SOC MAT MA DO CHAN THONG

l. Al CONG:
Soc mut muo do chun thoong u cap coo noi-ngoai kboa kban cap do gum oo oong
muo oo thong. nh thoong muo oo thong o tro om khoung 80 mL/kg cun nung. Soc
xuy ru kh oong muo mut tron 25%.
Ngoycn nban:
Vo tung duc tgun,uch, thun...) trong chun thoong bong kn.
Cuy xoong on txoong do, xoong chuo).
Dot cuc much muo on.
Fban do mat mao:
Do l: mut < l5% tho tch muo: duo hoo snh ton t thuy do, tm nhunh, hoyot up
bnh thoong.
Do ll: mut l5 - 25% tho tch muo: tm nhunh, hoyot up kop, kch thch.
Do lll: mut 26 - 40% tho tch muo: hoyot up tot, much nho, o mo.
Do lV: mut tron 40% tho tch muo: soc nung, much khong but dooc, hoyot up
khong do dooc, hon mo, du unh.
1ro om co tho khong co tot hoyot up nho ngoo on do mut mot oong muo dung ko. V
cong oong tm vu hoyot up dong much dooc doy tr bung nhp tm tung vu co much
non tot hoyot up thoong co o gu doun tro, soc nung.
ll. CHAN OAN:
1. Cong vicc cban doan
a) Hoi bcnb:
Chun thoong: co cho chun thoong.
Xout hoyot: v tr, oong muo mut.
Cuch so coo cum muo.
b) kbam Iam sang:
Duo hoo snh ton, tho gun phoc ho muo du.
Duo hoo thoo muo, no chuy muo.
Moc do tr guc.
Khum tm, pho, bong, duo, ch.
c) Can Iam sang:
C1M, too cuo dom, Hct, nhom muo.
Dong muo toun bo.
1m ngoyon nhun: Xqoung bong khong sou soun, X-qoung xoong noo co duo hoo
ngh guy xoong, soo um bong.
2. Cban doan xac d|nb:


Duo hoo soc.
Dung chuy muo houc duo hoo thoo muo houc Hct < 30%.
lll. lF Tk]:
1. Ngoycn tac dico tr|:










So coo cum muo.
o oong muo mut.
Doo tr ngoyon nhun: phuo thout cum muo.
2. ico tr| ban dao:
2.l Noo thuy muo dung chuy: nhunh chong cum muo bung cuch: dong guc vu un ngon
tuy vuo no muo dung chuy, nung cuo cho b thoong dung chuy muo, khong cot gurrot
ngou tro troong hop dot u ch vu khong kom sout dooc chuy muo o cuc much muo
on. Suo do mo khum ngou khou nguy up toc.
2.2 1ho oxy.
2.3 Num duo phung, chun cuo.
2.4 Lup 2 doong troyon tnh much on o ch tthoong ch tron)vo km oon
Luy muo xot nghom: Hct, nhom muo, dung ky muo.
1royon dch trong kh cho muo tdoong troyon l).
Luctuto kngor huy Normu suno do tung tho tch toun houn vu bo oong dch thoo
hot. un duo troyon 20 mL/kg chuy nhunh, suo do toy thoo dup ong cou bonh nhun
mu doo chnh toc do. O tro doo 6 too mu khong chch tnh much dooc th co tho
troyon tum tho qou doong toy xoong trong tho gun chch houc boc o tnh much.
2.5 1royon muo toun phun tdoong troyon 2)
1royon muo toun phun cong nhom 20 mL/kg. Noo khong co muo cong nhom,
troyon muo nhom O. 1oc do toy thoo tnh trung hoyot dong. Noo dung soc nung vo
much=0, hoyot up = 0 th bom troc top. Ch dnh troyon muo: Hct thup < 30%
houc suo kh du troyon nhunh 40 mL/kg dong dch don gu vun khong nung dooc
hoyot up.
1op toc troyon dong dch don gu qou doong troyon l.
Noo cun troyon muo toc do nhunh, oong nhoo th muo cun dooc um um do trunh
ro oun nhp tm.
Noo chou co muo suo kh troyon dong dch don gu 40 mL/kg mu bonh nhun con
soc: troyon cuo phun to tCoutno) 20 mL/kg, toc do toy thoo tnh trung soc.
3. ico tr| ticp tbco:
Suo kh troyon muo toun phun 20 mL/kg:
u. Cu thon tot: bonh nhun ru soc vu Hct bnh thoong: top toc doy tr dch don gu,
toy nhon trunh troyon qou nhunh co tho guy qou tu. Noo ngoyon nhun soc do vo tung
duc th mo ngou khou cun thop phuo thout.
b. Dup ong nhong hoyot up tot kh gum toc do troyon dch: top toc bo dch vu muo.
Noo co ch dnh phuo thout th so ho soc song song vo phuo thout.
c. Khong dup ong:
Noo con soc vu Hct thup < 30% th cun troyon muo top toc. So oong top thoo toy
tnh trung hoyot dong cou bonh nhun oc do. Kh troyon muo kho oong on > 50
mL/kg, cun xot nghom choc nung dong muo vu too cuo. Noo ro oun dong muo
th troyon hong cuo ung vu hoyot toong too dong unh l0 mL/kg. Noo gum too
cuo t<50.000/mm
3
) troyon too cuo dum duc l don v/5 kg. Do CVl do hoong dun
bo dch vu muo. Mo buc s ngou khou xom xot ch dnh phuo thout cum muo.



Cucom: kh troyon qou 40 mL/kg muo toun phun cun cho y cho cuc goconuto
l0% l-2 mL 1MC.
4. Cb d|nb ngoai kboa:
Dot much muo: cun thop ngou khou nguy trong oc ho soc soc
Vo tung duc:
- Kh tnh trung bonh nhun tum on dnh hoyot dong hoc
- Kh troyon muo tron 50 mL/kg mu bonh nhun con soc huy Hct doo 30% chong to
bonh nhun dung chuy muo nung cun phuo thout cum muo.
lV. Tbco doi:
Much, hoyot up, too muo du mo l5 phot cho don kh ru soc vu suo do mo go.
Hct suo troyon muo vu mo go cho don kh on dnh
Nooc too mo 4-6 go.
Vong bong o bonh nhun chun thoong bong kn, tnh trung chuy muo tu vot
thoong.

An chut/ bung op cum muo noo vot thoong dung chuy
muo o ut
1ho Hct, nhom muo
1hot up 2 doong troyon tnh much:
- Luctuto kngor 20mg/kg chuy nhunh l5 phot
tdoong troyon l).
- 1royon muo 20m/kg tdoong troyon 2)
Hoyot dong hoc on dnh - Hct >30%

Luctuto kngor
l0m/kg
lhuo thout cum
muo.
1royon muo.
XN: choc nung dong muo kh oong muo
troyon >50m/kgkL dong muo: HC
ung + hoyot toong too dong unh + too
cuo.
Xom xot ch dnh phuo thout cum muo:
ho soc song song vo phuo thout
+
Soc mat mao
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