{"id":5949,"date":"2019-04-02T13:57:15","date_gmt":"2019-04-02T06:57:15","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=5949"},"modified":"2019-04-02T13:57:15","modified_gmt":"2019-04-02T06:57:15","slug":"so-sanh-kep-day-ron-cham-va-vuot-mau-day-ron-o-tre-sinh-non","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/so-sanh-kep-day-ron-cham-va-vuot-mau-day-ron-o-tre-sinh-non\/","title":{"rendered":"So s\u00e1nh k\u1eb9p d\u00e2y r\u1ed1n ch\u1eadm v\u00e0 vu\u1ed1t m\u00e1u d\u00e2y r\u1ed1n \u1edf tr\u1ebb sinh non"},"content":{"rendered":"<p>B\u00e1c s\u0129 Nguy\u1ec5n Mai An \u2013 Nh\u00f3m nghi\u00ean c\u1ee9u sinh non \u2013 B\u1ec7nh vi\u1ec7n M\u1ef9 \u0110\u1ee9c<\/p>\n<p>V\u00e0o n\u0103m 2012, <strong>hi\u1ec7p h\u1ed9i S\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3 (ACOG \u2013 American College of Obstetricians and Gynecologists) \u0111\u00e3 khuy\u1ebfn c\u00e1o tr\u00ec ho\u00e3n k\u1eb9p c\u1eaft r\u1ed1n 30-60 gi\u00e2y cho t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p sinh non<\/strong>. Hi\u1ec7p h\u1ed9i S\u1ea3n ph\u1ee5 khoa Ho\u00e0ng gia Anh (RCOG \u2013 Royal College of Obstetricians and Gynecologists) c\u0169ng khuy\u1ebfn c\u00e1o tr\u00ec ho\u00e3n vi\u1ec7c n\u00e0y cho c\u00e1c tr\u01b0\u1eddng h\u1ee3p sinh \u0111\u1ee7 th\u00e1ng v\u00e0 non th\u00e1ng kho\u1ebb m\u1ea1nh t\u1eeb 2-5 ph\u00fat sau sinh. B\u00ean c\u1ea1nh \u0111\u00f3, T\u1ed5 ch\u1ee9c Y t\u1ebf th\u1ebf gi\u1edbi (WHO \u2013 World Health Organization) c\u0169ng khuy\u1ebfn c\u00e1o k\u1eb9p c\u1eaft d\u00e2y r\u1ed1n ch\u1eadm l\u00e0 ch\u1edd d\u00e2y r\u1ed1n ng\u1eebng \u0111\u1eadp ho\u1eb7c t\u1eeb 120-180 gi\u00e2y nh\u01b0 l\u00e0 th\u1ef1c h\u00e0nh chu\u1ea9n trong ch\u0103m s\u00f3c tr\u1ebb s\u01a1 sinh kh\u00f4ng c\u1ea7n ph\u1ea3i h\u1ed3i s\u1ee9c t\u00edch c\u1ef1c.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-5950 aligncenter\" src=\"https:\/\/www.vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep.jpg\" alt=\"k\u1eb9p \" width=\"450\" height=\"450\" title=\"\" srcset=\"https:\/\/vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep.jpg 450w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep-350x350.jpg 350w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep-150x150.jpg 150w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep-300x300.jpg 300w, https:\/\/vnras.com\/drug\/wp-content\/uploads\/2019\/04\/kep-100x100.jpg 100w\" sizes=\"auto, (max-width: 450px) 100vw, 450px\" \/><\/p>\n<p>C\u00e1c b\u1eb1ng ch\u1ee9ng hi\u1ec7n h\u1eefu \u0111\u1ec1u cho th\u1ea5y vi\u1ec7c k\u1eb9p c\u1eaft d\u00e2y r\u1ed1n ch\u1eadm \u1edf tr\u1ebb non th\u00e1ng gi\u00fap c\u1ea3i thi\u1ec7n t\u00ecnh tr\u1ea1ng thi\u1ebfu m\u00e1u, nhu c\u1ea7u truy\u1ec1n m\u00e1u, gi\u1ea3m vi\u00eam ru\u1ed9t ho\u1ea1i t\u1eed v\u00e0 xu\u1ea5t huy\u1ebft trong n\u00e3o th\u1ea5t b\u1eb1ng c\u00e1ch l\u00e0m gia t\u0103ng l\u01b0\u1ee3ng m\u00e1u trong tu\u1ea7n ho\u00e0n tr\u1ebb.<br \/>\nTuy nhi\u00ean, trong nh\u1eefng t\u00ecnh hu\u1ed1ng c\u1ea7n h\u1ed3i s\u1ee9c s\u01a1 sinh g\u1ea5p th\u00ec vi\u1ec7c k\u1eb9p c\u1eaft r\u1ed1n ch\u1eadm s\u1ebd kh\u00f3 c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n \u0111\u01b0\u1ee3c.<br \/>\n\u0110\u00e2y l\u00e0 1 nghi\u00ean c\u1ee9u RCT \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n t\u1eeb 18\/4\/2014 \u0111\u1ebfn 5\/6\/2018 t\u1ea1i B\u1ec7nh vi\u1ec7n Good Samaritan \u1edf Cincinnati, Ohio, Hoa K\u1ef3 tr\u00ean 204 tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c chia 2 nh\u00f3m (104 \u1edf nh\u00f3m k\u1eb9p r\u1ed1n ch\u1eadm v\u00e0 100 \u1edf nh\u00f3m vu\u1ed1t m\u00e1u d\u00e2y r\u1ed1n), m\u1ee5c \u0111\u00edch c\u1ee7a nghi\u00ean c\u1ee9u \u0111\u1ec3 so s\u00e1nh hi\u1ec7u qu\u1ea3 c\u1ee7a vi\u1ec7c k\u1eb9p r\u1ed1n ch\u1eadm v\u00e0 \u201cvu\u1ed1t m\u00e1u\u201d (milking) d\u00e2y r\u1ed1n \u1edf tu\u1ed5i thai t\u1eeb 23 0\/7 \u0111\u1ebfn 34 6\/7 tu\u1ea7n.<\/p>\n<p>K\u1ebft qu\u1ea3 thu \u0111\u01b0\u1ee3c t\u1eeb nghi\u00ean c\u1ee9u:<\/p>\n<ul>\n<li>Kh\u00f4ng c\u00f3 s\u1ef1 kh\u00e1c bi\u1ec7t v\u1ec1 t\u1ef7 l\u1ec7 truy\u1ec1n m\u00e1u (15.5% so v\u1edbi 9.1%; P = 0.24), vi\u00eam ru\u1ed9t ho\u1ea1i t\u1eed (5.8% so v\u1edbi 3%; P = 0.49) v\u00e0 xu\u1ea5t huy\u1ebft trong n\u00e3o th\u1ea5t (15.5% so v\u1edbi 10.1%, P = 0.35), v\u00e0 c\u00f3 v\u1ebb th\u1ea5p h\u01a1n \u1edf nh\u00f3m \u0111\u01b0\u1ee3c vu\u1ed1t m\u00e1u.<\/li>\n<li>Nh\u00f3m vu\u1ed1t m\u00e1u d\u00e2y r\u1ed1n c\u00f3 Hct cao h\u01a1n so v\u1edbi nh\u00f3m k\u1eb9p r\u1ed1n ch\u1eadm (6.2% so v\u1edbi 7.7%, P = 0.07) m\u1eb7c d\u00f9 kh\u00f4ng c\u00f3 \u00fd ngh\u0129a.<\/li>\n<li>N\u1ed3ng \u0111\u1ed9 \u0111\u1ec9nh bilirubin v\u00e0 c\u1ea7n ph\u1ea3i chi\u1ebfu \u0111\u00e8n l\u00e0 nh\u01b0 nhau \u1edf c\u1ea3 2 nh\u00f3m.<\/li>\n<\/ul>\n<p>C\u00e1c t\u00e1c gi\u1ea3 sau nghi\u00ean c\u1ee9u n\u00e0y r\u00fat ra \u0111\u01b0\u1ee3c k\u1ebft lu\u1eadn r\u1eb1ng vi\u1ec7c vu\u1ed1t m\u00e1u d\u00e2y r\u1ed1n c\u00f3 th\u1ec3 l\u00e0 ph\u01b0\u01a1ng ph\u00e1p ch\u1ecdn l\u1ef1a thay th\u1ebf cho k\u1eb9p c\u1eaft r\u1ed1n ch\u1eadm m\u00e0 kh\u00f4ng l\u00e0m t\u0103ng nguy c\u01a1 c\u00e1c bi\u1ebfn ch\u1ee9ng hay b\u1ec7nh su\u1ea5t \u1edf tr\u1ebb s\u01a1 sinh.<\/p>\n<p>Ngu\u1ed3n: Delayed clamping versus milking of umbilical cord in preterm infants, a randomized controlled trial. Shirk, Samantha K. et al. American Journal of Obstetrics &amp; Gynecology, Volume 220, Issue 1, S75 &#8211; S76.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>B\u00e1c s\u0129 Nguy\u1ec5n Mai An \u2013 Nh\u00f3m nghi\u00ean c\u1ee9u sinh non \u2013 B\u1ec7nh vi\u1ec7n M\u1ef9 \u0110\u1ee9c V\u00e0o n\u0103m 2012, hi\u1ec7p h\u1ed9i S\u1ea3n ph\u1ee5 khoa Hoa K\u1ef3 (ACOG \u2013 American College of Obstetricians and Gynecologists) \u0111\u00e3 khuy\u1ebfn c\u00e1o tr\u00ec ho\u00e3n k\u1eb9p c\u1eaft r\u1ed1n 30-60 gi\u00e2y cho t\u1ea5t c\u1ea3 c\u00e1c tr\u01b0\u1eddng h\u1ee3p sinh non. Hi\u1ec7p h\u1ed9i S\u1ea3n [&#8230;]\n","protected":false},"author":1,"featured_media":5950,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-5949","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\/5949","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=5949"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/5949\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/5950"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=5949"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=5949"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=5949"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}