Bước đầu nhận xét sự thay đổi huyết động với test truyền dịch ở bệnh nhân sốc nhiễm khuẩn bằng phương pháp đo cung lượng tim PiCCO

gian mac benh ngan thud'ng co kha nang hdi phyc

nhanh hon vS tdt ban. Kit qua xuat sac va tdt cQng

giam dan theo sd dTa dem bj thoat vj. Cac thdng ke theo

cac tieu chi nSy da dupe chung toi thyc hifn d mpt sd

nghien ciru trude.

Ty le xuat sac vS tdt d eSc benh nhan cd tiln su md

hd cung thap ban ty Ip ehung. Tuy nhien, vi sd bpnh

nhan nay it nen nhgn xet ehi co tinh tham khao.

BAN LUAN

Trung tam Vgt ly Y Sinh hpe (Phan vipn Vgt ly Y Sinh

hpe) va hien nay Vipn Ngogi khoa Laser IS nai thyc hipn

dau tien ky thuat PLDD d Vipt Nam. Trong 11 nam qua

cung cd mpt vai dan vj khac thyc hipn, nhu'ng mdi dUng

Igi d mire dp thii' nghiem. Thyc t l 11 nSm da ciing co

kit lugn rang PLDD IS mpt ky thugt egn thipp ngogi khoa

tdi thieu c6 nhilu uu diem trong dilu tn thoat vj dia dpm

cpt sdng, nlu dirpc thyc hipn bai ban. Uu thi ndi bgt

cua PLDD so voi md hd IS:

Thyc hien duoi gay te. Hgu phau nh? nhSng.

Benh nhan ngogi tru, khong phai lu'u vien.

Khong tgo seo, khdng gay xa dinh than kinh.

Khong ISm mat dp vu'ng chic cua cpt sdng.

Thoi gign hgn chi vgn dpng ngan.

Cd the Igp Igi vS khong can trd phau thugt hd, nlu

can.

Co thi thyc hipn mpt lue d nhieu ting, nhieu vj tri

each xa nhau.

Dp an toSn cao.

Co the thyc hien eho eSc bpnh nhan co tinh trgng tim

mgch, gan, thgn, tilu dudng va tinh trgng sUc khoe

Chung kem mS viec md hd eo thi trd nggi hoge khong

thyc hien dupe.

Ve dSnh giS kit qua, tat ca cac tSe gia tren thi gidi

diu dya vao mire dp cai thipn tren lam sSng. Vi dya vSo

lam sang nen khd djnh lirpng vS cQng ed mpt sd sy

khac nhau trong tieu chi dSnh gia. Tuy vgy, ed thi ndi

kit qui eiia chung toi cung tuang duong vai kit qua

trung binh eiia thi gidi.

Cai kho cua ky thugt PLDD IS phau thugt vien khong

quan sat tryc tiep dupe cSc hipu irng tuang tSc laser

tren md. Hieu irng nay chi c6 the phSn doSn mOt cSch

giSn tilp qua tinh trgng thoSi hda, mit nude cua dTa

dem, cSc diu hieu thoSt hai, thoSt djeh, than hda trong

quS trinh thyc hien ky thu^t. Vi v|ly, vi#c chpn cSc thong

sd bipc xg laser tdi uu ddng vai trd quylt djnh thSnh

edng. De chpn dupe thdng sd tdi uu cin c6 hilu bilt

sau sac ve hipu ung tuang tSc cua buc xg laser vdi mo

sinh hpe va kinh nghipm. Co le day cung IS nguyen nhan

ISm mpt sd trung tam khSc bd cupc.

Di biit thdm chi tiit, Hdn hi tare tiip vdi BS. Trin

CdngDuygt DT: 0988160788.

TAI LIfU THAM KHAO

1. -Choy D.S.J. Percutaneous Igser disc

decompression - A practical guide. Springer 2003.

2. Choy D.S.J. Percutaneous Laser Disc

Decompression (PLDD): 352 Cases with an 81/2 - Year

Follow-up .J. Clin. Lgser Med. & Surg. Vol.13 No. 1 (19

95), 17-21.

3. Ha Viet Hien, Tran Cong Duyet. Some comments

on indication for percutaneous laser disc

decompression., 10th Congress Asign- Pacific

Association for Laser Medicine & Surgery, Shanghai,

Trung Qudc 2004. Free paper.

4. Ha Vilt Hiln, VQ Cong Lgp, Trin Cong Duy$t, Le

Due Td.Y nghTa ciia vipc chup cpng hudng tir kilm tra

sau ky thugt giam Sp dTa dpm cpt sdng bing laser qua

da. Tgp chi Y hpe thyc hSnh 2000;8(385):45-47.

5. HS Vilt Hiln, Trin Cong Duyet. Giam Sp dTa dem

cpt sdng bing laser qua da cho bpnh nhan da phau

thugt hd. Tgp ehi Y hpe thyc hSnh 2001 ;6(398):29-31.

6. Hellinger J. Nonendoscopic Percutgneous 1064-

Nd-YAG-Laser Disk Decompression. Mechanism,

Technique and Experience. Abstract of XII. International

Congress of the Intemational Society of Laser Medicine

& Surgery. Rostock Germany (1997). 40.

7. Hellinger S. and J. Hellinger. Percutaneous Laser

Disk Decompression and Nudeotomy in Cases of

Postnueleotomy Syndromes. Abstract of XII.

International Congress of the Intemational Society of

Laser Medicine & Surgery. Rostock Germany (1997). 38.

8. Hiraishi K., N. Ohmori, R. kosaka, T. Yonezawa,

T. Onomura, I. Adachi, T. Matsuoka, G. Honghan, I.

Narabayashi. Serial Changes on MR Imaging of

Herniated Lumbar Disc Treated by Percutaneous Laser

nudeotomy: Correlation with Early Clinical Results.

JMRM Vol. 16 No. 5 (1999), 176-186.

9. Kanayama T. Limits of Efficacy of Percutaneous

Laser Disc Decompression (PLDD) for Lumbar Disc

Hemiation. X. Congress of Intemational YAG Laser

Symposium.Ho Chi Minh City Vietnam (1998).

DUAC DAU NHAN XETSlTTHAY DOI HUYET DONG vAl TEST TRUYEN DjCH QT DENH

NHAN SOC NHliM KHUAN DAN G PHUITNG PHAP DO CUNG LlATNG TIM PICCO

TOM TAT

Myc tieu: Bwdc dau nh$n xet sw thay doi huyet dgng

vdi test tniyen djeh d benh nhan soe nguyen khuan bang

phwang^phap do cung Iwgng tim lien tiic PICCO

Thiet ke: Nghien ciru lam sang mo ta cd so sinh

Dja diem: Khoa Cap ewu b$nh vi$n B$ch mai

NGUYIN HQU QUAN, NGUYIN ANH TUXN

NGUYI N DAT ANH

Khoa Cip CCPU BSnh vi§n Bach mai

B$nh nhan: 5 b$nh nhin soe nhiem khuin

Can thl$p: Truyen djeh

Ket qua nghien ciru: Cic thdng so huyet dgng dwgc

do d^c dwa theo phwang phap hoa loang nhiet Sau khi

test truyen djeh lam tang mgt each co y nghTa CVP (p<

0,05) tir 10 ±5 len 12 ±5 cmH20, GEDVI tir 714 ± 207

Y HOC THl/C HANH (729) - SO 8/2010 21