V sinh: la kha Wang sir Ong phim gv sinh, hoc kiem sok eh& nang ciia met va bong dal de duy tri ye sinh cá nhan.
2.9. Ire'nh ca tim
Benh ca tim dugc chulAn doin xac dinh ben bac sy chuyen khoa tim mach, sac trung bai sg suy giam Vinh vin chat nang tarn that clugc xac nhan bang sieu am tim. Benh dan den ten thuang thgc the Vigh vien ttrang ang vari it nhat la Mt 3 dm bang phan loai suy tim cüa Hip hei Tim mach New York (NYHA) theo ck tieu chuan nhu sau:
Nhom 3: Han ch.& van dOng the lye nhieu. Mk cla benh nhan }thee khi nghi ngai nhtmg chi can van Ong nhe da c6 trieu chang ca nang.
Nligin 4: Khong van dOng the lye nao ma khong gay kh6 chiu. Trieu chirng suy tim xay ra khi nghi ngai.
Loai trir benh ca tim lien quan den sa dung rugu, bia. 2.10. Hein me
Hon me kdo dal it nhAt 96 gier. ChAn doan phai dap ang tAt ca cac dieu kin sau: Khong dap (mg vgi kith thich ben ngoai trong vOng it nit& la 96 gia; Can cc!, cac bin phap h8 trg de duy tri skr song;
Tan thucrng nal.) an den di ChUng than kinh vitt vin dtrgc danh gia it nhAt 30 ngay sau khi bi h6n me.
Loai trimh6n me do sir dung rugu, bia, thuoc hoc chat gay nghien. 2.11. PhAu thuat nOi tAt dting mach vanh
La phAu thuat tim ha a saa chaa hoc dieu tri dung mach vanh bang manh ghop n6i tit.
Loai trir phau thuat tax) hinh mach mau, dt gia da mach mau (stent) hay cac k thuat th6ng long clang mach , hoc dieu tri bang keyhole hay laser.
2.12. Viem nao do virus
La tinh trang viem,ctia nhu mo nao (ban cau dal nao, than nao hoac tieu nao) do nhi8m virus, gay ra di chang than kinh nghiem tong va vinh viôn keo dai it nhat 6 (sau) min va dugc bac sjl chuyen khoa than kinh xac nhan.
Loai tra viem nao do nhi8m HIV. 2.13. 13?nh ph6i giai &mit cad
Benh gay ra suy h6 hap man tinh, chAn doan phai dap ang tAt ca cac d'Au hieu sau:
Ket qua do the tich khi the( ra ging sat trong giay dAu tien (FEV I) Von luon dyed 1 (m0t) lit va can phai dieu tri lien tgc liu phap cung cap Oxy do tinh trang giam Oxy matt; KM qua phan tich khi mau clang mach cho thAy áp lac Oxy ban phAn lac nghi th 55mmHg tr6 xuong (Pa02 < 55mm Hg) va c6 trieu chang kh6 the; khi nghi ngoi.
Chan doan phai duct xac nhon bai bac sy chuyen khoa ho hap. 2.14. Wa1th suy gan giai doan cutoi
La suy gan giai dean cuoi c6 tAt ca cac dau hieu sau: Yang da keo dai;
CO twang; Benh nao do gan.
• 4 4
Loai air b'enh gan tha Oat do sir dung rugu, bia hay chat gay nghien. 2.15. Viêm gan sieu vi tOi cep
Benh viem gan sieu vi lam hoai t& nhu mO gan dan tai hi cluing suy gan t6i cap. Benh dugc chAn doan xac dinh lchi c6 tAt cá cac dau hieu sau:
Giam nhanh kich thuk gan dugc xk nhan bang sieu Am bung; Hoai ta toan b'0 cac thity lien quan, chi con khung luai cUa gan; Suy giam nhanh cac 'cat nghiem chirc nang gan;
Vang da dam; Benh nao do gan. 2.16. Nhai man ca tim
La ch'et ingt phan ca tim do khong cung cAp du mau nuoi. Chan doan phai dap Ong tat ca cac tieu chuan sau va phai nhat quan yeti trtramg hop nhai mau co tim cAp:
Benh sCm cna con dau nut dian hinh; Cac thay d6i mei tren din tam do;
Tang cac men (enzyme) tim car gia tri chAn clan nhu: . Men CPK-MB tang cao;
. Troponin T> 1.0 ng/ml;
. AccuTnI > 0.5 ng/ml hoc ngtiang tucrng duang cUa Tropinin 1. Loai trir cat twang hgp sau:
flgi chi:mg mach vanh cap khac bao Om can dau that nut, thieu mau ca tim; Nhi mau ca tim Bong dc hieu;
Tang the men tim hoc Troponin T hay Troponin I sau Ichi thgc hien the tha thuat xuyen da hay cac tha thuat nei mach tha tim bao gom thU thuot chip hinh Ong mach vanh, tar) hinh deng mach vanh.
2.17. Thay the van tim
La phau that tim ha a thay tha hay saa chea cac bAt thuang dm van tim. Cac bat thuang tha van tim phai can dr vao ket qua tir the thuat th8ng tim hoc sieu am tim va viec thoc hien dieu tri nay phai can thiet ve mat y khoa do bac sy chuyen khoa tim mach chi dinh.
2.18. Suy than
Suy than khong 118i plow man tinh tha ca 2 (hai) than, can phai dugc dieu tri bang tham ph'a'n phk mac, chay then nhan tao vinh vin hay ghap than.
2.19. Mat kha nAng sOng d0c letp
La mat kha nang thuc hien tói thieu ba (03) trong sau (06) Chirc Nang Sinh Hogt Hang Ngay (có hay khong sir dung thiet bi 116 try) do benh hoc than thuang gay ra trong thei gian lien tkic it nhat sau) (06)thdng. Benh duct chan doan xac dinh bei bac sy chuyen khoa do cong ty chi dinh.
Logi tit benh kh8ng do ton thuang thuc the nhu nhang benh ve than kinh hay tam than. 2.20. Cam
Mit kha nang noi hoan toan va thong 1181 phoc do benh hay Mn thucmg day thanh am trong tinted hai (12) thing lien Ale. Cac bang chung y te phai do bac sy chuyen khoa Tai Mi Hong xac nhan.
Logi tifr moi tinh trang cam al lien quan den tam than. 2.21. Chan thacmg SQ nAo nghiem trong
Chan thuang so nao do tai ngn có di chimg than kinh nghiem trong va vinh vin trong thin gian it nhat 3 (ba) thing ke tü ngay xay ra tai nail. Di chUng nay lam mat hoan tok va vinh vin kha' nang thuc hien 61 thieu 3 (ba) trong 6 (sau) Chat Nang Sinh Hogt Hang Ngay.Benh ducc chan doan xac dinh bed bac s9 chuyen khoa than kinh.
2.22. Ghep cif quan chinh
La sr suy giam khong có kha nang 118i,plthc cüa cac ca quan nhu tim, ph6i, gan, then hay
tüy xucmg va viec cAy ghep la can thiet ye mat y khoa. Chan doan phai duce the nhen bai bac sy chuyen khoa va phai có phau thOt &Ay ghep tim, ph8i, gan, then hay thy xuong. 2.23. Benh nang thy than
La benh then tien hien do di truyen, ride trung tbei su hien din cac nang trong thy then, teo tieu quan then va xa boa cac Ong ke then dan den cac bieu hien lam sang nhu thieu mau, tieu nhieu va mat Natri, tien trien tai suy than man tinh.
Chan doan phai duce xac dinh bang sinh thiet then. 2.24. Benh t bao than kinh van Ong
La tinh trang thoa1 hOa tien trien cdc be ve nao thy sting va ck te bao simg truk dm thy seng hoc cac te bao than kinh ly tam cUa hanh.nao dan den di cheng than kinh vinh vin, bao gem benh teo ca thy song, lit hanh nao tien trien, va xa cling cOt ben nguyen phat.
Wenh dugc chan doan xac dinh bai bac sy chuyen khoa than kinh. 2.25. Benh xacieng rai rac
I •
Ld benh 19 do skr pha hay chat myelin 6 m8 than kinh nao. Benh phdi dugc bdc sy chuyen khoa than kinh chan doan can dr vdo lam sang, benh six theo dOi chat the tien trien NT& hOi phuc cUa benh.
Cac ket qud chan dodn hinh anh nhu chip cOng hugng tir (MRI), chip din toan cat lop (CT) hoc cac ket qua chan dodn hinh anh clang tin cay Ichdc phai xac nhan cho chin doan. Phiti c6 cdc dau hieu t6n thuang than kinh vinh vin, kdo dai lien tyc trong khoang thigi gian it nhat sau (06) thdrig.
Loai ti-Cr cdc nguyen nhan gay ton thuang than kinh khac nhu b'enh Lupus ban do he thong (SLE) N/A nhie'm HIV.
2.26. Lo3n cluung ea
La nhern benh thodi h6a ca di truyen dc trung bgi yeti va teo ca tin trien.Loan throng ca phdi ducrc bac s9 chuyen khoa than kinh chan dodn.Benh phai gay ra tinh trang mat hoan todn \TA vinh vin MIA nang thgc hien toi thieu ba (03) trong sdu (06) Chat Nang Sinh Hoat Hang NO)/ (c6 hay Ichong dung cu ho trg) trong thoi gian it nhat sau (06) thang lien tic.