Dieu tri thieu mau cho benh nhan suy than man tinh

Thứ ba, 20 Tháng ba 2012, 08:31 GMT+7

Thieu mau do suy than man tinh (STM) co the lam gia tang kha nang bi cac benh ly ve tim mach, dot quy, tang nguy co suy than man tien trien den giai doan cuoi... Vi the, viec dieu tri thieu mau can duoc tien hanh som.

Suy than man tien trien qua nhieu giai doan trong mot thoi gian dai, vi vay no anh huong den suc khoe va chat luong cuoc song cua nguoi benh. Suy than la hau qua cua nhieu bien chung nhu: dai thao duong, tang huyet ap, benh cau than va ong ke than, benh he thong… giai doan dau benh tiem an va rat kho phat hien.

Erythropoietin la chat dieu hoa tuy xuong, san xuat te bao hong cau. Do do khi than bi suy, chuc nang san xuat erythropoietin cua than bi giam va thieu mau se la hau qua ma benh nay gap phai. Thieu mau trong thoi gian dai co the dan den cac bien chung ve tim mach, dot quy, tham chi gay tu vong cho nguoi benh.


Dieu tri thieu mau cho benh nhan suy than man tinh

Theo thong ke, ty le suy than man (giai doan 3 - 5 cua benh than man tinh) la 3,1%. Uoc tinh theo dan so Viet Nam voi ty le nay thi co khoang 7 trieu nguoi lon bi suy than man. Tren thuc te, con so nay co the cao hon, va ngay cang gia tang. Dieu nay co nghia la ngay cang co nhieu benh nhan thieu mau do STM.

Khi bi thieu mau, benh nhan thuong cam thay met moi, chong mat, da xanh xao, niem mac co mau hong nhot nhat, tim dap nhanh, suc chiu dung kem va kha nang tap trung suy giam… Neu co benh ly co quan nao khac di kem thi cac trieu chung cua benh ly do se bieu hien nang them, vi du: thieu mau co suy tim thi suy tim tro nang hon, de thieu mau nao…

Dieu dang noi la hau het benh nhan STM deu khong biet minh dang bi thieu mau o cac muc do khac nhau, do la mot trong nhung nguyen nhan khien tinh trang benh tro nen nang hon. Vi vay viec dieu tri thieu mau cho nhung benh nhan nay, dac biet o giai doan som la mot trong nhung van de can duoc quan tam va la muc tieu hang dau cua cac thay thuoc.


Dieu tri thieu mau giai doan som giup cai thien chat luong song cho benh nhan STM.
Dieu tri thieu mau giai doan som giup cai thien chat luong song cho benh nhan STM.

Truoc day dieu tri thieu mau do suy than man thuong duoc xu ly bang truyen mau, nhung co rat nhieu tac hai nhu: nguy co nhiem trung, lay nhiem HIV, viem gan, tang su man cam cua nguoi ghep than; u dong sat (chung nhiem sac to sat)...

Trong nhung nam gan day, viec nghien cuu chuyen sau da cho phep tao ra nhung phuong phap moi hieu qua hon trong dieu tri thieu mau do STM. Mot trong so do la su dung Methoxy polyethylene glycol-epoetin beta (Micera). Thuoc nay duoc chi dinh dieu tri thieu mau do STM, dac biet thich hop o giai doan som. Methoxy polyethylene glycol-epoetin beta co the tiem tinh mach hoac tiem duoi da, co tac dung kich thich va tuong tac voi te bao tien than tao hong cau de tang san xuat te bao hong cau cho benh nhan.

Diem moi va tien loi cua Mircera la ngoai loi ich duy tri do on dinh Hemoglobin muc tieu tot hon, benh nhan chi can tiem moi thang mot lan nhung van dam bao hieu qua dieu tri cho benh nhan, giup nguoi benh tiet kiem duoc thoi gian di lai, thoi gian dieu tri, tam ly va ca suc khoe.

Ngoai ra, de phong tranh cung nhu han che hau qua do thieu mau gay ra, nguoi benh can an uong day du chat dinh duong, nhat la duong chat tao mau, dong thoi phai dieu tri tinh trang nhiem trung, viem nhiem, mat mau (neu co)… song song voi bu dap thieu hut chat erythropoietin noi sinh bang thuoc kich thich tao mau.

PGS.TS.BSC. Dinh Thi Kim Dung
Truong khoa Noi Than Tiet nieu – BV Bach Mai Ha Noi.



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