Đặc điểm lâm sàng, cận lâm sàng của tiêu cơ vân do ngộ độc cấp

DIEN DAN Y HOC

Nghien cii'u khoa hoc

Dac diem lam sang, can lam sang

cua tieu cd van do ngo doc cap

Bd Hdng Thu*, Nguyin Anh Tuan*

rCJA^ TAT

Bat van dfe: tieu cd vin (TCV) li mpt hpi chdng thudng gap trong ngp dpc cip (NDC) nhung it

duge phit hien vi khdng cd biiu hien tai co. Muc tieu nghien cifu: 1. Dae diim lim sing, can lim

sing cua tieu cd vin do NDC. 2. Nhin xet diiu trj tieu cd vin do ngp dpc cip tai Trung tim ching

dpc. Phuang phap nghien cdu: Hii cdu md ta. Bdi tifong nghien cifu; BN bj NDC cd CK > 1000 Ul/I.

BN chia 2 nhdm, nhdm 1:1000UI/I < CK< 16 000 Ul/I. Nhdm 2 cd CK>16000UI/I. Kit qua: nhdm 1:

113 BN (72,9%), nhdm 2: 42 BN (21,2%). 7 BN td vong (4,5%). Tile TCV do NDC chiim 5,7%. Tac

nhin giy TCV hay gap nhit li nhdm dpng vat dpc (27,1%), ddng thd hai li nhdm HCBVTV 24,4%,

thd ba li thuic hudng thin (23,8%), nguyen nhin khic 24,7%. Ke't luan: 45,8% BN bj TCV khdng cd

biiu hien tai cd. Si cdn lai: cd dau cd (30,9%), sung ni (15,5%, hoai td (7,8%). Nude tiiu do chiim

32,7%, den sim 24,7%. Suy thin cap (STC) 36,1%, ha Na^ miu 25,5%, tang K+ 12,3%, toan chuyin

hda 88,4%. BN nhdm II bj STC cao hdn nhdm I cd y nghia 81% so vdi 19,5%. Lugng djch truyin BN

nhdm 1 it hon nhdm 2(3911 ml so vdi 5128 ml), tile phai chay thin nhan tao, thdi gian nam vien nhdm

2 cao hon nhdm 1 cdy nghia thing ke 55,9% so vdi 18,2% vi 14,9 ngiy so vdi 6,1 ngiy

I. DAT VAN DE

Tieu CO van (TCV) thudng gap trong ngd dpc

cap (NDC) va nhanh chdng gay suy thart cap (STC).

O My cd 26000 trudng hgp/nam bj TCV trong cle

tnrdng hgp ngd dgc [4]. TCV chiem 13% cle

trudng hgp NDC [2]. TCV do nhieu nguyen nhan

vl khd phlt hien vi trieu ehung tai co khdug diert

hinh, bj che lap bdi cle trieu chiing eiia benh canh

chinh nen thudng phlt biert mudrt. STC do TCV

chiem tir 10- 35% [1], [3]. Chan dolrt va xir tri sdm

TCV trong ngd dgc lam ban che biert chiirtg rtartg,

cai thien tien lugng ciia benh nhan [1], [5]. Chiing

tdi nghien ciru: "Nghien ciru dac diem lam sang, can

lam sang eiia tieu eo van do ngo dgc cap tai Trung

tam Chdng dgc, Benh vien Bach Mai tir 2003 -

2005" vdi 2 mue tieu: 1. Md td dac diem lam sdng,

can lam sdng cua tieu cff vdn do ngd dgc cap. 2.

Nhdn xet dieu tri tieu cff vdn do ngd doc cdp tqi

Trung tdm Chdng dgc, Binh viin Bqch Mai.

II. DOI TlTffNG VA PHlTaNG PHAP NGHIEN CUU

1. Phmmg phap nghien cuu: hdi ciru md tl.

BN dugc chia thanh 2 nhdm: nhdm I: 1000 U/1

CK mlu < 16000 UI/1 (CK tartg miic do TB). Nhdm

IL CK mlu > 16000 UI/1. Khao sat tbdug sd vd:

-Trieu chihig tai co: dau co, sung ne co, hoai tir

eg, khdrtg rd trieu chihig co (BN khdng cd bieu

hien tai co hoac do BN hdn me nen khdng khai

thae dugc dau bieu dau co).

- Nudc tieu: vd nieu bolrt toIrt (lugrtg nudc tieu

< lOOml/24 gid. Thieu nieu (nudc deu < 500 ml/

* 7run^ tam Chong dde - Benh vien Bach hiai

** Binh vien Phu Tho

So 42 (Thang 07/2009) Y HOC LAM SANG j 53