{"id":2337,"date":"2018-11-19T15:10:21","date_gmt":"2018-11-19T15:10:21","guid":{"rendered":"https:\/\/robot.yeupet.vn\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa\/"},"modified":"2018-11-19T15:10:21","modified_gmt":"2018-11-19T15:10:21","slug":"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa","status":"publish","type":"post","link":"https:\/\/robot.yeupet.vn\/index.php\/2018\/11\/19\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa\/","title":{"rendered":"\u0110i\u1ec1u Tr\u1ecb S\u1ecfi Ti\u1ebft Ni\u1ec7u Theo Ph\u01b0\u01a1ng Ph\u00e1p N\u1ed9i Khoa"},"content":{"rendered":"<p>S\u1ecfi ti\u1ebft ni\u1ec7u l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean h\u1ec7 ti\u1ebft ni\u1ec7u c\u1ee7a ch\u00f3. Theo s\u1ed1 li\u1ec7u th\u1ed1ng k\u00ea n\u0103m 2011 c\u1ee7a Tr\u1ea1m Ch\u1ea9n \u0111o\u00e1n X\u00e9t nghi\u1ec7m v\u00e0 \u0110i\u1ec1u tr\u1ecb \u2013 Chi c\u1ee5c Th\u00fa y TP. H\u1ed3 Ch\u00ed Minh, qua 1570 ca b\u1ec7nh l\u00fd h\u1ec7 ti\u1ebft ni\u1ec7u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng k\u1ef9 thu\u1eadt si\u00eau \u00e2m \u0111\u00e3 ghi nh\u1eadn \u0111\u01b0\u1ee3c 675 ca s\u1ecfi ni\u1ec7u (chi\u1ebfm 43%). S\u1ecfi ti\u1ebft ni\u1ec7u l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n g\u00e2y suy th\u1eadn m\u00e3n t\u00ednh tr\u00ean ch\u00f3.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-6.jpg\" class=\"aligncenter size-full wp-image-5890\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-6\" width=\"422\" height=\"303\"><\/p>\n<p>X-quang ph\u00e1t hi\u1ec7n s\u1ecfi<br \/>\n\u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u tr\u00ean ch\u00f3.<\/p>\n<p>T\u00f9y theo v\u1ecb tr\u00ed, s\u1ecfi ti\u1ebft ni\u1ec7u bao g\u1ed3m s\u1ecfi th\u1eadn, s\u1ecfi ni\u1ec7u qu\u1ea3n, s\u1ecfi b\u00e0ng quang v\u00e0 s\u1ecfi ni\u1ec7u \u0111\u1ea1o. Tr\u00ean th\u1ef1c t\u1ebf s\u1ecfi th\u1eadn r\u1ea5t hi\u1ebfm g\u1eb7p \u1edf ch\u00f3 v\u00ec \u0111a s\u1ed1 s\u1ecfi ni\u1ec7u \u0111\u01b0\u1ee3c h\u00ecnh th\u00e0nh \u1edf b\u00e0ng quang.<\/p>\n<p>Theo th\u00e0nh ph\u1ea7n h\u00f3a h\u1ecdc s\u1ecfi ti\u1ebft ni\u1ec7u bao g\u1ed3m s\u1ecfi struvite, s\u1ecfi urate, s\u1ecfi oxalate v\u00e0 s\u1ecfi cystin\u2026( xem h\u00ecnh 1,2,3)Tr\u00ean 50% s\u1ecfi b\u00e0ng quang l\u00e0 s\u1ecfi struvite, c\u00f2n l\u1ea1i l\u00e0 s\u1ecfi oxalate, s\u1ecfi urate v\u00e0 s\u1ecfi cystin. S\u1ecfi struvite th\u01b0\u1eddng g\u1eb7p tr\u00ean ch\u00f3 c\u00e1i. S\u1ecfi ti\u1ebft ni\u1ec7u x\u1ea3y ra \u1edf m\u1ecdi l\u1ee9a tu\u1ed5i nh\u01b0ng ph\u1ed5 bi\u1ebfn \u1edf giai \u0111o\u1ea1n 4 \u2013 6 n\u0103m tu\u1ed5i.<\/p>\n<p>Nhi\u1ec5m tr\u00f9ng \u0111\u01b0\u1eddng ni\u1ec7u do Staphylococcus spp l\u00e0 m\u1ed9t y\u1ebfu t\u1ed1 \u0111\u00e1ng l\u01b0u \u00fd trong vi\u1ec7c h\u00ecnh th\u00e0nh s\u1ecfi struvite.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa.jpg\" class=\"aligncenter wp-image-5884\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa\" width=\"550\" height=\"198\"><\/p>\n<p>S\u1ecfi struvite (tr\u00e1i),\u00a0S\u1ecfi urate (ph\u1ea3i)<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-1.png\" class=\"aligncenter wp-image-5885\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-1\" width=\"379\" height=\"243\"><\/p>\n<p>S\u1ecfi oxalate<\/p>\n<p>Tri\u1ec7u ch\u1ee9ng l\u00e2m s\u00e0ng c\u1ee7a b\u1ec7nh l\u00fd s\u1ecfi ti\u1ebft ni\u1ec7u tr\u00ean ch\u00f3 l\u00e0 \u0111i khom l\u01b0ng, ti\u1ec3u kh\u00f3, ti\u1ec3u l\u1eaft nh\u1eaft, ti\u1ec3u kh\u00f4ng ki\u1ec3m so\u00e1t, ti\u1ec3u ra m\u00e1u ho\u1eb7c b\u00ed ti\u1ec3u. Tuy nhi\u00ean c\u0169ng c\u00f3 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n l\u00e2m s\u00e0ng v\u00e0 ch\u1ec9 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n t\u00ecnh c\u1edd qua ki\u1ec3m tra s\u1ee9c kh\u1ecfe \u0111\u1ecbnh k\u1ef3. Ch\u1ea9n \u0111o\u00e1n s\u1ecfi ti\u1ebft ni\u1ec7u \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n b\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p si\u00eau \u00e2m ho\u1eb7c ch\u1ee5p X-quang h\u1ec7 ni\u1ec7u kh\u00f4ng d\u00f9ng thu\u1ed1c ho\u1eb7c c\u00f3 d\u00f9ng thu\u1ed1c c\u1ea3n quang v\u00e0 x\u00e9t nghi\u1ec7m n\u01b0\u1edbc ti\u1ec3u (h\u00ecnh 4,5,6,7).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-2.png\" class=\"aligncenter size-full wp-image-5886\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-2\" width=\"364\" height=\"294\"><\/p>\n<p>S\u1ecfi b\u00e0ng quang tr\u00ean ch\u00f3 c\u00e1i:Vi\u00ean s\u1ecfi (m\u0169i t\u00ean \u0111\u1ecf) c\u00f3 hi\u1ec7n t\u01b0\u1ee3ng t\u0103ng \u00e2m, k\u00edch th\u01b0\u1edbc \u0111o \u0111\u01b0\u1ee3c l\u00e0 5,35 cm, k\u00e8m theo \u0111\u00f3 l\u00e0 v\u00f9ng b\u00f3ng l\u01b0ng (m\u0169i t\u00ean tr\u1eafng).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-3.png\" class=\"aligncenter wp-image-5887\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-3\" width=\"363\" height=\"281\"><\/p>\n<p>S\u1ecfi ni\u1ec7u \u0111\u1ea1o (m\u0169i t\u00ean \u0111\u1ecf) tr\u00ean ch\u00f3 \u0111\u1ef1c, S\u1ecfi c\u0169ng c\u00f3 h\u00ecnh \u1ea3nh \u0111\u1eb7c tr\u01b0ng l\u00e0 t\u0103ng \u00e2m v\u00e0 c\u00f3 b\u00f3ng l\u01b0ng. U: Urethral (ni\u1ec7u \u0111\u1ea1o); B: Bladder (b\u00e0ng quang).<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-4.png\" class=\"aligncenter wp-image-5888\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-4\" width=\"423\" height=\"268\"><\/p>\n<p>S\u1ecfi th\u1eadn hai b\u00ean v\u1edbi k\u00edch th\u01b0\u1edbc s\u1ecfi \u0111o \u0111\u01b0\u1ee3c l\u1ea7n l\u01b0\u1ee3t l\u00e0 2,92 cm v\u00e0 2,58 cm<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/img.yeupet.vn\/2018\/11\/dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-5.png\" class=\"aligncenter wp-image-5889\" alt=\"dieu-tri-soi-tiet-nieu-theo-phuong-phap-noi-khoa-5\" width=\"415\" height=\"271\"><\/p>\n<p>S\u1ecfi th\u1eadn tr\u00e1i c\u00f3 k\u00edch th\u01b0\u1edbc 2,08 cm; th\u1eadn ph\u1ea3i \u1ee9 n\u01b0\u1edbc ho\u00e0n to\u00e0n, v\u00f9ng v\u1ecf th\u1eadn m\u1ecfng (m\u0169i t\u00ean xanh), v\u00f9ng t\u1ee7y th\u1eadn c\u00f3 h\u1ed3i \u00e2m tr\u1ed1ng (m\u0169i t\u00ean t\u00edm).<\/p>\n<p>\u0110i\u1ec1u tr\u1ecb s\u1ecfi ti\u1ebft ni\u1ec7u l\u00e0 m\u1ed9t c\u00f4ng vi\u1ec7c r\u1ea5t ph\u1ee9c t\u1ea1p v\u00e0 l\u00e2u d\u00e0i. T\u00f9y v\u00e0o v\u1ecb tr\u00ed s\u1ecfi, k\u00edch thu\u1edbc s\u1ecfi, th\u00e0nh ph\u1ea7n h\u00f3a h\u1ecdc c\u1ee7a s\u1ecfi c\u0169ng nh\u01b0 t\u00ecnh tr\u1ea1ng \u1ee9 n\u01b0\u1edbc c\u1ee7a th\u1eadn \u0111\u1ec3 l\u1ef1a ch\u1ecdn c\u00e1ch \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p: \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa ho\u1eb7c \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i khoa ho\u1eb7c ph\u1ed1i h\u1ee3p c\u1ea3 hai ph\u01b0\u01a1ng ph\u00e1p. D\u01b0\u1edbi \u0111\u00e2y xin g\u1ee3i \u00fd m\u1ed9t v\u00e0i ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa s\u1ecfi ti\u1ebft ni\u1ec7u.<\/p>\n<p><strong>Thu\u1ed1c kh\u00e1ng sinh:<\/strong> Khi ch\u00f3 c\u00f3 c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a vi\u00eam th\u1eadn, vi\u00eam b\u00e0ng quang th\u00ec c\u1ea7n s\u1eed d\u1ee5ng m\u1ed9t trong nh\u1eefng lo\u1ea1i kh\u00e1ng sinh c\u00f3 t\u00e1c d\u1ee5ng tr\u00ean \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb: Nh\u00f3m cephalosporin t\u1eeb th\u1ebf h\u1ec7 th\u1ee9 hai tr\u1edf \u0111i (cefuroxim, ceftriaxon, cefepim); Nh\u00f3m quinolon (norfloxacin, enrofloxacin). C\u1ea7n l\u01b0u \u00fd tr\u00e1nh c\u00e1c kh\u00e1ng sinh g\u00e2y \u0111\u1ed9c tr\u00ean th\u1eadn (nh\u01b0 nh\u00f3m aminoside).<\/p>\n<p><strong>Thu\u1ed1c gi\u1ea3m \u0111au, an th\u1ea7n t\u00e1c \u0111\u1ed9ng \u0111\u1ebfn h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng:<\/strong> S\u1eed d\u1ee5ng trong tr\u01b0\u1eddng h\u1ee3p th\u00fa c\u00f3 d\u1ea5u hi\u1ec7u \u0111au qu\u1eb7n v\u00f9ng th\u1eaft l\u01b0ng, tu\u1ef3 thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 \u0111au m\u00e0 c\u00f3 th\u1ec3 ch\u1ecdn m\u1ed9t trong c\u00e1c lo\u1ea1i thu\u1ed1c sau: ketoprofen (cho u\u1ed1ng 2 mg\/kg th\u1ec3 tr\u1ecdng ng\u00e0y \u0111\u1ea7u ti\u00ean, sau \u0111\u00f3 gi\u1ea3m c\u00f2n 1 mg\/kg th\u1ec3 tr\u1ecdng m\u1ed7i ng\u00e0y); piroxicam (0,3 mg\/kg th\u1ec3 tr\u1ecdng cho u\u1ed1ng m\u1ed7i 2 ng\u00e0y); diazepam (2 \u2013 10 mg cho u\u1ed1ng 3 l\u1ea7n m\u1ed7i ng\u00e0y).<\/p>\n<p><strong>Thu\u1ed1c ch\u1ed1ng co th\u1eaft, g\u00e2y gi\u00e3n c\u01a1 tr\u01a1n, gi\u00e3n ni\u1ec7u qu\u1ea3n:<\/strong> No-spa, Spasfon.<\/p>\n<p><strong>Thay \u0111\u1ed5i ch\u1ebf \u0111\u1ed9 dinh d\u01b0\u1ee1ng:<\/strong> Kh\u1ea9u ph\u1ea7n \u0103n \u00edt \u0111\u1ea1m, \u00edt kho\u00e1ng\u2026<\/p>\n<p><strong>S\u1eed d\u1ee5ng thu\u1ed1c b\u00e0o m\u00f2n v\u00e0 l\u00e0m tan s\u1ecfi:<\/strong> Th\u1ef1c t\u1ebf \u00edt c\u00f3 thu\u1ed1c n\u00e0o c\u00f3 kh\u1ea3 n\u0103ng l\u00e0m tan s\u1ecfi. M\u1ee5c \u0111\u00edch s\u1eed d\u1ee5ng c\u00e1c thu\u1ed1c n\u00e0y l\u00e0 l\u00e0m thay \u0111\u1ed5i m\u00f4i tr\u01b0\u1eddng pH n\u01b0\u1edbc ti\u1ec3u, l\u00e0m gi\u1ea3m kh\u1ea3 n\u0103ng c\u00e1c tinh th\u1ec3 s\u1ecfi k\u1ebft d\u00ednh l\u1ea1i v\u1edbi nhau t\u1eeb \u0111\u00f3 l\u00e0m ch\u1eadm qu\u00e1 tr\u00ecnh h\u00ecnh th\u00e0nh s\u1ecfi:<\/p>\n<ul>\n<li>Ammonium chloride trong s\u1ecfi struvite: cho u\u1ed1ng li\u1ec1u 200 mg\/kg th\u1ec3 tr\u1ecdng\/ng\u00e0ychia l\u00e0m 3 l\u1ea7n.<\/li>\n<li>Allopurinol trong s\u1ecfi urate: cho u\u1ed1ng theo li\u1ec1u 30 mg\/kg th\u1ec3 tr\u1ecdng\/ng\u00e0y chia l\u00e0m 2\u2013 3 l\u1ea7n.<\/li>\n<li>Methionine trong s\u1ecfi struvite: 0,2 \u2013 1g cho u\u1ed1ng m\u1ed7i ng\u00e0y 3 l\u1ea7n.<\/li>\n<\/ul>\n<p>V\u0169 Kim Chi\u1ebfn<br \/>\nTr\u1ea1m Ch\u1ea9n \u0111o\u00e1n X\u00e9t nghi\u1ec7m v\u00e0 \u0110i\u1ec1u tr\u1ecb<br \/>\nChi c\u1ee5c Th\u00fa y TP. H\u1ed3 Ch\u00ed Minh<\/p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>S\u1ecfi ti\u1ebft ni\u1ec7u l\u00e0 b\u1ec7nh l\u00fd th\u01b0\u1eddng g\u1eb7p tr\u00ean h\u1ec7 ti\u1ebft ni\u1ec7u c\u1ee7a ch\u00f3. Theo s\u1ed1 li\u1ec7u th\u1ed1ng k\u00ea n\u0103m 2011 c\u1ee7a Tr\u1ea1m Ch\u1ea9n \u0111o\u00e1n X\u00e9t nghi\u1ec7m v\u00e0 \u0110i\u1ec1u tr\u1ecb \u2013 Chi c\u1ee5c Th\u00fa y TP. H\u1ed3 Ch\u00ed Minh, qua 1570 ca b\u1ec7nh l\u00fd h\u1ec7 ti\u1ebft ni\u1ec7u \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n b\u1eb1ng k\u1ef9 thu\u1eadt si\u00eau \u00e2m [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2337","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2337","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/comments?post=2337"}],"version-history":[{"count":0,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/posts\/2337\/revisions"}],"wp:attachment":[{"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/media?parent=2337"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/categories?post=2337"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/robot.yeupet.vn\/index.php\/wp-json\/wp\/v2\/tags?post=2337"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}