{"id":33193,"date":"2022-07-02T06:15:55","date_gmt":"2022-07-01T23:15:55","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=33193"},"modified":"2022-07-02T06:15:55","modified_gmt":"2022-07-01T23:15:55","slug":"roi-loan-tuoi-mau-gan-hepatic-perfusion-disorder","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/roi-loan-tuoi-mau-gan-hepatic-perfusion-disorder\/","title":{"rendered":"R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan – Hepatic perfusion disorder"},"content":{"rendered":"

T\u1ea3i file PDF b\u00e0i vi\u1ebft R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan – Hepatic perfusion disorder<\/strong> <\/b>t\u1ea1i \u0111\u00e2y<\/a><\/p>\n

B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu v\u00e0 Dr. L\u00ea V\u0169 Duy<\/p>\n

\u0110\u1ecbnh ngh\u0129a<\/h2>\n
R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan (Hepatic perfusion disorder (HPD)) \u0111\u1ec1 c\u1eadp \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng v\u1ec1 t\u01b0\u1edbi m\u00e1u c\u1ee7a m\u1ed9t s\u1ed1 h\u1ea1 ph\u00e2n th\u00f9y ho\u1eb7c ph\u00e2n th\u00f9y ho\u1eb7c th\u00f9y gan do nhi\u1ec1u nguy\u00ean nh\u00e2n kh\u00e1c nhau. R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan d\u1ef1 b\u00e1o m\u1ed9t b\u1ec7nh l\u00fd gan ti\u1ec1m \u1ea9n v\u00e0 MRI c\u00f3 th\u1ec3 d\u1ef1 \u0111o\u00e1n \u0111\u01b0\u1ee3c ch\u00ednh x\u00e1c t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u \u1edf m\u1ed9t s\u1ed1 b\u1ec7nh gan. Di c\u0103n gan giai \u0111o\u1ea1n s\u1edbm \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c m\u1ea1ch m\u00e1u nh\u1ecf trong gan. Tr\u00ean h\u00ecnh \u1ea3nh kh\u00f4ng th\u1ea5y \u0111\u01b0\u1ee3c di c\u0103n s\u1edbm nh\u01b0ng c\u00f3 th\u1ec3 th\u1ea5y \u0111\u01b0\u1ee3c c\u00f3 r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u.<\/p>\n
T\u1ef7 l\u1ec7 cao b\u1ec7nh l\u00fd vi\u00eam gan virus (\u0111\u1eb7c bi\u1ec7t l\u00e0 vi\u00eam gan B), b\u1ec7nh gan do r\u01b0\u1ee3u v\u00e0 b\u1ec7nh gan nhi\u1ec5m m\u1ee1 kh\u00f4ng do r\u01b0\u1ee3u. C\u00e1c b\u1ec7nh n\u00e0y c\u00f3 th\u1ec3 ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan v\u00e0 ung th\u01b0 gan, v\u00e0 g\u00e2y ra r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan. C\u00e1c b\u1ec7nh l\u00fd ngo\u00e0i gan nh\u01b0 d\u1ea1 d\u00e0y, t\u1ee5y, th\u1eadn, c\u00e1c kh\u1ed1i u sau ph\u00fac m\u1ea1c c\u00f3 th\u1ec3 g\u00e2y ra thay \u0111\u1ed5i huy\u1ebft \u0111\u1ed9ng c\u1ee7a \u0111\u1ed9ng m\u1ea1ch gan v\u00e0 t\u0129nh m\u1ea1ch c\u1eeda.<\/p>\n
Nguy\u00ean nh\u00e2n<\/h2>\n
C\u00e1c nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a HPD:<\/p>\n
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Shunt \u0111\u1ed9ng m\u1ea1ch gan \u2013 t\u0129nh m\u1ea1ch c\u1eeda<\/li>\n
\u0110\u1ed9ng m\u1ea1ch gan b\u1ecb ch\u00e8n \u00e9p ho\u1eb7c t\u1eafc, d\u1eabn \u0111\u1ebfn thay \u0111\u1ed5i c\u00e2n b\u1eb1ng huy\u1ebft \u0111\u1ed9ng gi\u1eefa \u0111\u1ed9ng m\u1ea1ch gan v\u00e0 t\u0129nh m\u1ea1ch c\u1eeda g\u00e2y ra t\u00ecnh tr\u1ea1ng r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan.<\/li>\n
C\u00e1c b\u1ea5t th\u01b0\u1eddng do c\u00e1c kh\u1ed1i u gi\u00e0u m\u1ea1ch.<\/li>\n
C\u00e1c b\u1ea5t th\u01b0\u1eddng m\u1ea1ch m\u00e1u v\u00e0 d\u1ecb d\u1ea1ng xu\u1ea5t huy\u1ebft th\u1ec3 gi\u00e3n m\u1ea1ch.<\/li>\n
C\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c.<\/li>\n<\/ul>\n
$\"\"$ $\"\"$ $\"\"$ $\"\"$ <\/p>\n
\u0110\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh<\/h2>\n
D\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m h\u00ecnh \u1ea3nh, r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan \u0111\u01b0\u1ee3c chia th\u00e0nh c\u00e1c d\u1ea1ng: lan t\u1ecfa; th\u00f9y ho\u1eb7c ph\u00e2n th\u00f9y; h\u00ecnh ch\u00eam hay d\u1ea1ng t\u1ea5m.<\/p>\n
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Lo\u1ea1i lan t\u1ecfa <\/i>\u0111\u1ec1 c\u1eadp \u0111\u1ebfn v\u00f9ng b\u1ea5t th\u01b0\u1eddng t\u01b0\u1edbi m\u00e1u c\u00f3 h\u00ecnh d\u1ea1ng v\u00e0 k\u00edch th\u01b0\u1edbc kh\u00e1c nhau, th\u01b0\u1eddng g\u1eb7p do huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch c\u1eeda ho\u1eb7c t\u0129nh m\u1ea1ch c\u1eeda b\u1ecb ch\u00e8n \u00e9p do kh\u1ed1i u \u00e1c t\u00ednh.<\/li>\n<\/ul>\n
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HPD lo\u1ea1i th\u00f9y-ph\u00e2n th\u00f9y <\/i>c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 s\u1ef1 b\u1ea5t th\u01b0\u1eddng t\u00edn hi\u1ec7u c\u1ee7a th\u00f9y ho\u1eb7c ph\u00e2n th\u00f9y gan \u1edf th\u00ec \u0111\u1ed9ng m\u1ea1ch, g\u1eb7p trong c\u00e1c kh\u1ed1i u gan ho\u1eb7c kh\u1ed1i u c\u00e1c t\u1ea1ng g\u1ea7n k\u1ec1, sau ph\u1eabu thu\u1eadt, \u0111i\u1ec1u tr\u1ecb can thi\u1ec7p ho\u1eb7c sau c\u00e1c t\u1ed5n th\u01b0\u01a1ng nhi\u1ec5m tr\u00f9ng.<\/li>\n<\/ul>\n
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Lo\u1ea1i h\u00ecnh ch\u00eam <\/i>\u0111i\u1ec3n h\u00ecnh c\u00f3 h\u00ecnh ch\u00eam ho\u1eb7c h\u00ecnh tam gi\u00e1c , th\u01b0\u1eddng n\u1eb1m \u1edf b\u1edd gan ho\u1eb7c c\u00e1c t\u1ed5n th\u01b0\u01a1ng gan nh\u01b0 ung th\u01b0, x\u01a1 gan, ho\u1eb7c b\u1ea5t th\u01b0\u1eddng t\u01b0\u1edbi m\u00e1u sinh l\u00fd.<\/li>\n<\/ul>\n
CT<\/h3>\n
CT kh\u00f4ng ti\u00eam thu\u1ed1c: HPD l\u00e0 c\u00e1c v\u00f9ng gi\u1ea3m t\u1ef7 tr\u1ecdng c\u00f3 h\u00ecnh tam gi\u00e1c ho\u1eb7c h\u00ecnh ch\u00eam. C\u01a1 ch\u1ebf c\u1ee7a hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y l\u00e0 gi\u1ea3m glycogen v\u00e0 t\u0103ng nhi\u1ec5m m\u1ee1 ho\u1eb7c ph\u00f9 n\u1ec1 th\u1ee9 ph\u00e1t do t\u1eafc ngh\u1ebdn d\u00f2ng ch\u1ea3y t\u0129nh m\u1ea1ch. Tr\u00ean CT ti\u00eam thu\u1ed1c: m\u1ed9t ho\u1eb7c nhi\u1ec1u v\u00f9ng t\u0103ng t\u1ef7 tr\u1ecdng \u0111\u1ed3ng nh\u1ea5t h\u00ecnh tr\u00f2n ho\u1eb7c h\u00ecnh ch\u00eam ho\u1eb7c h\u00ecnh d\u1ea1ng kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t (s\u1ed1 \u00edt tr\u01b0\u1eddng h\u1ee3p c\u00f3 bi\u1ec3u hi\u1ec7n gi\u1ea3m t\u1ef7 tr\u1ecdng do \u0111\u1ed9ng m\u1ea1ch gan b\u1ecb t\u1eafc hay ch\u00e8n \u00e9p); \u0111\u1ed3ng t\u1ef7 tr\u1ecdng ho\u1eb7c t\u0103ng t\u1ef7 tr\u1ecdng nh\u1eb9 trong th\u00ec t\u0129nh m\u1ea1ch c\u1eeda.<\/p>\n
V\u00ed d\u1ee5: HPD \u1edf b\u1ec7nh nh\u00e2n n\u1eef v\u1edbi u m\u00e1u th\u1ec3 hang. Phim tr\u01b0\u1edbc ti\u00eam cho th\u1ea5y v\u00f9ng gi\u1ea3m t\u1ef7 tr\u1ecdng ranh gi\u1edbi r\u00f5 \u1edf h\u1ea1 ph\u00e2n th\u00f9y II. H\u00ecnh B: th\u00ec \u0111\u1ed9ng m\u1ea1ch, t\u1ed5n th\u01b0\u01a1ng ng\u1ea5m thu\u1ed1c d\u1ea1ng n\u1ed1t c\u1ee7a u m\u00e1u v\u1edbi v\u00f9ng t\u0103ng t\u1ef7 tr\u1ecdng \u0111\u1ed3ng nh\u1ea5t d\u1ea1ng h\u00ecnh ch\u00eam n\u1eb1m c\u1ea1nh kh\u1ed1i u. H\u00ecnh C: th\u00ec t\u0129nh m\u1ea1ch c\u1eeda cho th\u1ea5y r\u00f5 h\u01a1n c\u00e1c n\u1ed1t c\u1ee7a u m\u00e1u. V\u00f9ng r\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u \u0111\u1ed3ng t\u1ef7 tr\u1ecdng v\u1edbi nhu m\u00f4 gan l\u00e0nh.<\/p>\n
$\"\"$ <\/p>\n
MRI<\/h3>\n
Tr\u01b0\u1edbc ti\u00eam: \u0111\u1ed3ng t\u00edn hi\u1ec7u tr\u00ean T1 v\u00e0 T2, v\u00e0 DWI. Sau ti\u00eam thu\u1ed1c: v\u00f9ng t\u01b0\u1edbi m\u00e1u b\u1ea5t th\u01b0\u1eddng tho\u00e1ng qua \u1edf th\u00ec \u0111\u1ed9ng m\u1ea1ch c\u00f3 d\u1ea1ng h\u00ecnh ch\u00eam ho\u1eb7c t\u00edn hi\u1ec7u kh\u00f4ng \u0111\u1ed3ng nh\u1ea5t. Th\u00ec t\u0129nh m\u1ea1ch c\u1eeda v\u00e0 th\u00ec mu\u1ed9n c\u00f3 t\u00edn hi\u1ec7u \u0111\u1ed3ng nh\u1ea5t ho\u1eb7c t\u0103ng t\u00edn hi\u1ec7u nh\u1eb9. Ranh gi\u1edbi r\u00f5, v\u00f9ng chuy\u1ec3n ti\u1ebfp h\u1eb9p v\u1edbi nhu m\u00f4 gan xung quanh, kh\u00f4ng \u0111\u1ea9y l\u1ec7ch c\u00e1c m\u1ea1ch m\u00e1u. Lo\u1ea1i ph\u00e2n th\u00f9y ho\u1eb7c h\u1ea1 ph\u00e2n th\u00f9y c\u00f3 th\u1ec3 c\u00f3 nhi\u1ec1u v\u1ecb tr\u00ed v\u00e0 th\u01b0\u1eddng \u1edf ngo\u1ea1i vi c\u1ee7a gan.<\/p>\n
V\u00ed d\u1ee5: B\u1ec7nh nh\u00e2n nam 56 tu\u1ed5i b\u1ecb x\u01a1 gan. Tr\u00ean xung T2 fatsat cho th\u1ea5y nhi\u1ec1u n\u1ed1t x\u01a1 gi\u1ea3m t\u00edn hi\u1ec7u v\u00e0 bao quanh l\u00e0 nhu m\u00f4 gan x\u01a1 d\u1ea1ng l\u01b0\u1edbi, kh\u00f4ng th\u1ea5y t\u1ed5n th\u01b0\u01a1ng t\u0103ng t\u00edn hi\u1ec7u b\u1ea5t th\u01b0\u1eddng. B: phim T1 tr\u01b0\u1edbc ti\u00eam kh\u00f4ng th\u1ea5y c\u00f3 t\u1ed5n th\u01b0\u01a1ng gi\u1ea3m t\u00edn hi\u1ec7u. C: h\u00ecnh \u1ea3nh T1 sau ti\u00eam th\u00ec \u0111\u1ed9ng m\u1ea1ch cho th\u1ea5y c\u00e1c v\u00f9ng nh\u1ecf t\u0103ng t\u00edn hi\u1ec7u d\u01b0\u1edbi bao gan, gi\u1ed1ng v\u1edbi t\u1ed5n th\u01b0\u01a1ng u ((pseudolesion)). D: h\u00ecnh \u1ea3nh T1 th\u00ec t\u0129nh m\u1ea1ch c\u1eeda, kh\u00f4ng nh\u00ecn th\u1ea5y t\u1ed5n th\u01b0\u01a1ng \u1edf v\u1ecb tr\u00ed \u0111\u00f3.<\/p>\n
$\"\"$ <\/p>\n
Phim ch\u1ee5p m\u1ea1ch: kh\u00f4ng l\u1ea5p \u0111\u1ea7y c\u1ea3n quang c\u1ee7a t\u0129nh m\u1ea1ch c\u1eeda (d\u1ea5u hi\u1ec7u c\u1ee7a t\u1eafc t\u0129nh m\u1ea1ch c\u1eeda trong gan) ho\u1eb7c ng\u1ea5m thu\u1ed1c h\u00ecnh ch\u00eam \u1edf th\u00ec \u0111\u1ed9ng m\u1ea1ch ho\u1eb7c nhu m\u00f4 tr\u00ean \u1ea3nh ch\u1ee5p m\u1ea1ch gan. C\u00e1c \u0111\u1eb7c \u0111i\u1ec3m t\u01b0\u01a1ng t\u1ef1 g\u1eb7p trong t\u1eafc t\u0129nh m\u1ea1ch gan ho\u1eb7c ngu\u1ed3n cung c\u1ea5p m\u00e1u kh\u00f4ng \u1ed5n \u0111\u1ecbnh.<\/p>\n
HPD kh\u00f4ng \u0111i\u1ec3n h\u00ecnh c\u1ea7n ph\u00e2n bi\u1ec7t v\u1edbi HCC, di c\u0103n gan, u m\u00e1u gan, FNH, adenoma, ho\u1eb7c c\u00e1c kh\u1ed1i u gan t\u00e1i ph\u00e1t sau \u0111i\u1ec1u tr\u1ecb c\u00e1c t\u1ed5n th\u01b0\u01a1ng gan kh\u00e1c.<\/p>\n
B\u1ea5t th\u01b0\u1eddng t\u01b0\u1edbi m\u00e1u sinh l\u00fd c\u00f3 th\u1ec3 x\u1ea3y ra do b\u1ea5t th\u01b0\u1eddng d\u00f2ng ch\u1ea3y th\u1ee9 3, th\u01b0\u1eddng x\u1ea3y ra \u1edf h\u1ed1 t\u00fai m\u1eadt, v\u1ecb tr\u00ed b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng, ph\u00eda tr\u01b0\u1edbc c\u1ee7a r\u00e3nh ngang, ph\u00eda tr\u01b0\u1edbc h\u1ea1 ph\u00e2n th\u00f9y II, ph\u00eda tr\u01b0\u1edbc v\u00e0 ph\u00eda sau h\u1ea1 ph\u00e2n th\u00f9y III, v\u00e0 c\u00e1c v\u1ecb tr\u00ed \u0111\u1eb7c bi\u1ec7t d\u01b0\u1edbi bao gan.<\/p>\n
HPD g\u00e2y ra b\u1edfi ung th\u01b0 v\u00e0 c\u00e1c b\u1ec7nh l\u00fd kh\u00e1c, bao g\u1ed3m x\u01a1 gan, u m\u00e1u gan, vi\u00eam, v\u00e0 t\u1ed5n th\u01b0\u01a1ng c\u00e1c t\u1ea1ng l\u00e2n c\u1eadn. HPD kh\u00f4ng c\u00f3 gi\u00e1 tr\u1ecb \u0111\u1eb7c hi\u1ec7u trong ch\u1ea9n \u0111o\u00e1n c\u00e1c b\u1ec7nh l\u00fd gan nh\u01b0ng n\u00f3 cho th\u1ea5y c\u00f3 s\u1ef1 b\u1ea5t th\u01b0\u1eddng d\u00f2ng ch\u1ea3y \u0111\u1ed9ng m\u1ea1ch gan, t\u1eafc ngh\u1ebdn t\u0129nh m\u1ea1ch c\u1eeda ho\u1eb7c shunt \u0111\u1ed9ng m\u1ea1ch-t\u0129nh m\u1ea1ch c\u1eeda v\u00e0 nh\u1eefng b\u1ec7nh l\u00fd ti\u1ec1m \u1ea9n kh\u00e1c.<\/p>\n
<\/h2>\n
Ngu\u1ed3n tham kh\u1ea3o<\/h2>\n
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Qing\u2011Yong Cao, Zhi\u2011Meng Zou, Qi Wang, Chun\u2011Ni He, Qing Zou, Bin Wang – MRI manifestations of hepatic perfusion disorders<\/a> – Spandidos Publications. Truy c\u1eadp ng\u00e0y 1\/7\/2022<\/li>\n
Jin-Lin Tian, Jin-Shan Zhang – Hepatic perfusion disorders: Etiopathogenesis and related diseases<\/a> – National Library of Medicine. Truy c\u1eadp ng\u00e0y 1\/7\/2022<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"
T\u1ea3i file PDF b\u00e0i vi\u1ebft R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan – Hepatic perfusion disorder t\u1ea1i \u0111\u00e2y B\u00e0i vi\u1ebft \u0111\u01b0\u1ee3c d\u1ecbch b\u1edfi Tr\u1ea7n Th\u1ecb Thu v\u00e0 Dr. L\u00ea V\u0169 Duy \u0110\u1ecbnh ngh\u0129a R\u1ed1i lo\u1ea1n t\u01b0\u1edbi m\u00e1u gan (Hepatic perfusion disorder (HPD)) \u0111\u1ec1 c\u1eadp \u0111\u1ebfn b\u1ea5t th\u01b0\u1eddng v\u1ec1 t\u01b0\u1edbi m\u00e1u c\u1ee7a m\u1ed9t s\u1ed1 h\u1ea1 ph\u00e2n th\u00f9y ho\u1eb7c […]\n","protected":false},"author":1,"featured_media":33196,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-33193","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=33193"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/33193\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/33196"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=33193"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=33193"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=33193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

Nguy\u00ean nh\u00e2n<\/h2>\nC\u00e1c nguy\u00ean nh\u00e2n ch\u00ednh c\u1ee7a HPD:<\/p>\n

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