on RL) 7 it mete) [Tyee PTR TL han tien quan vi 66 thal v8 84U Binh Iy6,, wisime va thai tré ge. Binh Xti tri cae r6i loan tam t tién hanh xem xét d6i voi cd hai d6i tuong: dU @ cAc yeu TO NGUY CO CO KHUYNH HUONG GAY RG, LOAN TAM THAN TRUOC VA SAU SINH i (vi thanh nién, < 20 tuéi) va 66 thai mudn (dé, Nguoi me tré tu so 6 tudi > 35) 8 me don than, c6 khé khan trong hn nhdn, ¢6 thai ngoai y mys, khong muén cé thai. Tinh trang x4 hoi khéng én dinh hay bap bénh. Tién sir bi bénh tam than trudc khi cé thai hodc tién su gia dinh, by bénh tam than, Tién st c6 con bj chét truéc khi c6 thai lan nay. Tién str bi lam dung hod bi ngugc dai trong tudi nién thiéu. = Nghién: rugu, thuéc la, ma tly, thude. Cée bién chting sn khoa V CAC ROI LOAN TAM THAN TRUGC SINH @ LAM SANG | M Céc réi loan tam than nhe va thodng qua | © Cac biéu hién thudng gap. | . Che tngu chimng khf sac hay tam trang, lo au - 4m sg, réi loan gide ngu, cdc bién déi hanh vi n udng. | @ Cac réi loan tram cam | Cing céc tiéu chun chén doan déi véi giai doan tram cam dién | hinh & ngudi dang cé thai. Duge quét bang CamScanner(orca aay Roi loan ta PUR UR UR Rae faa iu thai va sau aa id muc 46 nang cua giai do; 2 thudng gap nhat la & mac do tu nh wre 66 tir nhe gén vila. gigu hién lam sang doi k' : hi k é ane gif hong dién hinh va co thé bi benh nhan céc réi loan loan than cac giai doan an cap hid g loan than cap hiém gap trong khi dang mang tM? (@ CHAN DOAN PHAN BIET 1s viem tc tinh mach nao ss Mua giat khi c6 thai song kinh san giat 8 Ngo doe @ puNG THUOC HUONG TAM THAN TRONG THO! GIAN MANG THAI VA CHO CON BU 5 06 THAI = Tang thé tich phan bé (Va), tang t6e 49 lee cau than. phai diéu tri theo liéu duge khuyén cdo cho phy na co thai. 1 ké ding mot thud dieu tri c6 thoi gian ban thai ngan tuong quan Igi fch/ nguy ca cua mdi don thudc. am than (nguy co gay quai trir Khi 66 chi dinh tuyét doi. Trong panh gid Tranh ding cac thude hudng t thai, nhat Ia trong 3 thang dau thai ky) trugng hop nay ké dung: Thude chéng loan than: haloperidol, Thude chdng tram ¢ Thude ue ché tai hai citalopram. Duge quét bang CamScanner . a uu tie! . . amisulprid, olanzapin. am: rtralin, ip thu serotonin (' ‘6 is): fluoxetin, $eCea en Re ne een Roi loan tam than 6 phy nir co thai va sau sinh ~ Imipraminic: clomipramin, amitriptylin. ~ Thu6c tie ché hén hop tai hap thu serotonin va noradrenalin (IRS A) venlafaxin, Khéng duge ké ding paroxetin trong 3 thang dau cua thai ky. ® Thusc diéu chinh khi sac: ~ Uu tién chi dinh ding lamotrigin +++. Chéng chi dinh véi cdc thuée chéng co gidt khéc va lithium © Thuée gidi fo au Uu tién ding benzodiazepine: oxazepam, lorazepam. ~ Trong 3 thang dau ctia thai ky, nén trénh cho ding benzodiazepi, hoac thuée dugc ké véi ligu thap Theo d6i da chuyén nganh: bac si chuyén khoa nhi, san khoa, bie si chuyén khoa tam than V CAC ROI LOAN TAM THAN SAU SINH | @ HOI CHUNG “BUON BA VA U RO” SAU SINH | HAY “BABY-BLUES” | | @ > 50%, khéng nang. | m Kéo dai tir vai gid dén vai ngay. ™ Xay ra trong khoang tir ngay ther 3 dén ngay thir 5 sau sinh. } 4 “ » 2 2 Paareay | ™ Lam sang: cac triéu chting tram cam nhe, cam gidc tdi Idi. ™ Biéu tri: khong c&n diéu tri gi, déng vién cua Ngudi than trong gia dinh, tran an cho bénh nhan, theo doi. Duge quét bang CamScanner@ TRAM 1cAM SAU SINH 5 Theo pMS-5: cac triéu ching am cam phai xuat hién trong yong 4 tuan sau khi sinh con, nhieu tac gid cho rang co thé trong khoang thdi gian toi 7nam. Lam sang: cac triéu chung cua mot jai doan tram cam dién inh (EDC) cam giac pham tdi nang né 4m sg cuong buc. poi khi bénh canh lam sang bi penh nhan che gidu. Nguy co chinh: ty sat va con mdi sinh cac giét pieu tri hdng tl tramcam (thude thu serotonin u tien chon bude con bi, tam! xu et da chuyen Thuéc cl tre ché tai hap tri ligu hé tra, X' nganh, theo déi. Néu muc do nang: cho pénh nhan nap vien- Roi loan tai PCR UT na aa it thai va sau sinh. cé Cac tinh huong a Ta a @ HUNG CAM VA HUNG CAM NHE SAU SINH go tigu chuan Lam sang va cc chain doan di voi hung cém hoae hung giai doan cam nhe. Tinh trang dao dong kh sac nang m dieu tri. nh nhan nhap vien v0 u can, theo Cho bér khoa tam than né cach diéu tri nhaP vi séc khong can ky thuan hay nhap vier mat nguyen Cn loai trl it doc han thyc thé, do chai hoae do thude. . 2 oF 2 = & a eu ho trg, hUGN ai thich cho yur tri da chuyen nganh Theo doi sat. 7 . gc quét bang CamScanner td= a IY belt eu THAN @rinte TRANG LOAN LIEN QUAN vol SINH pe Benhly ng 0,2 % cae phy nv Khai phat dot Ngo" thu 5 sau dé. higm gap nhung nai a sau dé . 1: ngay thu 2 dén ngay 5 Lam sang: « Giai doan khai phat: “baby” hong dién hinh: lo 4U, gi ac mong, kich (hay ln I6n) voi blues" k! mat ngu v déng, lu lan gia tang nang trieu chung vao budi toi oan hinh thanh: mé sang ong nhu’ mong ), co che ° Gi hay hoang t tinh (délire onirique 4o gide chu dé tap trung vao su sinh con va quan hé gia me va tré mdi sinh, khong hé théng héa, gan két v6i rdi loan nay khong 6n dinh (dao d6ng nhiéu hodc it), co sy tham gia cam xuc manh liét, Id lan (hay lan l6n), khi sac dao dong. m Nguy co chinh: Ty sdt va giét con mdi sinh. n than Perey Po quan rd cé ao pieu tel: cho bénh nhan nhap vien cg, cuu vao khoa tam than néu cn, cho nha vien cha, soc y té khong cn bénh nha, ygidy dong thud, tam thy tach tré méi sinh khdi me (ngyy co ngudi me giét con minh mg sinh), cho me tiép xLc dan i voi tré sau khi me da dugc digy triva ludn cn theo doi sat oai tri nguyén nhan thye can loa thé, do chat d6c, thude Ngirng cho con bd me (chong chi dinh voi bromocriptin, ap dung cac bién phap ngtra thai co hoc) pidu tri bang thuéc: Thuéc chéng loan than thé hé 2. khi khong cé chéng chi dinh, thuéc an than kinh co tac dung an diu néu cé tinh trang kich déng, tam ly tri ligu h6 to, huéng dan gido duc, xt tri da chuyén nganh, theo doi va du phdng nguy co ty sat. Duge quét bang CamScanner