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Khiếm khuyết vách ngăn thất
Tóm tắt
Khiếm khuyết vách ngăn thất (VSD) là bệnh tim bẩm sinh phổ biến nhất được phát hiện ở trẻ em. Do việc đóng bàng diễn ra thường xuyên, bệnh nhân có VSD nhỏ nên được theo dõi lâm sàng mà không có giới hạn nào ngoài việc dự phòng viêm nội tâm mạc. Việc cấp cứu phẫu thuật chỉ được khuyến nghị cho các khiếm khuyết nhỏ có các tổn thương liên quan đáng kể như hở van động mạch chủ, sa van động mạch chủ, cản trở dòng chảy từ thất phải hoặc thất trái, hở van ba lá, shunt từ thất trái sang tâm nhĩ phải, hoặc viêm nội tâm mạc tái phát. Kích thước thất trái to lên hoặc chức năng thất trái suy giảm cũng sẽ là chỉ định cho phẫu thuật sửa chữa. VSD từ mức độ trung bình đến lớn trong thời kỳ sơ sinh thường yêu cầu điều trị suy tim sung huyết bằng thuốc lợi tiểu, digitalis và giảm tải trọng. Việc đóng bàng bằng phẫu thuật trước 9 tháng tuổi là cần thiết cho các VSD lớn và trước 2 tuổi cho các shunt mức độ vừa để ngăn ngừa bệnh lý cản trở mạch phổi và hậu quả của việc quá tải thể tích kéo dài. Việc đóng VSD bằng thiết bị vẫn đang trong giai đoạn nghiên cứu nhưng hứa hẹn mang lại tiềm năng cho điều trị các khiếm khuyết cơ apical hoặc nhiều.
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#khiếm khuyết vách ngăn thất #bệnh tim bẩm sinh #hở van #sửa chữa phẫu thuật #thuốc lợi tiểu #điều trị suy timTài liệu tham khảo
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