NI C S Da trn cun s 200 triu chng ca Y3 2nd edition BIN SON:NHM
SINH VIN Y4, Y5, Y6 NI C S 2 NI C S 3 LI TA: Cun sch ny ch l do 1
nhm sinh vin bin son, nn cha nhiu thiu st. Nhng thng tin c tng hp t
nhiu sch v chng ti u c ch thch ngun ca nhng thng tin . Chng ti mong
mun n s c ch cho cc bn trong t thc tp lm sng sp ti. Nu cc bn pht
hin ra nhng li sai trong sch, hoc c ch no thc mc, xin hy phn hi li
cho chng ti, chng ti c th sa cha kp thi. Hoc trong qu trnh hc mn Ni
Khoa ny, cc bn thy c nhng thng tin no hay mun chia s, nhng cu hi
thi lm sng hay, thm ch nu bn thy triu chng no cha hi lng v tm huyt
mun son li th chng ti cng sn sng tip nhn, cun sch ngy cng hon thin,
gip tt nht cho cc th h sinh vin tip theo! Mi kin ng gp gi v email:
[email protected] 09/2010 NI C S 4 NI C S 5 Mc lc: Chng 1: Tng
qut ............................... ..07 Chng 2: Tim mch......35
Chng 3: H hp..101 Chng 4: Tiu ha143 Chng 5: Huyt hc.197 Chng 6: Thn
tit niu....225 Chng 7: C xng khp.263 Ph lc 1.281 Ph lc 2.283 Ph lc
3.291 NI C S 6 NI C S 7 CHNG I TNG QUT NI C S 8 NI C S 9
ThiuOxymkhngtm:thiu mu Khng thiu oxy m tm: ahng cu 1. DA XANH TM DA
XANH BC THIU MU: DA XANH TM: NH NGHA -L tnh trng xut hin khi lng Hb
kh >5g/dl hoc >33% (lu , ng vi tnh trng Hb kh tng th lng Hb
xy ho cng gim, tuy nhin phi c nh ngha theo Hb kh, ch cngmhiul xanh
tmxuthintrongtnh trng thiu xy). -Ch con s tuyt il >5g/dl l quan
trng v c gi tr hn khi c s thay i v hm lng Hb mu ch s phn trm ch
tham kho. -Tnh trng xanh tm khng t l thun vi tnh trng thiu oxy t
chc. Vn c trng hp gim cung cp oxy cho t chc m khng xanh tm v ngc
li.V D -Khi thiu mu: do lng Hb gim nn khng c Hb trao i Oxy ti phi,
dn n gim Hb02 trong mu ngmch. Khi n ccm, t bo tng s dng oxy nn t l
Hb kh tng cao, nhng khng c xanh tm v nng Hb kh thc ra vn thp. (trng
hp ny c triu chng Da bc mu) -Bnh a hng cu: Do s lng Hb cao nn khi
ln phi khng trao i ht vi oxy, dn n tng Hb kh ngay trong mu ng mch.
Nu c ri lon h hp th rt d b xanh tm hn ngi bnh thng, v s lng Hb kh
vn cao. PHN LOI Xanh tm trung ng: Th hins kmbo ha mu ngmch,
SaO2
