Xét nghiệm cận lâm sàng trong bệnh đường hô hấp

XÉT NGHIỆM CẬN LÂM SÀNG
TRONG BỆNH ĐƯỜNG HÔ
HẤP
TS BS NGUYỄNTHỊ TO ÁNHƯ

NOÄI DUNG







 

!"  #

#



!" !


X-QUANG TIM PHOÅI

$%&'( )%* +$,-% .(/ */012 $(031$ .(/12 )/412
5/612#

$(7+8

9# $(7+)%*+$,-%.(3:;6<=$(7++$,-%</>)?;6+#$(7+
+$,-%):012@(012+$,612A/7%#
B# $(7++$,-%A,C12#
D# $(7++$,-%@/0)E(12)$/')F/G12+$:;12+$/6+F;*
$;%#
H# $(7++$&'.(/I1@;6%)$(,'<</I1.(/12#$(7+</6<?,J
K,0@/0</6<$,'<<,6F;*<$/')</I1.(/12#

Tia X vaứ ửựng duùng trong y hoùc

:7 $/'+ )$(7 A,6 )L ?&C @;6% <:;012 A,C <(I/ F,6 /61$ 5/612 );6% =
@;6%$&C5,'$/'+)$(7E%&M12<(I/):012@/C))$&-#

N:7$/'+)$(7<(I/)%/+$(7)$(,C<@/0,5,'?:;71212(3&M1
):I<(I/@/C))$&-O5,'?:;71212(3&M1):I<(I/)$/01$+$/P1
</'( )/7,1&M1@/C))$&-=$/35,'?:;71212(3&M1):I<,6)E,12
*,C))$&-)Q<$<,'AR1$<(I/@/C))$&-#

Tia X vaứ ửựng duùng trong y hoùc

$:@/C35:7$/'+)$(7)%/<(I/),-<$:6<<$:6/1$%&P(
$;%1$:+$,-%5&ST$/6<),-<$:6<?,I121$:*/6(U
1:;6<$/3),-<$:6<A/V<1$:*,M<;=5(71=W:;12#

X1$/I1$<(I/</6<),-<$:6<)E,12<;)$&-<,1
12:;0%F%&-($%&C1)E&M1*/012$(031$.(/12=)E&M1
+$%*.(/12F/G121$:S12$X1$)E/>12A&1@;6%
1$:S12A/C*A,CT$/6<1$/()(03)$(,C<@/0,)E,712
?:;712=5,'?:;712@/0A,CK/P3A/V<<(I/</6<12(3&M1):I
<(I/</6<@/C)<$/')</'()/7,1&M1),-<$:6<#

X1$5/612@/0$X1$*;0)E&M1
+$%*.(/12:

"/'($%&C(F,6128

:;012@%&P18

YZ8
9# 2$%12;0F&C1$?36<(I/A:;012$,M$/'+#
B# /6<F&C1$?36F&M112,0/%W,/1212:7<<,6/I1$
$:;I12A&'1F,C*/63$,M$/'+1$:@%&M*)(73</'+=
/F<&52/1@;S@/0,W,/12*/012+$,-%#
D# $&,K,S%A%&P()ER81$:@%&M*+$,-%=/6+W&+$,-%[#
H# $&,K,S%K%&J1)%&'1<(I/F&C1$8)$&,K,S%)$/M*
1$%&J*)E&M1+$,-%12$%12;0(F:;6(#
\# ]%&-*)E/1,C%T$Q.(/I1=</)$&)&E)^1$*/7<$K:6;%
A,01=5,1K&_/1`/1a<,6A(612@R)EQ<$:/#

Hình aûnh Xquang

,7<+$%*)%*+$,-%)$/b128

]%&-*)E/+$/P1T3S)$(/C)8
c:;012A,C)%/8F,61212:7<H#
c:)$&'A(6128

$:6):7A,7<+$%*8

:012,0/%@/0,)E,128*,M*&P*=*/012+$,-%=

W:;12=1$(*,M+$,-%):0)E&M1W(,'125,5/61$):012
F&M1</P1<$(636</6<@(012$/3FR<$&?/'+$/3)E(012
/I1$1$:AL1$+$,-%=A/63+$,-%=@(012)E(12)$/')
<$(636E,'1+$,-%=</6<*/7<$*/6(?;61=F,612)%*#

$%*)%*+$,-%d12$%&M12e8

$Q/F&M11/0,</P1A:;7<T$/I,
5/6)5&S12$%&M12@&P+$Q/A,6@/0
/6+5/6)@/0,F/I12+$%*#

$(636W:;12:6<=</6<@,0*
$,0/1$#

,0*$,0/1$+$/I%)$/'3E,S):0
)E:;6<E/5/(=@,0*$,0/1$)E/6%
)$/'3A:;7<BfD+$Q/5/()%*=
9fD)E:;6<)$:;012FRF,612)%*
<$&(012AL1$+$,-%)$:;012
FR<$&?/'+F;I%</6<A/P(W:;12
A,01=W:;12F/I@/%#

g
#

/#,C%<$:612@&P*/7<$*/6(8
$:S12)$/3A,-%@&P*/7<$*/6(+$,-%8
/4125:6<</I1<(I/A,C12*/7<$+$,-%8
c]$()E(68tắt nhánh phếá quản làm cho mạch máu vùng đó co
thắt lại vì thiếu oxy, máu sẽ được tái phân bố lại.

c/4125:6<</I1?/1E,C128có tăng áp động mạch
phổi .
/412?:(?:;7128thai kỳ


,C%<$:612+$&'.(/I1

$/01$+$&'.(/I1)$/'3A:;7<T$%8
c"/P3?&M1K,+$(01&P=K,@%&M*8)$/'3K/712
A:;012E/P3W&?:I/=K/712@,012<,6)$/01$K/P3#

c,012+$&'1/12?/'+K/P3KR<$8)$/'3T$Q/I1$
)E,12?,012+$&'.(/I1#"@%&M*+$,-%=1$,P%*/6(
+$,-%=+$(0+$,-%</'+K,T$QA,C<#

c,012+$&'.(/I1<$:6/KR<$1$:)E,12K/S1+$&'
.(/I1K/712<$(0*1$,=)E,12@%&M*+$&'.(/I1
)3+&=)E,12F&C1$@%&M*.(/61$1%&M*KR<$#

/#X1$*;0<(I/1$(*,M+$,-%#

Hoọi chửựng pheỏ nang

Hoọi chửựng moõ keừ
cX1$A:;012)$/b12=
c/7)1$,IOT&Mh=,')<(7<),=
c/6**;0),1$,IT$,M12A&P(#
/7)T&M8<,6A:;012TQ1$):09=\A&'19i**#
3+&+O+%1$&/Khj9=\**8A/P(T%*2$%*h8F(7%5/>)#
3+&*$/3.k9=\**lD**8F(7%5%?%<,5&=?/,#

3+& 1$/3E kD** A&'1l9i**85%?%<,5&$/3 T+$,-%)$:6
+$/6)

Ñöôøng thaúng:(ñöôøng Kerley)
:;012]&E?&38;I)$(03)E&M1=K/0%\m<*=K/P3D
H**#=.(/3$:;612@&PE,'1+$,-%

:;012]&E?&38;I)$(03K:;6%=K/0%BD<*=K/P3
B**=)$/b122,6<@;6%*/V)+$/b12<(I/*/012+$,-%=
<,6$X1$F/C<)$/12=

ε8$(0+$,-%K,5(3)%*:6$(3&')=@%&M*$&CF/7<$
KR<$K,(12)$:=;+$,-%12(3&M1+$/6)$/3)$:6
+$/6)=F(7%+$,-%=/E<,%K,5&=%&M**,MT&S5/(W/7)ER#


"/712?:;6%*/712$/7)8
$(0+$,-%=]+$,-%K,K%</41=;+$,-%*,MT&S#

"/712*/712?:;6%),-,128

%/IT&61+$,-%=

;+$,-%?/1),I/8/E<,%K,5&=n&)%<(?,5%5=5%?%<,5%5=
F&C1$<$/'))/7,T&,=+$,-%FR),-1)$:;12K,$,6/<$/')
?&6,*3<%1=/E/.(/)#

/012+$,-%8

E/01KR<$*/012+$,-%#


E/01T$Q*/012+$,-%

*/012+$,-%#

Chuïp phoåi caét lôùp (CT scan)

Noäi soi pheá quaûn

$LAR1$)E,12<$/-1
A,6/18
9# 2$%12;0]+$,-%#
B# ,E/*/6(#
D# />)+$&'.(/I112$%K,(=
K,KR@/C)A:;012)$;I=
12$%?/,=5/(<$/'1
)$:;12+$,-%12$%12;0
A:6)+$&'.(/I1=12$%E/6<$
)$(I12+$&'.(/I1#
H# /'3F&C1$+$/-*)X*@%
)E(0122/M3@%&M*+$,-%

Chæ ñònh trong ñieàu trò:

,E/*/6(=
/'3KR@/C)$,M$/'+=
&7++$,-%K,)/>)A/0*=
%&M*+$,-%$Q)=
/>)A,')T$,'%(F/G12/5&E.(/1,C%
5,%#

 

 85,%):;%=1$(,C*</'3#

n@%5%1$@/C)O?/,=+$&'</P(=[h

"Z 85,%):;%=1$(,C*</'3#

o

!"  8
$,7<K,0"#

X1$)$:;012")E/>12=)E,12

&'(<$,7<<$/7*)$:;128KR<$*/012+$,-%*/0(A,I$,P12=
A,M12#

E/01*/6(*/012+$,-%8*/0($,P12$/3A,IT$,M12A,M128
)$:;012K,]=Q)2/V+$;1K,?/,*/012+$,-%=5(3)%*E/')
$%&'*2/V+#

"R<$*(I8A(7<1$&7?,/S127=A(7<1$%&P(5/61$A/V<=

/SA/C(8?;71<;711$:F/SA/C(?/,

":;S12)E/'+8A(7<1$:5:S/#

"R<$<,6$,?&5)&E%18A(7<,612/61$O)E/01KR<$?/M(12/03

*/S1)Q1$h


L)E,71289=i99=iBm#

/7*),0/1+$/P18?F(*%1i=DH=92*p=

?,F(?%1\iqip#

r%FE%1,2&1DiH\p=

jm=sq=m

Dòch maøng phoåi
Dòch thaám Dòch tieát

L)E,712l9=i9mk9#i9m

E,)&%1O2*phlDkD

E,)&%1"f(3&'))$/1$
 li=\ki=\

n%@/?)/8/M*)Q1$K:;12)Q1$

"OfhlBiikBii

""f(3&'))$/1$
 li=mki=m 




SINH THIEÁT

%1$)$%&')*/012`+$,-%F/G12T%*8FE/*5=%?@&E*/1=
,+&

%1$)$%&')*/012+$,-%.(/1,C%5,%*/012+$,-%#

5%1$)$%&')+$,-%.(/1,C%5,%+$&'.(/I1=<$,7<$(6)F/G12
T%*

%1$)$%&')+$,-%.(/*;I12:7<#

%1$)$%&')</6<$/7<$

THĂM DÒ CHỨC NĂNG HÔ
HẤP CỦA PHỔI
$LAR1$8

c/P*5,6/)F&C1$A:;012$,M$/'+f</6<A,'%):;712<,6
1$%&P(12(3<;

c/61$2%/6<$:6<1/412$,M$/'+)%&P1+$/-(#

c2$%&M1<:6(@&P5%1$?36$,M$/'+#

c]%&-*)E/T&').(/I<(I/A%&P()ER*,C)F&C1$?36$,M$/'+#

c/61$2%/6$%&C(.(/I<(I/@%&C<)$:I)$(,'<2/M3<,)$/>)

<(I/+$&'.(/I1$/3?/0*K/S1+$&'.(/I1#

cf/I1$$:;I12<(I/5:72/>125:6<?&M1f