{"id":9346,"date":"2019-05-12T10:57:51","date_gmt":"2019-05-12T03:57:51","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=9346"},"modified":"2019-05-13T03:01:53","modified_gmt":"2019-05-12T20:01:53","slug":"roi-loan-cuong-duong","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/roi-loan-cuong-duong\/","title":{"rendered":"R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng"},"content":{"rendered":"

R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng l\u00e0 g\u00ec?<\/h2>\n
T\u00ecnh d\u1ee5c l\u00e0 m\u1ed9t kh\u00eda c\u1ea1nh ph\u1ee9c t\u1ea1p \u0111\u1eb7c bi\u1ec7t c\u1ee7a con ng\u01b0\u1eddi. Ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c ph\u1ee5 thu\u1ed9c v\u00e0o n\u0103ng l\u1ef1c gi\u1ea3i ph\u1eabu, sinh l\u00fd v\u00e0 h\u00e0nh vi. Nh\u01b0ng trong b\u1ed1i c\u1ea3nh \u0111a t\u1ea7ng v\u1ec1 ni\u1ec1m tin v\u00e0 \u00fd ngh\u0129a c\u1ee7a ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng trong t\u00ecnh d\u1ee5c v\u00e0 b\u1ec7nh t\u1eadt, s\u1ef1 gi\u00e1o d\u1ee5c v\u0103n h\u00f3a x\u00e3 h\u1ed9i c\u1ee7a anh ta, m\u1ed1i quan h\u1ec7 c\u1ee7a anh ta v\u1edbi b\u1ea1n t\u00ecnh v\u00e0 t\u00ednh ch\u1ea5t c\u1ee7a m\u1ed1i quan h\u1ec7 \u0111\u00f3, ni\u1ec1m tin v\u00e0 \u00fd ngh\u0129a c\u1ee7a b\u1ea1n t\u00ecnh trong ho\u1ea1t \u0111\u1ed9ng t\u00ecnh d\u1ee5c. Kh\u00f4ng c\u00f3 kh\u00eda c\u1ea1nh n\u00e0o kh\u00e1c c\u1ee7a ho\u1ea1t \u0111\u1ed9ng c\u1ee7a con ng\u01b0\u1eddi ch\u1ea1m v\u00e0o r\u1ea5t nhi\u1ec1u th\u00e0nh ph\u1ea7n c\u00e1 t\u00ednh c\u1ee7a m\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng v\u00e0 th\u00fac \u0111\u1ea9y t\u1edbi m\u1ee9c \u0111\u1ed9 ph\u1ee9c t\u1ea1p n\u00e0y.<\/p>\n
Trong b\u1ed1i c\u1ea3nh \u0111\u1ea7y ph\u1ee9c t\u1ea1p, R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/strong><\/a> \u0111\u00e3 \u0111\u01b0\u1ee3c \u0111\u1ecbnh ngh\u0129a l\u00e0 kh\u00f4ng c\u00f3 kh\u1ea3 n\u0103ng \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u00e0 \/ ho\u1eb7c duy tr\u00ec \u0111\u1ee7 \u0111\u1ed9 c\u1ee9ng c\u1ee7a d\u01b0\u01a1ng v\u1eadt \u0111\u1ec3 th\u1ecfa m\u00e3n t\u00ecnh d\u1ee5c. Nh\u1eadn th\u1ee9c v\u1ec1 \u0111\u1ecbnh ngh\u0129a n\u00e0y cho bi\u1ebft m\u1ecdi kh\u00eda c\u1ea1nh c\u1ee7a quy tr\u00ecnh, trong \u0111\u00f3 c\u00e1c b\u00e1c s\u0129 l\u00e2m s\u00e0ng h\u1ed7 tr\u1ee3 v\u00e0 h\u01b0\u1edbng d\u1eabn nam gi\u1edbi v\u00e0 c\u00e1c b\u1ea1n t\u00ecnh c\u1ee7a h\u1ecd trong vi\u1ec7c \u0111\u00e1nh gi\u00e1, ch\u1ea9n \u0111o\u00e1n v\u00e0 l\u1ef1a ch\u1ecdn c\u00e1ch x\u1eed l\u00fd.<\/p>\n
$\"r\u1ed1i$ <\/p>\n
Nhi\u1ec1u b\u1eb1ng ch\u1ee9ng phong ph\u00fa cho th\u1ea5y\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u r\u1ee7i ro cho s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a c\u00e1c t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd ti\u1ec1m \u1ea9n c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c nh\u01b0ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, l\u00e0m gi\u1ea3m ch\u1ea5t l\u01b0\u1ee3ng v\u00e0 th\u1eddi gian s\u1ed1ng (v\u00ed d\u1ee5, b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, b\u1ec7nh tim m\u1ea1ch -CVD) . Ngo\u00e0i ra, r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng ti\u00eau c\u1ef1c \u0111\u1ebfn tinh th\u1ea7n c\u1ee7a m\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng kh\u1ecfe m\u1ea1nh, m\u1ed1i quan h\u1ec7, v\u00e0 h\u1ea1nh ph\u00fac chung c\u1ee7a anh \u1ea5y. Do \u0111\u00f3, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng mang \u0111\u1ebfn c\u01a1 h\u1ed9i gi\u1ea3i quy\u1ebft nhi\u1ec1u v\u1ea5n \u0111\u1ec1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn s\u1ee9c kh\u1ecfe chung c\u1ee7a m\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng.<\/p>\n

D\u1ecbch t\u1ec5 h\u1ecdc v\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1<\/h2>\n
C\u00f3 \u0111\u1ebfn 30 tri\u1ec7u nam gi\u1edbi \u1edf Hoa K\u1ef3 v\u00e0 150 tri\u1ec7u nam gi\u1edbi tr\u00ean to\u00e0n th\u1ebf gi\u1edbi \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh b\u1ecb \u1ea3nh h\u01b0\u1edfng b\u1edfi\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/p>\n
C\u00e1c y\u1ebfu t\u1ed1 c\u00f3 nguy c\u01a1 \u0111\u1ed9c l\u1eadp \u0111\u1ed1i v\u1edbi\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 b\u1ec7nh tim m\u1ea1ch (CVD) \u0111\u01b0\u1ee3c ghi nh\u1eadn bao g\u1ed3m tu\u1ed5i, h\u00fat thu\u1ed1c, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng, t\u0103ng huy\u1ebft \u00e1p, r\u1ed1i lo\u1ea1n lipid m\u00e1u, tr\u1ea7m c\u1ea3m, b\u00e9o ph\u00ec v\u00e0 l\u1ed1i s\u1ed1ng \u00edt v\u1eadn \u0111\u1ed9ng.<\/p>\n
$\"r\u1ed1i$ <\/p>\n
B\u1eb1ng ch\u1ee9ng \u0111\u01b0a ra r\u1eb1ng c\u01a1 ch\u1ebf c\u01a1 b\u1ea3n ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0l\u00e0 m\u1ea1ch m\u00e1u v\u00e0 r\u1eb1ng CVD v\u00e0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u00f3 c\u00f9ng nguy\u00ean nh\u00e2n c\u0169ng nh\u01b0 sinh l\u00fd b\u1ec7nh. M\u1ee9c \u0111\u1ed9\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0t\u01b0\u01a1ng quan m\u1ea1nh v\u1edbi m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a CVD, v\u00e0 c\u00e1c nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y cho th\u1ea5y\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c coi l\u00e0 m\u1ed9t d\u1ea5u hi\u1ec7u \u1edf nam gi\u1edbi c\u00f3 CVD.<\/p>\n
Tri\u1ec7u ch\u1ee9ng c\u1ee7a\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u00f3 th\u1ec3 x\u1ea3y ra tr\u01b0\u1edbc m\u1ed9t v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn tim m\u1ea1ch \u0111\u1ebfn 5 n\u0103m. H\u01a1n n\u1eefa, khi\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0xu\u1ea5t hi\u1ec7n \u1edf nam gi\u1edbi tr\u1ebb tu\u1ed5i, n\u00f3 d\u1ef1 \u0111o\u00e1n m\u1ed9t d\u1ea5u hi\u1ec7u r\u00f5 r\u1ec7t t\u0103ng (g\u1ea5p 50 l\u1ea7n) nguy c\u01a1 x\u1ea3y ra bi\u1ebfn c\u1ed1 v\u1edbi tim trong t\u01b0\u01a1ng lai, cho th\u1ea5y nam than $\"r\u1ed1i$ h ni\u00ean m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0s\u1ebd \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb s\u00e0ng l\u1ecdc v\u00e0 can thi\u1ec7p y\u1ebfu t\u1ed1 nguy c\u01a1 CVD. S\u1ed1 l\u01b0\u1ee3ng nam gi\u1edbi m\u1eafc c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 CVD t\u0103ng l\u00ean song song v\u1edbi s\u1ef1 gia t\u0103ng tr\u00ean to\u00e0n th\u1ebf gi\u1edbi v\u1ec1 t\u1ef7 l\u1ec7 m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/span><\/p>\n
T\u0103ng huy\u1ebft \u00e1p<\/h3>\n
T\u0103ng huy\u1ebft \u00e1p l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng r\u1ea5t ph\u1ed5 bi\u1ebfn, \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn 29,1% ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh \u1edf Hoa K\u1ef3 trong kho\u1ea3ng th\u1eddi gian t\u1eeb 2011 \u0111\u1ebfn 2012. N\u00f3 th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 th\u01b0\u1eddng \u0111\u00f3ng g\u00f3p v\u00e0o nguy\u00ean nh\u00e2n c\u1ee7a n\u00f3 (t\u1ee9c l\u00e0, t\u1ed5n th\u01b0\u01a1ng h\u1eb9p \u0111\u1ed9ng m\u1ea1ch li\u00ean quan \u0111\u1ebfn t\u0103ng huy\u1ebft \u00e1p). N\u00f3 xu\u1ea5t hi\u1ec7n \u1edf 38% \u0111\u1ebfn 42% nam gi\u1edbi b\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 kho\u1ea3ng 35% nam gi\u1edbi b\u1ecb t\u0103ng huy\u1ebft \u00e1p m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0\u1edf c\u00e1c m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau.<\/p>\n
$\"T\u0103ng$ <\/p>\n
R\u1ed1i lo\u1ea1n m\u1ee1 m\u00e1u<\/h3>\n
D\u1eef li\u1ec7u t\u1eeb Kh\u1ea3o s\u00e1t ki\u1ec3m tra s\u1ee9c kh\u1ecfe v\u00e0 dinh d\u01b0\u1ee1ng qu\u1ed1c gia (2003-2006) ch\u1ec9 ra r\u1eb1ng kho\u1ea3ng 53% ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh \u1edf M\u1ef9 c\u00f3 b\u1ea5t th\u01b0\u1eddng v\u1ec1 lipid. C\u00f3 t\u1edbi 42,4% nam gi\u1edbi m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u0169ng b\u1ecb t\u0103ng lipid m\u00e1u. T\u0103ng t\u1ed5ng l\u01b0\u1ee3ng cholesterol v\u00e0 lipoprotein cholesterol t\u1ef7 tr\u1ecdng th\u1ea5p c\u00f3 m\u1ed1i t\u01b0\u01a1ng quan \u0111\u00e1ng k\u1ec3 v\u1edbi ED. trung b\u00ecnh \u0111\u1ebfn n\u1eb7ng . Nam gi\u1edbi c\u00f3 ch\u1ee9c n\u0103ng c\u01b0\u01a1ng d\u01b0\u01a1ng k\u00e9m \u0111\u1ebfn r\u1ea5t k\u00e9m c\u00f3 t\u0103ng g\u1ea5p \u0111\u00f4i t\u1ef7 l\u1ec7 cholesterol \/ lipoprotein t\u1ef7 tr\u1ecdng cao so v\u1edbi nam gi\u1edbi c\u00f3 ch\u1ee9c n\u0103ng c\u01b0\u01a1ng d\u01b0\u01a1ng t\u1ed1t v\u00e0 r\u1ea5t t\u1ed1t.<\/p>\n
$\"R\u1ed1i$ <\/p>\n
\u0110\u00e1i th\u00e1o \u0111\u01b0\u1eddng<\/h3>\n
R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ebfn ch\u1ee9ng ph\u1ed5 bi\u1ebfn nh\u1ea5t c\u1ee7a \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng. T\u00f9y thu\u1ed9c v\u00e0o m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng v\u00e0 th\u1eddi gian m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng, t\u1ef7 l\u1ec7 m\u1eafc ED dao \u0111\u1ed9ng t\u1eeb 20% \u0111\u1ebfn 85% . V\u1edbi s\u1ef1 gia t\u0103ng s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng l\u00ean 29 tri\u1ec7u v\u00e0o n\u0103m 2050, m\u1ee9c t\u0103ng t\u01b0\u01a1ng \u1ee9ng \u1edf nh\u1eefng ng\u01b0\u1eddi m\u1eafc ED c\u0169ng \u0111\u01b0\u1ee3c d\u1ef1 \u0111o\u00e1n. Kho\u1ea3ng 20% \u200b\u200bnam gi\u1edbi m\u1eafc b\u1ec7nh ED c\u0169ng m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng.<\/p>\n
$\"\u0110\u00e1i$ <\/p>\n
Nghi\u00ean c\u1ee9u L\u00e3o h\u00f3a nam Massachusetts, \u0111i\u1ec1u ch\u1ec9nh theo tu\u1ed5i, b\u00e1o c\u00e1o t\u1ef7 l\u1ec7 m\u1eafc ED \u1edf nam gi\u1edbi m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng l\u00e0 28% so v\u1edbi 10% \u1edf nam gi\u1edbi kh\u00f4ng m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng (nguy c\u01a1 t\u0103ng g\u1ea5p 3 l\u1ea7n). T\u1ef7 l\u1ec7 m\u1eafc ED \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng tr\u00ean 50 tu\u1ed5i, g\u1ea7n g\u1ea5p \u0111\u00f4i so v\u1edbi nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng \u1edf c\u00f9ng nh\u00f3m\u00a0 tu\u1ed5i\u00a0 kh\u00f4ng m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng (45,8% so v\u1edbi 24,1%). Ngo\u00e0i ra, s\u1ef1 gia t\u0103ng nguy c\u01a1 m\u1eafc ED t\u01b0\u01a1ng \u0111\u1ed1i c\u00f3 li\u00ean quan \u0111\u1ebfn vi\u1ec7c t\u0103ng th\u1eddi gian m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng. ED \u0111\u01b0\u1ee3c bi\u1ebft l\u00e0 x\u1ea3y ra \u1edf \u0111\u1ed9 tu\u1ed5i s\u1edbm h\u01a1n \u1edf nam gi\u1edbi m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng so v\u1edbi nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng m\u1eafc b\u1ec7nh n\u00e0y. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p, ED c\u00f3 th\u1ec3 l\u00e0 bi\u1ec3u hi\u1ec7n c\u1ee7a b\u1ec7nh \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng tr\u01b0\u1edbc \u0111\u00e2y kh\u00f4ng \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n, trong \u0111\u00f3 nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c s\u00e0ng l\u1ecdc nam gi\u1edbi b\u1ecb ED \u0111\u1ed1i v\u1edbi c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 li\u00ean quan \u0111\u1ebfn b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng.<\/p>\n
C\u00e1c b\u1ec7nh \u0111i k\u00e8m kh\u00f4ng do tim m\u1ea1ch kh\u00e1c<\/h3>\n
C\u00e1c b\u1ec7nh k\u00e8m theo ho\u1eb7c c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 kh\u00e1c th\u01b0\u1eddng li\u00ean quan \u0111\u1ebfn ED bao g\u1ed3m tr\u1ea7m c\u1ea3m, h\u00fat thu\u1ed1c, xu\u1ea5t tinh s\u1edbm (PE), c\u00e1c tri\u1ec7u ch\u1ee9ng \u0111\u01b0\u1eddng ti\u1ebft ni\u1ec7u d\u01b0\u1edbi (LUTS) th\u1ee9 ph\u00e1t do t\u0103ng s\u1ea3n tuy\u1ebfn ti\u1ec1n li\u1ec7t l\u00e0nh t\u00ednh (BPH) v\u00e0 c\u00e1c nguy\u00ean nh\u00e2n kh\u00e1c g\u00e2y ra r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng, nh\u01b0 b\u00e0ng quang ho\u1ea1t \u0111\u1ed9ng qu\u00e1 m\u1ee9c. Trong 3 kh\u1ea3o s\u00e1t v\u1ec1 nam gi\u1edbi b\u1ecb ED, tr\u1ea7m c\u1ea3m \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o l\u00e0 11% v\u00e0 PE kho\u1ea3ng 30% \u0111\u1ebfn 60% s\u1ed1 ng\u01b0\u1eddi \u0111\u01b0\u1ee3c h\u1ecfi. M\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u00e3 ghi nh\u1eadn m\u1ed1i li\u00ean quan ch\u1eb7t ch\u1ebd gi\u1eefa LUTS v\u00e0 ED. LUTS \/ BPH, \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u1edf 72% nam gi\u1edbi m\u1eafc ED, l\u00e0 c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp v\u1edbi nhau v\u00e0 chia s\u1ebb c\u1ea3 c\u00e1c y\u1ebfu t\u1ed1 kh\u00f4ng li\u00ean quan \u0111\u1ebfn tim m\u1ea1ch (v\u00ed d\u1ee5: tu\u1ed5i, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n) v\u00e0 tim m\u1ea1ch (v\u00ed d\u1ee5: b\u00e9o ph\u00ec, t\u0103ng huy\u1ebft \u00e1p, \u0111\u00e1i th\u00e1o \u0111\u01b0\u1eddng) . Nh\u1eefng m\u1ed1i quan h\u1ec7 n\u00e0y nh\u1ea5n m\u1ea1nh t\u1ea7m quan tr\u1ecdng c\u1ee7a vi\u1ec7c \u0111\u00e1nh gi\u00e1 ED \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng c\u00f3 c\u00e1c t\u00ecnh nguy c\u01a1 bi\u1ebfn n\u00e0y.<\/p>\n
Ch\u1ea9n \u0111o\u00e1n r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/h2>\n
\u0110\u00e1nh gi\u00e1 ban \u0111\u1ea7u<\/h3>\n
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L\u1ecbch s\u1eed t\u00ecnh d\u1ee5c – M\u1ed9t m\u00f4 t\u1ea3 chi ti\u1ebft v\u1ec1 v\u1ea5n \u0111\u1ec1, bao g\u1ed3m c\u1ea3 kho\u1ea3ng th\u1eddi gian x\u1ea3y ra c\u00e1c tri\u1ec7u ch\u1ee9ng<\/li>\n
L\u1ecbch s\u1eed v\u1ec1 vi\u1ec7c s\u1eed d\u1ee5ng thu\u1ed1c, b\u1ec7nh t\u00e2m th\u1ea7n v\u00e0 ph\u1eabu thu\u1eadt c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c ghi l\u1ea1i, c\u0169ng nh\u01b0 t\u00ecnh tr\u1ea1ng m\u1ed1i quan h\u1ec7 hi\u1ec7n t\u1ea1i, ti\u1ec1n s\u1eed v\u1ec1 b\u1ea1n t\u00ecnh v\u00e0 c\u00e1c m\u1ed1i quan h\u1ec7 tr\u01b0\u1edbc \u0111\u00f3. C\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 xu h\u01b0\u1edbng t\u00ecnh d\u1ee5c v\u00e0 gi\u1edbi t\u00ednh c\u0169ng c\u1ea7n \u0111\u01b0\u1ee3c l\u01b0u \u00fd. Cu\u1ed1i c\u00f9ng, b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c h\u1ecfi v\u1ec1 r\u01b0\u1ee3u, h\u00fat thu\u1ed1c v\u00e0 l\u1ea1m d\u1ee5ng thu\u1ed1c tr\u00e1i ph\u00e9p<\/li>\n
Vi\u1ec7c s\u1eed d\u1ee5ng c\u00e1c b\u1ea3ng c\u00e2u h\u1ecfi \u0111\u00e1nh gi\u00e1, \u0111\u1eb7c bi\u1ec7t l\u00e0 b\u1ea3ng Ch\u1ec9 s\u1ed1 Qu\u1ed1c t\u1ebf v\u1ec1 Ch\u1ee9c n\u0103ng c\u01b0\u01a1ng d\u01b0\u01a1ng (IIEF) ho\u1eb7c phi\u00ean b\u1ea3n ng\u1eafn h\u01a1n c\u1ee7a SHIM (Ki\u1ec3m k\u00ea s\u1ee9c kh\u1ecfe t\u00ecnh d\u1ee5c cho nam gi\u1edbi) c\u00f3 th\u1ec3 h\u1eefu \u00edch<\/li>\n<\/ul>\n
Ki\u1ec3m tra s\u1ee9c kh\u1ecfe<\/h3>\n
T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c kh\u00e1m s\u1ee9c kh\u1ecfe. Ki\u1ec3m tra b\u1ed9 ph\u1eadn sinh d\u1ee5c \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch v\u00e0 \u0111i\u1ec1u n\u00e0y r\u1ea5t c\u1ea7n thi\u1ebft n\u1ebfu c\u00f3 ti\u1ec1n s\u1eed:<\/p>\n
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Kh\u1edfi ph\u00e1t \u0111au nhanh.<\/li>\n
L\u1ec7ch d\u01b0\u01a1ng v\u1eadt trong qu\u00e1 tr\u00ecnh c\u01b0\u01a1ng c\u1ee9ng.<\/li>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a suy sinh d\u1ee5c.<\/li>\n
C\u00e1c tri\u1ec7u ch\u1ee9ng ti\u1ebft ni\u1ec7u kh\u00e1c (qu\u00e1 kh\u1ee9 ho\u1eb7c hi\u1ec7n t\u1ea1i).<\/li>\n<\/ul>\n
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Ki\u1ec3m tra k\u1ef9 thu\u1eadt s\u1ed1 (DRE) c\u1ee7a tuy\u1ebfn ti\u1ec1n li\u1ec7t kh\u00f4ng b\u1eaft bu\u1ed9c trong ED nh\u01b0ng n\u00ean \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh khi c\u00f3 tri\u1ec7u ch\u1ee9ng xu\u1ea5t tinh th\u1ee9 ph\u00e1t.<\/li>\n
N\u00ean \u0111o huy\u1ebft \u00e1p, nh\u1ecbp tim, v\u00f2ng eo v\u00e0 c\u00e2n n\u1eb7ng.<\/li>\n<\/ul>\n
X\u00e9t nghi\u1ec7m c\u1eadn l\u00e2m s\u00e0ng<\/h3>\n
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Vi\u1ec7c l\u1ef1a ch\u1ecdn x\u00e9t nghi\u1ec7m c\u1ea7n th\u1ef1c hi\u1ec7n t\u00f9y thu\u1ed9c v\u00e0o t\u00ecnh tr\u1ea1ng c\u1ee7a b\u1ec7nh nh\u00e2n. Lipid huy\u1ebft thanh, glucose huy\u1ebft t\u01b0\u01a1ng l\u00fac \u0111\u00f3i, v\u00e0 HbA1C n\u00ean \u0111\u01b0\u1ee3c \u0111o \u1edf t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n<\/li>\n
Suy sinh d\u1ee5c l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb \u0111\u01b0\u1ee3c c\u1ee7a ED, c\u0169ng c\u00f3 th\u1ec3 khi\u1ebfn nam gi\u1edbi \u00edt \u0111\u00e1p \u1ee9ng h\u01a1n, ho\u1eb7c th\u1eadm ch\u00ed kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf phosphodiesterase type 5 (PDE5i); do \u0111\u00f3, t\u1ea5t c\u1ea3 nam gi\u1edbi b\u1ecb ED n\u00ean \u0111\u01b0\u1ee3c \u0111o testosterone huy\u1ebft thanh tr\u00ean m\u1eabu m\u00e1u \u0111\u01b0\u1ee3c l\u1ea5y v\u00e0o bu\u1ed5i s\u00e1ng trong kho\u1ea3ng th\u1eddi gian t\u1eeb 08:00 \u0111\u1ebfn 11:00<\/li>\n
Kh\u00e1ng nguy\u00ean \u0111\u1eb7c hi\u1ec7u tuy\u1ebfn ti\u1ec1n li\u1ec7t n\u00ean \u0111\u01b0\u1ee3c xem x\u00e9t n\u1ebfu c\u00f3 ch\u1ec9 \u0111\u1ecbnh l\u00e2m s\u00e0ng. N\u00f3 ch\u1eafc ch\u1eafn n\u00ean \u0111\u01b0\u1ee3c \u0111o tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u s\u1eed d\u1ee5ng testosterone v\u00e0 3 – 6 th\u00e1ng sau khi s\u1eed d\u1ee5ng v\u00e0 h\u00e0ng n\u0103m sau \u0111\u00f3.<\/li>\n<\/ul>\n
H\u1ec7 tim m\u1ea1ch<\/h3>\n
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B\u1ec7nh m\u1ea1ch v\u00e0nh (CHD) c\u00f3 li\u00ean quan \u0111\u1ebfn nhi\u1ec1u y\u1ebfu t\u1ed1 nguy c\u01a1 gi\u1ed1ng nh\u01b0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng. Trong b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh (CAD) th\u01b0\u1eddng ch\u1ec9 c\u00f3 m\u1ed9t v\u00f9ng b\u1ecb \u1ea3nh h\u01b0\u1edfng nh\u01b0ng n\u00f3 c\u0169ng c\u00f3 kh\u1ea3 n\u0103ng \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn d\u00f2ng m\u00e1u \u0111\u1ed9ng m\u1ea1ch \u0111\u1ebfn th\u1ec3 hang c\u1ee7a d\u01b0\u01a1ng v\u1eadt<\/li>\n
R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng \u1edf m\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng kh\u00e1c c\u00f3 th\u1ec3 l\u00e0 d\u1ea5u hi\u1ec7u cho CAD ti\u1ec1m t\u00e0ng. T\u1ea5t c\u1ea3 nam gi\u1edbi b\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0kh\u00f4ng gi\u1ea3i th\u00edch \u0111\u01b0\u1ee3c n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng v\u00e0 m\u1ecdi y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed1i v\u1edbi CHD \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh c\u1ea7n \u0111\u01b0\u1ee3c gi\u1ea3i quy\u1ebft. M\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng b\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng tim m\u1ea1ch l\u00e0 m\u1ed9t b\u1ec7nh nh\u00e2n tim m\u1ea1ch cho \u0111\u1ebfn khi c\u00f3 c\u00e1c ch\u1ee9ng minh kh\u00e1c<\/li>\n
Ch\u1ee7 \u0111\u1ed9ng qu\u1ea3n l\u00fd\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0\u1edf b\u1ec7nh nh\u00e2n tim m\u1ea1ch (CV) t\u1ea1o ra c\u01a1 h\u1ed9i l\u00fd t\u01b0\u1edfng v\u00e0 hi\u1ec7u qu\u1ea3 \u0111\u1ec3 gi\u1ea3i quy\u1ebft c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 CV kh\u00e1c v\u00e0 c\u1ea3i thi\u1ec7n k\u1ebft qu\u1ea3 \u0111i\u1ec1u tr\u1ecb<\/li>\n
Nam gi\u1edbi b\u1ecb CHD \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc \u0111\u00f3 n\u00ean \u0111\u01b0\u1ee3c h\u1ecfi v\u1ec1\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0nh\u01b0 l\u00e0 m\u1ed9t ph\u1ea7n c\u1ee7a ho\u1ea1t \u0111\u1ed9ng gi\u00e1m s\u00e1t v\u00e0 qu\u1ea3n l\u00fd th\u01b0\u1eddng xuy\u00ean; \u0110i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0n\u00ean \u0111\u01b0\u1ee3c cung c\u1ea5p cho t\u1ea5t c\u1ea3 nh\u1eefng ai c\u00f3 nhu c\u1ea7u<\/li>\n
H\u01b0\u1edbng d\u1eabn c\u1ee7a NICE hi\u1ec7n t\u1ea1i khuy\u1ebfn ngh\u1ecb r\u1eb1ng t\u1ea5t c\u1ea3 nam gi\u1edbi m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng lo\u1ea1i 2 n\u00ean \u0111\u01b0\u1ee3c h\u1ecfi h\u00e0ng n\u0103m v\u1ec1\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng, \u0111\u00e1nh gi\u00e1 v\u00e0 \u0111\u1ec1 ngh\u1ecb \u0111i\u1ec1u tr\u1ecb b\u1eb1ng thu\u1ed1c u\u1ed1ng v\u1edbi thu\u1ed1c c\u00f3 chi ph\u00ed th\u1ea5p nh\u1ea5t<\/li>\n
Kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng cho th\u1ea5y c\u00e1c ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0\u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p hi\u1ec7n t\u1ea1i l\u00e0m t\u0103ng nguy c\u01a1 tim m\u1ea1ch \u1edf b\u1ec7nh nh\u00e2n c\u00f3 ho\u1eb7c kh\u00f4ng c\u00f3 CVD \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n tr\u01b0\u1edbc \u0111\u00f3<\/li>\n<\/ul>\n
Ki\u1ec3m tra chuy\u00ean m\u00f4n<\/h3>\n
H\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n kh\u00f4ng c\u1ea7n ki\u1ec3m tra th\u00eam tr\u1eeb khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee5 th\u1ec3. Tuy nhi\u00ean, m\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n mu\u1ed1n bi\u1ebft c\u0103n nguy\u00ean c\u1ee7a\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u1ee7a h\u1ecd v\u00e0 c\u1ea7n \u0111\u01b0\u1ee3c ki\u1ec3m tra th\u00edch h\u1ee3p. C\u00e1c ch\u1ec9 \u0111\u1ecbnh kh\u00e1c c\u1ea7n ki\u1ec3m tra chuy\u00ean m\u00f4n bao g\u1ed3m:<\/p>\n
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B\u1ec7nh nh\u00e2n tr\u1ebb lu\u00f4n g\u1eb7p kh\u00f3 kh\u0103n trong vi\u1ec7c \u0111\u1ea1t \u0111\u01b0\u1ee3c v\u00e0 \/ ho\u1eb7c duy tr\u00ec s\u1ef1 c\u01b0\u01a1ng c\u1ee9ng.<\/li>\n
B\u1ec7nh nh\u00e2n c\u00f3 ti\u1ec1n s\u1eed ch\u1ea5n th\u01b0\u01a1ng.<\/li>\n
Ph\u00e1t hi\u1ec7n th\u1ea5y s\u1ef1 b\u1ea5t th\u01b0\u1eddng c\u1ee7a tinh ho\u00e0n ho\u1eb7c d\u01b0\u01a1ng v\u1eadt.<\/li>\n
B\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi c\u00e1c li\u1ec7u ph\u00e1p y t\u1ebf c\u00f3 th\u1ec3 mong mu\u1ed1n \u0111i\u1ec1u tr\u1ecb ph\u1eabu thu\u1eadt cho\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/li>\n<\/ul>\n
B\u1ea5t th\u01b0\u1eddng d\u01b0\u01a1ng v\u1eadt<\/h3>\n
\n
C\u00e1c v\u1ea5n \u0111\u1ec1 ph\u1eabu thu\u1eadt g\u00e2y ra r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng c\u01b0\u01a1ng d\u01b0\u01a1ng, v\u00ed d\u1ee5 nh\u01b0 h\u1eb9p bao quy \u0111\u1ea7u, h\u1eb9p d\u00e2y ch\u1eb1ng v\u00e0 cong d\u01b0\u01a1ng v\u1eadt, c\u1ea7n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e2m s\u00e0ng v\u00e0 th\u01b0\u1eddng c\u00f3 th\u1ec3 \u0111i\u1ec1u tr\u1ecb b\u1eb1ng ph\u1eabu thu\u1eadt, k\u1ebft qu\u1ea3 l\u00e0 ch\u1eefa kh\u1ecfi\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u0129nh vi\u1ec5n.<\/li>\n<\/ul>\n
$\"r\u1ed1i$ <\/p>\n
Qu\u1ea3n l\u00fd theo ph\u00e2n lo\u1ea1i nguy c\u01a1 tim m\u1ea1ch<\/h2>\n
$\"R\u1ed1i$ <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Ph\u00e2n lo\u1ea1i r\u1ee7i ro<\/td>\n T\u00ecnh tr\u1ea1ng tim m\u1ea1ch<\/td>\n Khuy\u1ebfn ngh\u1ecb qu\u1ea3n l\u00fd\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0cho ng\u01b0\u1eddi ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe ban \u0111\u1ea7u<\/td>\n<\/tr>\n
Nguy c\u01a1 th\u1ea5p<\/td>\n<\/tr>\n<\/thead>\n
<\/td>\n \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u0103ng huy\u1ebft \u00e1p c\u00f3 ki\u1ec3m so\u00e1t<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng, \u22643\u00a0 y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed1i v\u1edbi CAD, kh\u00f4ng k\u1ec3 tu\u1ed5i v\u00e0 gi\u1edbi t\u00ednh<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B\u1ec7nh van tim nh\u1eb9<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh nh\u1eb9\/ trung b\u00ecnh<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 t\u00e1i th\u00f4ng m\u1ea1ch th\u00e0nh c\u00f4ng<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 CHF (NYHA \u00a0h\u1ea1ng I)<\/td>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Qu\u1ea3n l\u00fd nh\u01b0 \u0111i\u1ec1u tr\u1ecb\u00a0 r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0ban \u0111\u1ea7u<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Xem x\u00e9t l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a anh ta (n\u1ebfu c\u00f3 th\u1ec3)<\/td>\n<\/tr>\n<\/tbody>\n
Nguy c\u01a1 trung b\u00ecnh<\/td>\n<\/tr>\n<\/thead>\n
<\/td>\n \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 MI ho\u1eb7c CVA g\u1ea7n \u0111\u00e2y (t\u1ee9c l\u00e0 trong v\u00f2ng 6 tu\u1ea7n qua)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng nh\u01b0ng> 3 y\u1ebfu t\u1ed1 r\u1ee7i ro cho CAD, kh\u00f4ng k\u1ec3 tu\u1ed5i v\u00e0 gi\u1edbi<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 LVD \/ CHF (NYHA h\u1ea1ng II)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C\u00f3 ti\u1ebfng th\u1ed5i r\u00ec r\u00e0o kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110au th\u1eaft ng\u1ef1c \u1ed5n \u0111\u1ecbnh v\u1eeba ph\u1ea3i<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Gh\u00e9p tim<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 TIA t\u00e1i ph\u00e1t<\/td>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110\u00e1nh gi\u00e1 chuy\u00ean m\u00f4n \u0111\u01b0\u1ee3c khuy\u1ebfn ngh\u1ecb (v\u00ed d\u1ee5 ki\u1ec3m tra b\u00e0i t\u1eadp v\u1ec1 \u0111au th\u1eaft ng\u1ef1c, si\u00eau \u00e2m tim cho ti\u1ebfng th\u1ed5i)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c x\u1ebfp v\u00e0o nh\u00f3m nguy c\u01a1 cao ho\u1eb7c th\u1ea5p, t\u00f9y thu\u1ed9c v\u00e0o k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m<\/td>\n<\/tr>\n<\/tbody>\n
Nguy c\u01a1 cao<\/td>\n<\/tr>\n<\/thead>\n
<\/td>\n \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110au th\u1eaft ng\u1ef1c n\u1eb7ng ho\u1eb7c kh\u00f4ng \u1ed5n \u0111\u1ecbnh ho\u1eb7c kh\u00f3 tr\u1ecb<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 T\u0103ng huy\u1ebft \u00e1p kh\u00f4ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t (SBP> 180 mmHg)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 CHF (NYHA h\u1ea1ng III, IV)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 MI ho\u1eb7c CVA g\u1ea7n \u0111\u00e2y (t\u1ee9c l\u00e0 trong v\u00f2ng 14 ng\u00e0y qua)<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 R\u1ed1i lo\u1ea1n nh\u1ecbp tim nguy c\u01a1 cao<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B\u1ec7nh c\u01a1 tim ph\u00ec \u0111\u1ea1i<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B\u1ec7nh van tim trung b\u00ecnh \/ n\u1eb7ng<\/td>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tham kh\u1ea3o \u0111\u00e1nh gi\u00e1 v\u00e0 qu\u1ea3n l\u00fd chuy\u00ean bi\u1ec7t v\u1ec1 tim<\/p>\n
\u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u0110i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0\u0111\u01b0\u1ee3c ho\u00e3n l\u1ea1i cho \u0111\u1ebfn khi t\u00ecnh tr\u1ea1ng tim \u0111\u01b0\u1ee3c thi\u1ebft l\u1eadp v\u00e0 \/ ho\u1eb7c \u0111\u00e1nh gi\u00e1 chuy\u00ean\u00a0 m\u00f4n ho\u00e0n t\u1ea5t<\/td>\n<\/tr>\n
ED = r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng;\u00a0CAD = b\u1ec7nh \u0111\u1ed9ng m\u1ea1ch v\u00e0nh;\u00a0NYHA = Hi\u1ec7p h\u1ed9i Tim m\u1ea1ch New York;\u00a0MI = nh\u1ed3i m\u00e1u c\u01a1 tim;
\nCVA = tai bi\u1ebfn m\u1ea1ch m\u00e1u n\u00e3o;\u00a0LVD = r\u1ed1i lo\u1ea1n ch\u1ee9c n\u0103ng th\u1ea5t tr\u00e1i;\u00a0CHF = suy tim sung huy\u1ebft;\u00a0TIA = c\u01a1n thi\u1ebfu m\u00e1u n\u00e3o tho\u00e1ng qua;\u00a0SBP = huy\u1ebft \u00e1p t\u00e2m thu.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\u0110i\u1ec1u tr\u1ecb b\u1ec7nh r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/h2>\n
M\u1eb7c d\u00f9 c\u00e1c nguy\u00ean t\u1eafc c\u01a1 b\u1ea3n trong \u0111i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0l\u00e0 gi\u1ed1ng nhau \u0111\u1ed1i v\u1edbi t\u1ea5t c\u1ea3 nam gi\u1edbi – ph\u1ee5c h\u1ed3i ho\u1eb7c t\u0103ng c\u01b0\u1eddng ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c, c\u1ea3i thi\u1ec7n s\u1ee9c kh\u1ecfe th\u1ec3 ch\u1ea5t t\u1ed5ng th\u1ec3, v\u00e0 t\u1ed1i \u01b0u h\u00f3a ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 h\u1ea1nh ph\u00fac cho m\u1ed9t ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a anh ta. M\u1ed7i ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng mang \u0111\u1ebfn v\u1ea5n \u0111\u1ec1 v\u1ec1 l\u00e2m s\u00e0ng kh\u00f4ng ch\u1ec9 do c\u00e1c tri\u1ec7u ch\u1ee9ng c\u1ee7a m\u00ecnh, m\u00e0 c\u00f2n v\u00ec m\u1ee9c \u0111\u1ed9 \u0111au kh\u1ed5 c\u1ee7a anh ta; t\u00ecnh tr\u1ea1ng s\u1ee9c kh\u1ecfe li\u00ean quan; m\u1ed1i quan t\u00e2m c\u1ee7a b\u1ea1n t\u00ecnh v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 v\u1ec1 ch\u1ea5t l\u01b0\u1ee3ng m\u1ed1i quan h\u1ec7; v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn v\u0103n h\u00f3a x\u00e3 h\u1ed9i, gi\u00e1o d\u1ee5c v\u00e0 t\u00f4n gi\u00e1o c\u1ee7a anh ta.<\/p>\n
$\"r\u1ed1i$ <\/p>\n
X\u00e1c \u0111\u1ecbnh m\u1ed9t ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb th\u00edch h\u1ee3p \u0111\u00f2i h\u1ecfi ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng, b\u00e1c s\u0129 l\u00e2m s\u00e0ng v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a anh ta th\u00f4ng qua t\u1ea5t c\u1ea3 c\u00e1c v\u1ea5n \u0111\u1ec1 tr\u00ean \u0111\u1ec3 \u0111i \u0111\u1ebfn l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p . Nam gi\u1edbi n\u00ean \u0111\u01b0\u1ee3c th\u00f4ng b\u00e1o v\u1ec1 t\u1ea5t c\u1ea3 c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb kh\u00f4ng ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh v\u1ec1 m\u1eb7t y t\u1ebf v\u00e0 \u0111\u01b0\u1ee3c h\u1ed7 tr\u1ee3 trong quy tr\u00ecnh SDM \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh ph\u01b0\u01a1ng ph\u00e1p \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p. M\u1eb7c d\u00f9 nhi\u1ec1u ng\u01b0\u1eddi c\u00f3 th\u1ec3 ch\u1ecdn b\u1eaft \u0111\u1ea7u v\u1edbi c\u00e1c l\u1ef1a ch\u1ecdn \u00edt x\u00e2m l\u1ea5n nh\u1ea5t (v\u00ed d\u1ee5, thu\u1ed1c u\u1ed1ng), tuy nhi\u00ean ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u v\u1edbi b\u1ea5t k\u1ef3 lo\u1ea1i \u0111i\u1ec1u tr\u1ecb n\u00e0o, b\u1ea5t k\u1ec3 x\u00e2m l\u1ea5n hay \u0111\u1ea3o ng\u01b0\u1ee3c. Anh ta c\u0169ng c\u00f3 th\u1ec3 ch\u1ecdn t\u1eeb b\u1ecf \u0111i\u1ec1u tr\u1ecb. Trong m\u1ed7i tr\u01b0\u1eddng h\u1ee3p, vai tr\u00f2 c\u1ee7a b\u00e1c s\u0129 l\u00e2m s\u00e0ng l\u00e0 \u0111\u1ea3m b\u1ea3o r\u1eb1ng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a anh ta c\u00f3 s\u1ef1 hi\u1ec3u bi\u1ebft \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 l\u1ee3i \u00edch v\u00e0 r\u1ee7i ro \/ g\u00e1nh n\u1eb7ng c\u1ee7a c\u00e1c ph\u01b0\u01a1ng ph\u00e1p x\u1eed l\u00fd kh\u00e1c nhau. T\u1ea5t c\u1ea3 nam gi\u1edbi, b\u1ea5t k\u1ec3 quy\u1ebft \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng, n\u00ean \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o m\u1ea1nh m\u1ebd \u0111\u1ec3 gi\u1ea3i quy\u1ebft b\u1ea5t k\u1ef3 v\u1ea5n \u0111\u1ec1 y t\u1ebf ti\u1ec1m \u1ea9n n\u00e0o c\u00f3 th\u1ec3 g\u00e2y ra\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 t\u1ea1o th\u00e0nh c\u00e1c y\u1ebfu t\u1ed1 nguy c\u01a1 \u0111\u1ed9c l\u1eadp cho s\u1ee9c kh\u1ecfe, gi\u1ea3m thi\u1ec3u ch\u1ea5t l\u01b0\u1ee3ng cu\u1ed9c s\u1ed1ng v\u00e0 gi\u1ea3m t\u1ef7 l\u1ec7 s\u1ed1ng.<\/p>\n
M\u1ee5c ti\u00eau ch\u00ednh c\u1ee7a qu\u1ea3n l\u00fd\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0l\u00e0 cho ph\u00e9p c\u00e1 nh\u00e2n ho\u1eb7c c\u1eb7p v\u1ee3 ch\u1ed3ng t\u1eadn h\u01b0\u1edfng tr\u1ea3i nghi\u1ec7m t\u00ecnh d\u1ee5c th\u1ecfa \u0111\u00e1ng. \u0110i\u1ec1u n\u00e0y li\u00ean quan \u0111\u1ebfn:<\/p>\n
\n
X\u00e1c \u0111\u1ecbnh v\u00e0 \u0111i\u1ec1u tr\u1ecb b\u1ea5t k\u1ef3 nguy\u00ean nh\u00e2n \u00a0n\u00e0o c\u00f3 th\u1ec3 ch\u1eefa \u0111\u01b0\u1ee3c c\u1ee7a\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/li>\n
B\u1eaft \u0111\u1ea7u thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng v\u00e0 s\u1eeda \u0111\u1ed5i y\u1ebfu t\u1ed1 nguy c\u01a1.<\/li>\n
Gi\u00e1o d\u1ee5c v\u00e0 t\u01b0 v\u1ea5n cho b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c b\u1ea1n t\u00ecnh c\u1ee7a h\u1ecd.<\/li>\n
Tr\u01b0\u1eddng h\u1ee3p t\u00ecm th\u1ea5y nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 ch\u1eefa \u0111\u01b0\u1ee3c \u0111\u1ed1i v\u1edbi\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng, th\u00ec n\u00ean \u0111i\u1ec1u tr\u1ecb k\u1ebft h\u1ee3p v\u1edbi tr\u1ecb li\u1ec7u \u0111\u1eb7c hi\u1ec7u\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/li>\n<\/ul>\n
Nh\u1eefng nguy\u00ean nh\u00e2n c\u00f3 th\u1ec3 \u0111\u1ea3o ng\u01b0\u1ee3c c\u1ee7a\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/strong><\/h2>\n
N\u1ed9i ti\u1ebft t\u1ed1:<\/h3>\n
\n
Suy sinh d\u1ee5c.<\/li>\n
C\u01b0\u1eddng gi\u00e1p \/ suy gi\u00e1p.<\/li>\n
T\u0103ng prolactin m\u00e1u.<\/li>\n
R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng sau ch\u1ea5n th\u01b0\u01a1ng \u0111\u1ed9ng m\u1ea1ch \u1edf b\u1ec7nh nh\u00e2n tr\u1ebb tu\u1ed5i.<\/li>\n<\/ul>\n
Thu\u1ed1c c\u1ea3m \u1ee9ng r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng:<\/h3>\n
Thu\u1ed1c c\u00f3 th\u1ec3 g\u00e2y ra \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ph\u1ea3n \u1ee9ng t\u00ecnh d\u1ee5c theo m\u1ed9t s\u1ed1 c\u00e1ch:<\/p>\n
\n
Thu\u1ed1c g\u00e2y an th\u1ea7n c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn \u0111\u1ed9ng l\u1ef1c t\u00ecnh d\u1ee5c v\u00e0 gi\u00e1n ti\u1ebfp g\u00e2y ra\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/li>\n
Thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ch\u1ee9c n\u0103ng tim m\u1ea1ch, ch\u1eb3ng h\u1ea1n nh\u01b0 thu\u1ed1c ch\u1ed1ng t\u0103ng huy\u1ebft \u00e1p, c\u00f3 th\u1ec3 ho\u1ea1t \u0111\u1ed9ng t\u1ea1i ch\u1ed7 v\u00e0 c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn huy\u1ebft \u0111\u1ed9ng h\u1ecdc d\u01b0\u01a1ng v\u1eadt.<\/li>\n
M\u1ed9t s\u1ed1 lo\u1ea1i thu\u1ed1c \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c th\u00f4ng s\u1ed1 n\u1ed9i ti\u1ebft: Thu\u1ed1c ch\u1ed1ng androgen v\u00e0 oestrogen c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u1ea3 ham mu\u1ed1n t\u00ecnh d\u1ee5c v\u00e0 s\u1ef1 c\u01b0\u01a1ng c\u1ee9ng.<\/li>\n
Thu\u1ed1c g\u00e2y t\u0103ng prolactinaemia, ch\u1eb3ng h\u1ea1n nh\u01b0 phenothiazin, c\u0169ng c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ham mu\u1ed1n t\u00ecnh d\u1ee5c v\u00e0 c\u01b0\u01a1ng c\u1ee9ng.<\/li>\n
B\u1ea1n t\u00ecnh c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 t\u00ecnh d\u1ee5c.<\/li>\n
T\u01b0 v\u1ea5n v\u00e0 tr\u1ecb li\u1ec7u t\u00e2m l\u00fd.<\/li>\n
Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf tuy\u1ebfn ti\u1ec1n li\u1ec7t tri\u1ec7t \u0111\u1ec3<\/li>\n<\/ul>\n
Qu\u1ea3n l\u00fd l\u1ed1i s\u1ed1ng<\/strong><\/h3>\n
S\u1eeda \u0111\u1ed5i l\u1ed1i s\u1ed1ng c\u00f3 th\u1ec3 l\u00e0m gi\u1ea3m \u0111\u00e1ng k\u1ec3 nguy c\u01a1 m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng, v\u00e0 n\u00ean \u0111\u01b0\u1ee3c \u0111i k\u00e8m v\u1edbi b\u1ea5t k\u1ef3 li\u1ec7u ph\u00e1p d\u01b0\u1ee3c l\u00fd hay li\u1ec7u ph\u00e1p t\u00e2m l\u00fd n\u00e0o. Tuy nhi\u00ean, li\u1ec7u ph\u00e1p d\u01b0\u1ee3c l\u00fd kh\u00f4ng n\u00ean ng\u1eebng l\u1ea1i n\u1ebfu nh\u1eefng thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng kh\u00f4ng \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n<\/p>\n
C\u00e1c y\u1ebfu t\u1ed1 l\u1ed1i s\u1ed1ng bao g\u1ed3m:<\/p>\n
\n
V\u1ea5n \u0111\u1ec1 t\u00e2m l\u00fd x\u00e3 h\u1ed9i.<\/li>\n
T\u00e1c d\u1ee5ng ph\u1ee5 b\u1ea5t l\u1ee3i c\u1ee7a thu\u1ed1c kh\u00f4ng k\u00ea \u0111\u01a1n.<\/li>\n
\u1ea2nh h\u01b0\u1edfng c\u1ee7a b\u1ea5t k\u1ef3 b\u1ec7nh m\u1eafc k\u00e8m n\u00e0o, bao g\u1ed3m c\u1ea3 nh\u1eefng b\u1ec7nh c\u1ee7a b\u1ea1n t\u00ecnh<\/li>\n<\/ul>\n
Nh\u1eefng l\u1ee3i \u00edch ti\u1ec1m n\u0103ng c\u1ee7a thay \u0111\u1ed5i l\u1ed1i s\u1ed1ng c\u00f3 th\u1ec3 \u0111\u1eb7c bi\u1ec7t r\u00f5 r\u1ec7t \u1edf nh\u1eefng ng\u01b0\u1eddi m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0t\u00e2m l\u00fd, nh\u01b0ng kh\u00f4ng ph\u1ea3i \u1edf nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng m\u1eafc b\u1ec7nh tim m\u1ea1ch ho\u1eb7c ti\u1ec3u \u0111\u01b0\u1eddng n\u1eb7ng<\/p>\n
Suy sinh d\u1ee5c v\u00e0 li\u1ec7u ph\u00e1p thay th\u1ebf testosterone<\/strong><\/h3>\n
Lu\u00f4n lu\u00f4n ph\u1ea3i t\u00ecm ra nguy\u00ean nh\u00e2n g\u00e2y suy sinh d\u1ee5c tr\u01b0\u1edbc khi b\u1eaft \u0111\u1ea7u \u0111i\u1ec1u tr\u1ecb b\u1eb1ng testosterone, nh\u01b0ng \u0111i\u1ec1u n\u00e0y kh\u00f4ng c\u00f3 ngh\u0129a l\u00e0 \u0111i\u1ec1u tr\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0n\u00ean \u0111\u01b0\u1ee3c ho\u00e3n l\u1ea1i. \u0110\u00e1nh gi\u00e1 tr\u01b0\u1edbc v\u00e0 gi\u00e1m s\u00e1t an to\u00e0n n\u00ean \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n theo c\u00e1c h\u01b0\u1edbng d\u1eabn c\u00f3 hi\u1ec7n th\u1eddi.<\/p>\n
$\"testosterone\"$ <\/p>\n
\u0110\u00e0n \u00f4ng c\u00f3 t\u1ed5ng testosterone huy\u1ebft thanh \u1ed5n \u0111\u1ecbnh <12nmol \/ l c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c h\u01b0\u1edfng l\u1ee3i t\u1eeb th\u1eed nghi\u1ec7m li\u1ec7u ph\u00e1p thay th\u1ebf testosterone 3 th\u00e1ng \u0111\u1ed1i v\u1edbi\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 n\u00ean \u0111\u01b0\u1ee3c qu\u1ea3n l\u00fd theo h\u01b0\u1edbng d\u1eabn hi\u1ec7n h\u00e0nh<\/p>\n
C\u00f3 s\u1eb5n m\u1ed9t lo\u1ea1t c\u00e1c d\u1ea1ng b\u00e0o ch\u1ebf testosterone dung n\u1ea1p t\u1ed1t bao g\u1ed3m:<\/p>\n
\n
\u0110\u01b0\u1eddng u\u1ed1ng.<\/li>\n
Gel qua da.<\/li>\n
Dung d\u1ecbch th\u1ea5m qua da n\u00e1ch.<\/li>\n
Ti\u00eam t\u00e1c d\u1ee5ng k\u00e9o d\u00e0i 1000 mg \/ 4 ml ti\u00eam b\u1eafp s\u00e2u (3 th\u00e1ng 1 l\u1ea7n).<\/li>\n
Ti\u00eam truy\u1ec1n th\u1ed1ng 100\/250 mg (2 -3 tu\u1ea7n 1 l\u1ea7n).<\/li>\n
V\u1ea5y vi\u00ean<\/li>\n<\/ul>\n
\u0110i\u1ec1u tr\u1ecb first-line<\/strong><\/h3>\n
PDE5Is (v\u00ed d\u1ee5: avanafil, sildenafil, tadalafil, vardenafil):<\/p>\n
\n
\u0110\u00e3 \u0111\u01b0\u1ee3c ch\u1ee9ng minh t\u00ednh hi\u1ec7u qu\u1ea3 v\u00e0 an to\u00e0n \u1edf c\u1ea3 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng ng\u1eabu nhi\u00ean m\u1eafc\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 trong c\u00e1c nh\u00f3m b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3 (v\u00ed d\u1ee5, nam gi\u1edbi m\u1eafc b\u1ec7nh ti\u1ec3u \u0111\u01b0\u1eddng v\u00e0 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf tuy\u1ebfn ti\u1ec1n li\u1ec7t).<\/li>\n
Avanafil, sildenafil v\u00e0 vardenafil l\u00e0 nh\u1eefng thu\u1ed1c c\u00f3 t\u00e1c d\u1ee5ng t\u01b0\u01a1ng \u0111\u1ed1i ng\u1eafn, c\u00f3 th\u1eddi gian b\u00e1n th\u1ea3i kho\u1ea3ng 4 gi\u1edd, trong khi tadalafil c\u00f3 th\u1eddi gian b\u00e1n h\u1ee7y d\u00e0i h\u01a1n \u0111\u00e1ng k\u1ec3 17,5 gi\u1edd.<\/li>\n
Thu\u1ed1c kh\u00f4ng ph\u1ea3i l\u00e0 kh\u1edfi \u0111\u1ea7u c\u1ee7a s\u1ef1 c\u01b0\u01a1ng c\u1ee9ng, \u0111\u00f2i h\u1ecfi ph\u1ea3i c\u00f3 k\u00edch th\u00edch t\u00ecnh d\u1ee5c \u0111\u1ec3 t\u1ea1o \u0111i\u1ec1u ki\u1ec7n cho s\u1ef1 c\u01b0\u01a1ng c\u1ee9ng. V\u1edbi khuy\u1ebfn c\u00e1o hi\u1ec7n t\u1ea1i, b\u1ec7nh nh\u00e2n n\u00ean d\u00f9ng t\u00e1m li\u1ec1u thu\u1ed1c \u1ee9c ch\u1ebf PDE5 v\u1edbi k\u00edch th\u00edch t\u00ecnh d\u1ee5c \u1edf li\u1ec1u t\u1ed1i \u0111a tr\u01b0\u1edbc khi coi l\u00e0 b\u1ec7nh nh\u00e2n l\u00e0 kh\u00f4ng \u0111\u00e1p \u1ee9ng.<\/li>\n
\u0110\u1ed1i v\u1edbi nam gi\u1edbi b\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0v\u00e0 b\u1ecb LUTS l\u00e0m kh\u00f3 ch\u1ecbu, tigonafil s\u1eed d\u1ee5ng h\u00e0ng ng\u00e0y n\u00ean \u0111\u01b0\u1ee3c coi l\u00e0 li\u1ec7u ph\u00e1p \u0111\u1ea7u tay.<\/li>\n
K\u00ea \u0111\u01a1n ho\u1eb7c h\u01b0\u1edbng d\u1eabn kh\u00f4ng \u0111\u1ea7y \u0111\u1ee7 l\u00e0 nguy\u00ean nh\u00e2n ch\u00ednh g\u00e2y ra th\u1ea5t b\u1ea1i trong \u0111i\u1ec1u tr\u1ecb v\u1edbi PDE5I:<\/li>\n<\/ul>\n
-Ch\u1ebf \u0111\u1ed9 d\u00f9ng thu\u1ed1c h\u00e0ng ng\u00e0y ho\u1eb7c th\u01b0\u1eddng xuy\u00ean c\u00f3 th\u1ec3 gi\u00fap nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng th\u1ea5t b\u1ea1i v\u1edbi li\u1ec7u ph\u00e1p theo y\u00eau c\u1ea7u.<\/p>\n
-\u0110i\u1ec1u ch\u1ec9nh n\u1ed3ng \u0111\u1ed9 testosterone d\u01b0\u1edbi 10,4nmol \/ l c\u00f3 th\u1ec3 gi\u00fap nh\u1eefng ng\u01b0\u1eddi kh\u00f4ng \u0111\u00e1p \u1ee9ng v\u1edbi PDE5Is<\/p>\n
-C\u1ee9u v\u1edbt b\u1ec7nh nh\u00e2n kh\u1ecfi th\u1ea5t b\u1ea1i v\u1edbi PDE5Is l\u00e0 m\u1ed9t chi\u1ebfn l\u01b0\u1ee3c hi\u1ec7u qu\u1ea3 v\u1ec1 chi ph\u00ed<\/p>\n
Thi\u1ebft b\u1ecb c\u01b0\u01a1ng c\u1ee9ng ch\u00e2n kh\u00f4ng:<\/h3>\n
\n
C\u00f3 hi\u1ec7u qu\u1ea3 cao trong vi\u1ec7c g\u00e2y c\u01b0\u01a1ng c\u1ee9ng b\u1ea5t k\u1ec3 nguy\u00ean nh\u00e2n c\u1ee7a\u00a0\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng.<\/li>\n
Ch\u00fang c\u00f3 th\u1ec3 h\u1eefu \u00edch khi k\u1ebft h\u1ee3p v\u1edbi PDE5Is.<\/li>\n
K\u1ebft h\u1ee3p v\u1edbi c\u00e1c \u1ed1ng ch\u00e8n c\u00f3 k\u00edch th\u01b0\u1edbc thay \u0111\u1ed5i c\u00f3 th\u1ec3 h\u1eefu \u00edch trong vi\u1ec7c \u0111i\u1ec1u ch\u1ec9nh \u0111\u1ed9 cong c\u1ee7a d\u01b0\u01a1ng v\u1eadt.<\/li>\n
B\u00e1o c\u00e1o t\u1ef7 l\u1ec7 h\u00e0i l\u00f2ng bi\u1ebfn \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 t\u1eeb 35% \u0111\u1ebfn 84%.<\/li>\n
Vi\u1ec7c s\u1eed d\u1ee5ng l\u00e2u d\u00e0i c\u00e1c thi\u1ebft b\u1ecb ch\u00e2n kh\u00f4ng c\u0169ng c\u00f3 s\u1ef1 bi\u1ebfn \u0111\u1ed9ng nh\u01b0ng \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc cao h\u01a1n \u0111\u00e1ng k\u1ec3 so v\u1edbi li\u1ec7u ph\u00e1p t\u1ef1 ti\u00eam.<\/li>\n
H\u1ea7u h\u1ebft \u0111\u00e0n \u00f4ng h\u00e0i l\u00f2ng v\u1edbi c\u00e1c thi\u1ebft b\u1ecb ch\u00e2n kh\u00f4ng ti\u1ebfp t\u1ee5c s\u1eed d\u1ee5ng ch\u00fang l\u00e2u d\u00e0i.<\/li>\n
T\u00e1c d\u1ee5ng ph\u1ee5 bao g\u1ed3m b\u1ea7m t\u00edm, \u0111au c\u1ee5c b\u1ed9 v\u00e0 kh\u00f4ng xu\u1ea5t tinh. B\u1ea1n t\u00ecnh \u0111\u00f4i khi b\u00e1o c\u00e1o v\u1ec1 vi\u1ec7c d\u01b0\u01a1ng v\u1eadt c\u00f3 c\u1ea3m gi\u00e1c l\u1ea1nh.<\/li>\n
T\u00e1c d\u1ee5ng ph\u1ee5 nghi\u00eam tr\u1ecdng r\u1ea5t hi\u1ebfm nh\u01b0ng ho\u1ea1i t\u1eed da \u0111\u00e3 \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o.<\/li>\n<\/ul>\n
$\"r\u1ed1i$ <\/p>\n
\u0110i\u1ec1u tr\u1ecb second-line<\/strong><\/h3>\n
\n
Li\u1ec7u ph\u00e1p ti\u00eam g\u1ed1c d\u01b0\u01a1ng v\u1eadt (v\u00ed d\u1ee5: Caverject, Viridal)<\/li>\n
Thu\u1ed1c Alprostadil ni\u1ec7u \u0111\u1ea1o (v\u00ed d\u1ee5: MUSE)<\/li>\n
B\u00f4i ngo\u00e0i da Alprostadil (v\u00ed d\u1ee5: Vitaros)<\/li>\n<\/ul>\n
\u0110i\u1ec1u tr\u1ecb third-line<\/strong><\/h3>\n
Ph\u1ee5c h\u00ecnh d\u01b0\u01a1ng v\u1eadt:<\/p>\n
\n
N\u00ean \u0111\u01b0\u1ee3c cung c\u1ea5p cho t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n kh\u00f4ng mu\u1ed1n c\u00e2n nh\u1eafc, kh\u00f4ng \u0111\u00e1p \u1ee9ng ho\u1eb7c kh\u00f4ng th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb y t\u1ebf ho\u1eb7c c\u00e1c thi\u1ebft b\u1ecb b\u00ean ngo\u00e0i. T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n v\u00e0 b\u1ea1n t\u00ecnh c\u1ee7a h\u1ecd n\u00ean \u0111\u01b0\u1ee3c t\u01b0 v\u1ea5n tr\u01b0\u1edbc ph\u1eabu thu\u1eadt, xem v\u00e0 s\u1edd th\u1eed t\u1ea5t c\u1ea3 c\u00e1c thi\u1ebft b\u1ecb c\u00f3 s\u1eb5n v\u00e0, n\u1ebfu c\u00f3 th\u1ec3, h\u00e3y n\u00f3i chuy\u1ec7n v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n kh\u00e1c \u0111\u00e3 ph\u1eabu thu\u1eadt.<\/li>\n
\u0110\u1eb7c bi\u1ec7t th\u00edch h\u1ee3p cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb\u00a0r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng\u00a0c\u01a1 quan nghi\u00eam tr\u1ecdng, \u0111\u1eb7c bi\u1ec7t n\u1ebfu nguy\u00ean nh\u00e2n l\u00e0 b\u1ec7nh Peyronie ho\u1eb7c \u0111au d\u01b0\u01a1ng v\u1eadt. T\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c l\u1ef1a ch\u1ecdn b\u1ed9 ph\u1eadn gi\u1ea3 d\u1ec5 u\u1ed1n hay b\u01a1m h\u01a1i.<\/li>\n<\/ul>\n
$\"r\u1ed1i$ <\/p>\n
Gi\u00e1o d\u1ee5c b\u1ec7nh nh\u00e2n \/ \u0111\u1ed1i t\u00e1c \u2013 B\u00e0n b\u1ea1c v\u00e0 h\u01b0\u1edbng d\u1eabn<\/h3>\n
\n
L\u00fd do ch\u00ednh \u0111\u1ebfn g\u1eb7p b\u00e1c s\u0129 l\u00e2m s\u00e0ng n\u00ean \u0111\u01b0\u1ee3c g\u1ee3i ra. C\u00e1c y\u1ebfu t\u1ed1 th\u00fac \u0111\u1ea9y v\u00e0 k\u1ef3 v\u1ecdng n\u00ean \u0111\u01b0\u1ee3c l\u00e0m r\u00f5 c\u0169ng nh\u01b0 \u00fd \u0111\u1ecbnh, \u0111\u1ec3 ch\u1ea5p nh\u1eadn b\u1ea5t k\u1ef3 li\u1ec7u ph\u00e1p d\u01b0\u1ee3c l\u00fd, v\u1eadt l\u00fd ho\u1eb7c t\u00e2m l\u00fd c\u1ee5 th\u1ec3 n\u00e0o<\/li>\n
Hi\u1ec3u bi\u1ebft c\u1ee7a b\u1ec7nh nh\u00e2n v\u00e0 b\u1ea1n t\u00ecnh v\u1ec1 gi\u1ea3i ph\u1eabu c\u01a1 b\u1ea3n v\u00e0 sinh l\u00fd h\u1ecdc v\u00e0 m\u1ee5c \u0111\u00edch c\u1ee7a c\u00e1c x\u00e9t nghi\u1ec7m v\u1ec1 m\u00e1u v\u00e0 c\u00e1c ki\u1ec3m tra chuy\u00ean m\u00f4n l\u00e0 h\u1eefu \u00edch<\/li>\n
M\u1ed9t l\u1eddi gi\u1ea3i th\u00edch v\u1ec1 c\u00e1c nguy\u00ean t\u1eafc c\u1ee7a c\u00e1c l\u1ef1a ch\u1ecdn \u0111i\u1ec1u tr\u1ecb<\/li>\n
Cung c\u1ea5p th\u00f4ng tin gi\u00e1o d\u1ee5c c\u00f3 t\u00e1c d\u1ee5ng c\u1ee7ng c\u1ed1 c\u00f3 cho b\u1ec7nh nh\u00e2n<\/li>\n<\/ul>\n
\u00a0Li\u1ec7u ph\u00e1p Anderogen cho b\u1ec7nh nh\u00e2n r\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng<\/strong><\/h3>\n
$\"R\u1ed1i$ <\/p>\n
T = testosterone; PDE5i = phosphodiesterase type 5 inhibitors<\/p>\n
Sildenafil kh\u00f4ng k\u00ea \u0111\u01a1n (Viagra Connect 50 mg)<\/h3>\n
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MHRA \u0111\u00e3 ph\u00ea duy\u1ec7t vi\u1ec7c b\u00e1n sildenafil tr\u1ef1c ti\u1ebfp cho ng\u01b0\u1eddi ti\u00eau d\u00f9ng b\u1edfi c\u00e1c d\u01b0\u1ee3c s\u0129<\/li>\n
N\u1ebfu ph\u00e1t hi\u1ec7n b\u1ec7nh \u0111i k\u00e8m nghi\u00eam tr\u1ecdng, th\u00ec n\u00ean gi\u1edbi thi\u1ec7u \u0111\u1ebfn b\u00e1c s\u0129. BSSM h\u1ed7 tr\u1ee3 s\u00e1ng ki\u1ebfn n\u00e0y nh\u01b0 m\u1ed9t c\u00e1ch \u0111\u1ec3 nh\u1eefng ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng hi\u1ec7n kh\u00f4ng t\u00ecm ki\u1ebfm s\u1ef1 gi\u00fap \u0111\u1ee1 th\u00f4ng qua c\u00e1c tuy\u1ebfn ch\u0103m s\u00f3c s\u1ee9c kh\u1ecfe th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 ti\u1ebfp c\u1eadn h\u1ed7 tr\u1ee3.<\/li>\n<\/ul>\n
$\"viagra\"$ <\/p>\n
T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/h2>\n
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BSSM ED guideline: https:\/\/www.guidelines.co.uk\/mens-health\/bssm-ed-guideline\/454166.article<\/a><\/li>\n
Erectile Dysfunction: AUA Guideline (2018): https:\/\/www.auanet.org\/guidelines\/erectile-dysfunction-(ed)-guideline<\/a><\/li>\n<\/ol>\n
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R\u1ed1i lo\u1ea1n c\u01b0\u01a1ng d\u01b0\u01a1ng l\u00e0 g\u00ec? T\u00ecnh d\u1ee5c l\u00e0 m\u1ed9t kh\u00eda c\u1ea1nh ph\u1ee9c t\u1ea1p \u0111\u1eb7c bi\u1ec7t c\u1ee7a con ng\u01b0\u1eddi. Ch\u1ee9c n\u0103ng t\u00ecnh d\u1ee5c ph\u1ee5 thu\u1ed9c v\u00e0o n\u0103ng l\u1ef1c gi\u1ea3i ph\u1eabu, sinh l\u00fd v\u00e0 h\u00e0nh vi. Nh\u01b0ng trong b\u1ed1i c\u1ea3nh \u0111a t\u1ea7ng v\u1ec1 ni\u1ec1m tin v\u00e0 \u00fd ngh\u0129a c\u1ee7a ng\u01b0\u1eddi \u0111\u00e0n \u00f4ng trong t\u00ecnh d\u1ee5c v\u00e0 […]\n","protected":false},"author":1,"featured_media":9396,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9346","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\/9346","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=9346"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9346\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/9396"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=9346"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=9346"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=9346"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}