Chăm sóc người bệnh trước và sau các thủ thuật can thiệp

H Ni 10/2016 CHUN B BNH TRC V ThS SAU NHN TH THUT BS HONG VIT ANH Vin Tim mch Bnh vin Bch Mai HUI NGHI TIM MACH TOAN oua'c 2016 TM The Cath Phũng can thip Lab tim mch Cardiac Catheterization Procedures Right/Left heTarht Cathet insertion s cathtehteurizattiotn tim l A ternate entry i po nt for catheter hụng er ite T I r a d i HOI NGHI TIM MACH TOAN ouo'c 2016 vo Sheath M ựi Removnagl * RP s :ằ PSA HUI NGHI TIM MACH TOAN oua'c 2016 ,: : Pedal g vo M chi di khỏc Select peripheral interventions accesns Access via dorsalis pedis, anterior tibial, or posterior tibial artery HOI NGHI TIM MACH TOAN ouo'c 2016 ng vo M ii ~\ ~ ~ ~ H()ITIM M.!,CH HQC QUOC GIA VI~ NAM quay HUI NGHI TIM MACH ' ,: : Th thut tim mch can thip Chp v/hoc can thip MV Chp v can thip cỏc M khỏc Nong van Th thut chn oỏn (v) iu tr TBS Th thut chn oỏn (v) iu tr cỏc RLNT t cn vỏch liờn tht hai lỏ HUI NGHI TIM MACH TOAN oua'c 2016 Chun b bnh nhõn TRC TH THUT HUI NGHI TIM MACH TOAN oua'c 2016 Gii thớch cho bnh nhõn v th thut Th thut tim mch ú l gỡ? Ti bnh nhõn li phi lm th thut ú? Cỏc kh nng (nguy c) cú th xy cho bnh nhõn Bnh nhõn v ngi nh phi chun b nhng gỡ trc lm th thut ? Bnh nhõn s c tin hnh th thut nh th no? Sau th thut bnh nhõn cú th cú nhng gỡ? Sau vin bnh nhõn cn chỳ ý nhng gỡ? HUI NGHI TIM MACH TOAN oua'c 2016 HUI NGHI TIM MACH TOAN oua'c 2016 Rare, but potentially catastrophic mch ựi B i n c h n g Ea rly r ec og ni tio n an d The groin/leg/retroperitoneal spaces are large hide m large quantities of blood and before can evident taniavgemtecnthiskecy Hem atoma Pseudoaneurysm HOI NGHI TIM MACH ' ẫp tay sau rỳt sheath ựi Bleeding into the retroperitoneal space Cy hgouyndmeteỏctuedssiancue npohbỳleecdinmg the surface Initially ma Results in significant bleeding with Diagnosis with c oc ~etroperitonea curs at CT or hypotension, flank pain ultrasound l l b ood - ; ; -,.- HUI NGHI TIM MACH TOAN oua'c 2016 ,: : CRỏectrdopuerhitoi nuecahl sau Cullens Sign ii ~\ ~ ~ ~ H()ITIM M.!,CH HQC QUOC GIA VI~ NAM Bylemedỏiung Grey phỳc mc Turners Sign Access SBitenCgaộrep TR band placed at termination of mRacdhiaql TR Band structure (sectiona'I case uAarty ery view) HQI NGHI TIM M~CH TOAN uuac 2016 Bin chng ti vt chc mch Thrombus quay Dissectioti Haematoma Pseudo-Atieutvsm HQI NGHI TIM M~CH TOAN uuac 2016 Bin ii ~\ ~ ~ ~ H()ITIM M.!,CH HQC QUOC GIA VI~ NAM chng ti vt chc mch quay HUI NGHI TIM MACH TOAN oua'c 2016 ,: : Bin Flgure chng Photograph of patient forearm one day following ti vt transradial catheterlzation chc mch demonstrating extensive ecchymosls involving quay the right arm extending from the access site to the upper arm HQI NGHI TIM M~CH TOAN oucfc 2016 ,: EASY Hematoma , -: , Radial Classification after Transradial/Ulnar PCI ~".~r - ! -~ ~ : I I I Ir -I I I I I I '' Ulnar I"."a"* .-, I I I I , ' I \ - I 5cm forearm - - J r~ I I ; I ~-J arm I I 10 cm : J ,~,-_ -_-INCIDENCE s5% GRADE -ã s5% INCIDENCE - _ muscular infiltration I