BS: L Th Kim Chi

Trng i Hc Y Dc TPHCM

Hi c cc triu chng c nng h hp thng

gp
Khai thc c y cc tnh cht
Phn bit c cc nguyn nhn

Kh th
au ngc
Ho
Ho ra mu

Cm gic ch quan ca bnh nhn

M t bng cc t: hi th ngn li, dn dp, ht
hi, khng th ht su

C kh th hay khng? Bnh nhn dng cc t

m t:
Tnh cht kh th? Ht vo? Th ra?...
Mc kh th: (Nhiu hay t?)
Kh th cp: da vo li ni ca bnh nhn
Kh th mn: mMRC

Thi gian kh th: bt u t khi no, ko di trong

bao lu? Kh th cn hay lin tc? Chu k?
Tn xut kh th
Hon cnh khi pht kh th:

Tim mch
H hp
Thn kinh, tm l
Nguyn nhn khc: thiu mu

Suy tim tri:

Hp van 2 l:

ng h hp:
vim,u thanh kh ph qun, hen ph qun, COPD

Nhu m phi:
vim phi, x ha m k phi

Mch mu phi:
PE

Mng phi:
TKMP, TDMP

Hi bnh: 7 tnh cht

V tr
Hng lan
Tnh cht
Cng
Thi gian
Hon cnh khi pht au
Cc yu t tng gim au
Triu chng km theo

Thnh ngc: vim, chn thng, gy xng

H hp:
Tim mch:
Tiu ha:
Tm l

H hp:
C ch: do vim mng phi, mng phi b kch thch, hoc
do cng c nhiu
Tnh cht:
au ngc kiu mng phi: ti mng phi b vim, nng au
nhi, tng khi ht su, khi ho
au ngc cng c do ho nhiu: au ran ht c lng ngc, r
rt khi ho

Nguyn nhn:
Mng phi b vim: vim- TDMP, vim phi, nhi mu phi
Mng phi b kch thch: trn kh mng phi
Cng c do ho nhiu: mi nguyn nhn gy ho nhiu, ho ko
di

Tim mch:
Vim mng ngoi tim:
C ch: Do vim nng phi ln cn km theo
Nguyn nhn:
Vim mng ngoi tim do siu vi
Vim mng ngoi tim do nguyn nhn khc

Tnh cht:

V tr:
Tnh cht:
Lan:
Cng :
Thi gian au:
Yu t lm gim au:

Bnh mch vnh:

C ch: Do hp ng mch vnh hoc tc ng mch vnh

Nguyn nhn:
Tnh cht au:

V tr
Hng lan
Tnh cht
Cng au
Thi gian au
Hon cnh khi pht
Yu t tng gim au
Km theo

Phnh bc tch ng mch ch

C ch
Tnh cht:

V tr
Lan
Tnh cht
Cng au
Thi gian au
Km theo

Tiu ha:
Thc qun:
D dy:
Gan mt:

Thnh ngc:
C: chn thng phn mm, vim c, p xe c
Xng: vim khp sn sn, gy xng sn
Thn kinh lin sn: vim, Zona

Tm l:
Tr em, n tr

nh ngha
C ch
Nguyn nhn
Chn on

Phn x bo v ca c th nhm lm sch ng h

hp bi s tng hi th ra t ngt

Cc kch thch do vim: vim ng dn kh v ph

nang: vin thanh qun, kh ph qun, tiu ph
qun, vim phi, abces phi, gin ph qun
Cc kch thch c hc:
Ht d vt, bi
Hp ng dn kh
dch ti m k ph nang:

Cc kch thch ha hc
Kh:
Dch d dy
Thuc:

Kch thch nhit

Ho cp? Mn?
Tnh cht ho, lanh lnh, ho to,
m? Mu?, lng? Ko di?
Km theo? St? Kh kh? Chy nc mi?
Thi im:
Ho c lin quan theo ma? Ho v m?
Tin cn c bnh g c bit?

C ho ra mu khng?
Phn bit i ra mu, chy mu h hp trn
Phn nng ho ra mu
Nguyn nhn ho ra mu:

Vi th

Ho ra mu

i ra mu

Tin triu

Cm gic tanh, kh chu

hng

Bun nn, kh chu bng

Mu sc, tnh cht km

theo

ti bt, m

Nu en (nhng ti)
ln thc n.

PH

Kim

Acid

Vi th

Macrophage cha
hemosiderin

Khng c nh ngha chnh xc v ho ra mu ho ra

mu nh v trung bnh, nhng thng thng
<200ml/24h, M, HA n nh.
Ho ra mu nhiu, s lng > 200/24 M, HA nh
hng.
Ho ra mu c. >400ml hoc 600ml, M, HA nh
hng, Bn c th t vong rt nhanh.

Mi nguyn nhn gy ho du c th gy ho ra mu
Cc nguyn nhn thng gp nht l:
Lao phi
Dn ph qun
K phi