Bi ging lm sng Y3

Nm r nh ngha ph Nm r gi thuyt Starling trong sinh l bnh ca ph Bit cch phn loi ph Nm r cch xc nh c ph Nm r biu hin ph ca bn nhm nguyn nhn thng gp

Ph l tnh trng gia tng th tch dch trong m k Dng c bit: C trng, trn dch mng phi

S lu thng v phn b dch trong c th ty thuc vo s cn bng gia chnh p thy tnh v chnh p keo qua thnh mao mch.

Dn lu bch huyt c vai tr quan trng.

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A DCH RA LNG MCH

A DCH VO LNG MCH

p lc thy tnh trong lng mch p lc keo trong dch m k

p lc keo trong lng mch p lc thy tnh trong dch m k

p lc thy tnh ph thuc vo tng lng dch trong khoang p lc keo ph thuc vo tng lng protein trong albumin ng vai tr quan trng

Jv: S di chuyn ca dch P: p lc thy tnh : p lc keo c: Mao mch i: m k Kf: H s lc : H s phn hi
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PH TON THN

PH KHU TR

Tng dch m k ton thn Ph mt, thn, chi C th km theo trn dch mng phi, mng bng.

Do cc yu t ti ch C th gy lm ln vi ph ton thn

Suy tnh mch hai chn Tc nghn bch mch vng

chu

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PH MM

PH CNG

Gia tng n thun dch trong m k C du n lm

Ngoi dch, cn c tch t cc cht khc

Protein: Ph do vim, tc

mch bch huyt Mucopolysaccharide: Ph nim trong suy gip hoc cng gip

Khng c du n lm

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p lc thy tnh tng

Thn tng gi mui

Gim p lc keo
Gim tng hp

nc Tng p lc tnh mch Gim khng lc tiu ng mch

albumin Mt albumin qua ng tiu Mt albumin qua ng tiu ha Mt albumin do tn thng da

18

Tn thng mao mch Tc nghn dn lu bch huyt Ha hc

Vi sinh Chn thng D ng Min dch. Ung th Sau x tr Giun ch

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Bt thng lc Starling

Ph ton thn - Suy tim - X gan - Bnh thn: Hi chng thn h, vim cu thn cp - Suy dinh dng nng - Thuc

Ph khu tr - Tc tnh mch - Suy van tnh mch - Tc nghn h bch huyt do ung th, giun ch, x tr, phu thut

Tn thng mao mch

- Chn thng - Vim nhim ti ch - Thiu mu cc b - Bng - Ph mch

21

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Hi bnh
Cm gic nng n vng b ph Sng cng v mt cc vng lm bnh thng

Nhn eo tay cht hn, kh mang giy dp

Cn nng gia tng bt thng Lin quan t th, thi gian trong ngy, ch n

Km theo: au vng ph, tiu t, kh th, st

Ch khai thc y : V tr, thi gian xut hin,

tin trin, yu t tng gim, triu chng km theo.

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Nhn
Mt ch lm thng thng Thay i da vng ph Cc ch t hn ln vng ph S phn b ca ph

S
Du n lm Nhit da dy ca da

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29

30

Ph khu tr
Do vim: km theo au, nng, Do tc tnh mch: c th km theo tm v ri

lon dinh dng da Do phn ng d ng thng mt v c th km theo ph thanh qun

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33

34

Nguyn nhn Bnh thn

Suy tim

Tnh cht ph - Ph r v thng khi u cc m lng lo (m mt, mt) v sau lan ra ton thn - Nng hn vo bui sng - Thng xut hin u tin hai chn - Nng ln vo bui chiu

Triu chng km theo - Tiu c, nhiu bt gi tiu m nhiu - Tiu t - Tim to - Ting nga phi - Tnh mch cnh ni - Gan to do sung huyt - Kh th - Tun hon bng h - Vng da - Sao mch - Lng bn tay son - Ri lon dinh dng da do thiu cc vi cht km theo - C th c biu hin ca thiu mu thiu st (mng lm, c sc) 35

X gan

- Thng km theo c trng - Ph ch yu hai chn

Suy dinh dng - Ph m lng lo - Ph nh mu bn tay v mu bn chn

HI CHNG THN H

VIM CU THN CP

Ph nhanh, nhiu Trn dch a mng Tiu c, bt nhiu

Ph nh Tiu mu (i th/vi th) Tiu t Tng huyt p C th c ph phi do qu ti tun hon

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Ph nim: Do tch t mucopolysaccharide

Suy gip: Xut hin ni bt mt Cng gip do bnh Basedow: Ph cng

vng trc xng chy km thay i mu sc v cu trc da.

Thai k
Ph hai chn
Thai to cn tr hi lu tnh mch.

40

Ph do thuc
Estrogen, corticoid: Do gi mui nc Nifedipine: Thuc h p qua c ch gin ng

Ph v cn

mch,gy ph ch yu mt c chn.

Lin quan n tng tnh thm thnh mch Thng ph n 30-50 tui C chu k nhng khng lin quan n chu k

kinh nguyt Ph c th nng ln khi tri nng.

41

C ph hay khng? Ph loi g? Nguyn nhn gy ph? (4 nhm nguyn nhn thng gp) Khi xc nh c nguyn nhn, tip tc tip cn theo tng bnh l c th

42

Hi chng thn h nguyn pht, ln u, cha bin chng X gan mt b do ru bin chng vim phc mc nguyn pht Suy tim ton b, III (Hi ni khoa Vit Nam), do bnh tim thiu mu cc b, yu t thc y l vim phi

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Trn Kim Trang. Chn on ph. Triu chng hc ni khoa. 2009. Eugene Brauwald, Joseph Loscalzo. Edema. Harrisons Principles of Internal Medicine. 17th edition. 2008. Richard F. LeBlond. Edema. DeGowins Diagnositic examination. 9th edition. 2009

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