{"id":8462,"date":"2019-04-23T19:25:23","date_gmt":"2019-04-23T12:25:23","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=8462"},"modified":"2019-04-27T19:34:32","modified_gmt":"2019-04-27T12:34:32","slug":"thiet-bi-kep-qua-ong-thong-transcatheter-clip-cho-benh-nhan-suy-tim-ho-van-hai-la","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/thiet-bi-kep-qua-ong-thong-transcatheter-clip-cho-benh-nhan-suy-tim-ho-van-hai-la\/","title":{"rendered":"Thi\u1ebft b\u1ecb k\u1eb9p qua \u1ed1ng th\u00f4ng (transcatheter clip) cho b\u1ec7nh nh\u00e2n suy tim h\u1edf van hai l\u00e1"},"content":{"rendered":"<h2>\u0110i\u1ec3m tin nghi\u00ean c\u1ee9u m\u1edbi \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1: Thi\u1ebft b\u1ecb k\u1eb9p qua \u1ed1ng th\u00f4ng (transcatheter clip) cho b\u1ec7nh nh\u00e2n suy tim h\u1edf van hai l\u00e1.<\/h2>\n<p>Trong \u1ea5n b\u1ea3n NEJM Journal Watch (General Meidicne) Year in Review 2018, Editor c\u1ee7a t\u1ea1p ch\u00ed \u0111\u00e3 t\u1ed5ng k\u1ebft k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean s\u1ed1 l\u01b0\u1ee3ng l\u1edbn b\u1ec7nh nh\u00e2n ph\u1eabu thu\u1eadt van hai l\u00e1 v\u1ec1 hi\u1ec7u qu\u1ea3 c\u1ee7a thi\u1ebft b\u1ecb MitraClip.<\/p>\n<h2>D\u1eef li\u1ec7u hi\u1ec7n nay cho th\u1ea5y MitraClip l\u00e0m gi\u1ea3m t\u1ec9 l\u1ec7 m\u1eafc b\u1ec7nh v\u00e0 t\u1ec9 l\u1ec7 t\u1eed vong.<\/h2>\n<p>B\u1ec7nh nh\u00e2n suy tim h\u1edf van hai l\u00e1 th\u1ee9 ph\u00e1t th\u01b0\u1eddng \u0111\u01b0\u1ee3c ti\u00ean l\u01b0\u1ee3ng x\u1ea5u, nh\u01b0ng th\u1eed nghi\u1ec7m COAPT n\u0103m 2018 g\u1ee3i \u00fd r\u1eb1ng ph\u01b0\u01a1ng ph\u00e1p s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb y t\u1ebf c\u00f3 th\u1ec3 c\u1ea3i thi\u1ec7n ti\u00ean l\u01b0\u1ee3ng b\u1ec7nh. Th\u1eed nghi\u1ec7m \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh \u1edf B\u1eafc M\u0129, ph\u00e2n nh\u00f3m ng\u1eabu nhi\u00ean 614 b\u1ec7nh nh\u00e2n c\u00f3 tri\u1ec7u ch\u1ee9ng suy tim h\u1edf van hai l\u00e1 trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng (trong khi \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ti\u00eau chu\u1ea9n) \u0111\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb n\u1ed9i khoa \u0111\u01a1n \u0111\u1ed9c ho\u1eb7c k\u1ebft h\u1ee3p \u0111i\u1ec1u tr\u1ecb v\u1edbi thi\u1ebft b\u1ecb transcatheter clip (nh\u01b0 MitraClip).<\/p>\n<p>C\u00e1c b\u1ec7nh nh\u00e2n tham gia th\u1eed nghi\u1ec7m kh\u00f4ng th\u1ec3 ti\u1ebfn h\u00e0nh ph\u1eabu thu\u1eadt van hai l\u00e1 v\u00e0 c\u00f3 \u0111\u1eb7c \u0111i\u1ec3m gi\u1ea3i ph\u1eabu ph\u00f9 h\u1ee3p v\u1edbi thi\u1ebft b\u1ecb n\u00e0y. K\u1ebft qu\u1ea3, t\u1ec9 l\u1ec7 nh\u1eadp vi\u1ec7n v\u00ec suy tim \u1edf nh\u00f3m s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb th\u1ea5p h\u01a1n \u0111\u00e1ng k\u1ec3 (36% so v\u1edbi 68% b\u1ec7nh nh\u00e2n\/n\u0103m), t\u01b0\u01a1ng t\u1ef1 v\u1edbi t\u1ec9 l\u1ec7 t\u1eed vong trong 24 th\u00e1ng (29% so v\u1edbi 46%). Nh\u00f3m s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb c\u0169ng c\u00f3 ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 t\u00ecnh tr\u1ea1ng ch\u1ee9c n\u0103ng \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n nhi\u1ec1u nhi\u1ec1u h\u01a1n. T\u1ec9 l\u1ec7 kh\u00f4ng m\u1eafc c\u00e1c bi\u1ebfn ch\u1ee9ng li\u00ean quan \u0111\u1ebfn thi\u1ebft b\u1ecb trong 1 n\u0103m \u0111\u1ea1t 97% (NEJM JW Gen Med ng\u00e0y 1\/10 v\u00e0 N Engl J Med ng\u00e0y 23\/9; [e-pub]).<\/p>\n<p>M\u1eb7c d\u00f9 kh\u00f4ng ph\u1ea3i l\u00e0 th\u1eed nghi\u1ec7m m\u00f9 v\u00e0 do c\u00f4ng ty t\u00e0i tr\u1ee3, \u0111\u00e2y c\u0169ng l\u00e0 m\u1ed9t b\u1eb1ng ch\u1ee9ng quan tr\u1ecdng ch\u1ee9ng minh b\u1ec7nh nh\u00e2n ti\u00ean l\u01b0\u1ee3ng x\u1ea5u c\u00f3 nguy c\u01a1 cao c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb h\u1edf van hai l\u00e1 th\u1ee9 ph\u00e1t b\u1eb1ng m\u1ed9t thi\u1ebft b\u1ecb k\u1eb9p van \u0111\u01b0\u1ee3c \u0111\u01b0a v\u00e0o qua da tr\u00ean nh\u1eefng b\u1ec7nh nh\u00e2n ph\u00f9 h\u1ee3p, \u00edt nh\u1ea5t l\u00e0 trong ng\u1eafn h\u1ea1n. MitraClip v\u1ed1n \u0111\u00e3 \u0111\u01b0\u1ee3c FDA ph\u00ea duy\u1ec7t trong vi\u1ec7c ki\u1ec3m so\u00e1t h\u1edf van hai l\u00e1 nguy\u00ean ph\u00e1t do van \u1edf b\u1ec7nh nh\u00e2n c\u00f3 nguy c\u01a1 bi\u1ebfn ch\u1ee9ng ho\u1eb7c t\u1eed vong sau ph\u1eabu thu\u1eadt cao, tuy nhi\u00ean ph\u00ea duy\u1ec7t c\u1ee7a FDA cho \u0111i\u1ec1u tr\u1ecb h\u1edf van hai l\u00e1 th\u1ee9 ph\u00e1t s\u1ebd m\u1edf ra m\u1ed9t ch\u1ec9 \u0111\u1ecbnh m\u1edbi tr\u00ean qu\u1ea7n th\u1ec3 b\u1ec7nh nh\u00e2n m\u1edbi.<\/p>\n<p>Hi\u1ec7n nay, thi\u1ebft b\u1ecb n\u00e0y m\u1edbi \u0111\u01b0\u1ee3c \u0111\u1eb7t tr\u00ean b\u1ec7nh nh\u00e2n \u1edf c\u00e1c trung t\u00e2m chuy\u00ean khoa, th\u01b0\u1eddng l\u00e0 c\u00e1c trung t\u00e2m nghi\u00ean c\u1ee9u, sau khi th\u1ef1c hi\u1ec7n nhi\u1ec1u \u0111\u00e1nh gi\u00e1 \u0111a ng\u00e0nh chi ti\u1ebft. V\u1edbi nh\u1eefng k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u tr\u00ean, MitraClip h\u1ee9a h\u1eb9n s\u1ebd \u0111\u01b0\u1ee3c ph\u00e1t tri\u1ec3n r\u1ed9ng r\u00e3i h\u01a1n.<\/p>\n<p>Ngu\u1ed3n: <a href=\"https:\/\/www.jwatch.org\/na48078\/2018\/12\/27\/nejm-journal-watch-general-medicine-year-review-2018\" rel=\"noopener\">https:\/\/www.jwatch.org\/na48078\/2018\/12\/27\/nejm-journal-watch-general-medicine-year-review-2018<\/a><\/p>\n<p>Ng\u01b0\u1eddi t\u1ed5ng h\u1ee3p: Nguy\u1ec5n Th\u1ecb Thu H\u00e0 &#8211; \u0110o\u00e0n Th\u1ecb Ph\u01b0\u01a1ng Th\u1ea3o &#8211; C\u1ea3nh Gi\u00e1c D\u01b0\u1ee3c Qu\u1ed1c Gia.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u0110i\u1ec3m tin nghi\u00ean c\u1ee9u m\u1edbi \u0111\u01b0\u1ee3c c\u00f4ng b\u1ed1: Thi\u1ebft b\u1ecb k\u1eb9p qua \u1ed1ng th\u00f4ng (transcatheter clip) cho b\u1ec7nh nh\u00e2n suy tim h\u1edf van hai l\u00e1. Trong \u1ea5n b\u1ea3n NEJM Journal Watch (General Meidicne) Year in Review 2018, Editor c\u1ee7a t\u1ea1p ch\u00ed \u0111\u00e3 t\u1ed5ng k\u1ebft k\u1ebft qu\u1ea3 c\u1ee7a m\u1ed9t nghi\u00ean c\u1ee9u tr\u00ean s\u1ed1 l\u01b0\u1ee3ng l\u1edbn b\u1ec7nh [&#8230;]\n","protected":false},"author":1,"featured_media":8463,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-8462","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\/8462","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=8462"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/8462\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/8463"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=8462"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=8462"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=8462"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}