LIN QUAN GIA SC KHE

RNG MING V TON THN

MC TIU:
Kho st c mi quan h phc tp gia bnh ton thn v mt
s tnh trng vng rng ming.
Xc nh cc biu hin vng ming khc nhau lin quan n mt
s bnh ton thn nht nh
Phn bit c cc bnh ton thn nguy c c lin quan n cc
tnh trng c bit vng ming nh vim lot.
Ci thin k nng chn on bnh ton thn c biu hin vng
ming

 Rt nhiu tnh trng hm mt lin quan n bnh ton thn

Nhng mi quan tm ca nha s:

1. Su rng:
. Nguyn nhn chnh gy su rng
. Ngoi ra su rng cn chu nh hng ca yu t di truyn hay vic s dng
thuc iu tr bnh ton thn

NGUYN NHN
GY SU
RNG

Rng d
mn cm

Thi
gian

L su

Vi khun

ng

 Nhng tnh trng ton thn c th nh hng n s pht trin su rng:

i tho ng, lm dng thuc, chng cung n v bing n, tnh trng bnh l lm
gim kh nng v sinh rng ming.

2. Vim lot vng ming

Nguyn nhn:

Giang mai, lao, HIV/AIDS

Nhim virus: herpangina, vim ming herpes nguyn pht
Nhim nm candida hoc cc chng nm khc
Bnh t min: lupus, pemphigus, lichen phng

 Vim ng tiu ha, bnh tuyn gip, bnh v mu, bnh l c tnh
D ng thuc hoc phn ng thuc, bnh vim mch mu
Cy ghp ni tng hoc cc thuc chng thi ghp
Thuc iu tr mt s bnh (bnh tuyn gip)
Suy dinh dng gy nn vt lot trong ming

 Thm khm vt lot vng ming:

V tr
Thi gian tn ti
S ti pht
su
S lng
Kch c
S hnh thnh so
Vt lot khng lnh

 Vt lot do thuc Nicorandil

Hng ban a dng

3. Chy mu nu, tng sn, i mu

a. Chy mu nu
. Cc bnh ton thn gy ra tnh trng chy mu nu km lot nim mc
nh: hng ban a dng, lupus ban , bnh bch cu.
. Mt s tnh trng khc nh i tho ng khng kim sot, bnh Crohn
( cng gy ra tng sn nu, ban v chy mu), gim tiu cu nguyn
pht

 Vim nu do thay i ni tit trong thi k mang thai lm cho nu v

chy mu
Mt s loi thuc: Trileptal, thuc chng ng mu (Coumadin), warfarin,
heparin v cht ha tr
Thuc khng vim khng Steroid nh Aspirin
S kt hp ca cc tho dc: nh bch qu (gingko biloba), dong quai,
an sm (danshen)

b. Tng sn nu:
Bao gm:
Thuc c ch min dch, thuc chn knh Ca, thuc chng co git

c. i mu nu

Bnh Addison

 Nhim c bc

 Nhim c ch :

4. Khi u phn mm trong ming

Cng nng tuyn cn gip ( khi u Brown)

 Suy gim min dch

5. Kh ming
-Xut hin cc bnh ton thn nh hng n tuyn nc bt chnh hoc
ph
Vd: Hi chng Sjogren

5. au vng u mt:
Bnh tim
Bnh tuyn gip
Bnh xoang
Bnh suy gim min dch
au dy thn kinh V th pht
au vng s mt c ngun gc t c xng ( ri lon khp thi dng
hm)
Nhim trng

6. Ri lon vn ng xng hm
Vn ng xng hm c th b thay i bi 1 vi tnh trng bnh l nh hng
n c, h thn kinh, h thng mch mu hoc xng ca hp so hay hm
di
a. Cng hm
Xut hin trong cc bnh: x cng b, au x c, lon dng c bp, bnh
a x cng

b. H ming hn ch:
-Nhim trng
-Nhim c

c. au khi c ng hm
au x c tetanus, khi u
d. Cc vn ng cn chc nng ngt qung:
Vd: triu chng rung hm bn Parkinson.

6. Bt thng hnh dng rng:

7. i mu rng v nim mc
a. i mu rng
. Do iu tr nhim trng vi tetracycline. nh hng l vnh vin nu thuc
c s dng khi rng v xng ang pht trin
. M b nh hng: xng, rng, dy chng

b. i mu nim mc ming:
- Bnh Addison:

-i mu nu do thuc

8. Bnh hc xng
Bnh ton thn gy ra cc tn thng mt xng th kh him