benh nhan mac hoi chung W.P.W. Vi day la mot ky thuat  rat kho, phuc tap trong so nhung ky thuat  can thiep tim mach hoc, kho hon ca ky thuat  dat Stent nong mach vanh, doi hoi bac si phai nam vung ve ly thuyet lan ky thuat, nen chua duoc nhieu BV trong nuoc trien khai rong rai. Den nay, hien co hai BV thuoc Bo Y te la Bach Mai va Thong Nhat  cung BV Nguyen Trai  (thuoc So Y te, TP.HCM) ap dung phuong phap nay.

Lap ban do  dien hoc noi mac cua tim

De dieu tri nhung benh nhan bi roi loan nhip tim bang phuong phap dien sinh ly hoc can thiep, bac si se dua cac dien cuc vao trong buong tim nguoi benh, do cac hoat dong  dien trong buong tim dua tren moi tuong quan cua cac hoat dong  dien o buong tim de lap nen ban do  dien hoc noi mac cua tim, nho do se xac dinh chinh xac  nhung vi tri bat thuong o tim, ma no gay nen tinh trang roi loan nhip tim.

Khi do, bac si se su dung song radio  thong qua dau cac dien cuc trong buong tim de triet bo nhung vi tri bat thuong do - nguyen tac dieu tri cua phuong phap nay la nhu the. Theo tien si Pham Quoc Khanh, phuong phap nay khong can gay me, ma chi gay te tai cho (nguoi benh van tinh tao trong luc bac si thao tac), va chi can dieu tri mot lan duy nhat, moi lan binh quan vai gio dong ho, ty le thanh cong  cua phuong phap dien sinh ly hoc can thiep trong dieu tri loan nhip rat cao. Neu dieu tri bang phuong phap dien sinh ly hoc can thiep that bai, thi nguoi benh can phai duoc chuyen qua dieu tri noi nhu truoc.

Dien sinh ly hoc can thiep khong ap dung duoc cho nhung benh nhan bi roi loan nhip tim co kem theo benh ly nang khac; dong thoi cung co mot ty le tai bien, nhung rat nho, thong ke  cho thay, ty le tai bien cua phuong phap dien sinh ly hoc can thiep chi bang 1/20 so voi phuong phap chua tri bang thuoc.

Roi loan than kinh tim co anh huong den viec sinh san?

*Em toi nam nay ngoai 30 tuoi, vua lap gia dinh  duoc 2 nam. Gan day do thay nhip tim bat thuong, lai hay len con met bat chot nen den kham tai phong mach bac si va duoc ghi la bi roi loan than kinh tim. Xin bac si cho biet them thong tin  ve can benh nay? Lieu co anh huong den kha nang sinh con sau nay? (H.L.An, Long An)

- Chan doan roi loan than kinh tim la mot chan doan rat chung chung khi chua xac dinh duoc chinh xac  dang roi loan nhip tim. De chan doan chinh xac can do dien tam do. Trong nhung con roi loan nhip, dien tam do co the giup chan doan ngay, nhung neu con khong thuong xuyen thi can do dien tam do lien tuc 24 gio (ECG Holter).

Tuy theo benh trang roi loan nhip tim la gi ma muc do nguy hiem khac nhau. Co nhung loai roi loan nhip chi gay cam giac hut hang nhung khong anh huong den suc khoe  va khong anh huong den viec sinh san.


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Updated: 11/03/2008 | Views: 1029 | Comments: 0

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